- UPMC (Pittsburgh, PA)
- …and establishes and revises better best practice within the department. The Intermediate Clinical Auditor Analyst reviews medical records, creates, maintains, ... **UPMC Health Plan is looking for an Intermediate Clinical Auditor/Analyst to join the Quality Assurance...collaboration with appropriate Health Plan departments including Quality Improvement, Claims , and Medical Directors as needed to… more
- Travelers Insurance Company (Hartford, CT)
- … Intermediate + Value Determination- Intermediate + Settlement Techniques- Intermediate + Medical Knowledge- Intermediate **What is a Must ... is responsible for handling Personal and Business Insurance Auto Bodily Injury claims from the first notice of loss through resolution/settlement and payment… more
- Travelers Insurance Company (Hartford, CT)
- …This position is responsible for handling Personal and Business Insurance First Party Medical claims from the first notice of loss through resolution/settlement ... Intermediate . + Value Determination: Intermediate . + Settlement Techniques: Intermediate . + Legal Knowledge: Basic. + Medical Knowledge: Intermediate… more
- Travelers Insurance Company (Hartford, CT)
- … Intermediate + Value Determination- Intermediate + Settlement Techniques- Intermediate + Medical Knowledge- Intermediate **What is a Must ... and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provide quality claim handling throughout the claim life cycle (customer… more
- Travelers Insurance Company (Buffalo, NY)
- … with lost time to conclusion and negotiate settlements where appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a ... Medical Case Manager. Independently handles assigned claims ...rules and regulations applicable to the insurance industry. + Medical knowledge: Intermediate knowledge of the nature… more
- Travelers Insurance Company (Houston, TX)
- …oversight of the repair process and ensures appropriate expense handling. + On specified claims , evaluates medical treatment based on the nature and extent of ... moderate to complex Personal and Business Insurance Auto Damage claims as well as low complexity Bodily Injury Liability...skills and Windows proficiency, including Excel and Word - Intermediate + Verbal and written communication skills - … more
- Travelers Insurance Company (Albuquerque, NM)
- …contact with appropriate parties. + Develop and manage litigation strategy with Hearing Representative or Defense Counsel on litigated claims . + Engage specialty ... at their own expense to Albuquerque, NM. Under moderate supervision Investigate claims to determine compensability, and assert our customers legal rights to pay… more
- Travelers Insurance Company (Melville, NY)
- …**Target Openings** 5 **What Is the Opportunity?** This position handles First Party Medical Litigation or Arbitration claims from the first notice of ... + Settlement Techniques - Intermediate + Legal Knowledge - Intermediate + Medical Knowledge - Intermediate **What is a Must Have?** + High… more
- Travelers Insurance Company (Irvine, CA)
- … with lost time to conclusion and negotiate settlements where appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a ... Medical Case Manager. Independently handles assigned claims ...rules and regulations applicable to the insurance industry. + Medical knowledge: Intermediate knowledge of the nature… more
- Travelers Insurance Company (Melville, NY)
- …**Target Openings** 1 **What Is the Opportunity?** This position handles First Party Medical investigations that lead to resolution of claims . Provides quality ... + Settlement Techniques - Intermediate + Legal Knowledge - Intermediate + Medical Knowledge - Intermediate **What is a Must Have?** + High… more
- Travelers Insurance Company (Hartford, CT)
- …that requires satisfactory completion of required training to advance to Claim Representative - General Liability position. This position is intended to develop ... skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim… more
- Robert Half Accountemps (San Leandro, CA)
- …of Behavior Policy and Procedures and Scope of Services. * Display intermediate knowledge of insurance claims , insurance terminology, and claim administration. ... part in our finance team, focusing on reviewing payer contracts claims and performing third-party collection activities for hospital services. Responsibilities: *… more
- Universal Health Services (Las Vegas, NV)
- …patient experience. Learn more at: https://prominence-health.com/ Job Summary: Provider Relations Representative is responsible for assisting in the full range of ... in identifying and remediating operational short-falls and researching and remediating claims ; and is responsible for steerage initiatives, site visits, training,… more
- Travelers Insurance Company (West Bridgewater, MA)
- …requires satisfactory completion of required training to advance to the Claim Representative , Recovery position. This position is intended to develop skills for ... investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle… more
- Kelly Services (Mason, OH)
- …Degree preferred) + 1+ years' experience in high-volume call center experience + Medical related background ( medical billing, claims experience, in office ... 7:00PM (Training and Production) **GENERAL FUNCTION** The Customer Service Representative provides high quality multi-channel (telephonic, chat, email, social media,… more
- Garnet Health (Middletown, NY)
- … Representative on our Patient Financial Services team at/in Garnet Health Medical Center-Middletown. Responsibilities Files insurance claims to all payers in ... timely and accurate manner. Representative serves as primary contact for patient reimbursement issues...or equivalent required, Associates degree preferred in a related medical field or business. Must be proficient in computer… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Enrollment Services Representative II Job Category: Customer Service Department: Enrollment Services Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Customer Solution Center Enrollment Services Representative II is responsible to audit, research, update and maintain the… more
- TEKsystems (Phoenix, AZ)
- Description: + Inbound healthcare contact center representative role + Managing phone and message inquiries from our patients and those involved in their care as ... navigating or learning all things healthcare, including but not limited to medical records, authorizations, referrals, and coordinating care among our members' care… more
- UNC Health Care (Smithfield, NC)
- …carrier denial of claim is valid and if not, abstracts information from medical records to support appeal of denial. Works in conjunction with appropriate resources ... and quarterly Credit Balance reports. 6. Payor Audits & Pro-Active Medical Records Requests: Oversee and document all submissions pertaining to payor-generated… more
- The Cigna Group (Nashville, TN)
- …people at some critical points of their lives. The Call Center Customer Service Representative represents the company, and our people make all the difference in our ... from members, providers, and customers regarding Pharmacy inquiries, benefits and Claims , Drug price checks, general information, Home Delivery Services, and Retail… more
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