- The Cigna Group (Bloomfield, CT)
- …external customers. He/she will serve as a clinical educator and consultant to utilization management, case management, network, contracting, pharmacy, and service ... operations ( claims ). This is an entry to mid-level position for...benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and… more
- Prime Therapeutics (Hartford, CT)
- …meeting established financial targets. The Underwriter will serve as a consultant on matters pertaining to both financial and operational performance guarantees, ... Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims data +… more
- CVS Health (Hartford, CT)
- …Expertise** + Provide strategic oversight on healthcare insurance processes, including claims , eligibility, and compliance with HIPAA, HITECH, MACRA, and other ... Exceptional communication, negotiation, and stakeholder management skills + Salesforce Consultant Certification (Service Cloud and/or Health Cloud) preferred **Education**… more
- Weston & Sampson (Rocky Hill, CT)
- …documents and construction management requirements. + With municipality involvement, negotiate claims for extra work/change orders. + Maintain, liaison and attend ... provide coordination and assistance related to other requirements; supervise subordinate consultant staff and survey crew as appropriate. + Some overtime and… more
- Deloitte (Stamford, CT)
- …Business Tax Services Insurance practice. What you'll do As an Insurance Tax Senior Consultant within the Business Tax Services group, you will be a valuable member ... to clients in the insurance industry across business functions such as underwriting, claims , IT, finance and accounting + Coordinating with the client's tax and… more
- Amgen (Hartford, CT)
- …needs and goals to other Amgen team members. + Serves as a resource/ consultant to customers and Amgen staff regarding local, regional and national payer policies, ... processes (ie, eligibility and benefit verification, prior-authorization, billing, coding, claims , and appeals/denials), Medicare and Medicaid rules and regulations,… more