- 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 (Phoenix, 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
- Molina Healthcare (Phoenix, 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
- 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
- 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