• Claims Examiner

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Healthcare Claims Examiner skilled in the interpretation of Hospital and Ancillary ... Medical Policies and Payment procedures as well as capable of manually processing claims according to all outlined Policies and Procedures. This job description is… more
    Brighton Health Plan Solutions, LLC (06/12/25)
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  • Liability Claims Examiner (remote)

    Raphael and Associates (Rutherford, NJ)
    Liability Desk Examiner (remote) Company Overview: Raphael & Associates is a third-party claims administrator and independent claims adjusting company ... our services to our client's specific needs. As a claims organization, what we do is complex. Our mission...to provide superior reports so that proper evaluations of claim values can be made. + Appropriately represent the… more
    Raphael and Associates (05/14/25)
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  • Claims Examiner

    NTT DATA North America (Plano, TX)
    …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims Examiner to join our team in Plano, Texas (US-TX), United ... States (US). + Processing of Professional claim forms files by provider + Reviewing the policies...Work independently to research, review and act on the claims + Prioritize work and adjudicate claims more
    NTT DATA North America (07/22/25)
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  • Claims Examiner II

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    Position Purpose: The Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and ... adjusting claims and other duties as necessary. Key Responsibilities: +...Ensure that the proper benefits are applied to the claim using the appropriate tools (eg CMS guidelines) +… more
    DOCTORS HEALTHCARE PLANS, INC. (07/31/25)
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  • Claims Examiner - Fast Track Auto

    Philadelphia Insurance Companies (Bala Cynwyd, PA)
    …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Examiner - Fast Track Auto to join our team! Summary: Investigate and analyze ... insurance claims to determine extent of Insurer's obligations. Settle ...communication as well as results of investigation. Evaluates each claim in light of facts; Affirm or deny coverage;… more
    Philadelphia Insurance Companies (05/23/25)
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  • Claims Examiner - Disability…

    Thrivent Financial (WI)
    …liability within established guidelines. This position is accountable for analyzing claims to determine benefit/contract eligibility and processing claim ... + Determine extent of liability on routine and non-routine claims and make final claim decisions within specified dollar limits. Contribute to accurate fraud… more
    Thrivent Financial (07/23/25)
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  • Claims Examiner 2

    State of Montana (Helena, MT)
    …position is open until filled with frequent screening of applicants. **Title:** * Claims Examiner 2 (11722)* **Location:** *Helena* **Requisition ID:** *25141497* ... position is with the Health Resources Division. This position is a Medicaid Claims Specialist and provides technical support primarily in the areas of disputed or… more
    State of Montana (07/04/25)
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  • Claims Examiner

    NTT America, Inc. (Plano, TX)
    …as part of an overall sourcing strategy. NTT DATA currently seeks a ** Claims Processing Associate** to join our team for a remote position. **Role Responsibilities** ... -Processing of Professional claim forms files by provider -Reviewing the policies and...-Work independently to research, review and act on the claims -Prioritize work and adjudicate claims as… more
    NTT America, Inc. (07/24/25)
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  • Claims Examiner

    TEKsystems (Baltimore, MD)
    TekSystems is currently hiring for several FULLY REMOTE Medical Claims Associates, these positions can sit anywhere that is within the DMV area (EST Time Zone!) MUST ... HAVE: Any medical claims , medical billing, or medical data entry experience OR...such as medical records, police reports, or receipts. Determining Claim Validity Assess whether the claim meets… more
    TEKsystems (07/24/25)
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  • Senior Liability Claims Examiner

    Sedgwick (San Diego, CA)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Liability Claims Examiner | Must Reside in CA Must Reside in California ... resolution to appropriate parties. + Responsible for litigation process on litigated claims and follow defense counsel guidelines and service expectations + Responds… more
    Sedgwick (06/23/25)
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