- HUB International (Berkeley Heights, NJ)
- …Violation of Any Applicable Unfair Practices and Unfair Competition + Overage Disputes ** Claims Advocate Role** + Conduct Monthly Dashboard Analysis + Lead ... **About SPG:** Specialty Program Group (SPG) is the wholesale &...candidate will manage a variety of complex, high value claims across the divisions and provide technical direction and… more
- Axis (Red Bank, NJ)
- …of 7 years of experience as a Scrum Master, including at least 3 years in specialty insurance or financial services. + At least 5 years of experience in Property ... join AXIS Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand...& Casualty (P&C) Insurance Claims . + Expertise in portfolio management… more
- Providence (Renton, WA)
- **Description** Must be an accomplished senior level claims adjudicator with at least 3 years prior claims processing experience and a proven track record of ... USFHPs instance of Athena IDX software. This role will work closely with Claims Management and Providence MCA support teams to investigate, document, and write… more
- Pacific Medical Centers (Seattle, WA)
- **Description** Adjudicates claims submitted by outside purchased services for PMC's enrolled capitated population and communicates those actions. Adjusts complex ... claims for advanced processing needs. Responds to Customer Service...large group practice setting. + Experience with areas of specialty claim processing (COB, Adjustments, Point of Service, Home… more
- WTW (Arlington, VA)
- …global mission + Clear articulation of emerging trends in pricing, underwriting and the Specialty (re) insurance market and how that can create value for our ... in a senior pricing or underwriting focussed P&C Commercial Specialty market role + A passionate advocate ...clients' business challenges + Comprehensive understanding of P&C Commercial Specialty Lines insurance products + Experience or… more
- Corewell Health (Grand Rapids, MI)
- …access to specialty medications and drive utilization of internal specialty pharmacy services. Performs insurance benefit investigations and prior ... MCC team covers multiple provider offices and specialties and collaborates with insurance companies, pharmacies, and Corewell Health clinics to obtain the necessary… more
- AON (New York, NY)
- … insurance and claim experience to help clients make better decisions about their insurance coverage and claims ? This is a hybrid role working from our New ... + Interface with insurers and related stakeholders as claim advocate with a focus on EPl/ML claims ....experience to help clients make better decisions about their insurance coverage and claims ? This is a… more
- Mount Sinai Health System (New York, NY)
- …pharmacy revenue cycle management to optimize the payment cycle for retail and specialty pharmacy claims . Ensure maintenance and understanding of the overall ... ensure collection according to contracts, understand and follow-up with insurance companies to leverage the revenue process. Utilize preferred...and related vendor data feeds into systems as required. Advocate on behalf of MSHS to ensure the most… more
- Ascension Health (Mequon, WI)
- …Hospital - Ozaukee campus. **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ... 100 related healthcare facilities and employs more than 1,100 primary and specialty care clinicians from Racine to Appleton. Serving Wisconsin since 1848, Ascension… more
- The Cigna Group (Bloomfield, CT)
- …to utilization management, case management, network, contracting, pharmacy, and service operations ( claims ). This is an entry to mid-level position for a physician ... Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and state… more