(Agile) Claims Examiner

To analyze high-level commercial General Liability claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requi General Liability, Claims, Examiner, Liability, Insurance

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your...

To analyze low to mid-level commercial General Liability claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service Claims Representative, Claims, Liability, Representative, General Liability, Insurance

About the RoleSedgwick is seeking a highly skilled Claims Examiner to join our team. As a Claims Examiner, you will be responsible for analyzing and processing complex commercial general liability and bodily injury claims on behalf of our valued clients.Key ResponsibilitiesAnalyze and process claims through well-developed action plans to achieve timely and...

About the RoleSedgwick is seeking a highly skilled Claims Examiner to join our team. As a Claims Examiner, you will play a critical role in analyzing and processing complex commercial general liability and bodily injury claims on behalf of our valued clients.Key ResponsibilitiesAnalyze and process claims through well-developed action plans to achieve timely...

As an IT Facets Configuration Analyst, you will have the opportunity to be a part of a focused team dedicated to helping to make the health care system work better for everyone. Here, you'll partner with some of the smartest people you've ever worked with to design solutions to meet a wide range of health consumer needs. And we need world-class IT Facets...

Job Title: Purchasing AssistantJob Overview: The role of Purchasing Assistant is integral to streamlining procurement processes and boosting operational efficiencies within our organization. This position will be responsible for managing a substantial budget of approximately $10 million in essential supplies and finished products, ensuring that all...

Job Title: Purchasing AssistantJob Description The purchasing, operations, and IT support role will be crucial in optimizing the purchasing process and enhancing our company's operational efficiencies. Focusing on managing approximately $10 million in critical supplies and finished goods, this role will ensure that all procurement activities align with the...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. LHI is one of 4 businesses under OptumServe. OptumServe provides health care services and proven expertise to help...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

Position Title: Fraud Investigation Specialist Job Overview: The Fraud Investigation Specialist plays a crucial role in examining assigned cases, gathering, scrutinizing, and interpreting claim information to identify fraudulent, abusive, or wasteful practices within the healthcare sector. Key Responsibilities: Utilizing relevant systems and databases to...

Clinical Provider Auditor II Supports the Payment Integrity line of business Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights,...

Clinical Provider Auditor II Supports the Payment Integrity line of business Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights,...

JOB SUMMARYThe Patient Services Specialist 2 provides administrative help in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care. Duties include patient relations, check-in or check-out, scheduling, insurance verification and answering phones. May assist in training and mentoring junior...

Job Description: The Office of Inspector General (OIG) Benefits Program Integrity (BPI) Field Investigator V reports to the BPI Unit Manager. BPI Field Investigators conduct highly complex administrative and criminal investigations involving recipients of HHS programmatic services, such as Medicaid; the Children’s Health Insurance Program (CHIP); the...

Job Overview: This role is situated within the Provider Field Investigations (PFI) unit of the Medicaid Program Integrity division, reporting directly to a PFI Manager. The primary responsibility involves conducting administrative inquiries into Medicaid providers concerning allegations of fraud, waste, and/or abuse related to health and human services...

Job Overview: This role is situated within the Provider Field Investigations (PFI) unit of the Medicaid Program Integrity division, reporting directly to a PFI Manager. The position entails conducting thorough administrative investigations of Medicaid providers concerning allegations of fraud, waste, and/or abuse in the delivery of health and human services...