105 claims jobs found in Phoenix, AZ

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing  your life's best work.SM As member of the C&S UAT/Test Team, the Claims Business Process Technician will develop enhanced automation test opportunities and create & maintain test suites utilizing test automation applications.  You will work closely with our test team, technology & business partners to flawlessly deliver on test plans, & quality expectations, as it relates to the Claims End to End process on CSP Facets & surrounding systems.  This role should have a strong understanding of claims end to end system functionality as well as the up and down stream applications. These roles include, but are...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) Join the Claims team as a Software Engineer focusing on Full Stack. The team is responsible for developing, maintaining, enhancing and setting a high-quality bar for web and mobile apps which assists end users in taking control of their healthcare claims and benefits. The team has a strong and integrated relationship with the product team based on strong collaboration, trust and partnership.  Goals for the team are focused on creating meaningful positive impact for our customers through clear and measurable metrics analysis....

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Facilitate end to end management of external and internal client audits of pharmacy benefits and pricing Gather PBM plan documentation from internal teams to provide to external audit firm  Read and interpret plan design documents and PBM service agreements...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)   Join the Claims team as a Software Engineer focusing on Backend. The team is responsible for developing, maintaining, enhancing and setting a high-quality bar for web and mobile apps which assists end users in taking control of their healthcare claims and benefits. The team has a strong and integrated relationship with the product team based on strong collaboration, trust and partnership.  Goals for the team are focused on creating meaningful positive impact for our customers through clear and measurable metrics analysis. As a...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing  your life's best work.SM As member of the C&S UAT/Test Team, the Claims Business Process Technician will develop enhanced automation test opportunities and create & maintain test suites utilizing test automation applications.  You will work closely with our test team, technology & business partners to flawlessly deliver on test plans, & quality expectations, as it relates to the Claims End to End process on CSP Facets & surrounding systems.  This role should have a strong understanding of claims end to end system functionality as well as the up and down stream applications. These roles include, but...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) This position is responsible for the testing of system changes as it relates to claim processing, fee schedule updates, contract modifications, enrollment, premium billing, employer group, reconciliation and fulfillment within the Facets system. This position may be involved in day-to-day work as it relates to creating and executing test cases and on large scale initiatives. You’ll enjoy the flexibility to...

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve  your life’s best work.(sm) This is an opportunity that's all about where you've been. Your experience. Your potential. Your skills. Because on the team at UnitedHealth Group, your potential and your impact can be career changing. No company has put together better teams of passionate, energetic and all out brilliant Claims Representatives. This is where you come in. We'll look for your experience and expertise to help keep our service levels and accuracy extremely high. We'll also look for your ideas on how to constantly evolve our claims processes. We'll back you with the great training, support and opportunities you'd expect from a Fortune 5 leader. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.  Primary...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) This position is responsible for the testing of system changes as it relates to claim processing, fee schedule updates, contract modifications, enrollment, premium billing, employer group, reconciliation and fulfillment within the Facets system. This position may be involved in day-to-day work as it relates to creating and executing test cases and on large scale initiatives. You’ll enjoy the flexibility to...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work . SM Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing, and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary. This position is full-time. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends. *All Telecommuters will be...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) This position is responsible for the testing of system changes as it relates to claim processing, fee schedule updates, contract modifications, enrollment, premium billing, employer group, reconciliation and fulfillment within the Facets system. This position may be involved in day-to-day work as it relates to creating and executing test cases and on large scale initiatives. You’ll enjoy the flexibility to...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. This is an opportunity that’s all about where you’ve been. Your experience. Your potential. Your skills. Because on the team at UnitedHealth Group , your potential and your impact can be career changing. No company has put together better teams of passionate, energetic and all out brilliant Claims Representatives. This is where you come in. We’ll look for your experience and expertise to help keep our service levels and accuracy extremely high. We’ll also look for your ideas on how to constantly evolve our claims processes. We’ll back you with the great training, support and opportunities you’d expect from a Fortune 5 company leader. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm). It may be necessary, given the...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work . SM This position is full - time. Employees are required to work our normal business hours of 7:00 AM - 5:00 PM. It may be necessary, given the business need, to work occasional overtime. We offer 6 - 12 months of training.  Training will be conducted virtually from your home. *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Primary Responsibilities: Supervise, monitor, and track team’s productivity, schedule adherence, and quality results Serve as first point of escalation for staff on procedural and technical issues; and coach staff...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to...

ESIS recognizes each risk management program is unique, and we are committed to providing consultative and innovative solutions to drive superior results for your program. Our culture and vision enables us to effectively operate as an extension of your risk management program, aligning combined goals to form a collaborative partnership. We recognize our clients’ desire to do things differently, and we are confident that our integrated approach will deliver better overall results for your program. ESIS’ specialized claim intervention strategy integrates an effective deployment of resources and appropriate actions, which are essential to your program’s success ESIS, Inc. (ESIS) provides sophisticated risk management services designed to reduce claims frequency and loss costs. ESIS, the Risk Management Services Company of Chubb, provides claims, risk control & loss information systems to Fortune 1000 accounts. ESIS employs more than 1,500 professionals in nine regional...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary: Investigates, evaluates, disposes and settles less complex claims with moderate supervision and includes the investigation, determination and evaluation of coverage, liability and damages and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $5,000 liability and/or $10,000 workers compensation or greater. Key Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure to determine the proper course of action and to appropriately settle the claim. Interacts extensively...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Primary Purpose: Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. Claims involved are usually subject to standardized procedures which lead to a settlement with limited exercise of discretion. Claims involved occasionally require analysis and may require research to resolve coverage and/or damage issues. There is supervisory review of ongoing progress and results of work. There is more focused supervision on all complex files. Essential Duties and Responsibilities: Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. Receive claim assignments and verify/investigate coverage and document all appropriate information before Manager is involved with review of claims to ensure they are commensurate with ability Establish an investigative plan;...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) The Manager, BH Claims Oversight supports the VACCN Contract and is accountable for oversight of BH and Medical claim processing functions, providing expertise or general claims support, conducts research to resolve claims issues and collaborates with our claims business partner to identify trends along with implementing solutions.   You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.  Primary Responsibilities: Research, identify and obtain data/information needed...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the...