- CVS Health (St. Paul, MN)
- …- Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, ... and affordable. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as… more
- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking a Regional Claims Specialist . This is a full-time position and offers a hybrid schedule after training. ... The Regional Claims Specialist will be responsible for contacting...WC Law, medical terminology, and utilization of an automatic claims processing system. + Level II -… more
- NJM Insurance (Hammonton, NJ)
- …including basic knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system. + Level II - 3-5 years' experience as a ... Claims Team is seeking a Claim Account Specialist . This is a full-time position and offers a...WC Law, medical terminology, and utilization of an automatic claims processing system. + Sr Level -… more
- BrightSpring Health Services (Taunton, MA)
- Our Company PharMerica Overview Step Into a Rewarding Role as a Claims Specialist with PharMerica! Are you ready to make a real impact in a growing organization? ... Join our PharMerica team as a Claims Specialist , where you'll play a key...office environment for those who are willing to learn claims , billing and insurance processing . Pharmacy Technician… more
- BrightSpring Health Services (Uniondale, NY)
- Our Company PharMerica Overview Make the Move to PharMerica- Claims Specialist Opportunity! Ready to take your pharmacy experience to the next level? PharMerica ... that's a big plus! + Learn essential skills in claims processing while being part of a...for a minimum of 7 business days. Responsibilities TheClaims Specialist - 3rd Party: + Manages and identifies a… more
- Acosta Group (Dallas, TX)
- …provide high quality service to clients and make continuous improvements in claims processing . **RESPONSIBILITIES** **Duties and Responsibilities** + Processes ... **DESCRIPTION** The Claims Resolution Specialist is responsible for...procedures for assigned clients and adheres to them when processing claims + Uses advanced problem solving… more
- AIG (Atlanta, GA)
- …guidelines and authority, indemnity and legal payments through the appropriate Claims Processing Systems. + Forecasts potential recoveries and updates ... way we help customers to manage risk. Join us as a Recovery Specialist , Large Loss - Claims to play your part in that transformation. It's an opportunity to grow… more
- AIG (Atlanta, GA)
- …guidelines and authority, indemnity and legal payments through the appropriate Claims Processing Systems. + Forecasts potential recoveries and updates ... the way we help customers to manage risk. Join us as a Claims Recovery Specialist to play your part in that transformation. It's an opportunity to grow… more
- PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
- Overview The Claims Specialist , under the direction of the Supervisor (with guidance from a Team Lead), is responsible for processing medical claims ... a must + Health care or pharmaceutical experience, particularly in a medical claims processing , billing provider, or insurance environment + Knowledge of EOB… more
- CenterLight Health System (Flushing, NY)
- JOB PURPOSE: The Claims Specialist will support department operations related to provider communication, pended claim review, reporting, auditing, and oversight ... State, Federal, and contractual guidelines. JOB RESPONSIBILITIES: + The Claims Specialist will be responsible for reviewing...Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor + Attends JOC meetings… more
- City of New York (New York, NY)
- …employees serving in a permanent (not provisional) Civil Service title of Claim Specialist . To be considered for this position, PLEASE CLEARLY INDICATE YOUR CURRENT ... Adjustment (BLA), negotiates and approves all monetary settlement of claims and lawsuits involving the City of New York....Set up No-fault claim files which includes issuing and processing NF2 application, confirming the City's involvement on the… more
- Providence (OR)
- **Description** Providence Health Plan is calling an Associate Claims Specialist , Medicaid who will process claims for members, providers, and employers. ... empower them._** **Providence Health Plan is calling an Associate Claims Specialist , Medicaid who will:** + Process...member issues or concerns + Correctly analyze and adjudicate claims to reflect financial, check, and processing … more
- Sedgwick (Columbus, OH)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Claims Specialist , Professional Liability (Cyber) **PRIMARY PURPOSE** **:** To ... while providing high levels of customer service. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** Claims Management and Processing : + Handle a diverse portfolio of… more
- Sedgwick (Columbus, OH)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Specialist , Professional Liability **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** ... + Analyzes and processes complex or technically difficult liability claims by investigating and gathering information to determine the exposure on the claim; manages… more
- Sedgwick (Columbus, OH)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Environmental Claims Specialist **Job Description Summary** To analyze complex or ... technically difficult environmental claims ; to provide resolution of highly complex nature and/or...trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. +… more
- Whitney Young Health Center (Watervliet, NY)
- …date . Four (4) years of progressive experience in medical billing and claims processing in a multi-specialty healthcare setting. Professional coding experience ... Claims Coding Specialist (Req 100825) Watervliet, NY (http://maps.google.com/maps?q=1601+Broadway+Watervliet+NY+USA+12189) Apply Description GENERAL… more
- Crawford & Company (Fort Lauderdale, FL)
- …edjuster's claims handling professional-service methodology and its Web-based content claims processing and pricing platform/system - exclaim. + Operating ... with the Company's productivity and performance standards. + Work with Central Claims Processing to organize/direct the resources ( claims assistants,… more
- Extra Space Storage (Salt Lake City, UT)
- We are seeking a highly detail-oriented Workers Compensation Claims Specialist with 1-2 years of experience in risk management or insurance claims handling. ... processing of workers' compensation, general liability, and auto claims disputes and closures. + Collaborate with third-party administrators, insurance brokers,… more
- Crawford & Company (New Orleans, LA)
- …members of the medical profession and other persons pertinent to the investigation and processing of claims . + Verifies policy coverage for submitted claims ... In Everything We Touch Position Summary Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims . Documents… more
- Robert Half Accountemps (Allentown, PA)
- Description We are offering a contract to hire employment opportunity for a Claims Specialist in Allentown, Pennsylvania, United States. This role is primarily ... involved in the handling and processing of customer property damage claims that may arise from the operations or provision of electric service. The chosen… more