Lead Claims Specialist: TRICARE & USFHP Expert
Pacific Medical Centers
Pacific Medical Centers in Renton, WA, is seeking a Lead Claims Specialist for the US Family Health Plan (USFHP). This role adjudicates purchased services claims for capitated members and resolves complex situations with precision. You will handle advanced processing tasks, assist customer requests, and apply TRICARE reimbursement knowledge to ensure compliant, timely resolutions. The ideal candidate has extensive managed care/claims experience and a track record leading within a similar #J-18808-Ljbffr Pacific Medical Centers
- Pacific Medical Centers is seeking a Lead Claims Specialist to oversee adjudication of purchased services claims for the USFHP enrolled population. You will resolve complex claim issues, manage advanced processing, and respond to customer requests with precision. The role...Suggested
$26.9 - $41.89 per hour
Description Are you a claims professional ready to step into a lead role where your expertise drives... ...results? As a Lead Claims Specialist supporting the US Family Health Plan (USFHP) at Pacific Medical... ...applying your expertise in TRICARE reimbursement to ensure compliant...SuggestedMinimum wageFull timeLocal areaShift work- ...Providence Health & Services, is seeking a Lead Claims Specialist to adjudicate purchased services claims for the US Family Health Plan (USFHP). You will resolve complex claim... ...manage advanced processing needs, and apply TRICARE reimbursement knowledge to ensure timely...Suggested
- Pacific Medical Centers is seeking a Claims Specialist to review, process, and adjudicate TRICARE medical claims in our Renton area. You will investigate discrepancies, respond to provider and beneficiary inquiries, and ensure compliance with reimbursement guidelines in...Suggested
- Pacific Medical Centers (PacMed) seeks a Claims Specialist to review, process, and adjudicate TRICARE medical claims with accuracy and adherence to TRICARE regulations and company policies. The role involves investigating discrepancies, resolving provider and beneficiary...Suggested
$25.61 - $39.88 per hour
Description Adjudicates all claims submitted by outside purchased services for PMC's enrolled capitated population and communicates those... ...available Career Track: Admin Support Department: 3060 WA USFHP Address: WA Renton 620 Naches Ave SW Work Location: Blackriver Corporate...Minimum wageFull timeLocal areaShift work- Markel in Seattle is seeking a claims professional to investigate and resolve a range of lower‑exposure claims with sound judgment and timely service to insureds. You will manage a full claim workload with limited oversight, set reserves within authority, and negotiate...
- Providence Health Plan Group in Seattle seeks a Claims Specialist responsible for ensuring accurate patient account and claim information for timely billing and reimbursement. Candidates should have at least 2 years in a healthcare business setting and 1 year in customer...
$100 per hour
...and the chance to influence live transaction materials such as board decks, target screens, and integration plans. Join a network that connects experts with investors for paid engagements and advisory opportunities, with a focus on high-quality deck #J-18808-Ljbffr EthosRemote jobImmediate startFlexible hours- ...delivery teams to configure, test, and support Oracle SCM across procurement, inventory, manufacturing, and planning cycles. You will lead discovery workshops, validate solutions, and drive end-to-end testing and production readiness, ensuring scalable and #J-18808-...
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- Explico is seeking a Senior Testifying Expert to lead complex investigations, provide deposition and trial testimony, and mentor staff while contributing to business development. This role requires courtroom experience and a passion for forensic engineering. You will serve...
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- ...stakeholders, architects, and delivery teams to configure, test, deploy, and support Oracle SCM in a high-availability environment. You’ll lead functional discovery, testing, and production readiness, ensuring seamless integration with adjacent systems and data integrity. U.S...
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- Jackson Lewis P.C. in Seattle, WA seeks a Conflicts Counsel to manage the Conflicts Department and provide legal guidance on conflicts issues before matters commence. The role includes supervising the Conflicts team, coordinating workload, approving time off, mentoring ...
- AUSTIN POWDER COMPANY is seeking a Blaster to review drill patterns, ensure safety compliance, and communicate with job site personnel. Ideal candidates will possess a high school diploma and a current blaster's license, along with experience in handling explosives and ...
- BAILEY is seeking a Lead Technician to perform complex repair and installation work across the region. The LT leads high‑impact projects, trains technicians, troubleshoots mechanical and electrical systems, and drives regional performance. You will bill time for customer...
- We Are:Accenture is a leading solutions and services company that helps the world’s leading enterprises reinvent by building their digital core and unleashing the power of AI to create value at speed across the enterprise, bringing together the talent of our approximately...Full timeLive inWork at officeLocal area
- Providence Health & Services is seeking a Claims Specialist to review, process, and adjudicate TRICARE medical claims with accuracy and compliance. The role involves investigating discrepancies, responding to provider and beneficiary inquiries, and maintaining quality...
$61.91 - $97.72 per hour
...ensuring accurate and consistent application of and adherence to TRICARE policy guidelines, other regulations and department policies and... ...collaboratively and proactively with Director of Operations and USFHP Medical Director(s) to develop and implement strategic case...Full timeLocal areaShift work$24.64 per hour
Northwest Administrators, Inc. in Seattle, WA is seeking an experienced Medical Claims Processor to ensure claims are handled timely and accurately. Candidates should have a passion for customer service and strong analytical skills. Offering union scale wages starting...- Explico, a forensic engineering firm, seeks a Senior Human Factors Expert to lead investigations on perception, behavior, decision-making, and safety systems. You will provide testimony, manage expert reports, and work directly with clients and legal teams. Ideal candidates...
- Quickparts is seeking a Quality Manager - Additive Manufacturing to lead the QMS across DMLS, SLS, EBM and FDM in Seattle. You will own governance, audits, and customer/supplier engagement to ensure flight-critical AM components meet AS9100 Rev D and ISO 9001:2015. This...
$100 per hour
...remote, flexible work. Work on cutting-edge AI projects with leading LLM companies. Offer Details Pay rate: $100+/hour (depends on role and candidate expertise) Assessment: Shortlisted experts complete an evaluation before selection. Assignments: Contract...Hourly payContract workRemote workFlexible hours- ...Role Overview Turing invites Legal Experts to join projects that fine-tune AI models like ChatGPT. If you enjoy applying legal reasoning... ...Turing Opportunity to work on cutting-edge AI projects with leading LLM companies. Competitive compensation Flexible, fully...FreelanceRemote workFlexible hours
- Jobtailor is seeking a Network Operations professional to lead the development and maintenance of the Network Plan and provider handbook... ...adequacy and ensuring URAC and DoD standards are met within TRICARE contracts, while representing the plan in external relations. The...Contract work
$151.3k - $204.7k
Earned Value Compliance Analyst (Subject Matter Expert)Company:The Boeing CompanyThe Boeing Company is looking for Earned Value Compliance Analysts - Subject Matter Experts (Level 5) to join the Earned Value Management (EVM) Compliance Team within Boeing Global Services...Permanent employmentFull timeContract workWork experience placementRelocationVisa sponsorshipWork visaRelocation packageFlexible hoursShift work- Lane Construction is seeking a MOT Supervisor to oversee Maintenance of Traffic on a major project in Renton, WA. You will schedule and supervise MOT crews, coordinate with equipment and field teams, and ensure adherence to closure times and safety standards. The ideal ...Temporary work
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