NewMedical Claims Entry Operator Moda Partners IncMedical Claims Entry OperatorMilwaukie, OR$17.34–$18.92 / hourFor more information regarding accommodations please direct your questions to Kristy Nehler and Danielle Baker via our humanresources@modahealth.com email. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees.
Epic Certified Applications Analyst III Claims Expert In Recruitment SolutionsEpic Certified Applications Analyst III ClaimsHealth First, FLThe Epic Applications Analyst III drives performance improvement through data reporting, advanced configuration, and proactive system enhancements, ensuring reliable, secure, and user-friendly application functionality. Partners with cross-functional teams manage major EHR upgrades, requests for enhancements, testing cycles, and change management initiatives to drive performance improvement.
Claims analyst Integrated Resources, IncClaims analystOmaha, NebraskaContractorClaims AnalystJob Title: Claims analystLocation: Omaha NE 68154Duration: 12 monthsJob Description:Family Summary/MissionAchieve superior claim and member service performance through an integrated process of operational, quality, medical cost, and resource management meeting and/or exceeding member, plan sponsor, and provider expectations. (*)• In accordance with prescribed operational guidelines, manages claims on desk, route/queues, and ECHS within specified turn-around-time parameters (Electronic Correspondence Handling System-system used to process correspondence that is scanned in the system by a vendor).
NewClaims Rep II – GHA Redetermination Rep Broadway VenturesClaims Rep II – GHA Redetermination RepRemote$21–$24 / hourDetermine appropriate resolution to appeal request and adjudicate redetermination decision by resolving all error edits and audits, changing codes, entering allowable amounts, working with other units, pending requests for development, and adjudicating claim to completion. Where that is the case, the position and its final compensation are contingent upon award of the contract to Broadway Ventures and on the terms of the awarded contract, including any government-approved labor rates and the applicable wage determination.
Operations Manager SASI INCOperations ManagerElm Grove, WIFull timeAs a Third-Party Administrator (TPA), this role ensures the accurate and efficient management of benefit programs, including Premium Only Plans (POP), Flexible Spending Accounts (FSA and LPFSA), Dependent Care Assistance Plans (DCA), Health Savings Accounts (HSA), Health Reimbursement Arrangements (HRA), and other insurance premium payment plans. Additionally, the Operations Manager oversees the daily operations of the Cafeteria Operations Department, including staff supervision, training and development, knowledge management, process improvement, documentation maintenance, and operational compliance.
Claims testing Global Channel ManagementClaims testingMason, OhioClaims testing duties: Liaison to the Senior Analysts and Manager of the Claims Testing team to identify claims processing discrepancies due to system setup issues that require cross functional partnership and retesting. Work with cross functional departments to ensure system is ready for testing scenarios to be keyed.
Claims Analyst Integrated Resources, IncClaims AnalystSyracuse, New YorkContractorTesting categories include but are not limited to the following: Benefit, Contract, and Fee Schedule Configuration, System Enhancements, Report Validation, Validation of electronic file loads. Investigates problem claims to determine root cause of problem and/or error to address both individual claim resolution and improvement to process to avoid issues from occurring in the future.
Senior Claims Consultant, National Accounts Relation Insurance Services, IncSenior Claims Consultant, National AccountsNY$92,000–$154,000 / yearThe wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The Senior Claims Consultant, National Accounts serves as an advisor and primary claims resource for large, complex accounts through a range of internal and external resources.
NewAuto Claims Adjuster Trainee Warrior Insurance NetworkAuto Claims Adjuster TraineeBedford Park, IL$20–$30 / hourFull timeKnowledge and skills required for the position are:Excellent analytical, organizational, interpersonal and communication (verbal, written, and phone) skillsPrevious customer service experienceReady to join our team? To excel as a Full-Time Auto Claims Adjuster Trainee at Warrior Insurance Network, you'll need a dynamic skill set that empowers you to navigate the fast-paced insurance landscape effectively.
NASCO claims Specialist Diverse Lynx, LLCNASCO claims Specialist$110,000–$115,000 / yearInterpret and guide implementation of complex payer rules, benefit configurations, and provider contracts. Review test artefacts and guide offshore UAT teams to ensure domain accuracy.
