- UNUM (Raleigh, NC)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- Lowe's (Mooresville, NC)
- **Your Impact** The Sr Analyst-Workers Compensation Claims will provide insight and support to drive the operational excellence of the Workers Compensation Program. ... Will Do** + Evaluates monthly, quarterly, and annual performance of claims administrator and subcontracted vendors through analyses such as cost-benefit,… more
- Robert Half Accountemps (Fayetteville, NC)
- …within a dynamic and collaborative environment. Responsibilities: * Process and submit medical claims to insurance providers with accuracy and efficiency. * ... insurance claim processes and billing regulations. * Proficiency in medical coding and familiarity with healthcare billing software. * Excellent organizational… more
- CVS Health (Raleigh, NC)
- …credentialing/re-credentialing and contracting questions and issues. + Assist in compiling claim data for audits. Determines medical necessity, applicable ... services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive ...rights and responsibilities in accordance with contract. + Process claim referrals, new claim handoffs, nurse reviews,… more
- Sedgwick (Charlotte, NC)
- …Adjuster - Mid Atlantic Region **PRIMARY PURPOSE** **:** To handle losses or claims regionally unassisted up to $10M, including having the ability to address most ... and non-complex National Accounts. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines claim forms and other records to determine insurance coverage. +… more
- Brighton Health Plan Solutions, LLC (NC)
- …document all client interactions into our internal tracking system + Advanced claim processing including professional, facility and ancillary claims + ... claim payment/pricing inquiries upon client's request + Apply medical policy, contractual provisions and operational procedures to ensure accurate adjudication… more
- Sedgwick (Charlotte, NC)
- …General Adjuster - Mid Atlantic Region **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other companies ... including handling accounting-based losses (business interruption and stock). + Examines claim form and other records to determine insurance coverage. + Interviews,… more
- CVS Health (Raleigh, NC)
- …and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all ... identify the litigation strategy in every case assigned. + Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working… more
- Sedgwick (Fayetteville, NC)
- …Adjuster - Mid Atlantic Region **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any ... Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine insurance coverage. + Administers… more
- Elevance Health (Winston Salem, NC)
- …Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent ... in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies,… more