• Confidential Administrator - Claims

    PSEG (Springfield, NJ)
    …the ability to process basic transactions + 6 months to 1 year experience in claims processing or related field (ie customer service) **Desired** + Familiar with ... needed + Handles calls from internal clients and designs claim assignment to the appropriate Corporate Claims ...reports (Electric, Gas, Financials) + Assist Legal Department with processing Expense, Releases as well as obtaining W9 Forms… more
    PSEG (09/30/25)
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  • Epic Hospital Billing Claims Analyst

    CTG (CA)
    …Epic HB Claims configuration, including claim edit rules, claim definition rules, remit processing , and electronic remittance workflows. + Configure ... **CTG is seeking to fill an Epic Hospital Billing Claims Analyst opening for our client in California.** **Location:** Remote **Duration:** 18 months **Duties:** +… more
    CTG (09/30/25)
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  • Claims Supervisor

    Brighton Health Plan Solutions, LLC (NC)
    …+ Advanced knowledge of Excel. + Strong knowledge of contracts, medical terminology, and claims processing and procedures. + 5+ years of advanced claims ... 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
    Brighton Health Plan Solutions, LLC (08/08/25)
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  • Claims Setup Specialist

    Raphael and Associates (Rutherford, NJ)
    …the claims management system. You will play a key role in preparing claims for further processing by entering data, verifying policy details, and assigning ... adjuster and supervisor. + Set adjuster diaries with new claim notifications and necessary actions. + Claims ...new claim notifications and necessary actions. + Claims Acknowledgement Letters: + Generate and send acknowledgement letters… more
    Raphael and Associates (08/07/25)
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  • Claims Quality Assurance Inspector

    WellSense (Boston, MA)
    …and Enrollment entry. Ideal candidates will maintain a broad knowledge of corporate claims processing and enrollment entry rules for use in conducting all ... check **Competencies, Skills, and Attributes:** + Deep and demonstrated knowledge of medical claims processing + Very strong attention to detail required +… more
    WellSense (09/20/25)
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  • Claims Specialist

    Illumination Foundation (Santa Ana, CA)
    …up on outstanding account receivables + Review any rejected or denied claims and conduct proper follow up procedures (Escalations/Appeals/ Claim corrections) + ... knowledge in understanding, reading EOB's and Remittance Advice + Posting payment accurately to claims and continuing with the claim close out process + Assist… more
    Illumination Foundation (09/28/25)
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  • Medical Claims Processor - Remote

    Cognizant (Lincoln, NE)
    …Plan Document. **Role Responsibilities** + Responsible for reviewing the data in the claim processing system (Facets) and comparing it with the corresponding UB, ... and criteria has been met. + Responsible for reviewing claim and line item edits and warning messages for...required + A minimum of 1 years of medical claims processing is required + Facets experience… more
    Cognizant (10/02/25)
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  • Triage Claims Examiner

    ICW Group (San Diego, CA)
    …injured workers. + Communicates with insureds to obtain information necessary for processing claims . + Contacts and/or interviews injured workers, doctors, ... attorneys, and employers to get additional information. + Communicates claim activity and processing with the injured...and providing benefits as prescribed by law. + Ensures claim files are properly documented and claims … more
    ICW Group (08/26/25)
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  • Complex Claims Advisor | Commercial GL…

    Sedgwick (Sacramento, CA)
    …expertise preferred. **Skills & Knowledge** + Subject matter expertise in worker's compensation claims and/or liability claims processing + Ability to obtain ... FUNCTIONS and RESPONSIBILITIES** + Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional… more
    Sedgwick (09/25/25)
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  • Claims Examiner - Managed Care

    Cedars-Sinai (CA)
    …in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products and provider ... Dispute Request (PDR) fulfillment process from the point of claim review through letter processing and records...required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred.… more
    Cedars-Sinai (09/11/25)
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