- Huron Consulting Group (Chicago, IL)
- …within Optum CES. + Collaborate with cross-functional teams to enhance claims adjudication workflows. + Troubleshoot and resolve **system configuration ... in Facets Configuration/implementation to support one of our clients in optimizing claims editing and adjudication processes. The ideal candidate will have… more
- Elevance Health (Tampa, FL)
- … systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. + Perform pre- adjudication claims reviews ... position is not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies,… more
- Access Dubuque (Dubuque, IA)
- …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… more
- Sedgwick (Dubuque, IA)
- …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… more
- State of Massachusetts (Boston, MA)
- …counseling, educational counseling, credit collection, credit interviewing, credit investigation, claims adjudication , claims settlement, claims ... notes in accordance with internal procedures. * Review employment history and adjudication issues on the claimant's prior claim * Review wages/earnings and issues… 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, ... domains and underlying data sources. + Familiarity with pharmacy workflow and claims adjudication . + Experience as a project lead with cross-functional teams to… more
- NTT DATA North America (Lincoln, NE)
- …role reviewing medical benefits and claims . + 2 years of claims adjudication experience, preferably in life, and supplemental products (eg, critical ... our team in Lincoln, Nebraska (US-NE), United States (US). **Position: Medical Claims Case Manager:** **Must live in the Continental United States** **Pay:**… more
- TEKsystems (West Des Moines, IA)
- …identified claims issues, repetitive errors, and payer trends to expedite claims adjudication Work accounts in assigned queues in accordance with ... would be huge for this role! Will be bulk claims and denial work - no patient calling. -...delays, resulting from no response, denied, rejected and/or pending claims with the objective of appropriately maximizing reimbursements and… more
- USAA (St. Louis, MO)
- …of repair plan and timeline for repair in support of fast and accurate claims adjudication . + Responsible for reviewing additional damages received from repair ... responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate… more
- UnityPoint Health (Ankeny, IA)
- …of identified claims issues, repetitive errors, and payer trends to expedite claims adjudication + Work accounts in assigned queues in accordance with ... of payment delays, resulting from no response, denied, rejected and/or pending claims with the objective of appropriately maximizing reimbursements and ensuring that… more