- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Claims Analyst is responsible for claims processing , research and adjudication to correctly apply benefit determination and pricing for ... claims (CMS 1500 and UB04), in accordance with claims processing guidelines. **ESSENTIAL FUNCTIONS OF THE...benefits package includes the following - Immediate eligibility for health and welfare benefits - 401(k) savings plan with… more
- Axis (Short Hills, NJ)
- …to resolve complex or contentious claims . Leading initiatives to enhance claims processing efficiency and accuracy within the team. Providing expert opinions ... selection process. About the Team AXIS is hiring a Claims Specialist, Health Care Claims ,...and directing the development of training materials relevant to claims processing . Show a commitment to continuous… more
- LA Care Health Plan (Los Angeles, CA)
- …of the PPGs, capitated hospitals, and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates. Provides timely and ... minimal supervision during the audits of PPGs, hospitals and health plans. Conducts sub-delegation claims oversight audits...Experience Required: At least 4 years of experience performing claims audits or claims processing … more
- Molina Healthcare (Tacoma, WA)
- …or legal requests. * Assists with reducing rework by identifying and remediating claims processing issues. * Locates and interprets claims -related regulatory ... claims using standard principles and applicable state-specific regulations to identify claims processing errors. * Applies claims processing … more
- Stanford Health Care (Palo Alto, CA)
- … & Litigation Strategy, the Claims Manager oversees the workers' compensation claims program for Stanford Health Care, Stanford Health Care Tri-Valley, ... and Stanford Children's Health . The Claims Manager acts as the primary liaison with the...to support loss prevention. + Ensure timely and accurate processing of all claim invoices. **Education Qualifications** + Bachelor's… more
- Baylor Scott & White Health (Dallas, TX)
- …Manager the Claims Adjuster is responsible for the review, analysis and processing of assigned claims within their authority limits and consistent with ... of quality service while protecting the assets of the organization. The Claims Adjuster's primary duty includes the exercise of discretion and independent judgment… more
- Dignity Health (Bakersfield, CA)
- …of complex healthcare claims . This position requires expert knowledge of claims processing , coding, and regulatory compliance. The Claims Examiner ... **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing , with at least 2 years...Coder (CPC) **Where You'll Work** The purpose of Dignity Health Management Services Organization (Dignity Health MSO)… more
- Cedars-Sinai (CA)
- …in applicable tracking databases. **Qualifications** Experience: Three (3) years of medical claims processing for Medicare and Commercial products and provider ... claims required. Three (3) years of experience on an automated claims processing system (Epic Tapestry preferred) preferred. **About Us** Cedars-Sinai is… more
- TEKsystems (Brookfield, WI)
- …established time frame is reached without resolution. Monitors computerized system for claims processing errors and make corrections and/or adjustments as ... to external contract. Performs other duties and responsibilities as assigned. Skills claims processing , claims adjudication, call center, medicaid, Coding… more
- Elevance Health (Roanoke, VA)
- **Title: Claims Representative I ( Health & Dental) - FEP** **Roanoke, VA** **Location:** This role enables associates to work virtually full-time, with the ... 2/9/2026** **Hours:** **8 AM - 4:30 PM EST, Monday - Friday.** The ** Claims Representative I** will be responsible for successfully completing the required basic… more