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LOCATION: Remote
GENERAL STATEMENT OF JOB
Responsible for all accounting functions related to a designated area of physical and behavioral health medical claims processing to ensure that providers receive timely and accurate payment. This position is responsible for claims adjudication through continuous monitoring and quality control measures. Responsibilities include finalizing c...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one pe...

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers' compensation claims under close supervision, supporting the goals of claims department and of CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
* Receives claims, confirms policy coverage and acknowledgement of the claim
* Determines the v...

Become a part of our caring community and help us put health first
The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized at the Initial or Appeals/Disputes level. All work occurs within a context of regulatory compliance, and work ...

Company Description
Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician...

Become a part of our caring community and help us put health first
The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which m...

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
The Claims Examiner is r...

Crum & Forster Company Overview
Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recogni...

Crum & Forster Company Overview
Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recogniz...

The salary range for this job posting is $49,225.00 - $78,759.00 annually + bonus + benefits. Pay Type: Salary
The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information ...

The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health servi...

At Stout, we’re dedicated to exceeding expectations in all we do – we call it Relentless Excellence ® . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to le...

Overview
Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages three decades of experience solving complex challenges in Health, Defense, and Civilian missions. Our proven Empower AI Platform® provides a practical, sustain...

Employment Type:
Full timeShift:
Description:
POSITION PURPOSE
Work Remote Position
(Pay Range: $16.1738-$24.1614)
Performs day-to-day payment posting reconciliation activities within the hospital revenue operations ($3-5B NPR) of an assigned Patient Business Services (PBS) location. Serves as a member of the Payment Posting team at an assigned PBS location responsible for ensuring accurate ...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top...

Description
Liberty Mutual has an immediate opening for a Complex Claims Specialist to join our Miscellaneous Medical Facilities Unit. This is a high‑visibility, hands‑on role for an experienced professional‑liability claims handler with deep Miscellaneous Medical Facilities (MMF) and Long‑Term Care (LTC) facility PL expertise. With minimal supervision, the Complex Claims Specialist will manag...

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top ...

Description
Liberty Mutual has an immediate opening for a Complex Claims Specialist to join our Miscellaneous Medical Facilities Unit. This is a high-visibility, hands-on role for an experienced professional-liability claims handler with deep Miscellaneous Medical Facilities (MMF) and Long-Term Care (LTC) facility PL expertise. With minimal supervision, the Complex Claims Specialist will manage...

Location:
Work from home (Pennsylvania)
Shift:
Days (United States of America)
Scheduled Weekly Hours:
40
Worker Type:
Regular
Exemption Status:
Yes
Job Summary:
Acts as a leader, liaison, and resource working collaboratively with a diverse group, including management, physicians, clinical and non-clinical personnel utilizing the national correct coding standards, approaches, and industry ...

Location:
Work from home (Pennsylvania)
Shift:
Days (United States of America)
Scheduled Weekly Hours:
40
Worker Type:
Regular
Exemption Status:
No
Job Summary:
Contributes to the achievement of the strategic and financial goals of the organization by conducting thorough reviews of billed services, authorizations, plan benefit documents, itemized statements, medical records, discharge summ...