- USAA (Chesapeake, VA)
- …adjusting experience. + Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of ... **Injury Examiner** , you will be responsible to adjust complex bodily injury claims , UM/UIM, and small business claims to include confirming coverage,… more
- Sedgwick (Meridian, ID)
- …behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and ... best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
- USAA (San Antonio, TX)
- …adjusting experience. + Proficient knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of ... and framework, responsible to adjust attorney-involved, moderately complex bodily injury claims , and UM claims to include confirming coverage, determining… more
- Sedgwick (Irving, TX)
- …level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and ... to identify subrogation of claims and negotiate settlements with general supervision. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE:** + *Processes low level general… more
- University of Rochester (Rochester, NY)
- … claims ; determines final resolution. + Contacts payers on incorrectly paid claims completing resolution and adjudication . + Adjusts accounts or processes ... open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits … more
- Port of Seattle (Seattle, WA)
- …will provide daily management, program oversight, and confidentiality to the processing and adjudication of claims and legal documents associated with claims ... Insurance Commission, and internal auditing personnel. + You will ensure the claims record management system interfaces with multiple internal and external systems… more
- Henry Ford Health System (Troy, MI)
- …This includes but is not limited to: Coordinating timely and accurate claims submission for adjudication Coordinating and developing timely denial follow ... and identifying solutions to prevent denials. Oversee follow up to ensure all claims are resolved or responded to by the payers. Monitoring and adjusting workflow… more
- CVS Health (Lansing, MI)
- …and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- AdventHealth (Maitland, FL)
- …methodologies + Applies significant understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, CPT, HCPCS II, DRG ... + 3 years Healthcare, Managed Care, Hospital or Ancillary claims analysis, Hospital or Ancillary claims payment, or related field with bachelors degree + 5… more
- Molina Healthcare (Salt Lake City, UT)
- …Partners to ensure resolution within 30 days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more