• Claims Adjudication

    Mass Markets (Killeen, TX)
    …expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume… more
    Mass Markets (11/26/25)
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  • Copay Support/ Claims Processing…

    AssistRx (Phoenix, AZ)
    …claim reimbursement, Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication , troubleshoot claim ... The Copay Support/ Claims Processing Specialist is a critical...discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing and… more
    AssistRx (12/09/25)
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  • Senior Claim Data Specialist (Must reside…

    CVS Health (Oklahoma City, OK)
    …business/account implementations. **Fundamental Components:** + Reviews pre-specified claims or claims that exceed specialist adjudication authority or ... a fulltime teleworker opportunity in Oklahoma. The **Senior Claim Data Specialist ** handles end-to-end processes associated with claim data management. This person… more
    CVS Health (12/10/25)
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  • Adjudication Specialist

    Polaris Pharmacy Services, LLC (Covina, CA)
    …most, we invite you to grow with us. JOB SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing and ... Adjudication Specialist Job Details Job Location...and enhance our services. DUTIES/RESPONSIBILITIES: + Manage and Identify Claims Portfolio: + Review and evaluate insurance claims more
    Polaris Pharmacy Services, LLC (12/11/25)
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  • Claims Specialist II

    AON (NY)
    …is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your ... and written communication. Skills that lead to success: + Claims adjudication experience. + Clear and professional... Specialist II Do you have experience in claims adjudication and enjoy resolving issues for… more
    AON (11/04/25)
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  • Lost Time Claims Specialist II

    UPMC (Pittsburgh, PA)
    UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The selected ... Virginia workers comp adjuster license. The UPMC WorkPartners Workers Compensation Lost Time Claims Specialist II reports to the Workers Compensation Claims more
    UPMC (10/28/25)
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  • Casualty Claims Specialist III,…

    AIG (Lenexa, KS)
    …reimagining the way we help customers to manage risk. Join us as a Casualty Claims Specialist III to play your part in that transformation. It's an opportunity ... and efficiency. How you will create an impact The Claims Specialist III will handle auto and...that may involve litigation. The position also ensures ongoing adjudication of claims within the Company standards,… more
    AIG (12/10/25)
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  • Licensed Auto Claims Adjuster - Bodily…

    Sedgwick (Fort Worth, TX)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Licensed Auto Claims Adjuster - Bodily Injury Specialist (New York License Required) ... claims to determine scope of damages; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify… more
    Sedgwick (11/14/25)
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  • Medical Claims Specialist

    University of Washington (Seattle, WA)
    …Medicine Faculty Practice Plane Services has and outstanding opportunity for a ** Claims Specialist (Patient Account Representative 2).** This position is ... responsible for claims review, clearing claim edits, and timely and accurate...rejections, or forwarding the claim to a medical coding specialist for review and coding changes prior to submitting… more
    University of Washington (11/06/25)
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  • Medical Claims Contract/Benefit…

    Trinity Health (Columbus, OH)
    …**Description:** Successful candidates will have a strong understanding of Medical claims particularly within Medicare guidelines. Researching claims that do ... audit, provider relations and more. **Position Purpose** Contracts/Benefits Configuration Specialist position performs a variety of analytical and configuration… more
    Trinity Health (12/08/25)
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  • Medicare/Medicaid Claims Editing…

    Commonwealth Care Alliance (Boston, MA)
    …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... 011250 CCA- Claims Hiring for One Year Term **_This position...the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr.… more
    Commonwealth Care Alliance (11/25/25)
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  • Claims Investigator

    Allied Solutions (Plano, TX)
    …Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the ... Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This… more
    Allied Solutions (10/12/25)
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  • Claims Supervisor Workers Compensation

    Adecco US, Inc. (Ontario, CA)
    …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... Adecco is assisting a local client recruiting for ** Claims Supervisor Workers Compensation** opportunities in **Ontario, CA...AM - 4:30 PM M-F Weekly paycheck Dedicated Onboarding Specialist & Recruiter Access to Adecco's Aspire Academy with… more
    Adecco US, Inc. (12/13/25)
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  • Claims Examiner III

    Dignity Health (Bakersfield, CA)
    …advanced-level role responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims . This position requires expert ... knowledge of claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most challenging cases, mentor junior staff, and… more
    Dignity Health (11/24/25)
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  • Billing Specialist

    Masonicare (Wallingford, CT)
    Billing Specialist Job Location: Wallingford Center, Connecticut Billing Specialist Masonicare Corporate Services - Wallingford, CT Day Shift / 40hrs/wk **THIS ... IS ON-SITE** Under general supervision from Patient Accounts Management, The Billing Specialist performs a variety of complex operations related to the eligibility,… more
    Masonicare (12/09/25)
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  • Personnel Security Specialist (T32)

    Army National Guard Units (East Greenwich, RI)
    …EXCEPTED SERVICE POSITION. This National Guard position is for a PERSONNEL SECURITY SPECIALIST (T32), PD# NGD2481000 and is part of the RI Joint Force Headquarters. ... primary purpose of this position is to serve as a Personnel Security Specialist , responsible for processing personnel security clearances and all tasks related to… more
    Army National Guard Units (12/05/25)
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  • Unemployment Specialist

    Sedgwick (Salem, OR)
    …difficult unemployment claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices or ... as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Unemployment Specialist **PRIMARY PURPOSE** : To analyze complex or technically… more
    Sedgwick (12/11/25)
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  • Claim Specialist III

    AIG (Atlanta, GA)
    …service with empathy and efficiency. How you will create an impact The Specialist will handle and analyze general liability claims under general supervision ... claims involving litigation. The position also ensures ongoing adjudication of claims within the Company standards, industry best practices and specific… more
    AIG (12/06/25)
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  • Insurance Billing Specialist

    TEKsystems (West Des Moines, IA)
    …identified claims issues, repetitive errors, and payer trends to expedite claims adjudication Work accounts in assigned queues in accordance with ... would be huge for this role! Will be bulk claims and denial work - no patient calling. -...Medicaid experience preferred. The Insurance Billing and Follow Up Specialist II will be responsible for performing all billing… more
    TEKsystems (12/03/25)
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  • Pharmacy Clinical Review Specialist , Rx…

    UPMC (Bridgeville, PA)
    …via telephone, e-mail and face to face required. + Knowledge of electronic claims adjudication and resolution required + Experience with prioritizing and ... is looking for a full time Pharmacy Clinical Review Specialist to join their dedicated team! This position provides...dedicated team! This position provides prescription data entry and adjudication of claims under the supervision of… more
    UPMC (12/08/25)
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