Claims Operations Support Specialist

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...

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...

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...

Claims Assessment Specialist - Managed Care Providers Avispa Technology is looking for a skilled Claims Assessment Specialist to join our team. This role involves performing thorough reviews of claims and billing processes, managing denial resolutions, and processing various payer types including Medicare and Commercial Payers. The ideal candidate will...

Job OverviewOBJECTIVE:The Claims Processing Specialist is responsible for the preparation, documentation, and reconciliation of warranty claims, ensuring accurate submission to manufacturers and distributors for faulty components.KEY RESPONSIBILITIES:Evaluate warranty claims, confirming compliance with manufacturer or distributor requirements.Input necessary...

Claims Assessment Specialist - Managed Care Providers Avispa Technology is currently seeking a Claims Assessment Specialist to join a leading hospital and healthcare organization. This role involves conducting thorough reviews of claims and billing processes, managing denial resolutions, and processing various payer types including Medicare and...

Job OverviewThe Hospital Risk Claims Specialist plays a crucial role in managing hospital-related risk claims, ensuring compliance with external regulations and the contractual commitments of Health Plans and/or Hospitals/IPAs. This position involves thorough research, review, and communication with provider services to resolve claims-related issues...

Job OverviewClaims Review Specialist - Managed Care ProvidersA leading healthcare organization is in search of a Claims Review Specialist to perform comprehensive reviews of claims and billing processes, manage denial resolutions, and oversee transactions involving Medicare, Medi-Cal, and various Commercial Payers. The ideal candidate will possess over three...

Join Our Team at American Family Insurance Agency Staff At American Family Insurance Agency Staff, we are undergoing a significant transformation in our claims operations, focusing on enhancing customer experiences and effectively safeguarding their aspirations during challenging times. Our mission is to leverage our extensive knowledge, innovative...

Job DescriptionTrigent Software is seeking a highly skilled Insurance Claims Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely claims processing.Key Responsibilities:Claims Processing: Review and resolve claim edits in the billing scrubber for all government and non-government...

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 accuracy and efficiency of our claims processing operations.Key ResponsibilitiesReview and verify incoming claims to ensure compliance with regulatory requirements and internal standards.Process...

Job OverviewThe Matian Firm, APC is seeking a Claims Settlement Specialist to enhance our Personal Injury Department. This position involves overseeing and negotiating the resolution of personal injury claims prior to litigation. The ideal candidate will possess exceptional communication and negotiation abilities, substantial experience with insurance...

Position Overview:We are seeking a meticulous and experienced Senior Claims Adjustment Specialist to join our dynamic Medical Claims Department. This role is essential in ensuring the accurate and timely processing of medical claims adjustments.About the Organization:The Motion Picture Industry Pension & Health Plans (MPI) is a distinguished multi-employer...

About Allstate Insurance CompanyAllstate Insurance Company is a leader in the insurance industry, dedicated to providing innovative solutions that meet the evolving needs of our clients. We specialize in a wide range of insurance products, including auto, home, and health insurance, delivered through a robust network of independent agents and...

Job SummaryWe are seeking a highly skilled Construction Defect Claims Specialist to join our team at AXA XL. As a key member of our Construction Defect Claims team, you will be responsible for handling and resolving complex, highly specialized, and high exposure Primary and Excess Construction Defect claims.Key ResponsibilitiesInvestigate and evaluate...

Job OverviewThe Claims Correspondence Specialist will collaborate closely with the Personal Injury Division. This role demands exceptional attention to detail, the ability to manage multiple tasks efficiently, and the capacity to thrive in high-pressure situations. Additionally, the Claims Correspondence Specialist may undertake special assignments as...

The Motion Picture Industry Pension & Health Plans (MPI) is seeking a meticulous and organized Senior Claims Adjustment Specialist to enhance our Medical Claims Department within the Adjustments Team. Position Overview:This role is essential for ensuring the precise and timely processing of medical claims adjustments. Key Responsibilities:Evaluate and test...

Position Overview:We are seeking a skilled Claims Review Specialist / Medical Coder to join our esteemed client, a prominent Medical Center affiliated with a leading California Public Ivy university and a major health delivery system in the state.*** Candidates must have authorization to work in the USA without requiring sponsorship...

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,...

Position OverviewHanna, Brophy, Maclean, Mcaleer & Jensen, LLP is a prominent legal firm focusing on workers' compensation defense. We are currently on the lookout for a Claims Resolution Specialist to enhance our team. In this role, you will be tasked with overseeing and resolving lien cases through proficient communication, legal documentation, and...