Senior Claims Specialist: Complex Claims & Managed Care
Providence Health & Service
Providence Health & Services is seeking a skilled claims adjudicator to manage claims for their capitated population. The role involves complex claims processing and customer service for problem resolution, requiring a Bachelor's degree and significant experience in managed care. The ideal candidate will demonstrate expertise in health benefits and claims processing, leveraging systems like IDX. Providence offers a comprehensive benefits package to its employees. #J-18808-Ljbffr Providence Health & Service
- 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...Senior
- ...Centers Corp in Renton, Washington, seeks a Claims Adjudicator to manage claims for enrolled capitated populations. The role involves adjusting complex claims, problem resolution, and serving... ...as a resource for key areas in managed care operations. Ideal candidates have a...Senior
- Providence is looking for a skilled claims adjudicator in Renton, WA. You will manage claims for our enrolled capitated population... ...customer service while resolving complex situations. Our culture fosters patient-focused care, where your contributions are valued. Qualified...Senior
- Adjudicates all claims submitted by outside purchased services for... ...communicates those actions. Adjusts complex claims for advanced processing... ...claim situations. Assists in managing the workflow of assigned Line... ...patient‑focused, whole‑person care built on understanding,...Senior
- A leading insurance provider in Seattle seeks a Claims Specialist - Auto to manage complex first and third party auto claims. The role involves investigating claims, evaluating coverage, and documenting communication during the process. Candidates should ideally have a...Senior
- Liberty Mutual Insurance in Seattle, WA, seeks a Surety Claims professional to manage complex claims with high autonomy. Responsibilities include directing claims strategies, collaborating with consultants, and ensuring compliance with legal standards. The ideal candidate...Senior
$100k
...unique coverage and claims-handling needs of... ...Title(s): Senior Construction Defect... ...Technical Claims Specialist Team Lead Employment... ...This role will be managing three Claims Handlers... ...our most complex construction defect... ...family and medical care leave, disability...SeniorFull timeLocal areaRemote work$109.3k - $180.2k
...Who Are We? Taking care of our customers, our communities and each... ...factors, including the scope, complexity and location of the role; the... ...Travelers. What Will You Do? Manage the profitability, growth, and... ...? Four years of underwriting, claim, operations, risk assessment,...SeniorLocal area$109.3k
Company Overview Who Are We? Taking care of our customers, our... ...ability to independently assess complex risk and sell our products in... ...of Travelers. Responsibilities Manage the profitability, growth, and... ...Have Four years of underwriting, claims, operations, risk assessment,...SeniorLocal area$58.33k - $81.66k
...Purpose To provide clients with professional care handling losses or claims regionally unassisted, with the ability to address most complex adjustment issues pertaining to damages... ...assist on large losses with the ability to manage smaller and non‑complex claims. To handle...Work from homeFlexible hours- Cambia Health Solutions is seeking a Clinical Program Manager to oversee complex clinical programs while enhancing care quality. This hybrid role is available in various locations including Renton. The ideal candidate will have a strong background in healthcare project...Senior
- Fortegra is seeking a Senior Claims Adjuster in Washington to provide technical expertise in managing a wide variety of claims within Commercial Auto, Cargo, and Crane & Rigging. The selected candidate will work closely with third parties and the existing Specialty Claims...Senior
$82.8k - $97.3k
An insurance company based in Seattle, WA is seeking a Claims Specialist - Auto to investigate, evaluate, and settle complex insurance auto claims. The ideal candidate will have over 10 years of experience, with a preference for a Bachelor's degree. Responsibilities include...Senior- Philadelphia Insurance Companies in Seattle is looking for a Senior Claims Specialist - Commercial Auto BI to manage complex insurance claims. This role involves evaluating claims, communicating with stakeholders, and understanding various insurance coverages. Candidates...SeniorRemote job
$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- ...purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes... ..., and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes...SeniorFull timeLive outWork at officeLocal areaRemote workFlexible hours
- ...insurance firm is seeking a temporary Workers' Compensation Claims Adjuster to manage indemnity claims with a focus on customer service. The role... ...or in-office based in Seattle and involves adjudicating complex claims while collaborating with various departments. Ideal...Temporary workWork at officeRemote work
- ...General & Automobile Liability claims outsourced to a third-party... ...legal counsel and vendors to manage claims, including attending trials... ...of significant exposure and complexity on a regional or national... ...High School Diploma or GED. Senior Claims Law course work or other...Contract work
- ...Senior Territory Manager We are seeking a results-driven Senior Territory Manager to own and lead... ...with underwriting, product management, claims, and risk control teams to identify opportunities... ...limited supervision while managing complex priorities. Comfort leveraging data...SeniorWork experience placementNight shift
- Liberty Mutual Insurance Group is looking for a Complex Workers Compensation Investigator based in Seattle, Washington. In this role,... ...Candidates should possess a bachelor's degree and have 5-7 years of claims experience, including 1-2 years in complex claims. This...Senior
$150k
...The Travelers Indemnity Company is seeking a skilled professional to manage high complexity first-party property claims. The role is 100% remote and focuses on investigating, evaluating, and negotiating claims up to $150,000. Ideal candidates possess a Bachelor's Degree...Remote work$125.4k - $181.42k
Sr. Manager, Quality Assurance and Compliance page is loaded## Sr.... ...JR1387Founded in 1977 as the Senior Care Action Network, SCAN began with... ...most medically and socially complex populations, and next-... ...in operational areas such as claims, configuration, provider data...SeniorFor contractorsRemote work- ...years of experience. In this role, you will lead motions practice, manage depositions, and collaborate with clients to develop case... ...admitted to the Washington bar, and have extensive experience in complex litigation. Competitive compensation is offered, and the firm is...Senior
- A leading recruiting firm is seeking an experienced Tax Senior Manager to oversee complex tax engagements and manage client relationships. The role requires strong technical expertise and leadership skills to guide both clients and teams. The ideal candidate has 8-10 years...Senior
- Liberty Mutual Insurance is seeking a skilled Complex Workers Compensation Claims professional in Seattle, WA. This role involves investigating high-exposure claims, managing litigated files, and participating in pricing and reserving discussions. Candidates should possess...Senior
- Argo Group is seeking a Senior Construction Defect Technical Claims Specialist - Team Lead to manage a small claims team. The role is remote, with various office options available. You will oversee complex claims, ensuring high-quality service while mentoring your team....SeniorRemote jobWork at office
- BNBuilders in Seattle is looking for a Project Manager to oversee complex construction projects from start to finish. You will supervise multiple job sites, manage budgets, and coordinate with subcontractors to ensure successful project completion. The ideal candidate...SeniorFor subcontractor
$100k - $125k
A construction company in Bellevue, Washington is looking for an MEP Project Engineer to support complex construction projects. You'll coordinate MEP scopes, manage procurement, QA/QC, and work closely with project teams. Ideal candidates will have a Bachelor’s degree and...Senior$163.8k - $245.8k
...and a leading AI platform for managing people, money, and agents, we’... ...challenges with bold ideas and genuine care. We look for curious minds and... ...built. We’re forming small, senior, cross‑functional AI teams... ...systems that simplify complex business processes for customers...SeniorWork experience placementWork at officeRemote workHome officeFlexible hours$89.8k - $148.3k
...Who Are We? Taking care of our customers, our communities and... ...factors, including the scope, complexity and location of the role; the... ...Travelers. What Will You Do? Manage the profitability, growth, and... ...~ Two years of underwriting, claim, operations, risk assessment,...Local area
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