Claims Examiner II

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...

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 SummarySWBC Real Estate, LLC is seeking a skilled Claims Adjuster to investigate, evaluate, and negotiate auto claims, CPI and GAP, to determine the extent of liability by interpreting and calculating settlement. Responsible for issuing settlement payments to the Named Insured.Key ResponsibilitiesGathers and assembles pertinent claim information by...

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...

Job OverviewOptum is a worldwide leader in healthcare solutions, leveraging technology to enhance the well-being of millions. The contributions made by our professionals significantly impact health outcomes by linking individuals with essential care, pharmacy benefits, data, and resources necessary for optimal health. Our culture is rooted in diversity and...

Job OverviewOptum is a worldwide leader in healthcare services, leveraging technology to enhance the well-being of millions. The contributions you make will significantly influence health outcomes by linking individuals with essential care, pharmacy benefits, data, and resources necessary for optimal health. Our culture is rooted in diversity and inclusion,...

Job OverviewOptum is a leading global entity dedicated to enhancing healthcare delivery through innovative technology, assisting millions in achieving better health outcomes. The role you will undertake is pivotal in connecting individuals with essential care, pharmacy benefits, and vital resources, fostering a healthier community. Here, you will be part of...

Job OverviewOptum is dedicated to transforming healthcare delivery for seniors, emphasizing a physician-led approach that prioritizes patient care. Our focus is on fostering health and wellness among our patients through comprehensive care management.The Senior Claims Examiner plays a crucial role in supporting our operations by meticulously reviewing,...

Job OverviewOptum is dedicated to transforming healthcare delivery for seniors through innovative care models. Our focus is on enhancing the health and well-being of our patients by providing comprehensive support and services tailored to their needs.The Senior Claims Examiner plays a crucial role in our operations by delivering essential claims support....

Job OverviewOptum is dedicated to transforming healthcare delivery for seniors, focusing on a patient-centered approach that prioritizes well-being. Our commitment to excellence drives us to support our patients through tailored healthcare solutions.The Senior Claims Examiner plays a pivotal role in our operations by delivering comprehensive claims support....

Job OverviewOptum is a worldwide leader in healthcare solutions, leveraging technology to enhance the well-being of millions. The contributions you make will significantly influence health outcomes by connecting individuals with essential care, pharmacy benefits, data, and resources necessary for optimal health. Our culture is deeply rooted in diversity and...

Job OverviewOptum is dedicated to transforming healthcare delivery for seniors, ensuring they receive the necessary care from compassionate professionals. Our innovative care model focuses on enhancing the health of our patients while collaborating with various Medicare Advantage health plans.The Senior Claims Examiner plays a pivotal role in our operations...

Job OverviewOptum is dedicated to transforming healthcare delivery for seniors through a physician-led approach. Our mission is to enhance the health of our patients by ensuring they receive the necessary care from compassionate professionals. We collaborate with various Medicare Advantage health plans and are committed to expanding our services.The Senior...

Job OverviewOptum is dedicated to transforming healthcare delivery for seniors through a physician-led approach. Our commitment is to ensure that our patients receive the necessary care from compassionate healthcare professionals. We collaborate with various Medicare Advantage health plans and are poised for ongoing expansion.The Senior Claims Examiner plays...

Job OverviewOptum is a worldwide organization dedicated to enhancing health outcomes through innovative technology and comprehensive care solutions. The contributions made by our team play a crucial role in connecting individuals with essential healthcare services, pharmacy benefits, and vital resources to promote well-being. Our workplace fosters a culture...

Job OverviewOptum is a leading global organization dedicated to enhancing health outcomes through innovative technology and comprehensive care solutions. Our mission is to empower individuals to achieve optimal health by providing essential resources, pharmacy benefits, and data-driven insights. We foster a culture of diversity and inclusion, offering...

Job Title: Customer Support: Fraud Investigation SpecialistLocation: Hybrid work modelSchedule: Two available shiftsMonday - Friday 10am - 7pmTuesday - Friday 10am - 7pm and Saturday 8am - 4:30pmJob Type: Long-term contract with potential for permanent placementCompensation: $17 - $19 per hourNumber of Openings: 3 - 5Overview:The primary role of the Fraud...

Job SummaryArgo Group is seeking a highly skilled Medical Claims Adjuster to join our team. As a Medical Claims Adjuster, you will be responsible for determining whether coverage exists for medical claims, denying claims that are ineligible for benefits, and thoroughly investigating claims by interviewing injured workers, employers, and medical providers.Key...

Job SummaryArgo Group is seeking a highly skilled Medical Claims Adjuster to join our team. As a Medical Claims Adjuster, you will be responsible for determining whether coverage exists for insureds, denying claims ineligible for benefits, and thoroughly investigating claims by interviewing injured workers, employers, and medical providers.Key...

POSITION SUMMARY/RESPONSIBILITIES The Clinical Nurse Case Manager II is responsible for coordinating comprehensive treatment plans for patients within a specified population across the healthcare spectrum. This role involves facilitating service delivery, assessing effectiveness, monitoring outcomes, and acting as an advocate for patients to ensure their...