Claims Examiner - Washington

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected.We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. · ...

Evaluate incoming claims to determine eligibility, coverage and validity conduct thorough investigations including reviewing medical records and other relevant documentation analyze policy provisions and contractual agreements to assess claim validity utilize claims management sy ...

The Claims Examiner Lead works under the direction of the Claims Examiner Supervisor to manage the daily operations of the Claims Examiner team. · ...

The Claims Examiner II is an intermediate level position responsible for the timely review investigation and adjudication of all types of Medicaid Medicare group and individual medical dental and mental health claims. · Essential Responsibilities include:Adjudicate medical dental ...

The Claims Examiner II is an intermediate level position responsible for the timely review, investigation and adjudication of all types of Medicaid, · Medicare, group and individual medical, dental, and mental health claims.CareOregon offers a strong Total Rewards Program with co ...

+Job summary · The Claims Examiner Lead works under the direction of the Claims Examiner Supervisor to manage the daily operations of the Claims Examiner team.This position is responsible for assisting with work distribution, individual performance tracking, and measuring compete ...

The Claims Examiner II is an intermediate level position responsible for the timely review, investigation and adjudication of all types of Medicaid, Medicare, group and individual medical, dental, and mental health claims. · ...

The Claims Examiner II is an intermediate level position responsible for the timely review, investigation and adjudication of all types of Medicaid, Medicare, group and individual medical, dental, and mental health claims. · ...

This position is located in the Office of Unemployment Compensation, Department of Employment Services (DOES). The position provides for the collection and analysis of necessary data to assess the effectiveness of key program areas within the Unemployment Compensation Program.Rev ...

At least · 4 years of experience, · Reviewing and resolving disputes or claims-related issues ,Evaluation of medical evidence, · billing and treatment plans · Insurance claims (e.g., workers' compensation , liability , auto etc.) · Benefits ...

+Analyzes complex workers' compensation claims.+Manages claims through action plans to resolution.+Negotiates settlements within designated authority.++Calculates reserves.++Pays benefits due,+approves claim payments,+and settles claims within designated authority level.+Responsi ...

This is an opportunity for an experienced Claims Examiner to join a prestigious healthcare company. The role involves reviewing disputes and appeals for professional and hospital claims. · Reviews providers' disputes and appeals for professional and hospital claims to determine r ...

Job summary · This position is located in the D.C. Department of Employment Services (DOES), Office of Paid Family Leave (OPFL), Validations Unit. The mission of the Office of Paid Family Leave is to plan, develop and administer paid leave program for the District of Columbia und ...

WC Claims Examiner - Hybrid Schedule - Dedicated Client/MD Jurisdiction. · Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; · Negotiates settlement of claims wit ...

We are seeking an experienced Medical Claims Examiner in the Annapolis area for a great career opportunity with a prestigious national healthcare company. · This is an in-house role with real advancement opportunities. · ...

Investigate and settle advanced large loss complex claims promptly and equitably under minimal supervision within established authority on moderate-to-difficult claims reviews coverages determines liability and compensability secures information arranges property damage appraisal ...

Support cradle-to-grave acquisition actions including terminations, cost/price evaluations, and contract closeout. · Process and examine vouchers for federal payments. · Review invoices and IPAC claims. · Validate compliance with award terms. · ...

Serves as an entry level professional who develops baseline plans for ensuring the integrity and accuracy of claims processes and protocols. · ...

This position is in the Medicaid Fraud Control Unit (MFCU) within the District of Columbia Office of the Inspector General (OIG). The MFCU is a Unit responsible for investigating and prosecuting cases involving healthcare fraud by providers in the District Medicaid program and ab ...

Litigated Claims Consultant (Examiner) | Public Entity | Remote. Enjoy flexibility - This role is open to a work-at-home, remote, telecommuter setting in Ohio with some travel required. · ...