- WALGREENS (Empire, MI)
- …pharmacy errors and the Continuous Quality Improvement Program. * Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit. * Assists and supports Store Manager and Pharmacy Manager in analyzing and seeking to improve pharmacy financials, operational… more
- Merck & Co. (Rahway, NJ)
- …with electronic healthcare databases (electronic medical records and insurance claims ); efficiently manipulates large databases including complex data preprocessing, ... in SAS and\or R Real World Evidence programming including data processing , statistical procedures and graphing and tabulation techniques; systems and database… more
- MyFlorida (Tallahassee, FL)
- CLAIMS PROCESSING SUPERVISOR - 36000333 Date: Dec 3, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 866202 Agency: Department of Lottery Working Title: CLAIMS PROCESSING SUPERVISOR - 36000333 Pay Plan: Lottery Exempt Serv Position Number:… more
- Providence (Mission Hills, CA)
- …of functional area ie, claims operations, + HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc. ... Full time **Job Shift:** Day **Career Track:** Business Professional **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills… more
- Humana (Seymour, IN)
- …a part of our caring community and help us put health first** The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims ... either via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex administrative/operational/customer… more
- AssistRx (Phoenix, AZ)
- The Copay Support/ Claims Processing Specialist is a critical role within the organization and is responsible for servicing inbound calls, EOB faxes, and mail ... reimbursement, Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication, troubleshoot claim rejections, claim… more
- IQVIA (New Providence, NJ)
- **Patient Support Medical Claims Processing Representative** _Remote Role - Location (Open to Remote US)_ As the only global provider of commercial solutions, ... are looking for a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team. In this position, you… more
- NTT America, Inc. (Plano, TX)
- …an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims Processing Associate - Remote to join our team in Plano, ... NTT are getting into contract with Client to manage End to End Claims Administration services. Our NTT Business Process Outsourcing (BPO) team has implemented the… more
- NTT DATA North America (Plano, TX)
- …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims processing to join our team in Plano, Texas (US-TX), United ... these roles you will be responsible for: Review and process insurance claims . Validate Member, Provider and other Claim's information. Determine accurate payment… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Claims Processing + **Schedule:** Full Time, Days + **Facility:** Ascension Medical Group + **Location:** Jacksonville, FL ... party payers in an out-patient or medical office environment. + Prepare insurance claims for submission to third party payers and/or responsible parties. + Review … more
- MVP Health Care (Schenectady, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess… more
- Molina Healthcare (Buffalo, NY)
- …or legal requests. * Assists with reducing rework by identifying and remediating claims processing issues. * Locates and interprets claims -related regulatory ... claims using standard principles and applicable state-specific regulations to identify claims processing errors. * Applies claims processing … more
- Kelly Services (Honolulu, HI)
- …of the Claims Supervisor, you'll perform essential functions related to dental claims processing . This role requires adherence to claims processing ... + **Experience:** 1-2 years of related clerical, data entry, accounting, or claims processing experience, or an equivalent combination of education, experience,… more
- Cedars-Sinai (CA)
- …in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products and provider ... claims required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred. **About Us** Cedars-Sinai is… more
- Elevance Health (Boston, MA)
- …I :** Requires a HS diploma or GED and a minimum of 3 years of claims processing experience; or any combination of education and experience which would provide ... ** Claims Auditor I, II and Senior** **Location :**...or GED and a minimum of 5 years of claims processing experience including a minimum of...a minimum of 5 years of claims processing experience including a minimum of 1 year related… more
- PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
- …a must + Health care or pharmaceutical experience, particularly in a medical claims processing , billing provider, or insurance environment + Knowledge of EOB ... Prior experience in a high-volume processing setting (ie, doctor's office, claims processing department, etc.) a plus. + Will be trained to support programs,… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Claims Analyst is responsible for claims processing , research and adjudication to correctly apply benefit determination and pricing for ... Rx-drug claims (CMS 1500 and UB04), in accordance with claims processing guidelines. **ESSENTIAL FUNCTIONS OF THE ROLE** Processes and adjusts professional… more
- Ford Motor Company (Livonia, MI)
- …PSMAC, both virtually and in person. **What you'll do ** + Manage and own the Claims Processing and support teams + The Claims Team are Schneider Logistics ... personnel US based + Serve as the Subject Matter Expert (SME) for claims administration and processing + Administer dealer claims for US Dealers + Lead… more
- Molina Healthcare (Albany, NY)
- …of incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and claims processing errors. **Essential Job Duties** + Audits the ... leadership for improvements based on audit results. + Reviews timeliness of claims processing to ensure compliance with contractual and state/federal… more
- Molina Healthcare (Kearney, NE)
- …Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate ... application. * Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claim recovery (refund… more
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