Claims Processing Jobs in USA

SummaryPerforms validation reviews of Diagnosis Related Groups (DRG) Ambulatory Procedure Codes (APC) and Never Events (serious preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a...

This is a remote position.Claims EDI Helpdesk Support Indiana Medicaid (Remote)Employment Type: Full-TimePosition OverviewOur client is seeking a dedicated and customer-focused professional to join our Claims EDI Helpdesk team supporting the Indiana Medicaid account. This fully remote role invol...

Join Martins Point Health Care - an innovative not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force ofpeople caring for people Martins Point employees are on amission to transform our health care system while creating a healthier com...

At Allegiance our engineers make a meaningful impact by building and modernizing platforms that support our clients and their members. As a Software Engineering Director you will play a critical role in shaping the future of our core application platformsbalancing operational excellence today with t...

Customer Service Representative Benefit Plans & Claims ProcessingOpening created by internal promotion come grow with us!Are you the kind of person who can turn a benefits question into a clear confident answer Do you thrive on the phone and take pride in precision If so wed like to meet you.Were...

Join a team where product leadership people development and business impact come together. As a Product Owner Manager you will lead and develop Agile Product Owners while shaping product strategy that delivers meaningful outcomes for customers businesses and technology partners. This role blends han...

Claims Examiner II WarrantyJoin us as a Warranty Claims Examiner to make more of your specialist expertise and experience.Make your mark in Warranty: AIG Warranty delivers a full range of service solutions including warranty management administration extended service contracts and mobile insurance t...

Anticipated End Date:Position Title:Business Analyst III/Senior TesterJob Description:Business Analyst III/Senior TesterHybrid 1: This role requires associates to be in-office 1-2 days per week fostering collaboration and connectivity while providing flexibility to support productivity and work-life...

Sun Life U.S. is one of the largest providers of employee and government benefits helping approximately 50 million Americans access the care and coverage they need. Through employers industry partners and government programs Sun Life U.S. offers a portfolio of benefits and services including dental...

The Building Center Inc.Title:Benefits Specialist Reports to: SVP of Human Resources Division: Gastonia NC Summary:The Benefits Specialist is a Full-time On-site position responsible for managing and analyzing employee benefit programs ensuring compliance and providing support to employees with enro...

Responsibilities Responsible for employment best practices personnel policies and procedures employee records benefits administration; leadership development management best practices exempt and non-exempt salary administration employee communication and other human resources programs for the divisi...

Position Summary:Responsible for the timely review and resolution of clinical appeals submitted by providers and members across all lines of business. Communicates appeal determinations in accordance with regulatory requirements and serves as a clinical resource to support non-clinical staff with ad...

DescriptionJob SummaryWe are seeking a detail-oriented SIU Analyst/Investigator to join our this role you will play a crucial role in ensuring the accuracy compliance and integrity of healthcare claims through comprehensive audits analyses and process improvements. The SIU Investigator (Analyst) pr...

The Montana Department of Public Health and Human Services (DPHHS) has a career opportunity within the Disability Employment and Transitions Division.This position provides specialized technical support for the Social Security Administration (SSA) Disability program for Disability Determination Serv...

The Montana Department of Public Health and Human Services (DPHHS) has a career opportunity within the Disability Employment and Transitions Division.This position provides specialized technical support for the Social Security Administration (SSA) Disability program for Disability Determination Serv...

SummaryWe are currently hiring for a Claims Customer Service Advocate I to join BlueCross BlueShield of South Carolina. You will be responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudic...

Contract Period:3 month (probationary) 12 month pending probationary periodWork Hours: 8:30am 5:30pm Person in needed: 1Key Responsibilities: Review new submissions to ensure all required documentation and claim details are included File and manage shortage claims based on shortage investigation r...

Review new submissions to ensure all required documentation and claim details are includedFile and manage shortage claims based on shortage investigation report theft notification and/or warehouse incident reportInvestigate and process damage claim submissions based on return authorizations and QC r...

DescriptionBenefitsAs a Billing Specialist youll join a team and be a part of a culture thats dedicated to providing top quality care to our patients. Our full-time employees enjoy a robust benefits package which may include health insurance 401(k) licensure/certification reimbursement tuition reimb...

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the bodys musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons each with a specific area of expertise.Cen...