Claims Legal Specialist - Conditional Demands Sentry InsuranceClaims Legal Specialist - Conditional DemandsGoldsboro, NC$31.25–$37.50Experience in handling conditional demands, preferably including bodily injury claims, on behalf of an insurer as an attorney, technical specialist, claims manager or similar role sufficient in one more of the following states to develop a high degree of technical expertise: CA, FL, TX, GA, or SC. Act as a subject matter expert, provide technical advice, direction, and guidance to other claims associates as need arises including instruction and authority on all complex conditional settlement demands received by enterprise.
NewMailroom Document Processor Conduent Commercial Solutions, LLCMailroom Document ProcessorSpringfield, MA$18Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. Perform repetitive duties in a high-speed environment such as removing staples, rubber bands, repairing torn documents or copying document types and inserting the appropriate patch sheets to separate the claims.
Claims Supervisor Health Source MSOClaims SupervisorAlhambra, CAFull timeProviding expertise or general claims support to teams in reviewing, researching, investigating, negotiating, process, and adjusting claims. Responsibilities include, but not limited to: • Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including: Contractual agreement rates.
Claims Specialist Medical Malpractice Diedre Moire Corp.Claims Specialist Medical MalpracticeUnion, NJ$100,000–$140,000 / yearFull timeCONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #UnderwriterJobs. Manage total claim costs for highly complex or severe injury medical malpractice claims while negotiating to resolution and providing high levels of customer service.
Claims Auditor Health Source MSOClaims AuditorAlhambra, CAFull timeResponsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including: Contractual agreement rates. Job Description : Claims Auditor will be responsible for auditing claims processed by Claims Examiners.
NewManager, Claims Operations (Subrogation) USAAManager, Claims Operations (Subrogation)Phoenix, AZ$103,450–$197,730 / yearThis role leads Auto, Property or other Claims subrogation employees who are responsible for serving our members, and providing appropriate solutions as they investigate, evaluate and negotiate the claim. 6 years of progressive customer service, operational, military or leadership experience to include a minimum of 2 years of claims handling experience required with demonstrated proficiency.
Claims Auto Adjuster - Non Injury USAAClaims Auto Adjuster - Non InjuryPhoenix, AZSupports members, business partners, and claimants, through use of varying communication channels to include utilization of digital tools to drive timely and effective resolutions through exceptional service. Within defined guidelines and framework, responsible to adjust moderately complex auto insurance claims presented by or against our members to include the end-to-end claims process and settling claims in compliance with state laws and regulations.
NewClaims Specialist LSI StaffingClaims SpecialistPapillion, NEWe are currently looking for a full-time Claims Specialist to join our team in the Papillion area . If you're interested in joining our team, we'd love to hear from you!
NewClaims Representative II (Workers Compensation) Society Insurance CompanyClaims Representative II (Workers Compensation)Fond du Lac, WIRemoteThis role will investigate, evaluate, and resolve moderate-to-severe complex Workers’ Compensation claims by determining coverage and liability, coordinating with injured workers, employers, and medical providers, and negotiating appropriate claim resolutions in accordance with company guidelines, policy provisions, and state regulations. Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants/injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting with experts when appropriate.
NewTechnical Business Analyst - Claims Module 2 The Computer Merchant, LtdTechnical Business Analyst - Claims Module 2Remote$60–$62.50 / hourContractorWhile an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and business considerations. Drive the claims module and process, domain knowledge, performs analysis of business requirements, designs and develops documentation, ensures quality process, coordinates with customers.
NewClaims Representative I (Workers' Compensation) Society Insurance CompanyClaims Representative I (Workers' Compensation)Fond du Lac, WIRemoteThis role will investigate, evaluate, and resolve mildly complex Workers’ Compensation claims by determining coverage and liability, coordinating with injured workers, employers, and medical providers, and negotiating appropriate claim resolutions in accordance with company guidelines, policy provisions, and state regulations. Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants/injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting with experts when appropriate.
