- Centene Corporation (Austin, TX)
- …Friday; 2:00 pm - 10:30 pm EST, schedule.** **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and handles more ... outbound calls with members and provider offices to provide resolution to claims (ie: additional information requests...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- Actalent (Westwood, MA)
- …and submit timely and accurate appeals to insurance companies. + Follow up on appealed claims to ensure resolution and payment. + Document all actions taken in ... and denial management workflows. Key Responsibilities: + Review and analyze outstanding claims from the legacy system. + Identify and categorize denials by type… more
- Baylor Scott & White Health (Dallas, TX)
- …**Job Summary** + Under the Safe Choice Claims Manager, the Safe Choice Claims Specialist II reviews, studies, and processes assigned claims within their ... efficient service while protecting the organization's assets. + The Claims Specialist II's main duty involves using...independent judgment on important financial and confidential matters. + ** HYBRID ** position - 2 days onsite each week -… more
- Zurich NA (Schaumburg, IL)
- …your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to ... Specialist 125621 Zurich is currently seeking a Sr. Claims Professional to join our Latent & Environmental team...member of our **Pollution** team, you will manage a claims caseload from assignment through resolution , with… more
- Travelers Insurance Company (Richardson, TX)
- …employs creative resolution strategies. + Promptly and properly disposition all claims within delegated authority. + Negotiates disposition of claims with ... This job does not manage staff. Travelers offers a hybrid work location model that is designed to support...legal representatives. + Recognizes and implements alternate means of resolution . + Manages litigated claims . Develops litigation… more
- Johns Hopkins University (Middle River, MD)
- … III_** who will be responsible for the collection of unpaid third-party claims and independent resolution of complex appeals, using various JHM applications ... payers to resolve issues and facilitate prompt payment of claims . Communicates with providers regarding appeals and medical policy...and expertise using Epic Resolute for A/R functions and resolution of revenue cycle issues in an academic medicine… more
- Elevance Health (AL)
- …prevent unnecessary medical-expense spending. **Title** : Financial Operations Recovery Specialist II **Location:** This role enables associates to work virtually ... commuting distance from an office. Please note that per our policy on hybrid /virtual work, candidates not within a reasonable commuting distance from the posting… more
- Travelers Insurance Company (Houston, TX)
- …proper indemnity and expense reserves. + Recognize and implement alternate means of resolution . + Manages litigated claims . + Develop litigation plan with staff ... reserving, negotiating and resolving assigned serious and complex General Liability claims . Provides quality claim handling throughout the claim life cycle (customer… more
- Duke Energy (Charlotte, NC)
- …Summary This position is the intermediate level of the Work Management Specialist classification hierarchy. Employees at this level solve more complex problems and ... customer escalations submitted by the CCO through the Customer Resolution Tool and manages Customer Ready Work/AC Work -...and O&M Blanket, UG Repair/Replace, Customer Ready Work, Damage Claims , Locates - new and refresh, Open prereq, Site… more
- Entergy (New Orleans, LA)
- **Job Title:** Senior Category Management Specialist **Work Place Flexibility:** Hybrid **Legal Entity:** Entergy Services, Inc.-ESI (OLD) **Please note:** ... or purchases** + **Assist tactical groups** in negotiating Terms and Conditions, Claims and Dispute Resolution . + Leads negotiations and contract development… more