6,012 Results for

Claims Processor Jobs in Annapolis, MD

Jobs

Manager, Payment Integrity Auditing Premera Blue Cross

Washington

You will monitor audit performance, oversee internal and vendor audit activities, identify payment and billing trends, and leverage data-driven insights to improve payment accuracy, reduce inappropriate healthcare expenditures, and strengthen the organization's overall payment integrity strategy. This role is responsible for developing and executing audit strategies across multiple audit types, including DRG validation, itemized bill reviews, level of care reviews, hospital readmission audits, and other post-payment and pre-payment audit initiatives.

27 days ago

Customer Service Rep II Premera Blue Cross

Washington

To help us continue to provide the best support for our customers, Premera is hiring additional Customer Service Representatives based out of Eastern Washington, Idaho, Oregon, Montana, Utah, Minnesota, Wisconsin, Tennessee, North Carolina, South Carolina, Georgia, Florida, Texas, and Arizona areas. CSR II serves both Premera members and providers which includes doctors, facilities (clinics, hospitals, skilled nursing facilities, etc.), and vendors for multiple geographic locations.

6 days ago

Emergency Medical Tech 1 (EMT) Inova Health System

Alexandria, VA

Emergency Medical Technician Job Responsibilities: Demonstrates correct stabilization and immobilization of spine and proper fitting of splints for extremities; Demonstrates ability to assess neurovascular status after splint application and reports deviations to Registered Nurse and physician. Collects patient specimens following department/facility policies and procedures; Assists mid-level providers and physicians with collecting, labeling and transporting irretrievable specimens.

30+ days ago

Administrative Action Specialist Medicare Peraton Inc

$51,000–$82,000 / year

Review and verify evidence supporting administrative action as it relates to payment suspensions, revocations, overpayments as well as other administrative actions that can be pursued (payment suspension, revocation, prepayment edits, auto-denial edits). SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

3 days ago

Administrative Action Specialist Team Lead Peraton Inc

$66,000–$106,000 / year

As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual's experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations.

15 days ago

Deputy Assistant Secretary & Chief Program Officer (PROGRAM MANAGER SENIOR IV) State of Maryland

Baltimore City, MD

The Deputy will lead implementation of key strategic plan priorities for UI operations, including improving the timeliness and quality of benefit payments, reducing backlogs, strengthening call center performance and customer service, and improving the accuracy and effectiveness of employer tax accounting and administration. Program Modernization & Continuous Improvement: Serves as principal changeÂ leader for modernizing UI operations, adopting innovative strategies, and partnering withÂ technology, data, and quality units to drive service delivery improvements.Â.

12 days ago

Appeals and Grievances Clinical Specialist Healthfirst

$83,100–$120,360 / year

Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case.

30 days ago

Executive Program Manager CGI Inc

Washington, DC

However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with CGI's legal duty to furnish information. Position Description: The Executive Program Manager leads the full U.S. Department of Veterans Affairs (VA) Medical Disability Examination (MDE) enterprise, providing strategic oversight, disciplined governance, and proactive risk management for a nationally distributed, high volume federal program.

16 days ago

MedTech Coding Specialist, Patient Access Program (PAP) Operations IQVIA

Washington, District of Columbia

The Coverage and Coding Access Specialist is a dynamic, public-facing role that is focused on supporting a variety of patient access and reimbursement functions, with an emphasis on researching and responding to a diverse range of coding and coverage inquiries from clients, healthcare providers, and patients seeking access to innovative diagnostic and therapeutic interventions. IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries.

19 days ago

Insurance Authorization Supervisor Revive Bhs Llc

Severna Park, MD

Full time

The ideal candidate will have extensive experience with behavioral health insurance authorizations, including substance use disorder and mental health levels of care, and a strong understanding of commercial insurance, Medicaid, managed care organizations (MCOs), and utilization management processes. Ensure authorizations are obtained and maintained for applicable behavioral health services, including residential treatment, partial hospitalization (PHP), intensive outpatient (IOP), and outpatient services.

2 days ago

Pharmacy Pre-Grad Intern - WM 3035 Walmart Inc

WASHINGTON, DC

$23.50–$36.50 / hour

Provides Pharmacy products and services to Customers in accordance with local state and federal laws and Company policies and procedures by assisting with processing prescription andor overthecounter OTC orders and purchases stocking and securing Pharmacy supplies and merchandise entering prescription information andor filling prescriptions completing maintaining and securing paperwork forms and required documentation. Respect the Individual: Embraces differences in people cultures ideas and experiences creates a workplace where associates feel seen supported and connected through a culture of belonging creates opportunities for all associates to thrive and perform helps to attract the best talent.

