- Sedgwick (San Diego, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | Roseville or San Diego, CA (Hybrid) **PRIMARY ... Ten (10) years of experience handling litigation including 5 years of claims management experience or equivalent combination of education and experience required.… more
- AmeriHealth Caritas (Newtown Square, PA)
- …organization. ; The manager must have the ability to determine correct coding, review claims , medical records and billing data from all types of healthcare ... performance goals. + Proactively identify and analyze patters or anomalies in pharmacy claims and operations indicative of fraud, waste and abuse.; + Lead and manage… more
- Kemper (Dallas, TX)
- …College Degree or equivalent work experience * Three years of insurance claims experience or related fraud analytics background. **Position Requirements:** + Strong ... are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or Fraud Claims ...and Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner (CFE) designations are + preferred. + This position… more
- Baylor Scott & White Health (Temple, TX)
- … records, patient billing records, and incident reports are obtained and managed. Medical examiner 's reports are included if available. All documents are ... and/or level **Job Summary** Manages detailed assessments of high-risk claims with a medical /legal plan to prevent...detailed assessments of high-risk claims with a medical /legal plan to prevent claim elevation. Reviews and evaluates… more
- New York State Civil Service (Endicott, NY)
- …to qualify and quantify an employee/claimant.* Communicate with claimants, policyholders, medical providers, and various entities to gather information needed to ... process assigned work.* Examine accident and medical reports to determine compensability and liability, seeking guidance and expertise as needed if complex … more
- City of New York (New York, NY)
- …Compensation Division are responsible for all medically related issues for medical management of workers' compensation claims . Responsibilities include: Consult ... not related to the claimant's job related injury. Assist examiner and legal staff to determine compensability of treatment...relates to the claimant's work injury and assist with medical case management of claims . Review and… more
- UCLA Health (Los Angeles, CA)
- …progress, recommending medical treatment interventions to the third-party claims examiner , and ensuring compliance with applicable workers' compensation ... Compensation Analyst and department manager, you will manage workers' compensation claims by supporting employees who have experienced work-related injuries or… more
- Johns Hopkins University (St. Louis, MO)
- …+ Experience in Occupational Medicine, Workers' Compensation, and DOT exams. + DOT Medical Examiner . + Certified Urine Drug Screen Collector + Certified Breath ... required for lab testing provided on-site. + Maintain patient medical records. _Work collaboratively with the Benefits and Safety...wellness events and initiatives. + To manage workers' compensation claims . + To expand clinic services and reach. +… more
- Johns Hopkins University (St. Louis, MO)
- …+ Experience in Occupational Medicine, Workers' Compensation, and DOT exams. + DOT Medical Examiner preferred. + Certified Urine Drug Screen Collector preferred. ... required for lab testing provided on-site. + Maintain patient medical records. _Work collaboratively with the Benefits and Safety...wellness events and initiatives. + To manage workers' compensation claims . + To expand clinic services and reach. +… more
- Molina Healthcare (Idaho Falls, ID)
- …health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU ... with other internal departments, including Compliance, Corporate Legal Counsel, and Medical Officers in order to achieve and maintain appropriate anti-fraud… more