• Medical Specialist Principal - Life Company…

    USAA (Tampa, FL)
    …Ability to conduct complex healthcare fraud investigation reviews. + Knowledge of health insurance claims operations, particularly Medicare Supplement ... + Interprets relevant medical literature for application to appropriate health insurance underwriting policies and guidelines. +...advanced medical expertise by serving as primary resource for Health Claims for the approach to medical… more
    USAA (05/22/25)
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  • Senior Stop Loss Claims Analyst/HNAS

    Highmark Health (Frankfort, KY)
    …+ Bachelor's degree **EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience ... processing 1st dollar health insurance claims + 3 years of experience with medical terminology **Preferred:** + 3 years of experience in a Stop Loss … more
    Highmark Health (04/26/25)
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  • Claims Compliance Lead

    UCLA Health (Los Angeles, CA)
    …play a critical role in in ensuring the timely, accurate, and compliant processing of health insurance claims . The ideal candidate will be responsible for ... monitoring claims workflows, coordinating with internal departments, and maintaining compliance...experience in an HMO environment (ie, MSO, IPA, or health plan) - Required + Comprehensive knowledge of industry-standard… more
    UCLA Health (05/21/25)
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  • Team Lead - Claims Processing

    CVS Health (Franklin, TN)
    …or staffing shortages. **Required Qualifications** * 3+ years of experience in health insurance claims processing, preferably with Medicare Supplement ... At CVS Health , we're building a world of health...**Position Summary** The Team Lead for the Medicare Supplement Claims Processing team is responsible for overseeing day-to-day operations… more
    CVS Health (05/01/25)
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  • Medical Claims Examiner

    CHS (Clearwater, FL)
    **Overview** ** Health Insurance Medical Claims Examiner** **(Initial Training On Site - 90 days - Remote position after training in FL)** **Must live within ... **Summary:** The Medical Claims Examiner adjudicates medical claims based on health policy provisions and... Examiner adjudicates medical claims based on health policy provisions and established guidelines. **Essential Duties and… more
    CHS (05/07/25)
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  • Medical Claims Adjuster

    University of Utah Health (Salt Lake City, UT)
    …**Qualifications** **Required** + Three years of experience collecting, organizing and maintaining health insurance and processing medical claims . + ... **Overview** _As a patient-focused organization, University of Utah Health exists to enhance the health ...if adjustment is necessary. + Adjusts and documents medical claims or electronic records. + Researches and verifies appropriate… more
    University of Utah Health (05/08/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    **Overview** ** Claims Manager** **Servicing** ** Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... Actual results will be compared to goals in each period. ** Claims Manager** ** Health Insurance Policies or Benefits** **Qualifications** **Qualifications and… more
    CHS (05/09/25)
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  • Investigator Senior

    Elevance Health (Houston, TX)
    … experience required with understanding of health insurance policies, health insurance claims handling and provider network contracting. **How will ... Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity,... claims . Health insurance more
    Elevance Health (05/20/25)
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  • Appeals Hearing Specialist

    Intermountain Health (West Valley City, UT)
    …Intermountain Healthcare. + Understands ERISA, self-funded and federal and state laws around health insurance claims . + Develops and maintains collaborative ... + Computer Literacy + Medical terminology + Problem Solving + Health Insurance + Collaboration + Detail-oriented **Physical Requirements:** **Qualifications**… more
    Intermountain Health (05/13/25)
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  • Medical Billing & Coding Specialist

    Arab Community Center for Economic and Social Serv (Dearborn, MI)
    …close supervision, the Medical Billing and Coding Specialist is responsible for processing health insurance claims for services provided at all clinics. ... codes + Enter the correct codes into patients- electronic health records + Review claims to make...with other staff members to ensure accuracy + Enter insurance claims into specialized billing programs +… more
    Arab Community Center for Economic and Social Serv (03/14/25)
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