Medical Claims Processor

Job Summary: As a Claims Representative at Elevance Health, Inc., you will be responsible for reviewing and processing health insurance claims. This role involves working under direct supervision, relying on others for instruction, guidance, and direction.Key Responsibilities:Review and process health insurance claims for paymentWork closely with healthcare...

Join us at Global Channel Management as we continue to grow and innovate in the healthcare industry.As a Sr. Configuration Data Analyst, you will be responsible for leading our product configuration efforts for Government and Medical-Surgical products.**Key Responsibilities:**Lead cross-functional project teams to implement new Government/Medical-Surgical...

We are seeking board-certified MDs or DOs in Occupational Medicine, Physical Medicine & Rehab, or Orthopedics to join our team as Medical Examiners. This is an exceptional opportunity for both seasoned providers and those looking to embark on a rewarding career path in Medical Evaluations.As a Medical Examiner, you will be responsible for conducting...

About the Role">We are seeking a board-certified Medical Examiner in Orthopedics to conduct comprehensive medical assessments and provide objective opinions in support of claims adjudication and case management processes.Responsibilities:">">Conduct thorough medical evaluations and assessments in accordance with Ohio BWC guidelines and regulations.">Perform...

Company OverviewMRG Exams is a leading provider of medical evaluation services, specializing in Independent Medical Evaluations (IME) and Permanent Partial Impairment Ratings for the Ohio Bureau of Workers' Compensation (BWC), third-party administrators, Managed Care Organizations (MCOs), and employers.We are seeking board-certified MDs or DOs in...

Job OverviewData Validation Specialist: The JobRialto company is seeking a skilled Data Validation Specialist to review and validate data extracted from physical vision insurance claims. As a key member of our team, you will be responsible for ensuring the accuracy of medical codes and patient information displayed on a screen. This involves verifying the...

About UsGlobal Channel Management OverviewAt Global Channel Management, we're dedicated to delivering exceptional products and services that meet the evolving needs of our clients.Salary Range: $80,000 - $120,000 per annumJob DescriptionWe're seeking an experienced Sr. Configuration Data Analyst to join our team!This is a challenging role that requires...

Company Overview">MRG Exams is a leading provider of independent medical evaluations (IMEs) and permanent partial impairment ratings (PPIRs) for the Ohio Bureau of Workers' Compensation (BWC), third-party administrators, managed care organizations (MCOs), and employers.">We are currently seeking dedicated and board-certified MDs or DOs in occupational...

About the role at Global Channel Management**Job Summary:**We are seeking an experienced Sr. Configuration Data Analyst to lead our product configuration efforts for Government and Medical-Surgical products.**Responsibilities:**Represent Product Configuration on cross-functional project teams to implement new Government/Medical-Surgical productsServe as the...

Job OverviewWe are looking for a highly skilled Senior Product Configuration Lead to lead cross-functional project teams in implementing new Government/Medical-Surgical products. The successful candidate will have experience with Claims Processing, Medical Plan Benefit Configuration, and SQL database management.

About the RoleAt Global Channel Management, we are seeking an experienced Data Configuration Specialist to join our team. The ideal candidate will have 5+ years of experience in health plans or medical claims and a strong background in configuration data analysis.

About the JobWe are seeking a detail-oriented and analytical professional to join our team as a Managed Care Plan Setup Specialist. In this role, you will be responsible for setting up new Managed Care groups in the claims system, fulfilling requested revisions to existing groups, and creating standard products using the Product Key Sheet method.About the...

At Elevance Health, we are seeking a skilled Clinical Fraud Investigator to join our team. This role is ideal for healthcare professionals with experience in fraud and abuse investigations.About the JobThe Clinical Fraud Investigator will be responsible for identifying potential risks associated with fraud and abuse in the healthcare industry. This involves...

Estimated Salary: $45,000 - $65,000 per year**Job Summary**This role involves working closely with patients and colleagues to provide exceptional service and support in selecting, ordering, and dispensing eyewear. You will maintain a thorough understanding of third-party plans and claims, process medical billing information, and balance accounts.We offer a...

Claims Processor needs 1 years' claims processing/data entry experience. Claims Processor requires: •Data entry and claims processing knowledge •working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet •Some basic working knowledge of software programs, specifically Excel and Access •Understands...

Claims Processor needs 1 years' claims processing/data entry experience. Claims Processor requires: •Data entry and claims processing knowledge •working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet •Some basic working knowledge of software programs, specifically Excel and Access •Understands...

About the job Claims Processor Claims Processor needs 1+ years experience Claims Processor requires: Ability to learn and adopt new processes quickly and with ease Onsite Medium-Advance level of expertise with Microsoft Excel Proficient with Outlook Familiar with Cloud-based applications (i.e. OneDrive) Ability to multi-task and perform duties using...

About the job Claims Processor Claims Processor needs 1+ years experience Claims Processor requires: Ability to learn and adopt new processes quickly and with ease Onsite Medium-Advance level of expertise with Microsoft Excel Proficient with Outlook Familiar with Cloud-based applications (i.e. OneDrive) Ability to multi-task and perform duties using...

