- Humana Inc (Boston, MA)
- …products, or other medical management organizations, hospitals/Integrated Delivery Systems , health insurance, other healthcare providers, clinical group practice ... management. Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. Experience with national guidelines such as MCG(R) or InterQual Internal Medicine, Family… more
- University of North Carolina System (Raleigh, NC)
- Director of Financial Reporting and ERP Systems About the Opportunity The Director of Financial Reporting and ERP Systems leads efforts to produce consolidated ... and comprehensive financial reports for the UNC System and is responsible for reporting UNC ...NCSEAA, and NC Arboretum)is a VEVRAA Federal Contractor. To claim veteran's preference, all eligible persons must indicate their… more
- The James Allen Companies Inc (Chicago, IL)
- …Total Insured Values (TIVs). Prepare year-over-year insurance cost comparisons and historical claim analysis for executive review. Claims and Incident Management ... with executive and asset management leadership and ownership on claim strategy. Serve as point of contact with carriers...closeout. Create and manage internal reporting tools and tracking systems for all open and closed claims .… more
- Stryker Corporation (Chicago, IL)
- …payment information and claims status by phone, written correspondence and/or claims system . Communicates with the claimants' providers to set expectations ... of claims process by phone, written correspondence and/or claims system . Coordinates investigative efforts ensuring appropriateness; provides thorough… more
- Stryker Corporation (Chicago, IL)
- …payment information and claims status by phone, written correspondence and/or claims system . Communicates with the claimants' providers to set expectations ... of claims process by phone, written correspondence and/or claims system . Coordinates investigative efforts ensuring appropriateness; provides thorough… more
- Sedgwick Claims Management Services Ltd (Chicago, IL)
- …payment information and claims status by phone, written correspondence and/or claims system .* Communicates with the claimants' providers to set expectations ... of claims process by phone, written correspondence and/or claims system .* Coordinates investigative efforts ensuring appropriateness; provides thorough… more
- Contact Government Services, LLC (San Francisco, CA)
- Senior Discovery Business and System Analyst Employment Type: Full-Time, Executive-Level Department: Legal CGS is seeking a dedicated Senior Discovery Business and ... System Analyst to join a fast-paced and hard-working team...for success: The Contractor shall provide business and IT systems analysis support to include, but not limited to… more
- GEICO (Palo Alto, CA)
- …not just model performance.**Why Join Shape the next generation of AI-powered claims systems .* Work on meaningful, high-leverage problems with real operational ... and the ability to apply AI in complex, real-world systems .You will work closely with engineers, claims ...do Design and lead applied AI initiatives across the claim lifecycle (eg, Claim intake, automation, document… more
- Socotra, Inc. (San Francisco, CA)
- …and large financial liabilities. This role is an opportunity to shape an industry-leading claims management system . Our vision is to establish a single, Unified ... solutions. Responsibilities: Define and drive the long-term technical roadmap for claims management systems , aligning priorities with Product, Operations,… more
- Magnus Medical, Inc. (Burlingame, CA)
- …provides support across the entire reimbursement lifecycle including prior authorization, claims submission, appeals, and denial management. They work closely with ... to proactively address payer‑specific challenges, streamline authorization workflows, troubleshoot claim denials, and optimize appeal strategies. Essential Job Duties… more
