- Providence (NM)
- …we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, Evaluate, and Manage Professional, ... + Work with defense attorneys specializing in defense of medical negligence claims + Have direct responsibility...+ 7+ years of relevant general and professional liability claims processing or management experience + 5+… more
- Trinity Health (Farmington Hills, MI)
- …managed care organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, ... Office, including Outlook, Word, PowerPoint, and Excel. **Experience performing hospital medical claims follow-up with the Medicare and Medicare Advantage… more
- Sedgwick (Columbus, OH)
- …benefits offering including medical , dental vision, 401K on day one. \# claims #claimsexaminer # remote As required by law, Sedgwick provides a reasonable ... growth, and inclusion. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- Sedgwick (Alexandria, VA)
- …growth, and inclusion. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Representative | VA Jurisdiction | Remote Are you looking… more
- Sedgwick (Columbus, OH)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an opportunity to… more
- Providence (OR)
- …Correctly analyze and adjudicate claims to reflect financial, check, and processing accuracy **Providence Health Plan welcome 100% remote work for applicants ... (Examples: Clinical, Back office, Insurance Support, Etc.) + 2+ years' experience processing insurance claims + 2+ years' experience in membership accounting… more
- Sedgwick (Roseville, CA)
- …Forbes Best-in-State Employer Claims Examiner - Auto - Commercial Trucking I Remote (Pacific or Mountain Time Zone) Handling claims for large commercial ... : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the… more
- Martin's Point Health Care (Portland, ME)
- …of education and relevant experience. + 5 or more years of related medical claims auditing experience or equivalent experience. + Detailed knowledge of ... + Support of auditors, regarding audit development activities and audit processing . + Perform claims audits to identify and recover claims overpayments. The… more
- Sedgwick (King Of Prussia, PA)
- …Workplace(R) Forbes Best-in-State Employer LIability Complex Claims Examiner | Commercial Claims Experience | Remote **PRIMARY PURPOSE** : To analyze complex ... or technically difficult general liability claims to determine benefits due; to work with high...professional and timely manner. + Communicates claim activity and processing with the claimant and the client; maintains professional… more
- The Cigna Group (Bloomfield, CT)
- …degree preferred + 3+ years of experience as a subject matter expert for claims system configuration, processing , reporting, issue triage and testing - REQUIRED ... 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 the… more
- The Cigna Group (Bloomfield, CT)
- …Senior Analyst. This highly technical systems role requires the review of our claims processing system to ensure all configurations were input correctly into ... the system per the specifications of the provider. The Claims System Configuration Senior Analyst will have in depth knowledge of the eviCore claims systems and… more
- Reynolds & Reynolds (Phoenix, AZ)
- Remote - Claims Adjuster - Automotive/RV Phoenix, AZ Full-Time Apply Here ‹ View jobs Position description: This is a full-time, remote position. American ... (AGWS), an affiliate of Reynolds and Reynolds, is seeking Claims Adjuster - Automotive/RV for our growing team. In...- Answering inbound calls - Provide information about claim processing and explain the different levels of contract coverage… more
- Molina Healthcare (WA)
- …**Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and accurate reports. ... As the senior level team member, this role leads efforts to ensure the claims teams and other departments have access to quality claims data through processes… 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 ... Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for...Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills &… more
- Medical Mutual of Ohio (Toledo, OH)
- …keyboarding skills at a minimum of 6,000 ksph + Proficiency with claims processing systems and basic Microsoft Office Skills. Medical Mutual is looking to ... and standard office procedures + Knowledge of health insurance claims processing and provider coding + Alpha-numeric...keyboard, mouse and headset. + Whether you are working remote or in the office, employees have access to… more
- Veterans Affairs, Veterans Health Administration (Denver, CO)
- Summary This position is in the Beneficiary Claims Processing Unit, CHAMPVA program, 3.1 Network Development and Operations, Integrated External Networks, ... Examiner reports to the Supervisor of the Beneficiary Claims Processing Unit. The primary function of...medical equipment as they pertain to the beneficiaries' claims . Examines reimbursement of expenditures for accuracy, adequacy of… more
- CHS (Clearwater, FL)
- … medical terminology **Qualifications** **Qualifications:** Minimum two (2) years of medical claims processing experience **Education and/or Experience:** ... **Overview** **Health Insurance Medical Claims Examiner** **(Initial Training on...Examiner** **(Initial Training on Site - 30 days - Remote after training)** **Must live within a reasonable commuting… more
- PSKW LLC dba ConnectiveRx LLC (Whippany, NJ)
- …the direction of the Supervisor (with guidance from a Team Lead), is responsible for processing medical claims received from patients and/or HCPs across a ... billing a must + Health care or pharmaceutical experience, particularly in a medical claims processing , billing provider, or insurance environment +… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …. Processes claims edits from receipt to completion. . Utilizes claims and ancillary systems and adheres to processing procedures resulting in ... **_The Claims Representative II position allows you the flexibility...50-mile radius of the Brooklyn, OH or Rossford, OH Medical Mutual offices._** Founded in 1934, Medical … more
- Highmark Health (Pittsburgh, PA)
- …**systems and technology** **will be essential.** **This includes k** nowledge of claims processing platforms, data management systems, and relevant technologies ... medical , dental, pharmacy, etc.). **Demonstrated success with leading** ** claims ** **transformations as well as experience with claims...like AI/ML to optimize claims processing . **ESSENTIAL RESPONSIBILITIES** + Understand the… more
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