- Magellan Health Services (Maryland Heights, MO)
- …accounts and priorities. Strong verbal and written communication skills. Minimum 1 year health claims audit experience. General Job Information Title ... This position supports management in the design, implementation, and maintenance of claims auditing programs. Responsible for auditing claims for accuracy.… more
- WelbeHealth (Los Angeles, CA)
- … Plan Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate ... experience specifically with auditing Medicare and Medicaid professional, institutional, and dental health insurance claims . Experience working with CMS and… more
- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...at LogixHealth: We offer a comprehensive benefits package including health , dental and vision, 401(k), PTO, paid holidays, life… more
- Axis (Red Bank, NJ)
- …AXIS is seeking a Senior Claims Specialist to join our North America Accident & Health Claims team reporting to the Head of Accident and Health Claims ... expertise for all product lines of the Accident and Health division, both claims adjudicated in-house and... reports and findings. May be part of a Claims Audit Team or travel to assess… more
- Conduent (Detroit, MI)
- …culture where individuality is noticed and valued every day. **Remote Supplier Claims Auditor** Location: Remote (US). Pay Rate: $45.5/hour. Work Schedule: Part time ... North America Supplier Claim Activity ("SCA") group is responsible for receipt, audit , processing, accrual and forecasting of supplier obsolescence and cancellation … more
- Centene Corporation (Sacramento, CA)
- …one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national ... **Position Purpose:** The Delegation Oversight Compliance Auditor - Medical Claims is responsible for scheduling, coordinating, and conducting delegated entity… more
- Axis (Red Bank, NJ)
- …upon request for candidates taking part in the selection process. AXIS is seeking a ** Claims Specialist** to join our North America Claims team reporting to the ... Manager of Casualty Claims . This position requires senior claims management and handling expertise for both the oversight and management of TPA handled claims… more
- UCLA Health (Los Angeles, CA)
- …Take your career to the next level. You can do all this and more at UCLA Health . The Claims Quality Auditor will be responsible for the daily audit of ... + Knowledge of claims adjudication systems + Flexibility and adaptability UCLA Health is a world-renowned health system with four award-winning hospitals and… more
- Axis (Princeton, NJ)
- …+ Maintain guidelines, practices and procedures and benefit clarifications for Accident & Health Claims . + Ensure timely notification to key stakeholders of ... service and accurate reinsurance reporting. Develop and execute on post- audit Management Action Plans (MAP) as needed. + Lead... health , disability, stop loss or life and health claims leadership role. + Effective negotiation… more
- CVS Health (Cumberland, RI)
- …team environment* Experience negotiating with vendors and landlords to settle audit claims * Experience preforming Contract Compliance Audits EducationBachelor's ... Bring your heart to CVS Health . Every one of us at CVS ...Cumberland, RI office three days per week.** The Internal Audit Recovery Analyst will be a key member of… more
- Providence (Anaheim, CA)
- **Description** Manage the claims internal audit functions, which includes audit process for adjudicated claims and encounters. Monitor check run process ... for accuracy. Develop policies and procedures for periodic claims audits and ensure compliance with affiliated health plans, client groups, and administrative… more
- Sedgwick (San Diego, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than… more
- Sedgwick (Philadelphia, PA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than… more
- 2-10 Home Buyers Warranty (Denver, CO)
- Associate Manager, New Home Claims Targeted compensation: $75,000 - $90,000 base + bonusCompensation commensurate with experience and skill set Who we are: Founded ... centric Associate Manager to join our team. As an Associate Manager, New Home Claims you will apply your knowledge and experience adjudicating claims as well… more
- Sedgwick (Columbus, OH)
- …management reports and takes appropriate action. * Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than… more
- AIG (Alpharetta, GA)
- …point for colleagues. + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes, ensuring ... Senior Claims Analyst Join us as a Senior ...spent at work to offer benefits focused on your health , wellbeing and financial security-as well as your professional… more
- MyFlorida (Tallahassee, FL)
- …on pending claims , initiating management and security review as deemed necessary. + Audit paid claims to ensure prizes were paid in compliance with the ... CLAIMS PROCESSING SPECIALIST - 36000116 Date: Jun 19,...listed below: + Approximately 97.5% of the premium for health insurance + Individual (~$8/month) or Family (~$30/month) +… more
- Axis (Chicago, IL)
- …request for candidates taking part in the selection process. **TPA & Programs Claims Shared Services Lead** AXIS is seeking a **_TPA & Programs Claims_** **_Shared ... our TPA, Litigation and Vendor Management Services North America Claims team. As a direct report to the Head...TPA's + Driving key performance metrics and meet target audit results from all TPAs, in collaboration with key… more
- Marshfield Clinic (Marshfield, WI)
- …the overall aspects of claim processing, both in and outside of Security Health Plan (SHP). Audit responsibilities include applying effective, appropriate and ... support the most exciting missions in the world!** **Job Title:** SHP Claims Auditor (remote) **Cost Center:** 682891379 SHP- Claims **Scheduled Weekly Hours:**… more
- Robert Half Accountemps (Sterling Heights, MI)
- …We are offering a contract to hire employment opportunity for a Medical Insurance Claims Specialist in STERLING HEIGHTS, Michigan. This role is situated in the ... Health Insurance industry and involves intricate tasks such as...tasks such as reconciliation of integrated accumulator exchanges and claims processing. The successful candidate will be working in… more