Average salary: $147,259 /yearly
More stats ...Continued employment will be subject to the applicant's successful completion of a background security investigation and favorable adjudication. Failure to successfully meet these requirements will be grounds for termination.
Qualifications
Eligibility...
Suggested
Holiday work
Permanent employment
Full time
Temporary work
Part time
Work experience placement
Trial period
Flexible hours
Night shift
...Continued employment will be subject to the applicant's successful completion of a background security investigation and favorable adjudication. Failure to successfully meet these requirements will be grounds for termination.
Throughout the recruitment and hiring...
Suggested
Holiday work
Permanent employment
Full time
Temporary work
Part time
Work experience placement
Local area
Immediate start
Remote job
Overseas
Flexible hours
Night shift
...capacity in problem resolution.
NOTE: For state employees this experience is interpreted at the level of a Labor Department Adjudications Specialist, Labor Department Business Services Specialist, Labor Department Career Development Specialist, Labor Department...
Suggested
Holiday work
Full time
Immediate start
Flexible hours
Day shift
Monday to Friday
...client representatives to provide background, status, reasoning, and disposition of cases assigned.
+ Will be responsible for adjudicating Life, Accidental Death, and Dismemberment (and various other benefits) claims for The Hartford, as well as providing superior service...
Suggested
Contract work
Temporary work
Remote job
Flexible hours
3 days per week
...large-scale offshore vendor support arrangements
~3+ years of healthcare experience in one or more of these areas:
~ Claim Adjudication
~ Claim Payment/Banking, Electronic Funds Transfer
~ Network and Provider data management; Network Contracting & Pricing
~...
Suggested
Hourly pay
Holiday work
Full time
Temporary work
Remote job
Offshore
...cadence appropriate for each account based on profitability
* Handle individual or reconcile multiple claim issues including adjudication of more complex claims
* Perform documentation reviews to assess sales versus submission, repair order and used car trends
*...
Suggested
Holiday work
Contract work
Remote job
Relocation
Flexible hours
...directly with patients to enhance their understanding of their medications.
Contribute to operational objectives by managing data, adjudicating test claims, and preparing follow-up action plans.
Organize and update relevant data using database applications.
Apply...
Suggested
Full time
Shift work
Day shift
Monday to Friday
...responsibilities on personnel matters. When necessary, counsel supervisors on discipline
procedures and required documentation. Adjudicate staffing issues and determine next steps up to and including terminations of employment.
10. Establish credibility throughout...
Suggested
Full time
Temporary work
...insurance carrier websites clearinghouse work queues to investigate information needed for claim resolution
Keep current with claim adjudication procedures, timely filing limits; following carrier guidelines for corrected claims and appeals
Demonstrate knowledge of ICD-...
Suggested
Private practice
Remote job
...monies.
5+ years understanding of first dollar stop loss claims or medical claims, Prior experience in medical or Stop Loss claim adjudication
Proficient in Excel with advanced skills, including complex formula construction, pivot table manipulation, Vlookup, queries...
Suggested
Remote job
Flexible hours
...Continued employment will be subject to the applicant's successful completion of a background security investigation and favorable adjudication. Failure to successfully meet these requirements will be grounds for termination.
Throughout the recruitment and hiring...
Suggested
Holiday work
Permanent employment
Full time
Temporary work
Part time
Work experience placement
Remote job
Flexible hours
...the like play an integral role in our business
Understanding of SFTP (Secure File Transmission Protocol), file layouts, claim adjudication, billing and invoicing
If you will be working at home occasionally or permanently, the internet connection must be...
Suggested
Holiday work
Work from home
Shift work
Night shift
...subject to the completion of a favorable suitability or fitness determination, where reciprocity cannot be applied; unfavorably adjudicated background checks will be grounds for removal.
Selective Service Requirement: Males born after 12-31-59 must be registered or...
Suggested
Permanent employment
Full time
Contract work
Temporary work
Part time
For contractors
For subcontractor
Relocation
Trial period
Flexible hours
...customer-facing Reporting
2 years utilize Single Sign-On and partnering with external IDPs
2 years in Claims handling/adjudication, Plan Loading, Reporting/Portal capabilities (functional development/testing/analysis) with Paid Family Medical Leave, Absence,...
Suggested
Remote job
Full time
Temporary work
Work experience placement
Work from home
Relocation package
Flexible hours
...support for all client technical requirements.
Onboard clients' transactional data files to facilitate on-going claims adjudication and continuation of care.
Manage new clients' file and disruption analyses and reporting to facilitate clients' decisions...
Suggested
Holiday work
Full time
Work experience placement
Local area
Work from home
3 days per week
...been completed correctly.
Ensure the finalized peer review is given to applicable contract staff for correction and comment.
Adjudicate the corrections and comments made by the staff.
File the adjudicated peer review in the appropriate place of record.
Must...
Holiday work
Full time
Contract work
Temporary work
Immediate start
Remote job
Flexible hours
