Senior Health Claims Specialist: Complex Adjudication
$18.5 - $42.35 per hourHispanic Alliance for Career Enhancement
CVS Health is seeking a Medical Claims Adjudicator in New Jersey. The role involves reviewing and adjudicating medical claims, addressing inquiries, and ensuring compliance with regulatory requirements. Candidates should have at least 18 months of medical claim processing experience and a high school diploma. The position offers a full-time schedule with competitive pay ranging from $18.50 to $42.35 per hour, alongside a comprehensive benefits package. #J-18808-Ljbffr
- CVS Health is seeking a Medical Claims Processor in Rhode Island to review and adjudicate complex medical claims while ensuring compliance with guidelines. Duties include training team members and conducting follow-up calls for necessary information. Candidates require...Senior
$137.5k - $165k
Argonaut Management Services, Inc in Richmond, VA is seeking an experienced claims adjuster to handle complex marine claims. This role requires at least 7 years of commercial inland marine claims experience, a Bachelor's degree, and an active General Adjuster License. The...SeniorWork at office$151k - $181.25k
...Senior Technical Garage Bodily Injury Claims Specialist Argo Group is an underwriter of specialty insurance products... ...in Denver and is focused on adjudicating commercial Garage Bodily Injury... ...the highest degree of technical complexity, potentially with major impact...SeniorLocal area$100k
...Senior Technical General Liability Bodily Injury Claims Specialist Argo Group is an underwriter of specialty... ...and is focused on adjudicating commercial General Liability... ...degree of technical complexity, potentially with... ...programincluding health, dental, vision,...SeniorLocal area$100k
...unique coverage and claims-handling needs of... ...a highly skilled Senior Inland Marine Technical Claims Specialist to join our team in... ...company's most complex inland marine claims... ..., you will: Adjudicate highly complex inland... ...program-including health, dental, vision, 4...SeniorFor contractorsWork at officeLocal area$100k - $125k
...A leading risk and claims administration partner based in Richmond, Virginia, is seeking a Senior Claims Specialist in Professional Liability. The role involves analyzing complex claims, conducting investigations, and negotiating settlements. Ideal candidates should have...SeniorRemote work- ...Senior Claims Examiner Come grow with James River Insurance! James River Insurance is... ...manages a caseload of moderate to high complexity P&C insurance claims. The Senior Claims... ...or certifications preferred Claims Specialist High school diploma required...SeniorFull timeH1b
$100k - $140k
...Senior Claims Specialist The Senior Claims Specialist is responsible for managing all aspects of complex third-party liability claims, including class actions and high exposure matters, from inception through conclusion, brought against a wide variety of insureds, with...Senior- ...Sedgwick Claims Management Services Ltd is seeking a Claims Investigator to manage complex claims for personal, casualty, or property loss. This role requires investigating claims, negotiating settlements, and preparing detailed reports on findings. The ideal candidate...Senior
- ...Job Description ESIS Senior Claims Representative, WC Description Are you ready to make a meaningful impact in the world of workers... ...and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group...SeniorContract workLocal area
- ...Claims Adjuster BerkleyNet is an innovative workers compensation... ...Workers' Compensation Act, adjudication process, and regulatory compliance... ...salary & Benefits include Health, dental, vision, life,... ...factors, including the scope, complexity and location of the role; the...SeniorFull timeWork experience placementWork at officeRemote workMonday to Thursday
- Elevance Health is seeking a Group Underwriter Consultant to assess insurance risks and determine premium rates for large group cases... ...underwriters, coordinate reporting accuracy, and analyze data for complex cases. A BA/BS degree, 5+ years of experience, and proficiency...Senior
- ...leading insurance provider is seeking a Senior Workers’ Compensation Claims Adjuster to work in Richmond, VA. This role will involve adjudicating claims in several jurisdictions and... ...competitive compensation package, including health benefits and professional development...Senior
$15k
...Surety Bond Desk Adjuster. In this role, you will handle losses and claims valued up to $15,000, utilizing technology for efficient claim... ...will need strong analytical skills and the ability to manage complex claims. A Bachelor's degree and the ability to obtain your IIA-...Senior$61.05k - $98.33k
CorVel Corporation is seeking a Senior Liability Claims Specialist to manage mid to complex Heavy Auto and General Liability claims from a remote location. Candidates should have at least five years of experience in General Liability claims and two years in Auto Liability...SeniorRemote job$23.16 per hour
