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Summary of essential job functions: Fraud Mitigation: Monitor, investigate, and resolve complex fraud alerts across all banking channels, including checks, ACH, deposit accounts, debit cards, wires, and Zelle. You will protect the bank and our customers by leading complex fraud investigations, providing guidance on high-risk activity, and ensuring adherence to regulatory requirements and internal controls.

YEAR

First Virginia Community Bank (FVCbank)

Fraud Analyst

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Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally): Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms. X Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.

TRISTAR Insurance Group, Inc

Claims Assistant - Workers compensation

Minimum of three (3) years experience in healthcare coding directly related to determining appropriate diagnosis, procedure and other codes used in billing for services, utilization management, medical record auditing, or health care quality improvement. Duties and Responsibilities: Responsibilities include, but are not limited to: Plan and perform audits and investigations focused on detecting and preventing fraud waste and abuse utilizing knowledge of CPT, ICD, HCPS coding guidelines and regulations, benefit coverage, clinical medical and payment policies.

Neighborhood's employees come from a diverse background but all are committed to creating a more equitable health care system. Our array of experiences allows us to have a broad perspective and great creativity in facing whatever challenges arise. Unlike many other health insurance companies, we have nearly 30 nurses and social workers on staff. This structure speaks to our focus on active and compassionate care management for our members; we know that people who are alienated from the health care system require additional advocacy, outreach and support. 

Neighborhood offers an exceptional compensation package to employees. We annually review base salaries/benefits and adjust as appropriate.

Neighborhood Health Plan of Rhode Island

RN Clinical Auditor (44947)

FULL_TIME

West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity.

West Bend Insurance Company

Manager – Special Investigations Unit

[AW]-iCims

Preferred Candidates will possess some of the below attributes: Preference may be given to applicants with one of the following certifications: Certified Public Accountant (CPA), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), Certified Information Systems Auditor (CISA), or Certified Management Accountant (CMA). The Auditor's Office also examines the financial books kept by the other county officials to see that accurate and complete records are maintained.

Utah County, UT

Staff Internal Auditor

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GDIT's Federal Health Division is hiring a Healthcare Coding Expert to support the Centers for Medicare and Medicaid (CMS), you will be trusted to identify trends in the data and create leads and referrals for the Healthcare Fraud Prevention Partnership (HFPP) members (Partner) and the Trusted Third Party (TTP). To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available.

General Dynamics Information Technology solves our customers’ challenges through future-focused technology and services, ingenuity and deep mission-knowledge. Partnering with government, defense, the intelligence community, industry leaders and cutting-edge technology companies, we deliver solutions that make a difference – helping our customers to advance mission performance, transform operations and discover opportunities to build a better future.

 Headquartered in Fairfax, Va., with major offices worldwide, General Dynamics IT and General Dynamics Mission Systems form the Information Systems and Technology (IS&T) business group of General Dynamics. IS&T and the Aerospace, Combat Systems and Marine Systems groups form General Dynamics Corp.

General Dynamics Information Technology

Healthcare Coding Expert (certified professional coder)

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As a Claims Examiner at Allianz Partners, you'll help customers navigate important moments with clarity and care-backed by the resources of a global industry leader. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.

HOUR

Allianz SE

Claims Examiner

ADAPTED_NOW

Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management. This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing.

In 1999, two historic Catholic charities became one, forming CHRISTUS Health and creating a unique purpose in the modern health care market - to take better care of people. To extend the healing ministry of Jesus Christ, the mission that the Sisters of Charity Health Care system and Incarnate Word Health system shared for more than a century, is now also the mission of CHRISTUS Health. Ranked among the top 10 Catholic health systems in the United States by size, the CHRISTUS Health system includes more than 40 hospitals and facilities in seven U.S. states, Chile and six states in Mexico, with assets of more than $4.6 billion. Whether seeking care in Alexandria Louisiana, or Coahuila, Mexico, patients discover that the healing spirit is alive at CHRISTUS Health.

CHRISTUS Health

Claims Examiner Senior - Health Plan Admin

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Jobot

Software Patent Prosecution Attorney

Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. Attorneys and staff work alongside accomplished professionals on complex, meaningful matters in an environment that values teamwork, professional growth, community involvement, and long-term careers.

