• Subrogation Examiner

    Elevance Health (Louisville, KY)
    …on injury claims . + Utilizes various research methods and vendor systems to gather information. + Works with subrogation staff, other departments and outside ... **Subrogation Examiner ** **Locations:** Wisconsin, Indiana, Kentucky **Virtual:** This role...claims relevant to each case. + Reviews internal systems /applications for various information needs. + Assists with small… more
    Elevance Health (09/27/25)
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  • Specialist, Config Oversight (healthcare Medical…

    Molina Healthcare (KY)
    …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... applied to the appropriate modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim...+ Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using… more
    Molina Healthcare (09/24/25)
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  • Analyst, Configuration Oversight ( Claims

    Molina Healthcare (Owensboro, KY)
    …combination of education and experience **PREFERRED EXPERIENCE:** 3+ years of experience in claims as Adjuster or claims examiner in the healthcare ... * Apply previous experience and knowledge to verify accuracy of updates to claim /encounter and/or system update(s) as necessary. * Works with fluctuating volumes… more
    Molina Healthcare (09/17/25)
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  • Telephonic Case Manager

    Sedgwick (Frankfort, KY)
    …support systems . + Effectively communicates and builds relationships with the claims ' examiner , client, injured worker, attorney and supervisor. + Identifies ... recovery. + Provides recommendations for alternate clinical resources to support claim resolution. + Maintains client's privacy and confidentiality, promotes client… more
    Sedgwick (09/19/25)
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  • Investigator, Special Investigative Unit - FLORIDA

    Molina Healthcare (Covington, KY)
    …Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation pertinent to investigations. + Detects ... + Documents appropriately all case related information in the case management system in an accurate manner, including storage of case documentation following SIU… more
    Molina Healthcare (09/22/25)
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  • Investigator

    Highmark Health (Frankfort, KY)
    …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... **Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC)… more
    Highmark Health (09/10/25)
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