Medical Claims Examiner Jobs

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1000+ Medical Claims Examiner jobs found on Monster.

Jobs 1 to 20 of 3976
QualCare, a successful Managed Care Organization, is currently seeking an individual to join our team to work out of the Piscataway, NJ office: Medical Claims Examiner Reporting to the Manager of Claims, and works within the Managed Care Regulatory Guidelines. Responsibilities include the processing and adjudicating of paper, electronic and scanned claims for multiple benefits and tier plans. ...
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...
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 Claims Examiner I-Ops Woodland Hills, CA JOB SUMMARY: Under close supervision, processes routine claims within product lines to determine type and amount of benefit payable. Performs limited duties, subject to review and approval, for the processing of such claims assigned, consistent with applicable policies, procedures and department guidelines. ESSENTIAL DUTIES AND RESPONSIBILITIES:...
Medical Claims Examiner Woodland Hills, CA JOB SUMMARY: Under close supervision, processes routine claims within product lines to determine type and amount of benefit payable. Performs limited duties, subject to review and approval, for the processing of such claims assigned, consistent with applicable policies, procedures and department guidelines. ESSENTIAL DUTIES AND RESPONSIBILITIES: · De...
Healthcare Sr. Claims Examiner Opportunities Dell has the opportunity to assist a client, located in San Ramon, CA in hiring Sr. Level Claims Examiners, preferably with IDX or QNXT experience to join their healthcare organization. Role Responsibilities -Ability to analyze, review and adjudicate provider claims -Experience in processing claims for inpatient, outpatient facility and professional...
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 ...
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...
Description : As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient c...
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...
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...
Experienced claims examiner to process medical claims, good phone skills required. Manalapan area . No medical billers. Salary commensurate with experience. Full benefit package. E-mail resumes to *****...
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;...
Insurance Overload Services, a leader in insurance industry staffing, is working with a regional self-insured client located South of Boston. Our client, a top name in the hospitality industry, is in need of a Risk Management Associate to join their staff on a long term temporary, possibly temp to hire, position to replace an outgoing employee. In this role, you wil be responsible for: Responsi...
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...
Randstad is looking for experience claims examiners to work in a stop loss claims area. Candidate will Conduct analysis and audits of excess risk claims and claims reimbursement process and reports results to management. Responsibilities will include: Design and conduct claims audits on specific types of business and authorize reimbursements and excess risk claims that exceed release limit. Monito...
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...
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...

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