• Senior Claims Specialist

    Axis (Alpharetta, GA)
    …upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist ** AXIS is seeking a Senior Claims Specialist ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...plus. **What will you do in this role?** + Auditing of Third-Party Administrators to ensure reserve adequacy. +… more
    Axis (06/25/25)
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  • Specialist 3rd Party Rx Ops Pharmacy Tech…

    Walgreens (Deerfield, IL)
    **Job Description:** **Job Summary :** Responsible for the update, maintenance, auditing , and operation of third party prescription plans including Commercial, ... and Audits, Prescriber and prescriptive authority tickets, proper processing of prescription claims including order of claims processing for government payers.… more
    Walgreens (06/17/25)
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  • Specialist -Denial II RN

    Baptist Memorial (Memphis, TN)
    …activities related to denied claims such as obtaining authorizations, claims review, patient billing, appeal writing, auditing , and/or denial management; ... Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA...collaborate with coding/billing for formulation of appeal with corrected claims and denial resolution in order to defend our… more
    Baptist Memorial (07/11/25)
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  • Coding Audit Response Specialist

    Novant Health (NC)
    …Full time with benefits What You'll Do: + The Coding Audit Response Specialist position responds to external and internal audits for INPATIENT services that include ... for all applicable Novant Health facilities. + The Coding Audit Response Specialist will support the Corporate Coding Audit Response Lead/Coding Supervisor by… more
    Novant Health (07/20/25)
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  • Investigation Specialist II

    MyFlorida (Gainesville, FL)
    INVESTIGATION SPECIALIST II - 79001410 Date: Jul 29, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 857645 Agency: Business and Professional Regulations Working Title: INVESTIGATION SPECIALIST II - 79001410 Pay Plan: Career Service Position Number: 79001410… more
    MyFlorida (07/29/25)
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  • Investigation Specialist II - 1

    MyFlorida (Orlando, FL)
    …action, equal employment opportunity, regulatory work as a paraprofessional or higher, claims adjusting, auditing , financial examining, land appraisal work, land ... INVESTIGATION SPECIALIST II - 64085664 1 Date: Aug 1,...Estimator Tool (https://compcalculator.myflorida.com/) Department of Health Division of Medical Quality Assurance Bureau of Enforcement Investigative Services Unit -… more
    MyFlorida (08/02/25)
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  • English/Bilingual Enrollment Support…

    UNUM (Annapolis, MD)
    …services. + Maintain Individual and Team performance metrics + Complete thorough Quality Assurance via review of metrics, auditing of calls, coaching/performance ... (UNUM Group's) portfolios to provide benefits education, retention of policies, quality assurance, technical support and assist with other project initiatives. **Job… more
    UNUM (08/01/25)
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  • Inpatient Clinical & Coding Specialist…

    Independent Health (Buffalo, NY)
    …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on ... proficiency demonstrated by long-standing, consistent results, advanced coding knowledge and auditing skills evidenced by their ability to train others, to identify… more
    Independent Health (07/15/25)
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  • Ops Investigation Specialist II - 1

    MyFlorida (Tampa, FL)
    …action, equal employment opportunity, regulatory work as a paraprofessional or higher, claims adjusting, auditing , financial examining, land appraisal work, land ... OPS INVESTIGATION SPECIALIST II - 64801130 1 Date: Jul 31,...Estimator Tool (https://compcalculator.myflorida.com/) Department of Health Division of Medical Quality Assurance Bureau of Enforcement Investigative Services Unit -… more
    MyFlorida (08/02/25)
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  • Appeals Specialist II, (Remote)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Appeals Specialist II will be responsible for the initial analysis of appeals/grievance correspondence, and determination ... FUNCTIONS:** + Independently researches contractual benefits, limitations & exclusions and claims to assist medical professional staff in performing the review of… more
    CareFirst (07/30/25)
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