- Integra Partners (Troy, MI)
- …Medicaid, and NCQA regulations relevant to Utilization Management (UM), Credentialing and Claims , with the ability to translated them into operational requirements + ... and mock reviews to ensure readiness for NCQA, CMS, Medicaid and external health plan audits + Strong analytical and problem-solving skills with the ability to… more
- University of Rochester (Rochester, NY)
- …dollar accounts. + Prepares information for and attends meeting with third-party insurance representatives on claims and systems issues for scheduled in-person ... to successful closure and obtain maximum revenue collection. Researches, corrects, resubmits claims , submits appeals and takes timely and routine action to resolve… more
- The Hartford (Danbury, CT)
- …stakeholder management, and leadership skills. Preferred Qualifications: + Deep understanding of Claims processes and systems in the Insurance industry. + ... make a difference and are proud to be an insurance company that goes well beyond coverages and policies....leader to oversee the development and maintenance of our Claims application ecosystem. This role is pivotal in driving… more
- Sedgwick (Dayton, OH)
- …or GED required. Associate degree preferred. **Experience** Two (2) years of claims management or insurance experience or equivalent combination of education ... Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple...dental, vision, 401k and matching, PTO, disability and life insurance , employee assistance, flexible spending or health … more
- Hackensack Meridian Health (Neptune City, NJ)
- Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to ... healthcare and serve as a leader of positive change. At Hackensack Meridian Health at Home, we recognize our full- and part-time benefit eligible team members… more
- Marriott (Washington, DC)
- …group disability insurance , travel discounts, adoption assistance, paid parental leave, health savings account (except for positions based out of or performed in ... * Works with the unemployment services provider to respond to unemployment claims ; reviews provider reports for accuracy and corrects errors. * Prepares, audits… more
- Sedgwick (Des Moines, IA)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : To perform clinical evaluations, ... work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes medical review of all … more
- Marriott (New York, NY)
- …group disability insurance , travel discounts, adoption assistance, paid parental leave, health savings account (except for positions based out of or performed in ... * Works with the unemployment services provider to respond to unemployment claims ; reviews provider reports for accuracy and corrects errors. * Prepares, audits… more
- Marriott (Boston, MA)
- …group disability insurance , travel discounts, adoption assistance, paid parental leave, health savings account (except for positions based out of or performed in ... * Works with the unemployment services provider to respond to unemployment claims ; reviews provider reports for accuracy and corrects errors. * Assists with… more
- Hartford HealthCare (Farmington, CT)
- …accurate collection of third-party revenue cycle activities associated with outstanding insurance claims across all Hartford HealthCare Hospitals, Medical Group ... revenue cycle AR team activities associated with timely resolution of outstanding insurance claims . 2. Contributes to decisions that impact workflows effecting… more