Senior Medical Claims & Benefits Operations Specialist
4004 Aetna Medicaid Administrators
CVS Health in the United States is seeking an experienced medical claims processor to adjudicate complex encounters and support multiple Medicaid plans. The role requires strong analytical skills and the ability to work in a fast-paced production environment. The position demands proficiency with MS Office, independent work capabilities, and teamwork. It offers a full-time schedule (40 hours) with a comprehensive benefits package and opportunities for cross‑functional collaboration across #J-18808-Ljbffr 4004 Aetna Medicaid Administrators
$70k - $82k
Job Title: Senior Benefits Administrator Location (city, state): Phoenix... ...package, including: Medical insurance with PPO and high-... ...absence programs, disability claims, workplace accommodations, retirement... ...workflows, improve operational efficiency, and enhance the...SeniorMedicalClaimsTemporary workWork at officeLocal areaImmediate startFlexible hours- ...workflows. • Serve as a senior coding resource for complex procedural... ...• 5+ years of professional medical coding experience, preferably... ...Strong experience reviewing operative reports and complex clinical... ...in medical records or claims. • Accuracy is critical in...SeniorMedicalClaimsWork at officeRemote work
$124k - $280k
...Middle Office / Technology / Operations Consultant you will advise... ...Advisory practice. As a Senior Manager you will lead large... ...focus areas that may include claims processing, reimbursement models... ...PwC offers a wide range of benefits, including medical, dental, vision, 401k,...SeniorMedicalClaimsFull timeH1bWork at office- ...strong client relationships with employee benefit brokers and consultants, stop loss... ...clinicians, underwriters, actuaries, and claims professionals, to develop comprehensive risk... ...Eligible full-time teammates enjoy access to medical, dental, vision, life, disability, and AD...SeniorMedicalClaimsFull timeTemporary workWork at officeRemote workWork from homeShift workDay shift
- TRISTAR is seeking an experienced Claims Examiner to manage indemnity claims from inception to resolution under... ...investigations, determining compensability, managing medical treatment and billing, calculating benefits, and finalizing settlements. #J-18808-Ljbffr...SeniorMedicalClaims
- King's Insurance Staffing is seeking an experienced Workers’ Compensation Claims Representative to support claims across Arizona. You will manage indemnity and medical-only files, including higher-exposure litigated cases, from investigation through resolution. The ideal...SeniorMedicalClaimsRemote job
- Paycom - ATS in Phoenix, AZ is seeking a Medical Billing Specialist II to ensure revenue cycle objectives are met, handling complex claims and denials. This role emphasizes accuracy, HIPAA compliance, and teamwork. The ideal candidate will have 5+ years of billing experience...SeniorMedicalClaims
- Masis Professional Group is seeking a Revenue Cycle Medical Coder (Temp-to-Hire) in Phoenix, AZ. The role supports the Revenue Cycle Management team with accurate medical coding, claim review, compliance, and coaching for internal teams. Responsibilities include coding...SeniorMedicalClaimsTemporary work
- ...seeking a Billing/Revenue Cycle professional for a remote role serving the greater Phoenix area. You will handle electronic and paper claims, patient statements, and support AR objectives with accuracy and timely processing. Requires strong hospital billing background,...SeniorMedicalClaimsRemote jobWork at office
$99k - $232k
...OpportunityAs a Life, Annuity & Group Benefits Operations Consultant - Manager you will lead client... ...solutions for policy administration, claims, servicing, and book of business management... ...a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation...MedicalClaimsFull timeH1bShift work- ...Senior Vice President, Benefits About the Company Global risk management firm... ...strategic risk analytics claims advocacy bermuda market... ...for driving growth, operational excellence, and client satisfaction... ...experience in the medical stop loss, self-funding, or...SeniorMedicalClaims
- PHI Health seeks a Medical Billing Specialist in Phoenix, AZ to manage follow-up and collections, patient accounts and payor reimbursements. You... ...timely payments. Collaborate with the PFS team to resolve claims in a timely and accurate manner while upholding PHI policies...SeniorMedicalClaims
- UnitedHealth Group is seeking a Senior Biller to support AHN physician billing and third-party accounts receivable in a National Remote capacity within the U.S. You will research complex claims, file appeals, and ensure timely follow-up with payers. Under the Business Office...SeniorMedicalClaimsRemote jobFull timeWork at office
$75k - $85k
...Administrator, is looking for a Senior Workers' Compensation... ...Lost Time Workers Compensation claims Effectively manages a caseload... ...compensability of claims and administer benefits, based upon state law and in... ..., childbirth and related medical conditions), gender identity...SeniorMedicalClaimsWork at officeLocal area2 days per week$80k - $100k
