Senior Medical Claims Adjudication Specialist
NTT DATA North America
NTT DATA North America is looking for a Senior Adjudicator to handle medical claims within the Xcelys environment. The role requires processing complex medical claims, conducting quality reviews, and enhancing claims workflows. Candidates should have over 5 years of claims adjudication experience and a strong background in coding and provider contracts. The ideal applicant will demonstrate excellent analytical and communication skills and will participate in system testing and improvements. #J-18808-Ljbffr NTT DATA North America
- A tribal healthcare provider in Wisconsin seeks a Claims Examiner to analyze and process medical claims. The role requires a minimum of five years in medical claims processing and offers comprehensive benefits including health insurance and paid time off. With responsibilities...SeniorMedical
$100k
...the unique coverage and claims-handling needs of... ...Description Business Title(s): Senior Construction Defect Technical Claims Specialist Employment Type: Full-... ...VT. This role will be adjudicating our most complex... ..., denial of family and medical care leave, disability...SeniorMedicalFull timeLocal areaRemote work- ...in Houston, TX. The position focuses on accurate, timely processing of physician claims and addressing denials to keep revenue cycles healthy. The ideal candidate has 3+ years in medical billing, strong Excel skills, and familiarity with athenaHealth. HIPAA compliance...SeniorMedical
$100k
...Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist, Professional Liability | Medical Malpractice | Long Term Care PRIMARY PURPOSE OF THE ROLE: To analyze complex or technically difficult...SeniorMedicalFull timeLocal areaFlexible hours- ...future for employees everywhere! We are seeking a skilled Senior Claims Representative to enhance our team. Reporting to the Claims Team... ..., national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age...SeniorMedicalLocal area
- ...Murphy's Creative Risk Solutions team is seeking a Liability Claims Specialist to leverage client service expertise in a dynamic risk... ...environment. You will review auto and general liability coverage, adjudicate and negotiate settlements, maintain reserves, and mentor...Senior
- Tristar-d43fac80 is seeking a Claims Examiner II to oversee a workers’ compensation caseload and administer indemnity and medical benefits in line with company policies and state rules. The role involves coordinating treatment, reviewing bills, and maintaining precise documentation...SeniorMedical
- ...Insurance Staffing is seeking an experienced TX workers' compensation claims professional to handle moderate to complex cases with minimal supervision. The role requires rigorous investigations, medical management, and guidance of litigation to influence outcomes. You...SeniorMedicalRemote job
$70k - $80k
Responsibilities Handle moderate to complex TX workers' compensation claims with minimal supervision and guidance from the manager. Conduct thorough investigations, manage medical treatment, influence early full return-to-work, guide litigation and control claim outcomes...SeniorMedicalRemote jobFlexible hours- To serve as a senior-level adjudicator and SME for medical claims within the Xcelys environment. Provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations. Key Duties & Responsibilities Adjudication...SeniorMedicalContract work
- Jobtailor in Wisconsin is seeking a mid- to senior-level claims professional to analyze general liability claims and determine benefits due. You will adjudicate claims to company standards and assess liability exposure. The role requires identifying subrogation opportunities...Senior
$18 per hour
A leading global innovator in business and technology services is looking for a Healthcare Claims Processor in Wisconsin. The role involves processing claims and ensuring compliance with regulations. Candidates should have 1-3 years of experience in claims processing and...MedicalRemote jobHourly pay- We are seeking a detail-oriented Claims Processing Specialist to support the Claims Processing Team in... ...claim errors are corrected prior to adjudication Send various reports to employer... ...of three (3) years of experience in medical claims processing Customer service...MedicalCasual workRemote work
$101.18k - $119.78k
...meet the unique coverage and claims-handling needs of businesses.... ...Description Business Title(s): Senior EnvironmentalClaims Adjuster... ...York City and is focused on adjudicating first and third party commercial... ...), denial of family and medical care leave, disability (mental...SeniorMedicalFull timeLocal areaRemote work- 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...MedicalFull time
$70k - $97k
...Progressive Insurance is seeking a Senior Claims Specialist to efficiently resolve injury claims. This hybrid role requires visiting the office four times a month, providing flexibility while ensuring team collaboration. The successful candidate will have strong negotiation...SeniorWork at office- ...Mobilitas, a CSAA-backed commercial insurance venture, is hiring a Sr. Claims Specialist, Commercial Casualty for a remote USA role. You will resolve 1st and 3rd party injury claims across regions, requiring multi-state licensing and strong casualty claims expertise....SeniorRemote work
- ...) specializing in innovative claims management solutions. At CRS,... ...Workers’ Compensation Claims Specialist to join our team. Experience... ...Generates checks for indemnity and medical payments daily. Develops and... ...will possess the ability to adjudicate lost time claims across...MedicalFull time
- Optimum Life Reinsurance (United States) is seeking a claims adjudication professional to timely handle life, AD&D, waiver of premium, and critical illness claims. You will set up, review, verify policy and treaty alignment, and approve payments or denials. The role involves...
