Processor • garland 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 My Funded Futures, we're transforming the world of proprietary trading by giving traders the capital, tools, and community they need to succeed.We blend innovation, transparency, and performance... Show more
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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
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Green Brick Mortgage is looking for a detail-oriented loan processor to join our team in Plano, TX.As a loan processor, you will be responsible for preparing and organizing loan files, ensuring all... Show more
About the Role Mercor is building realistic, high-fidelity simulated environments to evaluate and train AI models on real-world procurement workflows for a leading spend-management technology compa... Show more
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We are seeking an experienced and detail-oriented Loan Processor to manage and support a variety of consumer real estate loan products from application through funding.This role is responsible for ... Show more
Quality Control Specialist - Quality Control Department .DebtBlue, LLC is a fast‑growing debt settlement organization committed to helping individuals and families regain financial stability.W... Show more
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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
This role is intended for Hindi / Urdu fluent speakers.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... Show more
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General Accounting Data Processor (Accounts Receivable & Accounts Payable).Headquartered in Englewood Cliffs, N.Samsung Electronics America, Inc.Sales and Marketing subsidiary, is a leader in mobil... Show more
The average salary range is between $ 27,300 and $ 68,750 year , with the average salary hovering around $ 33,280 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.
