Processor • allen tx
Summary Of Position: Under the guidance and direction of the Team Leader (Claims Supervisor), the primary role of a Senior Claims Examiner is that of a superior claims processor with a thorough kno... Show more
At TJX Companies, every day brings new opportunities for growth, exploration, and achievement.You’ll be part of our vibrant team that embraces diversity, fosters collaboration, and prioritizes your... Show more
Analyzing and processing provider transactions in accordance with plan provisions.Should follow the policy and procedure which is defined by the customer.Established working knowledge and applicati... Show more
Are you ready to go uP?  We are named in Top Workplaces NYC for 2024 We are one of the winners of USPAACC’s Fast 100 Asian American Business awards We are recognized as one of the Top 50... Show more
Originate portfolio loans, secondary market conventional, FHA, VA and RD loans which are compliant with investor requirements and all State and Federal laws and regulations; Promote Bank products a... Show more
Job Description/h2pCome join our amazing team!/ppResponsible for developing and maintaining broker/seller relationships to sell wholesale and correspondent mortgage loan products.Calls on potential... Show more
TEMP BPO Senior Representative.Analyzing and processing provider transactions in accordance with plan provisions.Should follow the policy and procedure which is defined by the customer.Established ... Show more
The primary purpose of this employee is to assist CUTX in living out its vision to deliver an unexpected experience.To achieve this goal, the employee must provide outstanding service to both inter... Show more
Benchmark holds knowledge, growth, and efficiency as pillars of our Excellence Core Value.The Senior Processor demonstrates these attributes in the mortgage loan process for our Mortgage-as-a-Servi... Show more
Senior Strategic Growth And Execution Associate.Unleash your expertise in product development and optimization by leveraging user research, analyzing metrics, and collaborating across one of the wo... Show more
Pay: $16/hour- Please note this pay rate may be below your state's minimum wage.Please take this into consideration when applying.Monday Friday | Scheduled start times may vary between 3:00 AM 6:... Show more
Go Up With Universal Processing.Are you ready to go uP? We are named in Top Workplaces NYC for 2024.We are one of the winners of USPAACC's Fast 100 Asian American Business awards.We are recognized ... Show more
Our mission is to establish long-term, mutually beneficial financial relationships with our clients, team members, and community.Recruit, reward, and retain a team of market leading professionals.C... Show more
Associate Relationship Manager.You are a strategic thinker, passionate about delivering solutions to clients, and have experience in relationship management.As an Associate Relationship Manager wit... Show more
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clien... Show more
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clien... Show more
Come join Payroll Tax Operations (PTO) as a payroll tax professional responsible for the accurate and timely resolution of payroll tax issues across Notices, Corrections, Amendments, and Pay & File... Show more
The Snappy Salads Shift Leader is enthusiastic and passionate about providing guests with the best hospitality experience possible.This position is accountable for opening and closing the restauran... Show more
Under the direction of the Branch and/or Production Manager, markets and promotes Highland Home Loan's products and services to its client base of realtors, builders, bank officers and potential an... Show more
Under the direction of the Branch and/or Production Manager, markets and promotes PrimeLending products and services to its client base of realtors, builders, bank officers and potential and past c... Show more
The average salary range is between $ 31,200 and $ 47,840 year , with the average salary hovering around $ 34,418 year .
The average salary range is between $ 29,250 and $ 53,648 year , with the average salary hovering around $ 35,100 year .
Summary Of Position: Under the guidance and direction of the Team Leader (Claims Supervisor), the primary role of a Senior Claims Examiner is that of a superior claims processor with a thorough knowledge of all claims processing systems, claim processing rules and medical policy. The successful candidate will also possess analytical skills to aid in research and resolution of Adjustment inquiries and/or correspondences. The incumbent will also possess a cooperative spirit that will lead to information sharing with the goal of enhancing the overall performance of the Department.
Major Duties And Responsibilities: Proficient in the use of all claim related systems, including Claims Processing System, Claims Workflow, Claims Pricing system, Claims processing rules and Desk Level procedures. Interpret and apply applicable processing guidelines while interacting with on-line system edits/pends. Research written and/or verbal queries from providers/members/internal departments to determine appropriate action on claim and process corrections as required. Analyze patient and medical information to identify instances where investigation for determining appropriate Claim Benefits, Pricing, Prior Authorization or Coordination of Benefits is necessary and process claims accordingly. Adjudicate all claim types, including professional and facility for all lines of business. Process voids and adjustments as required. Meet and maintain individual and departmental productivity and quality standards. Review and release high dollar claims or other complex claims adjudicated by less senior examiners as directed by the Team Leader (Claims Supervisor). Review reports and research pended claims to ensure timely adjudication within accepted corporate cycle times. Reports include, but are not limited to, daily hot and pend reports, weekly cumulative pend, and other special reports as received from customer. Identify, based on review and research of pend reports, and inform.
Job Location: USTXPAOC01 Plano - TX USA, CLT Alternate.
){kind=logo}
