- Trinity Health (Columbus, OH)
- **Employment Type:** Full time **Shift:** **Description:** Remote position - Seeking Claims processing with Medical Insurance Minimum of 5 years experience in ... claims auditing, billing and/or coding. **Why MediGold?** MediGold (https://medigold.com/)...and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes… more
- Trinity Health (Schenectady, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Claims Processing Tech II - Eddy Senior Care - FT Days** **Narrative:** Eddy Senior Care ... with providers to resolve billing problems. Previous experience and knowledge of medical claims processing very helpful. Accuracy and speed due to high volume… more
- IQVIA (Columbus, NC)
- **Program Support Medical Claims Processing Team Lead - (Remote)** **At IQVIA, we look for the very best people, and then give them meaningful work to do. We ... evolution of your transparency and performance management. **Role Purpose:** + A Medical Claims Processing Team Lead is expected to be an expert in reading… more
- Sedgwick (Syracuse, NY)
- …team meetings and assigns accountability for follow-up items. + Gathers important compliance/ claims processing information to be presented at team meetings. + ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Team Lead Assistant | Dedicated Client | NY Workers Comp… more
- The Cigna Group (Bloomfield, CT)
- …Lives?** EviCore, a line of business within The Cigna Group, is hiring a Claims System Configuration Lead Analyst. This **highly technical systems** role acts as ... degree preferred + 3+ years of experience as a subject matter expert for claims system configuration, processing , reporting, issue triage and testing - REQUIRED… more
- Lincoln Financial Group (Columbus, OH)
- …performance metrics * Meeting all established quality assurance benchmarks. * Ensuring claims processing is consistent with applicable policies, procedures, and ... Role at a Glance** We are excited to bring on a highly motivated Lead Supplemental Health Claims Associate to our Lincoln team! As a Lead Supplemental Health… more
- Eaton Corporation (Beachwood, OH)
- …for third-party vendors. * Collaborate with cross-functional teams to ensure seamless claims processing and reporting. * Provide detailed reports and updates ... Eaton's Corporate Sector division is currently seeking a Lead Analyst - Insurance Claims . This position will be located at our Beachwood, OH facility. We are… more
- M&T Bank (Getzville, NY)
- **Overview:** This is a Team Lead position (no direct reports) and is a fantastic career stepping stone for those interested in becoming a people leader/manager. + ... Consumer Default Servicing, specifically Vehicle Repossession paperwork, Titles, and Insurance Claims . + Performs highly specialized duties within the work team,… more
- State of Minnesota (St. Paul, MN)
- …plays a critical role in the Paid Leave Division of overseeing the claims processing team, ensuring efficiency, accuracy, and compliance with program ... responsibilities include: + Oversees the quality and timeliness of claims processing . + Assign and monitor staff...the adjudication process. + Ability to coach, mentor, and lead a team. + Ability to communicate effectively with… more
- Healthfirst (NC)
- …(CPT4, ICD9 or ICD10, and HCPCS), provider contract concepts and common claims processing /resolution practices. + Experience working with and leading ... **Duties & Responsibilities** : + Lead and deliver projects related to the development...management system). + Experience with Power MHS or other claims processing systems necessary. + Comprehensive knowledge… more
- Sutherland Global Services (Columbus, OH)
- …and beyond. What you will be doing as a Claims Examiner: + Work independently, processing claims via data entry for 90% of your day. + Be responsible for ... is a data entry position where you will be processing medical claims per the specific client... claims needing additional information + Refer problem claims to a Lead and/or auditor for… more
- ManpowerGroup (Columbia, SC)
- …Diploma or equivalent + 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience ... of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality...desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and promptly reports… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Master's Degree Experience Required: A minimum of 5 years of experience performing claims audits or claims processing related to Medi-Cal, Cal ... Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of issues in...capitated hospitals and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates.… more
- Elevance Health (East Syracuse, NY)
- …**Preferred Skills, Capabilities and Experiences:** + Experience with healthcare insurance claims processing highly preferred. + Strong data entry skills ... Medicaid Services to transform federal health programs. The **SCA Claims Processor I** is responsible for processing ...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Elevance Health (Columbus, OH)
- ** Claims Representative I (Health and Dental)** **Location:** Remote, within 50 miles of an Elevance Health pulse point. **Hours:** An 8-hour shift, Monday - Friday, ... between the hours of 7 am - 6 pm EST. The ** Claims Representative I** is responsible for successfully completing the required basic training. Able to perform basic… more
- Molina Healthcare (Columbus, OH)
- …knowledge of Excel + SQL knowledge preferred + Advanced knowledge of healthcare claims and claim processing from receipt through encounter submission. + Ability ... and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases...the overall goals for the department and Molina. + Lead department to make it a high performing unit.… more
- Elevance Health (Atlanta, GA)
- **Title: Claims Representative I (Health & Dental) - FEP** **Location:** This position will work a **hybrid model (remote and office)** . The ideal candidate will ... during the first 12 weeks of training. Start date: 3/10/2025.** The ** Claims Representative I** will be responsible for successfully completing the required basic… more
- Amentum (Washington, DC)
- …This involves monitoring various claim statuses or queues and identifying claims assignable within the Special Master's guidance. + Determine individual team ... data to provide daily determination entry numbers to the Lead Project Manager. + Work with Claim Review Team...on weekly Eligibility-Only claim review assignments to SMO's for claims produced for approval. + Update SharePoint site as… more
- Cardinal Health (Twinsburg, OH)
- …between dispensing pharmacies + Review patient insurance coverage status and adjudicate claims for patient orders + Data Entry of prescriptions in pharmacy system ... of supervision + Work typically involves regular review of output by work lead or supervisor + Refers complex unusual problems to supervisor _Candidates who are… more
- Woodforest National Bank (The Woodlands, TX)
- …The Team Lead Debit Card Dispute is responsible for investigating and processing debit card dispute claims initiated by customers regarding the authorization ... complex cases. Additional responsibilities will include approval of delegated dispute claims , re-dispute processing , review of high-risk transactions and assist… more