Medical Claims Review Specialist
Medlogix
Medlogix, LLC, located in Southfield, MI, is seeking a Medical Review Specialist to review medical bills and make reimbursement recommendations. This full-time role requires at least 1 year of medical coding experience, proficiency in CPT and ICD-10 coding, and strong interpersonal skills. Responsibilities include analyzing medical documentation, providing customer service to claimants and adjusters, and ensuring compliance with company standards. Medlogix offers a dynamic work environment focused on innovative medical claims solutions. #J-18808-Ljbffr
- Sedgwick Claims Management Services Ltd is seeking a Disability Representative Sr in Southfield, MI. This role involves managing complex disability claims, including reviewing medical information and ensuring compliance with regimen guidelines. Candidates should have a...Medical
- ...Claims Processor Job Category: Client Services Requisition Number: CLAIM001705 Posted... ...and process assigned claims by product (medical, dental, vision, FSA or HRA) and group.... ...claim. Identify and escalate claims for review or audit based on business rules....MedicalFull timeFlexible hours
$67.3k - $75k
...Michigan Personal Injury Protection Claim Specialist – The Auto Club Group Join the team committed... ...will include the following: reviewing assigned claims, contacting the insured... ...with insureds, physicians' offices and medical insurance carriers to obtain necessary...MedicalFull timeWork experience placementRemote workWork from homeHome officeFlexible hours$65k - $85k
...to apply for the Workers' Compensation Claims Specialist role at Arcadis Arcadis is the world’s... ...initial report to resolution. Gather, review, and submit all required documentation... ...restrictions and accommodations as recommended by medical professionals. Continuous Improvement...MedicalFull timeWork at officeLocal area$10k - $75k
...Metro Detroit Field Property Claim Specialist -AAA The Auto Club Group This role reports to... ...technical issues and complex claims. Review assigned claims, contacting the insured... ...comprehensive benefits packages, including: ~ Medical, dental and vision benefits ~401k...MedicalFor contractorsWork experience placementRemote workWork from homeHome officeFlexible hoursNight shift$58.24k - $76.96k
...PIP Claims Representative CURE Auto Insurance is a leading direct writer of auto insurance... ...reserves for the exposure. Assign medical case managers or other experts to a case... ...in accordance with CURE's Decision Point Review Plan. Work closely with the Special Investigation...MedicalWork at officeLocal areaRemote workWork visaFlexible hours1 day per week- ...experience. Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously... ...assignment. Above average computer skills Clinical experience in ICU, ER, or medical surgical unit preferred....MedicalRemote work
- ...of MI unrestricted RN license. You will perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including...MedicalWork at officeRemote workFlexible hours
$50k - $55k
...Workplaces in Financial Services & Insurance Claims Representative, Auto PRIMARY PURPOSE OF... ...policies and endorsements Ability to review and assess Property Damage estimates, total... ...is offered including but not limited to, medical, dental, vision, 401k and matching, PTO,...MedicalContract workWork at officeFlexible hours$75k - $80k
...Workplaces in Financial Services & Insurance Claims Examiner, Auto | Bodily Injury PRIMARY... ...and commercial transportation claims by reviewing coverage, completing investigations,... ...comprehensive benefits offering including medical, dental vision, 401K on day one. Work...MedicalWork at officeLocal areaFlexible hours$36 per hour
Title: Medicare Advantage RN Review Analyst Location: Detroit, MI (Remote - Must be local... ...for the approval or rejection of claims and/or benefit interpretation. May be required... ...experience a plus. Expertise in the use of medical terminology. Finely honed critical...MedicalContract workLocal areaRemote workMonday to Friday- ...looking for a Field Adjuster to inspect losses and manage insurance claims. The role involves communicating with diverse parties,... ...Microsoft Office skills. The position offers industry-leading medical benefits, a 401(k) plan, and generous PTO. Join a team that values...MedicalWork at office
$50k
...for a role focusing on reducing incoming claims and ensuring safe transit of freight.... ...communication skills. Responsibilities include reviewing freight pictures, taking detailed notes,... ...$50,000/year, along with comprehensive medical benefits, 401(k), paid vacation, and...MedicalFull time$19 - $22 per hour
...Michigan Claim Customer Service Representative AAA The Auto Club Group Reports To: Claim... ...consistent with all reported facts. Reviews necessary legal and police/fire reports... ...comprehensive benefits packages, including: ~ Medical, dental and vision benefits ~401k Match...MedicalHourly payWork experience placementRemote workWork from homeHome officeFlexible hoursShift work$80k - $100k
...with local offices Participate in monthly quality insurance reviews and market audits as required Supporting our internal platforms... ...to Kaufman Institute ~ Health and welfare benefits including medical, vision and dental ~401K with employer match ~ Paid...MedicalLocal areaWorldwideFlexible hours$61.2k - $165.1k
