- TEKsystems (Rockford, IL)
- …initiative driven by the No Surprises Act, with a mission to resolve complex claim disputes and ensure fair payment outcomes. What You'll Do + Review and validate ... claim data to determine appropriate payment outcomes. + Analyze...supporting documentation to identify the correct party in disputed claims . + Work primarily with emergency services claims… more
- Sedgwick (Kokomo, IN)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Client Liaison **To be considered for this position, candidates must reside in ... regarding client claimants to follow-up and resolve high exposure and difficult claims or union representative issues; to resolve benefit representative or client… more
- Sedgwick (Orlando, FL)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Leave of Absence Coordinator **Leave of Absence Coordinator** **Our teams thrive ... based on client plans, state and federal regulations. Ensures that on-going claim management is within company service standards and industry best practices.… more
- Sedgwick (Coralville, IA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Leave of Absence Coordinator **Our teams connect! We collaborate in-office and ... based on client plans, state and federal regulations. Ensures that on-going claim management is within company service standards and industry best practices.… more
- Elevance Health (Ashburn, VA)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and… more
- Sedgwick (Boston, MA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Clinical Behavioral Health Specialist **The ideal candidate would be able to work ... and address psychosocial, medical, and employment issues within a claim and be actively engaged in resolution; to work...conjunction with and provide recommendations and education to the claims examiner, claimant, and clinical team; to work with… more
- Guidehouse (Minneapolis, MN)
- …of assigned Medicare and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. ... include: + Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific...Unlikely Edits (MUE) + Medical Necessity edits + Other claim level edits as assigned + As needed, review… more
- Cognizant (Jefferson City, MO)
- …and optimizing benefit, pricing, and configuration solutions that directly enhance claim processing accuracy and auto‑adjudication rates. You will be a valued ... Conduct backend SQL queries to validate configuration accuracy and ensure correct claim processing behavior. + Partner with business teams to provide strategic… more
- World Insurance Associates, LLC. (Middletown, CT)
- Summary World Insurance Associates is a unique insurance organization offering top products and services from major providers, combined with attentive service ... agents. Founded in 2011, World is one of fastest-growing insurance brokers in the US with over 2,200 employees...service, and professional communication + Handling renewals, service requests, claims , billing and new policies + Maintain a thorough… more
- World Insurance Associates, LLC. (Bridgewater, MA)
- Summary World Insurance Associates is a unique insurance organization offering top products and services from major providers, combined with attentive service ... from local agents. Founded in 2011, World is one of the fastest-growing insurance brokers in the US with over 2,200 employees in over 260 offices across North… more