Medical Claims Examiner Jobs

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JOB DESCRIPTION Job Title: Medical Claims Examiner Reports to: Claims Manager Department: Claims Supervisory Responsibilities: No Status: Full time FLSA Classification: Non-exempt Position Summary: This position is responsible for accurately and timely processing of medical claims and related correspondence. RESPONSIBILITIES/DUTIES: (not all-inclusive) all of the duties listed below are e...

Job Description: Healthcare 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 c...

Manpower is currently hiring for a dynamic Medical Claims Examiner for one of our top clients located in Farmington, Connecticut! Main Responsibilities: 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 Supports claim mana...

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SENIOR WORKERS COMPENSATION CLAIMS EXAMINER/SUPERVISOR (COEUR D ALENE AREA) Compensation: Competitive Wage DOE An insurance company in the Coeur d' Alene, ID area is seeking an experienced and cheerful SENIOR WORKERS COMPENSATION CLAIMS EXAMINER/SUPERVISOR to join its team. This is a full-time position, 8:30am-4:30pm weekdays, offering a competitive wage and benefit package including medical/den...

Randstad is looking for outstanding employees that want a career in claims! We have an immediate opening for an experienced claims examiner to work in a stop loss claims area of a Fortune 500 organization in downtown Minneapolis. This is a possible temporary - permanent position. You will conduct analysis and audits of excess risk claims and claims reimbursement processes and report results to man...

Open Medical Claims Examiner Position Available in Farmington, CT Open Medical Claims Examiner Position Available in Farmington, CT. Candidates must have a minimum of a Bachelor’s degree or equivalent business experience required. A minimum of 4 years of claims related experience required; prior insurance experience in a health/disability claim environment required. Must have demonstrated analyti...

Interested in working in an Medical Claims Examiner position in Farmington, CT with a dynamic and growing company? In this role our client is a fortune 500 company with room for growth and stability. We are looking for someone who is smart, dependable and driven. RESPONSIBILITIES AND DUTIES INCLUDE: The Long Term Disability Examiner is responsible for all aspects of claim adjudication, including...

JOB DESCRIPTION Job Title: Medicare Claims Examiner Reports to: Claims Manager Department: Claims Supervisory Responsibilities: No Status: Full time FLSA Classification: Non-exempt Position Summary: This position is responsible for accurately and timely processing of Medicare claims and related correspondence. RESPONSIBILITIES/DUTIES: (not all-inclusive) all of the duties listed below are...

AmeriHealth Caritas is growing! We are the nation’s leading provider of health care solutions for the underserved—a mission-driven organization that has helped people in need for 30 years. Our companies positively impact the lives of nearly 5 million individuals in 13 states. As we expand, AmeriHealth Caritas is seeking talented, passionate associates to join our team. Together we can build stron...

Manpower is currently recruiting for a dynamic Claims Examiner to work one for our top clients in Dallas, TX! Job Responsibilities: Provide primary processing of incoming Utilization Review referrals, ensuring accuracy of information, coordinating with requesting providers, adjusters and case managers to ensure all supporting medical documentation is secured to perform the review. Provides esse...

Do you excel and take pride in your work knowing that thousands of lives are positively impacted? Are you interested in being part of an award-winning Health Plan? Do you thrive in a mission-driven and fast-growing environment where the frontier of healthcare is constantly being pushed? Then, let's talk! We're looking for smart thinkers who enjoy challenges and will help us shape the future of hea...

Claims Examinerneeded for acontractopportunity with Yoh's client located in San Francisco, CA. The Big Picture - Top Skills You Should Possess: - Experience within Managed Care - Knowledge of Medi-Cal guidelines What You'll Be Doing: - Keep the department's claim inventory current and clear edit queues by process claims according to verification of eligibility, interpretation of program benef...

Top-rated insurance carrier with domestic and international customers seeking an attorney to perform E&O insurance claims. Functions: *** Own responsibility for case results on special risk and high-exposure E&O and other non-medical professional liability claims. *** Investigate claims, analyze coverage, manage litigation and resolve litigated claims. *** Prepare claim summaries and other per...

POSITION TITLE: Medi-Cal Claims Examiner II POSITION PURPOSE To accurately review, research, and complete all Medi-Cal and PartnershipAdvantage Crossover pended electronic and Imagenet claims within established timeframes, applying appropriate program policies and procedures. Medi-Cal claim types include: medical, facility (inpatient and outpatient), ancillary, long term care, supplies, DME, m...

Role and Responsibilities Effectively manages a caseload of 150 to 180 workers’ compensation files, including very complex claims.* • Initiates and conducts investigation in a timely manner.* • Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.* • Manages medical treatment and medical billing, authorizing a...

Workers Compensation Claims Examiner: JT2 Integrated Resources, a successful statewide TPA, has a career opportunity for a Claims Examiner in Northern California (Oakland Branch). Benefits: After 30 days of employment: Medical/Dental/Vision package; 401k Retirement Plan; Company paid & Voluntary Life Insurance; Health & Dependent Care Spending Accounts: PTO (10 days/start accruing after 90 days;...

Sedona Staffing Services along with a Sun Prairie, WI medical claims corporation have immediate openings for Claims Examiners. Expectations Candidate would need experience in handling auto bodily injury claims. The claims will be primarily California losses, so CA experience is preferred. Responsibilities Analyzes/manages/resolves complex or technically difficult claims by investigating and ga...

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 ...

The MMIA, Helena MT, is seeking a Senior Workers’ Compensation Claims Examiner. The position works under the general supervision of the MMIA Claim Manager and is responsible for the investigation, processing and management of workers’ compensation claims for the MMIA member communities which include medical expenses and lost wages. Requires a: Bachelor’s degree; 5+ years of increasingly responsib...

Job Description: AppleOne is looking for experienced Claims Examiner the ability to work in a high volume claims environment including daily processing of various types of claims with a minimum of 400 claims paid on average. The various types of claims include PPO, ASO, Medicare, Patient Pays and COB. DUTIES AND ACCOUNTABILITIES: ? Processing of various types of claims ? Knowledge of CPT and ...