- AIG (Atlanta, GA)
- Claim Compliance Reviewer Join us as a Claims Compliance Reviewer to make more of your specialist expertise and experience. Make your mark in ... claim adjudication or claim operations experience for multi-line commercial claims . Claim Audit or file review experience...multi-line commercial claims . Claim Audit or file review experience is desirable. + Knowledge of key regulatory… more
- LA Care Health Plan (Los Angeles, CA)
- …This position serves as a liaison between partnering departments ie Payment Integrity and Claims Compliance . This position works to ensure claims are being ... of First Pass /Provider Dispute Resolution (PDR)/Adjustments regulatory guidelines. Strong claims compliance knowledge including turn around time frames for… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will ... claims adjudication, clinical coding reviews for claims , settlement, claims auditing and/or utilization review required + 7+ years experience with… more
- Sedgwick (San Diego, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (Sacramento, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (Syracuse, NY)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (Indianapolis, IN)
- …reviews and analyzes management reports and takes appropriate action. * Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. * Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (West Hills, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (Long Beach, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... over the authority of individual PL Specialists. + Maintains periodic review of claims that are litigated, sensitive, or questionable as determined by the… more
- Kelly Services (Columbia, SC)
- …$13-14.00/hr - Shift: Monday - Friday 8-4:30p Roles and Responsibilities: - Review and adjudicate complex or specialty claims , following organizational policies ... and procedures. - Determine whether to return, deny, or pay claims , ensuring compliance with business/contract regulations and internal standards. - Assist in… more