Strategic Reinsurance Claims Specialist (Stoploss)
CVS Health
CVS Health is seeking a claims professional to review and adjudicate Reinsurance/Stoploss medical claims, including large and complex cases. You will apply medical necessity guidelines, verify eligibility, and resolve discrepancies while supporting internal partners across functions. The role emphasizes accurate claim adjustments, timely customer responses, and adherence to policy language. A background in claims processing and collaboration within teams is essential for success. #J-18808-Ljbffr CVS Health
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Strategic Reinsurance Claims Specialist (Stoploss) in Oklahoma City, OK vacancy
- CVS Health is seeking a dedicated Claims Adjuster for Reinsurance/Stoploss with a focus on complex, high-dollar medical claims. You will review, research, and adjust claims across all dollar levels, applying medical necessity guidelines and contract language to ensure...SuggestedContract work
- LexisNexis Risk Solutions is seeking a Contract Specialist to identify and engage contract workers, independent contractors, and small businesses that provide public record data and document acquisition, verification, and related services. You will negotiate terms, support...SuggestedContract workFor contractors
$95.14k - $142.08k
...employer groups of high complexity and leading strategic rating decisions that balance... ...profitability. This role applies deep expertise in claims analysis, actuarial concepts, and... ...features a robust provider network, including specialists, primary care physicians and hospitals....SuggestedPermanent employmentFull timeTemporary workTraineeshipCurrently hiringRemote workShift workSentara Health
Oklahoma City, OK4 days ago- ...implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals. 8. Diversity - Shows respect and sensitivity for cultural differences; Promotes a harassment-free environment. 9. Ethics -...SuggestedWork at office
Oklahoma Farm Bureau Insurance
Oklahoma City, OK4 days ago - ...Stops in Oklahoma City is seeking a Warranty Support Representative to provide OEM warranty and billing support. You will process claims, audit invoices, and maintain accurate case documentation while collaborating with Shops and internal teams to resolve issues. You...Suggested
- LHH is seeking a Commercial Contracts Specialist in Oklahoma City. In this high-impact role, you will manage the contract lifecycle, which includes intake, review, risk assessment, and execution. Collaborating with cross-functional teams, you'll support negotiations, maintain...Contract work
- Oklahoma Farm Bureau Insurance is seeking an experienced Auto Total Loss Claims Adjuster to evaluate auto total loss claims and expedite settlement. You'll confirm coverage, obtain appraisals and estimates, analyze data, and settle claims within authority while maintaining...Work at office
$10k
We are seeking a Senior Subrogation Claims Specialist to be part of the newly established in-house subrogation team specializing in high-value claims (>$10K) and total losses. Reporting to the Senior Manager of Subrogation Claims, you will manage complex subrogation cases...Work at officeVisa sponsorshipFlexible hours- GlobalHealth, Inc. is seeking a Claims Processor to handle all types of Medicare, Medicaid, and Commercial insurance claims with accuracy and efficiency. The role supports the Team Leader and Claims Supervisor to meet regulatory standards for quantity, quality, and timeliness...Remote job
- A leading insurance provider is seeking a PIP Claims Specialist to handle moderately complex claims involving Personal Injury Protection. This role requires 1-2 years of claims experience and a Bachelor's degree in business or a related field. The position allows remote...Remote jobShift work
$57.29k - $63.65k
...an opportunity to be innovative and adaptable. We hire good people for a brighter tomorrow. We are actively hiring for a PIP Claims Specialist! Your Role As a PIP Specialist, you will handle to conclusion moderately complex claims involving first‑party Personal Injury...Remote jobHourly payFull timeShift workAfternoon shift- The Hanover Insurance Group is hiring a Total Loss Adjuster for its Auto Claims team. This full-time, exempt role offers a hybrid schedule (two days in the office) across Worcester, MA; Richmond, VA; Syracuse, NY; Itasca, IL; Howell, MI / Farmington Hills, MI. You will...Full timeWork at office
- ...changes. Participate with management in strategizing for Process Improvement initiatives to... ...system. Processes outgoing referrals to specialists outlined by the patient’s insurance... ...billing errors and edits to ensure all claims are filed in a timely manner. Follow-up...Hourly payDaily paidWork at office
- Arthur J. Gallagher & Co. is seeking a Claims Specialist for workers' compensation. This remote-ready role requires thorough claims experience, licenses for handling claims across states, and proficiency with claims software. You will analyze exposure, coordinate with parties...Remote job
- Gallagher Bassett is seeking a Claims Medical Only Representative to provide administrative, claim and customer support. You will handle communications with claimants and clients, document activities, set reserves, and assist in claim disposition under established standards...
