- MyFlorida (Miami, FL)
- …records management activities relating to Social Security and Medically Needy disability claims . This includes receipt from the Social Security field offices and ... Department of Children and Families (Medically Needy cases), reviewing claims that are initialized through the automated claims process, initial review,… more
- University of Rochester (Albany, NY)
- … to obtain and verify insurance coverage. Follows up on unpaid accounts working claims . Reviews reasons for claim denial. Reviews payer website or contacts payer ... America, 12224 **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours : 40 Department: 910402 United Business Office Work Shift: UR - Day… more
- USAA (Seattle, WA)
- …for settlement amounts outside of authority limits. + Maintains accurate and current claim file with critical documentation throughout the claims process for ... investigate, evaluate, negotiate and settle the highest complexity property insurance claims presented by or against our members. You will confirm/analyze coverage,… more
- University of Rochester (Rochester, NY)
- … to obtain and verify insurance coverage. + Follows up on unpaid accounts working claims . + Reviews reasons for claim denial. + Reviews payer website or contacts ... 14624 **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours : 40 Department: 500011 Patient Financial Services Work Shift: UR - Day… more
- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …to prevent fraud and ensure compliance with policy terms. + Resolve Rejected Claims : + Calculate benefit payments and approve claim settlements based on ... SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing and maximum payer reimbursement. They prioritize… more
- Port of Seattle (Seattle, WA)
- …of Washington. You will act as the System Administrator of the Origami claims management system. + You will provide daily management, program oversight, and ... confidentiality to the processing and adjudication of claims and legal documents associated with claims ....will participate in and support auditing activities by providing claim records and material as requested by external regulators… more
- Sedgwick (Southfield, MI)
- …+ Reviews member contracts submitted to pool administration, prepares presentations on claims and issues of interest for meetings and/or strategic planning. + ... for members and trainings, and coordinates with pool administrator on cases, claims , and messaging. + Oversees the pool's liability program. + Represents the… more
- Sedgwick (Cincinnati, OH)
- …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... specifications in assisting with questions and solving problems related to the claims application and servicing processes. + Educates and informs the customer via… more
- Sedgwick (Cincinnati, OH)
- …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... specifications in assisting with questions and solving problems related to the claims application and servicing processes. + Educates and informs the customer via… more
- Prime Therapeutics (San Diego, CA)
- …pharmacy audits and is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance, and supporting ... downstream claim corrections to eliminate potential waste. **Responsibilities** + Evaluate...to Prime's travel and expense policy + Analyze pharmacy claims to identify those at the highest risk for… more