• Claims Examiner - Workers…

    Sedgwick (Shreveport, LA)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation (REMOTE - Needs SE state Exp FL, GA, ... AL) **PRIMARY PURPOSE** : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims more
    Sedgwick (05/07/25)
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  • Claims Examiner , Bodily Injury…

    Sedgwick (Baton Rouge, LA)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner , Bodily Injury (Auto) **PRIMARY PURPOSE** : To analyze and ... process complex auto and bodily injury claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
    Sedgwick (04/24/25)
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  • Claims Examiner

    Intermountain Health (Baton Rouge, LA)
    **Job Description:** The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims , in a timely and ... to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely… more
    Intermountain Health (05/08/25)
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  • Claims Team Lead - Liability (GL, Lit, BI…

    Sedgwick (Shreveport, LA)
    …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
    Sedgwick (04/26/25)
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  • Disability Determinations Examiner 1/2/3

    Louisiana Department of State Civil Service (Shreveport, LA)
    Disability Determinations Examiner 1/2/3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4777517) Apply  Disability Determinations Examiner ... Group, vacancies may be filled from this recruitment as a Disability Determinations Examiner 1,2,or 3 depending on the level of experience of the selected… more
    Louisiana Department of State Civil Service (04/07/25)
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  • Audit Manager

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …consists of Administrative Headquarters, Veterans Contact Assistance, Veterans Assistance Claims Division, State Approving Agency, Veterans Cemeteries, and Veterans ... funding agency auditing experience. Certified Public Accountant (CPA), Certified Fraud Examiner (CFE), Certified Internal Auditor (CIA) designation This position is… more
    Louisiana Department of State Civil Service (05/01/25)
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  • Estimate Review Specialist Sr. (Repair Solutions)

    Sedgwick (Shreveport, LA)
    …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... to advance to the next round, a recruiter will be in touch. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable range of compensation for… more
    Sedgwick (04/24/25)
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  • SIU Investigator

    Prime Therapeutics (Baton Rouge, LA)
    …and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively ... compliance with federal, state and local laws pertaining to investigations and fair claims handling practices; evaluate risk to determine how best to proceed with… more
    Prime Therapeutics (05/07/25)
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  • SIU Clinical Consultant

    Prime Therapeutics (Baton Rouge, LA)
    claims processing environment **Preferred Qualifications** + Certified Fraud Examiner or Accredited Health Care Fraud Investigator + National Pharmacy Technician ... and client initiatives; engage in cross functional analysis of medical and pharmacy claims ; lead FWA investigations for federal employee program + Stay current on… more
    Prime Therapeutics (05/07/25)
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  • Investigator

    Highmark Health (Baton Rouge, LA)
    …**Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) ... (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have… more
    Highmark Health (05/08/25)
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