• Claims Adjudication

    Mass Markets (Killeen, TX)
    …expanding, industry-leading organization. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume… more
    Mass Markets (08/28/25)
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  • Pharmacy Processing Manager

    AdventHealth (Apopka, FL)
    …for all activities regarding Rx Plus Pharmacy's state licensed data entry, claims adjudication , prior authorization, pharmacy specialist , and technician ... of prescription order intake of various media, technician quality assurance, claims adjudication and copay assistance, prior authorization, and prescription… more
    AdventHealth (10/10/25)
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  • Claims Specialist II

    AON (NY)
    …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 ... and written communication. Skills that lead to success: + Claims adjudication experience. + Clear and professional... Specialist II Do you have experience in claims adjudication and enjoy resolving issues for… more
    AON (11/04/25)
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  • Lost Time Claims Specialist II

    UPMC (Pittsburgh, PA)
    UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The selected ... Virginia workers comp adjuster license. The UPMC WorkPartners Workers Compensation Lost Time Claims Specialist II reports to the Workers Compensation Claims more
    UPMC (10/28/25)
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  • Licensed Auto Claims Adjuster - Bodily…

    Sedgwick (Fort Worth, TX)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Licensed Auto Claims Adjuster - Bodily Injury Specialist (New York License Required) ... claims to determine scope of damages; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify… more
    Sedgwick (11/14/25)
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  • Claims Research Specialist

    Dignity Health (Bakersfield, CA)
    **Job Summary and Responsibilities** The Claims Research Specialist will oversee and manage research efforts related to claims overpayments, underpayments, ... and working collaboratively with providers and internal departments to enhance claims processes and improve financial outcomes. **Essential Functions:** - To… more
    Dignity Health (11/01/25)
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  • Medical Claims Specialist

    University of Washington (Seattle, WA)
    …Medicine Faculty Practice Plane Services has and outstanding opportunity for a ** Claims Specialist (Patient Account Representative 2).** This position is ... responsible for claims review, clearing claim edits, and timely and accurate...rejections, or forwarding the claim to a medical coding specialist for review and coding changes prior to submitting… more
    University of Washington (11/06/25)
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  • Medicare/Medicaid Claims Editing…

    Commonwealth Care Alliance (Boston, MA)
    …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... 011250 CCA- Claims Hiring for One Year Term **_This position...the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr.… more
    Commonwealth Care Alliance (08/26/25)
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  • Claims Representative

    CDPHP (Latham, NY)
    …Representative shall assume full responsibility and ownership for all aspects regarding claims adjudication and adjustments. In addition, the incumbent will ... diploma or GED required. + Minimum of one (1) year experience in health care claims review and adjudication to payment/denial utilizing CPT-4, ICD 10 and HCPCS… more
    CDPHP (11/20/25)
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  • Claims Investigator

    Allied Solutions (Plano, TX)
    …Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the ... Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This… more
    Allied Solutions (10/12/25)
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