- Guardian Life (New York, NY)
- …generative AI to process and understand unstructured data such as contracts, claims , medical records, and customer interactions. + Build autonomous agents and ... learning, and reasoning into practical solutions that support underwriting, claims automation, customer servicing, and risk assessment. + Collaborate with… more
- Guardian Life (New York, NY)
- …to process and interpret unstructured data such as contracts, underwriting notes, claims , medical records, and customer interactions. + Develop autonomous agents and ... agentic AI and reinforcement learning into practical applications for underwriting, claims automation, customer servicing, and risk assessment. + Work closely with… more
- Centene Corporation (Tallahassee, FL)
- …**Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics** **Perform ... care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management… more
- City of New York (New York, NY)
- …Program and Pre-Tax Benefits & Citywide Programs, including the Deferred Compensation Plan and NYCE IRA. In addition to negotiating collective bargaining ... and non-City payroll entities into the MBF database. - Claims Processing: Review and process Health and Fitness ...Claims Processing: Review and process Health and Fitness claims in accordance with program guidelines. - Inquires Processing:… more
- Centene Corporation (Columbus, OH)
- …fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare ... mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect...permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits… more
- New York State Civil Service (Albany, NY)
- …Conducts hearings to review and/or decide appeals from agency determinations, claims regarding issues such as eligibility for benefits, discontinuance, denial, ... and binding hearing decisions.* Recommends the acceptance or rejection of claims or compromise settlements according to laws, regulations, policies, and precedent… more
- Elevance Health (Carroll, IA)
- …medical policy, reimbursement and provider utilization patterns. + Coordinates prompt claims resolution through direct contact with providers, claims , pricing ... strongly preferred Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any… more
- Harvard University (Cambridge, MA)
- …policies and Code of Conduct + Analyze electronic health records, administrative claims , and national survey data Basic Qualifications + Bachelor's degree in ... completion of research projects + Previous experience with health care claims (Medicare, Medicaid, and private insurance plans) strongly preferred + Ability… more
- Elevance Health (Atlanta, GA)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... and specialty care procedures. + Recommends policy changes and claims system changes to pursue cost savings. + Reviews...be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with… more
- Utilities Service, LLC (St. Albans, WV)
- …the crew. + May be delegated the authority to investigate incident reports, damage claims , etc., and to settle minor damage claims . + Maintains accurate records, ... Any unsolicited resumes will become the property of the company, and no fees or compensation will be paid to the recruiter, employment agency, or staffing service. more