- HUB International (Nashville, TN)
- …experience and in-depth knowledge of insurance markets, policy provisions, claim processes, business environment, and risk mitigation, applies independent and ... responsible. These include non-routine coverage issues and questions, denial of claims , renewal strategies for key accounts, and interpretation of non-routine… more
- Medical Mutual of Ohio (OH)
- …including HEDIS audit submission, Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS). Supports data capture and ... Produces in depth, and customized trend reporting across multiple systems and delivers recommendations to improve quality metrics.Collaborates with multiple… more
- PeaceHealth (Vancouver, WA)
- …and safety. Job Summary Responsible for leading and overseeing the health system 's clinical risk management program. This role provides strategic and operational ... daily operations of the Clinical Risk Management team across the health system . Handles day-to-day risk management operations and tasks including on call coverage,… more
- MetLife (Oriskany, NY)
- …of MetLife. The customers who call into our call center call to file their claims , or to service their active claims . Call types include callers with disability, ... needs. * Research requests regarding various product aspects, policy provisions, claim status, basic procedures, etc. * Efficiently process transactions and refer… more
- Sedgwick (Columbus, OH)
- …worker's injury, medical treatment, psychosocial needs, cultural implications and support systems . + Effectively communicates and builds relationships with the ... claims ' examiner, client, injured worker, attorney and supervisor. +...+ Provides recommendations for alternate clinical resources to support claim resolution. + Maintains client's privacy and confidentiality, promotes… more
- Ankura (Phoenix, AZ)
- …+ Research and analyze project cost records and financial statements + Reconcile claim amounts to accounting systems and to insurers' calculations + Develop ... client relationship manager and technical expert on high-profile construction disputes, claims , and litigation matters Value Proposition: This role is based in… more
- Dignity Health (San Bernardino, CA)
- …administrator. + Initiate and oversee timely investigations for all work-related injury claims , including Root Cause Analysis. + Monitor claim progress, ensuring ... providers, and our third-party administrator. You will guide the claims process from start to finish-investigating work-related injuries, managing documentation,… more
- AUI Partners (TX)
- …and tool inspections. + Investigate accidents, incidents, and worker compensation claims , ensuring timely and effective resolution. + Coordinate and conduct safety ... + Assist the Safety Supervisor/Safety Team on Worker Compensation claims and other claims involving the public,...as guidelines. Accident and Incident Investigations + Conduct Utility Claim Investigations within 24 hours and provide a report… more
- CDM Smith (New Haven, CT)
- …Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. ... Management: The candidate must understand and be knowledgeable in project delivery systems , contracting strategies, and typical contract forms and terms. The role… more
- Veterans Affairs, Veterans Health Administration (Alexandria, LA)
- …the Cardio/Respiratory Service. Oversee the development and implementation of systems redesigns projects, quality improvements and assurance programs of inpatient ... and peer review. Participates in clinical review process such as tort claims , peer reviews, management reviews and administrative activities, as directed by the… more