4884 claims processor jobs found

Summary As a Claims Processor I, you will be responsible for the accurate and timely processing of claims. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team! Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future. Logistics This position...

Summary Functions as the team lead and subject-matter expert for a claims area. Responsible for creating reports, distributing workload and training new employees. Description CGS is now hiring full-time work Lead Claims Processor with a competitive starting salary in the government healthcare industry. CGS Administrators, LLC – “We IMPACT Lives.” Is our mission which ties directly into our company’s vision. “To IMPACT the future of our communities and nation by being the premier administrator of government healthcare programs.” A day in the life of a CGS Lead Claims Processor : Functions as the team lead and subject-matter expert for a claims area. Responsible for creating reports, distributing workload and training new employees. This position can be remote if applicable. (more than 50miles from building location) Work hours: Can be flexible with start and end times. What You'll Do: Responds accurately and timely to inquiries from team members,...

Summary Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members. Description Position Purpose We are currently hiring for a Claims Processor II to join BlueCross BlueShield of South Carolina. In this role as Claims Processor II you will review and adjudicate complex or specialty claims. You will also determine whether to return, deny or pay claims following organizational policies and procedures and assist in training or mentoring new staff members. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of...

Full job description Summary Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members. Description Position Purpose We are currently hiring for a Claims Processor II to join BlueCross BlueShield of South Carolina. In this role as Claims Processor II you will review and adjudicate complex or specialty claims. You will also determine whether to return, deny or pay claims following organizational policies and procedures and assist in training or mentoring new staff members. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are...

Hi, we're Oscar. We're hiring a Claims Processor to join our Claims Production team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About The Role You will process incoming work associated with Claims operations following standard operating procedures. You will report to the Claims Production Team Lead. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If you live within commutable distance to our Tempe office (off the 101 at University Dr), you can come into the office on a voluntary basis. Otherwise, this is a remote / work-from-home role. You must reside in Arizona. Pay Transparency The base pay for this role is: $19.00 per...

Hi, we're Oscar. We're hiring a Claims Processor to join our Claims Production team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role You will process incoming work associated with Claims operations following standard operating procedures. You will report to the Claims Production Team Lead. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If you live within commutable distance to our Tempe office (off the 101 at University Dr), you can come into the office on a voluntary basis. Otherwise, this is a remote / work-from-home role. You must reside in Arizona. #LI-Remote Pay Transparency: The base pay...

Full job description Hi, we're Oscar. We're hiring a Claims Processor to join our Claims Production team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role You will process incoming work associated with Claims operations following standard operating procedures. You will report to the Claims Production Team Lead. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. This is a remote / work-from-home role, however you must reside in Florida. #LI-Remote Pay Transparency: The base pay for this role is: $19.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 10...

Hi, we're Oscar. We're hiring a Claims Processor to join our Claims Production team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role You will process incoming work associated with Claims operations following standard operating procedures. You will report to the Claims Production Team Lead. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. This is a remote / work-from-home role, however you must reside in Texas. #LI-Remote Pay Transparency: The base pay for this role is: $19.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 10 days per year...

Full job description Hi, we're Oscar. We're hiring a Claims Processor to join our Claims Production team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role You will process incoming work associated with Claims operations following standard operating procedures. You will report to the Claims Production Team Lead. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. This is a remote / work-from-home role, however you must reside in Georgia. #LI-Remote Pay Transparency: The base pay for this role is: $19.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 10...

Job Description: Essential Job Functions: Conducts correspondence related to client requests for information Evaluates available information to validate claims Verifies contract information, effective dates, status and verification of claim eligibility Identifies need for additional information Contacts appropriate source to obtain needed information Verifies beneficiary or claimant information if claim is warranted Identifies payment amount and obtains required management approvals for payment Processes payment Investigates moderate to highly complex claims and determines level or resolution if appropriate; advises claimant of status; assists in negotiating settlement and resolution of claim Receives demand letters; researches and investigates claims, responds within individual parameters and escalates as appropriate Mandatory Qualifications: High school diploma or G.E.D. 3+ years of insurance/claims processing experience Experience working with insurance and/or medical...

Summary Responsible for the accurate and timely processing of claims. Description Research and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes. Resolves system edits, audits and claims errors through research and use of approved references and investigative sources. Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary. Required Education: High School Diploma or equivalent Required Work Experience: 1 year-of experience in a healthcare or insurance environment. Required Skills and Abilities: Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills. Required Software and...

