- Humana (Boston, MA)
- …of variable factors. This role requires in depth knowledge of subrogation /payment integrity methodologies regarding third party liabilities and procedures, as well ... various new tools driven by AI, NLP, RPA, etc. Subrogation is a unique & complex practice, and near-term...+ Influence department's strategy and perform cost/benefit analysis of subrogation 's future organization model as we define the selection… more
- Sedgwick (Boston, MA)
- …practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** ... our clients. + Manages claim recoveries, including but not limited to: subrogation , Second Injury Fund excess recoveries and Social Security and Medicare offsets.… more
- Zurich NA (Boston, MA)
- …federal laws and regulations and internal control requirements. + Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud. + ... Contribute to profitable growth by providing risk insight, information and trends to Business Unit or customer as needed. + Protect Zurich's reputation by keeping claims information confidential. + Maintain professional and technical knowledge by participating… more
- Sedgwick (Boston, MA)
- …within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + ... manages action plan pursuant to the claim or client contract. + Manages subrogation of claims and negotiates settlements. + Communicates claim action with claimant… more
- Sedgwick (Boston, MA)
- …practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** ... our clients. + Manages claim recoveries, including but not limited to: subrogation , Second Injury Fund excess recoveries and Social Security and Medicare offsets.… more
- Sedgwick (Boston, MA)
- …within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + ... manages action plan pursuant to the claim or client contract. + Manages subrogation of claims and negotiates settlements. + Communicates claim action with claimant… more
- Sedgwick (Springfield, MA)
- …the file towards prompt and appropriate resolution. + Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage. + ... Communicates claim action/processing with insured, client, and agent or broker when appropriate. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required.… more
- Elevance Health (MA)
- …appropriate. + Identifies and refers cases or issues to QI, SIU, Subrogation , Underwriting, or other departments as appropriate. + Documents appropriate clinical ... information, decisions, and determinations in a timely, accurate, and concise manner. + Develops a working knowledge of member benefits, contracts, medical policy, professional standards of practice, and current health care practices. Position requirements: +… more
- USAA (Boston, MA)
- …resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics. + Identifies coverage ... concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies. + Determines and negotiates complex… more
- Sedgwick (Boston, MA)
- …cost for our clients. + Identifies and investigates for possible fraud, subrogation , contribution, recovery, and case management opportunities to reduce total claim ... cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is… more