Claims and Policy Processor Jobs

1000+ jobs

Arthur J. Gallagher & Co., one of the world's largest insurance brokerage and risk management services firms, provides a full range of retail and wholesale property/casualty (P/C) brokerage and alternative risk transfer services globally, as well as employee benefit brokerage, consulting and actuarial services. Gallagher also offers claims and information management, risk control consulting and ap...

Description Benefits Supplemental Questions This position is with the Department of Administrative Services, Enterprise Goods and Services, Risk Management section. There is one permanent, full-time position located in Salem, Oregon This recruitment will be used to establish a list of qualified applicants to fill the current vacancy and may be used to fill future vacancies as they occur. This p...

Job Summary: The Claims Edit Payment Policy Manager is responsible for managing the plans payment integrity claims editing software for multiple lines of business. Using his/her extensive knowledge of healthcare claims correct coding, outpatient code edit, reimbursement and CMS payment rules, the Claims Edit Payment Policy Manager will collaborate will stakeholders and leverage CES software to en...

Apply Now Claims Edit Payment Policy Manager Job Location: Boston, MA Job Description Job Summary: The Claims Edit Payment Policy Manager is responsible for managing the plans payment integrity claims editing software for multiple lines of business. Using his/her extensive knowledge of healthcare claims correct coding, outpatient code edit, reimbursement and CMS payment rules, the Claims Edit ...

Role: PNO Claims Payment Policy Consultant Assignment : Provider Process Network Operations Location : Louisville, KY (Blankenbaker) Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associat...

Collaborates with Sales to identify appropriate Solution Designdeliverables. Gains an understanding ofthe client's business problem and engages in the Sales process to capturehigh-level business, technical, and strategic requirements. Partners with theSales Executive, who leads the Sales strategy, relationship, and messaging. 99 Month Experience 16 Years Education Preferred Skills None Given J...

RESPONSIBILITIES: Kforce has a client seeking a Claims Processing Supervisor in Rancho Cucamonga, CA. Overview: Responsible for the operations of one or more claims processing units, including timely and proper adjudication of claims in accordance with contractual benefits Responsible for providing leadership and direction to employees Directs the processing of insurance claims to meet operat...

Description: Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. Flexible, Friendly, Fast on your feet, that's a great start. Accurate, Accountable, Self Directe...

Description: Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. Flexible, Friendly, Fast on your feet, that's a great start. Accurate, Accountable, Self Directe...

Description: Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. Flexible, Friendly, Fast on your feet, that's a great start. Accurate, Accountable, Self Directe...

A Snapshot of TBG 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, wh...

Claims Trainer: Healthcare Claims Processing Trainer Dell is looking for Healthcare Claims Processing Trainers. The Claims Trainer provides fully qualified claims processing personnel to the Claims department. Design, plan and execute classroom style training materials and department policies and procedures. Schedule, coordinate and communicate training activities to the Claims Operations Manage...

The insurance industry is experiencing an unprecedented demand for personnel who are seeking stability, challenge and growth. In fact, According to the most recent data from the U.S. Bureau of Labor Statistics (BLS), as of November 2014 insurance industry employment was up year over year. This entry level position presents a great opportunity for qualified candidates to get valuable training and ...

The insurance industry is experiencing an unprecedented demand for personnel who are seeking stability, challenge and growth. In fact, According to the most recent data from the U.S. Bureau of Labor Statistics (BLS), as of November 2014 insurance industry employment was up year over year. This entry level position presents a great opportunity for qualified candidates to get valuable training and ...

Claims Processor Level IIneeded for aFull Time/Contractopportunity with Yoh's client located inSan Diego, CA. Top Skills Should You Possess: - Two - five (2- 5) years of Claims Processing Experience in a Acute Care Setting - Experience with UB04 and CMS-1500 claim forms - Experience in processing Health Plan Claims What You'll Be Doing: - Examine and process claims from the UB04 and CMS-1500...

Position Summary Under general supervision the Wellness Claims processor is responsible for processing Wellness benefit claims. Essential Functions Link and set-up Wellness and Physician consult claims in the work distribution system and policy administration system Process for payment, denial or request additional information for Wellness and Physician Consult benefit claims. Other duties as...

Job Description Analyst will be responsible for manually reviewing submissions for reimbursement received from third parties contracted to make payments on behalf of client. Decisions will be made to pay, curtail or deny the reimbursements. Company Description American Mortgage Consultants, Inc. (AMC) is a Financial & Professional Services provider for Residential lending products. Established ...

PharMerica Corporation is a premier institutional pharmacy services provider, dedicated to providing quality patient care and innovative pharmacy solutions to institutional customers and patients in long-term care settings. With nearly $2 billion in annual revenues, PharMerica is the second largest institutional pharmacy company in America. PharMerica operates more than 100 institutional pharmacie...

PharMerica Corporation is a premier institutional pharmacy services provider, dedicated to providing quality patient care and innovative pharmacy solutions to institutional customers and patients in long-term care settings. With nearly $2 billion in annual revenues, PharMerica is the second largest institutional pharmacy company in America. PharMerica operates more than 100 institutional pharmacie...

Work from Home - Remote Roles & Responsibilities: - Analyze, review and adjudicate claims - Determine claim processing protocols and apply the correct policies to the claim. - Properly adjudicate claims based on your knowledge of covered benefits, insurance and provider contracts. - Verifying member eligibility, benefit coverage and researching or applying authorizations - Accurately documen...