NewManager, Claims Operations- (DCT Property) USAAManager, Claims Operations- (DCT Property)Colorado Springs, CO$103,450–$191,970 / yearAs a dedicated Manager, Claims Operations , you will manage and be accountable for property and other claims operations member service employees who are responsible for serving our members, and providing appropriate solutions as they investigate, evaluate and negotiate the claim. 6 years of progressive customer service, operational, military or leadership experience to include a minimum of 2 years of claims handling experience required with demonstrated proficiency.
NewManager, Claims Operations (Auto Non Injury Complex) USAAManager, Claims Operations (Auto Non Injury Complex)Colorado Springs, CO$103,450–$197,730 / yearAs a dedicated Manager, Claims Operations, you will lead and be accountable for auto, property, and other claims operations member service employees who are responsible for serving our members, and providing appropriate solutions as they investigate, evaluate and negotiate the claim. 6 years of progressive customer service, operational, military or leadership experience to include a minimum of 2 years of claims handling experience required with demonstrated proficiency.
Independent Medical Evaluators - Occupational Medicine, PM&R and Orthopedists MRG ExamsIndependent Medical Evaluators - Occupational Medicine, PM&R and OrthopedistsLatonia, KYCompany Overview: MRG Exams is a leading provider of Independent Medical Evaluations (IME) and Permanent Partial Impairment Ratings (PPIR) services for the Ohio Bureau of Workers' Compensation (BWC), third-party administrators, Managed Care Organizations (MCOs), and employers. Joining our team as an independent medical provider presents an excellent opportunity for both experienced providers seeking a new challenge and newly starting physicians looking to establish themselves in a unique field outside of patient care.
NewFull-Stack Developer (React) Vaco LLCFull-Stack Developer (React)Concord, CARemote$60–$70 / hourDetermining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.
Sr. Medical Claims Processor Ultimate Staffing ServicesSr. Medical Claims ProcessorPasadena, California$24–$29 / hourEnsure accuracy of claim details, including patient information, coding (ICD-10, CPT, HCPCS), and billing data prior to submission. Investigate and resolve denied, rejected, or pending claims by working with providers, payers, and internal departments.
Director of Quality & Technical Service Michael Page USADirector of Quality & Technical ServiceHammond, IN$140,000–$175,000 / yearFull timeOperating out of its Northwest Indiana facility, the company processes large steel coils through services including slitting, cut-to-length processing, pickling, oiling, and inventory management, helping customers transform raw steel into production-ready material. Our client is a leading steel service and processing company that supplies manufacturers in various sectors - primarily automotive but also construction, agriculture, and large scale appliances.
NewMedical Claims Processor GlobalchannelmanagementMedical Claims ProcessorParamus, New JerseyPartner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system. Medical Claims Processor duties: Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
Third-Party Medical Claims Processor Hire Up Staffing ServicesThird-Party Medical Claims ProcessorFresno, CAIdeal Candidate: The perfect fit for this role has at least 3 years of experience in medical billing or claims processing especially if that experience includes working with a third-party administrator (TPA) within an insurance company . Prior TPA exposure is highly preferred due to the nature of this employers group benefit processing.
Medical Claims Processor Datamark, Inc.Medical Claims ProcessorEl Paso, TXIn this role, you will be responsible for verifying insurance coverage, conducting research, and resolving coverage-related issues to ensure timely and accurate prescription processing. As a Medical Claims Processor at DATAMARK, you'll play a vital role in the success of our operations by ensuring accurate and efficient back-office support.
Remote Medical Claims Processor I (Temporary role) Broadway VenturesRemote Medical Claims Processor I (Temporary role)Remote$20–$23 / hourAs an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Actual pay offered depends on job-related factors, which may include skills, experience, education, certifications and licensure, geographic work location, contract funding and budget.
