- Baystate Health (Springfield, MA)
- …The Sr Director of Clinical Safety and Risk Management also collaborates with the Claims Managers in the operations of the system-wide claims program of the ... clinical personnel, management personnel, and attorneys on matters related to potential claims , claims or lawsuits and recommends appropriate actions to minimize… more
- Trinity Health (Ann Arbor, MI)
- …Experience in health care, insurance, or managed care industries is highly preferred . Experience performing medical claims processing, financial counseling and ... for the purpose of establishing the patient and service specific record for claims processing and maintenance of an accurate electronic medical record. Registers and… more
- MTA (Brooklyn, NY)
- …and NYCT / MTA Bus / HQ administrative and operating departments to ensure claims are properly managed and conduct strategy discussions with TPA to ensure claims ... are progressing towards resolution. This includes responding to employee claims questions and treatment options available as an escalation point from TPA and… more
- Walmart (Battle Ground, WA)
- …facility level training and execution of asset protection safety functions and claims and receiving procedures by reviewing the application of policies procedures ... training needs and developing and delivering the training where needed Manages claims and receiving operations by ensuring proper policies and procedures are… more
- Molina Healthcare (Kenosha, WI)
- …appeals experience. **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, including 2 ... years in a manager role. * Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/Inpatient UB92, Universal Claims , Stop Loss, Surgery,… more
- Zurich NA (New York, NY)
- …work collaboratively across business units including but not limited to; claims , finance, risk engineering, actuary, and technical underwriting while gaining ... and interpersonal skills to grow and develop relationships with preferred distribution partners in an assigned territory. This role...and 2 or more years of experience in the Claims or Underwriting Support area AND + Knowledge of… more
- MyFlorida (Tallahassee, FL)
- …and journal corrections. Prepares special category payments for Real Estate Recover Claims , Construction Recovery claims , Auctioneer Recover claims , Minority ... (ie, recording revenue in FLAIR) in a state agency accounting office preferred . Familiarity with State Treasury processes. Ability to enhance and document accounting… more
- Zurich NA (Boston, MA)
- … claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful ... Commercial Auto personal injury cases. At Zurich North America Claims we acknowledge that work life-balance and flexibility are...legal environment + Knowledge of the law and procedure Preferred Qualifications: + Member of the Rhode Island and/or… more
- Abbott (Princeton, NJ)
- …strategy, establishing a pipeline of new product and novel product claims innovations, partnering with cross-functional colleagues to develop new products, and ... aid in definition of value proposition, product positioning, branding, messaging, claims , pricing, advertising campaign concepts, and sales tool effectiveness +… more
- LA Care Health Plan (Los Angeles, CA)
- …or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member information, document ... stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data… more