Claims Examiner I Metroplus Health Plan IncClaims Examiner INew York, NY$50,000–$54,194 / yearPerforms other related duties, i.e., maintaining individual production counts, updating manuals and reference materials, attending all refresher training seminars. Scope of Role & Responsibilities: Process claims involving medical and/or surgical services; screens for complete member/provider information.
Supply Chain Facility Director JCPenneySupply Chain Facility DirectorReno, Nevada$126,750–$195,875 / yearFull timeCoordinates Logistic Center activities with appropriate Associates in Supply Chain management and other Home Office departments, such as Industrial Engineering, Systems, Inventory Control, Controller, Human Resources, Advertising, Marketing, Construction Services, and Legal. • Education: College degree or equivalent business experience preferred What you get: Our corporate office, located within the exciting new development of Legacy West in Plano, Texas, supports JCPenney stores and supply chain facilities nationwide.
Insurance Processor Global Channel ManagementInsurance ProcessorNew YorkResearch insurance claim payments in the AS/400 to identify correct claim based on customer information, date of service and service/material procedure codes and related charges. Identify and recommend systems and process modifications necessary to improve the efficiency and effectiveness of the Assignment processes.
Sr Epic Resolute (Billing & Claims) Certified Analyst UNC HealthSr Epic Resolute (Billing & Claims) Certified AnalystMorrisville, NC$41.45–$59.58 / hourThis position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job. This role supports external partner clinics using UNC Health's Epic platform, with a focus on professional billing (PB), claims management, and end-to-end revenue cycle workflows, with strong alignment to ambulatory operations.
Fractional Customer Service (Claims) Manager Silva-Lining HRFractional Customer Service (Claims) Managerlos Angeles, CARemoteSilva-Lining HR is seeking a Fractional Customer Service (Claims) Manager for a client to oversee and optimize the end-to-end claims process, ensuring timely resolution, operational efficiency, and exceptional customer experience. Lead project management efforts for claims resolution, including task delegation and coordination with internal team members, vendor partners, shipping providers, and repair services.
Claims Quality Assurance CorVel Enterprise Claims, Inc.Claims Quality AssuranceDallas, TXRemote$70,276–$116,942 / yearPart timeConduct testing to ensure products perform according to user requirements and within established guidelines; if a product does not perform within specifications, report defects to EC Operations and the BOT teams identifying and recommending solutions, improvements, and updates. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Claims Coordinator LotSolutions, Inc.Claims CoordinatorJacksonville, FLPart timeAdditional responsibilities include preparing and managing correspondence, troubleshooting operational issues, and performing administrative tasks, ensuring collaboration across teams to advance Fortegra's claims processes. This role is responsible for generating and distributing reports, communicating with internal teams and external partners, and verifying claims information.
Healthcare Billing Invoicing Processor Global Channel ManagementHealthcare Billing Invoicing ProcessorMason, OhioBilling Invoicing Processor duties: Facilitates accurate invoicing by identifying high risk clients and validating billing process. Understanding of Insurance and Billing Procedures: Familiarity with different insurance plans, billing processes, and coding systems (e.g., ICD-10, CPT).
Purchased Referred Care Claims Analyst Tuba City Regional Health Care CorpPurchased Referred Care Claims AnalystTuba City, AZThe PRC Claims Analyst works closely with department leadership to monitor program compliance, budget, reports, and claims accuracy by performing the following: monitoring fund control and appropriate use of dollars spent on allowed services, auditing claims processed for patient eligibility for third party programs, and ensuring proper codes are submitted to cover primary provider, diagnosis, and clinic. Work closely with departmental leadership to monitor program compliance, budget, reports, and claims accuracy by performing the following: monitoring fund control and appropriate use of dollars spent on allowed services, auditing claims processed for patient eligibility for third party programs, and ensuring proper codes are submitted to cover primary provider, diagnosis, and clinic.
NewAuto Liability PD Claims Specialist LonestarAuto Liability PD Claims SpecialistRichardson, TXFull timeAuto Liability Property Damage Claims SpecialistJoin a Team That Values Expertise, Collaboration, and Customer ServiceAre you an experienced Auto Liability Claims professional looking for an opportunity to make a meaningful impact? In this role, you'll work alongside dedicated professionals in a collaborative, high-energy environment where your expertise, problem-solving abilities, and commitment to customer service are recognized and valued.