Claims Examiner II

ESSENTIAL JOB FUNCTIONS:Adjudicates complex professional and institutional claims.Responsible for meeting performance measurement standards for productivity and accuracy.Adjudication of claims adjustment.Follow all appropriate Federal and State regulatory requirements and guidelines applicable to HealthPlan operations or as documented in company policies and...

JOB SUMMARY: Is responsible for adjudicating complex claims which include high dollar claims. Responsible for accurate manual/auto pricing of claims. Identify provider billing issues that impact claims processing. Works closely with the Supervisor to identify any reporting or training needs and system problems that may be encountered. Maintains quality and...

JOB SUMMARY: Is responsible for adjudicating complex claims which include high dollar claims. Responsible for accurate manual/auto pricing of claims. Identify provider billing issues that impact claims processing. Works closely with the Supervisor to identify any reporting or training needs and system problems that may be encountered. Maintains quality and...

JOB SUMMARY: Is responsible for adjudicating complex claims which include high dollar claims. Responsible for accurate manual/auto pricing of claims. Identify provider billing issues that impact claims processing. Works closely with the Supervisor to identify any reporting or training needs and system problems that may be encountered. Maintains quality and...

JOB SUMMARY: Is responsible for adjudicating complex claims which include high dollar claims. Responsible for accurate manual/auto pricing of claims. Identify provider billing issues that impact claims processing. Works closely with the Supervisor to identify any reporting or training needs and system problems that may be encountered. Maintains quality and...

Description: Remote from Southern, CA only. Candidates must reside in SCAL. Job Summary:Responsible for the administration of medical malpractice and other professional and general liabilty claims made during the course of conducting company business across the enterprise, having a material impact on legal reserves that are listed as a separate line item on...

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...

Description: Job Summary:The Nurse Practitioner (NP) is responsible for the assessment of selected patients in the designated service. The NP performs physical examinations, confers with patients in person and by phone/electronically, collaborates with others in the department to assure smooth flow of patient care consistent with established quality...

Insight Global is looking for a Benefits Manager to join a biopharmaceutical company in Pasadena, CA. This is a contract to hire role and is onsite 5 days a week. In this role, the Benefits Manager, People Services & Culture will work closely with employees at our corporate location in Pasadena, California and our other locations in San Diego, California,...

Insight Global is looking for a Benefits Manager to join a biopharmaceutical company in Pasadena, CA. This is a contract to hire role and is onsite 5 days a week. In this role, the Benefits Manager, People Services & Culture will work closely with employees at our corporate location in Pasadena, California and our other locations in San Diego, California,...