• Senior Analyst, Claims Research

    Molina Healthcare (Kenosha, WI)
    …solutions. + Interprets regulatory and contractual requirements to ensure compliance in claims adjudication and remediation processes. + Develops, tracks, and / ... and project management. + Advanced knowledge of medical billing codes and claims adjudication processes. + Strong analytical, organizational, and problem-solving… more
    Molina Healthcare (12/05/25)
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  • Claims Team Lead - Workers Compensation…

    Sedgwick (Portland, OR)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (12/05/25)
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  • Claims Team Lead - Liability

    Sedgwick (Charlotte, NC)
    …monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex ... and documentation standards. . Provides technical and jurisdictional guidance on claims adjudication , including quality reviews and reserve evaluations for… more
    Sedgwick (12/03/25)
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  • Claims Team Lead - General Liability…

    Sedgwick (Hartford, CT)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (12/02/25)
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  • Claims Team Lead - Liability (Must Reside…

    Sedgwick (Atlanta, GA)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (11/27/25)
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  • Claims Team Lead - Workers Compensation…

    Sedgwick (Riverside, CA)
    …monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex ... and documentation standards. + Provides technical and jurisdictional guidance on claims adjudication , including quality reviews and reserve evaluations for… more
    Sedgwick (11/22/25)
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  • Assistant Claims Team Lead - Workers…

    Sedgwick (Springfield, IL)
    …monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex ... and documentation standards. + Providing technical and jurisdictional guidance on claims adjudication , including quality reviews and reserve evaluations for… more
    Sedgwick (11/21/25)
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  • Claims Team Lead | Auto Liability Bodily…

    Sedgwick (Indianapolis, IN)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (11/20/25)
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  • Claims Representative

    CDPHP (Latham, NY)
    …Representative shall assume full responsibility and ownership for all aspects regarding claims adjudication and adjustments. In addition, the incumbent will ... + Minimum of one (1) year experience in health care claims review and adjudication to payment/denial utilizing CPT-4, ICD 10 and HCPCS coding preferred.… more
    CDPHP (11/20/25)
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  • Liability Claims Team Lead - Commercial…

    Sedgwick (Rancho Cordova, CA)
    …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
    Sedgwick (11/08/25)
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