Claims Process Specialist

POSITION OVERVIEW/RESPONSIBILITIES Frontier Management is seeking skilled CLAIMS Analysts to join our dynamic team, focusing on our comprehensive healthcare programs. The CLAIMS Analysts will evaluate intricate issues related to claim settlements, eligibility criteria, supplementary insurance, transplant cases, and system-related challenges that exceed...

Position Overview:This role is for a dedicated and experienced Claims Manager within a leading healthcare organization. The ideal candidate will be instrumental in overseeing the medical claims processing operations, ensuring accuracy and compliance with industry standards.About Us:We are a reputable healthcare network committed to delivering exceptional...

{"Job Title": "Fraud Specialist", "Job Summary": "We are seeking a highly skilled Fraud Specialist to join our team at Apex Systems. As a Fraud Specialist, you will be responsible for processing actionable alerts, conducting research, and analyzing fraud claims. You will also be responsible for reviewing accounts and transactions for fraud activity, taking...

About the Role:Become a part of EControls, a prominent global entity renowned for its innovative integrated control solutions tailored for internal combustion engines and electric drive systems across diverse sectors. Our committed workforce engineers exceptional engine management systems for leading OEMs around the globe, guaranteeing peak performance and...

About Elevate Claims SolutionsWe are a leading provider of claims solutions, founded on the belief that human experience and claim quality are the essence of profitable growth and retention for our partners, clients, and ourselves.Job DescriptionWe are seeking a highly skilled and experienced Property Claims Adjuster to join our team in San Antonio, Texas....

Job DescriptionAt Assure Fertility Partners of San Antonio, we are dedicated to providing exceptional fertility care services to our patients. As a key member of our team, the Charge Entry Specialist plays a vital role in ensuring the smooth operation of our billing and claims process.Key Responsibilities:Documentation Review: Conduct thorough reviews of...

Job DescriptionAt Assure Fertility Partners of San Antonio, we are dedicated to providing exceptional fertility care to our patients. As a key member of our team, the Charge Entry Specialist plays a vital role in ensuring the smooth operation of our billing process.Key Responsibilities:Documentation Review: Thoroughly review medical documentation to...

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...

POSITION OVERVIEWAccountable for the daily acquisition of grant and entitlement claims.Key Responsibilities:Conduct thorough reviews of clinical documentation for billing efficiency, ensure precise billing and tracking, and collaborate with clinics to rectify billing discrepancies and gather necessary information. Provide regular updates on critical...

Medical Claims AdjudicatorAs a Medical Claims Adjudicator at University Health, you will play a critical role in ensuring the accuracy and efficiency of medical claims processing.Key Responsibilities:Adjudicate medical claims for Medicaid, Commercial, and CHIP according to departmental and regulatory requirements.Maintain audit standards as defined by the...

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 Title: Guidewire Claims Center Integration SpecialistWe are seeking a skilled Guidewire Claims Center Integration Specialist to join our team at Syntricate Technologies. As a key member of our team, you will be responsible for integrating different vendor points with our Guidewire Claims Center system.Key Responsibilities:Work with business stakeholders...

Job Summary052 SLIC Insurance Agency, LLC is seeking a skilled Claims Examiner II to join our team. As a Claims Examiner II, you will be responsible for reviewing and evaluating incoming claims for payment or denial, and acting as a liaison for the carrier and the financial institution.Key ResponsibilitiesClaims Adjudication: Adjudicate routine to moderately...

Claims Specialist Job DescriptionKelly Services, Inc is seeking a skilled Claims Specialist to join their team.Key Responsibilities:Manually key claims into the Claims Payment SystemExamine claims to ensure accuracyRoute claim issues to outside departments through separate channelsAbout the Role:This Claims Specialist role is a great opportunity to work with...

Job Title: Claims Adjuster SpecialistCompany: Fred Loya InsuranceThe Claims Adjuster Specialist position focuses on managing cases represented by legal counsel, assessing, and negotiating settlements with attorneys in a professional manner. Additionally, unrepresented claimants will be addressed as necessary.Benefits:Incentive payComprehensive training...

POSITION OVERVIEW/RESPONSIBILITIES Serves as a vital resource within the Claims Department to enhance, evaluate, and optimize departmental efficiency. Recognizes opportunities for enhancement, documents operational workflows, investigates industry best practices, gathers relevant data, and collaborates with process stakeholders to facilitate improvements and...

Job SummarySports Medicine Associates of San Antonio is seeking a highly skilled Insurance Verification professional to join our Business Office department. As an Insurance Verification specialist, you will play a critical role in ensuring accurate and timely insurance coverage verification for our patients.Key ResponsibilitiesVerify patient insurance...

Medical Biller Job OpportunityCreative Financial Staffing has partnered with a reputable healthcare provider in San Antonio to find a skilled Medical Biller. This is an excellent chance to join a dedicated team in a thriving healthcare environment.About the Company and OpportunityOur client is a leading healthcare provider known for its commitment to patient...

Job SummaryWe are seeking a highly skilled and motivated individual to join our team as a Guidewire Claims Center Integration Specialist. As a key member of our team, you will be responsible for working on Guidewire claims center integration, writing programs in GOSU programming language, and integrating different vendor points with Claims center.Key...

Job Description:We are seeking a highly skilled Automation Specialist to join our team at Cynet Systems. As a key member of our team, you will be responsible for analyzing and identifying topics/events in Guidewire, as well as developing and implementing automation strategies for QA automation, Selenium, and Unit/Functional testing using Junit/JMeter.Key...