Hybrid Claims Specialist - Healthcare Adjudication
Pacific Medical Centers
PacMed Clinics DBA Pacific Medical Centers in Renton, WA seeks a Claims Specialist to review, process, and adjudicate TRICARE medical claims with accuracy and compliance. You will investigate discrepancies, address provider and beneficiary inquiries, and uphold reimbursement guidelines while maintaining fast turnaround times. Join a Providence-affiliated network committed to patient-focused care. This role offers a hybrid schedule, with base pay disclosed in the wage range and opportunities for #J-18808-Ljbffr Pacific Medical Centers
- Providence Health Plan Group in Renton, WA is seeking a Claims Processor to adjudicate claims for its capitated population. You'll be responsible for complex claims adjustments and act as a primary resource in specific areas like EDI and Health Plan Repricing. Join us...Suggested
- Pacific Medical Centers is seeking a Claims Specialist to review, process, and adjudicate TRICARE medical claims in our Renton area. You will investigate discrepancies, respond to provider and beneficiary inquiries, and ensure compliance with reimbursement guidelines in...Suggested
- Pacific Medical Centers (PacMed) seeks a Claims Specialist to review, process, and adjudicate TRICARE medical claims with accuracy and adherence to TRICARE regulations and company policies. The role involves investigating discrepancies, resolving provider and beneficiary...Suggested
- ...Administrators, Inc. in Seattle is seeking an Appeals Specialist to join the Health and Welfare Claims Department. You will focus on member disputes and... ...accuracy and adherence to policies. This role offers a hybrid schedule with three days in the office, and you may work...SuggestedWork at office
- CampusPoint in Seattle is seeking an Appeals Specialist to support health and welfare claims disputes and appeals, joining a team focused on accuracy and... ...to present cases for resolution. This role offers a hybrid schedule with 3 days in the office in the Seattle area...SuggestedWork at office
$21.55 - $33.53 per hour
Description The Claims Specialist is responsible for reviewing, processing, and adjudicating TRICARE medical claims accurately and in accordance... ..., ensures compliance with healthcare reimbursement guidelines, and... ...Park-Renton Workplace Type: Hybrid Pay Range: $21.55 - $33.53...Minimum wageFull timeContract workLocal areaShift work- Northwest Administrators, Inc. is seeking an Appeals Specialist to join our Health and Welfare Claims team in Washington. You will handle member disputes and appeals, reviewing claims and policies to determine accurate outcomes while coordinating with internal teams for...
- Providence is looking for a skilled claims adjudicator in Renton, WA. You will manage claims for our enrolled capitated population, providing excellent customer service while resolving complex situations. Our culture fosters patient-focused care, where your contributions...
- Pacific Medical Centers, part of Providence Health & Services, is seeking a Lead Claims Specialist to adjudicate purchased services claims for the US Family Health Plan (USFHP). You will resolve complex claim situations, manage advanced processing needs, and apply TRICARE...
$99.6k - $186k
...support profitable growth across industries like manufacturing, healthcare, technology, and real estate.What We’re Looking ForEffective... ...may be provided)* The Hartford is proud to offer our teammates a hybrid work environment. Selected candidate must be located in commuting...Full timeTemporary work- The Hanover Insurance Group, Inc. is seeking a Senior Underwriting Specialist for Specialty General Liability who can work remotely or in hybrid arrangements. The role covers high hazard product liability underwriting with occasional travel to key specialty locations. You...Remote job
$80k - $100k
...Successful candidates will ideally have a Bachelor's degree or equivalent experience in the insurance industry. The role offers a hybrid work model with a salary range of $80k - $100k annually, along with various teammate benefits focusing on total well-being. #J-1880...- ...Job Title Adjudicates all claims submitted by outside purchased services for PMC's enrolled capitated population and communicates those actions... ...the administration of managed care products. ~ IDX healthcare software application. ~ CHAMPUS, Medicare and/or Medicaid...
