- CRC Insurance Services, Inc. (FL)
- …of America) **Please review the following job description:** A Complex Claims Manager - Construction Defect and Environmental is responsible for investigating, ... evaluating, and resolving insurance claims related to environmental damage, as well as ...precedents, and environmental regulations. + Calculate and assign appropriate claim reserves based on the potential damages and liability… more
- Elevance Health (Louisville, KY)
- ** Medical Claims Data Integrity Consultant** **Location:** Atlanta, GA; Norfolk, VA; Indianapolis, IN; Chicago, IL; Louisville, KY (preferred). This role ... position is not eligible for current or future visa sponsorship._ The ** Medical Claims Data Integrity Consultant** (Business Information Developer Consultant… more
- Prime Healthcare (Ontario, CA)
- …requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the development and execution of Claim ... technology and data to improve the quality and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit… more
- CHS (Clearwater, FL)
- **Overview** **Health Insurance Medical Claims Examiner** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical ... Claims Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and Responsibilities:** + Reviews… more
- Sedgwick (Lexington, KY)
- …FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims , including bodily injury and ensures claim files are properly ... and commercial line auto policies, coverage's, principles, and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge… more
- NTT DATA North America (MO)
- …methodology/ fee schedule/ **Required Skills for this role include:** + 2+ year(s) of Medical Claims experience + 2+ year(s) using a computer with Windows ... **Job Title** : Medial Claims Processor **Industry** : Healthcare **FSLA status** :...be responsible for:** + Processing of Professional and Hospital claim forms files by provider + Reviewing the policies… more
- FlexStaff (Chappaqua, NY)
- …Number** 168166 Claims Management Specialist Are you a seasoned medical insurance professional with a passion for leadership and operational excellence? ... - Monitor daily workflows to ensure timely and accurate claim submission, follow-up, and resolution. - Serve as a...Qualifications: - Minimum of 3-5 years of experience in medical insurance billing and claims management, with… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims ,… more
- Pacific Medical Centers (Seattle, WA)
- …creating equal opportunities for advancement. **Requsition ID:** 378470 **Company:** Pacific Medical Jobs **Job Category:** Claims **Job Function:** Health Plans ... **Description** Adjudicates claims submitted by outside purchased services for PMC's...needs. Responds to Customer Service Requests and resolves problem claim situations. Providence caregivers are not simply valued -… more
- NTT DATA North America (Plano, TX)
- NTT DATA is currently seeking 20 Remote Claims Examiners to join our team. (Amisys or Xcelys experience is a plus) Must be able to work Monday to Friday 7 AM to 4 PM ... be responsible for: + Processing of Professional and Hospital claim forms files by provider + Reviewing the policies...Work independently to research, review and act on the claims + Prioritize work and adjudicate claims … more