- Independent Health (Buffalo, NY)
- …will aid in training other team members, evaluating appeals, and share audit trends across the team. Expertise and proficiency demonstrated by long-standing, ... ability to train others, to identify coding patterns and share knowledge and audit tips across the team. The Clinical & Coding Specialist-Senior will support the… more
- Walmart (Chino, CA)
- …safety regulatory agencies Assists with thirdparty audits Develops and presents audit findings to facility management Responds to inquiries by regulatory authorities ... Consults on complex claims and settlements Designs preventative claims management...management benchmarks Designs crossfunctional risk management processes tools and audit mechanisms Reviews and assesses risk management policies and… more
- Philadelphia Insurance Companies (Pasadena, CA)
- Description Marketing Statement: TM Claims Service (TMCS) is an independent global claims management firm established in 1987 to provide clients with a broad ... range of claims related services in the areas of transportation, product...processes. Handle mail processes. Participate in the annual accounting audit preparation. Participate in accounting's disaster recovery plan. Participate… more
- Highmark Health (Springfield, IL)
- …responsible for assisting in the processing and investigation of non-complex health care claims to determine the legitimacy of claim charges. The incumbent will also ... services and charges; will monitor internal referrals from sources such as claims , customer service, Medicare C&D Compliance, and Fraud Hotlines; will alert… more
- City of Boise (Boise, ID)
- …This role is pivotal in coordinating workers' compensation and liability claims , insurance renewals, and risk-related investigations. The right candidate is ... Processes, investigates and provides recommendations for liability and workers' compensation claims by compiling, verifying the accuracy of, completing research and… more
- DHL Express, Inc. (Plantation, FL)
- …opportunities. **Job Purpose:** The Property and Auto Physical Damage Claims Adjuster will be responsible for independently managing first-party commercial ... property damage claims , including losses to company-owned buildings, machinery, equipment, and...Maintain accurate and detailed claim file documentation to support audit compliance, carrier reporting, and financial accuracy. + Collaborate… more
- Sedgwick (Pierre, SD)
- …United States. **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, ... FUNCTIONS and RESPONSIBILITIES** + Consults on and evaluates complex claims to determine objective, quantifiable, medically supported work restrictions/accommodations.… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …them to achieve their goals. Our talented team delivers actuarial, audit , corporate communications, financial and investment, human capital services, information ... TMNAS BA Practice. This role will support the PHLY Claims Department, and the technology that enables them to...The individual in this position should possess knowledge of claims handling, understand the processes involved in claims… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …with a strong emphasis on quality control and improvements to enhance claims processing stability, flexibility, and innovation. The Director will be responsible for ... as well as managing day-to-day activities related to supporting core claims processing system configurations and changes. Primary Responsibilities + Establishes… more
- Ithaca City School District (Ithaca, NY)
- …lunch applications, account receivables, verify accounts payables, track attendance and audit timesheets, inventory, submit claims for reimbursement, prepare ... various reports and other duties as assigned. Location(s): Ithaca High School Anticipated Start Date: 2/24/2025 Posting Dates: 1/22/2025 - until filled Number of Vacancies: 1 Hours per Week: 38.50 (Schedule will be determined by building.) Civil Service… more