- University of Rochester (Rochester, NY)
- …methodology, including add-ons - - Follow up with payers on incorrectly paid claims through final resolution and adjudication , including refund of credits - ... independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues that affect… more
- TEKsystems (Los Angeles, CA)
- …91325 What You'll Do Are you a detail-driven professional with a passion for healthcare claims and compliance? Join our team as a Claims Compliance Auditor , ... a pivotal role in ensuring accuracy, efficiency, and regulatory alignment across our claims operations. In this role, you'll: + Lead audits and compliance reviews… more
- Texas Veterans Commission (Fort Worth, TX)
- …case law, existing statutes and procedures, precedent rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting ... assisting veterans and eligible persons with the Department of Veterans Affairs claims process. Work involves collaboration with external partners to include the… more
- Sedgwick (Honolulu, HI)
- … claims to determine benefits eligibility and ensure ongoing adjudication aligns with company standards and industry best practices. **ESSENTIAL RESPONSIBLITIES ... Fortune Best Workplaces in Financial Services & Insurance Workers Compensation | Claims Associate | In-office, (Honolulu, Hawaii) Are you looking for an impactful… more
- Doosan Bobcat (Buford, GA)
- …a worldwide leader. + Location: Buford-Main Office Job Information Responsible for adjudication of Company product warranty claims in North America, including ... Warranty Claims Analyst Last Updated Date: Sep 10, 2025...and warranty reporting as assigned. Role & Responsibility Warranty Claims Management + Review dealer-submitted warranty claims … more
- Elevance Health (St. Louis, MO)
- …The ** Claims Auditor I** is responsible for pre and post payment and adjudication audits of high dollar claims for limited lines of business, claim types ... ** Claims Auditor I** **Location :** This role enables...and products including specialized claims with appropriate guidance from management and peers. **How… more
- American Express (Phoenix, AZ)
- …department of AAC, and primary responsibilities will include enrolling, servicing, and adjudication of insurance policies and claims ; this role provides an ... exciting opportunity to handle claims for the Retail and Warranty products in the...to:** + Investigation by using tools available to settle claims quickly and efficiently + Maintaining state compliance +… more
- Prime Therapeutics (Santa Fe, NM)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Claims Specialist Sr **Job Description** The Claims Specialist is responsible for ... related to specific process or support systems (eg claim adjudication system) Escalate issues when appropriate + Partner with...accredited institution or equivalent GED + 1 year of claims experience + Must be eligible to work in… more
- Robert Half Office Team (Lombard, IL)
- Description We are looking for a skilled Workers Compensation Claims Specialist to manage and enhance the operational aspects of our Workers' Compensation Program. ... Workers' Compensation Program, ensuring efficient and quality management of claims . * Collaborate with external partners, including Third-Party Administrators, to… more
- AssistRx (Louisville, KY)
- DUTIES AND RESPONSIBILITIES: + Processes medical copay claims in accordance with program business rules. + Liaison with other program-specific AssistRx resources to ... daily reconciliation of batch postings, including automated/manual claim inputs. + Analyze claims for accuracy based on insurance coverage, cost of goods, allowable… more