- NTT DATA North America (Oklahoma City, OK)
- …reviewing medical benefits and claims . + 2 years of claims adjudication experience, preferably in life, and supplemental products (eg, critical illnesses ... via email, mail, and phone. + **Proactive Follow-Up:** Follow up on pending claims and assist in gathering required medical records. + **Benefit Calculation:**… more
- TEKsystems (West Des Moines, IA)
- …identified claims issues, repetitive errors, and payer trends to expedite claims adjudication Work accounts in assigned queues in accordance with ... Work directly with third party payers and internal/external customers toward effective claims resolution Skills epic, medical billing, follow up Top Skills… more
- Sedgwick (Miami, FL)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... Adjuster Join a team where your expertise drives impact-our remote GL Adjuster role puts you at the center...claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and… more
- USAA (San Antonio, TX)
- …adjusting experience. + Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of ... multi-tasking, and problem-solving skills. + Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims . + Ability to… more
- USAA (Phoenix, AZ)
- … claims , + Proficient knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of ... multi-tasking, and problem-solving skills. + Proficient knowledge of human anatomy and medical terminology associated with bodily injury claims . + Ability to… more
- University of Rochester (Rochester, NY)
- …independent decisions as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing issues. Maintain ... at all times. **Location** + Rochester Tech Park (RTP), Gates, NY - Remote options available after in-person training. + Occasional onsite meetings / work at… more
- Humana (Springfield, IL)
- …and quality related topics. + Educate on processes including claims submissions, recoupments, reconsiderations, authorizations, referrals, medical record ... limits. **Preferred Qualifications** + Bachelor's Degree. + Understanding of claims systems, adjudication , submission processes, coding, and/or dispute… more
- Healthfirst (NY)
- …investigation, determination and reporting of financial processes** **_specifically around Healthcare Claims Adjudication and Claims Processing_** + ... **This position is 100% Remote .** **Scope of Responsibilities:** + **Conduct moderately complex...the quality of the network.** + **Review and investigate claims and encounters for medical , facility, pharmacy,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …policies are implemented and integrated in all systems for accurate claims adjudication . This includes analysis of changes to medical code sets to determine ... 3 years of relevant health plan or provider office medical coding/ claims and/or Business Analyst experience in...rest of the week you are empowered to work remote . Equal Employment Opportunity Statement Individuals with a disability… more
- Humana (Oklahoma City, OK)
- …providers (eg, provider relations, claims education) + Understanding of claims systems, adjudication , submission processes, coding, and/or dispute resolution ... issues with appropriate enterprise business teams, including those associated with claims payment, prior authorizations, and referrals, as well as appropriate… more