- Sedgwick (Topeka, KS)
- …Executive General Adjuster - Midwest Region **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Prepares loss experience reports to help… more
- Lowe's (Nashville, TN)
- …* Coordinate with 3PL (third-party logistics) partners to resolve customer and cargo-related claims . * Input and manage claims (eg, property damage) into Lowe's ... claims portal. * Ensure timely updates and resolution of claims to preserve customer trust. * Communicate with Lowe's retail teams, supply chain nodes (eg, RDC,… more
- Elevance Health (Atlanta, GA)
- …of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you ... fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing + Correlates review...well as other areas of the company relative to claims reviews and their status + Analyzes and trends… more
- US Tech Solutions (Columbia, SC)
- …or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to ... collection/input into system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines… more
- Tutor Perini (Sylmar, CA)
- …This individual will be engaged in the ongoing review of complex projects, claims , disputed change orders and identifying early warning signs of problem projects. ... positions. + Review of contract accounting revenue recognition, contract provisions and claims revenue recognition. + Must be considered an expert in accounting for… more
- CVS Health (Monroeville, PA)
- …area, has an opportunity available for a full time Pharmacy Claims Biller/Adjustment Specialist. As a Biller/Adjustment Specialist, you will ensure timely ... and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare...method required by the payer. + Transmit or submit claims (paper/electronic) to insurance payors for reimbursement. + Resolve… more
- Aston Carter (Naperville, IL)
- …+ A minimum of a year of office experience in data entry, dispatchers, claims , or provider relations. (Open to entry level Bachelor's Degree candidates as well). + ... This position is responsible for the review, investigation, and evaluation of claims to determine eligibility and negotiate resolutions in compliance with all… more
- Robert Half Accountemps (Indianapolis, IN)
- …8am - 4:30pm EST Key Responsibilities: + Examine denied and unpaid medical claims to determine and document reasons for discrepancies. + Communicate directly with ... payers to follow up on outstanding claims , submit technical and clinical appeals, resolve payment variances,...compliance, provider relations, or medical billing. + Experience with claims review/analysis and working knowledge of the revenue cycle.… more
- US Bank (St. Paul, MN)
- …discover what you excel at-all from Day One. **Job Description** The Fraud Check Claims Case Processor plays a critical role in protecting customers and the bank by ... onboarding and managing check fraud claims with precision and care. This position delivers a...collaboration, and service. **Position Highlights** + Onboards incoming fraud claims from FDI or customer‑submitted paperwork and enters cases… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and reimbursement policies are implemented and integrated in all systems for accurate claims adjudication. This includes analysis of changes to medical code sets to ... * Serve as a liaison to other divisions/departments (Health Management, Service, Claims ) for coding policy and coding/payment issues. * Directs and coordinates… more