Claims and Policy Processor Jobs
Come join the hardest working, not-for-profit health plan in California and help deliver our mission to ensure all Californians have access to high-quality health care at an affordable price. Blue Shield of California was founded in 1939 by a group of physicians who believed that everyone should be able to afford a visit to their doctor. More than 70 years later, Blue Shield now serves 3.3 million...
We Need to Fill 14 Positions ASAP!!! · Official title of these positions are Member Services Representative · Answer member and pharmacy calls in the Member Services and Pharmacy call center. · The employee will utilize the RxCLAIM and INFO Call Tracking systems while assisting pharmacies with the processing of claims and members with basic inquiries about their pharmacy plan benefits. · As yo...
United States We currently are seeking a highly motivated Senior to support client engagement teams, work with a wide variety of clients to deliver professional services, and lead business development activities on strategic and global priority accounts. Ernst & Young's Financial Services Office (FSO) is a uniquely industry-focused business unit that provides a broad range of integrated services...
IBM - Any, NY
Digital Operations / Guidewire Consultant for Guidewire Policy, Claims and Billing Suite - Strategy and Analytics (S&A) Job ID GBS-0681264 Job type Full-time Regular Work country USA Position type Professional Work city - Any Posted 01-Aug-2014 Travel Up to 4 days a week (home on weekends-based on project requirements) Job area Consulting & Services Business group Global Business Services Job...
Xerox is the world's leading enterprise for business process and document management. Its services, technology, and expertise enable workplaces - from small businesses to large global enterprises - to simplify the way work gets done so they operate more effectively and focus more on what matters most: their real business. Xerox offers business process outsourcing and IT outsourcing services, inclu...
About us The Boon Group is a third party administrator with 30+ years of experience in providing employee benefits, insurance products and services to government contractors and commercial businesses. We have evolved into a national enterprise, becoming the industry leader in providing affordable benefit solutions as well as worksite wellness programs and occupational health services, which are p...
Allstate® Good Work. Good Life. Good Hands.® Voted one of the World’s Leading Top 100 Companies by Forbes magazine Do you have a passion for helping others? Have an eye for detail? Do you have strong organizational and time management skills? Are you looking to accelerate your career at a renowned company? Allstate Insurance Company has an exceptional career opportunity for a Claims Service Sp...
Austin's Original Employment Source-Serving the Best Texas Employers Since 1967 CLAIMS PROCESSORS NEEDED Professional and notable company can use several claims processors to help clients get their needed benefits. Responsible for assisting staff with resolving issues to meet claims processing requirements via daily claim payment QC/QA audits and benefit eligibility correspondence. Will assist ...
This position requires previous insurance / medical healthcare claims experience, or someone with a background in Medical Coding / Medical Billing. Job Purpose: Reviews, evaluates and processes claims for Veterans utilizing the Aid and Assistance Program for payment in accordance with the terms and conditions of the policy and within established deadlines and company objectives. Ensures the appro...
We are seeking a Foreign Claims Processor who will possess: • High School diploma or equivalent • One year experience in a position requiring personal computer and data entry skills • One year experience as a medical claims processor, TRICARE experience preferred Key Responsibilities: • Process all TRICARE overseas claims from receipt through resolution in accordance with TRICARE regulations,...
Molina Healthcare Inc Long Beach, CA
Job Summary Perform daily audits on processed claims to ensure payment accuracy. Compile and report audit findings. Essential Functions • Collects claims sample data from system to perform audits. • Evaluates the adjudication of Medicaid claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, wa...
Molina Healthcare Long Beach, CA, 90802
Job Summary Perform daily audits on processed claims to ensure payment accuracy. Compile and report audit findings. Essential Functions • Collects claims sample data from system to perform audits. • Evaluates the adjudication of Medicaid claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, wast...
Wellcare Health Plans Inc Tampa, FL
Claims Coding Specialist - CPC Preferred/Claims Processing Exp Required - 1407573 About WellCare: WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled, as well as prescriptio...
This position is with MAPFRE Insurance located in Webster, MA. Higher tiered level available commensurate with experience. Daily responsibilities include the screening, coding and input of all new business, renewal, endorsement and cancellation transactions within departmental standards. Basic analysis is performed to assure the issuance system entry requirements are met and to identify and reso...
Description: Position Description: Energize your career with one of health care's fastest growing companies. You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading healt...
Description : The Claims Specialist is responsible for working with internal/external customers on the receipt, analysis, impact, resolution and posting/reporting of all contractual payments across multiple customer segments including Health Plans, PBMs, Part D, GPOs, Wholesalers, and State and Federal Government as well as maintaining all related documentation for those payments. In this role, t...
Introduction Bell & Clements Inc.is an innovative and well respected Insurance organization which commenced operation in the US in July 2002. With headquarters in Reston, VA, we specialize in providing US Managing General Agents (“MGAs”) with a comprehensive service for surplus lines business. With the Group’s London affiliate, Bell & Clements Ltd., we are acknowledged market leaders in arrangin...
This position is with MAPFRE Insurance located in Gilbert, AZ. The schedule for this position is Monday – Friday from 8:30 a.m. – 5:00 p.m. Daily responsibilities include the screening, coding and input of all new business, renewal, endorsement and cancellation transactions within departmental standards. Basic analysis is performed to assure the issuance system entry requirements are met and to i...
Description: What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere....
Voted one of the World's Leading Top 100 Companies by Forbes magazine Do you have a passion for helping others? Have an eye for detail? Do you have strong organizational and time management skills? Are you looking to accelerate your career at a renowned company? Allstate Insurance Company has an exceptional career opportunity for an Inside Auto Liability Claim Trainee in Overland Park, KS. Comb...
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Claims/Policy Processing Clerk
$20,000.00 - $38,000.00
Typical Salary for Claims/Policy Processing Clerk
Source: Monster.com Careerbenchmarking Tool
Education / Training
Some College Coursework Completed
Source: Monster.com Careerbenchmarking Tool
Claims/Policy Processing Clerk
Processes insurance claims and policies by performing related duties.
Rate of Growth
Size of Industry in 2006:
Source: Bureau of Labor Statistics, May 2006
Administrative Writing Skills
Provides customer service, such as giving limited instructions on how to proceed with claims or providing referrals to auto repair facilities or local contractors.
Calculates premiums by comparing policyholder information to rate standards; referring variances to underwriters.
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Sample Resume for an Insurance Claims Processor
Use this sample resume for an automotive insurance claims processor to help you stake your claim on your next insurance job.