Healthcare Claims Integrity Specialist
Independent Living Systems, llc
Independent Living Systems is seeking a Claims Examiner in Miami, FL to thoroughly review and evaluate insurance claims for accuracy and compliance. You will analyze medical documentation, policy terms, and billing data to determine validity, collaborating with providers and internal teams to resolve issues and ensure timely reimbursement. The role requires 2+ years in claims/exam, familiarity with ICD-10/CPT, and proficiency in claims software and MS Office. #J-18808-Ljbffr Independent Living Systems, llc
$60k - $80k
Radiology is the second most used healthcare service, used by over 51% of the workforce annually. Despite the critical... ...and payers on every exam. We’re hiring a Lead Claims Analyst to own the day-to-day integrity of our claims and adjudication workflows and to help...SuggestedImmediate start- ...seeking a detail-oriented, analytical, and results-driven Medical Claims Specialist to join our team. As a Contestation Specialist, you will... ...requirements. This is an excellent opportunity for a healthcare analytics professional who enjoys problem-solving, financial...Suggested
- A national healthcare recruiting firm is seeking a candidate with 2-3 years of experience in claims processing and billing. The role involves investigating insurance claims, verifying patient eligibility, and updating records accordingly. Strong customer service skills...Suggested
- Position Summary The Claims Examiner III is responsible for processing submitted electronic claims to ensure proper filing procedures and that processing guidelines and rules have been followed. The Claims Examiner III also validates claim or referral submissions to determine...SuggestedWork at office
$70k - $125k
...your next opportunity? Sompo has a unique opportunity for a Claims Specialist, Construction in our Casualty Claims team. Sompo is committed... .... We achieve this by establishing our claims team as an integral component of the underwriting process and aligning our claims...SuggestedFull timeWork at officeWorldwideFlexible hours- Provider Network Solutions LLC seeks a Claims Examiner III to process electronic claims, verify filing procedures, and apply coding and guidelines to ensure compliant submissions. The role includes adjudicating complex claims, applying medical necessity guidelines, performing...Work at office
- ...appropriateness of payments authorized. Evaluates claims referred for medical management and... .... Our innovative care management model integrates the needs of providers, payors and... ...dollars savings that keep the cost of healthcare down. We are building a model for managing...
$98.16k - $176.69k
...property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of...Temporary workWork experience placementWork at officeLocal area2 days per week1 day per week- ...LLC is seeking experienced bilingual Auto Insurance Adjusters to join our onsite team in Florida. You will investigate and assess claims across Bodily Injury, Personal Injury Protection, Property Damage, Payment Adjustment, Appraisal, and Special Investigation Units,...
$100k - $200k
...repayment capacity, evaluate risks, and protect the portfolio ensures capital is deployed responsibly and the business can scale with integrity.Background Great candidates for this role may come from:5+ years of revenue-based financing or merchant cash advance underwriting...Relocation package$119k - $150k
...brand awareness for Everest Evolution.Collaborate closely with Claims, Actuarial, Operations, Product, and Distribution teams.Monitor... ...actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk....Full timeFor contractorsWork at officeRemote workFlexible hours- Loyalty MGA LLC is seeking a Florida Auto PIP / Medical Payments Adjuster to join our claims team in Miami. You will review medical bills, apply PIP statutes, and communicate with insureds and providers to ensure timely, accurate payments. The role requires knowledge of...