Medical Claims Processor I Moda HealthMedical Claims Processor IMilwaukie, OR$17.34–$19.41 / hourResponsible for utilizing resources efficiently for the accurate and timely entry, review, and resolution of simple to moderately complex medical claims in accordance with policies, procedures, and guidelines as outlined by the company. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.
Medical Claims Processor - Remote NTT DATAMedical Claims Processor - Remoteremote, TXRemoteThe quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools .
Medical Claims Processor, Remote NTT DATAMedical Claims Processor, Remoteremote, TXRemoteThe quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools .
Medical Claims COB Processor I Moda HealthMedical Claims COB Processor IMilwaukie, OR$18.39–$20.58 / hourAssists in customer service inquiries regarding contractual and administrative policies and applies excellent customer service when a phone call is needed to complete a COB claim. Minimum of 6 months medical claim processing or customer service dealing with all types of plans/claims and consistently exceeding performance levels.
NewClaims Processor (52219) GlobalHealth, Inc.Claims Processor (52219)Oklahoma City, OKWHO YOU ARE: The Claims Processor is primarily responsible for processing all types of contracted and non-contracted claims accurately and timely for Medicare, Medicaid and Commercial Insurance products. We are looking for future employees who exude our core values of taking accountability through ownership, being driven, innovative and who have a passion for continuous learning.
Healthcare Claims Processor Bakinaw Saginaw Chippewa Indian TribeHealthcare Claims Processor BakinawMt Pleasant, MichiganTrend Monitoring: Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting. *Minimum of 5 years’ experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following states: FL, GA MD, MI, TX .
Dental Claims Processor DY MANAGEMENT CONSULTANTS LLCDental Claims ProcessorSan Antonio, TXFull timeAs a Dental Claims Processor, you'll work alongside experienced professionals while learning every aspect of dental insurance billing, including: Process and follow up on dental insurance claims. We provide comprehensive, hands-on training that gives you the skills needed to become an expert in dental insurance claims and revenue cycle management.
Claims Processor AND Customer Service Representative Addison GroupClaims Processor AND Customer Service RepresentativeTulsa, Oklahoma$20–$22 / hourAbout Our Client: Addison Group is partnering with our client, a well-established organization in the employee benefits and healthcare administration space, to hire a Claims Processor/Customer Service Representative. This role involves reviewing and processing healthcare claims, verifying eligibility, explaining benefit coverage, and resolving claim-related inquiries with accuracy and professionalism.
Claims Processor - Johnstown Senior LIFEClaims Processor - JohnstownJohnstown, PennsylvaniaFull timeSenior LIFE is an innovative home and community based Medicare and Medicaid funded program which provides all-inclusive healthcare services and support to seniors living in the community. Our team is committed to partnering with our seniors to remain at home through promoting open communication and shared decision making while providing excellent care and services.
NewCash Claims Processor Global Channel ManagementCash Claims ProcessorCincinnati, OhioResearch 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. High school degree required, Cash Claims Processor duties: Research and apply insurance payments from clients to the appropriate system invoice.
Claims Processor Self-Funded Marpai AdministratorsClaims Processor Self-FundedRemoteMarpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.
Claims Processor I Medical University of South CarolinaClaims Processor ICharleston, SCAccount maintenance: Updating registration, authorization issues, identifying charge correction,, processing adjustments as needed and denial follow up according to payer rules and departmental policies. Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
Claims Processor I MUSCClaims Processor ISouth CarolinaAccount maintenance: Updating registration, authorization issues, identifying charge correction,, processing adjustments as needed and denial follow up according to payer rules and departmental policies. Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
Claims Processor Conduent IncClaims ProcessorNYRemoteThrough our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form.
