- Sedgwick (Brea, CA)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- OneMain Financial (Fort Worth, TX)
- … Examiner** The Claims Examiner is responsible for evaluating and processing claims on primarily one business/product line by performing all functions ... with internal and external customers. + Research additional information to support claim processing . Perform benefit calculations. Conduct claim … more
- LA Care Health Plan (Los Angeles, CA)
- …of the PPGs, capitated hospitals, and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates. Provides timely and ... This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the...Experience Required: At least 4 years of experience performing claims audits or claims processing … more
- NTT DATA North America (Decatur, IL)
- …and insured members. + Assist with audits for assigned group. + Assist with claims processing and over specific for new or backlogged groups. **KNOWLEDGE, SKILLS ... providers and case management company for information regarding problem claims . + Print/mail EOBs and claim forms...High School Education required. + Minimum 3 Years of Claims Processing experience + TPA Experience **Preferred:**… more
- Sedgwick (San Diego, CA)
- …accuracy, and files necessary documentation with state agency. + Communicates claim action/ processing with claimant, client and appropriate medical contact. ... + Ensures claim files are properly documented and claims coding is correct. + May process routine payments and prescriptions and status reports for lifetime… more
- Sedgwick (Memphis, TN)
- …accuracy, and files necessary documentation with state agency. + Communicates claim action/ processing with claimant, client and appropriate medical contact. ... + Ensures claim files are properly documented and claims coding is correct. + May process routine payments and prescriptions and status reports for lifetime… more
- Sedgwick (Eden Prairie, MN)
- …accuracy, and files necessary documentation with state agency. + Communicates claim action/ processing with claimant, client and appropriate medical contact. ... + Ensures claim files are properly documented and claims coding is correct. + May process routine payments and prescriptions and status reports for lifetime… more
- Sedgwick (Richmond, VA)
- …accuracy, and files necessary documentation with state agency. + Communicates claim action/ processing with claimant, client and appropriate medical contact. ... + Ensures claim files are properly documented, and claims coding is correct. + May process routine payments and prescriptions and status reports for lifetime… more
- Molina Healthcare (Nampa, ID)
- …member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. * ... Job Summary Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim … more
- Sedgwick (Dallas, TX)
- …accuracy, and files necessary documentation with state agency. * Communicates claim action/ processing with claimant, client and appropriate medical contact. ... * Ensures claim files are properly documented and claims coding is correct. * May process routine payments and prescriptions and status reports for lifetime… more