Medical Claims Examiner Jobs

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21 Medical Claims Examiner jobs found on Monster.

Jobs 1 to 20 of 21
Ajilon is currently recruiting for a Claims Examiner job in Indianapolis, IN. Three to five years of previous medical claims adjudicating experience is required for this position. Previous experience in third party claims is preferred. This position will be processing a high volume of claims as well as researching issues and documenting results. Qualifications: • Three to five years in medical c...
Zenith American Solutions. Remarkable People, Remarkable Results. We are far more than a benefits administrator – we are the strongest, most respected third-party administrator in the industry, and we are pleased to announce two exciting new opportunities! We are currently seeking a Medical Claims Examiner and a Lead Medical Claims Examiner to join the Claims team in our office in Deforest, WI. O...
Medical Claims Examiner Reserve National Insurance Company, a Division of Kemper Corporation is seeking qualified candidates to fill a Medical Claims Examiner position. Job Responsibilities: Analyze & adjudicate professional and institutional medical claims according to the benefits available under individual health plans. Claims must be processed in a timely and accurate manner taking into con...
Job Description: Well known Health Care Organization 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, unbundli...
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. JOB DUTIES: Accurate and timely processing of direct contract and delegated claims per regulatory and contractual guidelines. Processing claims for all lines of business, including compl...
Company Confidential Corona, CA, 92881
Job Summary: Position is responsible for the adjudication and processing of medical claims, review of medical records and identifying provider billing issues that impact claims processing. Qualifications: i. Expertise in medical terminology and medical claim calculations/payments. ii. Ability to interpret standard reference materials [current procedure terminology (CPT) / California Relative V...
Open Systems Technologies, Inc. Farmington, CT, 49504
Job Description Position:Medical Claims Examiner Associate Location:Farmington, CT, 06032 Contract:5+ months Job Summary: The Long Term Disability Examiner is responsible for all aspects of claim adjudication, including but not limited to contract evaluation, medical records evaluation, financial evaluation, eligibility determination, and benefits calculation and offset management. The posit...
We are in need of Medical Claims Examiners, well-versed in the entire claims process, for ongoing, temporary work. Working Monday through Friday, with occasional Saturday overtime. Flexibility in hours is needed and the ability to work 8 hours within the hours of 7am to 7pm. Must be able to adapt to complex computer databases and processes quickly. Hourly rate will depend upon experience and range...
Are you looking for temp to hire work? Are you available on first shift, Monday through Friday? Do you have experience processing claims? If so, SPHERION has a GREAT opportunity for you!! Our West Madison client has a great opening to put your experience to use in their beautiful office! This position has full-time hours, Monday through Friday. Again, this is a Temp to Hire opportunity. Positio...
Johns Hopkins Hospital/Health System Glen Burnie, MD, 21060
Johns Hopkins employs more than 20,000 people annually across our health system. Upon joining Johns Hopkins, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate loca...
Medical Claims Examiner Reserve National Insurance Company, a Division of Kemper Corporation is seeking qualified candidates to fill a Medical Claims Examiner position. Job Responsibilities: Analyze & adjudicate professional and institutional medical claims according to the benefits available under individual health plans. Claims must be processed in a timely and accurate manner taking into con...
Job Description Medical Claims Examiner Work for a company where you are a 100% employee owner and for a company that is one of the Best Places to Work in Illinois! We are looking for full-time Medical Claims Examiner to: Process Medical/Dental/Vision/Short Term Disability Claims Analyze claims for eligibility via Plan Document Process all Correspondence and material for scanning Answer and...
Hewlett-Packard Company Palo Alto, CA
Medical Claims Examiner - 1291250 Description Job Description: The Insurance/Healthcare job family contains positions associated with providing consultancy utilizing knowledge and expertise on insurance and healthcare. Develops and implements general insurance and health policies in accordance with state and federal laws. Provides expertise to investigate and adjudicate claim characteristics tha...
For almost 25 years, IMG has provided high quality global medical insurance benefits and developed a reputation of excellence and leadership in the international medical insurance market. With around-the-clock medical management services, multilingual claims administrators and highly trained customer service professionals, IMG is confident in its ability to provide the products international trave...
Summary: The medical Claims Examiner is responsible for analyzing and correctly adjudicating claims for GMS TPA operations. Essential Duties and Responsibilities: Examine, process and adjudicate claims for medical, dental and prescriptions. Identify claims to be processed in order of identified importance and work within time limitations. Resolve issues and identify customer needs (call on iss...
Care1st Health Plan is a full service managed care organization offering Medi-Cal and Medicare plans. We are committed to providing health care that is medically excellent, ethically driven and delivered in a patient-centered environment that recognizes the positive relationship between health education, a culture of wellness, an emphasis on prevention and a cost-effective delivery of care. We ar...
Molina Healthcare Inc Long Beach, CA
Job Summary Claims Processing of complex claims (stop loss, etc.) and adjudication and claims research when necessary. Must meet and/or exceed qualitative and quantitative production standards. Provides informational resource for employees, assist in training new staff, handle difficult claims. Essential Functions • Quality Standard - Meet and Maintain quality standard for position. • Claims A...
Molina Healthcare Long Beach, CA, 90802
Job Summary Claims Processing of complex claims (stop loss, etc.) and adjudication and claims research when necessary. Must meet and/or exceed qualitative and quantitative production standards. Provides informational resource for employees, assist in training new staff, handle difficult claims. Essential Functions • Quality Standard - Meet and Maintain quality standard for position. • Claims Adj...
Attention current TriHealth employees: Please apply for this position by submitting an online internal application via SuccessFactors. Please be certain to update your SuccessFactors Employee Profile prior to applying to this position. QUALITY CONTROL AUDITOR: The Quality Control performs audits of practices to ensure compliance with CMS regulations, and in accordance with SSAE guidelines. Coord...
NAMM California Ontario, CA, 91761
Overview: Processing of medical claims including verification, adjudication and accuracy. Responsibilities: Accurately process manual professional claims. Responsible for editing and adjusting of claims per the EDI daily audit report. Analyze and adjudicate claims to ensure accurate payment. Interpret Fee for Service (FFS) and capitated provider contracts. Review claims on a periodic basis....

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Healthcare Career Tools

Medical Claims Specialist/Examiner

Salaries

$24,000.00 - $52,000.00
Typical Salary for Medical Claims Specialist/Examiner
(241 Respondents)
Source: Monster.com Careerbenchmarking Tool

Education / Training

Bachelor's
23.5%
Some College Coursework Completed
22.5%
Associates
16.6%
High School
14.4%
Certification
11.8%
Vocational
7.5%
(187 Respondents)
Source: Monster.com Careerbenchmarking Tool
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