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
- Adjudicates all claims submitted by outside purchased services for PMC's enrolled capitated population... ...problem claim situations. Assists in managing the workflow of assigned Line of... ...culture of patient‑focused, whole‑person care built on understanding, commitment, and...Senior
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- 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
$100k
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$115.3k - $264.1k
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Company Overview Who Are We? Taking care of our customers, our communities and each other... ...success of Travelers. Responsibilities Manage the profitability, growth, and retention... ...designation. Must Have Four years of underwriting, claims, operations, risk assessment, actuarial,...SeniorLocal area- ...and delivering compassionate, high-quality care across a complex health system? If you... ...invites your expertise. The Role The Senior Director, Women and Children Services... ...relationships with Medical Directors, Managers, Senior Leaders, and the elected Chief of...SeniorLive in
$58.33k - $81.66k
Primary Purpose To provide clients with professional care handling losses or claims regionally unassisted, with the ability to address most complex... ...coverage and to assist on large losses with the ability to manage smaller and non‑complex claims. To handle losses and...Work from homeFlexible hours- ...outcomes by collaborating with various stakeholders to enhance care delivery. Candidates will engage in identifying high-value healthcare... ...should possess an advanced degree and significant experience in managing healthcare datasets. This role offers a chance to make a...Senior
$130k - $175k
Proactive Health is looking for a Partner Manager to manage relationships with senior care partners in Seattle. You will drive referral growth and act as the primary contact for partners, ensuring they receive support and resources to succeed. This full-time role offers...SeniorFull time$72.8k - $130k
Stryker Corporation is seeking a Senior Behavioral Health Care Advocate to manage care coordination for members with complex behavioral needs, ensuring compliance with standards. This role involves working as a liaison among members, families, and providers and requires...SeniorRemote work- Texas Health Institute in Seattle is seeking a Senior Behavioral Health Care Advocate to manage care for members with complex behavioral health needs. This role ensures compliance with standards while coordinating care across providers and community services. The position...SeniorRemote work
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...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...SeniorWork experience placementWork at officeRemote workHome officeFlexible hours- Kin On Health Care Center in Seattle is looking for a Resident Care Manager to oversee daily operations and ensure quality care for our residents. This role requires... ...ADN with an active RN license and a passion for senior care, along with strong leadership and problem-...Senior
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A leading senior care service provider is seeking an experienced Healthcare Account Executive in Bellevue, WA. In this outside sales role, you will manage accounts with hospitals and skilled nursing facilities, driving lead generation and move-ins to communities. The ideal...Senior$88.79k - $133.18k
...President (SVP) or a pairing of SVP/Vice Presidents. This role manages the executive's day-to-day and priorities. This role is strictly... ...our benefits can be found on our website About Us Hope. Care. Cure. These three simple words capture what we do at Seattle Children...SeniorFull time- ...Senior Vice President, Medicare About the Company Ambitious healthcare management organization Industry Hospital & Health Care Type Non Profit Founded 1945 Employees 10,001+ Categories Biotechnology Health Diagnostics Health & Wellness...Senior
$68.18k - $94.64k
Trane Technologies seeks a Senior Project Administrator in Bellevue, WA. This role involves managing claims execution, documentation, invoicing, and team collaboration. Ideal candidates have practical experience or a one-year technical certificate. Strong communication...SeniorFlexible hours$100k
...meet the unique coverage and claims-handling needs of... ...Holdings Inc. Job Title Senior Environmental Technical Claims Specialist Employment Details Employment... ...individual will report to a manager in New York City and is focused on adjudicating first and third party commercial...SeniorFull timeLocal areaWork from homeVisa sponsorship- Care Coordination offered by Chinese Information and Service Center... .... However, those living in senior residential communities (... ...those who need assistance with managing personal care and daily living... ...Community Living Connections specialist must complete and email the...SeniorTemporary work
$96.18 - $153.77 per hour
Description Providence is calling for Senior Manager Pharmacy - Remote The Senior Manager, Clinical Pharmacy - Procurement is the enterprise... ...and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your...SeniorMinimum wageFull timeWork at officeLocal areaRemote workShift work$105k - $115k
...A senior living community in Seattle is seeking an experienced registered nurse to join their team. The role focuses on conducting assessments... ...have a current RN license and experience in community-based care. The position offers competitive pay starting at $105,000 to $11...Senior
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