- CVS Health (Plantation, FL)
- …- Performs claim rework calculations. **-** Ensures accurate and timely claims processing **Required Qualifications** Applicant must have at least 2 years ... expert by providing members and providers with high quality claim adjudication. May handle customer service inquiries and problems....medical terminology. - Hands on experience in end-to-end medical claims processing . - Knowledge of the ACAS… more
- 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
- Publix (Lakeland, FL)
- **33789BR** **Position Title:** PROFIT Plan Claims Processing Specialist, Retirement - Lakeland **Department:** Benefits Administration **Location:** Lakeland, ... System + 2 years retirement related experience and 2 years of claims processing experience, or 4 years customer service experience in retirement related field… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …Essential Qualifications + Strong knowledge of contracts, medical terminology, and claim dispute processing and procedures. + Previous experience handling ... claim disputes. + Claim knowledge including professional, facility and ancillary claims...+ Strong knowledge of contracts, medical terminology, and appeals processing and procedures. + High School Diploma or GED… more
- Superior Ambulance Service (Elmhurst, IL)
- …pertaining to specific claim issues. + Maintain working relationships with departments processing claims . + Handle claims involving loss due to fire, ... a database system. + Determining policy coverage and calculating claim amounts. + Processing claim ...pressure. + High attention to detail. + Provide timely processing and adjudication of claims . + Prepare… more
- Molina Healthcare (Salt Lake City, UT)
- …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
- Henry Ford Health System (Troy, MI)
- …in an out-patient or medical office environment. Responsibilities: . Prepares insurance claims for submission to third party payers and/or responsible parties. . ... Reviews claims for accuracy, including proper diagnosis and procedure codes. . Reviews claim rejections and communicates with payers to resolve billing issues. .… more
- Wells Fargo (San Antonio, TX)
- …the Head of Claims and Recovery. This group is responsible for end-to-end claims processing for all dispute types. This individual will lead the ATM, Debit ... Fargo is seeking a Fraud & Claims Operations Director to report to...transformation initiatives. **Required Qualifications:** + 8+ years of Fraud Claim Investigation or Policy Violations, Risk Management, or Compliance… more
- NJM Insurance (Trenton, NJ)
- …and use of sound decision-making capabilities + Working knowledge utilizing an automated claim processing system and Microsoft Office tools including Word and ... claim , and outlining and recommending an action plan to manage the claim . The WC Claims Specialist will work with and communicate to all internal and external… more
- Equitable (Charlotte, NC)
- … management system, ensuring all details are captured for proper claims processing . + Maintain accurate and up-to-date claim records, including claim ... Claim Intake Specialist to join our Disability and Absence Claims organization. The ** Claim Intake Specialist** is responsible for supporting the disability … more