- LogixHealth (Bedford, MA)
- …issues and appeal if necessary, using software or other resource tools + Prepare audit results and keep department manager current of all findings and audits and ... services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting dashboards for clients… more
- BankFinancial (Chicago Ridge, IL)
- …FMLA, ADA, PWFA, and state and local laws. + Administers the Workers Compensation claims process and annual audit . + Coordinates the associate separation process ... maintenance. + Acts as back-up to the administration of unemployment claims . BankFinancial is an Equal Opportunity Employer (minorities/ females/ veterans/… more
- Citizens (Wilmington, DE)
- …of Risk Managers and/or Senior Risk Managers primarily supporting the Fraud and Claims line of business Qualifications: + 8-12+ years experience in Risk Management, ... Audit , or Compliance + Prior experience implementing and supporting enterprise wide Risk programs + Demonstrated strong negotiation skills; including the ability to… more
- Prime Therapeutics (Lansing, MI)
- …combined pharmacy and PBM experience to include:##1 year of work experience in claims processing in an operations, audit or quality assurance environment##1 year ... for recoupment of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations Unit (SIU) teams. **Responsibilities** + Perform… more
- AIG (Dallas, TX)
- …best meets clients' needs. + Working collaboratively with home office, distribution, actuary, claims , loss control, premium audit , credit and legal to develop ... and maintain a profitable portfolio of primary accounts business. + Ability to collaborate with other product lines to provide full product support to the client. + Ability to interact with all levels of the organization. + Drive a culture that promotes… more
- AIG (Atlanta, GA)
- …best meets clients' needs. + Working collaboratively with home office, distribution, actuary, claims , loss control, premium audit , credit and legal to develop ... and maintain a profitable portfolio of primary accounts business. + Adhering to underwriting rules and guidelines. + Ability to collaborate with other product lines to provide full product support to the client. + Strong relationships with brokers to ensure a… more
- AIG (Chicago, IL)
- …and foster business development Working collaboratively with home office, distribution, actuary, claims , loss control, premium audit , credit and legal to develop ... and maintain a profitable portfolio of primary accounts business. Adhering to underwriting rules and guidelines. + Ability to collaborate with other product lines to provide full product support to the client. + Strong relationships with brokers to ensure a… more
- New York State Civil Service (Albany, NY)
- …managed care organizations which includes evaluations of financial records and medical claims .* Propose solutions to the audit team regarding issues encountered ... during the audit . * Prepare audit work papers and reports to document scope, findings...scope and timeframe to be reviewed.* Assist in planning audit activities, including specific audit tasks.* May… more
- UPMC (Pittsburgh, PA)
- …modification to policies and procedures. + Completion of special projects including focused claims diagnosis codes and/or coding related audit support. + Assists ... records for Hierarchical Condition Category (HCC) diagnosis codes for focused claims reviews and government audits. Performs auditing functions including monitoring,… more
- AIG (Boston, MA)
- …on the portfolio. + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes, ensuring mitigation ... Join us as a Claims Analyst IV to take on key responsibilities within a world-class claims function. Make your mark in Claims As a Claim Analyst IV, you will… more