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The Workers' Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel.
This is a remote role; candidates must reside in New Mexico and have an active adjuster license in the state.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
* Receives Workers' Compensation claims...

An exciting opportunity exists to join the ProAssurance family of companies!
Our mission is powerful and simple: We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance?
At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, l...

POSITION SUMMARY
The Medical Claim Processor (RRT Analyst) is responsible for reviewing, analyzing, and adjusting medical claims to ensure accurate processing in accordance with regulatory requirements, payer policies, and internal guidelines. This role involves investigating claim discrepancies, validating benefit coverage, correcting errors, and communicating with providers, members, and int...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one pe...

The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health servi...

The salary range for this job posting is $49,225.00 - $78,759.00 annually + bonus + benefits. Pay Type: Salary
The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information a...

Crum & Forster Company Overview
Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recogniz...

Location:
Work from home (Pennsylvania)
Shift:
Days (United States of America)
Scheduled Weekly Hours:
40
Worker Type:
Regular
Exemption Status:
No
Job Summary:
Contributes to the achievement of the strategic and financial goals of the organization by conducting thorough reviews of billed services, authorizations, plan benefit documents, itemized statements, medical records, discharge summaries...

Job Description
Position: Medical Billing Specialist
Location: Remote / On-site
Department: Revenue Cycle Management
Overview:
CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools that enhance medical billing workflows. The ideal candidate will have expe...

Job Description
Business Analyst (Policy remediation)
Location: Remote
Interview Process: 1 round, virtual
Duration: 12 MonthsEmployment Type: ContractExperience Required: 05+ Years
Candidate Location: Candidate MUST be a SC resident. No relocation allowed.
Project Scope:
We are seeking an experienced Business Analyst with expertise in policy remediation, medical coding, and healthcare claims ...

Job Description
JOB DESCRIPTION Job Summary
Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).
Essential Job Duties
• Facilitates comprehensive research a...

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here.
Job Summary
The Claims Specialist resolves medical claims that are not automatically adjudicated by the claims processing system in a timely and accurate manner according to divisional standards of quality and productivity. Resolution may include additional investigation or communication in order to obt...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one pe...

Job Description
JOB DESCRIPTION Job Summary
Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).
Essential Job Duties
• Facilitates comprehensive research a...

Job Description
JOB DESCRIPTION Job Summary
Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).
Essential Job Duties
• Facilitates comprehensive research a...

The salary range for this job posting is $55,132.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary
The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information ...

Salary: $75,940.00 - $91,000.00 Annually
Location : Wauwatosa, WI
Job Type: Full-Time
Remote Employment: Remote Optional
Job Number: 20265
Department: Claims
Division: Worker's Compensation
Opening Date: 04/14/2026
Closing Date: 5/8/2026 5:00 PM Central
FLSA: Exempt
Bargaining Unit: N/A
Department: Worker's Compensation
Summary of Job
SERVICE FIRST. INSURANCE ALWAYS.
Under the general supervis...

At WelbeHealth, we serve our communities' most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and our participant-focus lead the way no matter what.
The Claims Audit Specialist is accountable for ensuring the timely and accurate payment or denial of claims while meeting federal/state regulations, provider agreement terms, and company p...

Pay: $21.56 - $24.57 per hour
Job description:
We are seeking a highly organized and detail-oriented Revenue Cycle Specialist to manage the full lifecycle of healthcare claims-from documentation review and coding to claim submission, denial management, and payment reconciliation.
The ideal candidate has strong experience with Medicaid billing, ICD/CPT coding, claim documentation, and resolving ...

Job Description
The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, per diem, case rate etc.) and adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance issues as they relate to claims processing and ability to identify and address non-contracted providers.
Pro...