Senior Medical Claims & Adjudication Specialist
CVS Health
CVS Health in the United States is seeking a claims processor to adjudicate complex medical claims across self-funded, fully insured, and RX programs. The role handles refunds, refunds checks, and may respond to customer inquiries while applying medical necessity guidelines to determine coverage. The position requires approximately 2+ years of experience in medical claim processing, working in a production setting, and strong communication skills. #J-18808-Ljbffr CVS Health
$90k - $115k
Remote Liability Claims Examiner | General Liability Exp. Required By joining Sedgwick,... ...Apply your knowledge and experience to adjudicate complex customer claims in the context of... ...comprehensive benefits offering including medical, dental vision, 401K on day one. As...MedicalRemote jobLocal areaFlexible hours- Otsuka America Pharmaceutical, Inc. seeks a Medical Science Liaison (Sr Manager) to lead clinical and scientific engagement in CNS. You will work with ecosystem teams to tailor regional medical strategies, engage KIs, LPLs, providers, and patient groups, and translate evidence...SeniorMedical
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$15 per hour
Summary The Wikimedia Foundation is looking for a Senior Software Engineer, iOS to join the App Growth team within the Core Experiences... ..., religion, color, national origin, sex, pregnancy or related medical conditions, parental status, sexual orientation, gender...SeniorMedicalPermanent employmentFull timeContract workFor contractorsCurrently hiringLocal areaRemote work- ...required by government contract. Additional Benefits & Requirements Travel Requirements Relocation Provided Incentive Bonus Plans ~ Medical, Dental, Vision benefits ~10 Paid Holidays ~ Employee Stock Purchase Plan ~ All qualified applicants will receive consideration for...SeniorMedicalRemote jobContract workLocal areaRelocation
$120k - $130k
...ANM is seeking a Senior Client Success Manager to join our exceptional team. Who We Are: ANM is a leading IT solutions provider helping... ...: ANM offers a comprehensive benefits package including: Medical, Dental and Vision Insurance Life Insurance; Short-Term and Long...SeniorMedicalTemporary workWork experience placementLocal areaFlexible hours- Mosai is seeking a Senior Clinical Informaticist to serve as the clinical conscience of its AI initiatives for home-based care. You will own the clinical ground truth used to train models and ensure safe, high‑quality outputs for nurses, therapists, and hospice teams....SeniorWork from home
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$120k - $139.5k
...next steps. Our partner is looking for a Senior Service Designer based in the United... ...data scientists, researchers, and other specialists to define problems, align priorities, develop... ...assume. Comprehensive Healthcare: Medical, dental, and vision insurance. Retirement...SeniorContract workTemporary workRemote workFlexible hours- ...Group is hiring for a Casualty Evaluator (Remote) to manage owner/adjuster responsibilities, handling 1st and 3rd party auto liability claims with exposure under $50,000 across multiple states, including licensed and statutory states. The role supports the claims...Remote workFlexible hours
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$25.32 - $28.13 per hour
Auto Claims Adjuster- Remote Requisition Number: R8051 Locations: Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Colorado - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Iowa...Remote jobHourly payCurrently hiringWork from homeMonday to FridayFlexible hoursShift workAfternoon shift$25 - $30 per hour
...The AR Follow-Up Specialist is responsible for timely and accurate follow... ...proactive payer outreach, claim status monitoring, denial... ...Compensation claims to ensure prompt adjudication Conduct direct outreach to... ...claims for timely filing, medical necessity, eligibility...MedicalHourly payFor contractorsWork at officeRemote workMonday to Friday$46.99k - $122.4k
...community at a time. Position Summary The Senior Analyst, PPO Network Discount... ...objectives. The Senior Analyst leverages claims, reimbursement, and market data to assess... .... The benefits for this position include medical, dental, and vision coverage, paid time off...SeniorHourly payFull timeContract workTemporary workLocal areaRemote work$35k - $150k
...We do not sell insurance and we do not work for insurance companies. We advocate on behalf of homeowners throughout the insurance claims process. No experience necessary. WE PROVIDE TRAINING !! Work can be done from home using video-conferencing software Must be able...Full timePart timeFor contractorsLive inRemote workWork from homeFlexible hours$67.9k - $165.95k
...Dallas-Fort Worth area or Oklahoma The Senior Manager negotiates, executes, conducts high... ...resolve complex escalations related to claims, contract interpretation, and provider data... .... The benefits for this position include medical, dental, and vision coverage, paid time...SeniorHourly payFull timeContract workTemporary workWork experience placementLocal area- Med-Trans Corporation seeks a Helicopter Pilot to perform safe, efficient air medical transport for critically ill and injured patients. In this Emergency Services role, you will conduct preflight planning, complete safe takeoffs and landings in diverse conditions, and...Medical
$148.48k - $185.6k
Position Information: Job Title: Senior Manager - Regional Organic Growth Location: Arizona, Denver, CO, Portland, OR, Salt Lake City, UT, Reno, NV, Las Vegas, NV or Albuquerque, NM Salary Range: $148,480 - $185,600 Schedule: Remote Job Summary The location of this...SeniorWork at officeLocal areaRemote work- ...patient care technician provides direct care to patients, assisting with daily activities, monitoring vital signs, and supporting the medical team to ensure patient comfort and well-being. Highlights : Complete in as short as a few weeks to a few months Online and...Medical
$182 per hour
...working experience as a Dentist Ability to build rapport with patients Compassionate and caring demeanor Familiarity with medical terminology A valid and current CPR card (American Heart Association) Must have up to date credentials in the state of NM...MedicalWork experience placementMonday to FridayShift workDay shift- ...healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will... ...What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance...Medical
- ...services, requiring licensure and 3+ years of clinical experience, with EMR proficiency and CST work hours. Responsibilities include medical necessity reviews, applying guidelines, coordinating with care teams, crisis triage, and discharge planning. #J-18808-Ljbffr CVS...MedicalRemote job
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