Senior Health Claims Specialist: Complex Adjudication
$18.5 - $42.35 per hourHispanic Alliance for Career Enhancement
CVS Health® is seeking a Medical Claims Specialist to review and adjudicate sensitive medical claims. This full-time role in Illinois requires a minimum of 18 months of medical claim processing experience with a health insurance payor. You'll be responsible for ensuring compliance with regulatory requirements, supporting customer service operations, and mentoring team members. The position offers an hourly pay range of $18.50 - $42.35, along with a comprehensive benefits package including medical, dental, and vision coverage. #J-18808-Ljbffr
$23.16 per hour
...Excess Risk and Reinsurance) claims in accordance with established... ...reviews and analyzes various complex potential claims with... ...Determines whether to pend or adjudicate claims following organizational... ...relevant, progressive experience in health insurance claims 3 years of...SeniorFor contractorsWork at officeLocal area$212k - $318k
...We are seeking a Partner, Senior Health Actuary to join our Actuarial and Financial Group (AFG) in Mercer's Health practice. The location... ...ability to manage client relationships and effectively deliver complex presentations and recommendations. Experience leading and developing...Senior$115.4k - $251.6k
...Job Description About Oracle Health Applications & Infrastructure Oracle Health Applications... .... About the Role As an Senior Principal Product Manager, you will own product... ...go-to-market teams. You will translate complex healthcare needs into clear product...SeniorTemporary workFlexible hours$78.1k - $145.7k
...working environment. A day in the life. As a Senior Claims Consultant, you will be responsible for... ...these skills: Proficient in managing complex construction claims through thorough... ...competitive total rewards package which includes health and welfare benefits, tuition assistance...SeniorMinimum wageWork at officeWork from home$100k - $125k
...Workplaces in Financial Services & Insurance Sr. Claims Specialist, Professional Liability | E&O, D&O, EPL | Remote Primary Purpose To analyze complex or technically difficult errors and... ...assistance, flexible spending or health savings account, and other additional voluntary...SeniorWork at officeLocal areaRemote workFlexible hours$68k - $136k
...qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in... ...executives, and scientists. The Opportunity The Senior Trademark Paralegal is a highly... ..., responsible for independently managing complex trademark matters and larger portfolio initiatives...SeniorWorldwide$68k - $80k
...Financial Services & Insurance Claims Adjuster - Workers Comp... ...regulations, filings, and claim adjudication practices. Are you looking... ...and experience to adjudicate complex customer claims in the... ...assistance, flexible spending or health savings account, and other additional...Contract workFlexible hours- ...CVS Health® in the United States is seeking a Senior Analyst for their Periodic Access Review team. The role involves executing access review processes, training junior analysts, and ensuring compliance with internal and external regulations. The ideal candidate will...SeniorFull time
$78.4k - $136.95k
## Senior Financial Planning AnalystApplyremote type: Hybrid (8 days/month)locations: USA... ...and trend analysis.* Develop and update complex financial models.* Analyze profit-and-loss... ...customers, we help to advance sustainability, health, justice, prosperity, and commerce around...SeniorWork at officeWorldwide$77k - $131k
...athenahealth is seeking a Medical Coding Automation Senior Associate in Illinois. This role involves analyzing operational data to drive improvements in coding accuracy and efficiency. Candidates should have a bachelor's degree, a CPC or CCS certification, and at least...Senior$89k - $121.4k
...a part of our caring community The Senior Business Intelligence Engineer builds and... ...'s work assignments involve moderately complex to complex issues where the analysis of... ...include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more...SeniorFull timeTemporary workApprenticeshipRemote work$123.4k - $176.3k
...Application Development & Maintenance contributes to Cardinal Health Information Technology oversees the effective development, delivery... ..., processes, metrics, or models Works on or may lead complex projects of large scope Projects may have significant and long...SeniorTemporary workWork experience placementLocal areaImmediate startFlexible hours- Green Key Resources is seeking an experienced Program Manager / Owner’s Representative in Illinois to support healthcare construction and renovation projects. This role is crucial as it involves representing the client's interests throughout project delivery processes....Senior
$150k - $165k
...Purpose Develops Talent Manages Conflict Financial Acumen Managers Complexity Functional Attracts Top Talent Communicates Effectively Drives... ...which working. USDA: Accredited by the USDA Animal and Plant Health Inspection Service, National Veterinary Accreditation Program...SeniorTemporary workLocal areaFlexible hoursShift work- ...Baylor Scott & White Health is seeking a skilled Analytics Developer to join the Customer Analytics team. The role involves gathering data requirements, developing analytic solutions, and providing valuable insights through dashboards and reports. The ideal candidate...Senior
$126.2k - $264.1k
