Claim Adjudication Jobs (NOW HIRING)

This person will follow up on claim adjudication to include claim rejects, underpayments and appropriate reimbursement to respective payer contacts. This person may also work on co-pay and drug ...

Claims Adjudication Associate Charlotte, North Carolina, United States; Denver, Colorado, United ... Negotiate or support resolution of complex claim issues with internal stakeholders, providers ...

The Claims Adjudication Associate is responsible for evaluating claims submitted by policyholders ... Negotiate or support resolution of complex claim issues with internal stakeholders, providers ...

Combined Insurance, a Chubb Company, is seeking a Group Claim Adjudication Manager to join our fast-paced, high energy, and growing company. For nearly 100 years in the insurance industry, our ...

Claim adjudication * Manage authorizations and prior authorization process * Collect co-pays * Verify eligibility Skills * Home Infusion or Specialty Pharmacy RCM Background - collector, biller ...

This person will follow up on claim adjudication to include claim rejects, underpayments and appropriate reimbursement to respective payer contacts. This person may also work on co-pay and drug ...

... FNOL, claim adjudication, payments, reserves, recoveries, and Guidewire configuration capabilities. • Experience working in Agile/Scrum environments with excellent stakeholder management ...

Claims Adjudication Associate Charlotte, North Carolina, United States; Denver, Colorado, United ... Negotiate or support resolution of complex claim issues with internal stakeholders, providers ...

The Claims Adjudication Associate is responsible for evaluating claims submitted by policyholders ... Negotiate or support resolution of complex claim issues with internal stakeholders, providers ...

Handles escalations for difficult claim rejection resolution cases/questions to ensure accurate and timely completion of adjudication. * Adjudicates pharmacy claims for prescriptions in active ...

Coordinate with claims examiners, configuration, and payment integrity teams to ensure accurate claim adjudication. * Document and maintain claim processing instructions and workflows to ensure ...

Handles escalations for difficult claim rejection resolution cases/questions to ensure accurate and timely completion of adjudication. * Adjudicates pharmacy claims for prescriptions in active ...

This high-profile IT Director role is jointly responsible for the transformation, modernization and automation strategy along with its execution for the Claim adjudication platform. Major ...

Responsibilities Responsibilities for Senior Claim Adjudicator: * Utilize claims processing experience and working knowledge of Medicare and Medicaid to effectively and efficiently process claims for ...

Proficient knowledge of UB04 / CMS-1500 claim adjudication process, including Medicare and Medicaid reimbursement methodologies (i.e. Per Diem, PPS, FFS, APG, Capitation, etc.) required. * Must ...

Handles escalations for difficult claim rejection resolution cases/questions to ensure accurate and timely completion of adjudication. * Adjudicates pharmacy claims for prescriptions in active ...

Handles escalations for difficult claim rejection resolution cases/questions to ensure accurate and timely completion of adjudication. * Adjudicates pharmacy claims for prescriptions in active ...

Responsibilities for Senior Claim Adjudicator: * Utilize claims processing experience and working knowledge of Medicare and Medicaid to effectively and efficiently process claims for payment while ...

The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of ...

Handles escalations for difficult claim rejection resolution cases/questions to ensure accurate and timely completion of adjudication. * Adjudicates pharmacy claims for prescriptions in active ...