Senior Claims Examiner

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

Claims Examiner RoleAs a Claims Examiner at University Health, you will play a critical role in ensuring the accuracy and efficiency of our claims processing system.Key Responsibilities:Conduct thorough reviews and analyses of various claim types, including coordination of benefits and DME claims.Analyze provider appeals and document outcome determinations...

Performs adjudication of medical (HCFA) or hospital (UB 92) claims for Medicaid, Commercial, and CHIP (Children s Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department. Claims, Examiner, Healthcare

Job DescriptionWellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans...

To analyze high-level commercial general liability / bodily injury claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific clie General Liability, Claims, Examiner, Liability, Insurance

Get To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans. Key position details: This is a fully in office position: 19100 Ridgewood Pkwy San Antonio, TX 78259 Training schedule: 8:00am - 4:30pm Monday - Friday What is your...

Job DescriptionGet To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans. Key position details: This is a fully in office position: 19100 Ridgewood Pkwy San Antonio, TX 78259 Training schedule: 8:00am - 4:30pm Monday -...

WellMed is part of OptumCare , a division under the greater UnitedHealthcare Group umbrella. We have a network of doctors, specialists and other medical professionals that specialize in providing the highest level of medical care for more than 1 million older adults with over 16,000 doctors’ offices in Texas and Florida. We’re growing, and we are making...

Job DescriptionOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity...

At 052 SLIC Insurance Agency, LLC, we are seeking a skilled Claims Examiner II to join our team. As a Claims Examiner II, you will play a critical role in assessing and reviewing incoming claims for payment or denial, serving as a liaison between the carrier and the financial institution.This role provides the opportunity to make a meaningful impact on...

Job SummaryUniversity Health System is seeking a highly detail-oriented and analytical Claims Examiner to play a critical role in ensuring the accuracy and fairness of medical and hospital claims for Medicaid, Commercial, and CHIP programs.Key ResponsibilitiesAdjudicate medical (HCFA) and hospital (UB 92) claims in accordance with departmental and regulatory...

You can make a difference in the San Francisco community. San Francisco Health Plan is seeking a full-time Claims Examiner. The Claims Examiner is responsible for claims processing, adjudication, and research. In addition, this position keeps current on claim processing procedures, produces a quality and timely work product, and assists Claims Management...

Job DescriptionJob DescriptionYou can make a difference in the San Francisco community. San Francisco Health Plan is seeking a full-time Claims Examiner.The Claims Examiner is responsible for claims processing, adjudication, and research. In addition, this position keeps current on claim processing procedures, produces a quality and timely work product, and...

Job DescriptionJob DescriptionIndustry: ITTitle: Claim Examiner/AdjusterLocation: RemoteRates: $19/hr. - $20/hr. without benefitsDuration: 7 months Contract with higher extension possibilities. JOB DESCRIPTIONThis is a Claims Examiner for Travel Insurance ClaimsMust-Have Active New York Adjusters LicenseResponsibilities:• Investigate, evaluate, and settle...

Job Category : Workers' Compensation ClaimsRequisition Number : CLAIM007236Employment Type: Full-TimeSalary Range: $65,220.24 USD to $109,989.53 USDLocation: Remote/Hybrid options available for qualified candidates.The Senior Claims Examination Specialist is responsible for managing a diverse portfolio of claims, ensuring exceptional service delivery to...

Job Category : Workers' Compensation ClaimsRequisition Number : CLAIM007236Employment Type: Full-TimeSalary Range: $65,220.24 USD to $109,989.53 USDLocation: Remote options available for qualified candidates.The Senior Claims Examination Specialist is responsible for managing a portfolio of moderate to complex claims, ensuring exceptional service delivery to...

Job SummarySWBC Real Estate, LLC is seeking a skilled Claims Adjuster to investigate, evaluate, and negotiate auto claims, CPI and GAP, to determine the extent of liability by interpreting and calculating settlement. Responsible for issuing settlement payments to the Named Insured.Key ResponsibilitiesGathers and assembles pertinent claim information by...

Are you seeking a fulfilling career where your contributions are valued? At ICW Group, we prioritize innovation and adaptability in our workforce. We foster a dynamic work environment that encourages creativity and collaboration to deliver exceptional solutions. Our mission is to provide an unparalleled insurance experience. ICW Group, headquartered in San...

Overview: Administer indemnity claims and handle complex claim issues. Use strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation. Keenan, an Accretive company, is an insurance brokerage and consulting firm meeting the insurance needs of hospitals, public...

POSITION SUMMARY/RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children's Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department. EDUCATION/EXPERIENCE High school diploma or GED equivalent is required....