- 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
- Sedgwick (Boston, 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
- BJs Wholesale Club (Marlborough, MA)
- …determines compensability, scheduling of IME's, medical case management, surveillance, subrogation and litigation tasks are completed timely. Utilize risk ... information system to track claims progress. + Provides direction to ensure the accurately setting monitoring of claim reserves, including written summaries. Approves and suggests amount for reserves and settlements up to authority level. + Serves as the… more
- Travelers Insurance Company (Woburn, MA)
- …ensure appropriate claim resolution and pursuit of alternative recovery sources (eg Subrogation , SIU, etc.). + Negotiates the claim with the customer and/or repair ... facilities leveraging appropriate resources and achieve agreement on value including required payments. + For applicable Total Loss claims, determines settlement amounts, including applicable coverages and deductibles. + Negotiates and conveys claim… more
- Sedgwick (Boston, MA)
- …Issues settlement checks, files regulatory documents, and handles salvage and subrogation as applicable. + Recommends litigation by legal department when settlement ... cannot be negotiated. + Attends litigation hearings and participates in depositions as necessary. + Revises case reserves in assigned claims files to cover probable costs. + Maintains an expected caseload efficiently. + Utilizes technology and automation tools… more