Health Claims Handler - Insurance
EmblemHealth
A major health insurance provider is looking for a professional to manage claims performance and analyze discrepancies. Responsibilities include supporting contract management, monitoring claims, and conducting research to identify trends. Candidates should have a Bachelor's degree and 2-3 years of related experience. Strong analytical and problem-solving skills are essential, along with proficiency in MS Office applications. Join a dynamic team focused on delivering quality services to the community.
#J-18808-Ljbffr EmblemHealth
$32.85 - $35.71 per hour
Broadcast Standards & Practices Associate / Ad Review Specialist 2 days ago Be among the first 25... ...department deals with a high volume of claims. It is essential that the candidate has... .../or statistical analysis. Excellent analytical, critical thinking, organizational, and...ClaimsFixed term contract- ...improvement opportunities. They will coordinate payor denials and audit activities while ensuring timely responses to claims denials and audit reviews. Candidates should have a Bachelor's degree and significant experience in Anesthesia and Healthcare Revenue Cycle management...Claims
- ...Position: Case Review Specialist – Phone Intake & Documentation Location: Remote Remote Status: Remote Job Id: 1678 # of Openings: 1 About... ...Case Management, Customer Support, Medical Directors, Appeals, Claims, Operations) to ensure cases move forward efficiently. Support...ClaimsWork at officeLocal areaRemote workMonday to FridayShift work
$85k - $95k
...best you can be. Opportunity We are looking for a Senior Specialist, Measurement and Analytics within our Commerce Intelligence department. You will... ...fraudulent job communications from individuals falsely claiming to be from Flywheel. We've identified fraudulent activity...ClaimsWork at officeLocal areaImmediate start- ...Director of Utilization Review Under the direction of the Director of Utilization Review, the Specialist will coordinate Medicaid Managed Care authorizations and re-authorizations... ...programs. The Specialist will monitor claims and approvals, and coordinate internally and...ClaimsTemporary workFlexible hours
$22 per hour
..., seeking a seasoned Revenue Cycle Specialist with health insurance claims experience to fill a role in the Revenue... ...established payer timelines. Review, analyze, and appeal denied or underpaid... ...of applications required. Strong analytical skills. Strong communication with...ClaimsHourly payPermanent employmentFull timeTemporary workWork at officeRemote work- ...LEVEL OVERVIEW The Duty Drawback Specialist is responsible for end-to-end... ...processing duty drawback claims, including analyzing import and... ...informal coaching and review support to Duty Drawback Specialist... ...building skills Strong data analytics and attention to detail Ability...ClaimsRemote work
- ...Senior Specialist, Talent Acquisition at nTech Workforce Title: Payment... ...this position focuses on the analytical side of healthcare finance. You will be responsible for reviewing medical correspondences,... ...providers warrants a change in claim payment. This is a non-phone,...ClaimsContract workRemote work
- ...Cost Outlier and Readmission reviews. Under the direction of the Appeals... ...the department. The Appeals Specialist level II performs research,... ...in inpatient claims, DRG and High-Cost Outlier claims... ...ExcelExcellent problem solving and analytical skills requiredAbility to manage...Claims
- ...remote Workers Compensation Specialist. The successful candidate will... ...and OWCP regulations to manage claims, ensure compliance, and guide... ...include comprehensive claim reviews and leading projects while... ...relevant experience, with strong analytical skills and proficiency in...ClaimsRemote work
- ...Services. Standards & Practices Associates review high profile national advertising... ...be able to identify express and implied claims and assess the adequacy of a variety of... ...and/or statistical analysis. Excellent analytical, critical thinking, organizational, and...ClaimsContract workFixed term contractWork at officeRemote work
- ...progress. The Underwriting Specialist in the Excess Casualty Profit... .... Conduct regular reviews of existing policies to assess... ...regulatory requirements, and claims processes. Help mentees develop... ...property/casualty sector. Strong analytical skills and the ability to...ClaimsWork at officeWorldwide
- ...ACH Risk Management Specialist Responsibilities include but are not limited to: Review ACH transactions and reports to detect... ...Investigate and resolve ACH disputes, claims, and exceptions, and... ...or core system. Excellent analytical, problem-solving, and decision...ClaimsBank staff
- ...Responsibilities The Revenue Cycle Specialist is responsible for providing... ...and timely processing of claims and patient accounts to... ...well as admissions, utilization review, and compliance to maintain strong... ..., computer science, analytics). Minimum three (3) years' experience...ClaimsFull timeLocal areaRemote work
