Insurance Claims Adjuster Jobs

Description In the business world, the ability to identify and forecast financial situations is indispensable. The Senior Financial Analytics Professional ensures Humana's profitability and financial security by analyzing and reporting on ..

... 2 conducts reviews on pharmacy claims to assess for recoveries. The ... of action. Responsibilities The Pharmacy Claims Professional 2 analyzes and answers ... and answers inquiries regarding pharmacy..

... contract is responsible for processing claims for more than 6 million ... than 6 million members, the claims processing and financial management functions ... to an external vendor. The..

Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..

Description The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of ..

Description The Senior Pharmacy Claims Professional oversees processes and ensures ... coordination of benefits (COB) adjudicated claims. The Senior Pharmacy Claims Professional work assignments involve moderately ... factors. Responsibilities The..

Description The Claims Review Representative 4 (formerly Team ... based on strong knowledge of claims procedures, contract provisions, and state ... state and federal legislation. The Claims Review Representative 4..

Job Information Humana Pharmacy Desktop Auditor (Claims Professional 2) in Cincinnati Ohio Description The Humana Pharmacy Solutions traditional Desktop Audit team oversees and manages multiple aspects related to reviewing pharmacy claim ..

... member of the Field Property Claims Team, you will play a ... resolve a variety of homeowner claims in a fast paced, detail-oriented, ... challenge, as our Field Property..

Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..

Description The Manager, Fraud and Waste, Genetic Counseling provides clinical support for investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works within specific guidelines ..

Description The Pharmacy Claims Professional 2 is responsible for ... maintaining guidelines. Responsibilities The Pharmacy Claims Professional 2 analyzes and answers ... and answers inquiries regarding pharmacy claims adjudication, including..

Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..

Description The Claims Review Representative 3 makes appropriate ... based on strong knowledge of claims procedures, contract provisions, and state ... state and federal legislation. The Claims Review Representative 3..

... specific problems related to systems, claims, networks, providers, eligibility, billing, collections, ... issues which the majority are claims issues. Understands department, segment, and ... 5 years of group health..

Description The Claims Processing Representative 2 reviews and ... and adjudicates complex or specialty claims, submitted either via paper or ... via paper or electronically. The Claims Processing Representative 2..

Job Information Humana Insurance Product Management Representative 2 in ... in Cincinnati Ohio Description The Insurance Product Management Representative 2 Manages ... Product Management Representative 2 Manages insurance product offerings..

Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..

Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..

Description The Pharmacy Claims Professional 2 monitors and ensures ... ensures appropriate adjudication of pharmacy claims. The Pharmacy Claims Professional 2 work assignments are ... of action. Responsibilities The Pharmacy..

Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..

Job Information Humana Medical Claims Processing Representative 2 in Cincinnati ... Cincinnati Ohio Description The Medical Claims Processing Representative 2 reviews and ... and adjudicates complex or specialty claims, submitted..

Job Information Humana Pharmacy Claims Specialist, Remote in Cincinnati Ohio ... Cincinnati Ohio Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy..