Claims Review jobs

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Claims Denial & Appeals Specialist
Communicates directly with the payor, resubmits denied claims, underpaid claims and claims that are inaccurately processed by auditing accounts to check on...
Licensed Utilization Review Nurse II (Call Center Nurse) - R...
Review of claim edits, pre-noted inpatient admissions or, episodic outpatient therapy such as physical therapy that is not associated with a continuum of care,...
Medical Billing - Accounts Receivable
Loudoun Medical Group - 16 reviews - Leesburg, VA 20175
Review, process, edit, and approve claims for filing either electronically or on paper. Review accounts receivable and follow up with patients and insurance...
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Medical Document Reviewer

The IMA Group - 5 reviews - Albany, NY 12205
Two years experience with in claims environment as LPN. Review outstanding reports lists, charts pending dictation and charts pending doctor signature again to...

Medical Claims Rep Trainee, New Brighton, MN

Progressive - 1,228 reviews - New Brighton, MN
Our Medical Claims Representative Trainees are crucial to the success of our claims team, analyzing and adjusting medical claims....

Associate Claims Representative

UnitedHealth Group - 5,391 reviews - Duluth, MN 55806  +5 locations
As an Associate Claims Representative , you’ll be responsible for handling incoming healthcare claims ensuring a high level of customer service and maximizing...

Medical Claims Processor

PAI - 4 reviews - Glastonbury, CT 06033
Medical claims processing:. Ability to review and understand payment/account history. Medical Claims Processor for PAI will support customers on the West Coast....
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Claims Representative I/II/III (Hlth & Dntl)

Anthem, Inc. - 2,111 reviews - South Portland, ME
Researches and analyzes claims issues. The Claims Representative has multiple levels; Adjusts voids and reopens claims on-line within guidelines to ensure...

REMOTE OPPORTUNITY - Physician Advisor (LTD and STD Reviews)...

Dane Street - 9 reviews - United States
We provide customized Independent Medical Exam and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the...
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Customer Services Representative I

MetroPlus Health Plan - 57 reviews - New York, NY
$39,084 a year
The primary responsibilities include but are not limited to documenting all customer contacts into the tracking system, process complaints, conduct outreach...

Claim Benefit Specialist

Aetna - 2,218 reviews - Jacksonville, FL 32207 (Spring Park area)  +4 locations
Click here to review the benefits associated with this position. This position will be responsible for processing medical and hospital claims on the ACAS...

Medical Claim Review Nurse RN

Molina Healthcare - 425 reviews - Spokane, WA
1-3 years clinical nursing experience, including 1 year Utilization Review and/or Medical Claims Review experience. Assists with Complex Claim review;...

Claims Representative I/II/III (Health & Dental)

Anthem, Inc. - 2,111 reviews - Midland, GA  +1 location
Researches and analyzes claims issues. The Claims Representative has multiple levels; Adjusts voids and reopens claims on-line within guidelines to ensure...
Orthopedic Claims Resolution Specialist
TSI Healthcare, Inc - Chapel Hill, NC 27517
Review LCD policies. Review denials based on modifiers/diagnoses codes. The Claims Resolution Specialist duties include, but are not limited to:....
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Intern - Warranty & ESP Claims Entry
Pulls parts for RMA review. Reviews sales transactions for warranty eligibility. Submits warranty claims to third party for processing....

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