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Claims Associate Three Jobs in Virginia (NOW HIRING)

Infinia Search Inc

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Associate Adjuster - Auto

Richmond, VA · On-site

$24/hr

Associate Adjuster Auto Hybrid - Worcester, MA - Howell, MI - Syracuse, NY - Itasca, IL - Richmond ... claims organization. What's in it For You? Career Development: Average 3-4 months temp to hire ...

Randstad

Associate Auto Adjuster

Richmond, VA · Hybrid

$23.50 - $24/hr

Kickstart Your Claims Career with an Industry Leader! Ready to build a meaningful career in ... Hybrid Flexibility: 2-3 days in-office / 2-3 days remote after training (38.75 hrs/week). * ...

Elevance Health

Business Analyst III

Norfolk, VA · On-site

$73K - $92K/yr

Hybrid 1 : This role requires associates to be in-office 1 - 2 days per week, fostering ... Experience with healthcare claims data analysis and validation is preferred. * Strong analytical ...

Elevance Health

Business Analyst III

Norfolk, VA · On-site

$73K - $92K/yr

Hybrid 1 : This role requires associates to be in-office 1 - 2 days per week, fostering ... Experience with healthcare claims data analysis and validation is preferred. * Strong analytical ...

Virginia Jobs

Pharmacy Tech

Staunton, VA · On-site

$56K/yr

Direct Service Associate III Hiring Range: Salary Up to $56,000 Pay Band: 3 Agency: Dept Behavioral ... claims in alignment with pharmacy billing requirements. - Maintain an organized, safe, and ...

State of Virginia

Pharmacy Tech

Staunton, VA · On-site

$56K/yr

Direct Service Associate III Hiring Range: Salary Up to $56,000 Pay Band: 3 Agency: Dept Behavioral ... claims in alignment with pharmacy billing requirements. - Maintain an organized, safe, and ...

1915 South / Ashley

Associate of Guest Solutions

Danville, VA · On-site

$14.75 - $18/hr

... 3 distribution centers across the southeast, including locations in Georgia, Florida, Alabama ... Associates take incoming calls, manage customer care issues, process service and warranty claims ...

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All JobsClaims Associate Three JobsClaims Associate Three Jobs in Virginia

Claims Associate Three information

Is claims processing a stressful job?

Claims processing can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. Claims associates often handle complex cases and must maintain attention to detail while managing customer expectations, which can contribute to job stress.

What is the role of a claims associate three?

A Claims Associate Three is responsible for reviewing, investigating, and processing insurance claims to ensure accurate and timely resolution. They often handle complex cases, communicate with clients and providers, and use claims management systems to document actions and decisions.

What is the difference between Claims Associate Three vs Claims Associate Two?

AspectClaims Associate ThreeClaims Associate Two
Required CredentialsHigh school diploma or equivalent; some roles may prefer relevant certificationsHigh school diploma or equivalent; entry-level position
Work EnvironmentOffice setting, handling complex claims, collaborating with teamsOffice setting, processing standard claims, customer interaction
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, claims processing centers
Common Search & ComparisonClaims Associate Three vs Claims Associate Two

The Claims Associate Three typically handles more complex claims and may require some experience or specialized knowledge, whereas the Claims Associate Two focuses on standard claims processing. The roles differ mainly in responsibility level and complexity, with Claims Associate Three often taking on more advanced tasks within the same industry environment.

What are popular job titles related to Claims Associate Three jobs in Virginia? For Claims Associate Three jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Claims Associate Three jobs in Virginia look for? The top searched job categories for Claims Associate Three jobs in Virginia are:
What cities in Virginia are hiring for Claims Associate Three jobs? Cities in Virginia with the most Claims Associate Three job openings:
Claims Associate Three jobs near you
Infographic showing various Claims Associate Three job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 69% Full Time, 27% Part Time, 1% Temporary, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.

Claims Review Nurse (CERT)

Catapult Consultants, LLC

Arlington, VA

Full-time

Re-posted 5 days ago

Job description

Company Description

Catapult Consultants is a global, professional services and management consulting company specializing in business, analytical and information systems solutions. We support mission-critical programs in the Intelligence Community and Defense and Civilian sectors.  Our health care soultions division is currently looking for Registered Nurse to support our transplant program quality assessment and performance improvement program.  For more information about us go to www.catapultconsultants.com.

Job Description

This position provides support for a federal government project to review Medicare documentation as part of the Centers for Medicare & Medicaid Services' (CMS) Comprehensive Error Rate Testing (CERT) program to measure improper payments in the Medicare fee-for-service (FFS) program.

  • Full-Time, Monday - Friday
  • Two open positions located in Richmond, Virginia

Responsibilities:

  • Review claim documentation and associated medical records related to the CMS CERT program and determine whether Medicare FFS program services qualify for coverage and payment.
  • Assess whether claim documentation and associated medical records complies with Medicare coverage, coding and billing rules.
  • Compare documentation assessments to those of the Medicare contractor who originally reviewed and paid the claims and note which claims are in "error" if they have been incorrectly billed, paid or processed the services.
  • Other duties as assigned
Qualifications
  • Registered Nurse (RN) with an active license
  • Associate's, Diploma or Bachelor's degree in Nursing
  • 5 years of full-time work experience
  • 3 to 5 years of experience in coding
  • At least 2 years of experience in inpatient, acute care coding for Medicare reimbursement and MS-DRG experience
  • Knowledge of standard coding conventions, such as DRGs, ICD-9-CM, HCPS and CPT
  • Knowledge of Payment methodologies and Medicare guidelines
  • Familiarity and understanding of Medicare rules, regulations, policies and procedures
  • Familiar with Microsoft Word, Excel and Outlook
  • Highly-motivated, detail-oriented, quick learner with a professional demeanor
  • Ability to effectively work independently
Additional Information

Catapult Consultants does   not discriminate in practices or employment opportunities on the basis of an   individual's race, color, national or ethnic origin, religion, age, sex,   gender, sexual orientation, marital status, veteran status, disability, or   any other proscribed category set forth in federal or state regulations.

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