Senior Health Claims Specialist: Complex Adjudication
$18.5 - $42.35 per hourHispanic Alliance for Career Enhancement
Hispanic Alliance for Career Enhancement in North Carolina seeks a dedicated Medical Claims Specialist. This full-time role involves reviewing and adjudicating complex medical claims, ensuring compliance with policies and regulations, and mentoring team members. Candidates should have at least 18 months of experience in medical claim processing and a strong attention to detail. The competitive pay range for this position is $18.50 - $42.35 per hour, with comprehensive benefits including medical and retirement options. #J-18808-Ljbffr
$18.5 - $42.35 per hour
...We're building a world of health around every individual - shaping a... .... Position Summary Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established... ...specified claims and those that exceed specialist adjudication authority or...SeniorHourly payFull timeWork experience placementLocal areaRemote work$95k - $120k
Insurance Recruiting Solutions is seeking a Complex Claims Technical Specialist in the United States, North Carolina. The role involves investigating, evaluating, negotiating, and settling serious claims for a leading property & casualty firm. Qualified candidates will...Senior$27.02 per hour
...membership; analyzes data such as individual health, type of industry, characteristics of employee groups, or past claim experience to determine what benefits can be offered... ...across a continuum from routine to highly complex. Engage in teams/workgroups and contribute...SeniorFor contractorsWork at officeLocal area$23.16 per hour
...Excess Risk and Reinsurance) claims in accordance with established... ...reviews and analyzes various complex potential claims with... ...Determines whether to pend or adjudicate claims following organizational... ...relevant, progressive experience in health insurance claims ~3 years...SeniorFor contractorsWork at officeLocal area$105.1k - $150.1k
Cardinal Health seeks a Program Manager for Program & Project Management in Raleigh, NC. This role involves managing the execution of multiple initiatives while adhering to budget, schedule, and scope. Responsibilities include developing business cases and serving as a...Senior- A national architectural firm is seeking a seasoned professional to plan and develop healthcare departments within large medical facilities. The ideal candidate will have a minimum of ten years of experience with comprehensive knowledge of healthcare codes and standards...Senior
- ...Sedgwick is seeking a Claims Examiner specializing in Liability claims. In this role, you will analyze and adjudicate complex claims, ensuring timely resolutions and settlements in line with industry standards. The ideal candidate will have at least five years of Liability...Remote workFlexible hours
$95k - $120k
...providing an exceptional work culture for their ever-expanding team of highly talented staff. Our client currently seeks a Complex Claims Technical Specialist Claims professional to join their organization in one of the following locations: Scottsdale, Hartford, Chapel Hill....Temporary workFlexible hours- ...courses toward professional designations or continuing education. Senior Underwriter Bachelor's degree or equivalent work experience... ...~ Professional designation is preferred Underwriting Specialist ~15+ years industry experience, 10+ years in Excess and Surplus...SeniorFull timeWork experience placementH1bRemote work
$110k - $140k
First Citizens Bank is seeking an AVP, Underwriter IV - CEF to support advanced underwriting for Capital Equipment Finance. The ideal candidate will have strong risk management skills and experience in loan analysis, providing guidance for both new and renewal credits. ...Senior- A specialty insurance provider is seeking a Workers' Compensation Claims Adjuster for a temporary assignment to adjudicate complex claims in the mining sector. The role is flexible with working remotely from anywhere in the continental U.S. Responsibilities include investigating...Hourly payTemporary workRemote workFlexible hours
- ...LLC in North Carolina is looking for an insurance Underwriter to evaluate and negotiate insurance risks. The role involves managing complex cases while ensuring exceptional service and maintaining communication with agents and carriers. The ideal candidate will possess...Senior
- ...A leading advisory firm in Raleigh, NC seeks a Tax Senior Manager to provide strategic leadership for complex tax engagements. Ideal candidates should have over... ...and offers competitive benefits including paid time off and comprehensive health coverage. #J-18808-Ljbffr...Senior
$67.9k - $182.55k
...Position Overview The Senior Manager, Medical... ...closely with claims operations to apply... ...processing (intake, edits, adjudication, denials, appeals,... ...and resolve complex configuration... ...Certified Coding Specialist required. License... ...eligible for a CVS Health bonus, commission...SeniorHourly payFull timeTemporary workLocal area- ...A leading construction company is seeking a Senior Superintendent to manage and execute multiple complex projects. This role involves team management, safety culture leadership, and ensuring timely project completion. The ideal candidate will have over 10 years of construction...Senior
