Clinical Coding & Claims Resolution Analyst
Universal Health Services
South Texas Health System seeks an experienced coding professional to serve as a key liaison across Texas facilities, focusing on outpatient coding edits, NCCI, and medical necessity. You will resolve complex coding issues in real time, supporting DNFB initiatives and audits while collaborating with HIM, Revenue Cycle, and clinical teams to ensure compliant, timely claim submissions. This role demands advanced ICD-10-CM/CPT knowledge, strong decision-making, and the ability to interact with #J-18808-Ljbffr Universal Health Services
- UHS is seeking a healthcare coding specialist to act as a key liaison among Texas facilities and departments. The role focuses on real‑time corrections for coding and claims, standards adherence, and timely claim submissions across multiple sites. The position requires...SuggestedRemote work
- UHS is seeking a Coding and Claims Specialist to serve as a liaison for Texas facilities, coordinating with ATCBO, HIM, Revenue Cycle and... ...), NCCI, and medical necessity edits, while addressing DNFB resolution, audit support, and continuous process improvement through cross...Suggested
$60k - $75k
...Workplaces in Financial Services & Insurance Claims Adjuster - Workers Compensation |... ...workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and... ...are properly documented and claims coding is correct. May process complex lifetime...SuggestedFull timeContract workLocal areaRemote workFlexible hours- Aptus Health Care is looking for a detail-oriented Insurance Verification Clerk (IVC) to join our administrative team. In this role, you will be responsible for verifying patient insurance information, ensuring accurate and timely billing, and assisting with the coordination...SuggestedFull timeMonday to Friday
$64k - $85k
...Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation | Jurisdiction: WA & OR |... ...through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure...SuggestedRemote jobFull timeFlexible hours- ...experience in medical terminology. Understanding of life and disability insurance policies, as well as proficiency with CPT and ICD 10 codes in medical terminology. Ability to analyze insurance and other related documents. Mastery of Microsoft Office: Word, Excel and Power...Temporary workWork at officeMonday to Friday
- ...DESCRIPTION Analyzes, processes, and adjudicates all types of complex claims submitted in Centers for Medicare and Medicaid Services Form 150... ...and adjudication, applying payment policies, fee schedules, and coding guidelines, or in a Provider Call Center in the Health Insurance...Contract workLocal areaImmediate start
- MCS Puerto Rico in San Juan seeks an experienced claims adjudicator to analyze and process CMS‑1500 and UB‑04 claims, applying the highest level of analytical judgment to determine payments or denials. Responsibilities include handling adjustments, reimbursements, COB,...
- At AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Intake Analyst (FNOL) in the Claims Department to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make...Work at office
- ...this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Claims Analyst Claims Review & Audit Full Time Clerical San Juan, PR, US 5 days ago Requisition ID: 1522 Position Summary: The Claims...Daily paidFull timeWork at office
- .... The candidate will review medical terminology and insurance policies, analyze documents, and ensure accuracy using CPT and ICD-10 codes. Proficiency in Word, Excel, and PowerPoint is required, along with strong customer service and analytical abilities. The ideal candidate...Temporary workWeekday work
- Select how often (in days) to receive an alert: Claims Specialist Date: Oct 29, 2026 Short Description Responsible for providing excellent... .... Performs account reconciliations as part of the dispute resolution effort. Provides merchants with the documentation that...
- Chubb Ltd. in the United States region seeks a Financial Lines Claims Adjuster to manage FI, E&O, EPL, Cyber, Environmental and D&O claims from notification to resolution, including coverage analysis, liability, reserving and settlement. You will negotiate with claimants...
- AssuranceAmerica Corporation is hiring a Liability Adjuster I in McAllen, TX. The role focuses on initial handling of straightforward liability claims, with a caseload of non-complex files and guidance from a supervisor. The ideal candidate has at least one year of auto-claims...
