• Claim Field Analyst (Tampa/Orlando,…

    CVS Health (Tallahassee, FL)
    …+ 3+ years of experience in medical billing and coding, specifically related to claims processing and root cause analysis. + 3+ years of experience with ... non-participating providers. Additionally, they will assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues. as well as… more
    CVS Health (09/24/25)
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  • Claim Benefit Specialist

    CVS Health (Franklin, TN)
    …providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims . + Determines if claims processing activities comply with ... codes and other necessary data elements to ensure accurate tracking, reporting, and processing of claims in all appropriate applications. + Conducts reviews and… more
    CVS Health (10/02/25)
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  • Senior Claim Benefit Specialist

    CVS Health (MN)
    … claim or reconsideration. **Required Qualifications** - 18+ months of medical claim processing experience. - Experience in a production environment. - ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
    CVS Health (09/27/25)
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  • Medical Claim Review LVN/LPN (CA LVN…

    Molina Healthcare (Long Beach, CA)
    …has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing . * Evaluates medical records and/or medical notes ... **Job Description** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding… more
    Molina Healthcare (09/17/25)
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  • Commercial Auto Claim Representative

    Sedgwick (Indianapolis, IN)
    …FUNCTIONS and RESPONSIBILITIES** + Processes auto property damage and lower level injury claims ; assesses damage, makes payments, and ensures claim files are ... and pursues subrogation opportunities; secures and disposes of salvage. + Communicates claim action/ processing with insured, client, and agent or broker when… more
    Sedgwick (09/19/25)
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  • Data Operations Analyst - Excel & Claims…

    TEKsystems (Dallas, TX)
    …Must score 94% or above Preferred Experience + Experience in charge entry or claims processing + Familiarity with healthcare data and HIPAA compliance Work ... Data Operations Analyst to support our Charge Entry & Claims Submission processes. This role is ideal for someone...be responsible for transforming raw data into clean, accurate claim files ready for automated submission. Key Responsibilities +… more
    TEKsystems (10/04/25)
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  • Property Claim Associate

    Sedgwick (Portland, OR)
    …FUNCTIONS and RESPONSIBILITIES** + Processes uncomplicated personal and commercial line property claims and ensures claim files are properly documented and coded ... and pursues subrogation opportunities; secures and disposes of salvage. + Communicates claim action/ processing with insured, client and agent or broker when… more
    Sedgwick (09/23/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Warren, MI)
    …appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing . + Identifies and reports quality of care issues. + ... to providers. **Job Duties** + Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which… more
    Molina Healthcare (09/06/25)
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  • Claim Specialist

    City of New York (New York, NY)
    …New York, and has a wastewater conveyance and treatment system capable of processing over 1.3 billion gallons of wastewater per day to protect the environment ... is involved in a significant amount of litigation and claims filed with the New York City Comptroller's Office....BLA is seeking qualified candidates for the position of Claim Specialist 2 in the Litigation Support Unit. This… more
    City of New York (08/13/25)
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  • Copay Manager - Support Program/ Claims…

    AssistRx (Orlando, FL)
    …to implement and support all operational and financial processes related to claim processing activities. In addition, manager will ensure effective day-to-day ... and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay utilization, establish escrow account minimum balances… more
    AssistRx (10/01/25)
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