- Children's Hospital Los Angeles (Los Angeles, CA)
- …and risk partners to identify and recommend risk management approaches for CHLA Claims Management * Overseeing and optimizing claim investigation, reserving and ... is directly accountable for contributing to audit functions, business continuity, claims management, insurance, physical security, integrated risk management and all… more
- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …to prevent fraud and ensure compliance with policy terms. + Resolve Rejected Claims : + Calculate benefit payments and approve claim settlements based on ... SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing and maximum payer reimbursement. They prioritize… more
- TEKsystems (Milwaukee, WI)
- …and resolve billing errors, edits, Stop Bills, and "DNBs" to ensure timely claim submission. + Accurately transmit claims daily and ensure all required ... documentation is included. + Verify eligibility and claim status for unpaid claims . + Review...for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits… more
- Alight (IN)
- …and guidance to claim examiners as they manage short- and long-term disability claims . Using MDGuidelines, which is the gold standard in clinical guidelines ... health field. + Preferred experience in disability claims management or Workers Compensation claim management....disability claims management or Workers Compensation claim management. + Dedicated to providing high quality customer… more
- The Hartford (Lake Mary, FL)
- …we help shape the future. Sr. Performance Analytics Consultant, Auto & Property Claims Performance Analytics, The Hartford Reporting to the Director of Auto and ... Property Claims Performance Analytics, this Senior Performance Analytics Consultant role...labor and material costs, impact of storm intensity on claim severity, etc.) . Work as a thought-partner to… more
- Sedgwick (Eden Prairie, MN)
- …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... specifications in assisting with questions and solving problems related to the claims application and servicing processes. + Educates and informs the customer via… more
- Sedgwick (Eden Prairie, MN)
- …US This position is dedicated to supporting the General Liability (GL) claims team, requiring specialized knowledge and experience in handling GL claims ... successful candidate will: + Monitor and analyze trends in General Liability claims , including bodily injury, property damage, and premises liability. + Ensure… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …all necessary documentation required from payors to ensure accurate adjudication of claim for reimbursement. They will process claims correctly following ... not limited to; Commercial, Medi-Cal and Managed Care professional claims . This position is responsible checking status of unpaid...edits and take necessary steps to send a corrected claim or appeal to payor for reprocessing of … more
- USAA (Portland, OR)
- …accurately manages claims outcomes. + Maintains accurate, thorough, and current claim file documentation throughout the claims process. + Advance knowledge ... and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes… more
- TevisHR (CA)
- …home office in Sacramento, CA. Job Summary: A Loss Consultant for insurance claims is responsible for evaluating the extent of damage to residential properties ... with policyholders, contractors, and other relevant parties to ensure fair and timely claim settlements. Overall, an estimator for a claim plays a critical… more