4,378 Results for

Claims Processor Jobs in Clifton, MD

Jobs

Paralegal Amentum

Washington

In accordance with the Health and Welfare provisions of the SCA, and in addition to your base hourly rate, you may be eligible to receive an additional health and welfare payment for each hour you work to ensure compliance with the minimums set forth by the act. Ensure all incoming correspondence reviewed for completeness ensuring file documents match claimant and Personally Identifiable Information (PII) compliance prior to CMS upload.

30+ days ago

Documentation Specialist ECS Federal LLC

Washington, DC

Everforth ECS has an opportunity for a Documentation Specialist in support of the Marine Corps'' Manpower and Reserve Affairs (M&RA) Service Treatment Record program by ensuring accurate digitization of paper-based medical and dental records. This role will be responsible for the organization and preparation of paper medical records for transition to digital images in order to expedite the adjudication of USMC Veteran claims processing.

10 days ago

QA Engineer - DM platform (Remote) - Blue Bell, PA AHU Technologies

Washington, District of Columbia

Remote

They are responsible for utilizing internal data sources to perform in-depth research and analysis on client data inquiries, execute a varying level of implementation functions such as testing new file extracts, provide defect and enhancement support to development and product teams. Job Description: Looking for a mid level QA Testing Job Requirements - QA Engineers Overall qualifications : •Bamboo, and Github experience required •Cucumber-TestNG framework using JAVA, Selenium, RestAssured, Maven for UI and API Automation Testing experience preferred.

30+ days ago

Multisite Business Office Manager United Surgical Partners International Inc

Pikesville, MD

Reviews billing and collection patterns of scheduled patients by daily monitoring of front desk applications and informs office management of any patients that continue to present with outstanding balances. Plans, organizes and directs all aspects of the Business Office including review appointments, POS collections, scheduling, admissions, medical records, and claims processing.

30+ days ago

Call Center Representative Ascensus LLC

Washington, DC

Remote

Service center teams are accountable for servicing Flexible Spending Accounts (FSA), 529 Educational Savings accounts, Qualified Plan Retirement accounts and State Sponsored Retirement Program accounts. Ascensus is the leading independent technology and service platform powering savings plans across America, providing products and expertise that help nearly 16 million people save for a better today and tomorrow.

30+ days ago

Senior Business Analyst Syms Strategic Group, LLC (SSG)

Towson, MD

Remote

$78,167–$103,855 / year

Professional Certifications None required Years of Professional Experience 10 years of professional (an additional 10 years of experience may be substituted for education) Desired experience Experience working in an Agile environmentWorking knowledge of VA’s Veterans Independence Program (VIP)VA SQA Testing experienceCertified Scrum Master (CSM) or Professional Scrum Master (PSM)Experience working for a Federal Health Agency (VA, DHA, HHS, etc.)Healthcare billing and claims processing application knowledge Formal Education Master’s degree in Engineering or a related scientific or technical discipline Citizenship Requirement U.S. Citizenship required for this specific opportunity Security Clearance Requirements Must possess or qualify for a Public Trust (MBI) CRITICAL NOTES: SSG will not make assumptions regarding your qualifications. Experience: Experienced Security Clearance Level: Public Trust (MBI) Salary Range: $78,167 - $103,855 If you have previously applied to Syms Strategic Group (SSG), there is no need to reapply.

3 days ago

Temporary Call Center Representative Ascensus LLC

Washington, DC

Remote

6 days ago

Nurse US Department of Health and Human Services

Woodlawn, MD

$85,447–$133,142 / year

This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained; OR a Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools. College Transcripts and Foreign Education: Applicants who have completed part or all of their education outside the U.S. must have their foreign education evaluated by an accredited organization to ensure that it is comparable to the education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the National Association of Credential Evaluation Services website.

30+ days ago

Contract Clinical Services Support Technician Prescryptive Health Inc

$20–$40 / hour

As the Contract Clinical Services Support Technician at Prescryptive, you will maintain clinical drug lists and prior authorization documents, resolve drug list and benefit setup questions, and prepare reports and client business review materials. Strong follow-through and clear written and verbal communication to coordinate with pharmacists, Operations teams, and internal stakeholders and meet deadlines in a high-volume environment.

