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.
NewTrainee Casualty Claims Specialist Warrior Insurance NetworkTrainee Casualty Claims SpecialistBedford Park, IL$27.88–$31.25 / hourFull timeThey will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. At the end of the training program, you will be expected to and able to successfully investigate, evaluate, negotiate, and resolve bodily injury, uninsured/underinsured motorist bodily injury, and medical payments claims.
Claims Processer IconmaClaims ProcesserDes Moines, IA$19–$20 / hourOur Client, an IT Services and Consultant company, is looking for a Claims Processer for their Des Moines location (will be working remotely but must be located in Iowa). Documentation: Record claim activity, maintain audit trails, and prepare reports for management.
Claims Adjuster Epitec StaffingClaims AdjusterPortland, OR$47–$52 / hourStrong communication and interpersonal skills to effectively interact with claimants, customers, insureds, brokers, attorneys, etc., in a positive manner regarding losses. Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
Medical Record Review Registered Nurse 22nd Century Technologies, Inc. (TSCTI)Medical Record Review Registered NurseHarrisburg, PA$40–$45 / hourFull timeAssignments will consist of a combination of ongoing process responsibilities, standing workgroup participation, and time-limited projects related to the management and operations of all aspects of the Pennsylvania Medicaid program, including but not limited to: Evaluation and implementation of system enhancements for provider enrollment, provider inquiry, and medical review; Evaluation of current processes and implementation of recommended process improvement; Consult with senior staff to outline major operational issues and develop resolutions based on sound data analysis; Act as a liaison between the Client and external stakeholders (individuals and/or groups); Assist in determining if any changes should be made to criteria or regulations to better serve clients; Review certain claims, analyze, and process through the payment system; Provide operational input for claims processing decisions; Assist with coding and procedure code groupings; Participate in the yearly coding updates and assist in updating the system according to the reviewed and accepted codes for the PA Medical Assistance Program; Perform other related duties as assigned by the managerial staff; Consultant will report to the state supervisor staff. Be available as a full-time consultant, approximately 37.5 hours per week; Possess an active Pennsylvania Registered Nurse license; Possess a documented work history of five (5) or more years of experience with claims review/coding or processing; be familiar with HCPCS II, CPT, or Dental coding; Possess computer skills, including familiarity with Microsoft Office programs, including Microsoft Excel/Word/PowerPoint; Possess prior experience with PROMISe or similar claims processing system; Possess prior experience with Medicare or Medical Assistance coding rules; Possess prior experience with researching medical policies, out of state comparison, participation in studies or projects.
Medical Biller AtriumMedical BillerPark Ridge, NJOur client is a boutique medical billing company based in Bergen County, New Jersey, specializing in out-of-network (OON) insurance billing for a wide range of healthcare providers and facilities. With a new orthopedic account coming onboard, the company is expanding and seeking a Medical Biller to support claim processing, insurance follow-up, and accurate billing operations.
NewCorporate Insurance & Risk Management Specialist Rausch CompaniesCorporate Insurance & Risk Management SpecialistGreenland, ARDescription: Reporting to the Corporate Insurance and Risk Manager, the Corporate Insurance & Risk Management Specialist is responsible for the day-to-day management of insurance compliance, renewal data workstreams, and initial claims processing, ensuring the organization’s risk/insurance portfolio remains accurate. Duties & Responsibilities Renewal Data Management: Lead the annual collection of underwriting values (property schedules, vehicle lists, payroll, and revenue) across departments to assist Director of Risk Management in building comprehensive submissions for brokerage partners.
NewPayroll and Total Rewards Manager COLECTIVO COFFEE ROASTERSPayroll and Total Rewards ManagerMilwaukee, WIProcess and verify bi-weekly payroll, including: review of reports of time and labor, verify all leave taken (in accordance with CCR Policy, federal, state, and local law), calculate and allot tips, Process and verify salary or wage adjustments, pay-line adjustments, ACH returns or reversals, collection and reimbursement garnishments, tax liens, and child support. The Payroll and Total Rewards Manager will oversee the company's payroll and benefits programs to create an approachable experience and beneficial offerings to Colectivo’s co-worker population.
NewHealthcare Claims Processor Pride GlobalHealthcare Claims ProcessorNew York, NY$30–$32 / hourThis applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793. Only applicable for San Francisco Candidates : Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.
Dental Insurance Claim Processor Comfort Dental East MesaDental Insurance Claim ProcessorMesa, AZPrimary Duties Include: Preparing and electronically submitting dental insurance claims promptly and accurately, including pre-authorizations, narratives, and supporting documentation. Monitoring outstanding claims, generating aging reports, following up with insurance carriers on delays/denials, and pursuing appeals to recover maximum reimbursements.
