• Senior Appeals Examiner

    CVS Health (Phoenix, AZ)
    …from multiple business units. Ensure timely, customer focused response to complaints/ appeals . Identify trends and emerging issues and report and recommend solutions. ... of plan documents, claims research, letter writing. + 1 plus years working with appeals , claims, or compliance. (and/ or) + 1 plus years experience working with… more
    CVS Health (10/15/25)
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  • DOLA Plans Examiner (Inspector II)

    State of Colorado (CO)
    …then "re-review" construction documents as necessary. Recommendations will be made to the BCS Senior Plans Examiner . Job Duties The job duties of this position ... DOLA Plans Examiner (Inspector II) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5034978) Apply  DOLA Plans Examiner (Inspector II)… more
    State of Colorado (10/08/25)
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  • Xcelys Sr. Claims Examiner - Remote US

    NTT DATA North America (Ontario, CA)
    ** Senior Claims Examiner (Xcelys System)** **NTT DATA Services currently seeks a Senior Claims Examiner to join our team working 100% Remote and work on ... mandatory 2-4 week training on camera.** **Job Description** To serve as a senior -level adjudicator and SME for medical claims within the Xcelys environment. Provide… more
    NTT DATA North America (09/27/25)
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  • Fraud Investigator

    Blue KC (Kansas City, MO)
    …to peers and clinical standards, etc. In conjunction with the Manager and/or Senior Investigator, evaluate FWA risks and prioritize for further review, based upon ... accordance with SIU policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations. + Create and maintain detailed… more
    Blue KC (10/16/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    …as well as transparency in reporting results, trends and issues to Senior Management and clients. * Management of relationships with Preferred Provider Organizations ... sent to re-pricing entities, unable to be systematically "matched", auto-adjudicated, in Examiner queues waiting to be adjudicated, and in either audit or needing… more
    CHS (08/08/25)
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  • Manager Network Audit Government Oversight…

    CVS Health (Phoenix, AZ)
    …communications and process flow standards. + Prepare preliminary responses to examiner inquiries, criticisms, or findings. + Creating demonstratives and scenarios to ... all levels of management with timely escalation of any high-risk issues to senior management. + Proven ability to work independently and in collaboration with solid… more
    CVS Health (09/26/25)
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  • Assistant Engineer - Civil Level I/II *Revised

    Sacramento County (Sacramento, CA)
    …classes in Sacramento County service: an Assistant Engineer - Civil (Level I), Senior Engineering Technician or higher. A Master's Degree in Civil Engineering may be ... continuously employed by the County as an inspector, plans examiner or building official, for not less than two...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
    Sacramento County (09/04/25)
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