- Sedgwick (New York, NY)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... and specific client service requirements. **ESSENTIAL RESPONSIBILITIES** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- Sedgwick (Cincinnati, OH)
- …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
- Commonwealth Care Alliance (Boston, MA)
- …Revenue Integrity, Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills & Abilities (must have):** ... claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies… more
- New York State Civil Service (New York, NY)
- …Representative 2, the incumbent will oversee all aspects of workers compensation claims processing from inception to closing; initially determine the ... NY HELP Yes Agency Insurance Fund, State Title Claims Services Representative 1/Trainee 1/2 (Group 90 Lost...with case analysis over the anticipated life of the claim ; recommend cases for appeal to WCB; negotiate and/or… more
- Sedgwick (Marlton, NJ)
- …accuracy, and files necessary documentation with state agency. + Communicates claim action/ processing with claimant, client and appropriate medical contact. ... + Ensures claim files are properly documented and claims coding is correct. + May process routine payments and prescriptions and status reports for lifetime… more
- Apex Health Solutions (Houston, TX)
- …key requirements Shall perform user acceptance testing for any impacted changes to claims processing as directed Meets or exceeds production and quality ... of paper/electronic claims for inpatient, outpatient and professional medical claims Resolve claim edits, review history records and determine benefit… more
- Sedgwick (Rochester, NY)
- …regulations and processes. This position is responsible for managing and processing workers' compensation claims , ensuring timely and accurate decisions ... payment timelines, and compliance with statutory requirements. + **Negotiate** settlements of claims within designated authority to reach claim resolution. +… more
- Sedgwick (Charlotte, NC)
- …accuracy, and files necessary documentation with state agency. * Communicates claim action/ processing with claimant, client and appropriate medical contact. ... * Ensures claim files are properly documented and claims coding is correct. * May process routine payments and prescriptions and status reports for lifetime… more
- Mass Markets (Killeen, TX)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... hear from you. This role involves handling inbound communications, evaluating warranty claims , and working closely with customers and service partners to ensure… more
- NTT DATA North America (Decatur, IL)
- …and insured members. + Assist with audits for assigned group. + Assist with claims processing and over specific for new or backlogged groups. **KNOWLEDGE, SKILLS ... providers and case management company for information regarding problem claims . + Print/mail EOBs and claim forms...High School Education required. + Minimum 3 Years of Claims Processing experience + TPA Experience **Preferred:**… more
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