Claims Processing Jobs
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Search Results - Claims Processing Jobs
Mindlance-Columbia (MD)-
processing environment. This role is responsible for ensuring stability, performance, and continuous improvement of applications supporting claims vouchering, adjudication, and EDI processing.
The ideal candidate will combine mainframe expertise, application...
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Solis Health Plans-Doral-
involves applying benefit plans, policies, and regulatory guidelines to ensure proper claim processing, including new claims, reprocessed claims, overturned disputes, and appeals. The Claims Examiner plays a critical role in maintaining compliance, ensuring...
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Tier4 Group-Baton Rouge-
In this role, you'll investigate and resolve medical claims issues, process adjustments, research Coordination of Benefits (COB), correct payment discrepancies, and help recover overpayments.
If you have at least 2 years of hands-on medical claims processing...
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Express Employment Professionals – Hawaii-Honolulu-
with the opportunity to develop and mentor a team
✅ Collaborative and professional work environment
What You’ll Do
Claims Operations & Leadership
• Oversee daily claims processing operations and departmental workflow
• Ensure accuracy, efficiency, and turnaround...
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Globalchannelmanagement-Mason (OH)-careers-page.com-
Data Entry Claims Processing needs 1 years claims processing
Requires:
• Data entry and claims processing knowledge
• Has a working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet
• Some basic...
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TEK NINJAS-Durham-
and operational requirements.
Nice to have skills
FACETS Developer with handson experience in Claims Processing, Enrollment, and SQL
Skilled in healthcare payer systems, FACETS configuration, data analysis, troubleshooting, and database querying to support...
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University Health-San Antonio-
HMO/PPO claims experience required. Amisys claims processing system experience preferred. Knowledgeable of all benefit programs offered by the CFHP, Medicaid, HMO, PPO, ASO.
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University Health-San Antonio-
POSITION SUMMARY/RESPONSIBILITIES
Supervises, assists, and directs the activities of the assigned claims processing unit and the assigned staff. Responds to issues escalated through the claim examiners. Provides solutions to problems in accordance...
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Sunshine Enterprise USA-Columbia-
for Medicaid enrollment, eligibility systems, claims processing, workflows, and document management systems.
Key Responsibilities:
• Develop and execute test plans, test cases, and QA/UAT processes
• Perform Smoke Testing, System Integration Testing (SIT...
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Covet Health-New York-
of working at a healthcare payer as a claims processor/examiner with TPA knowledge.
What Will You Be Doing
The essential functions listed represent the major duties of this role, additional duties may be assigned.
• Day-to-day processing of claims based...
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Molina Healthcare-New York-
CFE) and/or Accredited Health Care Fraud Investigator (AHFI). • Experience working in group health insurance, particularly within claims processing or operations. • Working knowledge of local, state and federal laws and regulations pertaining to health...
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LHH-White Plains (NY)-
processing. Reviewing the validity of customer deductions and required chargebacks. Apply/clear all claims appropriately. The ability to review and interpret proof of delivery documentation (PODs) is critical to this task
• Reconciliation of sub-leger...
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Samprasoft-Owings Mills-
Science or Business or equivalent relevant work experience in business analysis, systems analysis and/or testing. Knowledge, Skills, Abilities:
• Has demonstrated experience in Facets claims processing/testing functions.
• Has demonstrated experience...
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Fairfax Radiology Centers (FRC), LLC-Fairfax (VA)-
Investigate payer denials, underpayments, authorization issues, claims-processing discrepancies, and other challenges affecting reimbursement.
• Collaborate with Inova, external billing partners, and internal teams to coordinate resolution of payer and billing...
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Gwinnett Eye Clinic-Duluth (GA)-
Skills:
• Experience with iPad technology
• Knowledge of long-term disability and health care benefits
• Experience with ordering and claims processing
Salary and Benefits:
Minimum Salary: $40,000.00
Maximum Salary: $60,000.00
Benefits: Vacation...
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