- TEKsystems (Honolulu, HI)
- Description Manage provider onboarding, credentialing, and enrollment processes Maintain accurate provider data in systems and databases Ensure compliance with ... regulatory, payer, and organizational requirements Support contract administration and provider agreements Act as a liaison between providers and internal… more
- Elevance Health (Overland Park, KS)
- …day-to-day claims /encounters operations, develops workflows for efficiency, and ensures provider and member issues are resolved in alignment with state and ... /encounters process, including receipt, adjudication, payment, and performance reporting on claims timeliness, accuracy, backlog and provider payment compliance.… more
- Point32Health (MA)
- …accurate processing of Member Reimbursements + Act as role model and mentor to core claims processors. + Participate in initiatives or provide back up support to ... dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members , Point32Health builds on the legacy of Harvard Pilgrim Health Care… more
- USAA (San Antonio, TX)
- …as a Claims Manager/Supervisor + Experience applying advanced knowledge to provide guidance for complex claim settlements that mitigate risk of litigation. + ... for more effective lawsuit avoidance. + Demonstrated experience proving guidance to team members on escaladed complex claims issues. + US military experience… more
- USAA (Colorado Springs, CO)
- …under supervision to investigate, evaluate, negotiate, and adjust low complexity auto insurance claims presented by or against our members . This will include the ... expectations with external and internal business partners to facilitate claims resolution. + Support members , business partners,...Diploma or equivalent experience or GED + Ability to provide exceptional customer service for our members … more
- USAA (Colorado Springs, CO)
- **Why USAA?** At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted ... - define how we treat each other and our members . Be part of what truly makes us special...us special and impactful. **The Opportunity** As a dedicated ** Claims Litigation Manager Senior** (Western States), you will responsible… more
- USAA (Tampa, FL)
- …dedicated Sr Auto Claims Adjuster, you will adjust highly complex auto insurance claims presented by or against our members to include the end-to-end ... and sets expectations with external and internal business partners to facilitate claims resolution. + Supports members , business partners, and claimants, through… more
- USAA (Tampa, FL)
- …Within defined guidelines and framework, responsible to adjust moderately complex auto insurance claims presented by or against our members to include the ... and sets expectations with external and internal business partners to facilitate claims resolution. + Supports members , business partners, and claimants, through… more
- Brighton Health Plan Solutions, LLC (NC)
- …of claim examiners and claim team leaders, including remote employees + Provide full-time technical support to Claims , internal departments, vendors, and ... or leadership role. + Advanced knowledge of Excel. + Strong knowledge of contracts, medical terminology, and claims processing and procedures. + 5+ years of… more
- CHS (Clearwater, FL)
- … claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost ... Department in delivering exceptional service to insurance companies, employers, and members . In this pivotal role, you'll oversee claims adjudication, drive… more
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