Document processor • plano 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
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Tyler Technologies is looking for a temporary Revenue Specialist to join our Corporate Finance team! The Revenue Specialist is responsible for accurate processing and invoicing of accounts receivab... 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
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.Col... Show more
As a Wholesale Credit Risk Policy Document Manager within Wholesale Credit Risk, you join the team that's writing and providing independent review and challenge to Wholesale Credit Risk (WCR) docum... Show more
Cancellation Administrative Specialist.Position: Cancellation Administrative Specialist.Job Title: Cancellation Processor - Department: Contract Administration.Pay Grade: Overtime Eligibility: Non-... Show more
Thank you for your interest in our company! To apply, click on the button above.You will be required to create an account (or sign in with an existing account).Your account will provide you access ... Show more
Senior Associate, Travel & Expense - Contract-to-Hire A/P Analyst.Our client, located in Irving, is seeking a Senior Associate of Travel & Expense to join their team on a contract-to-hire basis.Rol... Show more
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The Document Specialist will be assigned to one or more projects.The Document Specialist must have an understanding of right-of-way projects and solar operations, timelines, and project requirement... Show more
About the role We are hiring expert Evaluators in **Document/deck production QA** to review and assess AI-generated work products (documents, spreadsheets, and slide decks) for accuracy, rigor, and... Show more
The average salary range is between $ 29,738 and $ 48,750 year , with the average salary hovering around $ 35,000 year .
The average salary range is between $ 29,231 and $ 46,067 year , with the average salary hovering around $ 33,150 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.
