• Claims Examiner

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …contracts, Medical Policies and Payment procedures as well as capable of manually processing claims according to all outlined Policies and Procedures. This job ... About The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced...Essential Qualifications + Knowledge of contracts, medical terminology, and claims processing and procedures. + 1+ year… more
    Brighton Health Plan Solutions, LLC (06/12/25)
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  • Senior Accident & Health Claims

    Kemper (Chesterfield, MO)
    …us in Growing for LIFE. **POSITION SUMMARY** : Kemper is seeking a Senior Accident & Health Claims Adjuster to support our organization's Health Claims ... team. As a Senior Accident & Health Claims Adjuster, you will support our customers by processing claims with adherence to company policies and contract… more
    Kemper (06/28/25)
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  • Claims Adjudicator - State Program…

    State of Minnesota (St. Paul, MN)
    …will be considered for this position.** One (1) year* of experience processing claims and/or appeals. *Associate's degree in Business Administration, Public ... due to a qualifying condition, such as a severe health condition that prevents them from working, or when...adapt to changes in policies, procedures, or legislation impacting claims processing . **Preferred Qualifications** + Knowledge of… more
    State of Minnesota (07/14/25)
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  • Claims Processor I (Remote)

    CareFirst (Baltimore, MD)
    … claim documents. **Preferred Qualifications** + Less than one year claims processing , billing, or medical terminology experience. **Knowledge, Skills ... resident within the DMV **ESSENTIAL FUNCTIONS:** + Examines and resolves non-adjudicated claims to identify key elements of processing requirements based on… more
    CareFirst (07/30/25)
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  • Audit and Quality Control Claims Specialist

    Wittenberg Weiner Consulting LLC (Santa Fe, NM)
    …contract to support disaster relief. This position involves receiving, evaluating, and processing claims for compensatory damages for injuries resulting from the ... Canyon Claims Office ( Claims Office), by receiving, evaluating, and processing claims for compensatory damages for injuries from the Hermit's Peak/Calf… more
    Wittenberg Weiner Consulting LLC (06/17/25)
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  • Claims Research Consultant

    CVS Health (St. Paul, MN)
    …resolutions for complex customer service issues. **What you will do:** + Process claims by leveraging provider contracts and processing guidelines. + Respond to ... efficient, and customer-focused. **Required Qualifications** + 2-4 years of experience in health insurance and claims . + Ability to work Monday-Friday 8am-5pm… more
    CVS Health (08/01/25)
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  • Claims Representative

    CDPHP (Albany, NY)
    …preferred. Strong PC skills and Microsoft Windows and working knowledge with on-line claims processing and procedural review highly preferred. + Experience with ... work closely with all departments such as Member Services, Claims Operations, Provider Relations, Health Care Network...to determine, analyze and solve problems related to benefits, claims appeals, claims pricing/ processing by… more
    CDPHP (07/23/25)
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  • Claims Reviewer - Senior (Team Lead)

    Wittenberg Weiner Consulting LLC (Santa Fe, NM)
    …contract to support disaster relief. This position involves receiving, evaluating, and processing claims for compensatory damages for injuries resulting from the ... Canyon Claims Office ( Claims Office), by receiving, evaluating, and processing claims for compensatory damages for injuries from the Hermit's Peak/Calf… more
    Wittenberg Weiner Consulting LLC (06/17/25)
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  • Warranty Claims Investigator

    Amrize (Nashville, TN)
    …budget goals. + Provides guidance to Junior Warranty Claims Investigator regarding claims analysis and processing . **WHAT WE ARE LOOKING FOR** + 6+ years ... Warranty Claims Investigator Requisition ID: 13348 Location: Nashville, TN,...a repair contractor, ordering/shipping materials, reviewing work completed and processing contractor invoices. This Investigator position is for our… more
    Amrize (06/13/25)
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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 (05/28/25)
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