Senior Claims Adjudicator - Medicare/Medicaid Expert
NaphCare
A leading healthcare technology company is seeking a Senior Claims Adjudicator to join their Birmingham, AL office. This on-site position is essential for processing claims accurately and efficiently, requiring five years of adjudication experience and an Associate Degree or equivalent. The role emphasizes customer service and attention to detail. NaphCare offers excellent benefits, including health insurance starting on day one, tuition assistance, and a supportive corporate environment for employee growth. #J-18808-Ljbffr
- ...Overview Senior Claims Adjudicator NaphCare is hiring an experienced Senior Claims Adjudicator just like you to join our team at our Corporate... ...claims processing experience and working knowledge of Medicare and Medicaid to effectively and efficiently process claims for...SeniorClaimsFull timeWork experience placementWork at office
- ...Description Job Description Senior Clinical Pharmacist... ...for the Plan’s Medicare Part D Coverage Determinations... ...as the subject matter expert for Opioid Part D... ...Centers for Medicare & Medicaid Services (CMS) as a high... ...Experience in the RX Claims system Board Certified...SeniorClaimsWork at officeImmediate startWork from homeFlexible hours
- ...The Senior Underwriter is responsible for underwriting energy accounts independently within delegated authority and making data-driven... ...articulate coverage differences and risk appetite. Collaborate with Claims, Actuarial, Engineering, Legal and UW Support; participate in...SeniorClaimsLocal area
- ...Balfour Beatty is seeking an experienced Senior Quantity Surveyor to join our Regional Building... ..., and key stakeholders, providing expert commercial support throughout the project... .... Preparing, submitting, and negotiating claims where required, protecting Balfour Beatty...SeniorClaimsContract workFor subcontractorRemote work
$80k - $95k
...Description Job Description: Title: Senior Account Manager - Commercial Lines... ...or omissions. Serve as a subject matter expert for the account management team.... ...requests, policy administration, billing, claims, and coverage analysis. ~ Policy...SeniorClaimsFor contractorsRemote work- ...residents to resolution. Completes all necessary insurance claim requirements. Follows up on unpaid claims. Responds to... ...on an account. 10. Processes/posts remittances from Medicare, Blue Cross/Blue Shield, Medicaid, and other major third party payors. Processes...ClaimsWork at office
$81.7k - $135k
...world. Tax - Indirect Tax - Sales and Use Lookback Review COE - Senior Will you shape the future or will the future shape you?... ...use tax recoveries Prepare and defend sales and use tax refund claims Participation on a motivated team of professionals...SeniorClaimsSummer holidayImmediate startFlexible hours- ...setting with a strong knowledge of insurance, managed care, Medicare and Medicaid. Reports directly to the Director of Billing. Prolonged... .... Monitors and reports immediately to management on any claim submission problems. Participates in special projects and/or...ClaimsWork at officeImmediate start
- ...Senior Software Engineer At Jack Henry, we're more than a technology company, we're a force for good in financial services. We're redefining... ...of discrimination of any kind, pursuing any discrimination claim, or cooperating in related investigations. Requests for full...SeniorClaimsPermanent employmentH1bWork at officeLocal areaRemote work
- ...or similar system) for incident, change, and release management. ~ Experience working with institutional and professional medical claims data (i.e., Stratasan). ~ Able to work with teammates, customers, and partners to design robust and efficient solutions. ~ Able...SeniorClaimsContract work
- ...3-5 years of industry experience Career Level Senior Salesperson Exemption Exempt Senior Account... ...from NextGen Security's HR department shall not be deemed to form part of any Engagement for which the Agency may claim remuneration.SeniorClaimsFull timeContract work
$171.6k - $392.1k
...experiences emerging as the most critical "hot spot" alongside claims, underwriting, policy, and billing. Our ambition is to be the C‑... ...and go‑to‑market asset creation - while building and sustaining senior client relationships and serving as a trusted advisor on transformations...SeniorClaimsWork experience placementSummer holidayFlexible hours$45k - $55k
...people sleep well so they live well is at the core of what we do. The right mattress matters, and so does the right career. Our Sleep Experts® are at the heart of what we do: helping customers find their dream mattress and get better sleep. By joining our team, you’ll get...Full time- ...Noland Health Services in Birmingham, AL is seeking a billing/collections specialist to manage insurance billing, follow up on unpaid claims, and communicate with patients and payors. Responsibilities include processing remittances, auditing accounts, and maintaining...ClaimsWork at office