Patent Prosecution Attorney

We’re in search of highly motivated Casualty Claims Examiners with prior casualty and bodily injury experience, in private passenger automotive liability claims, looking to help deliver world-class service to our clients. Negotiate claims settlements for evaluated damages with insureds, claimants and/or attorneys as assigned from letter of representation through settlement or verdict.

We know you know GEICO, but we want you to know that with us, you’ll find a rewarding career no matter which path you take. Our over 37,000 associates have been unexpectedly delighted to find that their jobs have turned into successful, illuminating careers. You know us for insurance. Get to know us for careers, too. Visit us at http://www.geico.jobs for more!

GEICO

Casualty Claims Examiner

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Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. #insurancecareers #insurancejobs #claimsexaminer #WorkersCompClaims #WorkersCompensationClaims #paralegalcareers.

AIG and its member companies form one of the world’s leading insurance organizations. We provide insurance for businesses and individuals, helping individual customers plan for their futures by offering life insurance, travel insurance, product warranty, auto insurance and retirement products. Our commercial clients have come to rely upon our risk expertise and financial strength to help them address some of their most complex challenges – from huge construction projects to protecting themselves from the emerging threats to data security. We offer our people the chance to grow in a dynamic company that values teamwork, fresh perspectives, and a commitment to helping their clients.

American International Group

Senior Workers' Compensation Claims Examiner - Federal Claims

The role requires sound judgment when handling confidential information, strong customer service skills, and the ability to manage multiple claims while meeting deadlines. This includes new claims, reviewing information for accuracy, determining eligibility, calculating benefit payments, and following up on required documentation.

Remedy Intelligent Staffing

TDI Claims Examiner

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GD Information Technology

Investigation and overpayment administration: Facilitate claims investigation, negotiate settlements, interpret medical records, respond to Department of Insurance complaints, and authorize payment to claimants and providers. Overpayment reviews and recovery of claims overpayment; corrected financial histories of patients and service providers to ensure accurate records.

Guide Well

Claims Examiner I

We're in search of highly motivated Casualty Claims Examiners with prior casualty and bodily injury experience, in private passenger automotive liability claims, looking to help deliver world-class service to our clients. Negotiate claims settlements for evaluated damages with insureds, claimants and/or attorneys as assigned from letter of representation through settlement or verdict.

GEICO GENERAL INSURANCE COMPANY

The Casualty Claims Examiner will work alongside claims management, providing direction and oversight ensuring that compliance with best practices and state/local guidelines. Management reserves the right to add to, modify, or change the work assignments of the position as business needs dictate.

AssuranceAmerica Corporation

Manager - Special Investigations Unit

Responsibilities: Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.

Iconma LLC

Claims Examiner - Workers Compensation (Hourly)

The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants. Researches all complex claims, disputes and appeals thoroughly to make accurate payment decisions in a timely manner with input from the Claims Analysts for quality assurance.

Claims Examiner Jobs in the United States

Fraud Analyst First Virginia Community Bank (FVCbank)

Claims Assistant - Workers compensation TRISTAR Insurance Group, Inc

RN Clinical Auditor (44947) Neighborhood Health Plan of Rhode Island

Manager – Special Investigations Unit West Bend Insurance Company

Staff Internal Auditor Utah County, UT

Healthcare Coding Expert (certified professional coder) General Dynamics Information Technology

Claims Examiner Allianz SE

Claims Examiner Senior - Health Plan Admin CHRISTUS Health

Software Patent Prosecution Attorney Jobot

Patent Prosecution Attorney Jobot

Casualty Claims Examiner GEICO

Senior Workers' Compensation Claims Examiner - Federal Claims American International Group

TDI Claims Examiner Remedy Intelligent Staffing

Healthcare Coding Expert (certified professional coder) GD Information Technology

Claims Examiner I Guide Well

Casualty Claims Examiner GEICO GENERAL INSURANCE COMPANY

Casualty Claims Examiner AssuranceAmerica Corporation

Manager - Special Investigations Unit West Bend Insurance Company

Claims Examiner - Workers Compensation (Hourly) Iconma LLC

Claims Examiner South Florida Community Care Network

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