- CRC Insurance Services, Inc. (TX)
- …fostering great working relationships with insureds, brokers and underwriters in the handling and adjudication of all claims . 8. Maintain claims and suspense ... America) **Please review the following job description:** Analyzes and processes claims by gathering information and drawing conclusions. Manages and evaluates… more
- VetsEZ (PA)
- …HL7, X12) and data governance in regulated environments; prior experience with claims adjudication , care coordination, or patient engagement systems is highly ... Intelligent Document Processing (IDP) pipelines to extract and validate data from claims , authorizations, and medical documentation. + Integrate LLMs and… more
- Providence (OR)
- …specialty societies, and assists with implementation of such changes to the claims adjudication and editing software. This position requires extensive knowledge ... we must empower them. **_Providence Health Plan welcomes 100% remote work for applicants who reside in the following...be considered. + 2 years of experience with Facets Claims Adjudication system and/or Optum CES editing… more
- American Family Insurance - Corporate (Madison, WI)
- …Senior Manager will provide leadership for staff whose primary tasks are the adjudication and settlement of claims involving the most technically challenging ... claims . You will possess extensive claims and litigation experience across all lines of our...activities such as team meetings, trainings and cultural events. \#LI- Remote We provide benefits that support your physical, emotional,… more
- UPMC (Pittsburgh, PA)
- …adjudication of the following: Workers' compensation lost time claims , Workers' compensation claim investigations (including subrogation) and compensability ... UPMC WorkPartners is hiring a full-time Workers Comp Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The… more
- Community Health Systems (Franklin, TN)
- …The Denial Coordinator is responsible for reviewing, tracking, and resolving denied claims , ensuring that appropriate appeals are submitted, and working closely with ... critical part in the denials management process, supporting efforts to improve claims resolution, reduce future denials, and ensure compliance with payer guidelines.… more
- Prime Therapeutics (Richmond, VA)
- …understanding of pharmaceutical claims data and general understanding of medical claims data; highly analytical + Experience with commercial software ... pharmacy with us. **Job Posting Title** Principal Solution Strategist - JUDI - Remote **Job Description** **We are currently on the lookout for a Principal Solution… more
- Access Dubuque (Dubuque, IA)
- …ID: 4647791008 Posted On 04/24/2025 Refreshed On 11/27/2025 **Job Overview** SISCO, our medical claims TPA, is looking for an experienced sales professional to ... **True Integration** - SISCO's "One Roof" service model includes expert claim adjudication for both self-funded medical and insured ancillary benefits. Optional… more
- NTT America, Inc. (Little Rock, AR)
- …will possess in-depth expertise in Medicaid systems, particularly in all facets of claims adjudication and demonstrate a strong ability to translate complex ... document business, technical, and user requirements related to Medicaid Claims Adjudication and other functional areas. *...for specific roles. The starting pay range for this remote role is $89,032- $145,000. This range reflects the… more
- Adecco US, Inc. (Mesa, AZ)
- …GED required. Associate degree or higher preferred. * Minimum 1-2 years with medical claims denials. * Minimum 1-2 years' experience performing healthcare ... ** and will be responsible for resolving denials on medical or behavioral claims . The Medical...and Modifier experience required. * Experience with behavioral health claims preferred. * Experience working in a remote… more