...Job Description We pride ourselves on revolutionizing the way health data is captured, analyzed, and transformed into actionable... ...executive briefings on regulatory and policy impacts. Advise senior leaders on compliance risks and strategy. Defining and driving...SeniorTemporary workFlexible hours$66.5k - $88.02k
...Cardinal Health is seeking a Sr Regulatory Affairs Specialist to support their Medical Solutions team by providing regulatory expertise for a diverse portfolio of medical devices. Remote applicants are welcome, especially those near Mansfield, MA or Waukegan, IL. The...SeniorWork at officeRemote work- An innovative healthcare consulting firm is seeking a Senior Radiation Oncology Consultant. This remote role is critical for delivering... ...clinical operations and providing training. Benefits include flexible working, health insurance, and a dynamic work culture. #J-18808-LjbffrSeniorRemote workFlexible hours
$86.7k - $173.3k
...helping people with diabetes manage their health with life-changing products that provide... ...mothers, female executives, and scientists. Senior Software Engineer, Cloud – Opportunity... ...designing, implementing, and maintaining highly complex asynchronous messaging and backend...Senior- ...Cardinal Health is seeking a Senior Coordinator, Prior Authorization to manage payer approvals for durable medical equipment orders. This fully remote position involves preparing and submitting prior authorization requests, conducting follow-ups, and ensuring compliance...SeniorRemote workFlexible hours
$79.1k - $158.2k
...Job Description Oracle Health Government Services is seeking a skilled Senior Consultant to join our VA Critical Support Team within a mission-driven organization... ..., Support teams, and VA stakeholders to resolve complex, persistent issues impacting end users within live...SeniorTemporary workFlexible hours$284.32k - $355.4k
...patient needs in oncology, urology, women's health, rare diseases, cell & gene therapies and... ...individual for the position of Senior Medical Director, Clinical Research (Neurology... ...multi-regional, matrix team through highly complex decisions. · Responsible for and lead all...SeniorWorldwideFlexible hours$71.2k - $158.2k
...obtain a Federal Security Clearance. When you join Oracle Health Consulting as a Senior Organizational Change Consultant professional, you become... ...skills coupled with an ability to communicate complex ideas in a simple manner Have a proven ability to work...SeniorTemporary workWork experience placementWork at officeLocal areaFlexible hours- ...medicines and solutions that solve serious health issues today and address the medical... ...can be remote anywhere in the U.S. The Senior Site Reliability Engineer will be... ...across various platforms Abstract the complexity of Observability implementation by writing...SeniorTemporary workRemote work
$91.4k - $187k
...Job Description Oracle Health is transforming healthcare through... ...are seeking a highly motivated Senior Product Manager to lead... ...requirements, and delivering complex products from concept to launch... ...Experience with prior authorization, claims management, eligibility...SeniorTemporary workWorldwideFlexible hours$62.4k - $93.6k
...Sr Representative Claims - CH08BE We’re determined to make a difference and are proud to be an insurance company that goes well beyond... ...team as we help shape the future. The Workers’ Compensation Senior Claim Representative is accountable for planning, recommending,...SeniorTemporary workRemote workMonday to Friday3 days per week$17 per hour
...Kelly® Professional & Industrial comes in. We’re seeking Claims Specialist to work in a temporary to hire opportunity with a Top Healthcare... ...at home to do this position Job Duties: Processing complex claims requiring investigation and coding Resolving pending...Temporary workWork at officeLocal areaRemote workMonday to FridayFlexible hoursShift work$25.48 - $60.63 per hour
...Job Description Senior Consultant - Oracle Health – Prosthetics Location: United States Travel: Potentially up to 50% No visa sponsorship... ...work products to an engagement. Performs varied and complex duties and tasks that need independent judgment, in order...SeniorHourly payContract workTemporary workWork experience placementLocal areaVisa sponsorshipFlexible hours$32.95 per hour
...trials, protocol procedures, and protocol compliance for investigators, nurses, pharmacists, pathologists, radiologists, and other health care personnel both inside and outside of Memorial. # Coordinates the timely scheduling of tests, procedures, appointments and treatments...SeniorWork at officeLocal area$89.2k - $209.5k
...Job Description Oracle Health is transforming the future of healthcare by building secure, scalable, AI-enabled healthcare platforms... ...platforms, developing innovative applications, solving complex technical challenges, and delivering solutions that directly impact...SeniorTemporary workFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Health Claims Specialist: Complex Adjudication. Be the first to apply!
- claims specialist remote Springfield, IL
- claims consultant Springfield, IL
- insurance claims processor Springfield, IL
- life insurance claim analyst Springfield, IL
- medical claims analyst Springfield, IL
- claim specialist Springfield, IL
- remote medical claims processor Springfield, IL
- claims analyst Springfield, IL
- claim representative (remote) Springfield, IL
- medical insurance claims specialist Springfield, IL



