- Centene Corporation (Frankfort, KY)
- …matters; while maintaining an investigative workload of moderate to high complexity. Assists manager on monitoring team caseload and report on metrics. + Serve as ... teams as needed. + Supports the provider escalation project team to resolve claims and payment issues. + Identifies root-cause issues to ensure enterprise solutions… more
- Commonwealth Care Alliance (Boston, MA)
- …Lead ongoing communication efforts, working closely with Provider Communications Manager , to keep providers informed of organizational objectives, regulatory ... and performance monitoring of value-based arrangements, including shared savings, risk -sharing, and quality incentive programs. * Partner with provider engagement,… more
- WMCHealth (Poughkeepsie, NY)
- …lawsuit, etc.) and alerts the department director, medical staff leadership, and claims manager . + Conducts special studies in collaboration with medical ... staff on issues that are high- risk , high-volume, or problem-prone. This includes chart review, data...etc.) and alerts the department director, administration, and the claims manager . Initiates a more thorough review… more
- AUI Partners (TX)
- …growth. 2) Inspections: + Report Safety Inspection findings to the Project Manager and Superintendent and ensure recommended changes have been implemented. + Hand ... + Assist HR, Legal and Compliance on Worker Compensation claims and other claims involving the public,...controls in place on assigned projects to the Project Manager and Superintendent + During the Project, conduct overview… more
- Access Dubuque (Dubuque, IA)
- …with regulatory and jurisdictional requirements. + Monitor captive performance, analyze claims data, and recommend adjustments to optimize risk financing ... solutions. This role involves working closely with businesses to assess risk profiles, design tailored captive structures and ensure regulatory compliance while… more
- Covenant Health Inc. (Knoxville, TN)
- …Performs other duties as needed. Reports to the Revenue Integrity Manager . Recruiter: Suzie McGuinn || ###@covhlth.com Responsibilities Integrity + Identifies and ... evaluates company risk areas and provides auditing procedures related to documentation...+ Reviews information from third party payers relative to claims charging, coding, and billing in order to ensure… more
- Zurich NA (Schaumburg, IL)
- …of a collaborative team that plays a key role in supporting Zurich's risk strategy by ensuring accurate execution of assumed reinsurance transactions and partnering ... across finance, actuarial, underwriting, claims and global reinsurance teams. This position is based...hybrid work schedule, with in-office days coordinated with your manager to support collaboration, business need, and your personal… more
- Sedgwick (Indianapolis, IN)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... combination of education and experience required to include two (2) years account manager experience or five (5) years adjuster experience including two (2) years in… more
- Sedgwick (Bedford, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... Case Coordinators. We help auto customers through the manufacturing claims process. **_We offer benefits on day one:_** +...+ Escalate customer, dealer or 3rd party issues to manager as appropriate + Ensure quality of service on… more
- Empirical Systems Aerospace, Inc. (San Luis Obispo, CA)
- …the goal of maximizing financial and operational performance and minimizing risk . + Review and/or prepare subcontracts, contracts, agreements, amendments, change ... and make presentations at meetings + Support negotiations of claims , manage contractual changes and resolve disputes or conflict...on items out of the ordinary or carrying significant risk + Support supply chain in supplier and vendor… more