- AIG (San Francisco, CA)
- Claims Complex Director - Healthcare Professional...an exciting time to join us - across our operations , we are thinking in new and innovative ways ... create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims Department of General… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and...on financial ability and forecasting for small to large Operations Management + Collaborate system and data configuration into… more
- Molina Healthcare (Columbus, OH)
- …to increase the quality and efficiency of claims processing . Fields claims questions from Molina Operations teams . Interprets, communicates, and presents, ... impacted claims . Provides excellent customer services to our internal operations teams concerning claims projects . Appropriately convey information and… more
- Molina Healthcare (MI)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Healthsource blog: https://healthsource.premera.com/ . We are seeking an experienced and dynamic ** Claims Operations Director** to join our team and oversee our ... claims management organization. This position offers an exceptional opportunity...strategic direction, business planning, and overall leadership for Premera's healthcare payer operations across various customer segments… more
- Molina Healthcare (Columbus, OH)
- …Advanced knowledge of Excel + SQL knowledge preferred + Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission. + ... and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases...with a focus on goals and improvement to daily operations . + Build and maintain strong trusted relationships with… more
- Sharp HealthCare (San Diego, CA)
- …Must have strong leadership skills and experience. Knowledge of clinical and business operations in a healthcare environment. Knowledge of hospital and clinic ... for you if you had the following certification: Resolute Professional Billing Claims and Remittance Administration. An ideal candidate would have 3+ years'… more
- Molina Healthcare (Long Beach, CA)
- …advanced Excel or SQL. + Must be able to conduct root cause analysis in Healthcare Porvider claims data.. + Experienced in Healthcare domain specifically ... + Analyze, review, and load documents to support department operations . + Maintains reconciliation and production reports for department. +… more
- Banner Health (Phoenix, AZ)
- …with healthcare risk management, quality management, in house liability claims management (including litigation and claims reserves) and litigation** ... claims management processes and procedures and other related healthcare regulatory and/or litigation experience preferred. Additional related education and/or… more
- AIG (Chicago, IL)
- …an impact + This position will ensure high quality claim handling in the Healthcare Professional Liability ("HPL") Claims Department of General Insurance (AIG, ... Senior Claims Analyst, Severity Join us as a Senior...The analyst will investigate losses, orchestrate defense strategies for healthcare provider insureds, conduct independent assessments as to exposures… more
- LA Care Health Plan (Los Angeles, CA)
- …to achieve that purpose. Job Summary The Claims Supervisor works with the Claims Manager to oversee the daily operations of the claims department. ... Supervisor, Claims Job Category: Claims Department: ...Duties Continued Education Required Bachelor's Degree in Business or Healthcare Related Field In lieu of degree, equivalent education… more
- Guidehouse (Lewisville, TX)
- …in lieu of Diploma / GED. + 1-3+ year's experience in within business, operations , customer service or healthcare fields. **What Would Be Nice to Have** ... **:** + Proficient with Microsoft Products such as: Excel, Word. + Thrive in a fast-paced environment. + Enjoy problem solving with a keen attention to detail. + Experience with working claim rejections via the Waystar clearinghouse. NextGen and GPMS… more
- Guidehouse (San Antonio, TX)
- …in Lieu of Diploma / GED. + 0-2+ year's experience in office, business, operations , customer service or healthcare field. **What Would Be Nice To Have** ... **:** + Knowledge and utilization of desktop applications to include Word and Excel is essential for job responsibilities. + Ability to initiate and follow through on projects and work independently with minimal supervision. + For insurance specific clients:… more
- Sutherland Global Services (Columbus, OH)
- …_Unlocking digital performance. Delivering measurable results._ This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator ... products and platforms, we drive digital transformation, optimize critical business operations , reinvent experiences, and pioneer new solutions, all provided through… more
- Humana (Green Bay, WI)
- …health first** The Claims Research & Resolution Representative 3 manages claims operations that involve customer contact, investigation, and settlement of ... claims for and against the organization. Approves all claim...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- State of Colorado (CO)
- … Claims System processes, both internally to the agency and the Disabled Buy-In Claims System operations staff, as well as to external entities. + Review ... Disabled Buy-In Claims Test Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4792294) Apply Disabled Buy-In Claims Test Analyst… more
- AIG (Atlanta, GA)
- …range of products to customers through a diversified, multichannel distribution network. Claims Our claims professionals support AIG policyholders through some ... or recoup the value of a lost family heirloom or a prized possession. Our Claims team is an industry leader, drawing daily on its unparallelled levels of expertise… more
- Kelly Services (Houston, TX)
- …claim vendor. - Develop and implement backup extracts and protocols to support ongoing claims operations . - Create a data dictionary for the new SQL database ... for historical data loading. - Implement reporting necessary for IPA claims operations and delegated reporting responsibilities. - Collaborate with… more
- LA Care Health Plan (Los Angeles, CA)
- …Equivalency Certificate Education Preferred Experience Required: At least 6 months of healthcare claims processing experience in a managed care environment. ... analyzing and reporting of specific enhancements. (5%) Attend meetings as required. Claims Department/ Operations Division is represented at internal and external… more
- UCLA Health (Los Angeles, CA)
- …preferred or equivalent work experience, preferred + 5 years previous experience in claims operations specifically related to Medicare Advantage or managed care ... Description We are seeking a detailed-oriented and experienced Claims Manager to join our Claims ...in a complex and diversified healthcare or health insurance company + 3 years experience… more
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