- Prime Therapeutics (Boise, ID)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Claim Technical Analyst - JUDI Ops Team - Remote **Job Description** The Claims ... Technical Analyst is responsible for serving as the claims analysis resource for an assigned operations team. This role is responsible for developing queries to… more
- MetLife (Oriskany, NY)
- …Preferred: * Bachelor's degree * Knowledge of system applications and Disability claims knowledge/working knowledge of FMLA/ Disability /Leave procedures ... preferred Business Category Operations - Claims Equal Employment Opportunity/ Disability /Veterans If you need an accommodation due to a disability , please… more
- City of New York (New York, NY)
- Job Description The Tort Division is seeking a Claim Specialists Level 1. This position encompasses work of varying degrees of difficulty and responsibility ... assist in the preparation for trial of less serious claims for and against the City. Secures evidence by...walking in all kinds of weather, often carrying files. CLAIM SPECIALIST - 30726 Qualifications 1. A baccalaureate degree… more
- CVS Health (Hartford, CT)
- …all with heart, each and every day. **Hybrid in Hartford, CT required** ** Claim Supervisor:** Responsible for the overall supervision of Medical Claim Processing ... + Develop, train, evaluate and coach staff to provide cost effective claim review/processing and claim service while ensuring compliance and quality… more
- CVS Health (Augusta, ME)
- …day. **Position Summary** -Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and ... staff for review. -Organized and prioritizes work to meet regulatory and claim turn-around times -Promotes communication, both internally and externally to enhance… more
- Medical Mutual of Ohio (OH)
- …mind to more than 1.2 million members through our high-quality health, life, disability , dental, vision and indemnity plans. We offer fully insured and self-funded ... of care. **Responsibilities** + Independently evaluates basic to complex medical claims and/or appeal cases and associated records by applying clinical, regulatory,… more
- CVS Health (Hartford, CT)
- …with other departments to enhance the overall customer service experience, managing claim processing teams, and implementing claim training programs. Applies ... + **Industry Leadership:** 7-10 years of experience leading high-performing teams in claims and healthcare operations, with a strong track record of driving results.… more
- Point32Health (MA)
- …as required by the plan. + Manually calculate and/or apply pricing to each claim when necessary. + Process complex claims adjustments as assigned by supervisor: ... back out and adjustment reason codes. + While processing claim adjustment, ensure that claims maintains or...plans + Paid time off + Employer-paid life and disability insurance with additional buy-up coverage options + Tuition… more
- Walmart (Bentonville, AR)
- …appropriately tenured case manager with the necessary skill set to achieve an optimal claim outcome. + Escalate claims to leadership based on the internal ... procedures and regulatory requirements. + Review complex, high-exposure, and litigated claims and provide technical guidance on claim valuation, reserving,… more
- AIG (Atlanta, GA)
- …Claim Supplier Management, the role will be responsible for the management of the Claims Law Firm and Claim Vendor function for AIG North America business. ... documentation in line with the team's standard operating process. + Lead discussions with Claim leadership to develop Claims Law Firm / Vendor strategies to… more