Claims Examiner

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

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 -...

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...

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...

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,...

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...

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...

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...

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....

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 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 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...

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...

Job DescriptionJob DescriptionOrganizational DescriptionThe Community Health Center Network (CHCN), sister organization to the Alameda Health Consortium, is made up of the eight federally qualified community health centers in Alameda County. CHCN functions as the managed care MSO for our health centers, contracting with Alameda Alliance for Health. To help...

SWBC is seeking a talented individual to review and evaluate incoming claims for payment or denial and acts as a liaison for the carrier and the financial institution. This role allows you to help those who are dealing with difficult circumstances in their lives. Your help gives them a sense of relief in times of need. You will also have a team who is...

POSITION SUMMARY/RESPONSIBILITIES Performs review, analysis, and adjudication of all claim types including coordination of benefits and DME claims. Performs analysis of provider appeals and documents outcome determination via correspondence. Acts as a provider liaison for claim issue resolution by utilization of appropriate corporate functionalities. ...