• Claims Representative II ( Health

    Elevance Health (Houston, TX)
    …II ( Health & Dental)** is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. **How ... ** Claims Representative II ( Health & Dental)**...** Claims Representative II ( Health & Dental)** **Must be located within 50...you will make an impact:** + Participate in claims workflow projects. + Responds to telephone and written… more
    Elevance Health (11/07/24)
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  • VP of Health Plan Operations…

    Prime Healthcare (Ontario, CA)
    …seeking new members to join our corporate team! Responsibilities TheVice President of Health Plan Operations and Claims is responsible for the development and ... to improve the quality and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health... Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of … more
    Prime Healthcare (10/03/24)
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  • Claims Examiner II, Accident…

    AIG (Lenexa, KS)
    …skills and experience as a valued member of the team. Make your mark in Accident and Health Claims Our Claims teams are the proven problem solvers of choice ... providing world class service to external and internal customers. + Handle Accident & Health claims as part of the A&H team, handling claims such as A&D,… more
    AIG (10/30/24)
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  • Claims Examiner IV, Accident…

    AIG (Lenexa, KS)
    …skills and experience as a valued member of the team. Make your mark in Accident and Health Claims Our Claims teams are the proven problem solvers of choice ... claims experience of at least 5+ year(s) with exposure to Accident and Health claims , which include sickness and bodily type injury claims or any related… more
    AIG (10/30/24)
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  • Business Process Owner Senior - Medicare…

    USAA (Tampa, FL)
    …related to Centers for Medicare & Medicare Services (CMS) + Extensive experience working health claims and/or health insurance products with an insurance ... **Business Process Owner Senior** that will support Medicare Supplement Claims for USAA Life Company Claims Operations....Medicare Supplement Claims for USAA Life Company Claims Operations. This employee will report to the Life… more
    USAA (10/23/24)
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  • Claims Rep I ( Health & Dental) (US)

    Elevance Health (Columbus, GA)
    **Title: Claims Representative I ( Health & Dental)** **Location:** This position will work a **hybrid model (remote and office)** . The ideal candidate will live ... within 50 miles of our Elevance Health PulsePoint location at **6087 Technology Pkwy, Columbus** **,...first 6 weeks of training. Start date: 1/6/2025.** The ** Claims Representative I** will be responsible for successfully completing… more
    Elevance Health (11/06/24)
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  • Claims Representative I ( Health

    Elevance Health (Houston, TX)
    ** Claims Representative I ( Health & Dental)** **Location:** Must live within 50 miles of the Mason, OH, Norfolk, VA, Richmond, VA, Grand Prairie, TX, Houston, ... IN, Atlanta, GA, Miami, FL, or Tampa, FL PulsePoints. The ** Claims Representative I ( Health & Dental)** is responsible for successfully completing the required… more
    Elevance Health (11/25/24)
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  • Senior Product Manager - Claims

    Highmark Health (Pittsburgh, PA)
    …milestone reviews with the Delivery team. **A d** **eep understanding of the health ** **insurance** ** claims process** **will be essential** **.** This includes ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Senior...**Job Description :** **JOB SUMMARY** The Senior Product Manager, Claims will define the product strategy, vision, and value… more
    Highmark Health (10/10/24)
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  • PAR - Claims Representative II

    Medical Mutual of Ohio (Toledo, OH)
    …+ High School diploma or GED + 2 years of experience as a Claims Representative in health insurance operation or equivalent experience with professional, ... of data entry and standard office procedures + Knowledge of health insurance claims processing and provider coding + Alpha-numeric keyboarding skills at a… more
    Medical Mutual of Ohio (11/28/24)
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  • Legal Administrative Specialist (Insurance…

    Office of Personnel Management (Washington, DC)
    …and/or their authorized representatives, including responses on appeals of disputed health benefit claims , benefits regulations, and other program related ... with internal clinical advisors (eg nurse) to resolve disputed health benefits claims and develop responses to inquiries and correspondence. Conduct thorough… more
    Office of Personnel Management (11/27/24)
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  • Legal Administrative Specialist (Insurance…

