Senior Health Claims Specialist: Complex Adjudication
$18.5 - $42.35 per hourHispanic Alliance for Career Enhancement
CVS Health® is seeking a dedicated Claims Specialist to review and adjudicate complex medical claims. The ideal candidate will have at least 18 months of medical claim processing experience and the ability to work efficiently in a high-volume environment. Responsibilities include training and mentoring team members while ensuring compliance with all regulatory requirements. This role offers a competitive pay range of $18.50 - $42.35 per hour and a comprehensive benefits package, supporting the health and well-being of employees and their families. #J-18808-Ljbffr
$18.5 - $42.35 per hour
...We're building a world of health around every individual - shaping a... .... Position Summary Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established... ...specified claims and those that exceed specialist adjudication authority or...SeniorHourly payFull timeWork experience placementLocal areaRemote work- ...Blue Cross Blue Shield of Michigan seeks a Medical Only Claims Specialist II in Lansing, Michigan. This role requires investigating and managing workers’ compensation claims, ensuring effective communication with all stakeholders, including clients and medical providers...SeniorWork at office
$27.02 per hour
...membership; analyzes data such as individual health, type of industry, characteristics of employee groups, or past claim experience to determine what benefits can be offered... ...across a continuum from routine to highly complex. Engage in teams/workgroups and contribute...SeniorFor contractorsWork at officeLocal area- ...ESIS Senior Claims Representative, WC Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader... ...and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group...SeniorFull timeContract workTemporary workLocal area
- ...Complex Casualty Claims Specialist US-MI-Lansing Job ID: 2026-8627 # of Openings: 1 Category: Claims Farm Bureau Center Overview Complex Casualty Claims Specialist Objective To assure the consistent application of company procedures...SuggestedWork at office
$67.3k - $75k
...A leading insurance provider is looking for a Michigan Personal Injury Protection Claim Specialist to manage complex claims with minimal supervision. Responsibilities include reviewing claims, conducting thorough investigations, and communicating with policyholders. Candidates...Remote work$37.66 - $53.16 per hour
...leading insurance firm is seeking a Workers' Compensation Claims Adjuster to manage complex claims remotely across the U.S. This temporary position... ...and a Bachelor's degree. Responsibilities include adjudication, investigation, and negotiation of claims. A competitive...Hourly payTemporary workRemote work$66k - $112k
.... Medical Coding Automation Senior Associate We are looking for... ...quality, reduce denials, optimize claim adjudication outcomes, and strengthen... ...industry that becomes more complex by the day, we stand for... ...We Can Do For You Along with health and financial benefits, athenistas...SeniorFull timeTemporary workWork at office$66k - $112k
.... Medical Coding Automation Senior Associate We are looking for... ...quality, reduce denials, optimize claim adjudication outcomes, and strengthen... ...industry that becomes more complex by the day, we stand for... ...We Can Do For You Along with health and financial benefits, athenistas...SeniorFull timeTemporary workWork at office$67.9k - $182.55k
...Position Overview The Senior Manager, Medical... ...closely with claims operations to apply... ...processing (intake, edits, adjudication, denials, appeals,... ...and resolve complex configuration... ...Certified Coding Specialist required. License... ...eligible for a CVS Health bonus, commission...SeniorHourly payFull timeTemporary workLocal area- ...Benefits Package Job Family: Claims Processing Industry:... ...Medical Bill Review Specialist I Primarily... ...technical review of more complex medical bills, including... ...QA for basic bills for adjudication within Bill Review system... ...Workers' Compensation Health Care Services Rules...
