Claims Examiner

Job SummaryWe are seeking a skilled Medical Claims Examiner to join our team at Insight Global. As a Medical Claims Examiner, you will be responsible for analyzing and adjudicating routine claims, determining approval on file, eligibility, identifying discrepancies, and applying all cost containment measures to assist in the claim adjudication process.Key...

Claims Adjudication RoleWe are seeking a detail-oriented Claims Adjudication Specialist to review, process, and resolve insurance claims at Staffing Now.Key Responsibilities:Review and analyze insurance claims to ensure compliance with company policies and guidelines.Communicate with claimants and healthcare providers to resolve claims efficiently.Maintain...

Job Title: Claims AdjudicatorLocation: Miami, FLPay: $20 per hour Monday - Friday 8:30am - 5PMWe are seeking a detail-oriented Claims Adjudicator to review, process, and resolve insurance claims.Key Responsibilities: Review and analyze insurance claims. Communicate with claimants and healthcare providers. Ensure compliance with company policies and...

PayerFusion is seeking an experienced Senior Medical Claims Operations Manager to lead our claims department. As a member of our team, you will be responsible for supervising the claims operations, ensuring timely and accurate processing of claims, and maintaining a high level of customer satisfaction.**About Us:**We are a leading provider of medical claims...

About Secure Eclaims LLCSecure Eclaims LLC is a leading benefits management company serving Puerto Rico and South Florida.Job OverviewWe are seeking a highly skilled Medical Claim Analyst to join our team. The selected candidate will be responsible for reviewing medical/surgical billings, examining coding of operative reports, and performing hospital length...

Senior Auditor Job DescriptionCGS is seeking a highly skilled Senior Auditor to provide general auditing and accounting services in support of fraud investigations involving complex financial transactions and organizations attempting to evade detection.The ideal candidate will develop, coordinate, and draft technical audit guidelines, be proficient in...

Job SummaryWe are seeking a highly organized and detail-oriented Accounts Receivable Specialist to join our team at Northeastern Tribal Health System.The successful candidate will be responsible for performing accounts receivable support functions, including reviewing patient accounts, making adjustments, and following up with responsible parties.This is a...

Job Title: Compliance Officer: PTBuffalo Run Casino & Resort is seeking a highly skilled Compliance Officer: PT to join our team. The successful candidate will be responsible for ensuring that our casino operates within all applicable laws and regulations.Key Responsibilities:Assemble and maintain an accurate and current library of Federal, State, and Tribal...

Job DescriptionJob DescriptionWe are looking for a detail-oriented Claims Examiner to join our team and help ensure the accuracy and efficiency of our claims processing. Job Summary: The Claims Examiner will be responsible for reviewing, analyzing, and processing claims to ensure compliance with company policies and regulations. The ideal candidate will have...

Job DescriptionJob DescriptionWe are hiring an experienced Claims Examiner to work with a very successful company in the Coral Gables, FL area. We are interested in bringing an examiner into the claims department to resolve balance billing and appeals sent by clients, patients, and/or providers. This is an in-office position, working full time in Coral...

Job SummaryThis position is primarily responsible for adjudicating all medical and non-medical provider claims and submitting enrollments/disenrollment to Florida Medicaid and CMS. The position is key to PACE's revenue and expense process, procuring Medicare rate tables, processing provider claims for expenses by service line, ensuring client enrollment for...

Job Title: Medical Claims AdjudicatorJob Summary:This position is responsible for the accurate and timely adjudication of medical and non-medical provider claims, as well as the submission of enrollments and disenrollments to Florida Medicaid and CMS. The successful candidate will play a key role in PACE's revenue and expense process, ensuring compliance...

Job DescriptionJob DescriptionImmediate need for a Claims Manager in the Miami, FL. area. This is an ON-SITE position available with one of our best clients in the insurance services industry. In this role, you will supervise and manage day-to-day claims operations, ensuring quality and compliance with industry standards and state regulations. Your...

Job DescriptionJob DescriptionWe are hiring a Claims Manager in the Coral Gables, FL. area in Miami. This is an in-office position available with one of our best clients in the insurance services industry. In this role, you will manage day-to-day claims operations, ensuring quality and compliance with industry standards and state regulations. Your...

Position purpose:To ensure that the Casino operates within all applicable laws and regulations for Indian Gaming Enterprises in Oklahoma.Responsibilities/Duties/Functions/Tasks:Assemble and maintain an accurate and current library of Federal, State, and Tribal regulatory requirements for Indian Gaming.Serve as a gaming operation liaison for compliance audits...

Summary This is an open continuous announcement that will remain open until filled. Applications will be accepted on an ongoing basis. Eligible applicants will be referred each week for consideration until a selection is made. Responsibilities This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement...

SoftDev is seeking a qualified candidate to serve as a Program Integrity Analyst to join our team! SoftDev is performing Medicare and Medicaid Program Integrity work for the Centers for Medicare & Medicaid Services (CMS). The overall project includes data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to...

Summary This is an open continuous announcement that will remain open until filled. Applications will be accepted on an ongoing basis. Eligible applicants will be referred each week for consideration until a selection is made. Responsibilities VA offers a comprehensive total rewards package. VHA Physician Total Rewards. Pay: Competitive salary, annual...

Description Job Summary Assists in examinations and treatment of patient's care under the direction of the physician and/or clinician. Supports patient care management by performing various administrative functions. Job Specific Duties Answers telephones, routes calls, takes, and relays accurate phone messages. If applicable, prepares and administers...

POSITION SUMMARY:The Cargo Handler is responsible for ensuring warehouse duties assignments are finalized within the allocated period as assigned by the Warehouse Supervisor/ Lead Cargo Handler. The Cargo Handler is assigned duties in the Miami Warehouse from cargo acceptance, build-up, breakdown, scanning, tie-down, and other functions assigned by...

POSITION SUMMARY: The Cargo Handler is responsible for ensuring warehouse duties assignments are finalized within the allocated period as assigned by the Warehouse Supervisor/ Lead Cargo Handler. The Cargo Handler is assigned duties in the Miami Warehouse from cargo acceptance, build-up, breakdown, scanning, tie-down, and other functions assigned by...