- IQVIA (Philadelphia, PA)
- **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team....+ High School Diploma or equivalent + Experience in claim processing required + Medical Billing Certification… more
- Sedgwick (Philadelphia, PA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit ... and retention by providing accurate and timely resolution in processing medical claims . You will be a...Ability to use multiple computer applications at one time. Claim processing experience. **Desired qualifications** We are… more
- CVS Health (Harrisburg, PA)
- …the Eastern or Central Time Zone** **Position Summary** Reviews and adjudicates routine claims in accordance with claim processing guidelines. * Analyzes ... inquiries and written correspondence related to claim processing issues. * Routes and triages complex claims... processing issues. * Routes and triages complex claims to Senior Claim Benefits Specialist. *… more
- Sedgwick (Pittsburgh, PA)
- …expertise preferred. **Skills & Knowledge** + Subject matter expertise in worker's compensation claims and/or liability claims processing + Ability to obtain ... FUNCTIONS and RESPONSIBILITIES** + Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional… more
- CVS Health (Harrisburg, PA)
- … claim or reconsideration. **Required Qualifications** + 2+ years of medical claim processing experience. + Previous experience in a production environment. + ... competently, accurately and efficiently. **Preferred Qualifications** + Self funded medical claim processing experience. + DG system knowledge. + Associate's… more
- CVS Health (Harrisburg, PA)
- …competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience - DG system ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- Sedgwick (Harrisburg, PA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim ...depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client;… more
- Sedgwick (Harrisburg, PA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Guardian Life (Harrisburg, PA)
- …+ College degree preferred or equivalent work experience + Claim processing experience preferred or working knowledge of claims processes + Knowledge ... As the ** Claims Case Manager I** , **Supplemental Insurance,** you...you will be responsible for Accident and Hospital Indemnity claim decision making according to the plan provisions, state… more