• Manager, MIG Claims - Michigan - McLaren…

    McLaren Health Care (Flint, MI)
    …https://www.mdwise.org/ . **Position Summary:** Provides overall management in providing superior claims operations for McLaren Integrated HMO Group's health ... Recruitment, performance management, training). + Four (4) years' experience in health plan claims , billing or claims adjudication operations for multiple… more
    McLaren Health Care (07/29/25)
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  • Claims Quality Auditor

    UCLA Health (Los Angeles, CA)
    …Take your career to the next level. You can do all this and more at UCLA Health . The Claims Quality Auditor will be responsible for the daily audit of all ... + Knowledge of claims adjudication systems + Flexibility and adaptability UCLA Health is a world-renowned health system with four award-winning hospitals and… more
    UCLA Health (05/08/25)
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  • Leader, Claims Support

    MVP Health Care (Schenectady, NY)
    …but equivalent experience may be substituted. + Requires at least 3 years of health insurance claims experience. 1 year of supervisory experience or 2 years' ... At MVP Health Care, we're on a mission to create...improvement. To achieve this, we're looking for a Leader, Claims Support to join #TeamMVP. If you have a… more
    MVP Health Care (07/28/25)
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  • Claims Representative

    CDPHP (Albany, NY)
    …incumbent will work closely with all departments such as Member Services, Claims Operations, Provider Relations, Health Care Network Strategy, Configuration and ... diploma or GED required. + Minimum of one (1) year experience in health care claims review and adjudication to payment/denial utilizing CPT-4, ICD 10 and HCPCS… more
    CDPHP (07/23/25)
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  • Complex Claims Adjuster

    AIG (Croydon, PA)
    …using the key fraudindicators. What you'll need to succeed * Previous Accident & Health or Personal Accident claims experience * Policy language skills enabling ... Join us as a Claims Adjuster to grow your experience in handling...spent at work to offer benefits focused on your health , wellbeing and financial security-as well as your professional… more
    AIG (07/16/25)
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  • Medical Claims Examiner

    CHS (Clearwater, FL)
    **Overview** ** Health Insurance Medical Claims Examiner** **(Initial Training On Site - 90 days - Remote position after training in FL)** **Must live within a ... **Summary:** The Medical Claims Examiner adjudicates medical claims based on health policy provisions and... Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and… more
    CHS (05/07/25)
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  • Team Leader, Claims

    UPMC (Pittsburgh, PA)
    …+ Bachelor's degree or equivalent experience. + Minimum of five years of health insurance, medical claims processing, claim adjustment; coordination of benefits, ... **Purpose:** Provide technical and plan support to claims examiners and adjustment/COB staff. Assist with development...with development and training of team members. Process VIP claims and adjustments. Resolve customer concerns as needed. Assume… more
    UPMC (07/02/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... (ERM). Actual results will be compared to goals in each period. ** Claims Manager** ** Health Insurance Policies or Benefits** **Qualifications** **Qualifications… more
    CHS (05/09/25)
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  • Medical Claims Representative

    Robert Half Office Team (Columbus, OH)
    …of healthcare billing, reimbursement policies, and denial reasons. + Familiarity with electronic health records (EHR) and claims systems. + Knowledge of HIPAA ... seeking experienced HIM Associates with a strong background in working denied claims and commercial payer follow-up. This fully remote, contract-based opportunity is… more
    Robert Half Office Team (07/22/25)
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  • Risk Management Analyst (Non Clinical) - St Peters…

    Trinity Health (Albany, NY)
    …and identify potential risks and mitigation associated with that risk. **LIABILITY CLAIMS SUPPORT:** Works collaboratively with assigned Trinity Health Area ... identify witnesses, schedule interviews, depositions and other discovery). In litigated claims , assists Trinity Health Insurance and Risk Management Services… more
    Trinity Health (06/18/25)
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