- TEKsystems (Dallas, TX)
- …of the servicer and/or client + Files respective investor/insurer initial and final claims based on the respective guidelines for allowable limits + Reviews MI claim ... and research curtailment reasons for potential rebuttal + Files Appeal or Supplemental Claims ensuring all allowable advances and interest are recovered from the MI… more
- Molina Healthcare (Austin, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Providence (Renton, WA)
- …Directors and Officers, Employment Practices, Fiduciary, Property, Cyber, Managed Care, and Auto Claims . The Senior Quality Analyst assists the Claims ... and regulations pertaining to self-insured health care organizations. The Senior Quality Analyst is also responsible for maintaining a claims quality assurance… more
- AIG (Atlanta, GA)
- …AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Analyst IV to play your part in that transformation. It's an opportunity to ... efficiency. How you will create an impact The Casualty Claims Analyst IV within the Lexington and...investigation, damage evaluation and claim resolution in accordance to regulatory and company standards. + Conducts a thorough investigation… more
- UMB Bank (Kansas City, MO)
- **Duties & Responsibilities :** Open to hybrid or remote working schedule The Sr Card Fraud Claims Analyst will be a member of the UMB Card Operations team and ... will report directly to the Card Fraud Claims Manager. Responsibilities of this position will include supporting...to ensure compliance with Reg E and Reg Z regulatory requirements. Serving as back-up for working basic reconciliation… more
- Lowe's (Mooresville, NC)
- **Your Impact** The primary purpose of this role is to serve as a high-risk claims analyst for the Legal department, handling high risks/high value cases and ... issues. The role will also serve as an escalation point for the Claims Management department to transfer cases that, through development, meet specific triggers,… more
- Highmark Health (Frankfort, KY)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- CenterLight Health System (NY)
- JOB PURPOSE: The Claim Analyst will play a pivotal role in enhancing the efficiency and effectiveness of the claims department by evaluating and refining ... guidelines. This position requires a working knowledge of Government Programs medical claims payment system and configuration with strong focus on data review and… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Position Summary: Working under the direction of the SVP Claims , the Senior Data Analyst - Payment Integrity & Claims will provide ... and Executive Teams. * Conduct independent research and analysis using regulatory guidance, government data and statistics, reports, publications, and other publicly… more
- Molina Healthcare (Cleveland, OH)
- … claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are appropriately applied. Manages and leads ... claims projects + Assists with reducing re-work by identifying and remediating claims processing issues + Locate and interpret regulatory and contractual… more