- ...communications agency is seeking a Managing Supervisor to join their Health & Life Science practice. This role involves overseeing projects... ...strong project management skills, and the ability to translate complex clinical data. The position offers a hybrid work model with...Senior
$109.2k - $223.4k
...Job Description Oracle Health Data Intelligence (HDI) is seeking a highly technical Senior Principal Technical Program Manager (IC5) to lead large-scale cloud transformation... ...programs. This role is focused on driving complex technical programs involving OCI cloud migration...SeniorTemporary workFlexible hours$31.04 - $44.62 per hour
...UNC REX Healthcare is seeking a Senior Respiratory Therapist for night shifts in Smithfield, North Carolina. This role requires expertise... .... The position includes administering medication, managing complex respiratory needs, and the flexibility to perform on-call duties...SeniorHourly payDaily paidNight shift- ...Humana Inc is looking for a Senior Product Manager located in Raleigh, NC. This role involves leading complex projects that align technology with enterprise strategy. The... ...years of experience in Product Management or Health Informatics. The position offers a competitive...Senior
$15k
A leading claims management firm is seeking an Experienced Surety Bond Desk Adjuster in Raleigh, NC. The role involves handling claims up to $15,000, requiring strong analytical and legal knowledge. Responsibilities include investigating claims, determining liability,...SeniorHourly pay$33.04 - $47.5 per hour
...A healthcare organization in Raleigh, NC is seeking a CT Technologist to conduct complex imaging procedures in collaboration with various teams. Requires an accredited educational background and advanced certification in CT with three years of experience. The position...SeniorHourly payDaily paid$54.3k - $145.86k
...The Hispanic Alliance for Career Enhancement is seeking a Project Manager to lead complex projects supporting the Federal Employees Health Benefits Program. This full-time role involves collaboration with various stakeholders, managing procurement activities, and ensuring...SeniorFull time- ...Join a forward-thinking organization dedicated to enhancing community health as a Construction Project Manager Sr. In this pivotal role, you will oversee complex construction projects, ensuring they meet budget, schedule, and compliance standards. Your leadership will...Senior
$18.5 - $31.72 per hour
...re building a world of health around every... ...Position Summary The Senior Coordinator, Complaints... ...responsible for managing complex complaint and appeal cases... ...HMO) or experience with claim platforms, products, and... ...reviewing claim adjudication and identifying processing...SeniorRemote jobHourly payFull timeLocal areaMonday to FridayFlexible hoursShift work- ...Maximus is seeking a Senior Technical Recruiting Specialist to lead advanced recruitment efforts for federal civilian, health, and defense markets. This remote position involves managing... ...a Bachelor's Degree. Knowledge of complex sourcing strategies, including Boolean...SeniorRemote work
- ...a Bachelor's Degree in a relevant field and clinical laboratory experience, particularly in moderate and high complexity testing. Join a dedicated team focused on improving community health since 1961, with opportunities for leadership and mentorship. #J-18808-Ljbffr...Senior
- ...Creative Solutions Services, LLC is seeking a Clinical Data Manager to lead data management activities for complex clinical studies, ensuring compliance with regulatory standards and overseeing database implementations. The role requires a strong understanding of data...Senior
$62.4k - $93.6k
...Sr Representative Claims - CH08BE Sr Representative Clms CA - CH08AN Consultant Claims... .... The General Liability Litigation Senior Claim Representative or Consultant is accountable... ...and judgment Accurately resolve complex coverage and compensability issues...SeniorFull timeTemporary workPart timeWork experience placementWork at officeRemote workMonday to Friday3 days per week$115.4k - $251.6k
...Job Description About Oracle Health Applications & Infrastructure Oracle Health Applications... .... About the Role As an Senior Principal Product Manager, you will own product... ...go-to-market teams. You will translate complex healthcare needs into clear product...SeniorTemporary workFlexible hours- ...clinical research organization is seeking a Clinical Data Manager in Raleigh, North Carolina to lead data management activities for complex studies. The role involves overseeing database implementation, ensuring compliance with regulatory standards, and managing vendor...Senior
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