- Martin's Point Health Care (Portland, ME)
- …to identify trends, root causes, and process improvement opportunities related to claim inaccuracies. + Partner with Claims , Provider Relations, Finance, ... and managing programs and processes to ensure accurate and appropriate claim payments. This role focuses on preventing overpayments, identifying incorrect … more
- MetLife (Clarks Summit, PA)
- …aligned goals and objectives. * Identify, remove, and challenge barriers related to claims management. Escalate to senior leaders in the organization as ... performing claim adjudication with the focus on Decisional, Financial, Claims Coding and Compliance Accuracy in accordance with the Customers' plan/policy and… more
- University of Southern California (Los Angeles, CA)
- …adverse events, and care-quality issues across Keck Medicine of USC. Reporting to the Senior Director of Claims and Finance within the Office of Integrated Risk ... The Specialist also provides critical operational support for insurer reporting, claims intake, subpoenas, legal record requests, and discovery coordination. This… more
- AmeriHealth Caritas (Charleston, SC)
- …complaints. In addition, this position will work in conjunction with the Enterprise Claims Department to ensure all contractual claim requirements are met with ... to Charleston office multiple times a year. **Responsibilities:** + Monitor claim related contractual requirements to ensure compliance, and oversee remediation plan… more
- Polk County Public Schools (Bartow, FL)
- …in administering the various insurance plans. Develops and supervises loss and claim processing procedures for all types of losses, accidents, and injuries. Reviews ... and audits all policies and invoices for payment of premiums/ claims . Investigates and reviews accidents involving School Board personnel, students, and public.… more
- Commonwealth of Pennsylvania (PA)
- …more years of full-time professional experience providing administrative assistance to senior level executives or stakeholders, such as individuals at the Secretary ... questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are… more
- Blue KC (Workman, MN)
- …and external customer resource for interpretation of transplant benefits and transplant-related claim adjudication. Serves as a company expert on current and future ... network. + Ensures proper payment of pre-transplant, transplant, and post-transplant claims . Sets up transplant pre-pay review for each individual claim… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** This Senior Consultant, Enterprise Rule & Edits position reports to our Enterprise Rules & Edits Manager and has the responsibility for ... The goal of the position is to ensure implementation clients exceed clean claim targets and report high satisfaction with Waystar edit processes and content. This… more
- Commonwealth of Pennsylvania (PA)
- …questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are ... Select the Level of Performance that best describes your claim . + A. I have experience developing presentations and...WORK BEHAVIOR 2 - TALENT PLANNING Consults with agency senior managers and executive staff to understand the business… more
- Pilot Company (Knoxville, TN)
- …encouraged to apply. **Job Description** An adjuster I will learn the claims handling process and develop skills to examine, investigate, and resolve liability ... claims . An adjuster I will primarily handle ... with an emphasis on continuous improvement of individual claim closure rate 3. Develop an understanding of the… more