- Boston Mutual Life Insurance (Canton, MA)
- …: Minimum of 1 year of business/office experience. Sr. Claim Examiner : Minimum of 2 years life/medical claims experience required. Knowledge Requirements: ... where we found them" **Statement of Position** The Life Claim Examiner reports directly to the Life... is responsible for managing and processing all assigned claims with adherence to company policies and contract provisions… more
- Sedgwick (Boston, MA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Liability (REMOTE; NY License , BI, and Litigation Exp ... investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and timely… more
- Sedgwick (Boston, MA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner , Bodily Injury (Auto) **PRIMARY PURPOSE** : To analyze and ... RESPONSIBILITIES** + Processes complex auto commercial and personal line claims , including bodily injury and ensures claim ...line claims , including bodily injury and ensures claim files are properly documented and coded correctly. +… more
- Intermountain Health (Boston, MA)
- **Job Description:** The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims , in a timely and ... standard and follows up timely to meet compliance standards for claims , pends, and tasks. Reviews claim images and batches to ensure accuracy. Uses proper plan… more
- Travelers Insurance Company (West Bridgewater, MA)
- …Imagine loving what you do and where you do it. **Job Category** Claim , Finance and Accounting **Compensation Overview** The annual base salary range provided for ... Range** $117,200.00 - $193,400.00 **Target Openings** 1 **What Is the Opportunity?** Travelers' Claim organization is at the heart of our business by providing peace… more
- Sedgwick (Boston, MA)
- …and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on ... projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles...claim status; and provides written resumes of specific claims as requested by client. + Assures that direct… more
- Sedgwick (Boston, MA)
- …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... to advance to the next round, a recruiter will be in touch. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable range of compensation for… more
- Prime Therapeutics (Boston, MA)
- …and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively ... compliance with federal, state and local laws pertaining to investigations and fair claims handling practices; evaluate risk to determine how best to proceed with… more
- Prime Therapeutics (Boston, MA)
- … claims processing environment **Preferred Qualifications** + Certified Fraud Examiner or Accredited Health Care Fraud Investigator + National Pharmacy Technician ... and client initiatives; engage in cross functional analysis of medical and pharmacy claims ; lead FWA investigations for federal employee program + Stay current on… more
- Highmark Health (Boston, MA)
- …**Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) ... (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have… more
- Eastern Bank (Lynn, MA)
- …and detailed records in the case management system. + Responsible for managing affidavits/ claims process submitted to the bank, to determine liability upon the bank ... languages, etc., required to perform the job.) + Certified Fraud Examiner (CFE), Certified Financial Crimes Investigator (CFCI) professional designation preferred +… more