- Sedgwick (Phoenix, AZ)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr . Claims Specialist , Medical Malpractice (LTC) **PRIMARY PURPOSE** ... : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- Bank of America (Phoenix, AZ)
- Sr Service Specialist - Year Up...client questions and inquiries **Skills:** + Analytical Thinking + Claims Management + Customer and Client Focus + Oral ... and municipal laws. The company also prohibits discrimination on other bases such as medical condition, marital status or any other factor that is irrelevant to the… more
- CVS Health (Phoenix, AZ)
- …And we do it all with heart, each and every day. **Position Summary** The ** Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ... amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, determine… more
- Sedgwick (Tucson, AZ)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Estimate Review Specialist **PRIMARY PURPOSE** **:** To review all ... services. + Monitors, assists, tracks, and provides approval for all claims that are re-inspected by the Carrier. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES**… more
- CRC Insurance Services, Inc. (AZ)
- …of America) **Please review the following job description:** Analyzes and processes claims by gathering information, drawing conclusions. tracking and managing the ... claims process. **ESSENTIAL DUTIES AND RESPONSIBILITIES** Following is a...of CRC Group offering the position. CRC Group offers medical , dental, vision, life insurance, disability, accidental death and… more
- CVS Health (Phoenix, AZ)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Molina Healthcare (Chandler, AZ)
- …complaints from Molina members, providers and related outside agencies. + Research claims appeals and grievances using support systems to determine appeal and ... grievance outcomes. + Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business… more
- The Hartford (Scottsdale, AZ)
- Specialist Claims - CH07DE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... a motivated, initiative-taker who would enjoy a fast-paced collaborative work environment! The claims specialist will enjoy working primarily on a caseload of… more
- Interior, Bureau of Indian Affairs (Keams Canyon, AZ)
- …inmates, security activities, and the interpretation of departmental policy; submitting to senior officials written and oral reports on such areas as inmate records, ... specialized experience and education that totals 100% of the experience requirement. MEDICAL REQUIREMENTS: The duties of this position require moderate to arduous… more
- Highmark Health (Phoenix, AZ)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Banner Health (Phoenix, AZ)
- …Rel **Work Shift:** Day **Job Category:** Risk, Quality and Safety The ** Senior Director, Clinical Risk Management & Patient Relations** will provide strategic and ... to the clinical risk management team and patient relations team. The Senior Director, Clinical Risk Management and Patient Relations has oversight for Clinical… more
- Banner Health (Tucson, AZ)
- …customers and communities. As the Risk Program Manager supporting Banner Medical Center-South and the Ambulatory entities (clinics, home health, Imaging), you ... the Risk Manager may be responsible for the functions in the Risk Specialist job description, this position most often provides guidance, oversight and offers… more
- Highmark Health (Phoenix, AZ)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... of financial exhibits. This is an entry level position, with oversight by Senior Underwriters and/or Management until the individual is acclimated to the Company… more
- Medtronic (AZ)
- …articulate to customers. + Execute engaging field sales and clinical specialist field education programs that are targeted, purposeful, and support electrophysiology ... Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through… more