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
- ...Description Overview 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 payment...SeniorClaimsFull timeWork experience placementWork at office
$93.6k - $154.5k
...transformation, and commercial excellence. This senior role within our Consulting practice... ...market access dynamics including IRA, Medicare, Medicaid would be appreciated Effectively... ...., pricing databases, prescription and claims databases, etc.) Experience with commercial...SeniorClaimsSummer holidayFlexible hours- ...Responsibilities Brasfield & Gorrie is looking for a Senior Planner/Scheduler will work closely with our preconstruction, project management... ...using CPM scheduling software, P6 preferred Familiarity with claims prevention and analysis techniques strongly preferred Ability to...SeniorClaimsFor subcontractorRelocation
- ...skill Ingenuity – solution and future focused Responsibilities This position is responsible for managing complex and/or catastrophic claims within all jurisdictions. This includes investigation, evaluation, and resolution of claims. Interface with underwriting, risk...SeniorClaimsWork experience placementFlexible hours
- ...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
- ...Senior Underwriter The Senior Underwriter is responsible for underwriting energy accounts independently within delegated authority,... ...articulate coverage differences and risk appetite. Collaborate with Claims, Actuarial, Engineering, Legal and UW Support; participate in...SeniorClaimsLocal area
- ...Fortune Best Workplaces in Financial Services & Insurance Senior Business Analyst PRIMARY PURPOSE : The Sr Business Analyst supports... ..., or supporting product delivery required. Experience in claims, insurance, healthcare, or other regulated operational environments...SeniorClaimsLocal area
$80k - $95k
...Senior Account Manager - Commercial Lines Hybrid Preferred: 1-2 days in Columbia, SC office... ...or omissions. Serve as a subject matter expert for the account management team. Key... ...requests, policy administration, billing, claims, and coverage analysis. Manage policy expirations...SeniorClaimsFor contractorsRemote work- ...preferably in digital health. ~ Experience in end-to-end process optimization for strategic book management ~ Previous experience with claims processing and adjustment management. ~ Familiarity Third Party Administrators, Aggregators and Resellers. ~ Proficiency with...SeniorClaimsTemporary workRemote workFree visa
- ...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
- ...that do not require personal attention of the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs other clerical duties, as assigned by...SeniorClaimsWork experience placementLocal areaImmediate startFlexible hoursAfternoon shift
- ...customer bills and insurance claims in an accurate and timely manner... ...responsible party by running Medicare plan comparisons during open... ...Perform prescription claims adjudication including communication with... ...billing requirements (Medicare, Medicaid, Prescription Drug Plans (...ClaimsFull timeTemporary workWork at officeFlexible hours
- ...Senior Leader, Information Systems About the Company Top health maintenance organization providing quality, accessible... ...Employees 501-1000 Specialties health insurance medicare medicaid and healthcare About the Role The Senior Leader...Senior
$77k - $202k
...Requirements: Up to 60% The Opportunity As a Property & Casualty Insurance Claims Operations Consultant, Sr. Associate, you will engage with... ...to help clients achieve their strategic objectives. As a Senior Associate, you will focus on building meaningful client connections...SeniorClaimsFull timeH1b- ...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
- ...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
- ...Independent Insurance Claims Adjusters Needed Now Is it time for a career change? Independent insurance claims adjusters are needed... ...knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you...Claims
- ...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
- ...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
- ...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
- ...Claims Trainee Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated claims trainee to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation...ClaimsTraineeship
$111.1k - $152.7k
...negotiations alongside PMs and DMs, contributing to balanced outcomes that protect both project and organizational interests. Strengthen claim defense readiness by coordinating stakeholders, compiling documentation, and supporting project teams and legal partners in the...SeniorClaimsFull timeContract workWork at office- ...functions, ensuring timely and accurate claims processing, and resolving issues related... ...reimbursement required 0-1 years of experience with Medicare preferred Knowledge, Skills and... ...insurance reimbursement and claim adjudication. Proficiency in electronic health records...Claims
$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-... ...needs and having truly globally integrated capabilities. As a Senior Manager in EY's Guidewire practice, you will lead the delivery,...SeniorClaimsFull timeWork experience placementSummer holidayFlexible hours- ...from home up to 3 days per week.Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to:Assemble facts, determine coverage,...ClaimsWork at officeLocal areaWork from home3 days per week
$15 per hour
Company Description Job Description Join Domino's as a delivery driver today! Being the best pizza delivery company in the world requires exceptional team members working together. At Domino's Pizza, our people come first! Deliver amazing food with exceptional ...Flexible hours- ...Auto-Owners Insurance Claims Professional A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. We offer a merit-based work-from-home...ClaimsLocal areaRemote workWork from home
$45k - $65k
...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...$16 - $18 per hour
...operational processes. Our in-house team includes revenue cycle experts, software developers, and process improvement specialists. We... ...financial operations of our clinics by helping ensure payments, claims, and patient accounts are accurate and up to date. This is an...ClaimsWork at officeMonday 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
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