Claims Examiner Jobs

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MDX Hawai'i is a health care third party administrator offering clients services such as access to our provider network, care coordination, claims processing and customer servicing. Together with our parent company, Medical Data Exchange (MDX) of California, we offer a variety of state-of-the-art physician-directed products, including Practice Management Solutions. We have over 25 years of experie...

Annuity Claims Examiner/Intermediate Annuity Claims Examiner (IS&R)-15000233 Description and Qualifications Company Description: The Transamerica companies offer a wide array of innovative financial services and products with a common purpose: to help individuals, families, and businesses build, protect and preserve their hard-earned assets. With more than a century of experience, we have built...

Company Description: The Transamerica companies offer a wide array of innovative financial services and products with a common purpose: to help individuals, families, and businesses build, protect and preserve their hard-earned assets. With more than a century of experience, we have built a strong reputation on solid management, sound decisions and consumer confidence. The Transamerica companies ...

Job Description: Medical Claims Auditor: $42,000 About the job This is a great role for someone who is looking for a challenging career, working for a great organization. Successful managed care organization seeks a professional Medical Claims Examiner to support a busy office. Skills/Responsibilities: -Working knowledge of ICD-9, CPT4, UB92/1500 forms & HCPCS -3 Years of experience as a Med...

Required Qualifications: Experience handling Auto Physical Damage, Bodily Injury, No-Fault/PIP, or Homeowners' Property claims from inception to close Must have proficient computer skills Preferred Qualifications: Adjuster Licenses are preferred but not required Job Description: Our client is seeking to add Multiple Inside Claims Examiners. This person will need to have experience handling a...

Required Qualifications: Experience handling at least one of the following lines of insurance: Auto Physical Damage/Bodily Injury/PIP/No-Fault/General Liability/Workers' Compensation/Property MUST have an active New York Adjusters' License Job Description: Our client is seeking to add Multiple Inside New York Licensed Claims Examiners to their office in Ballston Spa, NY. In addition, TheBestI...

Required Qualifications: Must have 2+ years 1st Party Personal Lines Homeowners' Property experience Good customer service skills Advanced estimating software experience required, Xactimate experience a plus Must have valid driver's license Must have an active North Carolina Adjusters' License Preferred Qualifications: Multiple adjuster licenses are preferred but NOT required Job Descripti...

JOB SUMMARY: The HMO Claims Examiner administers HMO contracts by processing medical claims in an efficient, cost-effective, and timely manner. Responsible for determining financial responsibility between group, health plans and contracted hospitals for accurate processing of claims. JOB RELATIONSHIPS: The HMO Claims Examiner is supervised directly by the Claims Manager and has regular interact...

Prospect Medical is searching for a qualified: Claims Examiner III SUMMARY Responsible for consistently and accurately adjudicating claims in accordance with policies, procedures and guidelines as outlined by the company policy. Process claims according to all CMS and DMHC guidelines. Examiner III will review, research and process complex claims. Handle recalculation of claims due to incorrect ...

Trover Solutions, Inc. is a leading independent provider of outsourced insurance subrogation, claims recovery and cost containment solutions for the healthcare payor and property and casualty industries. Trover delivers exceptional recovery outcomes by leveraging the expertise of our highly-trained staff with leading-edge technology, integrated systems and processes. We seek to attract, develop an...

Claims Examiner Lipman Insurance Administrators (LIA) is an industry leader in the administration of employee benefit plans. The company was founded in 1976, and over the past 35 years has grown to be one of the most respected third party administrators in the country; currently administering to the daily needs of approximately 17,000 active and retired Taft Hartley Plan participants and their de...

RESPONSIBILITIES: Kforce has a client seeking a Claims Examiner in Monterey Park, California (CA). This role will process, file and pay out claims related to Medicare, Medi-Cal, and Commercial Claims. The Claims Examiner will be responsible for verifying eligibility, processing the authorization and verifying if a claim is to be paid or denied. Additional responsibilities will be to analyze prici...

RESPONSIBILITIES: Kforce has a client seeking a Claims Examiner in Los Angeles, California (CA). This role will process, file and pay out claims related to Medicare, Medi-Cal, and Commercial Claims. The Claims Examiner will be responsible for verifying eligibility, processing the authorization and verifying if a claim is to be paid or denied. Additional responsibilities will be to analyze pricing...

WC Claim Examiner Rocky Hill, CT Position Summary/Overview: This position will be responsible for performing workers’ compensation claims adjudication and investigation. It will also be responsible for all technical aspects of claim management for assigned files including compliance with all established performance guidelines. This position will be handling CT claims and performing other tasks ...

Job Overview Primary Purpose and Essential Functions: Investigate, handle and settle first and third party insurance and business claims. Manage designated automobile, heavy equipment and non-auto related property damage claims with varying degrees of complexity and severity depending on coverage issues, multi-car accidents, liability determination and injury, etc. Manage case load of 150-200 cl...

Job Overview Primary Purpose and Essential Functions: Investigate, evaluate and resolve claims of a more complex nature including litigations with a focus on minimizing exposure to the Company. Responsible for the investigation, liability determination, negotiation, financial analysis and settlement of claims. May act as a subject matter expert in a particular area of claims handling. Lead and ...

Safety National is an alternative market insurance provider that offers a broad range of risk funding products through insurance agents and brokers. Founded in 1942, Safety National is the leading provider of excess workers’ compensation coverage to self-insured employers and groups nationwide, and has provided that type of coverage longer than any other company in the United States. The company c...

Job Description: We have a great direct hire opportunity for a Claims Examiner here in the East Bay. The position requires at least (2) years of prior Claims Processing experience, the faculty to multi-task; as well as, to have commendable communication skills. Claims must be processed accurately and timely. This position works within the Claims Department and requires experience in on-line claim...

Company Confidential
Looking for a seasoned Claims Examiner with a minimum of two years’ experience in a fast paced claims environment. The candidate should have intimate knowledge of most Medicare fee schedules such as RBRVS, APC, ASC, DRG, etc. Ability to adjudicate most types of claims such as PCP, Specialists, Anesthesia, inpatient (DRG, Case Rate, Per-Diem), outpatient APC, outpatient ASC, Skilled Nursing, Dialys...

Company Confidential
Looking for a seasoned Claims Examiner with a minimum of two years’ experience in a fast paced claims environment. The candidate should have intimate knowledge of most Medicare fee schedules such as RBRVS, APC, ASC, DRG, etc. Ability to adjudicate most types of claims such as PCP, Specialists, Anesthesia, inpatient (DRG, Case Rate, Per-Diem), outpatient APC, outpatient ASC, Skilled Nursing, Dialys...