- 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
- Akumin (Murfreesboro, TN)
- The ** Medical Reimburse Specialist ** is responsible for...the web to find out the status of the claim using the aging's, ticklers and touch point reports ... and other forms received through the lockbox to the Medical Billing system. Completes spreadsheets and balances work on...a daily basis and resolves credit balances on the Medical Billing system via refund, takeback request or adjustment.… more
- Vail Resorts (Broomfield, CO)
- …or until the position is filled (whichever is first). **Job Summary:** The Guest Claim Specialist 's primary responsibilities will be to assist the Litigation and ... Claims team and to investigate and manage guest ...are eligible for the above, plus: + Health Insurance; Medical Insurance, Dental Insurance, and Vision Insurance plans (for… more
- Axis (Short Hills, NJ)
- …About the Team AXIS is hiring a Claims Specialist , Health Care Claims , for its North America Claim Team. This role involves managing primary and excess ... healthcare liability claims for AXIS US policies. How does this role...for a comprehensive and competitive benefits package which includes medical plans for you and your family, health and… more
- CVS Health (Monroeville, PA)
- …the Monroeville area, has an opportunity available for a full time Pharmacy Claims Biller/Adjustment Specialist . As a Biller/Adjustment Specialist , you will ... ensure timely and accurate billing for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance… more
- MetLife (Cary, NC)
- …meeting all key performance indicators * Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and ... active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. These calls are… more
- MetLife (Warwick, RI)
- …by team member(s) within authority limit including Financial accuracy of coding Claims System including accurate claim Benefit Amount/Salary and appropriately ... claimant expectations and obtaining information necessary to administer the claim . . Basic knowledge of medical conditions,...Skills, Preferred: * Prior STD, state leave and/or Family Medical Leave Act claims knowledge preferred. *… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed ... improve overall claims accuracy and efficiency. The Claims Quality Specialist will work closely with...providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a… more
- Guardian Life (Pittsfield, MA)
- …for you to grow and enrich your career and future as a Disability Claims Specialist . We believe in your aspirations for purpose, leadership, and achievement ... competencies you will need to be a successful Disability Claims Specialist . In your first year, we...**In the role, you will** + Analyze policy language, medical , financial, and other claim documentation. +… more
- Philadelphia Insurance Companies (Plano, TX)
- …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle ... more complex first and third party commercial insurance auto claims . JOB RESPONSIBILITIES + Evaluates each claim in light of facts; Affirm or deny coverage;… more