- Sedgwick (Grand Rapids, MI)
- …behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and ... Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Workers Compensation (REMOTE- Midwest State Jurisdiction Exp needed) Are… more
- Sedgwick (Oklahoma City, OK)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... Work Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | General Liability BI | Captive |...General Liability BI | Captive | Remote As a Claims Examiner at Sedgwick, you'll have the opportunity to… more
- Molina Healthcare (Yonkers, NY)
- …and claims processing errors. Essential Job Duties Audits the adjudication of claims using standard principles, and state-specific regulations to ... JOB DESCRIPTION Job Summary Provides support for claims audit activities including identification of incorrect coding, abuse and fraudulent billing practices, waste,… more
- Sedgwick (Long Beach, CA)
- …level auto liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to ... Place to Work Fortune Best Workplaces in Financial Services & Insurance Liability Claims Representative - Auto Exp. Required Are you looking for an opportunity to… more
- Sedgwick (Naperville, IL)
- …general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and ... Work Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Liability - Naperville, IL - Hybrid...Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver… more
- Sedgwick (Dublin, OH)
- …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
- CVS Health (Woonsocket, RI)
- …the operations organization providing key metrics to guide various projects impacted by claims adjudication . The ideal candidate will be an adept communicator, ... of new domains and underlying data sources. Familiarity with pharmacy workflow and claims adjudication . Experience as a project lead with cross-functional teams… more
- Huron Consulting Group (Chicago, IL)
- …custom fee schedules, and value-based reimbursement models. Strong knowledge of claims adjudication and provider contracting workflows. Ability to analyze ... test adjudication and reconciling variances. Partner with Provider Contracting, Claims , Finance, and IT teams to support new contract implementations and pricing… more
- CVS Health (Frankfort, KY)
- …1+ years' experience with pharmacy appeal related processes and state regulations, and claims adjudication , including claims adjudication logic Preferred ... updates are operationalized. This role requires a thorough knowledge of claim adjudication , internal MAC & non-MAC related processes, and being a leader working… more
- Prime Therapeutics (Hartford, CT)
- …(GCP), pharmacy and industry trend, drug approval process, formulary design, and/or claims adjudication to support projects and initiatives throughout the ... is responsible for the synthesis of data findings in support of clinical claims and programs. Responsibilities Synthesizes a wide variety of data and outputs into… more
