- CVS Health (Woonsocket, RI)
- …insights and actions **Required Qualifications** + 2+ years of experience with pharmacy claims adjudication and NCPDP standards + 3+ years of analytical ... reporting and key performance metrics for reconciliation, revenue cycle, and adjudication / claims processes analysis. Facilitate effective solutions related to … more
- Mass Markets (Killeen, TX)
- …1-3 years of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a ... partner in the industry. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong critical thinking… more
- Polaris Pharmacy Services of Minnesota, LLC (Livermore, CA)
- …Livermore, CA Position Type Full Time Job Category Pharmaceutical Description THIRD PARTY ADJUDICATION CLAIMS SPECIALIST WHO WE ARE Polaris Pharmacy Services is ... opportunity for career advancement to all our team members. OVERVIEW The Third-Party Adjudication Claims Specialist is responsible for managing and identifying a… more
- AON (Garden City, NY)
- Aon is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your ... with strong technological skills. Experience: + Minimum of 2 years claims adjudication experience. + General Adjustor license for home state, or ability… more
- CHS (Clearwater, FL)
- …insurance companies, employers, and members. In this pivotal role, you'll oversee claims adjudication , drive operational strategy, and ensure high accuracy and ... clients. * Management of relationships with essential vendors involved with the Claims Adjudication process, including clearinghouses, claims cost control… more
- Cognizant (Lansing, MI)
- …procedures. Provide support to claims and client for issues related to claims adjudication and adjustments, Service Now and Inquiry resolution, and any basic ... - 4:30pm ET **Experience:** A minimum of 1 years claims processing is required. **Travel:** None required **About the...Processor, you will be responsible for timely and accurate adjudication of professional and hospital claims utilizing… more
- AssistRx (Orlando, FL)
- …pharma services, or HUB services environment. + Strong understanding of claims adjudication processes, reimbursement models, and affordability solutions. + ... and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay utilization, establish escrow account minimum balances… more
- Cognizant (Denver, CO)
- …and procedures. Provide support to claims and client issues related to claims adjudication and adjustments. Service Now and Inquiry resolution, and any basic ... to work with minimal supervision. + Excellent problem-solving skill in healthcare claims adjudication . + Ability to work at a computer for extended periods. +… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …claims processing and procedures. + 1+ year computer medical billing or claims adjudication systems experience. + Excellent written and oral communication, ... notice. Primary Responsibilities + Research and document pertinent information on claims requiring adjudication . Apply medical policy, contractual provisions,… more
- Sedgwick (San Diego, CA)
- …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
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