• Caris Life Sciences (Irving, TX)
    …Associate is responsible for reviewing outstanding denied claims with Medicare , Medicaid and Commercial insurance companies. This role involves following ... insurance denials and take appropriate action. + Check claims status via phone or poral. + Submit Medical...information. + Respond promptly and professionally to inquiries from insurance companies, patient, and client's representative with… more
    DirectEmployers Association (10/31/25)
    - Save Job - Related Jobs - Block Source
  • Patient Account Representative

    Guidehouse (El Segundo, CA)
    …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative ** **(Hospital Claims )** is an ... **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & CMS 1500… more
    Guidehouse (12/12/25)
    - Save Job - Related Jobs - Block Source
  • Claims Review Representative

    Humana (San Juan, PR)
    …a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong knowledge of ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer support… more
    Humana (12/13/25)
    - Save Job - Related Jobs - Block Source
  • Workers Compensation | Claims

    Sedgwick (Concord, CA)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation | Claims Representative (Future Medical)| In-Office ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
    Sedgwick (12/25/25)
    - Save Job - Related Jobs - Block Source
  • Claims Representative - Liability

    Sedgwick (Milwaukee, WI)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Liability **PRIMARY PURPOSE** : To process ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
    Sedgwick (12/11/25)
    - Save Job - Related Jobs - Block Source
  • Medicare Advantage Quality Consultant

    Highmark Health (Buffalo, NY)
    …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
    Highmark Health (11/06/25)
    - Save Job - Related Jobs - Block Source
  • Workers Compensation Claims Specialist, Sr

    NJM Insurance (NJ)
    NJM's WC Claims Department is seeking an experienced Claims Specialist, Sr. who lives in Western or Central PA to provide on-site service to our policyholders ... This is a 100% remote position which includes virtual claims handling for customers in any area of PA...+ 5+ years' experience as a Workers' Comp Claim Representative , or comparable knowledge and experience with various aspects… more
    NJM Insurance (12/03/25)
    - Save Job - Related Jobs - Block Source
  • Field Site Inspector - Medicaid / Medicare

    Allied Universal (Mission Viejo, CA)
    Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim… more
    Allied Universal (12/20/25)
    - Save Job - Related Jobs - Block Source
  • Claims Auditor

    Centers Plan for Healthy Living (Staten Island, NY)
    …of Experience Required: 2+ years of claim processing experience with a Medicaid/ Medicare Health Plan. Preferred: Experience in health insurance product ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
    Centers Plan for Healthy Living (10/14/25)
    - Save Job - Related Jobs - Block Source
  • Senior Workers' Compensation Claim…

    Travelers Insurance Company (Irvine, CA)
    …Bar or Irvine, CA locations. Under general supervision, manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
    Travelers Insurance Company (10/25/25)
    - Save Job - Related Jobs - Block Source
  • Senior Workers Compensation Claim…

    Travelers Insurance Company (Charlotte, NC)
    …**Target Openings** 2 **What Is the Opportunity?** Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate ... to resolve claims . Coordinate medical and indemnity position of the claim...losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best… more
    Travelers Insurance Company (12/19/25)
    - Save Job - Related Jobs - Block Source
  • Workers Compensation Claim Representative

    Travelers Insurance Company (Rancho Cordova, CA)
    …under direct supervision. As a trainee, you may also be exposed to claims that could involve litigation, settlement negotiations, Medicare set asides and ... Claim team is committed to partnering with our business insurance customers to help their injured employees return to...you will handle all aspects of a workers compensation claims . In this role, you will learn how to… more
    Travelers Insurance Company (10/22/25)
    - Save Job - Related Jobs - Block Source
  • Insurance Verification…

    Surgery Care Affiliates (Long Beach, CA)
    …for Primary insurance . + Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or ... guidelines and the process of collecting over the counter payments/deductibles/copay/co- insurance . Knowledge of payer contracts including Medicare , Medicaid… more
    Surgery Care Affiliates (12/23/25)
    - Save Job - Related Jobs - Block Source
  • Accounts Receivable Representative

    Ellis Medicine (Schenectady, NY)
    …outgoing data is accurate. + Review and resolve outstanding accounts receivable with insurance companies and patients. + Claims in dispute with payers are ... The Accounts Receivable Representative will be responsible for achieving accurate and...+ Review Billing Exception Report for Revenue Management, the Medicare system (FISS), and the claims scrubber… more
    Ellis Medicine (10/31/25)
    - Save Job - Related Jobs - Block Source
  • Billing Representative - Revenue Cycle

    Ascension Health (Austin, TX)
    …of the daily claims reconciliation process. + Prepare and complete claims for commercial insurance companies, third party organizations and/or government or ... 1345 Philomena Austin, Texas **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans… more
    Ascension Health (11/20/25)
    - Save Job - Related Jobs - Block Source
  • Billing Representative III

    Primary Health Care (Des Moines, IA)
    …and dental/medical billing requirements. + Experience working with dental/medical insurance contractual agreements, Medicare and Medicaid regulations, payment ... provide healthcare and supportive services to all, regardless of insurance , immigration status, or ability to pay. Based on...in Ames, Des Moines, & Marshalltown. As a Billing Representative III, you will be is responsible for timely… more
    Primary Health Care (12/24/25)
    - Save Job - Related Jobs - Block Source
  • Accounts Receivable Representative

    Care Plus NJ (Paramus, NJ)
    Accounts Receivable Representative Location:1 Kalisa Way, Paramus NJ On-site40 hours M-F: 8am-4pm or 9am-5pm Salary: $52k What We Offer: + Health, Dental and Vision ... Employee Discount and Rewards Program + Life & AD&D insurance ; STD & LTD coverage Note: That's not all!...The role requires strong knowledge of NJ Medicaid and Medicare billing, collaboration with clinical and executive teams, and… more
    Care Plus NJ (12/03/25)
    - Save Job - Related Jobs - Block Source
  • Patient Account Representative - Hospital…

    Guidehouse (San Marcos, CA)
    …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative - Hospital A/R Emphasis** is an extension ... three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials +... + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service… more
    Guidehouse (11/16/25)
    - Save Job - Related Jobs - Block Source
  • Billing Representative Clerk - Physicians…

    Surgery Care Affiliates (New Albany, IN)
    …and billing is accurate and up to date. + Submit accurate primary & secondary insurance claims to insurance providers following agency and payer guidelines. ... payments to our Practice. This position prepares and submits claims to insurance companies for medical services...payers in a timely fashion. + Knowledge of multiple insurance contracts, Medicare , and W/C Fee Schedule.… more
    Surgery Care Affiliates (12/02/25)
    - Save Job - Related Jobs - Block Source
  • Billing Representative

    Specialty Rx, Inc. (Ridgefield Park, NJ)
    Job Description SpecialtyRx is a full-service pharmacy. We need Billing Representative with Pharmacy experience in our Ridgefield Park, NJ location. Hours: ... "SpecialtyRx." We offer a competitive salary and benefits package. Billing Representative Responsibilities: + Perform duties assigned by the Billing Supervisor. +… more
    Specialty Rx, Inc. (12/17/25)
    - Save Job - Related Jobs - Block Source