• 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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  • Copay Support/ Claims Processing…

    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
    AssistRx (09/13/25)
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  • Senior Claim Benefit Specialist

    CVS Health (WV)
    …and problems. **Additional Responsibilities:** + Reviews pre-specified claims , or claims that exceed specialist adjudication authority or processing ... Benefit Specialist ** reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. This person acts as a… more
    CVS Health (10/05/25)
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  • Senior Claim Benefit Specialist

    CVS Health (MN)
    …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
    CVS Health (09/27/25)
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  • Adjudication Specialist

    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
    Polaris Pharmacy Services, LLC (09/10/25)
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  • Senior Claims Specialist

    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
    Providence (09/12/25)
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  • Claims Specialist , General…

    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
    Sedgwick (09/18/25)
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  • Claims and Litigation Specialist

    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
    Ascension Health (08/29/25)
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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 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 (07/13/25)
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