- Guardian Life (Columbus, OH)
- Grow your career with Guardian in our newly created opportunity as a **Claim Case Manager II , Supplemental Health** ! In a culture where "People Count," "We ... decisions via telephone and in writing. + Prioritize and review new claims to adhere to established departmental turnaround times. + Meet productivity requirements… more
- Walmart (Bentonville, AR)
- …denial of the claim; and reserving file for payments that exceed authority for manager and serious case review. + Minimizes legal exposure by securing services ... in the claim/image management system. + Handles monetary aspects of assigned claims by establishing reserves within approval level; notifying store managers of… more
- Marriott (Costa Mesa, CA)
- …Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** A Claims Adjuster II is responsible for the timely, good faith ... and complexity of Worker's Compensation and General Liability cases as determined by Claims Unit Manager .) **Expected Contributions** + Investigate claims … more
- USAA (Colorado Springs, CO)
- …liability and questionable coverage issues. + Applies intermediate knowledge of claims litigation processes. + Proactively manages litigation and acts as liaison ... negotiation, settlement, and trial decisions. + Represents USAA at mediations, case conferences, and/or trials. + Reviews, audits, and approves legal fees… more
- Elevance Health (Indianapolis, IN)
- **"Telephonic" Nurse Case Manager II ** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point ... of receipt and meet the criteria._** The **"Telephonic" Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** + Requires a… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager II ** **- $3000 Sign-On Bonus Offered** **Location: This is a virtual position, but you must reside in the State of Georgia.** ... of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** + Requires a… more
- Elevance Health (Atlanta, GA)
- …report to a Pulsepoint once a week (subject to future change). The **Nurse Care Manager II ** is responsible for care management within the scope of licensure for ... as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of...services in multiple states. **Preferred Experience** Certification as a Case Manager is preferred. BS in a… more
- Sutter Health (San Francisco, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and… more
- Sutter Health (Modesto, CA)
- …RN-Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + 3 years of recent Case Manager experience in Acute Care preferred. **SHIFT:** + The shift ... patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely… more
- LA Care Health Plan (Los Angeles, CA)
- …Worker; current and unrestricted California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... Care Management Specialist II Job Category: Clinical Department: Care Management Location:...skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and… more
- HCA Healthcare (Lone Tree, CO)
- …this role. The typical candidate is hired below midpoint of the range. **RN Case Manager ** **Part Time Wednesday, Thursday, Friday shifts** **Will Float to all ... any other healthcare provider. We are seeking a(an) RN Case Manager Part Time Float to join...acute care setting. + Performs telephonic clinical reviews with claims insurance personnel to facilitate reimbursement for the delivery… more
- Sutter Health (Burlingame, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and… more
- WellSpan Health (York, PA)
- Patient Financial Services Representative II Location: WellSpan Health, York, PA Schedule: Full Time Sign-On Bonus Eligible Remote/Hybrid Regular Apply Now See More ... Cycle functions including, submitting electronic and / or manual insurance claims , resolves claim edits, performs insurance account follow-up, researches claim… more
- State of Colorado (Greeley, CO)
- Employee Relations Specialist (Administrator II ) - Greeley Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4488772) Apply Employee Relations ... Specialist (Administrator II ) - Greeley Salary $48,396.00 - $55,644.00 Annually Location...is provided based upon multiple and complex federal laws, case law, regulations, state personnel system rules, as well… more
- LA Care Health Plan (Los Angeles, CA)
- …a clean record and Auto Insurance Required Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service… more
- CAMBA (Brooklyn, NY)
- …the ability to recognize, diffuse, and/or avoid violent situations. Position: Supervisor II Reports To: Program Manager Location: 955 Flatbush Avenue, Brooklyn, ... clients with assistance is processing Crime Victims Board Compensation Claims ; individual and group counseling' support groups, housing assistance,...NY 11226 What The Supervisor II Does: + Provide individual counseling to victims of… more
- Intrepid USA (Bartlett, TN)
- …Reporting . Outstanding Orders Reporting . Past Due Tasks Reporting . QA Manager Reporting . Visit Exception Reporting + Maintaining the patient's electronic medical ... requests for authorization to Authorization Department and/or obtains pre-authorization from case managers, state and county billers as needed. + Obtaining timely… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Patient Access Concierge II - St. Peter's Hospital - FT - Days Greets patients and family ... authorizations (pre-certifications, third-party authorizations, referrals) and contacts physicians and Case Management/Utilization Review personnel, as needed. Obtains and verifies… more
- U-Haul (Phoenix, AZ)
- …is seeking an experienced Major Case Unit Adjuster. Under the direction of the Major Case Unit Manager , you will be responsible for managing a desk of all ... claims that are taken over by MCU for affirmative...U-Haul was generated out of need. After World War II , there existed the widespread need for do-it-yourself moving… more
- HCA Healthcare (Round Rock, TX)
- **Description** **Introduction** Are you ready to manage in a new era as a Manager of Risk Management where building a healthier tomorrow is more than a job? Our St. ... hospital services happen at an HCA Healthcare facility. Be an impact as a(an) Manager of Risk Management where your passion for leading and creativity are valued? We… more