- ...Overview The Senior Underwriter administers the underwriting agencies within their assigned territory. Completes work in compliance... ...compensation package and excellent career advancement opportunities. Medical & Dental Plans Life Insurance, including eligible spouses &...SeniorMedicalWork experience placementHome officeFlexible hoursNight shift
$95k - $120k
...bonus. Benefits Employees and their families are eligible to participate in CopperPoint Insurance Companies benefit plans including medical, dental, vision, short-term disability, long-term disability, life insurance, a health savings account, a flexible spending account...SeniorMedicalHourly payTemporary workLocal areaFlexible hours- ...Medical Claims Analyst (full-time / remote / hybrid) MEDICAL CLAIMS ANALYST (FULL-TIME / REMOTE / HYBRID) This is a full-time... ...excellence. JOB SUMMARY Position responsibilities include the adjudication and processing of medical, dental, and vision claims while...MedicalFull timeWork at officeRemote work
- Sedgwick seeks an experienced General Liability Adjuster to handle complex auto, homeowner, and excess liability claims remotely from Texas. This role requires evaluating coverage, damages, and liability with an emphasis on accurate reserves and strong customer service...SeniorRemote job
- Zurich North America is seeking a Senior Claims Professional, Surety/Construction to manage a caseload of moderate to high complexity claims from start to settlement. This fully remote role allows a home-based office with occasional in-office expectations. You will interact...SeniorRemote jobWork at officeWork from home
- CorVel Corporation is seeking a Senior Indemnity Claims Specialist to handle complex workers’ compensation claims, coordinating with case managers and attorneys while managing subrogation and settlements. This remote role aims for favorable claim outcomes and high customer...SeniorRemote job
- ...requires a minimum 4-year degree in a related field and 5 years of relevant experience. The ideal candidate will exhibit strong skills in Medical Stop Loss Underwriting, strategic thinking, and relationship building, with additional preferences for certification progress...SeniorMedical
- Tokio Marine HCC is hiring a Senior Underwriter for a remote position in Texas. The ideal candidate will make underwriting recommendations... ...qualifications include a bachelor's degree and expertise in Medical Stop Loss Underwriting. Join us to take on opportunities with...SeniorMedicalRemote job
$18k
...our growing team. We are seeking a Claims Analyst II to examine and process paper... ...this position include the following: Adjudicate claims by following departmental policies... ...members Certificate of Coverage, established medical policies and procedures, and plan...MedicalContract workWork at officeLocal areaWork from homeHome officeMonday to Friday- ...Workplaces in Financial Services & Insurance Claims Examiner - Non Subrogation |... ...determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry... ...benefits offering including medical, dental vision, 401K on day one. WORK ENVIRONMENT...MedicalWork at officeWork from homeFlexible hours
- ...Summary: The Claims Specialist is responsible for following up directly with commercial and governmental payers to resolve billing issues and... ...of one year of relevant experience in mental health or medical insurance billing and/or collections required Demonstrated knowledge...MedicalWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Medical Claims Adjudication Specialist. Be the first to apply!
- medical specialist Wisconsin
- medical insurance specialist Wisconsin
- patient transport technician Wisconsin
- medical information specialist Wisconsin
- medical review specialist Wisconsin
- hca Wisconsin
- health care assistant hospital Wisconsin
- patient care associate Wisconsin
- patient care technician Wisconsin
- health care worker Wisconsin


