- Trinity Health (Livonia, MI)
- …files, coordinating claim process activities, opening and closing claim files, securing medical records for claims and incidents, tracking claim expenses and ... two days a week._** Claim technicians are a vital component to the IRMS Liability Claims operation. The position is responsible for maintaining electronic claim… more
- Citizens (Medford, MA)
- Description As a Fraud Claims Sr. Specialist, you'll play a pivotal role in our Fraud and Claims Operations group, one of our most critical departments at ... financial transactions. You'll use critical thinking skills to assist customers with existing claims and determine the best next step for the customer and the bank.… more
- Walmart (Bentonville, AR)
- …and responsibilities; documenting case details; determining whether payment is warranted; and managing multiple claims related to a single event as required. + ... primary job location** + Leads claim investigations by conducting ongoing medical and legal reviews; commissioning field investigators, reconstructionists, and cause… more
- TEKsystems (Minneapolis, MN)
- …of our healthcare clients is actively recruiting for fully remote Quality Assurance Specialists ! FULLY REMOTE and can sit anywhere in the United States! Start Date: ... + Review and quality test all healthcare benefits for the client + Work within multiple systems to make sure the plan is built out correctly and to the specs… more
- Truist (Whiteville, NC)
- …unresolved issues accurately, to ensure timely follow up and resolution. Servicing specialists act as client advocates to track client complaints and feedback ... One year of client servicing work experience (call center, retail, hospitality, medical , etc.) + Proficiency in computer applications (eg Windows, Microsoft Office),… more
- Travelers Insurance Company (Buffalo, NY)
- …bills, mail and wage statements. Prints and prepares claim documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to ... + CLAIM OPERATIONAL SERVICE AND PARTNERSHIPS: Partners with claim professionals in multiple departments to assist with the timely resolution of claims ,… more
- New York State Civil Service (Albany, NY)
- …auditors, investigators, nurses, data analysts, pharmacists, other clinical/ medical professionals, compliance specialists , program administrators/managers, ... of the Title Medicaid Integrity Specialist 1/Trainee 1 (NY HELPS) - multiple vacancies Occupational Category Other Professional Careers Salary Grade NS Bargaining… more
- Commonwealth Care Alliance (Boston, MA)
- …& Controls Assurance, the incumbent is responsible for independent quality reviews of medical claims , and evaluating Call Center activities for compliance with ... compiling review results and timely communication to the business area leadership. For Medical Claim reviews, post-payment review of claims that were manually… more
- Beth Israel Lahey Health (Plymouth, MA)
- …with malpractice, hospital litigation and depositions. + The Director will oversee the Risk Specialists for referral of lawsuits, claims and potential claims ... and patient safety issues. + Ensures that the Risk Specialists Investigate and monitor all hospital sentinel events and... Staff Officers with tracking/trending of adverse outcomes and medical malpractice claims in order to improve… more
- Travelers Insurance Company (Wyomissing, PA)
- …evaluate, reserve, negotiate and resolve the company's most severe and/or complex claims , in multiple jurisdictions, in accordance with Best Practices. Provide ... quality claim handling and superior customer service on assigned claims , while engaging in indemnity & expense management. Promptly manage claims by completing… more
- Ventura County (Ventura, CA)
- …entry level in this series. Incumbents work under supervision of higher level Medical Billing Specialists and within established guidelines. Medical Billing ... Medical Billing Specialist I/II Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4487403) Apply Medical Billing Specialist I/II Salary… more
- CVS Health (Hartford, CT)
- …improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims . You will be a key link in providing our ... make health care more personal, convenient and affordable. This Claims Benefits position is Onsite at our Hartford, CT...provided under a member's health plan + Efficiently use multiple systems and screens to obtain and record claim… more
- The County of Los Angeles (Los Angeles, CA)
- …non-panel physicians on procedure for becoming approved. + Refers patients to specific medical specialists who have been certified by the State Department of ... MEDICAL SERVICE COORDINATOR, CCS (Registered Nurse, Pediatrics -...to the program. This class manages complex cases involving multiple diagnoses and requiring coordination of services provided by… more
- Sacramento County (Sacramento, CA)
- …4/4/24, 4/25/24, 5/16/24, 6/6/24 (final) Under general supervision, Construction Management Specialists serve as assistants to the Resident Engineer on the ... construction phase of a single, complex public works project or multiple projects of less complexity. The Construction Management Specialist assists in ensuring that… more
- The County of Los Angeles (Los Angeles, CA)
- …experience will be accepted DEFINITION: Provides technical lead to Environmental Health Specialists III and Environmental Health Specialists II working in a ... duties as delegated and provide technical lead guidance to Environmental Health Specialists III and Environmental Health Specialists II engaged in inspection,… more
- Robert Half Finance & Accounting (Eugene, OR)
- …auditing and reconciling a wide range of personnel actions, unemployment insurance claims , and payroll documents for multiple companies, while also processing ... employee data and insurance claims . Our client will train to utilize Paychex payroll...employees. This position will be one of three Payroll Specialists processing payroll for multiple locations and… more
- CareOregon (Portland, OR)
- …of the following areas: Provider relations, managed care operations (eg, claims , appeals, grievances, customer service), medical /behavioral health clinic ... Medicaid arenas. + Conduct and/or support new provider orientations (PCPs, Specialists , Vendors); train clinic office staff on CareOregon administrative processes. +… more
- Surgery Care Affiliates (Port Saint Lucie, FL)
- …and resolves all rejections in electronic claim clearinghouse, prepares and mails UB claims , and gathers appropriate medical records to send with claims ... teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create… more
- CareOregon (Portland, OR)
- …of the following areas: Provider relations, managed care operations (eg, claims , appeals, grievances, customer service), medical /behavioral health clinic ... determinations and oversight. + Conduct new provider orientations (PCPs, Specialists , Vendors); train clinic office staff on CareOregon administrative processes.… more
- Colgate-Palmolive (Overland Park, KS)
- …scientific & clinical nutrition expertise during the core product and wellness claims substantiation, bundle development and approval processes. * Support the update ... and develop veterinary and clinical nutrition perspective on key competitors' claims and products to address competitive pressure and develop a cross-functional… more