- A leading health insurance provider in Seattle is seeking a Claims Processor to oversee claims adjudication for various types. Responsibilities include processing Institutional, Professional, and Dental claims, while adhering to privacy and quality standards. The ideal...Remote jobFlexible hours
- Pacific Medical Centers in Seattle is seeking a Claims Specialist to ensure patient accounts and claim data support timely billing and optimal reimbursement. You will monitor daily electronic claims transmissions, researching and resolving system and clearinghouse rejections...
- Providence Health Plan Group in Seattle is seeking a Claims Specialist to ensure patient accounts and claim data support timely billing and optimal reimbursement. You will monitor electronic claims and resolve rejections to minimize denials while coordinating billing across...
- Providence is seeking a Claims Specialist in Seattle to ensure the accurate and efficient processing of healthcare claims. In this role, you'll support financial workflows and work closely with various stakeholders to maximize reimbursement and ensure compliance. Required...
- Claims Specialist - Other Fiscal Services Be the engine behind accurate, efficient healthcare operations. As a Claims Specialist in Other Fiscal Services, you play a vital role in ensuring claims are processed correctly, payments are timely, and financial workflows run...Work experience placement
- Pacific Medical Centers in Renton, Washington is looking for an experienced claims adjudicator to manage and resolve complex claims. The ideal candidate will have a Bachelor's Degree in a related field and at least 4 years of Managed Care operations experience. This role...
- Zurich North America seeks an Underwriting Specialist OR Executive Underwriter, Large Property for the National Accounts Large Property Underwriting team in San Francisco or Seattle. This hybrid role requires in-office presence and a flexible schedule with your manager...Work at officeFlexible hours
- Zurich North America is seeking an experienced Underwriting Specialist or Executive Underwriter, Construction PL, to join our Specialties Construction team. This role offers a hybrid schedule and can be based out of any Zurich office location within our South or Western...Work at office
- Pacific Medical Centers in Renton, WA, is seeking a Lead Claims Specialist for the US Family Health Plan (USFHP). This role adjudicates purchased services claims for capitated members and resolves complex situations with precision. You will handle advanced processing tasks...
- Progressive Insurance is hiring for a hybrid claims professional in Washington. You will report to one of several WA offices and participate in meetings and training about four days per month, with additional in‑office opportunities if desired. In this role you will determine...Work at office
- Markel Group in Seattle seeks an experienced Ocean Cargo Underwriter to underwrite new business and renewals profitably within guidelines, and mentor less experienced underwriters. You will assess submissions, determine risk and pricing, manage relationships with agents...
- Markel Group in Seattle is seeking a Senior Underwriter to focus on retail Cyber/IT & Misc E&O underwriting, reviewing, analyzing, accepting, and declining risks to ensure profitability for Markel. The role involves collaborating with underwriting management, regional and...
$50k
...Responsibilities Investigate and resolve lower complexity and lower exposure claims. Manage a full claim workload with limited oversight and make... ...PTO, corporate holidays, and floating holidays. Parental leave. Hybrid working schedules of 3 days in the office and 2 days remote. The...Work at officeLocal areaRemote work$100k
...designed to meet the unique coverage and claims-handling needs of businesses. The Argo... ...Construction Defect Technical Claims Specialist Employment Type: Full-Time FLSA Status:... ..., MT, ND, SD, or VT. This role will be adjudicating our most complex construction defect claims...Full timeLocal areaRemote work$124k - $199.8k
...in all aspects of program management such as actuarial pricing, claim or TPA oversight, reinsurance accounting and collateral management... ...candidate’s qualifications***Location:This role will have a Hybrid Work arrangement, with the expectation of working in one of the...Full timeTemporary workWork at office3 days per week$26.49 - $40.99 per hour
...independent insurance agents, as well as directly to consumers. Auto Claims Estimator Key Responsibilities Applies mastered content in... ...Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident. #J-18808-...Work from homeVisa sponsorshipWork visa$26.49 - $40.99 per hour
...comprehensive estimate of damages for 1st and 3rd party material damage claims leading to the proper disposition. This role is utilized as a... ...Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident. Benefits...Contract workWork at officeWork from homeVisa sponsorshipWork visa
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