Medical Claims Processing Director

Job SummaryWe are seeking a highly skilled Medical Director to join our team at Humana. As a Medical Director, you will be responsible for leading the clinical review process and making determinations on whether requested services, level of care, and site of service should be authorized at the inpatient level.Key ResponsibilitiesLead the clinical review...

Job SummaryConduent State Healthcare, LLC is seeking a highly skilled Claims Department Manager to lead our medical claims processing team. As a key member of our organization, you will be responsible for overseeing daily tasks, setting priorities, and coordinating activities to ensure timely completion of claims processing.Key Responsibilities:Manage a team...

Job DescriptionAs the Claims Department Team Lead, you will oversee daily tasks, set priorities, and assist with coordinating activities to ensure timely completion. You will guide team members and work to resolve mission-critical escalated issues and projects. Your expertise will significantly impact the team's effectiveness, fostering efficiency and...

Job Title: Claims Department Team LeadConduent State Healthcare, LLC is seeking a highly skilled Claims Department Team Lead to join our team. As a key member of our operations team, you will be responsible for leading a complex medical claim processing team, overseeing daily tasks, setting priorities, and assisting with coordinating activities to ensure...

At Conduent State Healthcare, LLC, we are seeking a skilled Claims Department Manager to lead our medical claims processing team. As a key member of our organization, you will be responsible for overseeing daily tasks, setting priorities, and coordinating activities to ensure timely completion.Key Responsibilities:Manage a claims processing department to...

About SedgwickSedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Our purpose is to help organizations protect their people, assets, and reputation. We achieve this by delivering innovative solutions that address the complexities of risk, benefits, and integrated business needs.Job SummaryWe are...

Job Title: Claims Examiner 2Are you a detail-oriented and customer-focused individual looking for a challenging role in claims examination? We are seeking a Claims Examiner 2 to join our team at the State of Montana.Job Summary:The Claims Examiner 2 will be responsible for assisting the public with the claim process, explaining Unemployment Insurance...

Job Title: Claims Department Senior Manager PositionConduent State Healthcare, LLC is seeking an experienced Claims Department Senior Manager to lead our medical claims processing team. As a senior manager, you will be responsible for overseeing daily tasks, setting priorities, and coordinating activities to ensure timely completion. You will leverage your...

About the Role:Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. As a Claims Examiner - General Liability Specialist, you will play a critical role in analyzing high-level commercial General Liability claims on behalf of our valued clients to determine benefits due, while ensuring ongoing...

Job Summary: We are seeking a highly skilled Claims Department Manager to lead our complex medical claim processing team. As a key member of our leadership team, you will oversee daily tasks, set priorities, and coordinate activities to ensure timely completion. Key Responsibilities: Lead a team of medical claims processing professionals Oversee daily...

Role OverviewSedgwick is seeking a skilled Claims Examiner to join our team. As a Claims Examiner, you will be responsible for analyzing complex liability claims, determining benefits due, and ensuring ongoing adjudication of claims within service expectations and industry best practices.Key ResponsibilitiesAnalyze and process complex liability claims by...

Claims Team Lead - Liability SpecialistSedgwick is seeking a Claims Team Lead - Liability Specialist to supervise the operation of multiple teams of examiners and technical staff for liability claims for clients. The ideal candidate will have a thorough knowledge of claims management processes and procedures for multiple product lines, excellent oral and...

Job SummaryCottingham & Butler Claims Services is seeking a skilled Workers Compensation Claims Adjuster to join our team. As a key member of our claims team, you will be responsible for investigating, evaluating, negotiating, and settling workers compensation claims on behalf of our clients.Key Responsibilities:Investigate and evaluate workers compensation...

Empowering Montanans through Work and OpportunityAs a Claims Examiner 2 at the State of Montana, you will play a critical role in empowering Montanans through work and opportunity. You will assist the public over the phone in the claim process, utilizing the external customer-oriented online claims system to file the claim. Your exceptional customer service...

About the JobAt Montana State Fund, we're seeking a skilled Claims Attorney to join our team. As a key partner to the organization, you'll provide legal and strategic advice on a wide range of matters, representing the company in formal and informal legal proceedings.ResponsibilitiesRepresent Montana State Fund in various legal forums, including...

Job Summary:As a key member of The Staff Pad team, we are seeking a highly skilled Medical Coder to join our team. The successful candidate will be responsible for accurately assigning ICD-9 and CPT codes to clinic office visit, hospital, lab, and x-ray tickets in a timely manner, ensuring compliance with all applicable guidelines and regulations.Key...

About the RoleSedgwick is seeking a highly skilled Litigation Consultant - Liability to join our team. As a key member of our global claims team, you will be responsible for analyzing and processing complex commercial general liability claims on behalf of our valued clients.Key Responsibilities:Analyze and process claims through well-developed action plans...

About LumenLumen is a leading provider of digital solutions, connecting people, data, and applications with speed, security, and ease. Our mission is to ignite business growth by empowering our customers to succeed in a rapidly changing world.We are committed to creating a culture of teamwork, trust, and transparency, where our employees can thrive and reach...

Job SummaryAs the Senior Director of ServiceNow Platform, you will be responsible for leading the transformation of the overall ServiceNow implementation at Marriott International. This includes product function and capability, governance and compliance, as well as related product teams, suppliers, and managed service providers.You will drive a culture of...

We're seeking an experienced, clinically trained leader to join our team as the Director of the Outpatient Cancer Center.This role will oversee clinical operations, focus on quality outcomes, and ensure the financial health of the service line.You'll work across departments in a multidisciplinary setting, leading with a customer-focused, team-oriented...