Medicaid & CHIP Claims Adjudication Specialist
University Health
Community First Health Plans in San Antonio, TX is seeking an experienced Claims Examiner to join the Claims department. The role focuses on adjudicating medical (HCFA) and hospital (UB92) claims for Medicaid, Commercial, and CHIP, ensuring compliance with departmental and regulatory requirements. Requirements include a high school diploma or GED, and at least two years of claim processing or billing experience. Knowledge of ICD-9, CPT-4 coding and medical terminology is required. #J-18808-Ljbffr University Health
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Medicaid & CHIP Claims Adjudication Specialist in San Antonio, TX vacancy
- POSITION SUMMARY/RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children’s Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the...Suggested
- WebTPA, a GuideWell Company, is a healthcare third-party administrator seeking a Claims Examiner for in-office processing and adjudication of healthcare claims in San Antonio, TX. The role includes claims research, verification of medical necessity, and applying policy...SuggestedWork at officeMonday to Friday
- WebTPA is seeking a Claim Examiner to handle processing and adjudication of healthcare claims in an in-office, full-time role. You'll perform CPT/ICD-9 based reviews, research claims, and ensure correct application of policy guidelines while maintaining strong accuracy...SuggestedFull timeWork at office
- Community First Health Plans in San Antonio seeks an experienced Claims Analyst for its Claims department. You will analyze complex... ...insurance matters, including transplants, to support accurate adjudication. The role requires a high school diploma or GED and at least five...Suggested
$20.3 - $33 per hour
...Analyze complex problems pertaining to claim payments, eligibility, other insurance,... ...operations and reporting to assure auto adjudication. Perform in accordance with company standards... .... Knowledgeable of all benefit programs offered by the CFHP, Medicaid, HMO, PPO, ASO.SuggestedFull timeUniversity Health
San Antonio, TX10 hours ago- University Health in San Antonio seeks a claims analyst to review, analyze, and adjudicate all claim types, including coordination of benefits and DME, ensuring accurate processing and timely resolutions. The role also analyzes provider appeals, documents outcomes in correspondence...
- UT Health San Antonio is seeking an Insurance Follow-Up Specialist to manage unresolved claims and appeals, ensuring timely reimbursement across Medicare, Medicaid, Commercial, and Specialty payors. You will collaborate with Coding and Operations to resolve denials and...Work at office
- GuideWell, via WebTPA, seeks a Claim Examiner in San Antonio, TX, for in-office claims processing and adjudication across medical, dental, vision, and mental health lines. You will research claims, verify coverage, and ensure compliance with policy guidelines within a structured...Work at office
$85.04k - $162.55k
...business needs. The Opportunity As a dedicated Injury Claims Examiner (Central to West regions), you will be responsible... ...liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible...Contract workH1bWork at officeRemote workRelocation package3 days per weekUSAA Careers
San Antonio, TX4 days ago$20.8 - $34.75 per hour
...POSITION SUMMARY/RESPONSIBILITIES Acts as Claims Department resource to coordinate, analyze, and improve departmental performance... ...required. One to two (1-2) years supervisory experience preferred. Medicaid, Medicare and Commercial claims experience is required. Three (...Full timeUniversity Health
San Antonio, TX10 hours ago$25.1 - $40.25 per hour
...Supervises, assists, and directs the activities of the assigned claims processing unit and the assigned staff. Responds to issues... ...required. One to two (1-2) years supervisory experience preferred. Medicaid, Medicare and Commercial claims experience is required. Three (...Full timeUniversity Health
San Antonio, TX10 hours ago- ...12/7/2026 Schedule Monday to Friday 8:00am - 4:30pm Central Time for 4 weeks What is your impact? As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim complexity...Full timeTemporary workPart timeWork experience placementWork at officeMonday to FridayFlexible hours
- SWBC is hiring a Payment Protection Claims Processor to determine coverage, process claims payments, and support Claims Examiners. The role includes handling claim inquiries, preparing files, and coordinating with financial institutions and carriers. The ideal candidate...
- ...Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation | Multi State Jurisdiction |... ...valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices...Remote workFlexible hours
- POSITION SUMMARY/RESPONSIBILITIES Performs review, analysis, and adjudication of all claim types including coordination of benefits and DME claims. Performs analysis of provider appeals and documents outcome determination via correspondence. Acts as a provider liaison for...
