Senior Medical Claims Specialist: Expert Adjudication
CVS Health
CVS Health in Madison, Wisconsin seeks a Medical Claims Processor to review, adjudicate, and provide expertise on complex medical claims. The successful candidate will ensure compliance with regulatory requirements while effectively addressing customer inquiries. The role requires a minimum of 18 months of medical claim processing experience, attention to detail, and the ability to manage multiple assignments. Full-time position offers a competitive benefits package including medical, dental, and vision coverage. #J-18808-Ljbffr
- US Government Jobs - Other Agencies is seeking a Claims Specialist in Madison, Wisconsin. This vital role involves direct interaction with beneficiaries regarding their rights under Social Security laws. You will gather essential information to assess eligibility for various...Suggested
$27 - $40 per hour
Keystone Distinction Group in Wisconsin is seeking an Advanced CNC Machinist specializing in HMC/VMC setups and G-code programming. Join a leading aerospace manufacturer offering competitive pay between $27 and $40 per hour, along with unique benefits such as a deferred...SeniorHourly pay- Tom Trese is seeking an Advanced CNC Machinist in the Green Bay area. The ideal candidate will have over 3 years of experience with CNC machining, specifically HMC and VMC setups, along with proficiency in G-code programming. This role is crucial for maintaining high precision...SeniorHourly pay
- ...Group in Madison, Wisconsin is seeking a Sr Adjuster Field Service Claims to manage moderate to complex field property claims. This role... ...experience and strong communication skills. Benefits include medical insurance, 401(k) match, and flexible work arrangements. #J-188...SeniorFlexible hours
$67k - $100k
A leading insurance provider in Wisconsin is looking for a Workers’ Compensation Claims Representative. You will guide injured employees through the recovery process and ensure compliance and fair resolutions. The role requires excellent negotiation and problem-solving...Senior$35 - $50 per hour
A leading senior living oversight company located in Madison, WI, seeks a Senior Living Code Inspector. This role involves conducting on-site inspections for senior living properties, ensuring compliance with HUD standards. Candidates should have relevant certifications...SeniorHourly payFull time$23.16 per hour
...Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround... .... Determines whether to pend or adjudicate claims following organizational policies... ...insurance claims 3 years of experience with medical terminology Preferred: 3 years of experience...SeniorFor contractorsWork at officeLocal area- A leading global consulting firm is seeking a Senior Consultant Data Modeler to design and implement data models that drive business value. This role demands expertise in SQL and data modeling concepts, with responsibilities ranging from creating data models to collaborating...SeniorFlexible hours
$20.23 - $49.1 per hour
Baker Tilly Vantagen, LLC in Williamsport, PA is seeking a Payroll Specialist to manage payroll for clients, ensure accuracy, and establish strong client relationships. This position primarily works remotely, requiring candidates to be within 50 miles of specific Baker...SeniorRemote jobHourly pay$60k - $90k
Sedgwick is looking for a claims adjuster in Wisconsin to investigate and adjust property and casualty claims, both residential and commercial... ...$60k to $90k annually, plus a comprehensive benefits package including medical, dental, and retirement plans. #J-18808-Ljbffr SedgwickSenior- A leading precision manufacturing firm located in Brussels, WI, is seeking an Advanced CNC Machinist specializing in HMC/VMC setup with substantial G-code programming experience. This full-time role offers an opportunity to work in a cutting-edge environment supporting ...SeniorFull time
- CareOregon is hiring a Claims Examiner II in Wisconsin. This intermediate position is responsible for the timely review and adjudication of various claims including Medicaid, Medicare, and... ...related roles with a strong knowledge of medical coding and customer service skills....Remote jobWork from home
- An energy services company in Madison, WI is seeking a Senior Cloud Engineer to design and manage hybrid-cloud infrastructure using Azure and AWS. The ideal candidate must have over 6 years of experience in PC support, proficiency in Infrastructure as Code (IaC) with Terraform...Senior
- American Family Insurance is seeking a Software Developer based in Madison, WI. The role involves designing and developing software solutions, collaborating across teams, and ensuring applications meet business needs and standards. Candidates should have robust experience...SeniorWork at officeRemote work
