- Lincoln Financial (Omaha, NE)
- …#:** 74680 **The Role at a Glance** We are excited to bring on a highly motivated Claims Director to our Claims Organization! * As a Claims ... manage will oversee and ensure the fair, ethical and timely management of complex claims for your assigned area(s) of responsibility. You will also be directing and… more
- Sedgwick (Omaha, NE)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Business Development Director As a Business Development Director at Sedgwick, you'll have ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- JE Dunn Construction Company (Omaha, NE)
- Safety Director - Advanced Facilities Group (AFG) Location: Kansas City, MO, US, 64106Oklahoma City, OK, US, 73104Austin, TX, US, 78704Tempe, AZ, US, 85281North ... of industry professionals._ **Role Summary** The Advanced Facilities Group (AFG) Safety Director will provide overall direction and leadership on safety and health… more
- Molina Healthcare (Omaha, NE)
- …activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, ... focused reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care.… more
- Molina Healthcare (Bellevue, NE)
- …analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member ... Appeals and Grievances. * Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the… more
- Molina Healthcare (Bellevue, NE)
- …monitor and ensure service issues are resolved, including escalated claims payments/disputes, provider demographics, provider contracting accuracy and credentialing. ... **Job Qualifications** **Required Education** Bachelor's degree **Required Experience** * 8+ years of network relations and development, including experience building and maintaining relationships with provIder systems. * 7+ years of experience in a network… more
- Molina Healthcare (Bellevue, NE)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... management and credentialing. **Knowledge/Skills/Abilities** * In conjunction with the Director , Provider Contracts, develops health plan-specific provider contracting strategies,… more
- MetLife (Omaha, NE)
- …and render appropriate claim decisions pursuant to certificates on all claims . * Compare duration control guidelines and clarifies functional inconsistencies. * ... if/when to involve specialty resources such as Psychiatric Clinical Specialist, Medical Director or other clinical staff to obtain additional information on a claim… more
- Hy-Vee Food Stores (Council Bluffs, IA)
- …+ Professionalism Reporting Relations: Accountable and Reports to: District Store Director ; Store Manager; Assistant Managers of Health Wellness Home, Store ... containers. + Prepares prescriptions to be mailed. + Prepares and submits insurance claims . + Files prescriptions after they have been dispensed. + Reports any… more
- Zurich NA (Omaha, NE)
- …retail automotive finance or senior sales management (eg GM, GSM, Finance Director , Finance Manager). + Experience in dealership training (1:1, classroom, virtual). ... and traditional software/technology. + Knowledge of insurance, reinsurance, and warranty claims processes and F&I products. + Ability to analyze financial… more