Senior Health Claims Specialist
Virtual Vocations Inc
Seeking a full-time Senior Supplemental Health Claims Specialist to administer complex Supplemental Health and voluntary benefits claims, serving as a subject matter expert while working remotely in Tennessee or onsite in Omaha, NE. Key responsibilities Administer and adjudicate complex supplemental health claims, ensuring compliance with policies and regulations Maintain organizational service standards across a diverse caseload while providing clear communication and documentation of claims decisions Collaborate with cross-functional teams to enhance claims processes and support integrated claim strategies Required qualifications 5+ years of experience in Supplemental Health claims administration preferred College degree or equivalent experience preferred Strong analytical skills with the ability to make balanced and objective decisions Experience in mentoring and training team members Ability to manage multiple priorities in a fast-paced environment
- ...Jobgether is seeking a customer-focused specialist to support insurance-related inquiries. You will conduct professional interviews, verify information, and resolve concerns while using multiple systems in a fast-paced environment. The role offers remote flexibility...SeniorRemote work
- ...Intact Insurance Specialty Solutions is seeking a Senior Claim Representative for Accident and Health on a hybrid schedule, with offices in Denver, CO; Plymouth, MN; Chicago, IL; or Alpharetta, GA. The role handles complex specialty claims and requires a bachelor’s degree...Senior
- ...Banner Life Insurance Company seeks a Claims Representative II to research, evaluate, and process non-contestable life and health claims with a focus on accuracy and efficiency. You will communicate with claimants and partners, maintain complete claim files, and support...SeniorRemote work
$69.39k - $84.81k
...resources to make a positive impact on the future – including your own. We’re actively seeking a talented Senior Supplemental Health Claims Specialist to join our Team in Omaha, NE or remote in Tennessee. As a Senior Supplemental Health Claims Specialist you'...SeniorFull timeRemote workFlexible hours- ...CVS Health is seeking a detail-oriented professional to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. You will support the Claim Benefit area, analyze data, and report discrepancies to...Senior
$69k - $98k
Intact Insurance Specialty Solutions seeks a Senior Claim Representative for Accident and Health on a hybrid schedule in the United States. The role handles complex specialty claims, determines coverage and liability, and coordinates resources to move claims toward settlement...Senior- University of California Health in Los Angeles seeks a Claims Adjustment Specialist to analyze and process medical claim adjustments, ensuring accurate payments and compliance with CMS and DMHC guidelines. You will work on escalated claims, apply benefit plans and contracts...Senior
- Intact Insurance Specialty Solutions is hiring a Senior Claim Representative for our Accident and Health team in the US. The role supports complex claims with hybrid work options across multiple offices including Denver, CO; Plymouth, MN; Chicago, IL; and Alpharetta, GA...Senior
- ...DATA Services is seeking a HC & Insurance Operations Processing Sr Rep in Plano, Texas. The role centers on processing professional claim forms, reviewing benefits, and ensuring HIPAA compliance while meeting tight SLAs. Qualified candidates will have 3+ years in healthcare...SeniorRemote job
$18.5 - $38.82 per hour
...CVS Health Pharmacy Claim Specialist We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose,...SeniorHourly payFull timeTemporary work$18.5 - $38.82 per hour
...CVS Health Pharmacy Claim SpecialistWe're building a world of health around every individual — shaping a more connected, convenient and compassionate... ...support.Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise.Identifies...SeniorHourly payFull timeTemporary work- ...Great American Insurance Group is seeking a Senior Medical Only Claims Representative to investigate, manage, and resolve workers’ compensation medical-only claims with accuracy and customer focus. The role primarily covers Texas, Arkansas, and Oklahoma and is fully remote...SeniorRemote work
$18.5 - $38.82 per hour
...We're building a world of health around every individual - shaping a more connected, convenient... ..., and correcting pharmacy-related claim issues to ensure accurate benefit administration... ...-specified claims or claims that exceed specialist adjudication authority or processing...SeniorHourly payFull timeTemporary workLocal area$10k
