Claims Service Representative 3

Claims Service Representative 2 - Casualty Prompt Response The Automobile Club is seeking Casualty Prompt Response Claims Representative handing bodily injury claims, you're bringing your expertise to a best-in-class organization that is focused on delivering quality service to our members. Under the general supervision of Claims Management, your...

Claims Service Representative 2 - Casualty Prompt Response The Automobile Club is seeking Casualty Prompt Response Claims Representative handing bodily injury claims, you’re bringing your expertise to a best-in-class organization that is focused on delivering quality service to our members. Under the general supervision of Claims Management, your...

Job DescriptionJob Description This position is located in Cypress, CA The Need: We are seeking a Claims Supervisor to join our growing team. In this role, you will be responsible for providing leadership and oversight to the Claims team. Accountable for ensuring the team adheres to standard work and meets department key performance indicators. ESSENTIAL...

Job Description: Position is fully remote and will be a temp role through 3/31/23. Position has the option to go perm based on positive work. Candidates can sit anywhere in the US and schedule will be M-F 9AM-5PM local time. The training schedule will be M-F 9AM-5PM EST. Daily responsibilities will include the following: Candidates will be reviewing medical...

**Claims Examiner III** **Role Insights** **Primary Responsibilities** - Audit claims processing quality, develops, maintains and runs standard reports - Assist the Claims Supervisor/Director in reviewing the quality auditing tracking/reporting (financial and procedural) - Coordinating with various departments to resolve disputes or issues - Maintain the...

Job Description Job Summary Thorough knowledge of processing professional, outpatient facility, and inpatient facility claims for Medicare, Medicaid, and Marketplace plans. Assists Molina departments with reviewing and conducting analysis of claims to ensure regulatory requirements are appropriately applied. Clearly documents claims research results and...

**JOB DESCRIPTION** **Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Interacts with health plans and vendors regarding recovery outstanding...

Our client, a National Third Party Administrator, is looking for a Temporary Workers' Compensation Supervisor for their temporary remote opportunity.Required Qualifications:3 years of Supervising California Workers Compensation AdjustersMonitor colleagues' workloads, provide training, and monitor individual claim activitiesSIPPreferred Qualifications:College...

Our client, a National Third Party Administrator, is looking for a Temporary Workers' Compensation Supervisor for their temporary remote opportunity.Required Qualifications:3 years of Supervising California Workers Compensation AdjustersMonitor colleagues' workloads, provide training, and monitor individual claim activitiesSIPPreferred...

**Job Description** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards. ...

Job DescriptionJOB DESCRIPTIONJob Summary Molina Health Plan Dental Provider Network Management and Operations jobs are responsible for dental network development, dental network adequacy and dental provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant...

Job DescriptionJob DescriptionSparrow Company is looking for a Customer Service Account Representative for one of our clients in the LONG BEACH, CA area.This person will be responsible for providing external customer support and internal support functions relative to sales. Ensure customers receive product order on time and in good condition. Ensure...

Job Description The focus of this position will be research and root cause analysis of claims / config issues with direct provider interaction and collaboration with our provider relations team. Additionally, the role will help with overpayment recovery, claims payment and adjustment projects, and reviewing proposed SAI concepts from PI and provide guidance...

Job DescriptionJob Description The focus of this position will be research and root cause analysis of claims / config issues with direct provider interaction and collaboration with our provider relations team. Additionally, the role will help with overpayment recovery, claims payment and adjustment projects, and reviewing proposed SAI concepts from PI and...

Job DescriptionJob DescriptionThis position will be a remote position. Must have a California SIP (Workers Compensation - Sr. Work Comp Claims Adjuster)POSITION SUMMARY: Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines.DUTIES AND RESPONSIBILITIES:Effectively...

**Remote and must live New York** **Job Description**: Job Summary Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and...

Apply Today! (TSR, Technical Service Support Representative) Job location: Long Beach, CA Shift: WEEKEND. Hours: 6 AM -6 PM SAT & SUN. with choice of 2 days during the week. Compensation: $22 Type: Office Type: Temp- Full time, with opportunity to be Representative, Support, Equipment Repair, Technical Support, Service, Retail, Staffing

Job Description***Remote and must live in downstate New York***Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant...

Job Description***Remote and must live in New Mexico***Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal,...

Job DescriptionJOB DESCRIPTIONJob Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding...