Lead Claims Strategist - TRICARE/USFHP Expert
Pacific Medical Centers Corp
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 requires a Bachelor’s in a related field or equivalent experience, 4 years in managed care operations with 3+ years in claims processing, and lead capacity experience. Knowledge of IDX and CHAMPUS/Medicare/Medicaid is preferred. #J-18808-Ljbffr Pacific Medical Centers Corp
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$26.9 - $41.89 per hour
Description Are you a claims professional ready to step into a lead role where your expertise drives real results? As... ...the US Family Health Plan (USFHP) at Pacific Medical Centers, you'll... ...efficiency, and applying your expertise in TRICARE reimbursement to ensure compliant,...ClaimsMinimum wageFull timeLocal areaShift work- ...and department workflow of the Claims Adjudicators and Claims... ...supervision of the Director of USFHP Operations. Responsibilities include... ...same. Monitors Medicare and TRICARE coding and payment guidelines... ...Supervisory capacity, including Lead role; or six months supervisory...ClaimsMinimum wageContract workShift workNight shift
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Supervisor Health Plan Operations - USFHP Join to apply for the Supervisor... ...with standards. Monitors TRICARE and other pertinent regulatory guidelines... ...4 years Health care claims experience. 2 years Supervisory capacity, including Lead role; or six months supervisory...ClaimsContract workLocal area$21.82 - $28.6 per hour
...clerk duties in the designated department (grocery or freight), leading by example, and assisting the department manager in general... ...job offers and to verify the authenticity of any communication claiming to be from WinCo by checking the official WinCo careers website...ClaimsImmediate startShift workNight shift- Responsibilities Initiates assignments and leads integration and analysis of resource forecasts and/or Estimates at Completion (EACs) for control accounts, budgets, functions or pools; financial EACs for contracts or programs Develops performance reports Initiates assignments...
$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...ClaimsMinimum wageFull timeLocal areaShift work$27.92 - $42.73 per hour
Description Under the supervision of the USFHP leadership team, the Provider Relations Representative functions as a liaison among the... ...rosters to ensure accuracy of our provider data that supports our claims system and provider directory. Providence caregivers are not...ClaimsMinimum wageFull timeLocal areaShift work- Northwest Administrators Inc. is seeking an Appeals Specialist to assist in the operations of the Health and Welfare Claims Department. The role involves reviewing and processing appeals, analyzing claims, and collaborating with internal teams. Candidates should have a...ClaimsHourly pay
$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- 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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...and upskill IT and its partners by producing documentation and leading training sessionsEvangelize best practices both internally and... ...only reach out via LinkedIn or email with a brex.com domain. Any outreach claiming to be from Brex via other sources should be ignored.ClaimsWork at officeImmediate startRemote workWork from home- ...Surgeons is seeking a Remote Revenue Cycle Specialist to oversee billing processes from a home office, including charge entry, billing, claims, and patient AR. You will post payments and manage credits, supporting revenue-cycle workflows in a fully remote capacity....ClaimsRemote jobHome office
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$191k - $253k
...ABOUT THE JOBWe are looking for a Multi-Domain Mission Capabilities Lead, Multinational Digital Infrastructure to join our rapidly... ...Fraud: Should you encounter any questionable or fraudulent outreach claiming to be from Anduril, please report it immediately to contact@...ClaimsFull timeTemporary workWork experience placementLocal areaImmediate start- ...You will research, review, and resolve conflicts of interest for new matters and lateral hires, collaborating with Ethics Counsel, Claims Counsel, and Recruiting across the firm. Responsibilities include analyzing conflicts, drafting waivers, and advising attorneys on...ClaimsRemote job
- ...delivers a professional image in all client interactions. You will use a consultative approach to identify client needs, present recommendations, and work with in-house loss control and claims teams to support risk management. #J-18808-Ljbffr Relation Insurance ServicesClaims
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