Jobs 1 - 10 out of 10 for Medical Claims Processor

Manage claims across multiple groups with accuracy and speed, process CMS-1500 and UB-04 claims, accurately handle high-dollar claims, work with JAA/BlueCard claims, interpret group SPD’s and apply benefits appropriately, perform zero-dollar adjustments and review flagged claims, maintain accurate r...

Process and adjudicate healthcare claims, primarily Medicare and DSNP, within a managed care environment. Review, adjudicate, and reprocess claims accurately, handle disputes and appeals, apply benefits and coding edits, ensure compliance with regulations, and collaborate with internal teams.

Ensure accurate and thoughtful handling of medical claims, serving members, clients, providers, and internal operations teams. Responsible for resolving issues and protecting member trust, while directly impacting families' healthcare navigation.

Process professional claim forms filed by providers, review policies and benefits, comply with HIPAA regulations, research and act on claims, prioritize work, adjudicate claims per client guidelines, maintain quality scores, and respond to claims received via email.

Responsible for utilizing resources efficiently for the accurate and timely entry, review, and resolution of simple to moderately complex medical claims in accordance with policies, procedures, and guidelines. Enter claims data into the system while interpreting coding and understanding medical term...

Verify insurance coverage for new and existing patients, conduct research, resolve coverage-related issues, and ensure timely and accurate prescription processing. Document findings and decisions, meet productivity expectations, and support patients requiring specialty therapies.

Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house. Monitor rejected claim reports and adjust claims for resubmission. Download insurance carrier explanation of payments (EOPs) to post claim payments and denials. D...

Process professional claim forms filed by providers, review policies and benefits, comply with HIPAA regulations, research and act on claims, prioritize work, adjudicate claims per guidelines, maintain quality scores, and respond to claims received via email.

Process Professional and Hospital claim forms, review policies and benefits, comply with HIPAA regulations, research and act on claims, prioritize work, adjudicate claims per guidelines, maintain quality scores, and respond to claims via email.

Hiring multiple Claims Technicians for temporary to hire opportunities. Responsibilities include processing medical claims accurately and efficiently.