- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …strategies while collaborating with various business units including teams across HMM, Sales, Claims Operations , Finance, and Legal. * This position is eligible ... Consultant works with a wide variety of stake holders to analyze high-cost claims and members, evaluate clinical trends, and formulate business proposals to mitigate… more
- AIG (Dallas, TX)
- …of your technical expertise. Make your mark as a Forensic Analyst As a claims professional, you are respected for your deep accounting expertise. You balance the ... the quantification and the measurement of commercial business insurance claims . + Work with a team and supervisors and...an exciting time to join us - across our operations , we are thinking in new and innovative ways… more
- Stony Brook University (East Setauket, NY)
- …support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties ... are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up...to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital… more
- Kemper (Doral, FL)
- …SIU Investigator will conduct field as well as desk investigations of insurance claims referred to and accepted for investigation by the Special Investigative Unit. ... the Downers Grove and surrounding areas. Basic functions include: Investigation of claims , analysis and development of facts and evidence, and conducting and/or… more
- Sedgwick (Juneau, AK)
- …you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your ... and Special Risks and Marine. As we expand our operations , we are seeking individuals who are passionate about...of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team… more
- BWX Technologies, Inc. (Lynchburg, VA)
- …industry across four continents. Our joint ventures provide environmental restoration and operations management at a dozen US Department of Energy and NASA ... making a difference. **Position Overview:** The Senior Counsel supporting the Government Operations business segment at BWXT will rotate through and be available to… more
- LA Care Health Plan (Los Angeles, CA)
- …Continued Domain Specific Experience and Skills: Domain Focus: Authorization & Claims Operations Analytics Required: Experience with Utilization Management (UM) ... authorization workflows and prior authorization metrics. Knowledge of claims operations , including receiving, adjudication, and provider dispute resolution.… more
- Travelers Insurance Company (Hartford, CT)
- …business drivers and disciplines such as: underwriting, products, reinsurance, distribution, sales, operations , risk control, claim , and financials. + Able to ... the opportunity to coordinate with key business partners in Claim , Underwriting, Product and Finance. Key responsibilities include: -...of frequency and severity trends. - Working closely with Claim to understand individual claim activity and… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …dedicated teams, or part of the essential support staff who keep our operations running smoothly - every role at NeighborHealth is vital. Together, we're advancing ... RTE), Denials (research root cause, identify trends, correct, appeal), Claim Edits (ensure clean claim submission) &...trends, correct, appeal), Claim Edits (ensure clean claim submission) & Transaction history (track claim … more
- Tidelands Health (Myrtle Beach, SC)
- …reimbursement of service rendered and to maintain an industry standard clean claim rate. **What you will do** + Analyze medical records, interprets documentation, ... and verify all information required to produce a clean claim including special billing procedures that may be defined...with accuracy coding quality recommendations + Work with HIM operations as needed to clarify queries and documentation needs… more