Claims Operations Quality Assurance Specialist Pacific LifeClaims Operations Quality Assurance SpecialistOmaha, NE$32–$37 / hourHow You'll Make an Impact: Perform detailed quality audits of claims transactions across Pay QA, Set-Up QA, and Follow-Up QA, including claim payment accuracy, interest review and calculation, post-death interest, initial claim setup, documentation, beneficiary/payee information, follow-up requirements, and completion of required claim actions. How you'll help move us forward: Consistently apply sound judgment and accountability when evaluating pay accuracy, interest review and calculation, post-death interest, claim setup completeness, follow-up activity, documentation quality, and adherence to claims procedures.
QUALITY ASSURANCE CLAIMS SPECIALIST – REMOTE LoanCareQUALITY ASSURANCE CLAIMS SPECIALIST – REMOTERemote$22.45–$37.69 / hourFull timeWe provide the necessary equipment; all you need is a quiet, private place in your home and a high-speed internet connection with a minimum network download speed of 25 megabits per second (MBPS) and a minimum network upload speed of 10 MBPS. Lifestyle & Learning Perks : Enjoy discounts on gym memberships, pet insurance, and employee purchasing programs, plus access to a tuition reimbursement program that supports your continued education and professional growth.
Claims Specialist - Claims Processing Providence Health & ServicesClaims Specialist - Claims ProcessingAnaheim, CA$24–$33.73 / hourRequsition ID: 429445 Company: Providence Jobs Job Category: Claims Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Admin Support Department: 7520 CLAIMS PROCESSING CA HERITAGE SERVICES Address: CA Anaheim 200 W Center St Promenade Work Location: St Joseph Home Health-Anaheim Workplace Type: On-site Pay Range: $24.00 - $33.73 Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Senior Claims Specialist - Claims Processing Providence St. Joseph HealthSenior Claims Specialist - Claims ProcessingMission Hills, CATogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, per diem, case rate etc.) and adjudication and claims research when necessary.
Claims Specialist - Claims Processing Providence St. Joseph HealthClaims Specialist - Claims ProcessingAnaheim, CATogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Required Qualifications: HMO claims processing experience in a managed care environment, preferably PMG/IPA setting within the last 3 years or any combination of education and/or experience which produces an equivalency.
Senior Data Engineer - EDI Claims Processing NationsBenefits LLCSenior Data Engineer - EDI Claims ProcessingPlantation, FLThis role is responsible for designing, developing, and maintaining enterprise-scale healthcare data integration solutions focused on HIPAA X12 EDI transactions, Medicaid encounters, and CMS compliance. Through our comprehensive suite of innovative supplemental benefits, fintech payment platforms, and member engagement solutions, we help health plans deliver high-quality benefits to their members that address the social determinants of health and improve member health outcomes and satisfaction.
Education and Training Specialist - CLAIMS PROCESSING Providence Health & ServicesEducation and Training Specialist - CLAIMS PROCESSINGMission Hills, CA$29.62–$45.31 / hourRequsition ID: 450440 Company: Providence Jobs Job Category: Learning & Development Job Function: Human Resources Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 7520 CLAIMS PROCESSING CA HERITAGE SERVICES Address: CA Mission Hills 11165 N Sepulveda Blvd Work Location: Facey Sepulveda Annex-Mission Hills Workplace Type: On-site Pay Range: $29.62 - $45.31 Working under the general supervision of the Claims Director, provide an effective education program to advance the quality and production level of the Claims Department by developing and delivery claims training programs that continuously improves the Claims Department performance to meet the NSS strategic goals.
Claims Administrator Starkey Hearing Technologies IncClaims AdministratorEden Prairie, MN$40,000–$45,000 / yearResearch and resolve payer rejects, coverages, disputes, denials, and past due balances by interacting with network contracts, third party administrators, hearing providers and patients. Many recent advances are already being recognized as disruptive technologies that have positioned Starkey hearing aids as the industry's first devices that go beyond providing just audiological amplification.
NewClaims Analyst II Network HealthClaims Analyst IIMenasha, WIJob Responsibilities: Processes Professional and Facility claims for payment in accordance with members Certificate of Coverage, established medical policies and procedures, and plan benefit interpretation while maintaining a high level of confidentiality. Keeps current on group contracts specifics, provider discounts, percentages and per diems, enrollee certificates and agreements, authorizations and other utilization management policies, etc.