Senior Claims Specialist - Managed Care Adjudication
Providence Health Plan Group
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 and contribute to a patient-focused team that values its caregivers. Enjoy generous benefits including medical, dental, vision, and a 401(k) plan with employer matching. #J-18808-Ljbffr Providence Health Plan Group
- ...Centers in Renton, Washington is looking for an experienced claims adjudicator to manage and resolve complex claims. The ideal candidate will have a... ...Degree in a related field and at least 4 years of Managed Care operations experience. This role involves adjusting claims,...Senior
- ...Job Title Adjudicates all claims submitted by outside purchased services for PMC's enrolled capitated... ...problem claim situations. Assists in managing the workflow of assigned Line of... ...culture of patient-focused, whole-person care built on understanding, commitment,...Senior
- Providence is looking for a skilled claims adjudicator in Renton, WA. You will manage claims for our enrolled capitated population, providing excellent customer... ...situations. Our culture fosters patient-focused care, where your contributions are valued. Qualified candidates...Senior
$26.9 - $41.89 per hour
Description Are you a claims professional ready to... ...results? As a Lead Claims Specialist supporting the US... ...the go-to authority for adjudicating purchased services claims... ...claim situations, managing advanced processing needs... ...focused, whole-person care built on understanding...SuggestedMinimum wageFull timeLocal areaShift work- ...Health & Services, is seeking a Lead Claims Specialist to adjudicate purchased services claims for the US... ...will resolve complex claim situations, manage advanced processing needs, and apply... ...emphasizes leadership in a dynamic managed care environment, with opportunities to...Suggested
- DescriptionProgram Manager IV - Senior Care Initiatives, Clinical ExcellenceJob Summary:Manages medium-to-large scale programs or components with multiple workstreams and strategic business goals across departments, functions, or regions with responsibility and accountability...SeniorContract work
- AccentCare is seeking a Territory Operations Director Registered Nurse for the Renton area. You will manage daily operations and clinical services, ensuring quality care and compliance with policies. Ideal candidates should possess a Washington RN License and extensive...Senior
$228k - $342k
...00 company and a leading AI platform for managing people, money, and agents, we’re shaping... ...big challenges with bold ideas and genuine care. We look for curious minds and courageous... ...chapter gets built. We’re forming small, senior, cross-functional AI teams that bring...SeniorFull timeWork at officeRemote workHome officeFlexible hours$173.4k - $260.2k
...00 company and a leading AI platform for managing people, money, and agents, we’re shaping... ...big challenges with bold ideas and genuine care. We look for curious minds and courageous... ...domains.Basic Qualifications: Senior Partner Technical Enablement LeadExperience...SeniorFull timeWork at officeRemote workHome officeFlexible hours- Providence Health & Services is seeking a Claims Specialist to review, process, and adjudicate TRICARE medical claims with accuracy and compliance. The role... ...have a HS diploma or GED, at least 2 years in managed care operations, and 1 year of claims processing experience...
