- Berkshire Hathaway Homestate Companies (Omaha, NE)
- …notices to providers, injured workers, claims staff, and attorneys. Act as a medical resource in regards to utilization review to Claims Support Nurse, ... positive and close working relationship with other Company staff, including the claims staff, medical bill review , claims support nurse, special… more
- USAA (Phoenix, AZ)
- …what truly makes us special and impactful. The Opportunity As a dedicated Manager, Claims Operations, you will lead and be accountable for auto, and other claims ... assistance is not available for this position. What you'll do: Inspect and review quality of claim files and provide feedback to employees as appropriate.… more
- AUROBINDO (Durham, NC)
- …resumes, conducting phone screens, and interviewing.Assist with benefits administration including medical , dental, vision, COBRA and 401(k), health and welfare open ... and documentation in accordance with legal requirementsPerformance ManagementCoordinate performance review cycles and goal-setting processes.Support managers in delivering feedback… more
- Eisai, Inc (Nutley, NJ)
- At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care ... pharmaceutical laws and industry guidelines including the Anti-Kickback Statute, False Claims Act, federal and state pricing-related laws and regulations, PhRMA Code… more
- Chubb (Southfield, MI)
- …to a brighter future for employees everywhere! We are seeking a skilled Senior Claims Representative to enhance our team. Reporting to the Claims Team Leader, ... will play a vital role in investigating and managing claims promptly and equitably, in line with established best...and recommend reserve adjustments to the Team Leader. Regularly review claim progress with the Team Leader, identifying challenges… more
- INTEGRO (Tampa, FL)
- …collaboratively. Must pass a background check and drug screening. Position Responsibilities: Review and evaluate automotive extended warranty claims submitted by ... sounds like you, we want to hear from you! As an Experienced VSC Mechanical Claims Adjuster , you'll play a critical role in the claims administration process… more
- Sedgwick (Irving, TX)
- …are properly documented, and claims coding is correct. May process complex lifetime medical and/or defined period medical claims which include state and ... as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Liability - Irving, TX - Hybrid Are you looking for an… more
- Premier Administrative Solutions (Clearwater, FL)
- …strong operational controls relating to claims cost control, including review processes for potential pre-existing conditions, determining medical necessity, ... claims administration, is where submissions for payment/reimbursement/sharing from medical providers and covered individuals are reviewed, subject to cost… more
- POM Recoveries Inc (Farmingdale, NY)
- …expertise in medical collections, denial processing, appeal submission, and EOB review to resolve unpaid claims effectively. KEY RESPONSIBILITIES: The ideal ... professional with a minimum of 2 years of hospital in-patient and out-patient claims follow-up experience? Join our team as an Insurance Claims Follow-up… more
- CenCal Health (Santa Barbara, CA)
- …leadership for medical management functions; assists subordinate managers in resolving medical claims review , grievances, appeals, and other medical ... approves/denies or offers medical alternatives according to CenCal Health medical review criteria; willingness to outreach to providers by phone and in… more
- Berkshire Hathaway Homestate Companies (Walnut Creek, CA)
- …Reasonable caseload with in-house Medical Management support (UR, Med Bill Review , Resource Nurses); In-house Claims Assistant support Modern Office Setting ... Medical Management, Special Investigations, Client Services, Underwriting, and Claims Legal. Communicates effectively with individuals outside the company,… more
- Unknown (Lakewood, NJ)
- …to ensure timely and fair claim settlements. Duties and responsibilities: Review and analyze workers' compensation claims to determine eligibility ... About the role: Leading provider of innovative solutions claims handling and Risk Management in the Healthcare space seeks a Work Comp Claims professional to… more
- Sedgwick (Minneapolis, MN)
- …are properly documented and claims coding is correct. May process low-level lifetime medical and/or defined period medical claims which include state and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Liability - Richfield, MN PRIMARY PURPOSE : To process low… more
- Gallagher (Carrollton, TX)
- …Peters MO office 2-3 times per week How you'll make an impact Apply claims management experience to execute decision-making to analyze claims exposure and ... plan the proper course of action, and appropriately resolve claims . Interact extensively with various parties involved in the...depending on your job level these benefits may improve: Medical /dental/vision plans, which start from day one! Life and… more
- GameStop (Grapevine, TX)
- …policy renewals, deductibles, and self-insurance programs. Maintain insurance and claims -related documentation, dashboards, and reports for executive review . ... claims . Drive early intervention and return-to-work strategies, including medical provider coordination and accommodation oversight. Lead OSHA reporting and… more
- Bluefire Insurance Services LLC (Shreveport, LA)
- …offer a robust benefits package that includes: Health Care: Choices among several medical , dental, and vision plans. Retirement Plan: A 401K plan with a percentage ... arise during the investigation of the claim Reviews all claims assignments to ensure accuracy of prior claim handling...pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department… more
- Corvel (Rockville, MD)
- …customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with ... and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation … more
- Sedgwick (Meridian, ID)
- …are properly documented and claims coding is correct. May process low-level lifetime medical and/or defined period medical claims which include state and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Workers Compensation | Boise, ID Are you looking for an… more
- MCI Careers (Wichita, KS)
- …to complete account management tasks Accurately document and process customer claims in appropriate systems Follow all required scripts, policies, and procedures ... and effective call handling Attend meetings and training and review all new training material to stay up-to-date on...cars! Health Benefits: Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 60 days of… more
- Greenlife Healthcare Staffing (New York, NY)
- …: Active NYS Registered Nurse license Experience : At least 2 years in utilization review , claims , medical review , fraud investigation , or monitoring ... ; OR 3 years of clinical or administrative experience; OR Bachelor's in Nursing + 2 years clinical/administrative experience Minimum 1 year of nursing home survey experience is required Certifications : SMQT Certification is preferred (or must be obtained… more