Claims Processor II Medical University of South CarolinaClaims Processor IICharleston, SCAccount maintenance: Updating registration, authorization issues, identifying charge correction,, processing adjustments as needed and denial follow up according to payer rules and departmental policies. Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
Claims Processor II MUSCClaims Processor IISouth CarolinaAccount maintenance: Updating registration, authorization issues, identifying charge correction,, processing adjustments as needed and denial follow up according to payer rules and departmental policies. Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
Claims Processor Self-Funded Marpai Administrators LLCClaims Processor Self-FundedAtlanta, GARemoteFull timeMarpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.
Claims processor IconmaClaims processorRemote, AZRemote$12–$15 / hourRecord Keeping: Maintain detailed records of claims processed, decisions made, and communications with claimants for auditing purposes, and report daily results to the lead at the end of each day without fail. Conduct thorough evaluations of claims to assess legitimacy while meeting monthly production and quality targets.
Claims Processor 3 Zenith American SolutionsClaims Processor 3San Francisco, CaliforniaWe 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. High school diploma or general education degree (GED); two years related experience processing all types of group health and/or dental benefit claims.
Claims Processor 1 Zenith American SolutionsClaims Processor 1San Francisco, CaliforniaWe 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. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
Claims Processor Zenith American SolutionsClaims ProcessorPortland, OregonWe 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. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
Claims Processor II InnovAgeClaims Processor IIDenver, Colorado$22.84–$27.40 / hourFull timeInnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. Regardless of past practices, all candidates/resumes submitted by search firms to InnovAge by any means without a valid written search agreement in place for that position will be deemed the property of InnovAge and no fee will be paid in the event such candidate is hired by InnovAge.
NewClaims Processor ArsenaultClaims ProcessorLos Angeles, CaliforniaThrough our dedicated associates, Arsenault delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments creating exceptional outcomes for our clients and the millions of people who count on them. It is essential to have a good understanding of EOBs, FSAs, how to read receipts, doctor bills, and basic medical paperwork.
Claims processor Iconma LLCClaims processorAZRecord Keeping: Maintain detailed records of claims processed, decisions made, and communications with claimants for auditing purposes, and report daily results to the lead at the end of each day without fail. Conduct thorough evaluations of claims to assess legitimacy while meeting monthly production and quality targets.
Claims Processor Redeemer HealthClaims ProcessorPhiladelphia, PennsylvaniaFull timeResponsible to reconcile daily import, acceptance and rejection reports and collaborates with Billing Manager on all issues causing claim delays and achieving the HRHS CBO clean claims targets established by Senior Leadership. The Corporate Finance Department strives to contribute to this mission by working with the entire organization to provide the most positive financial climate possible, for continued caring, comforting and healing for all in need.
Dental Claims Processor I Moda HealthDental Claims Processor IMILWAUKIE, OR$17.34–$18.36 / hourFor more information regarding accommodations, please direct your questions to Kristy Nehler & 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.
Claims Processor Holy Redeemer Health System IncClaims ProcessorPhiladelphia, PAResponsible to reconcile daily import, acceptance and rejection reports and collaborates with Billing Manager on all issues causing claim delays and achieving the HRHS CBO clean claims targets established by Senior Leadership. The Corporate Finance Department strives to contribute to this mission by working with the entire organization to provide the most positive financial climate possible, for continued caring, comforting and healing for all in need.
Associate, Claims Receipt Processor Ametros Financial CorpAssociate, Claims Receipt ProcessorWilmington, MA$20–$23 / hourAmetros's team works closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to create a seamless experience for our clients. Ametros is changing the way individuals navigate healthcare by providing them with the tools and support necessary to make educated decisions on how to spend their medical funds.
Fleet Claims Processor Hyster-Yale, IncFleet Claims ProcessorGreenville, NCHyster-Yale Materials Handling, Inc. (HYMH), a world-class manufacturer of industrial lift trucks, has an outstanding opportunity for an exceptional and talented Fleet Claims Processor at our facility located in Greenville, NC. Who we are: HYMH designs, engineers, manufactures, sells and services a comprehensive line of lift trucks and aftermarket parts marketed globally under the Hyster and Yale brand names.