$20 - $25 per hour
...reproductive health, genetic testing, and diagnostic laboratory facility in Miami is seeking a self-directed, detail-oriented Medical Claims Specialist to join their revenue cycle team. This role is vital to managing payor follow-up, clearing backlogs, and ensuring accurate...Hourly payPermanent employmentFull timeTemporary workWork experience placementWork at officeRemote workMonday to FridayFlexible hoursShift work- ...We are seeking a Claims Examiner to join our team at Independent Living Systems (ILS).... .... The Claims Examiner collaborates with healthcare providers, and internal teams to resolve... ...Ultimately, this role contributes to the integrity and sustainability of the organization by...Work at office
- ...Check renewals regularly and review by exception.* Review underwriting figures on a regular basis in order that unusual trends, data integrity issues, and/or adverse movements may be dealt with by appropriate action.* Remain alert to developments affecting the business,...Worldwide
- ...underwriting guidelines are followed. You will collaborate with sales to issue accurate quotes and policies while maintaining portfolio integrity. The role targets detail-oriented, analytical professionals with Florida licensing and at least 1 year of experience, preferably...Flexible hours
$800 - $1,000 per week
...Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Inclusion...Rotational programPermanent employmentInternshipSummer internshipWork at officeRemote work- Sedgwick is seeking a Licensed Auto Claims Adjuster - Bodily Injury Specialist in Miami, FL. The role involves managing auto claims, assessing liability, and negotiating settlements. The ideal candidate will have a Bachelor's degree, four years of claims management experience...
$15 - $18 per hour
Claims SpecialistImmediate need for a talented Claims Specialist. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote)... ...other workflow management systems.3-5 years of healthcare Revenue Cycle Management experience.2 years of experience...Contract workRemote work- Norwegian Cruise Line Holdings Ltd. is seeking an experienced claims professional to research, review, investigate and adjust passenger personal injury or other claims. The role focuses on in-house adjustment, risk assessment and timely resolution in line with contracts...
- # Property Insurance Claims ProcessorRemote Full-timeDaily Drop — Subscriber PerkReduce DebtUp to $500 to reduce debt fastJoin to Unlock... ...high-quality properties in most major markets. We value integrity, respect, collaboration, customer focus, and performance. These...Temporary workRemote workHome officeOverseas
- Baptist Health is seeking a government programs reimbursement specialist to ensure timely and accurate reimbursement for government insurance accounts. You will manage a portfolio, verify COB and eligibility, and communicate with payers to maximize reimbursements. The...
- Norwegian Cruise Line Holdings Ltd. is seeking a Claims Representative in Miami to research, review and adjust passenger claims for personal injury or other complaints. The role requires a Bachelor's degree and 2-4 years in corporate claims, strong negotiation and communication...Work at office
- ...condition, providing accurate assessments in a timely manner. Ideal candidates have a background in automotive valuation and strong attention to detail, with the ability to communicate effectively with claim handlers and customers throughout #J-18808-Ljbffr Univista Holdings
- Sompo is seeking a Claims Specialist, Construction to join the Casualty Claims team. You will directly handle construction-related General Liability claims, assess coverage, reserve, and coordinate strategy with underwriters and counsel. The role requires 3-5 years in insurance...Work at office
$16 - $17 per hour
...collaborating with sales agents to issue accurate and timely quotes and policies. Your insight will be essential in maintaining the integrity of our portfolio while supporting the agency’s growth. Required Qualifications Valid Florida 4-40 or 2-20 Insurance License (...Hourly payFlexible hours- The Standard is seeking a Claims Liaison responsible for supporting policyholders, employers, and employees with group life, disability, and leave-related inquiries. You will manage claim processes, coordinate death claims, and assist with filing claims while ensuring...Contract work
- Independent Living Systems (ILS) in Miami, FL is seeking a full-time Claims Examiner to review health insurance claims for accuracy and... ...has a minimum of 2 years in claims examination or related healthcare billing, a solid grasp of medical terminology, and experience with...Full time
$230k - $250k
.... We consider qualified applicants with criminal histories, consistent with applicable law.Functional Area:UW - UnderwritingRisk Specialists Companies Insurance Agency, Inc.SummaryLocation: TX-Dallas; CO-Denver; DC-Washington; GA-Atlanta; TX-Houston; CA-Los Angeles; FL-...Full timeWork at office- ...COMMUTE TO/FROM OUR OFFICE IN CORAL GABLES, FLORIDA. Ascendant Claims Services LLC, a trusted affiliate of Ascendant Commercial... ...organization. At Ascendant, our core philosophy is simple: serve with integrity, professionalism, and excellence. We’re looking for the next...Work at officeLocal areaRemote workWork from home
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