30+ days ago

Pharmacy Pre-Grad Intern - WM 5129 Walmart Inc

Landover Hills, MD

$20.50–$33.50 / hour

30+ days ago

Pharmacy Pre-Grad Intern - WM 5968 Walmart Inc

WASHINGTON, DC

$24–$37 / hour

30+ days ago

Paralegal Specialist U.S. Department of Justice

Washington, DC

$63,046–$81,964 / year

If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C, Non-career SES or Presidential Appointee employee in the Executive Branch, you must disclose this information to the Human Resources Office by providing a copy of your applicable SF-50, along with a statement that provides the following information regarding your most recent political appointment: Position title; Type of appointment (Schedule A, Schedule C, Non-career SES, or Presidential Appointee); Agency; and. GS-09: In order to qualify for the GS-9 level of this position, you must meet ONE of the following qualification requirements: SPECIALIZED EXPERIENCE: Possess at least one full year of specialized experience equivalent to the GS-7 level in Federal service performing paralegal or legal work which demonstrates a basic knowledge of legal research and ability to interpret legal decisions.

30+ days ago

Field Adjuster - Property (Virginia and Maryland) Davies Group Ltd

Maryland, MD

This role is ideal for a field professional who can investigate losses, inspect sites, document findings, evaluate damages and exposures, and communicate effectively with insureds, claimants, carriers, clients, vendors, and internal stakeholders. You will be responsible for handling residential and commercial property losses, including inspections, scope review, damage assessment, estimate support, and related file documentation.

30+ days ago

Practice Coordinator (Bilingual Spanish) Advanced Behavioral Health, Inc.

Baltimore, MD

Full time

Advanced Behavioral Health, Inc. is looking for a Bilingual Practice Coordinator, who is responsible for all administrative (non-clinical) aspects of the patient encounter from greeting to accurate data entry for each patient. Manage and process medication refill requests for patients enrolled by following company protocols; complete medication prior authorizations as required by Maryland Medicaid through necessary paperwork and/or by calling the insurance company.

1 day ago

Client Relationship Officer - Commercial Admin Total Bank WesBanco Inc

Bowie, MD

$60,000–$70,000 / year

WesBanco has an excellent benefits package to include medical, dental, and vision, Health Care Flexible Spending, Dependent Care Flexible Spending, Transportation Fringe Benefit Plan, Group Life, Long Term Disability, Optional Life, access to voluntary benefit products such as Cancer, Term & Universal Life, Accident, Short-Term Disability and Critical Illness policies, and other ancillary benefit products. Assists the Commercial Banker in supporting the commercial loan closing process including communicating with Commercial Closing Officer, and coordinating activities of outside service providers including attorneys, accountants, insurance providers and government agencies.

30+ days ago

Customer Service Representative - State Farm Agent Team Member Stephanie Jameson - State Farm Agent

Baltimore, MD

Full time

As a Customer Service Representative - State Farm Agent Team Member with Stephanie Jameson - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.

30+ days ago

Electrical Contracting Company - Service Manager Generator Supercenter

Annapolis, Maryland

$45,000–$65,000 / year

We’re looking for amazing people who believe in helping others, through the sales, installation, and maintenance of whole home generators that empower our customers with peace of mind, security, and freedom. We're looking for an experienced Service Manager to oversee our growing service department and ensure top-quality performance, customer satisfaction, and operational efficiency.

30+ days ago

Account Representative - State Farm Agent Team Member Stephanie Jameson - State Farm Agent

Baltimore, MD

Full time

As a Account Representative - State Farm Agent Team Member with Stephanie Jameson - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. Employees of State Farm agents must be able to successfully complete any applicable licensing requirements and training programs.

11 days ago

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Claims Processor Jobs in Annapolis, MD

Manager, Payment Integrity Auditing Premera Blue Cross

Customer Service Rep II Premera Blue Cross

Emergency Medical Tech 1 (EMT) Inova Health System

Administrative Action Specialist Medicare Peraton Inc

Administrative Action Specialist Team Lead Peraton Inc

Deputy Assistant Secretary & Chief Program Officer (PROGRAM MANAGER SENIOR IV) State of Maryland

Appeals and Grievances Clinical Specialist Healthfirst

Executive Program Manager CGI Inc

MedTech Coding Specialist, Patient Access Program (PAP) Operations IQVIA

Insurance Authorization Supervisor Revive Bhs Llc

Pharmacy Pre-Grad Intern - WM 3035 Walmart Inc

Pharmacy Pre-Grad Intern - WM 5129 Walmart Inc

Pharmacy Pre-Grad Intern - WM 5968 Walmart Inc

Paralegal Specialist U.S. Department of Justice

Field Adjuster - Property (Virginia and Maryland) Davies Group Ltd

Practice Coordinator (Bilingual Spanish) Advanced Behavioral Health, Inc.

Client Relationship Officer - Commercial Admin Total Bank WesBanco Inc

Customer Service Representative - State Farm Agent Team Member Stephanie Jameson - State Farm Agent

Electrical Contracting Company - Service Manager Generator Supercenter

Account Representative - State Farm Agent Team Member Stephanie Jameson - State Farm Agent

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