2 days ago

Bilingual Call Center Representative Ascensus LLC

Washington, DC

Remote

30+ days ago

Analyst, Account Manager CVS Health Corp

$43,888–$76,500 / year

Operating within a highly customized service environment supporting globally distributed populations, the Account Manager partners closely with client contacts, internal business partners, and external vendors to resolve complex issues, drive service improvements, and execute account strategies aligned with client objectives and organizational goals. This role serves as the primary point of contact for a defined group of client stakeholders within designated geographic regions, providing strategic account management, operational support, and consultative guidance to ensure a high level of service and client satisfaction.

17 days ago

Auto Adjuster Analyst - Allstate Dealer Service Allstate Insurance Company

$50,000–$75,050 / year

Automotives, Automotive Warranty, Claims Processing, Customer Service, Decision Making, Documentations, Empathy, Mechanical Repairs, Negotiation, Vehicle Repairs, Vehicle Servicing, Warranties, Warranty Analysis, Warranty Claims, Warranty Processing. The Auto Adjuster Analyst reviews repair estimates related to vehicle breakdowns, verifies coverage eligibility, and determines whether repairs are covered under the customer's Vehicle Service Contracts.

15 days ago

Director - State Insurance Program (EXECUTIVE VII) State of Maryland

The Directorâs role is to unequivocally support the vision and goals of the Chief Deputy Treasurer and Treasurer in carrying out the Divisionâs mission: to act as a steward for the State Insurance Trust Fund, to procure all of the Stateâs 55+ commercial insurance programs in order to protect the Trust Fund from catastrophic loss, to ensure compliance with State laws and regulations, to provide oversight on loss control and litigation, and to ensure proper oversight of the Divisionâs Claims Unit matters. The Divisionâs goal is to provide statewide risk management through loss protection (Underwriting), loss control (Loss Prevention), loss restoration (Claims & Tort Litigation), and contract administration and advocacy for State employee injury coverage (Workersâ Compensation).Â

30+ days ago

BILLING SPECIALIST Universal Home Health Care Llc

Cheverly, MD

Full time

This position will work closely with the administrative team to verify service documentation, identify billing discrepancies, track outstanding claims, and maintain accurate billing records. High school diploma or equivalent required; Associate’s or Bachelor’s degree in Accounting, Finance, Healthcare Administration, or a related field preferred.

30+ days ago

Operations Analyst Ibility

Washington DC

Ibility is seeking an experienced Operations Analyst to supports the delivery, monitoring, and continuous improvement of automated workflows within a large-scale automation platform that interacts with internal and external systems. This role partners with cross-functional teams to ensure automated processes operate efficiently, meet service level targets, and evolve as new automation capabilities are introduced.

10 days ago

Software Architect, Senior Advisor Peraton Inc

$146,000–$234,000 / year

Articulates the architectural vision, conceptualizes, and experiments with alternative architectural approaches, creates models and component and interface specification documents, and validates the architecture against requirements and assumptions. Education & Experience: Bachelor''s degree in Computer Science, Information Technology, or a related field with 12+ years of relevant experience; or Master''s degree with 10+ years of relevant experience.

30+ days ago

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

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

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

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

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Claims Processor Jobs in Clifton, MD

Paralegal Amentum

Documentation Specialist ECS Federal LLC

QA Engineer - DM platform (Remote) - Blue Bell, PA AHU Technologies

Multisite Business Office Manager United Surgical Partners International Inc

Call Center Representative Ascensus LLC

Senior Business Analyst Syms Strategic Group, LLC (SSG)

Temporary Call Center Representative Ascensus LLC

Nurse US Department of Health and Human Services

Contract Clinical Services Support Technician Prescryptive Health Inc

Bilingual Call Center Representative Ascensus LLC

Analyst, Account Manager CVS Health Corp

Auto Adjuster Analyst - Allstate Dealer Service Allstate Insurance Company

Director - State Insurance Program (EXECUTIVE VII) State of Maryland

BILLING SPECIALIST Universal Home Health Care Llc

Operations Analyst Ibility

Software Architect, Senior Advisor Peraton Inc

Manager, Payment Integrity Auditing Premera Blue Cross

Administrative Action Specialist Team Lead Peraton Inc

Customer Service Rep II Premera Blue Cross

Administrative Action Specialist Medicare Peraton Inc

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