Summary Responsible for the accurate and timely processing of claims. Description Research and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes. Resolves system edits, audits and claims errors through research and use of approved references and investigative sources. Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary. Required Education: High School Diploma or equivalent Required Work Experience: 1 year-of experience in a healthcare or insurance environment. Required Skills and Abilities: Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills. Required Software...

Full job description Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Description ***This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. *** Position Purpose: Responsible for the accurate and...

Summary Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members. Description Examines and processes complex or specialty claims according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Verifies that claims have been keyed correctly. Ensures that claims are processing according to established quality and production standards. Corrects processing errors by reprocessing, adjusting, and/or recouping claims. Researches and resolves claims edits and deferrals. Performs research on claim problems by utilizing policies, procedures, reference materials, forms and coordinates with various internal support areas. Responds to routine correspondence and completes spreadsheet if applicable. Required...

Summary Responsible for the accurate and timely processing of claims. Description Research and process claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes. Resolves system edits, audits and claims errors through research and use of approved references and investigative sources. Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary. Required Education: High School Diploma or equivalent: Required Skills and Abilities: Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills. Required Software and Tools: Basic office equipment. Preferred Work Experience: 1 year-of experience in a...

Full job description Summary Location: This role is onsite in Columbia, SC. Why should you join the Legal Department at BlueCross and BlueShield of South Carolina? BCBSSC has been doing business in South Carolina for more than 70 years. In addition to being the largest insurance company in the state, we are part of the national landscape. We are one of the nation’s leading claims processors of government contracts, and we operate one of the most sophisticated data processing centers in the Southeast. We have a diverse family of subsidiary companies, with over 100 facilities and offices in 15? states and the District of Columbia, that allows us to build on our business strengths and offers a challenging and varied work environment for our lawyers in Columbia, S.C. If you are tired of billing hours and seeking a stable organization in which you can play a key role in the growth and success of the business, then look no further. Description...

TRAFFIC SIGNAL ELECTRICIAN, PUBLIC WORKS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4247268) Apply ? TRAFFIC SIGNAL ELECTRICIAN, PUBLIC WORKS Salary $104,814.48 Annually Location Los Angeles County, CA Job Type Full time Job Number C3686K Department PUBLIC WORKS Opening Date 10/02/2024 Description Benefits Questions Position/Program Information EXAM NUMBER: C3686K TYPE OF RECRUITMENT: Open Competitive Job Opportunity APPLICATION FILING PERIOD: We will begin accepting applications on Thursday, October 3, 2024, at 8:00 a.m. Pacific Time (PT) - Until the needs of the service are met and is subject to closure without prior notice. With more than 10 million residents, Los Angeles County has the largest population of any county in the nation. As the largest employer in Southern California, with 42 diverse departments and over 2,300 different job descriptions, the County offers a lifetime of opportunities and careers. We are Los Angeles County Public Works, the...

Summary This National Guard position is for a HUMAN RESOURCES ASSISTANT (MILITARY) (TITILE 32), Position Description Number D2017000 and is part of the G1 (DCSPER), Automation Branch, St. Augustine, FL. Responsibilities As a Human Resources Assistant, GS-0203-07, you will serve as a final reviewer or processor of actions, which may include but are not limited to: Research and draft responses to Legislative and IG inquiries, Evaluation Reports (NCOER/OER), accessions, promotions, reductions, discharges, transfers, separations, boards, evaluations, Simultaneous Membership Program (SMP), promotion eligibility, retirement eligibility, and actions that affect eligibility of educational or incentive benefits as well as sensitive, complex cases, which involve: allegations of inequitable, prejudiced, or similar treatment (e.g. issues of fraudulent enlistment or assignment; removal of military member from active or inactive status). Performs complete review of records and other case...

Summary This National Guard position is for a HUMAN RESOURCES ASSISTANT (MILITARY) (TITLE 32), Position Description Number D2014000 and is part of the FL DCSPER, National Guard. Responsibilities As a HUMAN RESOURCES ASSISTANT (MILITARY) (TITLE 32), GS-0203-7, you will serve as a final reviewer and/or processor of actions, which may include but are not limited to: accessions, discharges/separations, promotions, awards, reductions, transfers, boards, Non-Commissioned Officer Evaluation Reports (NCOERs), Office Evaluation Reports (OERs), promotion eligibility, Simultaneous Membership Program (SMP), discharges, waivers, award/withdraw, Military Occupational Specialty (MOS), retirement eligibility, iPERMS, RCAS, eMILPO, SIDPERS, DJMS, DMDC, CAC Automation,TAPDB-G, DSRO, and any additional or emerging systems that support personnel management and actions that affect eligibility of educational or incentive benefits as well as sensitive, complex cases, which involve: Allegations of...

