- NJM Insurance (Trenton, NJ)
- …litigation support services to the Workers' Compensation Staff Attorneys and Claims Staff. Leveraging technical expertise, the WC Litigation Support Supervisor will ... documents, assessment and preparation of Court files for hearings, and claims /legal file documentation while collaborating with other departments to proactively… more
- AdventHealth (Maitland, FL)
- …various sources using knowledge of healthcare managed care contracts and administrative claims data. + Employs existing complex models and implements them on new ... and capitation Working knowledge of population health, utilization measurement, and claims analytics Managed Care, Patient Financial services, health insurance … more
- Immigration and Customs Enforcement (Washington, DC)
- …ICE personnel on their law enforcement authorities, legal liability under the Federal Tort Claims Act and Bivens v. Six Unknown Named Agents of Fed. Bureau of ... met by the closing date of this announcement. Qualification claims will be subject to verification. Applicants must be...| 213.3102(u), and/or Disabled Veterans with a compensable service-connected disability of 30 percent or more as defined by… more
- MAPFRE Insurance (Webster, MA)
- …For this purpose, both Machine Learning and Graph analytics are applied to claims and policy data. With the graph analytics, the relationship among the claim, ... the insured, their policy, previous fraudulent claims , are detected. Later, the Machine Learning model calculates...11 states. If you require an accommodation for a disability so that you may participate in the selection… more
- PPL Corporation (Louisville, KY)
- …or obtaining parental guarantees. + Analyze and develop company position on claims and disputes, and subsequently consult with senior management to resolve/negotiate ... claims and disputes associated with complex procurements. + Lead...sex, national origin, protected veteran status, sexual orientation, gender identify, genetic information, disability status, or any other protected… more
- City of New York (New York, NY)
- …to its extensive infrastructure and operations, DEP is party to numerous lawsuits and claims filed with the New York City Comptroller and in Court. The Litigation ... attorneys who represent the agency in Court and Comptroller personnel who adjust claims against the City. The Litigation Support Counsel will also work on litigation… more
- NTT DATA North America (Plano, TX)
- …Texas (US-TX), United States (US). Roles and Responsibilities: * Process Adjudication claims and resolve for payment and Denials * Knowledge in handling ... authorization, COB, duplicate, pricing and corrected claims process * Knowledge of healthcare insurance policy concepts including in network, out of network… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial ... * Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...+ Company Paid Life insurance + Short-term and Long-term disability insurance + Tuition reimbursement + Personal Time Off… more
- Billings Clinic (Billings, MT)
- …with prescribed tablets/capsules, processing prescriptions and emergent prescriptions, adjudicating claims , performing point of sale functions, proper utilization of ... a neat and organized condition. * Processes complete prescription claims including proper adjudication/reconciliation, insurance verification, prior authorization, and… more
- CVS Health (Miami, FL)
- …in-person support across multiple worksites, handling complex benefit and claims inquiries, and providing education during open enrollment and health-related ... and Resolve:** Handle member inquiries and escalations related to benefits, claims , eligibility, and policy interpretation by identifying root causes, coordinating… more