- AIG (Atlanta, GA)
- …AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Law Firm Panel Director to play your part in that transformation. It's an ... the team's standard operating process. + Lead discussions with Claim leadership to develop Claims Law Firm...or financial services industry preferred. + Minimum 5 years prior experience working with Claim / Law… more
- AIG (Atlanta, GA)
- …knowledge of claim handling procedures, claims performance strategies, and claim best practices. + Prior management experience preferred. + Ability to ... customers to manage risk. Join us as a Managing Director to play your part in that transformation. It's...of claim file quality. + Conduct periodic claim file audits of field claims practices… more
- AIG (Atlanta, GA)
- …+ Bachelor's Degree or equivalent required. Multi-state adjuster licenses preferred. + Prior claims management experience desired. + Must possess excellent ... customers to manage risk. Join us as a Managing Director Complex Claims to play your part...expertise interpreting insurance contracts. + In depth knowledge of claim handling procedures, claims performance strategies, and… more
- CommuniCare Health Services Corporate (Akron, OH)
- …for proper documentation and will ensure that all necessary data was verified prior to billing. Additional responsibilities: + Check claim to verify correct ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...team, CBO cash posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management, and others. The… more
- Commonwealth of Pennsylvania (PA)
- …per week/two days per pay period . However, requests to telework must be sent to the Director prior to being off to ensure that no more than 20% of caseworkers ... attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements....Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using… more
- University of Colorado (Aurora, CO)
- …+ Establishes tracking mechanisms to monitor deliverables on assigned grants. + Obtains prior approval from Executive Director /PI and sponsor as indicated for ... **Finance & Accounting Assistant Director ** **Description** **University of Colorado Anschutz Medical Campus** **Department: College of Nursing** **Job Title:… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims Job Description **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. Analyst plays ... the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …determinations + Present reviewed cases to Medical Director + Resolve prior authorization issues derived from developed claims + Utilize internal system, ... a subject matter expert in the clinical review of claims , claim disputes, appeals and FWA special...and FWA special investigations Responsibilities: + Review of facility claim disputes including clinical records, itemized bills, prior… more
- Billings Clinic (Billings, MT)
- …regional affiliate locations to support risk functions as indicated by Risk Management Director . The Risk and Claims Specialist assists in coordination of the ... in coordination of medical malpractice claims at the direction of the Risk Management Director and/or the Risk and Claims Coordinator and Risk and Claims … more
- Beth Israel Lahey Health (Boston, MA)
- …a job, you're making a difference in people's lives.** Reporting to the Director of Revenue Cycle Operations, this position is responsible for planning, coordinating ... and managing HIPAA EDI activities including Claims , Remittance, as well as Provider Enrollment processing for...Enrollment is responsible for ensuring adherence to and communicating claim requirements for HMFP contracted payers, keeping current on… more
- Guidehouse (El Segundo, CA)
- …**:** None **What You Will Do** **:** The **Billing Supervisor - Healthcare Claims ** is responsible for the daily operations of billing and works closely with ... Billing Supervisor reports directly to an Operations Manager or Director level position and may perform any and all...Access, Medical Records and Information Systems to ensure clean claim rate meets established goals. + Works with both… more
- Beacon Mobility (Beacon, NY)
- …13,000+ vehicles at 200+ locations from New England to New Mexico. Reporting to the Director of Claims , the Region Claims Analyst provides oversight and ... management skills while delivering analytical support to operations, safety and claims leadership. Support to locations will require compliance with applicable… more
- City of New York (New York, NY)
- …Within AO, exists Office of Revenue that houses SNAP-CR. They establish SNAP claims for the agency according to the Federal SNAP guidelines to recover inaccurate ... supervise staff (PAAII, PAAI, Eligibility Specialist II) involved in Claims processing. - Monitor and distribute cases in the...and SNAP only sites, Quality Control and Internal Audits prior to establishing in WMS. - Conduct day to… more
- Insight Global (Minneapolis, MN)
- …issues in order to meet critical timelines. Escalates when necessary to Director . Review and oversight of completion for new system configuration setups. Review ... and approve prior to moves to production and ensures business sign...and Requirements Strong Facets configuration background, ideally focused on claims Strong knowledge of industry codes including HCPCs, ICD10s,… more
- IQVIA (Washington, DC)
- …coding, ie, CPT, HCPCS, ICD-10. + Understanding of CMS -1500 claim forms, prior authorization forms and appeals forms for claims adjudication. + Deep payer ... code or an unlisted CAT I CPT code. The Director , Patient Access Program Operations is also responsible for...+ 5-8 years of medical billing/coding, including benefit verification, prior authorization, and claim appeals. + Familiarity… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …growth, with a strong emphasis on quality control and improvements to enhance claims processing stability, flexibility, and innovation. The Director will be ... About The Role The Director of Application Support and Quality Assurance will...configuration including, benefit plans, accumulator exchange and provider contracts. Prior experience with implementing claims systems and… more
- MTA (New York, NY)
- Deputy Director , OCIP Management Risk Control Job ID: 10770 Business Unit: MTA Headquarters Location: New York, NY, United States Regular/Temporary: Regular ... Date Posted: Jun 16, 2025 Description JOB TITLE: Deputy Director , OCIP Management Risk Control SALARY RANGE: $128,255 -...of a staff of 2 people including the Sr Claims Administrator, 1 Analyst and approximately 7 consultants. +… more
- Prime Healthcare (Farmers Branch, TX)
- …Responsibilities The Corporate Director of Billing Optimization ... optimization and improved metrics across the clearing houses. The Director will partner with revenue cycle and business office...are not limited to: 837 files, billing edits, clean claim rate standards, billing errors and trends, as well… more
- Otsuka America Pharmaceutical Inc. (Bismarck, ND)
- **Job Description** Otsuka is seeking a Director , Global Clinical Development (GCD), who will be responsible for the design and oversight of clinical research ... for a global health-care market. The specific duties assigned to the Director , Global Clinical Development include the following: + Consults with patients or… more
- Veterans Affairs, Veterans Health Administration (Amarillo, TX)
- …System, Amarillo, Texas is seeking a Home Base Primary Care (HBPC Medical Director -Physician) within the Geriatric and Extended Care (GEC) Service. The HBPC Medical ... Director will provide clinical care within the GEC service...subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested… more