Medical Claims Specialist Jobs

1000+ jobs

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 purpose of this position is to delight our customers by resolving their issues through fast and accurate proble...

Location: Tampa, FL 33634 Department: Operations - Claims Reports to: Supervisor, Operations Day Shift - Monday through Friday Researches and processes institutional and professional claims. Provides subject matter expertise to departmental and corporate projects, analyzing and performing root cause analysis on all types of claims issues and adjustments. Serves as a primary point of contact to...

Job Description: Medical Claims Specialist eClusive isa third party administrator (TPA) that provides back-office functions for capitated health plans. Back-office functions include but are not limited to claims adjudication, member enrollment and reporting, and financial reporting. eClusive’s sister company, Mediture, has a long history in providing software solutions for managing care coordinat...

Medical Claims Specialist - Kendall Responsible for performing all proper and necessary actions to ensure the timely and accurate reimbursement of Medicaid insurance accounts. Contract assignment, Monday-Friday, 8:00 AM - 4:30 PM, $15/hr. Requirements: · 2-5 years of experience working with Medicaid hospital programs · Knowledge of both UB-04 and 1500 claim forms, EOB, medical terminology, re...

JOB DESCRIPTION We are currently seeking professional employees with strong administrative skills to support the healthcare advisory division of a large service delivery center. The position is full- time and $11.00/hr. Position requires: • Excellent customer service and telephone etiquette skills. Ability to work effectively with all levels of management and other colleagues, demonstrating ini...

Company Confidential
Medical Claims Follow-up Specialist Busy West Knoxville specialist office seeks a FT Medical Claims Follow-up Specialist. Applicants must be a team player, detail oriented, & must have 1yr. past exp. in a medical office setting (exp. required). Competitive pay/benefits. Fax resumes to 865-588-3383 or Email: ***** Posting provided by:...

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Local Medical Billing Company seeking new team member: In need of a medical claims examiner including problem solving skills for our fast paced environment. The job would require: positive attitude, coachability, strong communication, data entry, phone and customer service skills with a willingness to learn quickly. It would be beneficial to have Medicare/Medicaid, commercial insurance knowledge, ...

The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Claims Specialist to research and resolve problems and issues related to their area of specialty. The CareAdvantage Claims Development Specialist will contact non-contracted providers via telephone and correspondence, and resolve and develop pended claims within a timely manner in accordance with CMS guideline and a...

Claims Specialist III - Medical Claims Processing-1502383 About WellCare: WellCare Health Plans, Inc. is a Fortune 500 company traded on the New York Stock Exchange (symbol: WCG). It provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare...

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Collections Analyst - Clinical Appeals Work hours are Monday - Friday, from 8:30am - 5pm. You will monitor insurance denials by running appropriate reports and contacting insurance companies to resolve claims denied for clinical reasons Research and identify coding or clinical documentation issues and work to correct the errors in a timely manner Identify problem accounts and escalate them as ...

Job Summary The Claim Follow up Specialist is responsible for account resolution and resolving issues associated with unpaid/improperly filed insurance claims. Job Responsibilites: It is expected that all of the Principal Duties and Responsibilities identified below will be performed in a manner that reflects the values of Mercy Health, which are: Compassion, Excellence, Human Dignity, Justice,...

Description: Great sales are the result of strong purpose, conviction and pride - pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.(sm) This position is responsible for researching, defining and implemented the requirements for Facility Claims as defined b...

Healthcare/Medical industry related company currently hiring for a Medical Insurance Processing Specialist for their office located in Rancho Bernardo. This position requires one year of experience working directly with Medical Insurance preferably in a third party capacity. This position is working for a well established company involved in medical related testing and health planning. Qualificat...

At Liberty Mutual Insurance, doing the right thing is essential to all that we do. Our commitment to building and sustaining a talented and diverse workforce has helped us to become a global leader in property and casualty insurance. As of December 31, 2014, Liberty Mutual Insurance had $39.6 billion in annual consolidated revenue. Our financial strength and profitability rely on the skills, knowl...

The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Claims Specialist to review and resolve a weekly caseload of claims, with varying degrees of complexity, within established timeframes and adhering to appropriate program policies and procedures. The Claims Specialist reviews medical, facility (inpatient and outpatient), supplies and DME claims that require interven...

SUMMARY: This entry level position will examine, adjust, and manage claims for client company’s workers compensation benefits. ESSENTIAL JOB DUTIES AND RESPONSIBILITIES: Review employee injury reports to determine compensability. Examine workers' compensation claim forms. Advise employers on the proper management and impact of workers' compensation claims. Explain operation of alternate "light...

Seeking a detail oriented individual to process payments and insurance claims in our Claims Management Department. This individual must have excellent organization and computer skills and be able to work efficiently as a team member. In addition, this individual must have the desire and motivation to thoroughly research problems in the Claims process. Previous experience in Insurance and/or Medica...

Health Insurance Claim Follow-up Specialist Comstar – Rowley, MA We seek a high energy, promotable medical insurance specialist to join our growing company Company Overview: Comstar is a Massachusetts corporation, which processes medical claims, sends bills and provides collection services for primarily municipal ambulance services. We have been in business since 1984. Our 50+ employees curren...

General Description: Manage within company standards and best practices complex and problematic high visability workers' compensation claims within delegated limited authority to determine benefits due, work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer requirements to achieve the best possible outcome in the claim. Essential J...

General Description: Manage within company standards and best practices complex and problematic high visability workers' compensation claims within delegated limited authority to determine benefits due, work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer requirements to achieve the best possible outcome in the claim. Essential J...