...Great American Insurance Group seeks a Senior Medical Only Claims Representative to investigate and manage workers’ compensation medical-only claims across Minnesota, Iowa, Nebraska, South Dakota, Kansas, and Missouri. This fully remote role requires a self-motivated...SeniorRemote work$18.5 - $42.35 per hour
...CVS Health Job OpportunityWe're building a world of health around every individual — shaping a more connected, convenient and compassionate... ...SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in...SeniorHourly payFull timeContract workTemporary work- ...CVS Health in New York is seeking a claims processor to review and adjudicate SF, FI, Reinsurance, and RX claims, including complex cases. You will verify eligibility, apply medical necessity guidelines, process refunds, and handle inquiries in a fast-paced environment...SeniorFull time
- ...CVS Health in the United States is seeking a claims analyst to review and correct pharmacy-related claim issues to ensure accurate benefit administration, financial accuracy, and regulatory compliance. This role requires strong analytical skills, attention to detail, and...Senior
$18.5 - $38.82 per hour
...CVS Health in Pennsylvania is seeking a Pharmacy Claims Processor to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. The role requires strong analytical skills, attention to detail, and the...SeniorHourly payFull time$25.61 - $39.88 per hour
Description Senior Claims Specialist - USFHP - Renton, WA Schedule- Full Time/ Hybrid Adjudicates all claims submitted by outside purchased services... ...resource for at least one major area of expertise (EDI, Health Plan Repricing, Health Plus Repricing, or HPR). Providence...SeniorMinimum wageFull timeLocal areaShift work- ...Arizona Department Name: Litigation & Claims Mgmt Work Shift: Day Job Category:... ...our team members, who make Banner Health a great place to work. Bring... ..., and communities. As a Senior Claims Litigation Management Specialist, you will have the opportunity to...SeniorRemote workWork from homeMonday to FridayShift workWeekend work
- CVS Health is hiring a Senior Integrated Service Specialist in Phoenix, AZ, to serve as the primary contact for claims-related inquiries. You will provide clear information on submissions, status updates, denials, and reimbursements, and facilitate referrals to in-network...Senior
$22 - $25 per hour
...Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan... ...healthier lives. Ready to bring precision and expertise to the claims that matter most? Why This Role Matters High-dollar claims,...SeniorHourly payWork at office$10k
Great American Insurance Group seeks a Senior Medical Only Claims Representative to investigate, manage, and resolve workers' compensation medical-only claims across MN, IA, NE, SD, KS, and MO in a fully remote role. You will verify coverage, communicate with injured workers...SeniorRemote job- Great American Insurance Group is seeking a Senior Medical Only Claims Representative to investigate, manage and resolve workers’ compensation medical-only claims across multiple Midwest states in a fully remote role. You will communicate with injured workers, employers...SeniorRemote job
$10k
Great American Insurance Group is seeking a Senior Claims Representative focused on medical-only workers' compensation. This fully remote role serves injured workers, employers, and providers across Texas, Arkansas, and Oklahoma, handling claims from initial report to resolution...SeniorRemote job- Sedgwick is actively seeking a Sr. Claims Specialist to analyze complex medical malpractice claims and manage high exposure cases with strong analytical and negotiation skills. This role emphasizes timely resolutions and outstanding client service in a remote-capable setting...SeniorRemote job
- Great American Insurance Group's Strategic Comp unit is seeking a Senior Medical Only Claims Representative to investigate, manage, and resolve workers' compensation medical-only claims with accuracy, efficiency, and a strong customer focus. This fully remote role handles...SeniorRemote job
$65k - $80k
Great American Insurance Group, a member of American Financial Group, is seeking a Senior Medical Only Claims Representative for a fully remote role primarily handling Texas, Arkansas, and Oklahoma workers’ compensation medical-only claims. This position requires independence...SeniorRemote jobFull time- CVS Health is seeking a claims processor to research, review, and correct pharmacy-related claim issues ensuring accurate benefits and regulatory compliance. The role requires strong analytical skills, attention to detail, and the ability to work independently while meeting...Senior
- CVS Health is seeking a claims support professional to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. The role emphasizes analytic rigor, attention to detail, and the ability to work independently...SeniorFull time
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