Healthcare Claims Analyst

Position OverviewThe role of a Healthcare Claims Analyst encompasses the evaluation and processing of claims, ensuring adherence to industry regulations and contractual obligations. This position requires investigating and resolving complex claims issues while proposing improvements to existing processes. The analyst also acts as a crucial resource for the...

Insight Global is seeking a dedicated Healthcare Claims Analyst I to join our team. This role is essential for managing and resolving claims inquiries effectively. The Healthcare Claims Analyst will engage with members via phone, addressing any billing or claims issues they may encounter. This position involves: Responding promptly to scheduled reports and...

Job SummaryMedPOINT Management is seeking a highly skilled Claims Processor to join our team. As a Claims Processor, you will play a critical role in ensuring the accurate review and processing of claims in accordance with regulatory requirements, internal standards, and contractual obligations.Key ResponsibilitiesAccurately review all incoming claims to...

Claims Recovery Analyst Job DescriptionOverviewThe selected candidate will play a crucial role in pinpointing and rectifying significant overpayments related to processed claims across various service lines. This position will also involve supporting the execution of DOFR initiatives and associated workflows. The Claims Recovery Analyst will leverage...

As a Healthcare Revenue Integrity Analyst, you will be instrumental in overseeing and verifying claims to guarantee precision and adherence to regulations.Primary responsibilities include:Monitoring and managing Stop-loss related claims across multiple carriers.Conducting thorough audits to ensure compliance with healthcare standards.Collaborating with...

Senior Construction Claims Analyst At AXA Group, we pride ourselves on our commitment to excellence in claims management. Our Construction Defect Claims team is dedicated to navigating the complexities of construction-related claims with precision and expertise. As a Senior Construction Claims Analyst, your primary responsibility will be to manage and...

Job SummaryMedPOINT Management is seeking a skilled Healthcare Claims Auditor to join our team. As a key member of our Claims Department, you will be responsible for ensuring the accuracy and compliance of claims processes.Key ResponsibilitiesAudit daily processed claims through random selection, utilizing system-generated reports to identify trends and...

Job DescriptionOverview:The Healthcare Financial Analyst plays a crucial role within the Finance department, delivering essential financial insights, accounting support, and strategic planning assistance to the Finance Leadership Team. This position is accountable for the accurate and timely completion of monthly accounting close processes, balance sheet...

Position OverviewWe are seeking a dedicated Claims Operations Coordinator III to join our team at Kaiser Permanente. This role is essential in ensuring the smooth processing of health insurance claims.Key ResponsibilitiesManage the adjudication process for health insurance claims, ensuring compliance with regulatory standards.Address and resolve disputes,...

Job OverviewGENERAL SUMMARYThe role of the Claims Assessment Specialist is crucial in ensuring the precise and prompt evaluation of claims submitted in various formats. This position entails processing claims and related correspondence in accordance with established regulatory standards and internal policies.KEY RESPONSIBILITIESEvaluate and adjudicate claims...

Job OverviewPosition Summary:A Healthcare Claims Quality Auditor plays a crucial role in ensuring the integrity of claims processing and adherence to regulatory standards, in alignment with the contractual commitments of Health Plans and Hospital Clients. This position involves investigating, reviewing, and liaising with provider services regarding claims...

Description:Summary: The main function of a Workers' Compensation Claims Adjuster is to investigate, analyze, and determine the extent of insurance company's liability to determine how much compensation is needed/required.Job Responsibilities:• Analyze first reports of injury to determine nature of injury and what benefits are owed based on the statute.•...

Worker's Compensation Claims Coordinator Job DescriptionLocation: Los Angeles, CARole Overview: The Claims Management Coordinator will collaborate closely with the HR Analyst to ensure effective handling of Workers' Compensation claims and related processes.Manage and oversee HR Medical, Accommodations, and Workers' Compensation communications.Address...

Position OverviewWhat Will Be Expected in This Role?The Healthcare Revenue Analyst plays a crucial role in evaluating financial trends to pinpoint discrepancies and generate analytical reports for assessment. This position entails synthesizing data and insights, preparing presentation materials, and offering recommendations to oversee potential opportunities...

POSITION SUMMARYThe Claims Processing Specialist is tasked with ensuring the precise and prompt evaluation of claims submitted in CMS 1500 and/or UB-04 formats. This role involves managing all claims and related correspondence in compliance with Medicare and Medi-Cal regulations, contractual obligations, and established operational protocols. The Specialist...

POSITION SUMMARYThe Claims Assessment Specialist plays a crucial role in ensuring the precise and prompt evaluation of both paper and electronic claims submitted in CMS 1500 and UB-04 formats. This role involves processing all claims and relevant correspondence in alignment with Medicare and Medi-Cal regulatory standards, contractual obligations, and...

Job DescriptionJob Summary:The Reporting Analyst will play a crucial role in ensuring the accuracy, timeliness, and efficiency of reporting and data input related to all Claims and UM functions at MedPOINT Management. This position will be responsible for managing scheduled and ad hoc reporting needs, troubleshooting data integrity issues, and analyzing data...

Company OverviewKeenan & Associates is a premier insurance brokerage and consulting firm dedicated to addressing the insurance requirements of healthcare institutions, public organizations, and educational districts in California.Role SummaryThe Senior Claims Examiner will oversee indemnity claims and manage intricate claim matters. This position requires a...

Job Summary:Ampcus Incorporated is seeking a highly skilled Non-Clinical - Finance/Accounting/Billing Analyst to join our team. As a key member of our financial operations department, you will be responsible for ensuring the accuracy and efficiency of our billing and claims processes.Key Responsibilities:Coding and Claims Management: Utilize your coding...

Position OverviewThe Claims Operations Coordinator III plays a vital role in the management of health insurance claims. This position requires a thorough understanding of claims adjudication processes, including the handling of disputes, appeals, and grievances.Key ResponsibilitiesUtilize knowledge of regulatory guidelines to ensure compliance and interpret...