$163.8k - $245.8k
...00 company and a leading AI platform for managing people, money, and agents, we’re shaping... ...big challenges with bold ideas and genuine care. We look for curious minds and courageous... ...chapter gets built. We’re forming small, senior, cross-functional AI teams that bring...SeniorFull timeWork at officeRemote workHome officeFlexible hours- ...Cogir Senior Living is seeking an Executive Director to oversee all community operations, ensuring high-quality care and services. You will manage budgets, staffing, and daily operations in line with regulations, building strong relationships with staff, residents, and...Senior
$118.7k - $264.1k
...resilience required for modern business. Oracle is seeking a Senior Principal Product Marketing Manager - OCI to help define and execute the marketing strategy... ...life insurance (Employee/Spouse/Child) Health care and dependent care Flexible Spending Accounts Pre‑tax...SeniorTemporary workRelocation packageFlexible hours- Clinical Management Consultants is seeking an Acute Care Pharmacy Senior Manager for a premier Western Washington hospital. This role is pivotal in leading pharmacy operations within a mission-driven environment focused on patient-first care. The successful candidate will...Senior
$150k
Providence Health and Services is seeking an RN Manager for Long Term Care in Seattle, WA. This position focuses on managing skilled nursing units, emphasizing leadership and staff mentoring while ensuring exemplary patient care. Ideal candidates will have a Washington...Senior- Cogir Senior Living in Seattle seeks a Wellness Nurse (LPN) to oversee resident health and well-being. You will perform health assessments, manage medications, and coordinate with residents, families, and the care team to provide high-quality care. Collaborating with the...Senior
- .../PA-C to provide evaluation and medical management across multiple oncology service lines at... ...will coordinate complex cancer care during systemic anti-cancer therapy and... ...prescribe medications, and refer patients to specialists as needed. #J-18808-Ljbffr SitcancerSenior
- Seattle Humane is hiring a Senior Clinic Manager to oversee their Bellevue clinic, which serves over 12,000 animals annually. This leadership... ...managing a dynamic team, ensuring high standards of patient care, and driving innovative practices. The candidate should have...SeniorFull time
- Swickard Auto Group, representing Volvo Cars Seattle, is seeking a Senior Service Advisor. You will manage guest relationships, deliver premium service experiences, and translate complex repair details into clear, actionable recommendations. Ideal candidates have 3+ years...Senior
- Providence invites applications for Senior Manager Clinical Pharmacy - a hybrid leadership role guiding specialty pharmacotherapy clinics in... ...and performance oversight to deliver high-quality care for complex patients. Ideal candidates hold a PharmD or equivalent...Senior
- Cogir Senior Living in the United States is seeking a Wellness Nurse (LPN) to ensure high‑quality health care for residents. You will assess health, manage medications, and collaborate with the Health and Wellness Director to coordinate care with residents, families, and...SeniorMonday to FridayShift work
- ...Senior Vice President & General Manager, Senior Living About the Company Innovative provider of cloud-based software & services for the senior care industry Industry Computer Software Type Privately Held, VC-backed Founded 2000...Senior
$126.2k - $264.1k
...bold, industry-defining innovation in cloud computing? As a Senior Principal Product Manager, you will have the rare opportunity to drive the vision,... ...Supplemental life insurance (Employee/Spouse/Child) Health care and dependent care Flexible Spending Accounts Pre-tax...SeniorTemporary workWork experience placementWorldwideFlexible hoursShift work- ...as a Physical Therapist to impact the health of American Indian and Alaska Native patients. You will manage the Physical Therapy department, focusing on quality care and strategic planning while ensuring continuity of care through professional consultation. The ideal...Senior
- A prominent animal welfare organization seeks a Clinic Manager to oversee a team delivering vital services to over 12,000 animals annually. This leadership role demands expertise in veterinary care and strong team management skills. The ideal candidate must be passionate...SeniorFull time
$1,000 per month
...We connect pet parents with trusted pet care across the U.S., Canada, Europe, and Australia... ...planning, while serving as Rover’s senior advisor on complex employee relations and... ...organizational effectiveness and business performance.Manage the Director of International HR and...SeniorFull timeLocal area- Swedish Jobs in the Seattle area seeks a Senior Cardiac Device Technician to support implantable cardiac device care in an outpatient clinic. You will work with physicians... ...nurses, perform device interrogations, and manage remote transmissions under supervision. Requirements...SeniorDaily paidRemote workShift workDay shift
- Cogir Senior Living in Scottsdale, AZ seeks an Executive Director to oversee all community operations and ensure top-quality care and services. You will manage budgets, staffing, and daily operations in line with regulatory guidelines while fostering strong staff, resident...Senior
- A community resource center in Bellevue, WA is seeking a Senior Operations Manager to oversee Foster, Adoption, and Shelter Care programs. The role involves managing departmental teams and ensuring quality animal care. The ideal candidate has at least 5 years of animal...SeniorFull time
$96.68k - $157.59k
...Senior Facilities Project Manager Salary Range: $96,680.00 to $157,590.00 USD Would you like to have a career that makes a daily difference in people's lives? Do you want to be part of a caring, respectful, diverse community? If you answered yes to these questions...SeniorContract workFor contractorsFor subcontractorWork at officeRelocationShift work
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