• General Product and Liability Complex Claim…

    Sedgwick (Columbia, SC)
    …expertise preferred. **Skills & Knowledge** + Subject matter expertise in worker's compensation claims and/or liability claims processing + Ability to obtain ... and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the… more
    Sedgwick (08/29/25)
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  • Claims Adjustor

    Robert Half Accountemps (Des Moines, IA)
    …Moines, Iowa. In this role, you will handle medical-only workers' compensation claims , ensuring accuracy and prompt processing . This position requires excellent ... Description We are looking for a dedicated Claims Adjustor to join our team on a...actions. * Provide regular updates and reports on claim processing activities. Requirements * At least 1 year of… more
    Robert Half Accountemps (10/13/25)
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  • Auto Claims Representative

    Sedgwick (Shreveport, LA)
    …total loss evaluations, and related expenses to effectively negotiate first and third party claims . + Knowledge of total loss processing , State salvage forms and ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Auto Claims Representative **PRIMARY PURPOSE** : To analyze and process low to mid-level… more
    Sedgwick (10/10/25)
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  • Adjuster I

    UPMC (Pittsburgh, PA)
    …precision and efficiency, contributing to the overall accuracy and integrity of our claims processing operations. This position will work a hybrid structure, ... the Health Plan. + High school diploma or equivalent. + Two years claims processing experience required. + Ability to use a QWERTY keyboard. + Knowledge of… more
    UPMC (09/25/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Augusta, GA)
    …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
    Molina Healthcare (10/18/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (Chicago, IL)
    …offers the opportunity to play a key role in ensuring accurate billing and claims processing within the healthcare sector. The ideal candidate will bring ... * Utilize specialized billing platforms and tools, including Epaces, for claims processing . * Monitor and manage medical collections to ensure timely resolution… more
    Robert Half Accountemps (10/14/25)
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  • Claim Benefit Specialist

    CVS Health (Franklin, TN)
    …providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims . + Determines if claims processing activities comply with ... codes and other necessary data elements to ensure accurate tracking, reporting, and processing of claims in all appropriate applications. + Conducts reviews and… more
    CVS Health (10/02/25)
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  • Medical Claims Specialist - Remote

    Rising Medical Solutions (Tampa, FL)
    The Claims Specialist will assist in reviewing, processing , and coordinating claims accurately in accordance with the program requirements while ensuring ... + Maintain ongoing knowledge of program requirements + Analyze and process claims for accuracy, eligibility, and benefits coverage + Retain and strengthen… more
    Rising Medical Solutions (09/27/25)
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  • IT AVP - Data Science

    Philadelphia Insurance Companies (Bala Cynwyd, PA)
    …and automation into core business functions, such as underwriting, pricing, and claims processing , while staying ahead of industry trends, regulatory changes, ... fraud detection, and customer segmentation strategies + Claims Analysis: Analyze claims data to identify patterns, improve processing efficiency, and detect… more
    Philadelphia Insurance Companies (10/05/25)
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  • Senior Quality Analyst

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …Quality Analyst, who will oversee contract and benefit configuration to ensure accurate claims processing and network compliance. This is a remote role. Primary ... benefit setup discrepancies. + Collaborate with IT and operations to resolve claims configuration gaps. + Perform routine and complex audits of claim transactions… more
    Brighton Health Plan Solutions, LLC (10/04/25)
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