Medical Claims Examiner Jobs

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1000+ Medical Claims Examiner jobs found on Monster.

Jobs 1 to 20 of 2577
Our client is hiring for a Medical Claims Examiner in Miami, FL. Medical Claims Examiner Responsibilities: •Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin and extent of loss. •Engages and manages with parties involved in the claims process by determining facts, causation, damages and exposure; monitors costs to endure they are reason...
Job Description: Well-known company has an immediate need for a Medical Claims Examiner with at least 3 years of DIRECT health care claims processing experience in a managed care environment/health care setting. Knowledge of PDR (Provider Dispute Resolutions) is a huge plus! **Bilingual Spanish is a plus** JOB DUTIES: Accurate and timely processing of direct contract and delegated claims per re...
Claims Examiner Liability CLAIM YOUR FUTURE AS A GREAT PERFORMER! Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick has a strong commitment to its colleagues and its clients. If you are seeking a place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick is the p...
Claims Examiner Workers Compensation CLAIM YOUR FUTURE AS A GREAT PERFORMER! Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick has a strong commitment to its colleagues and its clients. If you are seeking a place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwi...
Superior Vision Houston, TX
Job Description: Scope and Purpose of Position: Review and adjudicate claims for services provided to members/patients enrolled through the company’s clients in accordance with contract and industry standards. Job Function: Review and process claims for covered services as defined by contract and in accordance with the established guidelines for claims administration performance standards and ...
Job Description: Medical Company has immediate opening for a Medical Claims Examiner. You will be responsible for the accurate and timely processing of direct contract and delegated claims per regulatory and contractual guidelines. You will process claims for all lines of business, including complex claims, monitor itemized billings for excessive charges, duplication, unbundling, and medical cod...
Medical Professionals San Francisco, CA
Do you have experience handling facility claims? Would you like to work for a Medical Service Organization that values its employees and the work you do? This company could be your next employer! Working under the direction of the Claims Manager, your position is responsible for processing IPA and/or hospital claims for members in a timely and accurate manner with attention to CMS guidelines and ...
UnitedHealth Group Inc. Buena Park, CA, 90620
AppleCare Medical Management was formed in 1996. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors—but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent phys...
UnitedHealth Group Inc Buena Park, CA
Position Description AppleCare Medical Management was formed in 1996. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors—but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-prac...
At Great American, we focus on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a "small company" entrepreneurial atmosphere with "big company" expertise. Great American has more than 25 specialty insurance divisions within our Property & Casualty Group, and our ...
Title: Medical Claims Adecco is assisting a local client in recruiting for a current Medical Claims job in Westchester. This is a temp to hire opportunity. As an Medical Claims you will need one year exp in medical claims examining, knowledge of HIPPA and well as ICD9 and CTP coding in a third party processing, have proven ability to make pay decisions and great attention to detail, proficient in...
Doherty Employment is seeking a Claims Examiner for a client in Minneapolis. This position is contract through the end of April with possible extensions, full time Monday-Friday with hours 7am-6pm, and pays $14-$15/hour. As the Claims Examiner you will research, resolve, examine and process paper and/or electronic claims submitted for payment. Interact with internal customers to obtain needed info...
Job Description: This Claims Examiner Position Features: ? Growth Potential ? Established Company ? Great Pay Immediate need for a Claims Examiner seeking growth potential in an established company that pays very well. Candidate will be responsible for the processing of medical claims including verification, adjudication and accuracy. Responsibilities Include: ? Editing and adjusting of cl...
Healthcare Opportunities Dell is looking for 2 Senior Travel Claims Examiners with Tapestry experience to join our team as part of this new exciting organization. Through the process of change, we are challenging ourselves to work faster, smarter, and more efficiently. These roles will be a key component in shaping how the business will work in the short, medium, and long term. The success of the...
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.(sm) The Claims Examiner is responsible for accurate and prompt payment of claims, in addition to reporting of statistic...
Claims Examiner LWP Claims Solutions, Inc. a Third-Party Administrator is expanding business and has an immediate opportunity to become part of a dynamic team. We are looking to add to our staff and have opportunities for experienced Workers’ Compensation Claims Examiners (Indemnity & Medical Only). LWP Claims Solutions, Inc. is a claims management company dedicated exclusively to workers' compe...
TRISTAR Risk Management has immediate opportunities for a Workers Compensation Claims Examiner I to work at our office in Fresno, CA. If you have at least a years' experience administering Workers' Compensation claims, possess exceptional interpersonal, verbal and written communication skills, provide excellent customer service and are a team player, we want to see your resume! POSITION SUMMARY ...
NF Claims Examiner Thorough knowledge of New York State NF Regulation 68 Knowledge of New York Workers Compensation Fee Schedule Reviews claims and policy to determine proper coverage Review claims for possible fraudulent activity and refer those claims to SIU Documents receipt of claim to reflect person(s) involved, injuries, details of the loss and the course of action that will be taken on...
ROLE & RESPONSIBILITIES: • Effectively manages a caseload of up to 125 workers’ compensation files, ranging from medical only to lost time & including some litigated claims and complex medical cases. • Initiates and conducts claims investigation in a timely manner. • Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company g...
Company Overview: Boston Mutual Life Insurance Company was founded in 1891 and has been a stable financially strong company for over 120 years. Boston Mutual is proud to promote our corporate principles of Service, Value, and Integrity. As well as being a financially strong and reputable company to do business with, Boston Mutual offers its employees a wide array of competitive benefits to full ...

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