At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary Under Supervision, This Position Is

Review, process and identify medical claims based on standard operating procedures on CPS Apply appropriate processes and procedures to process claims (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates) Review and apply member benefit plans and provider contracts, Pricing, CM

Accurately process professional claims. Responsible for editing and adjusting of claims per the EDI daily audit report. Analyze and adjudicate claims to ensure accurate payment Interpret Fee for Service (FFS) and capitated provider contracts Review claims on a periodic basis Meet Department Quality of 98.50% or better on a weekly and monthly basis. Meet production standar

A Customer Service Professional position requiring creativity, empathy, interpersonal skills and a strong desire to assist customers. Provides prompt claim investigation, evaluation and settlement or denial of claims with minor to severe exposures. Provides empathy and understanding and explains policy coverages and claims processes to customers. Authorizes payments in acc

Credit Acceptance is proud to be an award winning company with local and national workplace recognition in multiple categories! Our world class culture is shaped by dedicated Team Members who share a drive to succeed as professionals and together as a company. A great product, amazing people and our stable financial history have made us one of the largest used car finance

Responsible for meeting individual sales goals and new business targets and providing comprehensive service and/or solicitation activities on accounts. ESSENTIAL DUTIES AND RESPONSIBILITIES Identifies new leads and gathers the necessary information for submissions; Gathers necessary information; develops, delivers and sells new business and renewal proposals; Performs per

OPENTEXT OpenText is a global leader in information management, where innovation, creativity, and collaboration are the key components of our corporate culture. As a member of our team, you will have the opportunity to partner with the most highly regarded companies in the world, tackle complex issues, and contribute to projects that shape the future of digital transforma

GetToKnow Us! WebTPA, a GuideWell Company, is a healthcare third party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans. What is your impact? As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim co

Preparing, processing, and maintaining enrollment forms in accordance with Payer rules and internal processing metrics/SLAs. Analyzes problems with failed/rejected enrollment forms. Correspondence with customers and Payers to verify enrollment form status. Assist customers with Enrollment tools/access/self service capabilities. Initiate changes to increase or change workf

Self motivated, organized, and have a strong entrepreneurial spirit Recruit producers from all 50 states using our state of the art technology and marketing support Handle incoming and outgoing calls, gather and verify required information, answer questions and provide producers with product and marketing advice Provide presale assistance including case design, product se

Claims Program Manager, Medical Stop Loss (Remote or Eatontown, NJ) Job Locations US NJ EATONTOWN | US NJ Remote | US FL Remote | US TX Remote Job ID 2023 3471 Category Claims Type Regular Division A&H Crum & Forster Company Overview Crum & Forster (C&F) Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance p

OPENTEXT OpenText is a global leader in information management, where innovation, creativity, and collaboration are the key components of our corporate culture. As a member of our team, you will have the opportunity to partner with the most highly regarded companies in the world, tackle complex issues, and contribute to projects that shape the future of digital transforma

Why Orthofix? We are a leading global spine and orthopedics company with a premier portfolio of biologics, innovative spinal hardware, bone growth therapies, specialized orthopedic solutions and a leading surgical navigation system. Our combined company is over 1,600 strong, with products distributed in 68 countries worldwide and a global R&D, commercial and manufacturing

Why Orthofix? We are a leading global spine and orthopedics company with a premier portfolio of biologics, innovative spinal hardware, bone growth therapies, specialized orthopedic solutions and a leading surgical navigation system. Our combined company is over 1,600 strong, with products distributed in 68 countries worldwide and a global R&D, commercial and manufacturing

The UNT System Human Resources Department is one department made of a team of teams that supports various constituencies and component institutions within our UNT System Enterprise while working together to achieve the vision of becoming an enterprise that is values driven and customer focused with an emphasis on excellence, curiosity, and innovation. There are exciting t