- Beth Israel Lahey Health (Charlestown, MA)
- …them from work queue(s).** **Gathers all necessary documentation needed to have claims reprocessed/adjudicated** **Informs and/or transfers to management of any ... Hospital Billing, Follow-Up, and Denial activities necessary to obtain payment/resolution of claims .** **Review the entire account to ensure claims were billed… more
- Ardon (Portland, OR)
- …software system work queues. Must be able to understand and interpret claims adjudication issues with Pharmacy Benefit Management organizations, insurance plans, ... leadership and support to processes related to billing, insurance, and referral management and corresponding teams. This position acts as a liaison for pharmacists,… more
- WSP USA (New York, NY)
- …contractors and commit the SCA's resources on such change orders + Review contractors claims or disputed work and advise senior management as to appropriate ... and problems raised in field reports made by architects and construction management staff. + Work with architect/engineer of record regarding change orders,… more
- AmeriHealth Caritas (Southfield, MI)
- **Role Overview:** The Provider Network Management Contractor is responsible for developing, contracting, and maintaining provider relationships within an assigned ... terms that drive provider satisfaction. + Works with CPNM (Clinical Provider Network Management ) to manage the annual contracting schedule and expand the network as… more
- Capgemini (New York, NY)
- Capgemini Invent - Senior Consultant - Insurance Industry - Transformation Management At Capgemini Invent, we believe difference drives change. As inventive ... shape the future of the insurance industry. We are looking for Management Consultants with insurance transformation expertise to collaborate closely with our… more
- The County of Los Angeles (Los Angeles, CA)
- …for persons unable to come to the office. + Conducts administrative case management , including recording all customer interactions and claims activities by ... seeking qualified candidates to fill emergency Veterans Services Representative II(Veterans Claims Assistant II) vacancies related to the homelessness crisis. Under… more
- Access Dubuque (Dubuque, IA)
- …of business including but not limited to FMLA, Accommodations, and disability claims ; and to execute technical and jurisdictional requirements for accurate claims ... payment processing, and error correction of complex or high exposure claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and authorizes claims… more
- Sedgwick (Portland, OR)
- …+ Apply your adjuster knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... To provide clients with professional care handling losses or claims regionally unassisted, have the ability to address most...their customers. The ideal candidate also possesses the time management skills necessary to complete tasks in a timely… more
- Sedgwick (Fort Worth, TX)
- …Complex Casualty Adjuster **PRIMARY PURPOSE** **:** Handles complex, technically challenging claims on automobile, homeowner, and excess liability policies. Adjusts ... claims with complex coverage issues involving liability, damages, evidence,...of tort theories, legal concepts, negotiation strategies, and litigation management + Excellent oral and written communication skills, including… more
- Sedgwick (Harrisburg, PA)
- …as a department subject matter expert by providing guidance to the complex claims team to ensure consistency resolving matters optimally while creating a culture of ... targeted solutions, and technical guidance and oversight provided to claims team. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Proactively and strategically… more