- Sedgwick (Raleigh, NC)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim recoveries, including but… more
- Brighton Health Plan Solutions, LLC (NC)
- …or leadership role. + Advanced knowledge of Excel. + Strong knowledge of contracts, medical terminology, and claims processing and procedures. + 5+ years of ... About the Role The Claims Supervisor is responsible for supervising a staff of Claim Examiners and Claim Team Leads, 12-20 direct reports. The expectations… more
- MetLife (Cary, NC)
- Long Term Disability Claims Specialist II Job Location: Virtual but must be commutable to the following office locations: * Aurora, IL * Bloomfield, CT * Cary, NC * ... Effectively manages with minimal oversight an assigned caseload of moderately complex claims which consists of pending, ongoing/active and appeal reviews. The LTD CS… more
- Cognizant (Raleigh, NC)
- …and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and ... hospital claims utilizing payer specific policies and procedures. Provide support...stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA… more
- Sedgwick (Raleigh, NC)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... claims ' action plans to resolution, coordinates return-to-work efforts, and approves claim payments. + Approves and processes assigned claims , determines… more
- Sedgwick (Greensboro, NC)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... claims ' action plans to resolution, coordinates return-to-work efforts, and approves claim payments. + Approves and processes assigned claims , determines… more
- Sedgwick (Greensboro, NC)
- …properly documented and claims coding is correct. + May process low-level lifetime medical and/or defined period medical claims which include state and ... claims ' action plans to resolution, return-to-work efforts, and approves claim payments. + Approves and processes assigned claims , determines benefits… more
- Cognizant (Raleigh, NC)
- …Monday to Friday 8am - 4:30pm ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:** As Claims ... be responsible for timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to … more
- Compass Group, North America (NC)
- …be responsible for administering and managing leave programs under the Family and Medical Leave Act (FMLA), the Americans with Disabilities Act (ADA), and other ... fast-paced environment. **Responsibilities:** + Assist associates in the administration Family Medical Leave (FMLA), and American Disability Act (ADA). + Maintain… more
- Adecco US, Inc. (Charlotte, NC)
- … claim status and actions with claimants and clients. + Process complex medical claims , including state and physician filings and treatment approvals. + ... are not limited to: + Analyze and manage mid- to high-level workers' compensation claims , determining compensability and benefits due for medical and indemnity … more