- 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
- Polaris Pharmacy Services, LLC (Riverside, MO)
- …Fully Remote Position Type Full Time Job Category Pharmaceutical Description THIRD PARTY ADJUDICATION CLAIMS SPECIALIST WHO WE ARE Polaris Pharmacy Services ... for career advancement to all our team members. OVERVIEW The Third-Party Adjudication Claims Specialist is responsible for managing and identifying a… more
- AssistRx (Phoenix, AZ)
- …claim reimbursement, Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication , troubleshoot claim ... The Copay Support/ Claims Processing Specialist is a critical...discrepancies (missing info and duplicates) + Partners with claim adjudication vendors ensure proper claims processing and… more
- CVS Health (AL)
- …inquiries and problems. **Key Responsibilities** + Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing ... Claim Benefit Specialist reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. They will act as a… more
- CVS Health (Des Moines, IA)
- …inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …career advancement to all our team members. JOB SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing ... Adjudication Specialist Job Details Job Location...and enhance our services. DUTIES/RESPONSIBILITIES: + Manage and Identify Claims Portfolio: + Review and evaluate insurance claims… more
- Providence (Mission Hills, CA)
- **Description** The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, per ... diem, case rate etc.) and adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance issues as they… more
- Sedgwick (Honolulu, HI)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist , General Liability (Property) **PRIMARY PURPOSE** : To analyze ... exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and… more
- Ascension Health (Austin, TX)
- …and accurately, in accordance with regulatory requirements. + Strong understanding of claims adjudication process, provider contracts, fee schedules and system ... Additional Preference: + Three (3) years of experience in health-care claims adjudication required. + Expertise in the Facets platform preferred. + Experience… more
- 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
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