- Elite Staffing Inc. (Cary, NC)
- … Specialist Job Duties: Performs healthcare information & medical claims processing, healthcare billing & collection services, & provides financial guidance ... regarding hospital, HMO, clinical services to patients, their families & third-party representatives. Contact insurance companies to verify eligibility coverage for drug benefits. Function as a liaison between special drug program patients & their insurance… more
- CornerStone Staffing (Cary, NC)
- …in Cary, North Carolina. If you have experience in benefits investigation, claims processing, and copay assistance, this is a fantastic opportunity to work ... Diploma required1+ year of experience in Benefits Verification, Benefits Investigation, Claims , Copay, or Pharmacy experience1+ year of data entry experience,… more
- Sedgwick (Raleigh, NC)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Claims Specialist Professional Liability, Public Entity **PRIMARY PURPOSE** **:** ... entity; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within Company standards, industry best practices… more
- Lincoln Financial Group (Raleigh, NC)
- …73468 **The Role at a Glance** We are excited to bring on highly motivated Voluntary Claims Specialist I to staff our ever-growing claims organization. As a ... administering, processing, and adjudicating Accident, Critical Illness, and Hospital Indemnity claims for our members. You'll complete a thorough training to develop… more
- Lincoln Financial Group (Raleigh, NC)
- …**The Role at a Glance** We are excited to bring on a highly motivated **Group Claims Specialist ** to support our ever-growing claims organization in a work ... support our west coast employer groups. _Background details_ As a Group Claims Specialist , you will support our Short Term Disability or Integrated Absence… more
- Humana (Raleigh, NC)
- …a part of our caring community and help us put health first** The Claims Financial Recovery Coding Specialist /Medical Coding Coordinator 2 for the Financial ... claims procedures, contract provisions, and CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical...CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical Coding Coordinator 2 + Maintains required… more
- MetLife (Cary, NC)
- …* Independently manage an assigned caseload of the most complex claims which consists of pending, ongoing/active and appeal reviews. Provides timely, ... balanced and accurate claims reviews, documentation and recommended decisions in a time...information is needed to make a reasonable and logical claims determination based off the information available. Proficiently calculates… more
- Trustmark (Raleigh, NC)
- …colleagues, clients and communities. Responsible for reviewing and processing claims including, identifying irregularities and reviewing for accuracy, and ... Critical Care. **Key Accounabilities:** + Demonstrates strong understanding and performs claims handling processes and procedures related to Wellness, Hospital and… more
- TEKsystems (Cary, NC)
- Job Posting: Claims Processing and Pharmacy Reimbursement Specialist Location: Cary, NC (Onsite Only) Schedule: Monday-Friday, 9am-6pm Job Description: We are ... seeking a dedicated Claims Processing and Pharmacy Reimbursement Specialist to join our team in Cary, NC. This is a fantastic opportunity for individuals with… more
- Sedgwick (Raleigh, NC)
- …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Return-to-Work Specialist **PRIMARY PURPOSE** : To negotiate, facilitate and monitor successful ... Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) efforts through negotiation with… more
- Deloitte (Raleigh, NC)
- Operations & Technology Transformation Specialist Master, Guidewire Data Migration - ETL Developer What we do Operations and Technology Transformation delivers ... on July 31, 2024 Work you'll do As an OTT Insurance Transformation Specialist Master, you will bring considerable technical expertise to deliver effective solutions… more
- Randstad US (Cary, NC)
- …and financial operations occupations + referenceAB_4604573 job details The Reimbursement Specialist will perform healthcare information & medical claims ... reimbursement specialist . + cary , north carolina + posted...PM education: Bachelors Responsibilities Performs healthcare information & medical claims processing, healthcare billing & collection services, & provides… more
- Randstad US (Cary, NC)
- …and financial operations occupations + referenceAB_4605519 job details The Reimbursement Specialist performs healthcare information & medical claims processing, ... reimbursement specialist . + cary , north carolina + posted...High School Responsibilities + Performs healthcare information & medical claims processing, healthcare billing & collection services, & provides… more
- TEKsystems (Durham, NC)
- As the Medical Program Specialist If you're ready to explore the next step in your career: You'll enjoy Career Opportunities - Tons of growth opportunities for you ... to third party pharmacy (ex: Walgreens) + The Program Specialist is responsible for serving as the customer's primary...| Healthcare Industry | Medicare | Medicaid | Medical Claims Core Experience: + Major medical experience + Specialty… more
- Zurich NA (Raleigh, NC)
- Senior Design/Construction Management Consulting Specialist 113183 Zurich is looking for a highly skilled **Senior Design/Construction Management Consulting ... Specialist ** within Risk Engineering and our Zurich Resilience Solutions...prospect/existing customer base. + Providing periodic support to the Claims Department with technical assessment of complex claims… more
- MetLife (Cary, NC)
- …Provides exemplary customer service by processing group disability income insurance claims in a timely and accurate manner. Principal Responsibilities: * Manages ... assigned caseload of long-term disability (LTD) claims . * Determines whether to suspend, terminate,.... * Determines whether to suspend, terminate, or pay claims . * Updates current claims records (inputs… more
- Walgreens (Durham, NC)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Travelers Insurance Company (Raleigh, NC)
- …of the scene and to provide technical advice and consultation to attorneys and claims staff associated with the loss. + Conduct research and testing, prepare reports ... (verbal and written), and to aid the claims and legal staff with the scientific aspects of...needed to support the overall functions of Risk Control, Claims Services, and Underwriting. Such materials may include newsletters,… more
- Sutherland Global Services (Raleigh, NC)
- …sent to Legal. This will include: + Conducting collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or ... PPO, IPA and Capitation and how these payers process claims + Knowledge of Managed Care contracts, Contract Language...billing form requirements (UB04) and HCFA 1500 + Medical claims and/or hospital collections experience + Minimum high school… more
- ProTrain (Raleigh, NC)
- …+ Live Online instructor + Describe the role of the Certified Medical Billing Specialist + Describe the origin of medical language. + Analyze the component parts of ... the responsibilities assigned to insurance billing and coding specialists and electronic claims processors. + Describe the health care delivery system. + Explain the… more