    Office of Personnel Management (Washington, DC)
    …and/or their authorized representatives, including responses on appeals of disputed health benefit claims , benefits regulations, and other program related ... with internal clinical advisors (eg nurse) to resolve disputed health benefits claims and develop responses to inquiries and correspondence. Conduct thorough… more
    Office of Personnel Management (11/27/24)
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  • Claims Examiner - Claims

    Prime Healthcare (Victorville, CA)
    …- Qualifications Education and Work Experience + 2-3 years relevant experience in health care claims and customer service. + Knowledge of Medical Terminology, ... Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities Claims Examiner processes routine and non-routine … more
    Prime Healthcare (11/22/24)
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  • Director, HMO Claims Services

    Scripps Health (San Diego, CA)
    …been with Scripps Health for over 10 years. The Director of HMO Payment ( Claims ) Services for Scripps Health Plan, leads claims payment team and ensures ... of which in leadership. * Expertise is California DMHC claims regulations, NCQA regulations and health Plan...California DMHC claims regulations, NCQA regulations and health Plan experience. * Strong technical aptitude for computer… more
    Scripps Health (11/14/24)
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  • Medical Coder - Claims Resolution…

    Prairie Ridge Health (Columbus, WI)
    Prairie Ridge Health is seeking a Claims Resolution Specialist to join the Business Services team. This position is a 1.0 FTE (40 hours per week) and works a ... Monday-Friday, day shift. The Claims Resolution Specialist is responsible for researching and resolving...+ Experience with paper and electronic billing for various health insurances, including knowledge of hospital and professional claim… more
    Prairie Ridge Health (10/13/24)
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  • Claims Research and Resolution…

    Humana (Tampa, FL)
    **Become a part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that ... that require independent initiative and judgment. Tampa Office The Claims Research & Resolution Representative 2 + Works with...insurance and many other opportunities. **About Us** About CarePlus Health Plans: CarePlus Health Plans is a… more
    Humana (11/26/24)
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  • Claims Analyst

    Armed Forces Benefit Association (Lincoln, NE)
    …group claims experience reporting for renewal processing. + Adjudicate voluntary health and wellness claims per contract and benefit guidelines + Serve ... client experience and comprehensive portfolio of life and supplemental health products striving to deliver total health ...and wellbeing to employer groups and their employees. The Claims Analyst is an operations and sales support role… more
    Armed Forces Benefit Association (11/25/24)
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  • Medical Claims Examiner

    CHS (Clearwater, FL)
    **Overview** ** Health Insurance Medical Claims Examiner** **(Initial Training on Site - 30 days - Remote after training)** **Must live within a reasonable ... **Summary:** The Medical Claims Examiner adjudicates medical claims based on health policy provisions and... Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and… more
    CHS (10/24/24)
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  • Executive Director, Claims & Litigation…

    Banner Health (Phoenix, AZ)
    …& Litigation Counsel** will provide strategic and operational leadership to Banner Health 's teams responsible for claims and litigation management, clinical risk ... providing legal advice and direction for risk management incidents and grievances, claims and litigation. Banner Health believes leadership matters. We **value… more
    Banner Health (09/26/24)
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  • Director, Claims Operations

    Apex Health Solutions (Houston, TX)
    …internet access and a quiet and private workspace. Minimum 7 years of claims and health care administration and/or managed care management experience Strong ... S ummary: Position is responsible for overall strategy and effectiveness of Claims Operations. Position is responsible for oversight of claims adjudication and… more
    Apex Health Solutions (11/17/24)
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  • Claims Auditor II - Remote

    Martin's Point Health Care (Portland, ME)
    …Summary Job Description Position Summary: Under the supervision of the Director of Health Plan Operations, the Claims Auditor II will perform the following ... Join Martin's Point Health Care - an innovative, not-for-profit health...verbally or through written communications, regarding questions related to claims , claims audits or other matters directed… more
    Martin's Point Health Care (10/23/24)
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