- ...their state-of-the-art facilities that are changing our world. As a Senior Subcontract Administrator for Advanced Manufacturing, you will... ...change orders. Mitigate Subcontractor risk and assist with any claims or disputes. Works independently, with guidance in only the most...SeniorClaimsFor subcontractor
- ...Scientist Job Responsibilities Lead the design and development of advanced statistical and machine learning models that improve claims outcomes, operational efficiency, and risk management. Serve as the technical authority for complex modeling initiatives...ClaimsRemote work
- ...Senior Project Controls Manager The Senior Project Controls Manager at Quanta Power Solutions is responsible for leading project controls... ...Lead schedule risk analysis and scenario planning. Support claims analysis, delay analysis, and recovery planning when required....SeniorClaimsFor contractorsLocal area
- ...for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and... ...knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you...Claims
- ...transactions related to patient services. Responsibilities Payment Posting: Accurately post and reconcile payments from various sources. Claim Reconciliation: Collaborate with billing team to resolve payment discrepancies. Payment Verification: Confirm proper payment...ClaimsMonday to Friday
- ...Level Experienced (Non-Manager) Exemption Non-Exempt Senior Technician What we’re looking for: We are seeking an... ...from NextGen Security’s HR department shall not be deemed to form part of any Engagement for which the Agency may claim remuneration....SeniorClaimsFull timeContract workLocal area
- ...Scrum Master is responsible for ensuring structured, predictable, and transparent delivery of AI initiatives supporting insurance and claims operations. This role reinforces disciplined Agile practices, protects sprint commitments, and enables sustainable delivery...ClaimsRemote work
- ...functions, ensuring timely and accurate claims processing, and resolving issues related... ...required 0-1 years of experience with Medicare preferred Knowledge, Skills and Abilities... ...insurance reimbursement and claim adjudication. Proficiency in electronic health records...ClaimsFull timeShift work
- ...Healthcare, has an exciting opportunity for a Senior Provider Data Analyst position in... ...software Strong understanding of healthcare claims, provider, membership, financial, quality... ...-based care, provider contracting or Medicare Advantage Experience supporting executive...SeniorClaims
$103.22k - $136.11k
...with underwriting thought process. Serve as a subject matter expert to assist team members with complex risks. Through effective... ...articulating the company's capabilities in underwriting, risk control, and claims, across all business units at UFG. Collaborate with Business...SeniorClaimsContract workTemporary workWork at officeLocal areaRemote work- ...keep accounts receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take appropriate action including completion of submissions, reconsiderations, appeals, and denial management to ensure payment...ClaimsWork at officeLocal area
- ...Job Overview Auto-Owners Insurance is seeking a motivated claims trainee to join our team. The role handles entry‑level insurance claims under close supervision throughout the life‑cycle of a claim, including investigation, evaluation, and resolution. Responsibilities...ClaimsTraineeshipLocal area
- ...Product Manager / Product Owner – AI is responsible for end-to-end ownership of AI initiatives for a specific Line of Business or claims domain. This role partners directly with business stakeholders to define AI-enabled improvements to claims operations, cost control...ClaimsRemote work
$42k
...finish; verify insurance, post payments, adjust rejected bills for payment, refile claims, collect payments, etc. Some coding - they only use a few codes. Working with some Medicare and Medicaid claims. Will be in a separate office from medical practice; no patients....ClaimsPermanent employmentWork at officeMonday to Friday- ...achieve individual sales goals to support the store's sales and profit objectives, provide superior customer service, and take on other senior-level responsibilities within a store. Essential Functions (not all-inclusive): Generate sales to exceed personal...Work experience placementLocal area
- ...Field Claims Professional Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated and experienced field claims professional to join our team. This job handles insurance claims in the field under general supervision through the life-cycle of a claim...Claims
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