• Disability Representative Sr

    Sedgwick (Dublin, OH)
    … system. + Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims . + Evaluates and arranges appropriate ... Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr **PRIMARY PURPOSE** : Provides disability case management and routine claim… more
    Sedgwick (09/04/25)
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  • Sr Analyst-Workers Compensation

    Lowe's (Mooresville, NC)
    **Your Impact** The Sr Analyst-Workers Compensation Claims will provide insight and support to drive the operational excellence of the Workers Compensation ... Will Do** + Evaluates monthly, quarterly, and annual performance of claims administrator and subcontracted vendors through analyses such as cost-benefit,… more
    Lowe's (09/02/25)
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  • Sr VP Medical Director (Hourly)

    Sedgwick (Salem, OR)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr VP Medical Director (Hourly) The ideal candidate would work 8-20 hours per ... the following: + Conducting reviews on cases where the nurse is seeking treatment plan clarification, claim denial, disability...time frame. + The oversight of the appeal and review process including making a recommendation of specialty for… more
    Sedgwick (08/22/25)
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  • Sr . Claim Representative Construction…

    Travelers Insurance Company (Walnut Creek, CA)
    …internal and/or external resources for specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse consultants, and ... resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
    Travelers Insurance Company (09/01/25)
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  • Medical Bill Review Senior…

    Zurich NA (Schaumburg, IL)
    Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse ** to work from our ... and resolve issues by working with corporate law, Technical Claims and other, as necessary. + Prepare, attend and...adhering to Best Practices and participating in monthly peer review audits. + Ensure legal compliance by following regional,… more
    Zurich NA (09/10/25)
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  • RCM Representative Senior , Third-Party…

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *SUMMARY:* We are currently seeking a*RCM Representative Senior *to join our Third-Party Claims -HB&PB team. This full-time role will primarily work remotely ... of applicable federal and state regulations **Title:** *RCM Representative Senior , Third-Party Claims -HB&PB* **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… more
    Minnesota Visiting Nurse Agency (09/06/25)
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  • Multi-Site Senior Medical Assistant-…

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Multi-Site Senior Medical Assistant, (Multi-Site Sr . MA) position is responsible for working at multiple sites, within multiple ... specialties and service lines. The Multi-Site Sr . MA is responsible for providing high quality support...the direct supervision of a Physician, APP and/or Registered Nurse . This position oversees appropriate scope of practice, (ie… more
    Houston Methodist (08/29/25)
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  • Chronic Kidney Disease - Clinical Nurse…

    Blue KC (Workman, MN)
    …transplant network. + Ensures proper payment of pre-transplant, transplant, and post-transplant claims . Sets up transplant pre-pay review for each individual ... in FACETS UM system in accord with UM concurrent review guidelines. Consults with Medical Director on cases outside...global payment process to ensure accurate payment. Responds to claims inquiries. + Accurately reports potential high cost members… more
    Blue KC (08/20/25)
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  • Denials and Appeals Nurse

    Dayton Children's Hospital (Dayton, OH)
    …acute care experience in a hospital required + 3-5 years as progressive utilization review nurse and knowledge of payers and managed care contracts preferred + ... Facility:Work From Home - OhioDepartment:Utilization Review TeamSchedule:Full timeHours:40Job Details:Reporting to the Manager of Utilization Management and in… more
    Dayton Children's Hospital (09/05/25)
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  • Senior Risk Management Specialist

    UPMC (Pittsburgh, PA)
    …of professional liability and share information with appropriate management and staff. Review and evaluate potential and current claims with relevant internal ... UPMC Corporate Legal is seeking a Senior Risk Management Specialist to join the team...Management, the role involves systematically managing potential and actual claims . Analyzing clinical data is crucial for identifying liability… more
    UPMC (08/08/25)
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