Russell Tobin's client is hiring a Claims Processor in Mason, OH Employment Type: ContractLocation: Hybrid (2-3 days in the office) Mason, OH 45040Schedule: Monday-Friday 8am-4:30pmPay rate: $15-$17.85/hr Responsibilities:Responsible for the timely and accurate completion of key tasks supporting the successful implementation of new Small Business Clients...

Russell Tobin's client is hiring a Claims Processor in Mason, OH Employment Type: ContractLocation: Hybrid (2-3 days in the office) Mason, OH 45040Schedule: Monday-Friday 8am-4:30pmPay rate: $15-$17.85/hr Responsibilities:Responsible for the timely and accurate completion of key tasks supporting the successful implementation of new Small Business Clients...

Russell Tobin's client, a leading manufacturing company, is hiring a Claims Processor at Mason, OH Apply Now! Title: Claims ProcessorDuration: 03+ Months with possibility of extensionShift: 8AM – 4:30PM (30 Minutes Lunch)Location: Mason, OH 45040Pay Range: $16 - $17.85/hr. Job Description:The ideal candidate will be responsible for the timely and accurate...

Job Description: Pay Range: $11.24hr $17.24hr Responsibilities: Execute the preliminary steps to build a new client structure for implementation requests routed through shared Salesforce queue; using standard client set-up guideline(s) and process(es). Initiation of and accurate and timely tracking for all completed tasks using proprietary Salesforce...

Job Description: Pay Range: $14hr - $18hr Responsibilities: Execute the preliminary steps to build a new client structure for implementation requests routed through shared Salesforce queue; using standard client set-up guideline(s) and process(es). Initiation of and accurate and timely tracking for all completed tasks using proprietary Salesforce...

Job Description: Pay Range: $11.24hr $17.24hr Responsibilities: Execute the preliminary steps to build a new client structure for implementation requests routed through shared Salesforce queue; using standard client set-up guideline(s) and process(es). Initiation of and accurate and timely tracking for all completed tasks using proprietary Salesforce...

Russell Tobin's client is hiring a Claims Specialist in Mason, OHEmployment Type: ContractLocation: Hybrid Mason, OH 45040Pay rate: $20-$25/hrResponsibilities:Responsible for setting up new groups in the claims systemResponsible for fulfilling requested revisions to the existing group in the claims system (except Reseller product changes)Responsible for...

Russell Tobin's client is hiring a Claims Specialist in Mason, OHEmployment Type: ContractLocation: Hybrid Mason, OH 45040Pay rate: $20-$25/hrResponsibilities:Responsible for setting up new groups in the claims systemResponsible for fulfilling requested revisions to the existing group in the claims system (except Reseller product changes)Responsible for...

Anticipated End Date: 2025-01-23 Position Title: Claims Representative I (Health & Dental) Job Description: Claims Representative I (Health & Dental) Location: Must live within 50 miles of the Mason, OH, Norfolk, VA, Richmond, VA, Grand Prairie, TX, Houston, TX, Indianapolis, IN, Atlanta, GA, Miami, FL, or Tampa, FL PulsePoints. The Claims Representative I...

Anticipated End Date: 2024-12-19 Position Title: Claims Representative I (Health & Dental) Job Description: Claims Representative I (Health & Dental) Location: Must live within 50 miles of the Mason, OH, Norfolk, VA, Richmond, VA, Grand Prairie, TX, Houston, TX, Indianapolis, IN, Atlanta, GA, Miami, FL, Tampa, FL, Winston-Salem, NC, or Midland, GA...

Anticipated End Date: 2025-01-31 Position Title: Claims Representative I (Health & Dental) (US) Job Description: Claims Representative I (Health & Dental) Location: Must live within 50 miles of the Mason, OH, Norfolk, VA, Richmond, VA, Grand Prairie, TX, Houston, TX, Indianapolis, IN, Atlanta, GA, Miami, FL, or Tampa, FL PulsePoints. The Claims...

We are currently looking for Physicians to join our network to conduct examinations related to Veteran's Disability Claims in Columbus or Mason City, IA. Providers must reside within 50 miles of Mason City.The ideal candidate will have experience with Compensation and Pension (C&P) exams and be board-certified in Family Medicine, Internal Medicine,...

Job Overview: The Data Validation Specialist will primarily be responsible for reviewing and validating data extracted from physical vision insurance claims. This involves verifying the accuracy of medical codes and patient information displayed on a screen, making necessary corrections, and ensuring that the data is accurate and complete. The role may also...

Job DescriptionJob DescriptionJob Overview:The Data Validation Specialist will primarily be responsible for reviewing and validating data extracted from physical vision insurance claims. This involves verifying the accuracy of medical codes and patient information displayed on a screen, making necessary corrections, and ensuring that the data is accurate and...

Job DescriptionJob DescriptionJob Title: Independent Medical Evaluators - Occupational Medicine, Physical Medicine & Rehab, Orthopedists, Psychologists, Psychiatrists.Location: Ohio (Southern Ohio Preferred)Company Overview:MRG Exams is a leading provider of Independent Medical Evaluations (IME) and Permanent Partial Impairment Ratings (PPIR) services for...

About the job Sr. Configuration Data Analyst Sr. Configuration Data Analyst needs 5+ years experience with health plans or medical claims Sr. Configuration Data Analyst requires: Experience with Claims Processing, Medical Plan Benefit Configuration (Facets platform a plus) SQL and Database experience with basic queries. Excellent analytical and...