Claims Processing Specialist

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 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 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...

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...

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...

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...

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 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...

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...

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...

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...

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...

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 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 SummaryWe are seeking a highly skilled Claims Processing Supervisor to oversee the receipt, processing, and payment of monthly claims submitted by providers in compliance with contractual requirements, regulations, and agency policies and procedures.Key ResponsibilitiesSupervise the receipt, processing, and payment of monthly claims submitted by...

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 OverviewWe are seeking an experienced Case Manager to join our team at Javaheri & Yahoudai A Professional Law Corporation. As a Case Manager, you will be responsible for handling pre-litigation files from start to finish, providing exceptional customer service, and managing a high-volume caseload.Key ResponsibilitiesInitial and ongoing client contact to...

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 SummaryWe are seeking a highly skilled Claims Processing Supervisor to oversee the receipt, processing, calculation, payment, and reporting of monthly claims submitted by providers in compliance with contractual requirements, regulations, and agency policies and procedures.Key ResponsibilitiesSupervise the receipt, processing, calculation, payment, and...