Claims Analyst III Integrated Resources, IncClaims Analyst IIIDoral, FloridaContractorWill be utilizing Microsoft Excel heavily.*A minimum of 1-2 years' experience in claims processing with professionals or hospitals *Top 3 skills:Computer skills - Microsoft Excel (intermediate to advanced skills, i.e. pivot tables, v-look ups)Attention to detailStrong written communication skillsMust Haves:Claims backgroundKnowledge of billing guidelinesKnowledge of contract interpretationKnowledge of billing/coding - CPT & ICD-10Kind Regards,Arnab GhatakTechnical RecruiterIntegrated Resources, Inc. IT Life Sciences Allied Healthcare CROCertified MBE | GSA - Schedule 66 I GSA - Schedule 621IGold Seal JCAHO Certified for Health Care Staffing"INC 5 0 0 0 's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)
Bilingual Claims Administrator - R2710 Fort Myer Construction CorpBilingual Claims Administrator - R2710Washington, DCIf you do not mind hard work, desire job security associated with essential infrastructure projects, and want to make a difference in our communities, then please consider joining the Fort Myer Family. Summary:The Bilingual Claims Administrator manages the intake, processing, and resolution of workers compensation claims from the initial report of injury through claim closure.
HP Reimbursement Analyst, Sr. Cook Children's Health Care SystemHP Reimbursement Analyst, Sr.Fort Worth, TexasThe person in this position possess expert analytical skills in Excel, Access and SQL necessary to extract and evaluate claims report by identifying variances in claim payment, claim trends and claim accuracy. supports the delegation process by performing audits of the delegated entities as well as internally for CCHP claims system to ensure that claims process in accordance with policies and procedures and that, the Texas Health and Human Service Commission (HHSC) guidelines are met.
State Medicaid Technical Business Analyst Siritech Solutions CorpState Medicaid Technical Business AnalystAustin, TXContractorThe ideal candidate will work closely with business and technical stakeholders to gather requirements, analyze business processes, document system enhancements, support testing activities, and ensure successful delivery of Medicaid-related projects. Job Description: The client is seeking an experienced Technical Business Analyst with strong Medicaid domain expertise to support large-scale state healthcare initiatives.
Customer Service Associate - Claims MetLife IncCustomer Service Associate - ClaimsOriskany, NY$41,600–$48,900 / yearRecognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune Worlds 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworlds leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. This role is essential to ensuring timely and effective resolution of customer needs, which directly contributes to MetLifes commitment to providing exceptional customer experience and financial protection.xa0The position supports customers and internal stakeholders across the United States.
Claims Specialist II, Workers Compensation Nationwide Mutual Insurance CoClaims Specialist II, Workers CompensationColumbus, OHRemote$69,500–$129,000 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. As a Claims Specialist, you'll investigate and handle medical and/or loss-of-time workers compensation claims from multiple states to determine compensability, entitled benefits, average weekly wage and benefit rate according to applicable state workers' compensation statute.
Senior Claims Specialist - Healthcare Professional Liability - Long Term Care GallagherSenior Claims Specialist - Healthcare Professional Liability - Long Term CareHouston, TexasRemoteFull timeAbility to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence.
Senior Claims Specialist - Cyber Liability GallagherSenior Claims Specialist - Cyber LiabilityHouston, TexasRemoteFull timeAbility to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence.
Senior Claims Specialist - Complex Liability (Product, Construction, Environmental) GallagherSenior Claims Specialist - Complex Liability (Product, Construction, Environmental)Houston, TexasRemoteFull timeAbility to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence.
Senior Workers Compensation Claims Adjuster GallagherSenior Workers Compensation Claims AdjusterMechanicsburg, PennsylvaniaRemoteFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. How you'll make an impact : Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims.
Claims Business Analyst CentivoClaims Business AnalystBuffalo, New YorkHeadquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co. Proactively identify opportunities and recommend system solutions that increase automation, resolve system deficiencies, and enhance claims processing and reporting to meet and exceed business requirements.
Facets QA Lead Tata Consultancy Services LtdFacets QA LeadKansas City, MO$80,000–$100,000 / yearExperience in Member Enrollment workflows (Medicaid, Medicare, ACA). Perform EDI validation (837, 835, 834) including mock data creation.
Insurance Senior Sales Agent Aaron Kretzer Farmers InsuranceInsurance Senior Sales AgentPARKER, CO$75,000–$95,000 / yearThe Aaron Kretzer Agency of Farmers Insurance in Parker, CO is hiring an experienced Insurance Sales Agent to serve clients across personal lines and life products while contributing to consistent agency growth. You'll join an established agency with a strong performance record, structured training, and a supportive leadership team that has been building this business for over two decades.
Supervisor, Claims Zenith American SolutionsSupervisor, ClaimsSan Francisco, CaliforniaZenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Inside Auto Specialist - Charlotte, NC (Hybrid) Allstate Insurance CompanyInside Auto Specialist - Charlotte, NC (Hybrid)Charlotte, NCYour day-to-day activities include reviewing claims and managing the claim to resolution including communication with various stakeholders, including policyholders, claimants, agents, witnesses, repair facilities, and contractors. Join our team as an Inside Auto Claims Specialist, where you'll play a key role in guiding customers through the auto claims process following single or multiple vehicle losses.
Claims Technical Review Specialist Zenith American SolutionsClaims Technical Review SpecialistPerforms technical review and analysis of all types of claims, including large dollar and technically complex claims, to ensure accuracy and adherence to prescribed procedures and plan guidelines. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
Workers Compensation Claims Technician Liberty Mutual Holding Company IncWorkers Compensation Claims TechnicianGlendale, CAEffective analytical skills required to learn and apply basic policy/contract coverage and recognize questionable coverage/contract situations (which necessitate supervisory involvement) along with effective interpersonal skills to explain the facts and logic used to arrive at decisions in a way that the customer understands. Verifies information from claimants, physicians, and medical providers to assess compensability and/or causal relation of medical treatment, and make evaluations for cases with claim specific on-going medical management.
Claims & Provider Relations Oversight Specialist Western Health AdvantageClaims & Provider Relations Oversight SpecialistSacramento, CASupport Annual Network Review (ANR), Geo Access, Provider Appointment Availability Surveys (PAAS), Provider Satisfaction Surveys (PSS), after-hours surveys, and related compliance activities. Western Health Advantage is seeking a detail-oriented Claims & Provider Relations Oversight Specialist to support compliance and regulatory operations within our Claims and Provider Relations department.
Supplemental Health Claims Manager American FidelitySupplemental Health Claims ManagerOklahoma City, OklahomaWork with Supervisors, highly skilled Colleagues and other departmental or divisional leadership to set and manage goals and performance expectations which support accurate, fair service and the timely claim processing which comply with state and federal regulations. *Actively manage staff and plans for the appropriate allocation and use of resources; analyze past workloads to determine future needs and identify service trends which may detract from providing quality service to the Customer.
Claims Negotiation Analyst (Out of Network Mandates) Horizon Healthcare ServicesClaims Negotiation Analyst (Out of Network Mandates)Newark, New JerseyPrepares written responses including negotiation outcomes by completing a written justification on how Horizon BCBSNJ adjudicated the initial and adjusted claim, but not limited to, benefits, contracts, payment and pricing methodology, proof of plan and providing explanation of benefits within regulated timeframes. $58,029 - $77,074 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.