- Usaa (Boston, MA)
- …for determining settlement amounts outside of authority limits and accurately manages claims outcomes. Maintains accurate, thorough, and current claim file ... insurance claims . Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend,… more
- Commonwealth Care Alliance (Boston, MA)
- …and authorization process highly desired. + Experience with and understanding of Claims operations preferred. **Knowledge, Skills & Abilities (Required)** + ... provider community. In this highly visible field position, the provider relations specialist acts as the primary liaison between CCA and its providers including… more
- Commonwealth Care Alliance (Boston, MA)
- …Engagement & Performance **Position Summary:** The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening relationships with ... + **Operational Excellence:** + Collaborate with cross-functional teams (eg, Claims , Credentialing, Clinical Care Management, Member Services, Provider Services,… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …and much more! Role: Reporting to the Senior Director of Health Plan Operations , the Director of Utilization Management and Quality Programs is responsible for the ... activities to improve patient care and ensure efficient and cost-effective operations . The Director of Utilization Management and Quality Programs develops systems,… more
- Santander US (Quincy, MA)
- …the possibilities **We Want to Talk to You!** **The Difference You Make** : The Specialist , Claims & Fraud Operations performs routine, analytical review of ... Specialist , Fraud Operations Country: United States of America **Your Journey Starts Here:** Santander is a global leader and innovator in the financial services… more
- Travelers Insurance Company (West Bridgewater, MA)
- … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site… more
- Travelers Insurance Company (Boston, MA)
- …experience. + 5-10 years experience handling serious injury and complex liability claims preferred (casualty claim operations environment determining ... claim handling and superior customer service on assigned claims , while engaging in indemnity & expense management. Promptly...of some of the Company's severe and complex liability claims by providing claim handling guidance, recommendations… more
- Commonwealth Care Alliance (Boston, MA)
- …Knowledge, Skills & Abilities (must have):** + Knowledge and experience of claim operations , health care reimbursement, public health care programs and ... claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies… more
- Commonwealth Care Alliance (Boston, MA)
- …will not be considered at this time._** **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst ... of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the… more
- Zurich NA (Boston, MA)
- …service needs of prospective and current customers by developing and delivering claims services marketing presentations and Claim Service Proposal responses that ... retention by building lasting relationships with our customers' and brokers' claim contacts. + Business Travel, as required, will be...and 4 or more years of experience in the Claims or Operations area OR + High… more
