Claims Examiner II

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...

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...

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...

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....

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....

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...

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...

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 DescriptionWellMed 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,...

Job Description 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,...

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 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...

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 Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff in complex claim issue resolution. Work cooperatively with Configuration in...

POSITION SUMMARY/RESPONSIBILITIES Community First Health Plans (partnered with University Health) is actively hiring experienced CLAIMS Analyst for their newly obtained STAR PLUS program. The CLAIMS analysts analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim...

Location: Onsite in Mission ValleyDuration: 3-6 month contract with potential to extend or convertJob Summary Administer self-insured Workers’ Compensation claims. Provide informal training and guidance to less senior employees. Ensure proactive and cost-effective claims management. Occasionally lead department process improvement initiatives. Reports to...

Direct Hire California Workers Compensation Examiner / Adjuster remote opportunity in state of California . Must reside in California and have experience handling CA Workers Comp indemnity claims In this position you will : Investigate high exposure indemnity California Arizona workers comp claims/ Hire outside vendors if necessary Analyze applicable...

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 your...