- ...Bureau Insurance of Michigan is seeking a Director of Property Claims to enhance claims performance while ensuring compliance with company... ...contracts, leadership skills, and expertise in large loss and complex claims. The ideal candidate will have a bachelor’s degree and...SeniorWork at office
$90k - $105k
...Work® Fortune Best Workplaces in Financial Services & Insurance Complex Claims Advisor | Commercial Trucking PRIMARY PURPOSE OF THE ROLE To... ...life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. The...Work at officeLocal areaFlexible hours$130k - $160k
...A leading insurance firm is seeking a Senior Territory Production Underwriter for its Commercial Casualty team. This fully remote role involves underwriting complex E&S commercial casualty risks, developing territory strategies, and building strong relationships with...SeniorRemote work- ...Senior Clinical Project Manager – Oncology/Hematology (Phase III) (Remote – US/Canada)... ...Senior Project Manager and take ownership of complex Phase III trials, driving projects from... ...the anticipated low and high of the Syneos Health range for this position. Actual salary...SeniorContract workRemote work
$128k - $160k
...Guided by our mission to make the world's health data secure, accessible and actionable,... ...'re looking for a strategic and hands-on Senior Product Marketing Manager to lead how Datavant... ...platform to market. You will translate complex, technical offerings across data sourcing...Senior$130k - $160k
...Senior Territory Production Underwriter | Remote Our client, a highly rated insurance carrier, is continuing to grow its underwriting... ...lucrative production bonus Key Responsibilities Underwrite and price complex E&S commercial casualty risks, including coverage, terms, and...SeniorFull timeRemote workFlexible hours$68k - $80k
...Financial Services & Insurance Claims Adjuster - Workers Comp This... ..., filings, and claim adjudication practices. Are you looking for... ...and experience to adjudicate complex customer claims in the context... ...assistance, flexible spending or health savings account, and other...Contract workFlexible hours$115.88k - $261k
...We're building a world of health around every individual - shaping a more connected, convenient... ...with proven ability to distill complex concepts to leaders, colleagues and peers... ...Office technology and software, including Rx Claim and Medispan Demonstrated ability to: manage...SeniorHourly payFull timeTemporary workWork at officeLocal area- ...trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical... ...closely with customers, Data Scientists, and Engineers to translate complex business needs and data science possibilities into clear,...Senior
- ...owned medical malpractice insurer, is seeking an experienced Claims Specialist. This role involves managing medical malpractice claims, developing... ...work environment and comprehensive benefits, including health insurance, 401(k), and learning opportunities. #J-18808-Ljbffr...Remote work
- ...Overview The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision. Primarily responsible for the investigation and management of workers’ compensation claims. Conducts one‑point...Work at office
$93.38k - $122.56k
...The Doctors Company is seeking an experienced Claims Specialist for our Region II team. This is a remote or hybrid opportunity, depending on... ...educational background to ensure fair and competitive pay. Benefits Health, dental, and vision insurance Health care tax-free spending...Casual workWork at officeRemote work- ...in Michigan is seeking a Registered Nurse (RN) for Aria Nursing and Rehab. This role involves supervising care, assessing guests' health, and providing medication-related interventions. Candidates should have current RN licensure and CPR certification, with preferred...Senior
$82.4k - $138.05k
...Job Description This Senior Trucking Insurance Underwriter (Senior Business Development Consultant) position is responsible for... ...a region or territory. Reviews, analyzes, approves or rejects complex business within letter of authority. Serve as liaison with company...SeniorContract workWork at officeShift workNight shift- ...Job Purpose The Senior Clinical Research Associate (Sr. CRA) is responsible for the site... ...members (e.g., Clinician, Recruitment Specialist, Clinical Data Scientist). May act as a... ...Ability to evaluate, interpret and present complex issues and data to support risk...SeniorLocal areaRemote work
- ...responsibilities include submitting logs and communicating operational issues, along with ensuring compliance with patient care protocols. We offer a supportive environment that values work-life balance and aims to make a meaningful impact on the lives of seniors. #J-18808-Ljbffr...Senior
- 6AM City, LLC is seeking a Senior Phlebotomist for their client located in Bristol, TN. The ideal candidate will have experience performing... ...according to established procedures, ensuring compliance with health regulations, and providing clear communication to patients. The...SeniorContract work
$310k - $375k
...Senior Medical Director - Clinical Research About Pharming Pharming Healthcare Inc... ..., as well as the scope of the role, complexity, and external market and internal value... ...plans Tuition reimbursement program Health and wellness program Choice of company...SeniorTemporary workWork experience placementRemote workFlexible hours- ...coordinating care with community agencies. Applicants should have two years of lead therapist experience in substance abuse or mental health and possess relevant certifications. This role demands leadership, organizational skills, and dedication to community service. #J-1...Senior
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