- The Cigna Group (Franklin, TN)
- …savings from the proposed changes. This role will also be data mining historical claims data to develop algorithms and design tools to track medical cost expense and ... key drivers of medical trend and anomalous/outlier patterns in claims billing activity. + Use innovative technology and tools...SAS, SQL, Tableau or other related applications to query claims data and convert data into meaningful information. +… more
- Zurich NA (Los Angeles, CA)
- …Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 8 or more years of experience in the Claims or Underwriting Support area AND + Knowledge of...and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- CVS Health (Largo, FL)
- …in-person support across multiple worksites, handling complex benefit and claims inquiries, and providing education during open enrollment and health-related ... and Resolve:** Handle member inquiries and escalations related to benefits, claims , eligibility, and policy interpretation by identifying root causes, coordinating… more
- HSBC (Chicago, IL)
- …complex information to various committees, developing strategic responses, and overseeing claims and appeals processes. Your expertise in ERISA and employee ... + Present relevant items to the Benefits Administrative Committee and Claims and Appeals Subcommittee + Develop strategies for proposed responses, verifying… more
- WestCare Foundation (Fresno, CA)
- …DMC-ODS, Enhanced Care Management (ECM), and Community Supports. This position ensures claims are submitted accurately and timely directly to insurance carriers and ... those listed below. ESSENTIAL JOB FUNCTIONS: + Prepare, submit and track CalAIM claims directly to Medi-Cal Managed Care Plans and insurance carriers. + Verify… more
- Zurich NA (Atlanta, GA)
- …Diploma or equivalent and 10 or more years of experience in the claims or underwriting support areaOR + Zurich approved Apprenticeship program including an associate ... and 8 or more years of experience in the Claims or Underwriting Support area. + Knowledge of Microsoft...and 14 or more years of experience in the Claims or Underwriting Support area OR + Zurich Certified… more
- US Tech Solutions (Hershey, PA)
- …not limited to, physical therapists, specialists, and/or Nurse Case Managers. + Claims Management **Under the supervision of the physician or registered nurse, the ... as per company policy. + Acting as the Subject Matter Expert on work-related claims and claim statuses, collaboration with TPA claims adjusters and onsite claim… more
- Elevance Health (Louisville, KY)
- …The **Subrogation Examiner** is responsible for researching and examining routine health claims that may be related to Third Party Liability, Workers' Compensation ... insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party. + Responds to inquiries… more
- General Counsel (Washington, DC)
- …practice areas: benefits law; health care law; Court of Appeals for Veterans Claims litigation; revenue law; torts law; and loan guaranty. 2. Provides representation ... law and benefits, including loan guaranty benefits, and adjudication of veterans benefits claims . 3. Represents the Secretary and officials of the DVA in litigation… more
- Robert Half Accountemps (Vista, CA)
- …role is well-suited for someone who enjoys analytical work, problem-solving, and ensuring claims are billed correctly and reimbursed timely. You will play a critical ... role in the financial health of the organization by managing claims , resolving billing issues, and collaborating with internal clinical and administrative teams. The… more