- Avera (Brookings, SD)
- …for account review and follow up of unpaid, overpaid/over adjusted and denied claims . + Reviews, analyzes, and appeals denials received relative to claims ... payers. + Communicates with internal and external customers involved in the claims resolution process to ensure timely claims processing.) Identifies the… more
- Humana (Lansing, MI)
- …Program network providers in self-service functions - such as eligibility confirmation, claims submission and payment - by use of available tools. + Schedule, ... of provider inquiries, concerns, or problems, including those associated with claims payment, prior authorizations, referrals and state or Commissioner of Insurance… more
- TEKsystems (Milwaukee, WI)
- …strong understanding of the full revenue cycle and be comfortable navigating complex claims processes using multiple data sources. **CANDIDATES MUST RESIDE IN WI OR ... Stop Bills, and "DNBs" to ensure timely claim submission. + Accurately transmit claims daily and ensure all required documentation is included. + Verify eligibility… more
- Prime Therapeutics (Boise, ID)
- …Title** Claim Technical Analyst - JUDI Ops Team - Remote **Job Description** The Claims Technical Analyst is responsible for serving as the claims analysis ... and pharmacy remediation analysis caused by errors coded into the JUDI claims processing system. This position also researches and tests system capabilities.… more
- USAA (Phoenix, AZ)
- …trials, and mediations. + Provide legal advice to clients and P&C Claims team members. Develops, and implements legal strategy and ongoing budget projections ... to Claims Litigation, and clients, as appropriate on assigned cases....color, religion, sex, sexual orientation, gender identity, national origin, disability , or status as a protected veteran._ **If you… more
- Wounded Warrior Project (Colorado Springs, CO)
- …and assists the WWP National Service Officers in the development of warriors' claims . DUTIES & RESPONSIBILITIES + Educate and assist warriors and family support ... in the development of well-established Department of Defense/Veteran's Administration (DoD/VA) claims for benefits and all potential benefits. + Develop high-quality… more
- AIG (Atlanta, GA)
- …Adjuster is to investigate, evaluate and resolve first and third-party auto liability claims , minor injury claims and low complexity general liability losses. ... claim handling guidelines. + Communicates effectively with internal and external customers on claims and account issues. + Maintain and manage a diary system to… more
- NBC Universal (New York, NY)
- …matters, including general commercial disputes, media litigation (including defamation claims and journalist privilege issues), employment litigation, privacy ... claims , consumer protection claims , intellectual property claims (both affirmative and defensive), insured matters, internal investigations, regulatory… more
- Cognizant (Blaine, MN)
- …role in designing, developing and implementing OnBase solutions to enhance our healthcare claims processing systems. With a focus on Medicare and Medicaid claims ... Lead the design and development of OnBase solutions to optimize healthcare claims processing. - Collaborate with cross-functional teams to gather and analyze… more
- Elevance Health (AL)
- …Specialist II** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to ... state regulations. + Analyze comprehensive data sources such as COB Smart, HEW, claims , and membership data to verify coverage and resolve discrepancies. + Maintain… more