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Nuvance/Northwell Health
Poughkeepsie, New York
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St. Luke’s University Health Network
Bethlehem, Pennsylvania
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The Guthrie Clinic
Sayre, Pennsylvania
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St. Luke’s University Health Network
Tamaqua, Pennsylvania
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Carilion Clinic
Roanoke, Virginia
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Prisma Health
Columbia, South Carolina
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Atlantic Health
Freehold, New Jersey
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Prisma Health
Columbia, South Carolina
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The University of Texas Medical Branch
Galveston, Texas
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The University of Texas Medical Branch
Galveston, Texas
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St. Luke’s University Health Network
Palmerton, Pennsylvania
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Atlantic Health
Morristown, New Jersey
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Atlantic Health
Morristown, New Jersey
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University of Minnesota Physicians
Minneapolis, Minnesota
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Atlantic Health
Morristown, New Jersey
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Southern California Permanente Medical Group (Kaiser Permanente)
San Diego, California
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Claims Examiner Senior - Health Plan Admin
DescriptionSummary:The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving complex medical claims in accordance with claims processing guidelines and desktops, as well as, ensuring compliance with federal regulations. 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.Responsibilities:Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.Analyze medical claim information and take appropriate action for payment resolution in accord
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