- Elevance Health (Indianapolis, IN)
- …duties may include, but are not limited to: + Researches and interprets claims issues while ensuring good, accurate and timely customer service for our pharmacy ... sources in order to accommodate the needs of our clients; this includes claim processing, customer service, & medical account management. + Oversees benefit set up… more
- Highmark Health (Pittsburgh, PA)
- …and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Analyze and evaluate claim processes specific to professional, hospital, ambulatory surgical center, ... recover identified overpayments, performing a follow-up review to ensure that the claims were adjusted correctly, resulting in expected recovery/savings. + Perform … more
- Highmark Health (Pittsburgh, PA)
- …vision, development, planning, execution and leadership to the department regarding claims audits and investigations of various hospital and facility organizations ... years in a management role + 3 years in Claims Analysis and/or Investigations Activities (for Operations area) **Preferred:**...payments or hospital reimbursements + 5 years in provider claim review and recoveries + 5 years in positions… more
- Snapsheet (IL)
- About Snapsheet: Snapsheet exists to simplify claims . We leverage our expertise in virtual estimating and innovative claims management technology, transforming ... the end-to-end claims process - delivering faster, modern experiences for claims organizations of all sizes. What you'll get: + Remote working environment - your… more
- HUB International (Wilmington, MA)
- …Obtain claim reports and conduct monthly, quarterly and/or semi-annual claims as needed. + Responsible for implementation of Client Service Plan calls/quarterly ... . **SUMMARY OF RESPONSIBILITIES** : Responsible for client relations, service, sales , and administrative activities of new and existing select group benefit… more
- HUB International (Newport Beach, CA)
- …specific information including financial condition, employee demographics and previous claim experience to determine risk, potential benefit features and premium ... IBNR and experience reports as needed. + Knowledge of claim utilization and ability to dive into cost and...and education to clients, peers, and/or members of the sales and client service teams. + Completes peer review… more
- Philadelphia Insurance Companies (New York, NY)
- …staff of account executives, underwriters and loss prevention engineers and fair and timely claim settlement from a skilled team of claim professionals. We work ... with producers, key clients and any other external distribution channels. Utilize effective sales and negotiation skills to obtain and retain accounts on the most… more
- Cummins Inc. (Harrisburg, PA)
- …needs, gathers pertinent information, and opens work orders; provides quotes, develops claims , prepares repair plans, schedules work, and provides status updated to ... the warranty administration manual to determine eligibility for coverage and claim requirements; identifies items associated with repair that can be covered… more
- Geisinger (Danville, PA)
- …reimbursement or recovery recommendations based on PI team's review of claims for appropriate coding, billed statistics, policies, industry standards and compliance ... Partner with internal stakeholders to support product strategy and sales efforts with PI data. + Collaborate with internal...Integrity audits. + Responsible for Key Performance Indicators including claim edit and claim audit savings, dollars… more
- Air National Guard Units (Salt Lake City, UT)
- …have been gained in work such as computer operator or assistant, computer sales representative, program analyst, or other positions that required the use or ... equivalent to at least the GS-2210-07 (Must provide SF 50 to validate claim ) OR Experience receiving, maintaining, and issuing data storage media for computer… more