- 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
- Sedgwick (Pittsburgh, PA)
- …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 (Plano, TX)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a ** Medical Claims Processor** to join our team in **Plano, TX for a remote ... through NTT DATA only. **Role Responsibilities** -Processing of Professional claim forms files by provider -Reviewing the policies and...-Work independently to research, review and act on the claims -Prioritize work and adjudicate claims as… 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
- NTT DATA North America (Plano, TX)
- …part of an overall sourcing strategy. NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client and their team. **Note** : This ... NTT DATA only. **Role Responsibilities** + Processing of Professional claim forms files by provider + Reviewing the policies...Work independently to research, review and act on the claims + Prioritize work and adjudicate claims … more
- Harbor Group Management (Dallas, TX)
- …and subrogation/recovery processes for multifamily real estate properties. * Maintain claim reporting mechanisms for first- and third-party claims across ... service and providing exquisite living experience for our residents. Job Title: Claim Administrator Location: Onsite, Dallas, Texas JOB PURPOSE: The position works… 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
- Sedgwick (Cincinnati, OH)
- … action/processing with claimant, client and appropriate medical contact. + Ensures claim files are properly documented and claims coding is correct. + May ... process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims . + Maintains professional… more
- MVP Health Care (Schenectady, NY)
- …looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical claims and attention to detail this is the opportunity for you. **What's in ... + Knowledge of CPT, HCPCS, ICD-9-CM coding systems and Medical terminology preferred. + Strong PC skills required, Microsoft...and ensures the accuracy of all provider, member and claim line information for all claims for… more
- Sedgwick (Richmond, VA)
- … action/processing with claimant, client and appropriate medical contact. + Ensures claim files are properly documented, and claims coding is correct. + May ... process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims . + Maintains professional… more