- Mass Markets (Killeen, TX)
- …expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume… more
- AssistRx (Phoenix, AZ)
- …claim reimbursement, Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication , troubleshoot claim ... The Copay Support/ Claims Processing Specialist is a critical...discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing and… more
- CVS Health (Boston, MA)
- …inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …career advancement to all our team members. JOB SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing ... Adjudication Specialist Job Details Job Location...and enhance our services. DUTIES/RESPONSIBILITIES: + Manage and Identify Claims Portfolio: + Review and evaluate insurance claims… more
- AdventHealth (Apopka, FL)
- …for all activities regarding Rx Plus Pharmacy's state licensed data entry, claims adjudication , prior authorization, pharmacy specialist , and technician ... of prescription order intake of various media, technician quality assurance, claims adjudication and copay assistance, prior authorization, and prescription… more
- Ascension Health (Austin, TX)
- …and accurately, in accordance with regulatory requirements. + Strong understanding of claims adjudication process, provider contracts, fee schedules and system ... Additional Preference: + Three (3) years of experience in health-care claims adjudication required. + Expertise in the Facets platform preferred. + Experience… more
- Commonwealth Care Alliance (Boston, MA)
- …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... 011250 CCA- Claims Hiring for One Year Term **_This position...the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr.… more
- Allied Solutions (Plano, TX)
- …Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the ... Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This… more
- Dignity Health (Bakersfield, CA)
- …advanced-level role responsible for the detailed and accurate processing, review, and adjudication of complex healthcare claims . This position requires expert ... knowledge of claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most challenging cases, mentor junior staff, and… more
- Zelis (St. Petersburg, FL)
- …and the personal interests that shape who you are. Position Overview The Client Policy Specialist is a client facing role that will act as the subject matter expert ... support of the growth, and expansion of assigned clients. The Client Policy Specialist will lead the sales overview discussion of new/existing opportunities for the… more