- National Interstate Insurance Company (NIIC) is seeking a Workers Comp Senior Claims Representative. The role supports claims handling across remote or hybrid setups, with in-office days in or near New England states. You will evaluate coverage, investigate liabilities...Remote jobWork at office
- ...Emergency Medical Services in Oklahoma City, OK, seeks a Third Party Billing Associate for a hybrid role. You will manage ambulance claims across multiple states, ensuring accurate submissions and timely resolutions in line with payer requirements. Responsibilities...
$18.5 - $42.35 per hour
...-from-home position. You will handle member and provider inquiries via telephone, internet, or written correspondence, focusing on claims status, benefits, and eligibility. This full-time role offers an hourly wage between $18.50 and $42.35, with a comprehensive benefits...Remote jobHourly payPermanent employmentFull timeWork from home$60k - $65k
...advancement and increased responsibilities.Professional Development: Opportunities to strengthen marketing, communication, leadership, and strategic planning skills.Collaborative Work Environment: Join a supportive team that values innovation, teamwork, and individual...Alphabe Insight
Oklahoma City, OK4 days ago$53.9k - $89.8k
...collection processes and documentation. About The Role As a Contract Specialist, you will identify and engage contract workers, independent... ..., such as vendor management, vendor relationship management, strategic sourcing, or supply chain, is strongly preferred....Contract workTemporary workFor contractorsWork experience placementWork at officeLocal area- ...organization in Oklahoma City to identify a Commercial Contracts Specialist to support its Sales and Operations teams. This role plays a... ...of legal, sales, and operations , this is a great opportunity to contribute strategically and grow your career. #J-18808-Ljbffr LHHContract work
- ...About the Role The Company is in search of an AVP, Deputy Chief Underwriter to join their team. The successful candidate will be a strategic leader, providing expert underwriting consultation and shaping underwriting strategy. This executive role involves driving...
- Red Rock is seeking a dedicated finance professional in Oklahoma City to manage insurance claim denials, evaluate validity, and rebill as needed to optimize payments. The role emphasizes timely communication with clinical and business office staff and maintaining a healthy...Full timeWork at office
- ...Medical Records Technician - Biller to support the Business Office by accurately preparing and submitting outpatient and inpatient claims to third party payers within the Indian Health Service framework. The role emphasizes timely processing, auditing for documentation...Work at office
$55k - $72.16k
Atlas Elite Partners, a private equity firm, seeks a full-time Underwriter in Oklahoma City, OK. The Underwriter will be integral to our investment process, working with the investment team to identify, evaluate, and structure potential opportunities. The Underwriter will...Full timeWork at officeImmediate startRemote workAtlas Elite Partners
Oklahoma City, OK1 day ago$45.76k
...point of contact for families searching for senior care solutions. In this high-impact sales role, you'll use empathy, insight, and strategic guidance to help caregivers as they explore the best care options for their loved ones.Responsibilities:What you will doWork in a...Hourly payWork at officeRemote workWork from homeHome officeShift workWeekend workAfternoon shiftA Place for Mom
Oklahoma City, OK3 days ago$65k - $75k
Workers' Compensation Adjuster (Louisiana - Remote) Department: Claims Administration & Adjusting Employment Type: Permanent - Full... ...and catastrophic exposures. The adjuster develops and executes strategic action plans to ensure claims are resolved appropriately, efficiently...Remote jobPermanent employmentFull timeTemporary workFor contractorsLocal area$37.66 - $44.33 per hour
...products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned... ...to work in a fast-paced environment. Excellent evaluation and strategic skills. Strong claim negotiation skills. Strong customer focus....Hourly payTemporary workRemote work- RELX LexisNexis Risk Solutions is seeking a Contract Specialist to drive service-provider networks for public record data and document... ...stakeholders. The role requires experience in vendor management or strategic sourcing, plus an understanding of negotiation theory, risk...Contract work
$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
Oklahoma City, OK2 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Strategic Reinsurance Claims Specialist (Stoploss). Be the first to apply!
Related searches
- remote medical claims processor Oklahoma City, OK
- medical insurance claims specialist Oklahoma City, OK
- claims intake Oklahoma City, OK
- vice president claims Oklahoma City, OK
- property claims Oklahoma City, OK
- veterans claims Oklahoma City, OK
- claims processing Oklahoma City, OK
- medical claims auditor Oklahoma City, OK
- pharmacy claims Oklahoma City, OK
- healthcare claims Oklahoma City, OK