Claims Evaluation 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...

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...

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 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...

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 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...

Aspire General Insurance Company, along with its associated general agent, Aspire General Insurance Services, is dedicated to providing affordable specialty auto insurance solutions while maintaining exceptional service standards. Our core values can be encapsulated in the acronym ABLE: to always act with integrity, be authentic, learn and grow, and execute...

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 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...

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...

Job OverviewSummary:Effectively manage, evaluate, and process provider specialty claims, including UB04 forms, in accordance with external regulations, internal protocols, and contractual obligations. A solid grasp of medical terminology is essential. Extensive knowledge of Commercial, Medicare, and Medi-Cal coding is required. Basic computer proficiency is...

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 SummaryThis role is eligible to participate in Zenith's hybrid work schedule, providing the flexibility to work from home on select days of the week according to the in-office schedule established by regional executive leadership. Selected candidates must be able to report into the regional branch office on a weekly basis.Key ResponsibilitiesInvestigate,...

Position Overview:We invite you to explore an exciting opportunity with MedPOINT Management as a Claims Examiner. This role is essential for ensuring the accurate processing and evaluation of provider specialty claims.Role Summary:The Claims Examiner will be responsible for the meticulous review, input, and adjudication of provider specialty claims,...

Job OverviewPosition Summary:The Claims Operations Support Specialist plays a crucial role in facilitating the daily functions of the claims department. This position is designed to assist various sub-departments within Claims Operations, ensuring seamless workflow and efficiency.Key Responsibilities:• Digitally archive claims and relevant documents into...

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...

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...

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 SummaryGeorge Hills Company is seeking a skilled Claims Investigator/Insurance Adjuster to join our team. As a Field Claims Examiner, you will be responsible for investigating, evaluating, and adjusting General and Automobile Liability claims.Key ResponsibilitiesConduct thorough onsite investigations to gather information and assess the extent of the...

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...