Healthcare Claims Specialist

About the RoleBecome a part of our caring community and help us put health firstThe Claims Review Representative 3 makes appropriate claim decisions based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The role involves performing advanced administrative / operational / customer support duties that require...

Abarca Health is igniting a revolution in healthcare, and we're looking for a skilled Pharmacy Claims Quality Assurance Specialist to join our team.Job DescriptionWe're seeking a detail-oriented professional with 2+ years of experience in quality assurance and software development life cycles. As a Pharmacy Claims Quality Assurance Specialist, you'll be...

Company OverviewManpower Inc. is a global leader in the staffing industry, providing workforce solutions to meet the needs of clients worldwide. Job SummaryWe are seeking a Medical Claims Specialist to join our team in [location]. This role will be responsible for processing medical claims efficiently and effectively, ensuring timely payment and compliance...

Job SummaryWe are seeking a skilled Healthcare Collections Specialist to join our team in San Juan, PR. This is a challenging and rewarding role that requires excellent communication and problem-solving skills.About the RoleThis position plays a critical role in creating a quality experience for patients by resolving issues related to claims and accounts...

About the Role:As a Financial Claims Specialist at AIG, you will be responsible for assessing and managing complex liability claims within authority limits. You will perform coverage and quantum analysis throughout the claims' lifecycles, ensuring timely and accurate resolutions for our customers.What You'll Do:Proactively assess and manage complex liability...

Company OverviewOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.Job DescriptionThe Clinical Investigation Healthcare Specialist will be responsible for reducing medical costs by identifying waste and error in provider billing practices. This role involves determining the accuracy of bills...

About the RoleAbarca Health is seeking a skilled Pharmacy Claims Quality Assurance Specialist to join our team. As a key member of our Quality Oversight Department, you will play a critical role in ensuring the quality and integrity of our pharmacy claims testing and adjudication processes.Key ResponsibilitiesOptimize testing and monitoring activities to...

Job SummaryAbarca Health is seeking a highly skilled Pharmacy Claims Quality Assurance Specialist to join our team. As a key member of our Quality Oversight Department, you will play a critical role in ensuring the quality and integrity of our pharmacy claims testing and adjudication processes.Key ResponsibilitiesOptimize testing and monitoring activities to...

About the roleAbarca Health is seeking a skilled professional to join our PBM Operations & Services team as a Coverage Determination Specialist.The ideal candidate will possess strong analytical skills and the ability to communicate effectively with pharmacists, beneficiaries, and doctors.Responsibilities will include reviewing and responding to coverage...

Job Overview:">The Medical Billing Specialist - Accounts Receivable position at Acadia Healthcare is a rewarding opportunity for individuals with strong customer service skills and medical billing/collections experience. This role is responsible for the timely submission of claims to third-party payors and collection of outstanding accounts receivable.">Key...

We are seeking an experienced Auto Bodily Injury Claims Specialist to join our team at First Chicago Insurance Company. Our new office in Oak Brook is now open, and we are excited to expand our operations in the area.The Bodily Injury Claims Specialist will be responsible for investigating and settling automobile bodily injury claims. They will work closely...

We are seeking a highly skilled Auto Bodily Injury Claims Specialist to join our team at First Chicago Insurance Company. Our new office in Oak Brook is now open and we are looking for an experienced professional to support our growth.Key Responsibilities:Investigate and settle automobile bodily injury claimsReview and determine course of action on each file...

About the RoleThe Claims Manager - Complex Claims Leadership position at AIG is a key role in our General Insurance team. As a leader in medium complexity claims, you will be responsible for managing a high-performing team of adjusters, ensuring adherence to departmental and line of business best practices, and providing technical referral expertise and...

About the Role:As a Claims Representative I at Elevance Health, you will play a crucial role in ensuring the smooth processing of healthcare claims. Your responsibility will be to successfully complete the required basic training and perform basic job functions with the help of coworkers, specialists, and managers on non-basic issues.Key...

Critical Role in Healthcare Financial OperationsAs a Business Office Clerk at Acadia Healthcare, you will play a vital role in ensuring timely submission of claims to third-party payors and collection. Your attention to detail and strong customer service skills will be instrumental in maintaining positive relationships with clients and payors.Key...

Job SummaryThe Senior Claims Representative position at Ryder System, Inc. involves handling complex and mid-to-high exposure bodily injury and property damage claims.Key Responsibilities:Investigate and adjust claims, directing outside defense counsel, independent adjusters, experts, and vendors as needed.Supervise vendors to ensure claims are handled...

At UnitedHealth Group, we deliver care and aid technology to help millions of people live healthier lives. Our team works to improve health outcomes by connecting people with care, pharmacy benefits, data, and resources they need to feel their best. We value diversity and inclusion, and we offer talented peers, comprehensive benefits, and career development...

At UnitedHealth Group, we're committed to helping people live healthier lives. As a Recovery Resolutions Representative, you'll play a critical role in ensuring that our members receive the care they need. Your responsibilities will include reviewing medical records, identifying key details, and determining the next steps for claims processing. You'll work...

About the RoleAbarca Health is seeking a skilled Healthcare Data Analyst to join our team. As a key member of our Data Analytics team, you will be responsible for analyzing healthcare claims data to identify trends and opportunities for improvement.Key ResponsibilitiesAnalyze healthcare claims data to assess trend performance and identify potential...

Company OverviewUnitedHealth Group is a global organization that delivers care and pharmacy benefits to millions of people worldwide. We believe in creating a healthier atmosphere where everyone can thrive.About the RoleThe Healthcare Appeals Resolution Specialist will play a vital role in reviewing, researching, and resolving all types of appeals and...