- Sedgwick is seeking a dedicated Claims Examiner to analyze workers' compensation claims for clients across multiple jurisdictions. You will determine benefits due and adjudicate claims in line with client service requirements, while maintaining timely and accurate communications...Remote jobFlexible hours
- ...Antonio, TX 78259 Anticipated Training Class Start Dates: 1/5/2026 or 2/2/2026 What is your impact? As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim complexity...Full timeTemporary workPart timeWork experience placementWork at office
$107.6k - $161.4k
Specialist Claims - CH07DEConsultant Claims - CH08CEWe’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish...Full timeTemporary workWork at officeRemote work3 days per weekThe Hartford Financial Services Group
San Antonio, TX10 hours ago$107.6k - $161.4k
Specialist Claims - CH07DEWe’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals - and to help others accomplish theirs, too. Join our...Full timeTemporary workWork at officeRemote work3 days per weekThe Hartford Financial Services Group
San Antonio, TX10 hours ago- ...Job Description Job Description Position Title : Claims Supervisor Reports To : Claims Executive Director... ...for coverage for all relevant claims. Responsible for the claim adjudication process that includes the interpretation of warranty and...Immediate startFlexible hoursNight shiftWeekend work
CARS Protection Plus Inc
San Antonio, TX8 days ago - ...the San Antonio, TX office and three days from home. Essential Job Functions Account Review Appeals & Denials Medicare/Medicaid Insurance Follow-up Customer Service Billing UB-04 & CMS 1500 Complete all business-related requests and...Temporary workWork at officeFlexible hours
$59.52k - $89.28k
Property Claims Adjuster II### Property Claims Adjuster IIApply: Hybrid or 100% Remote: United States - Remote: Scottsdale, AZ: Lake... ...handle all claims by selecting the proper estimating resource to adjudicate the claim.This position will ensure quality standards are met...Full timeTemporary workFor contractorsWork at officeLocal areaRemote workMonday to FridayFlexible hours3 days per week$54.7k - $112k
...documents for CO approval, including draft DD Form 1594s, release of claims, and other necessary paperwork. Input contract obligations... ...lift and move boxes weighing up to 50 lbs. Desired Completed/adjudicated Tier 1 background check (formerly NACI). What You Can Expect A...Full timeContract workWork experience placementLocal areaFlexible hours- University Health is seeking a Claims coordinator to act as a resource in the department, coordinating, analyzing, and improving performance... .... The role requires 5+ years of claims experience, with Medicaid/Medicare/Commercial exposure, and strong data collection and analysis...
- FCE Benefits Administrators, Inc. is seeking a detail-oriented Claims Processor in San Antonio, TX. You will review, verify, and process medical and ancillary claims while ensuring accuracy and HIPAA compliance. A strong focus on data entry, communication, and timely processing...
- ...Resource Group is seeking an experienced Medical Accounts Receivable (AR) Specialist to manage all aspects of medical AR collections for a physician medical group. The role focuses on insurance claim denial follow-up, unpaid claims, and payment recovery. You will follow...
- ...Job Description Job Description Job Title: Claims Adjuster II Department: Claims Reports to: Claims Manager... ...VSC Adjuster II, you will play a key role in our operations by adjudicating multicomponent, moderately complex claims. This position is ideal...Contract workPart time
CARS Protection Plus Inc
San Antonio, TX9 days ago - Meridian Meadows, a respected insurance company in San Antonio, Texas, seeks a dedicated Claims Adjuster for a full-time position. You will investigate and assess claims, determine damages, and propose fair compensation, collaborating with policyholders and witnesses to...Full time
- ...Perform follow-up activities on outstanding insurance medical claims for Medicare, Medicaid, Commercial and Specialty insurance/program payors. Analyze, screen, and correct claim issues. Process appeals, write-offs, and determine if patient billing is necessary. Responsibilities...Full timeWork at office
UT Health Science Center at San Antonio
San Antonio, TX4 days ago $60.8k - $76k
...with highly motivated individuals on high-performance teams? Join WWT today! What is the SCLO Team and why join? The Contract Specialist Services role resides within our Sales Operations Service Contract & Licensing Operations team and interacts directly with Inside...Full timeContract workRemote workFlexible hoursShift workWorld Wide Technology
San Antonio, TX3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicaid & CHIP Claims Adjudication Specialist. Be the first to apply!
Related searches
- claims assistant San Antonio, TX
- claim examiner San Antonio, TX
- medical claims analyst San Antonio, TX
- remote medical claims processor San Antonio, TX
- claims assistant workers compensation San Antonio, TX
- medical insurance claims specialist San Antonio, TX
- claims analyst San Antonio, TX
- claims processor San Antonio, TX
- claims consultant San Antonio, TX
- claim specialist San Antonio, TX