• Claims Review Representative

    Humana (St. Paul, MN)
    …documentation and communications. + Exceptional attention to detail and accuracy in reviewing and processing claims . + Ability to quickly adapt to and learn new ... part of our caring community and help us put health first** The Claims Review Representative makes...systems and technologies relevant to claims processing . + Strong organizational skills with… more
    Humana (12/13/25)
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  • Claims Analyst/Processor

    TEKsystems (Milwaukee, WI)
    …Obtains additional information from appropriate person and/or agency as needed. Skills claims processing , claims adjudication, call center, medicaid, Coding ... High school diploma or equivalent preferred. + 2-4 years claims processing experience required + Knowledge of...plus + Prior experience with ACA, Medicaid, or similar health plans preferred not required + Coding experience preferred… more
    TEKsystems (12/05/25)
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  • Claims Auditor

    Molina Healthcare (Albany, NY)
    …of incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and claims processing errors. **Essential Job Duties** + Audits the ... leadership for improvements based on audit results. + Reviews timeliness of claims processing to ensure compliance with contractual and state/federal… more
    Molina Healthcare (12/04/25)
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  • Loss Control Claims Coordinator II

    Consolidated Electrical Distributors (Irving, TX)
    Summary Job title: Loss Control Claims Coordinator II Job ID: null Department: Loss Control Location: null-null Description Summary: Consolidated Electrical ... Inc. (CED), a large, nationwide wholesale electrical distribution company, is seeking a Claims Coordinator to join the Loss Control Department. The Claims more
    Consolidated Electrical Distributors (11/27/25)
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  • Manager, Claims Quality Review

    Centene Corporation (Indianapolis, IN)
    …related field, or equivalent experience. 4+ years of related Heath insurance or claims processing experience. Previous experience as a lead in a functional ... for our 28 million members. Centene is transforming the health of our communities, one person at a time....**Position Purpose** Manage the prospective review of high risk claims to ensure payment integrity and provide immediate feedback… more
    Centene Corporation (11/23/25)
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  • Claims Analyst

    WTW (Miami, FL)
    …such as supporting the effective management, analysis, and resolution of claims , ensuring accurate processing and timely communication between clients, ... team. + Ensure accurate and timely entry of claims data into the claims management system. **Analysis & Processing ** + Perform analytical reviews of … more
    WTW (11/20/25)
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  • Account Executive I

    Health Care Service Corporation (San Antonio, TX)
    …license within required time frame per state regulations. *4 years' experience in a health care management field, claims processing , customer service or ... including overnight stays. JOB REQUIREMENTS: *Must have state General Lines Agent Life, Health , and HMO license or obtain General Lines Agent Life, Health ,… more
    Health Care Service Corporation (11/20/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …Revenue Integrity, Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills & Abilities (must have):** ... (CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims ' processing policies, coding principals and payment methodologies +… more
    Commonwealth Care Alliance (11/25/25)
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  • Claims Examiner - Liability | Litigation,…

    Sedgwick (Columbia, SC)
    …distance to office** **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Fortune Best Workplaces in Financial Services & Insurance Liability Claims Examiner | General Liability & Auto with BI... within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting… more
    Sedgwick (12/12/25)
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  • Liability Claims Representative |

    Sedgwick (Marlton, NJ)
    …NJ** **Hybrid schedule** **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Liability Claims Representative | Marlton, NJ **Are you looking for an opportunity to join… more
    Sedgwick (12/12/25)
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