- WPS Health Solutions is seeking a Claims Examiner II to handle fraud and abuse allegations while ensuring compliance with TRICARE regulations... ...appeals, organizing case files, and collaborating with a medical team on complex cases. Candidates must have a high school...Remote job
$65.9k - $107.9k
...Sr Supplier Medical Process Specialist 132228 Zurich North America is seeking a skilled and motivated Nurse to join our Managed Care Team as... ...assurance, compliance, and process improvement efforts within claims and managed care operations. Basic Qualifications: ~...SeniorFull timeTemporary workWork at officeLocal areaRemote workVisa sponsorshipFlexible hours$70k
Sedgwick in Madison, Wisconsin is seeking a Claims Examiner, Auto to analyze and process complex auto and transportation claims. Ideal... ...pay of $70,000 and a comprehensive benefits package including medical, dental, vision, 401k matching, and PTO. #J-18808-Ljbffr SedgwickSenior- ...underwriting position. The Lead Senior Underwriter is... ...with the field, claims, brokerage and loss prevention... ...Staff, and Product Specialists in building the... ...division's coverages, adjudication of the division's claims... ...casualty insurance. Expert level knowledge regarding...SeniorWork experience placement
$62.4k - $93.6k
...Sr Representative Claims - CH08BE We're determined to make a difference and are proud to be an insurance company that goes well beyond... ...team as we help shape the future. The Workers' Compensation Senior Claim Representative is accountable for planning, recommending,...SeniorTemporary workRemote workMonday to Friday3 days per week$110k - $120k
PRIMARY PURPOSE : To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service...SeniorWork at officeFlexible hours- A healthcare staffing agency is seeking a board-certified oncology physician for a locums assignment in Wisconsin, focusing on radiation oncology. The role involves managing consults and follow-ups, with a schedule of Monday-Friday, 8 AM to 4:30 PM. Candidates must have...SeniorLocumMonday to Friday
- Claims Specialist Once selected for the Claims Specialist position in SSA, you will contribute to the Agency's mission through direct and... ...for initial and post-entitlement for benefits and payments; adjudicate and authorize entitlement or disallowance actions at all levels...Extra incomeWork at office
- A leading insurance company seeks an Underwriter to build relationships with Financial Advisors and underwrite Life, Disability, and Long-term Care insurance policies. The ideal candidate will have extensive underwriting experience, strong analytical skills, and the ability...SeniorRemote workFlexible hours
- Workers' Compensation Claims Specialist Join Creative Risk Solutions (CRS), a leading Third-Party... ...daily checks for indemnity and medical payments. Develop and monitor consistency... ...on designated accounts, as requested. Adjudicate lost time claims. Participate in...Full time
$143k - $243k
...A leading pharmacy benefits organization is seeking a Senior Principal Actuary to provide actuarial direction and innovative modeling. The role requires significant actuarial experience, strategic pricing advice, and collaboration across multiple teams. Candidates must...SeniorRemote work$79.2k - $178.1k
...internal peer equity. Oracle US offers a comprehensive benefits package which includes the following: # Medical, dental, and vision insurance, including expert medical opinion # Short term disability and long term disability # Life insurance and AD&D #...SeniorTemporary workFlexible hours- A leading insurance agency is seeking a Senior Underwriter specializing in Fidelity Bond,... ...candidate will work closely with Sales, Claims, and Actuarial teams to provide tailored... ...competitive compensation, including benefits like medical and retirement plans. #J-18808-Ljbffr...Senior
- A leading insurance provider is seeking a Property and Casualty Underwriter to manage a portfolio of accounts and drive business opportunities. The ideal candidate will underwrite new and renewal business, evaluate risks, and collaborate with brokers. Candidates should ...Senior
$68.93k - $86.17k
West Bend Insurance Company in Madison, Wisconsin is looking for a Staff Underwriter to drive commercial underwriting excellence. The role involves conducting file reviews, providing mentorship, and collaborating cross-functionally. Ideal candidates will have at least five...SeniorRemote job$22.4 - $30.87 per hour
Zurich 56 Company Ltd is currently seeking an RCIS Seasonal Crop Adjuster for the Wisconsin and Minnesota regions. This home-based role requires approximately 50% travel and involves conducting field inspections, measuring crop areas, and discussing loss with farmers. The...Hourly paySeasonal workWork from home
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