- AIG (Atlanta, GA)
- …moderate exposure claims involving litigation. The position also ensures ongoing adjudication of claims within the Company standards, industry best practices ... Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our… more
- USAA (San Antonio, TX)
- …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 (Miami, FL)
- …general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and ... role puts you at the center of resolving complex claims with flexibility and autonomy. **PRIMARY PURPOSE:** To analyze...to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** +… 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
- Dana-Farber Cancer Institute (Brookline, MA)
- …Bluebird Bio, and Gift of Life accounts to ensure accurate reimbursement and final adjudication of claims as needed. Works prebilling edits in the billing and ... scrubber systems to ensure timely submission of claims in accordance with department expectations. May also perform...the responsible parties in the billing system to ensure claims are addressed promptly. + Updates issues grid with… more
- OhioHealth (Columbus, OH)
- …medical billing to the appropriate party, works insurance edits/errors, follows-up on adjudication of claims , works payer rejections and denials. This position ... practices regarding information needed or to obtain status of insurance claims . **Responsibilities And Duties:** Performs accurate review, analysis, and correction… more
- Office of Justice Programs (Washington, DC)
- …professional knowledge of the statutes, orders, rules and regulations applicable to the adjudication of federal claims . Requires expertise in how to work in ... the public about the PSOB Program and the PSOB claims process. Provides information and guidance to the Office...be necessary, desirable, or relevant to such processing or adjudication , and in obtaining such evidence or information, including… more
- Elevance Health (Chicago, IL)
- …reimbursement criteria. **How you will make an impact:** + Ensures accurate adjudication of claims , by translating provider contracts, medical policies, ... system inquiries. + Conducts research of audit systems and system edits to identify claims audit rule inventory for accuracy. + Trains staff on system issues and… more
- AmeriHealth Caritas (Washington, DC)
- … submission and implementation of improved processes that result in increased auto- adjudication of claims . **Work Arrangement** This position is a hybrid ... position, working in the office 4 days / week. Office is located at 1201 Maine SW **Recruitment** + Responsible for compliance with State and accrediting agencies' network adequacy standards. + Ensures the provider network meets the health care needs of Plan… more
- BrightSpring Health Services (Valdosta, GA)
- …payor issues and report out. + Complete follow up process to ensure full adjudication of claims . + Identifies adjustments throughout the month for assigned ... billing, private insurance and/or federally funded programs, researching aging and claims . + Experience in reading and understanding remits for denial reasons… more