...Excess Risk and Reinsurance) claims in accordance with established... ...reviews and analyzes various complex potential claims with... ...Determines whether to pend or adjudicate claims following organizational... ...relevant, progressive experience in health insurance claims ~3 years...SeniorFor contractorsWork at officeLocal area$20 - $23 per hour
...responsibilities include verifying eligibility, researching unpaid claims, and contacting payers for secure payments. The ideal candidate... ...experience and intermediate knowledge of billing guidelines and health information systems. This role offers a competitive hourly...SeniorHourly pay- ...supporting the World Trade Center Health Program. In this role, you... ...to accuracy in processing complex medical claims. If you are eager to make a... .... Critical Analysis Adjudicate claims according to program... ...applicants with disabilities. Seniority level Mid‑Senior level...Full timeFor contractorsWork at officeRemote workMonday to FridayFlexible hours
$61.05k - $98.33k
The Senior Liability Claims Specialist manages mid to complex Heavy Auto and/or General Liability claims, including bodily injury and property damage. This role... ...management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was...SeniorMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours- Cardinal Health is looking for a Program Manager in Richmond, Virginia, responsible for managing the execution of multiple initiatives within constraints of budget, schedule, and scope. This role entails problem solving, developing project plans, mentoring junior project...SeniorWork experience placementWork at office
- ...cyber and privacy liability claims. The position will have increased... ...; draft routine and complex coverage correspondence; effectively... ...salary for the Sr. Claims Specialist, Casualty, & PL, Cyber is $78... ...option to select from multiple health, dental and vision insurance...SeniorFull timeLocal areaWork from home
- ...the file is then given to the claims department to submit claims... ...Mae)/FHLMC(Freddie Mac) Claims Specialist performs all tasks associated... ...the application of various complex methods, procedures, and knowledge... ...a dependent's reproductive health decision making, race,...Local area
$69.87k - $116.44k
...Overview: Sentara is hiring a Senior Benefit Configuration... ...design, build, and validation of complex benefit configurations... ...platform to support accurate claims adjudication and compliance. This role works... ...in a managed care or health plan environment. Required...SeniorFull timeContract workTemporary workRemote workRelocationShift work$211.55k - $317.33k
...Senior Medical Director – Claims page is loaded## Senior Medical Director... ...trusted advisor on complex clinical scenarios... ...Director for a health insurance payer* Deep... ...) Certified Coding Specialist-Physician (CCS-P) is... ...operations, claims adjudication, and payment integrity...SeniorFull timeRemote workFlexible hours- Summary/Objective The AVP, Complex Claims Specialist owns the handling and resolution of the organization’s most complex, high-exposure casualty... ...Maternity Leave Competitive Medical to support holistic health Medical, dental/ortho, vision, life and disability insurance...Full timeWork at officeLocal areaMonday to FridayFlexible hoursWeekend work
$90k - $125k
...Berkley Accident and Health Berkley Accident and Health is a risk management company that designs innovative solutions to address... ...system Collaborate with underwriting management to review more complex cases requiring a higher degree of underwriting authority...SeniorFull time- ...courses toward professional designations or continuing education. Senior Underwriter Bachelor's degree or equivalent work experience... ...~ Professional designation is preferred Underwriting Specialist ~15+ years industry experience, 10+ years in Excess and Surplus...SeniorFull timeWork experience placementH1bRemote work
$87k - $178.1k
...Cycle, multiple business processes or technology designs within Oracle Health Millennium applications. Operates independently to provide quality work products to an engagement. Performs varied and complex duties and tasks that need independent judgment, in order to...SeniorTemporary workFlexible hours- ...extensive and all-inclusive pet insurance and health advice. Put simply, Fetch makes vet... ...our success! Responsibilities Adjudicate assigned claims in accordance with the Terms &... ...solving skills and ability to work through complex medical/vet-related scenarios...Work at officeRemote workWork from home
$70.9k - $76.9k
...Ryder System, Inc. is seeking an experienced claims adjuster to handle Auto Liability claims under their self-insured program. The role involves investigating claims, managing litigation, and interacting with various stakeholders for effective claim resolution. A preferred...Senior
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