• Claim Specialist II - 1st Party No Fault…

    City of New York (New York, NY)
    …position include, but are not limited to the following: 1) Set up No-fault claim files which includes issuing and processing NF2 application, confirming the ... to gather information relevant to the investigation of the claim ; 13) Investigate, identify, and report fraudulent claims... claim ; 13) Investigate, identify, and report fraudulent claims , utilize statistical data to identify claims more
    City of New York (06/15/25)
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  • Claims Processing Specialist

    Kelsey-Seybold Clinic (Pearland, TX)
    …Services Supervisor, the Claim Edit Follow-Up Representative is responsible for processing the electronic claims edits, "front end "edits, as well as ... claims edits from secondary claims . In the event a claim edit...standards and performance measures for this position **Job Title: Claims Processing Specialist** **Location: Pearland Administrative Office**… more
    Kelsey-Seybold Clinic (05/02/25)
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  • Claims Processing Rep, Full-time

    Central Maine Medical Center (Lewiston, ME)
    …for our community and for each other every day. Central Maine Healthcare is seeking a Claims Processing Rep to join our Team. This is a full time 40-hour, ... The rate of pay is $20.00 per hour. The Claims Processing Billing Representative's responsibility is to...Maintains WIP counts at or below goal. 7. Identifies claim problems to include all denials, claim more
    Central Maine Medical Center (05/08/25)
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  • Patient Support Medical/Biller Claims

    IQVIA (Trenton, NJ)
    **Patient Support Medical Claims Processing ​ Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team....+ High School Diploma or equivalent + Experience in claim processing required + Medical Billing Certification… more
    IQVIA (05/02/25)
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  • Commercial Claims Processing

    MVP Health Care (Schenectady, NY)
    Commercial Claims Processing Associate, Claims ...and ensures the accuracy of all provider, member and claim line information for all claims for ... improvement. To achieve this, we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity...Reviews and ensures the accuracy of all changes to claim line information based on information received from other… more
    MVP Health Care (06/21/25)
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  • Claim Appeals And Audit Specialist

    CenterLight Health System (NY)
    …Validate Diagnosis-Related Group (DRG) grouping and (re)pricing outcomes presented by the claims processing vendor to ensure accuracy. + Coordinate with Finance ... JOB PURPOSE: The Claim Appeals and Audit Specialist will play a...in MS Excel, Word, PowerPoint, and experience using a claims processing system or comparable database software.… more
    CenterLight Health System (06/26/25)
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  • Claim Operations Specialist

    Travelers Insurance Company (Brookfield, WI)
    … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site...mail. Orders, receives and distributes supplies and/or equipment. + CLAIM PAYMENTS AND EXPENSE PROCESSING : Ensures the… more
    Travelers Insurance Company (06/19/25)
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  • Hiring Event | California, Workers Compensation…

    Sedgwick (Long Beach, CA)
    …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
    Sedgwick (06/25/25)
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  • Senior Claim Benefit Specialist

    CVS Health (Salem, OR)
    claim or reconsideration. **Required Qualifications** - 18+ months of medical claim processing experience. - Experience in a production environment. - ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
    CVS Health (06/25/25)
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  • Payments Claim Specialist

    City National Bank (Newark, DE)
    *PAYMENTS CLAIM SPECIALIST* WHAT IS THE OPPORTUNITY? The Payment Claims Specialist is responsible for the investigation and processing of payment fraud ... of actions as needed. * Perform quality checks of claims for accuracy and feedback for the claim intake team. * Performs additional duties as assigned. WHAT… more
    City National Bank (06/11/25)
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