...compensation with our salary and incentive program, in addition to medical, dental, and vision insurance. 401K, continuing education... ...monitor the credit portfolio to maintain strong asset quality; review quarterly trend analysis reports, address default situations, delinquencies...MedicalFull timeWork at officeFlexible hoursShift work$45k
...now or in the future What You Will Be Doing Collect, review and examine an applicant's financial history and records... ...Paid volunteer hours ~ Paid training and career development ~ Medical, dental, vision and life insurance ~401k with employer match...MedicalFull timeContract workWork at officeMonday to FridayFlexible hoursShift work$100k - $180k
...Economic Loss, Weather Reimbursement, Spot Delivery Coverage, etc. • Review new and renewal applications for trucking insurance coverage. •... ...80,000 including bonus plan; company paid full family coverage medical, dental, prescription and vision; matched 401(k); stock;...MedicalContract workRelocation package- ...and customer-specific operations Projects include: Review, revise and implement LTACH network and contracting strategy for... ...authorization vendor Support review and implementation of a lab medical policy editing system The position will lead research,...MedicalWork at office
- ...Maintains detailed underwriting records. Reviews submissions and referrals with supervisor... ...including customers, Sedgwick/Pools, claims, loss control, and accounting departments... ...comprehensive benefits offering including medical, dental, vision, 401K on day one. Work Environment...MedicalWork at office
$86k - $101k
...internal stakeholders and sponsorship clients. Periodically review and enhance compliance workflows to ensure accuracy, consistency... ...and experience. We offer competitive pay, comprehensive medical, dental and vision coverage, retirement benefits, maternity/paternity...MedicalLocal areaVisa sponsorshipWork visaFlexible hours- ...Job Title: EDI Claims Analyst Job Location: Remote Job Type: Contract Job Description: The EDI Claims Analyst is responsible... ...including claims and eligibility inquiries. This role involves reviewing and resolving claim rejections, ensuring accurate data...Contract workRemote work
- ...services that help our clients optimize their operations and captivate their customers. Job Description The Claims Specialist provides program claim review, claim entry assistance to both dealers and field personnel as needed. The Claims Specialist at times may act...Full time
- ...include analyzing underwriting referrals and maintaining records. This hybrid role offers opportunities for career growth and a comprehensive benefits package including medical, dental, and a 401(k) from day one. #J-18808-Ljbffr Hispanic Alliance for Career EnhancementMedical
- ...commercial accounts within assigned authority by assessing submissions, reviewing coverage terms, exposures, loss history, financials, and... ..., or industry-specific hazards). Engage internal partners (Claims, Actuarial, Risk Control, Legal) to structure appropriate terms...Local areaRemote work
- ...suppliers. Benefits Competitive Wages, Paid Holidays & Vacation, Medical & Rx Plans, Dental & Vision Plans, Flexible Spending Accounts,... ...maintain EDI and E-Commerce applications, tables, and files. Review EDI and E-Commerce software products to keep our systems state-...MedicalWork at officeFlexible hours
- ...Henry Ford Health System (HFHS). Conducts regular audits of claims data to ensure 340B program compliance. Evaluates all... ...for qualified and non-qualified patients. Performs chart and medical record review. Utilizing multiple data sources and business strategies...MedicalFull timeContract workWork experience placementWork at officeDay shift
- ...Claims Resolution Representative The Claims Resolution Representative primary role is to resolve high volumes of aging insurance... ...organizational and time management skills 3+ years Dental Front Desk or Medical or Dental Claims Processing experience Prior experience with...MedicalWork at officeRemote work
- ...A leading company is seeking a Physician Reviewer/Advisor for a telework opportunity. The role involves reviewing medical records and providing advisory opinions based on the clinical expertise and national guidelines. Ideal candidates will have a MI license, Board Certification...MedicalRemote work
- ...Job Description Job Description Claims Processor for durable medical equipment and pharmaceutical claims submitted from contracted and out of... ...verifying insurance coverage for date of service/diagnosis and reviewing all paperwork for proper documentation and payment of...Medical
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medical Claims Review Specialist. Be the first to apply!
- medical insurance claims specialist Southfield, MI
- remote medical claims processor Southfield, MI
- bilingual medical scheduler Southfield, MI
- medical communications Southfield, MI
- medical Southfield, MI
- remote medical data entry Southfield, MI
- medical driver Southfield, MI
- medical equipment planner Southfield, MI
- medical electronics Southfield, MI
- medical oncology Southfield, MI