- ...related experience in collections or customer service. Other Qualifications Excellent customer service, negotiation, and conflict resolution skills when dealing with customers in challenging situations. Ability to identify customer issues and needs and provide a variety...Full timeWork at officeImmediate startMonday to Friday
- Role Purpose The Finacial Lines Claims Adjuster is responsible to manage a mixture of Financial Institutions (FI), Errors & Omissions... ...Liability and Directors & Officers claims (D&O), from notification to resolution of claims, including coverage analysis, legal liability,...
- Role Purpose The Claims Adjuster is responsible for the proactive management of a high-volume portfolio of casualty claims, multinational... ...exceptional client service and timely, accurate claims resolution. The role applies technical expertise and strategic cost- benefit...Local area
- Chubb in Puerto Rico is seeking a Finacial Lines Claims Adjuster to manage FI, E&O, EPL, Cyber, Environmental and D&O claims from notification to resolution, including coverage analysis, reserving, and settlements. The role requires strong analytical skills, familiarity...
$61.9k - $102.9k
...skills? Kemper is looking for experienced Represented Bodily Injury Claims Adjusters for our growing teams! This specialized position... .... Time management skills ensuring deadlines are met for claim resolution. Strong analytical skills to evaluate claim information, assess...Full timeTemporary workFor contractorsCasual workWork at officeHome office$61.9k - $102.9k
## Represented Casualty Claims AdjusterApply: Lake Mary, Florida: McAllen, Texas: Downers Grove, Illinois: Richardson, Texas: Doral,... ...with various departments to efficiently move claim toward final resolution.* Performs other duties as assigned.**Position Requirements**:*...Full timeWork at office- APS Healthcare, Inc. in San Juan, Puerto Rico is seeking a Claims Analyst to process claims in accordance with policies and ensure quality production in the Claims Department. You will adjudicate claims, identify COB when applicable, maintain knowledge of provider contracts...
- Kemper is seeking experienced Represented Bodily Injury Claims Adjusters to join our growing teams. This role focuses on analysis and negotiation of complex bodily injury claims after initial coverage determinations, with inventories often involving attorney-represented...Work at office
- ...forms. Support on aging and payment reconciliation. Support on the claims process and analysis. Support on collections to medical plans.... ...the claims process is required. Knowledge of denied/rejections codes and be able to delinéate effective action plans to achive the collection...Work at office
- ...sales and underwriting, reviewing proposals, subscribing business per LOA, negotiating with brokers, and supporting operations and claims as needed. You will monitor production, visit producers, and present covers to insureds and prospects, ensuring adherence to Best...
- ...internally, other line of business underwriters and top management. Assist Operations Department in policy issuance as well as support Claims Department in the event of a claim under one of their accounts in order to interpret underwriting intention, if needed. Create...For contractors
- ...LOAs and underwriting appetite. Responsibilities include reviewing proposals, negotiating with brokers, managing new business and renewals, and supporting operations and claims when needed. Strong English/Spanish skills and a degree are required. #J-18808-Ljbffr Chubb
- ...Practices, and current underwriting appetite for Puerto Rico and the Caribbean. Responsibilities include examining proposals, subscribing business, negotiating with brokers, and supporting policy issuance, claims, and endorsements as needed. #J-18808-Ljbffr Chubb Ltd.
- ...thought, experiences, skills, and backgrounds.**Liability Adjuster I**TheLiability Adjuster I is responsible for the initial handling of claims involving straightforward coverage and liability issues. This role involves managing a caseload of non-complex claims and...Full time
- AIG LATIN AMERICA I I is hiring a Claims Intake Analyst (FNOL) to handle initial claim reports from policyholders, agents and third parties, ensuring timely and accurate setup in the claims system for efficient processing. The ideal candidate will work in a fast-paced environment...
- ...or payment of medical and/or life insurance claims to seek efficiency in the claim adjudication processes of each of the analysts, according to the parameters established in... ...departments when necessary. Evaluate and request new codes or the deactivation of codes and/or changes...Local area
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