Claims Examiner-HP Enrollment

Job Title: Claims ExaminerAt Maltos Law Firm PLLC, we are seeking a highly skilled Claims Examiner to join our team.About the Role:We are looking for an experienced Claims Examiner to manage and maintain client cases in our Case Management Software. The successful candidate will be responsible for preparing and sending letters of representation, obtaining...

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 Full time in office position: 19100 Ridgewood Pkwy San Antonio, TX 78259 What is your impact? As a Claim Examiner, you will handle...

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 Full time in office position: 19100 Ridgewood Pkwy San Antonio, TX 78259 What is your impact? As a Claim Examiner, you...

Reporting to the Manager, Claims, the Claims Examiner is responsible for claims processing, adjudication, and research. You will stay current on claim processing procedures, produce a quality work product, and assist Claims Management with special projects. You will have claims processing experience with the ability to maintain high qualitative and...

Reporting to the Manager, Claims, the Claims Examiner is responsible for claims processing, adjudication, and research. You will stay current on claim processing procedures, produce a quality work product, and assist Claims Management with special projects. You will have claims processing experience with the ability to maintain high qualitative and...

About OptumOptum 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...

Description: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation To ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of...

About the RoleAre you looking for a challenging and rewarding career in medical claims processing? Optum is seeking a Senior Claims Examiner to join our team. This role offers a unique opportunity to grow your career while making a positive impact on people's lives.Job DescriptionWe are responsible for providing claims support to our teams in reviewing,...

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 A high school diploma or GED equivalent is...

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 A high school diploma or GED equivalent is...

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 A high school diploma or GED equivalent is...

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...

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 A high school diploma or GED equivalent is...

About the RoleWe are seeking a highly skilled Complex Claims Examiner to join our team at Heritage MGA LLC.Job SummaryThe Complex Claims Examiner will analyze and review claims for accuracy, completeness, and eligibility. This role requires a strong ability to investigate losses, calculate and negotiate settlements, and prepare reports and records for...

Job OverviewAt University Health, we are seeking a skilled Medical Claims Examiner to join our team. This role involves performing adjudication of medical claims for Medicaid, Commercial, and CHIP according to departmental and regulatory requirements. ResponsibilitiesAdjudicate medical claims accurately and efficientlyMaintain audit standards as defined by...

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 A high school diploma or GED equivalent is...

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,...

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. ...

About USAAUSAA is a mission-driven organization that provides financial security to millions of U.S. military members and their families.Job DescriptionWe are seeking a dedicated Medical Claims Examiner - Risk Management Specialist to join our team. This hybrid role requires an individual to be in the office 3 days per week, where you will adjust complex...

**Job Overview:**We are seeking an experienced Claims Investigator to join our team at Command Investigations. As a Claims Investigator, you will be responsible for conducting investigations into insurance claims, gathering evidence, and writing detailed reports.The ideal candidate will have a strong background in insurance investigations, excellent...