BUFFALO BOARD OF EDUCATION DEPARTMENT OF HUMAN RESOURCES ROOM 720 CITY HALL BUFFALO, NEW YORK 14202 RECRUITMENT BULLETIN #24-043 September 11, 2024 BUFFALO BOARD OF EDUCATION VACANCY Civil Service residency requirements will apply (The City of Buffalo Civil Service does not require residency within the City of Buffalo for Native Americans. The City of Buffalo Civil Service does require tribal enrollment or community recognition as a Native American) POSITION: Senior Personnel Clerk – Temporary SALARY: $51,418 - $60,782 LOCATION: Department of Human Resources, Room 720 City Hall, Buffalo, NY 14202 APPLICATION: successfully received will generate a confirmation email to the account listed on the application. If you do not receive a confirmation email, we cannot guarantee that your application was received. You must submit an application until you receive a confirmation email. DISTINGUISHING FEATURES OF THE CLASS An incumbent to a position in...

We are promoting this job opportunity as provided by a third party, the employer. In case of your interest in this job opportunity and for more details please click on "Apply" button below, which will take you to the employer's website Overview Waterway is hiring for its renowned Manager Training and Development Program in the Denver Area. You don’t have to sit at a desk to earn good money and learn how to effectively manage and run a business. You can do that while being active and outdoors as a Manager at Waterway Carwash. Our Learn to Lead ® Manager Development Program teaches you how to run our business so that you can run any business. Successful Managers are highly motivated people who desire to work where they can get high-quality business and people management experience, where hard work is recognized, and where there is a clear-but path to advancement. Waterway Carwash is that place! We look for energetic leaders with the ambition and leadership skills to...

Commonwealth of Massachusetts Human Resources Division     2024 Springfield Deputy Police Chief Online Experience & Education (E&E) Claim    Examination Title : Deputy Police Chief Promotional Examination Date : October 23, 2024   Deadline for Online E&E Claim Submission : October 30, 2024, at 11:59 pm   This is the online Education & Experience (E&E) claim for the 2024 Springfield Deputy Police Chief Sole Assessment Center with E&E scheduled for October 23, 2024. There is no separate fee for filing this claim. Only eligible candidates who have already submitted an application and payment to participate in the 2024 Springfield Deputy Police Chief Sole Assessment Center with E&E scheduled for October 23, 2024, must complete this online claim. It is important that you read all the instructions before submitting the online E&E Claim. Failure to follow the instructions may result in...

Summary Researches and resolves escalated, complex, and high profile claims issues. Serves as POC (point of contact) with various professional and facility/hospital providers in the research and resolution of all claims issues. May assist with escalated issues to include, but not limited to provider enrollment, medical review, appeals and/or finance. Completes research efficiently and accurately to ensure the departmental goals are achieved. Description Researches and resolves high profile claims issues. Ensures claims processing errors are corrected according to the appropriate provider reimbursement contract. May also research and resolve high profile issues including, but not limited to provider enrollment, medical review, appeals and/or finance, which may be received via written or telephone correspondence. Serves as Point of Contact for various providers (professional and facility) to resolve all claims payment errors. Conducts weekly conference calls with...

Full job description Duties Fire Suppression, Monitoring, and Post-Fire Activities As an experienced leader within a wildland fire module or crew in fuels management, fire suppression, monitoring, and post-fire activities, applies an understanding of firefighter safety, fire behavior, topography of the area, weather, fuels, and training in fire management work to: 1) mentor and instruct lower graded employees on crewmember duties; 2) plan action and direct utilization of fireline resources on less complex fires; and 3) for more complex fires, direct assigned suppression operations and recommend and implement tactical strategy on attacking, controlling, or mopping up fires, building or patrolling firelines, cleaning up burned areas within firelines, suppressing spot fires, felling snags or trees, and cutting brush. Adjusts actions based on changing information and evolving situational awareness. Uses firing devices on a firing operation according to the...