- ...role Under the direction of the Claims Department Supervisor, the Sr. Claims Support Specialist / Total loss adjuster performs... ...company-required documents, and review them upon return; Comply with... ...organization, sound decision-making, and analytical skills, strong interpersonal...ClaimsFull timeWork experience placementRemote work
- ...PURPOSE OF JOB The Senior Coding Specialist is responsible for... ...assigned clients and specialties. Review the medical record and all applicable... ...as they relate to claims processing. Apply knowledge of... ...highly detailed with outstanding analytical and writing skills and the ability...ClaimsWork at officeLocal areaRemote work
- ...the Expedited Appeal unit, the Specialists are required to work weekends... ...perform triage function: review and evaluate appeal requests;... ...prior activity related to the claims, payment, or service in question... ..., problem solving and analytical skillsAbility to work under pressure...ClaimsHourly payContract workRemote workWeekend work
- ...HR contacts and managers for review and approval. Oversee the full... ..., paperwork, and routine claims issues with vendor partners.... ...go-to resource for other LOA Specialists on complex, sensitive, or escalated... ...resource for peers. Strong analytical, problem-solving, and communication...ClaimsRemote work
$93k - $130k
.... Join us as an Underwriting Specialist, Retail Property to play your... ...underwriters, producers, and claims adjusting personnel. Communicate... ...meets clients’ needs. May review, evaluate and make... ...Expert with underwriting analytical tools and technology. Ready...ClaimsWork at officeFlexible hours- ...Position Title: Patient Relations Specialist Department: Patient... ...received in all modalities. Reviews daily files submitted into Patient... ...relationship with Legal and Claims services to manage risk... ...products. Ability to think analytically, make decisions based on information...ClaimsFull time
$104k - $171.7k
...and where you do it. Job Category Claim Compensation Overview The annual base... ...or property damage by obtaining and reviewing appropriate records and damages documentation... ...track, and communicate information. ~ Analytical Thinking - Advanced. ~ Judgment/...ClaimsContract workLocal areaRelocation package- ...work that requires diligent review and notation working across a... ...organizing large data sets such as claim files and provider rosters Job Profile Summary The Senior Specialist, Network Contracting is... ...your leader, utilizes data and analytics of provider financial issues...ClaimsFull timeContract workWork experience placementRemote work
$99k - $110k
.../ Position overview FT Specialist, a business division of the Financial... ...to break news, and a sharp analytical approach. You will produce... ...role requirements & regular review. While flexible working... ...fraudulent job postings and offers claiming to be from the Financial...ClaimsWork at officeWorldwideFlexible hours- ...remote Workers Compensation Specialist to support our Department of... ...procedures to Workers' Compensation Claims. They will be tasked with, in... ...: Conduct comprehensive reviews of OWCP claims to determine eligibility... ...work case management. Strong analytical skills. Proficiency in...ClaimsTemporary workWork at officeLocal areaRemote work
- ...We’re hiring a Patient Safety Specialist! This hybrid position... ...risks through rounds, chart reviews, interviews, inspections, and... ...actions. Maintain investigative, claim, and legal files with strict... ...Microsoft Office software systems. Analytical ability to prepare, review...ClaimsWork at officeMonday to Friday2 days per week1 day per week
- 0090 Presbyterian System Services is seeking a Claims Analyst to validate claims payments against contract terms. The role demands strong analytical skills to identify trends and report issues to the Revenue Recovery team. Qualified candidates should have 1-2 years of experience...ClaimsContract workRemote work
- ...is hiring a full-time Licensed Medical Review Nurse to conduct reviews of medical documentation... ...managing appeals and validating claims to ensure medical necessity and compliance... ...license in Florida or Kentucky. Strong analytical skills and proficiency in coding are...ClaimsFull timeRemote work
$84k - $105k
...passionate about pharmacy benefits financial analytics and data? Does providing trusted advice... .... The Role • Provide technical review and analysis of PBM data, contracts, RFPs... ...preferred. • Previous Medical or Pharmacy Claims Auditing, Benefits Contracting, and/or...ClaimsContract workImmediate startRemote work- ...position to assist the Director of HIM with claim audits and coding processes. The ideal... ...certifications. Your role will involve reviewing claims for accuracy and compliance with... ...participating in presentations. Strong analytical and communication skills are essential for...ClaimsFull timeRemote work
$164k - $246k
Senior Natural Catastrophe Specialist, Vulnerability Are you passionate... ...and losses. Analyze claims data to empirically develop and... ...related technical field. Strong analytical and programming skills (e.g.,... ...powered tools to support the review and evaluation of applications...ClaimsFull timeTemporary workWork at officeRemote workFlexible hours
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