Vaco is seeking a Sr. Payroll & Benefits Specialist! What stands out about this role? Fully remote opportunity with a stable and growing organization... ...terminations Administer employee benefit programs including medical, dental, vision, disability, life insurance, and retirement...SeniorMedicalLocal areaRemote work- ...Senior Vice President, Liability Operational Strategy About the Company Renowned provider of workers... ...and Health Managed Care Medical Testing & Clinical Laboratories... ...general liability ~ ancillary benefit management ~ claims management ~ provider network...SeniorMedicalClaims
- ...Job Description for: Senior Account Executive Location... ...to manage their medical bills. About the Role... ...with Partnerships, Operations and Product, and you will... ..., and never over-claims a win. Patient financial... ...the best candidate. Benefits Our benefits package...SeniorMedicalClaimsBase plus commissionContract workRemote work
- ...Certified Senior Pharmacy TechnicianCustomer ExperienceEngages customers and patients by... ...Processes (corrects and resubmits) manual claims for third party program prescription services... ...good relationships with the local medical community, including physicians, nurses,...SeniorMedicalClaimsLocal areaImmediate start
- ...complex, multi-payment accounts. Submits appeal letters on underpaid claims as directed. Interprets payer contracts to determine if payment... ..., to include, but not limited to accounting courses or medical business office certificate program Preferred EXPERIENCE Other...SeniorMedicalClaimsWork at officeShift work
- ...Revenue Cycle Management Specialist This position is responsible... ...eligibility and obtain coverage and benefit information Contacts... ...and appeals unpaid and denied claims, includes analysis of coding... ...Qualifications ~7 years medical billing experience ~ Ophthalmology...SeniorMedicalClaims
- ...Senior Project Manager - Electrical Location: Phoenix... ...: Oversee daily operations of staff teams across... ...to mitigate claims and secure the best interests... ...and experience. Benefits: Competitive salary... ...healthcare plans including medical, dental, and vision....SeniorMedicalClaimsContract work
$60k - $90k
Senior Mainframe - Remote Cognizant is seeking an experienced... ..., and Healthcare Claims processing. The ideal... ...’s applicable plans. Benefits Cognizant offers the... ...requirements: Medical, Dental, Vision, and Life... ...transforming clients’ business, operating, and technology models...SeniorMedicalClaimsRemote jobTemporary work- ...Under the direction of the Billing Supervisor, bills and files all claims on both UBs and 1500 forms. References DDE for verification of... ..., Finance Preferred or Other / Certificate Complete advanced medical billing certification within two years of hire date Preferred...SeniorMedicalClaimsWork at officeRemote workShift work
$50k
...impacting our business. As a Senior Attorney at Liberty... ...balance and enjoy benefits that include eligible... ...litigation matters involving claims for monetary damages... ...legal workflows, operational efficiency, and remote... ...trends, and relevant medical, scientific, or engineering...SeniorMedicalClaimsLocal areaRemote workFlexible hours- ...of our comprehensive compensation and benefits program, employees are also eligible for... ...electronics manufacturing companies as well as medical technology and pharmaceutical companies... ...Must Have?Four years of underwriting, claim, operations, risk assessment, actuarial, sales,...SeniorMedicalClaimsFull timeLocal area
- ...Adhere to all statutory and regulatory fair claims practices. Recognize and identify... ...Supports workload surges and/or Catastrophe Operations as needed to include working overtime... ...ancestry, mental and physical disability, medical condition, genetic information, military...SeniorMedicalClaimsContract workLocal area
$57.97k - $97.82k
...compensation and comprehensive benefits Eligibility to participate in... ..., new systems, and complex claim processes on your own. For your... ...and catastrophe-response operations as needed, including mandatory... ...benefits include comprehensive medical, dental and vision plans, 401...SeniorMedicalClaimsH1bWork at officeRemote workRelocation packageFlexible hoursAfternoon shift3 days per week- ...seeking an experienced Senior Mechanical Project... ...orders, change orders, claims, and other contractual... ...identify financial or operational concerns, and implement... ...schools Universities Medical office buildings Stadiums... ...field leadership. Our Benefits Include Competitive...SeniorMedicalClaimsFor contractorsFor subcontractorWork at officeLocal area
$104k - $143k
...our caring community The Senior Research Scientist applies... ...and inform strategic and operational decisions. This role... ...deep-dive analyses using medical and pharmacy claims, enrollment, and operational... ...performance. Description of Benefits Humana, Inc. and its...SeniorMedicalClaimsFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome office- ...Full-Time Level:Experienced (3+ Years WC Claims) ABOUT THE ROLE We are seeking an experienced... ...closely with claimants, employers, medical providers, defense counsel, and applicant... ...a collaborative, professional demeanor. BENEFITS & PERKS We offer a comprehensive benefits...SeniorMedicalClaimsFull timeWork at officeRemote work2 days per week
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