Senior Claims Specialist - Managed Care & Complex Claims
Pacific Medical Centers
Pacific Medical Centers in Renton, Washington is looking for an experienced claims adjudicator to manage and resolve complex claims. The ideal candidate will have a Bachelor's Degree in a related field and at least 4 years of Managed Care operations experience. This role involves adjusting claims, responding to customer service requests, and serving as a primary resource for the department. Our benefits include a 401(k) plan, health care benefits, and paid time off. #J-18808-Ljbffr Pacific Medical Centers
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Senior Claims Specialist - Managed Care & Complex Claims in Renton, WA vacancy
- 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
- 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
- ...Job Title Adjudicates all claims submitted by outside purchased... ...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
- ...Health & Services, is seeking a Lead Claims Specialist to adjudicate purchased services... ...Health Plan (USFHP). You will resolve complex claim situations, manage advanced processing needs, and... ...emphasizes leadership in a dynamic managed care environment, with opportunities to...Suggested
$26.9 - $41.89 per hour
Description Are you a claims professional ready to step into... ...results? As a Lead Claims Specialist supporting the US Family... ...capitated population — resolving complex claim situations, managing advanced processing needs,... ...‑focused, whole‑person care built on understanding,...SuggestedFull timeLocal areaShift work- Argonaut Management Services, Inc is seeking a highly capable Senior Environmental Claims Adjuster to join our team. This role can be primarily remote, but candidates must... ...Seattle. The ideal candidate will adjudicate complex environmental claims, requiring excellent negotiation...SeniorWork experience placementRemote work
$180k - $225k
...the biggest barrier to care: insurance. The admin work - credentialing, claims, payment reconciliation... ...provider's week comes from managing their calendar, staying... ...About This Role As a Senior Designer leading our... ...systems-minded craft to complex, state-heavy problems (...SeniorWork from homeFlexible hours- DescriptionProgram Manager IV - Senior Care Initiatives, Clinical ExcellenceJob Summary:Manages medium-to-large scale programs or components with... ...business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate...SeniorContract work
- ...Centers in Renton, WA, is seeking a Lead Claims Specialist for the US Family Health Plan (USFHP).... ...for capitated members and resolves complex situations with precision. You will handle... .... The ideal candidate has extensive managed care/claims experience and a track record...
- Ignite Human Capital in Seattle is seeking a senior Case Manager to lead complex litigation support in a hybrid, full-time capacity. You will coordinate across attorneys, clients, outside counsel, paralegals, and vendors while managing budgets and case operations. The role...SeniorFull time
- ...construction companies, specializing in large, complex civil infrastructure. For 135 years, it... .... Description Coordinates and manages design firms as required, analyzes design... ...Developing Capabilities Quantity Management Claims Influencing and Communicating Design Coordination...SeniorContract workFor subcontractorWork at office
$173.4k - $260.2k
...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... ...when necessary to replicate complex testing or integration... ...domains.Basic Qualifications: Senior Partner Technical Enablement LeadExperience...SeniorFull timeWork at officeRemote workHome officeFlexible hours$98.8k - $184.8k
...Join our team as we help shape the future. Complex Liability Solutions (CLS)... ...engineering consultants, and liability claims professionals focused on hard-to-place products... ...responsible for the profitable growth and management of a specialized casualty portfolio by:Underwriting...SeniorFull timeTemporary workWork at office- First Insurance Company of Hawaii is seeking a Senior Claims Specialist for Commercial Auto BI to investigate and settle complex insurance claims. This role involves evaluating claims, communicating with parties, and understanding policy terms. The position requires a minimum...SeniorRemote job
$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...SeniorFull timeWork at officeRemote workHome officeFlexible hours$137.94k
...Contracts (Construction) Senior... ...lean into our mission: We Care. We Collaborate. We Deliver... ...is looking for a Senior Manager to join our Capital Projects... ...develop strategies to solve complex business problems using... ...delays, change orders, and claims. You are passionate about...SeniorFull timeContract workTemporary workFor contractorsFor subcontractorLocal areaRemote workFlexible hours$100k
...the unique coverage and claims-handling needs of... ...Description Business Title(s): Senior Construction Defect Technical Claims Specialist Employment Type: Full-... ...adjudicating our most complex construction defect... ...oversight under broad management direction, adjudicate construction...SeniorFull timeLocal areaRemote work- ...country, who actively, genuinely care about our clients, each other... ...Job Description The Senior Vice President (SVP) is responsible... ...platform. This includes managing the financial performance, employee... ...to minimize and prevent E&O claims. Create and implement strategic...SeniorWork at officeLocal areaFlexible hours
Trucordia
Seattle, WA26 days ago $117.5k - $222.99k
...most critical and complex issues, including... ...healthcare financing, risk management and regulatory... ..., technology specialists to plan administrators... ...cost and care management. MedInsight... ...MedInsight is seeking a Senior Product Strategy... ..., healthcare claims, clinical and pharmacy...SeniorHourly payFull timeTemporary workWork experience placementWork at officeRemote workWorldwideFlexible 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...Remote jobTemporary workWork at office
- Blue Shield of CA seeks an experienced Principal Project Manager to drive end-to-end delivery of complex operational and technology initiatives within the Pharmacy Benefits, Claims, and Network Operations team. You will coordinate multiple vendors, IT teams, and business...Senior
$118.7k - $264.1k
...modern business. Oracle is seeking a Senior Principal Product Marketing Manager - OCI to help define and execute... ...embraces ambiguity, and can translate complex technical concepts into compelling... ...(Employee/Spouse/Child) Health care and dependent care Flexible Spending...SeniorTemporary workRelocation packageFlexible hours- ...-C to provide evaluation and medical management across multiple oncology service lines... ...site. The incumbent will coordinate complex cancer care during systemic anti-cancer therapy and... ...medications, and refer patients to specialists as needed. #J-18808-Ljbffr SitcancerSenior
$115k - $145k
A recruiting firm is seeking a Senior Tax Accountant for a position in the Greater Seattle Area. The role involves preparing and reviewing complex tax returns while leading tax planning and research. Candidates should have 5-8+ years of public accounting experience with...SeniorRemote job$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 job- 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... ...and performance oversight to deliver high-quality care for complex patients. Ideal candidates hold a PharmD or equivalent, a valid...Senior
- 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
$105k - $115k
At Epiq, your work contributes to complex, global legal outcomes. You’ll join a values‑driven... ...Description:Job Summary:The Sr. Project Manager of Client Services serves as a key leader... ...services, consulting, client services, claims administration, litigation support, or related...SeniorFull timeLocal areaWork visa$1,000 per month
...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 employment... ...effectiveness and business performance.Manage the Director of International HR and functional...SeniorFull timeLocal area
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Claims Specialist - Managed Care & Complex Claims. Be the first to apply!
Related searches
- claims assistant Renton, WA
- insurance claims processor Renton, WA
- claim examiner Renton, WA
- medical insurance claims specialist Renton, WA
- claims consultant Renton, WA
- claim specialist Renton, WA
- medical claims analyst Renton, WA
- claims processor Renton, WA
- claims analyst Renton, WA
- remote medical claims processor Renton, WA