- Zurich NA (Madison, WI)
- Marine Claims Senior Claims Specialist 126574 Zurich North America is hiring a Marine Claims Senior Claims Specialist Role (With Hull and ... and 6 or more years of experience in the Claims and/ or Litigation Management area.OR + Juris Doctor...and 2 or more years of experience in the Claims and/ or Litigation Management area.OR + Zurich Certified… more
- Artera (Madison, WI)
- Claims Specialist Summary Title: Claims Specialist ID:1773 Location:Madison, WI Department:Legal More about this job > Description JOB PURPOSE: Manage all ... claims while under the general supervision of the Claims Director. Provide monthly updates and reporting. Coordination and database management; and other… more
- Carrington (Madison, WI)
- **Come join our amazing team and work remote from home!** The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring the proper incurred losses ... identified during the Quality Review Process, communicating findings to Loss Specialist for remediation. Ensure Loss Specialist provides corrections as… more
- Molina Healthcare (Madison, WI)
- …**Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines, ... overpayment notification and supporting documentation such as explanation of benefits, claims and attachments. + Maintains and reconciles department reports for… more
- TEKsystems (Madison, WI)
- …- Iowa, Quad Cities, and Wisconsin The Insurance Billing and Follow Up Specialist II will be responsible for performing all billing and follow-up functions, ... of payment delays, resulting from no response, denied, rejected and/or pending claims with the objective of appropriately maximizing reimbursements and ensuring that… more
- Sedgwick (Madison, WI)
- …Fortune Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims ... and RESPONSIBILITIES** + Performs standard clinical reviews of referred medical claims based on client requirements to ensure accurate and sufficient information… more
- Travelers Insurance Company (Madison, WI)
- …reserve, negotiate and resolve the company's most severe and/or complex claims , in multiple jurisdictions, in accordance with Best Practices. Provide quality ... claim handling and superior customer service on assigned claims , while engaging in indemnity & expense management. Promptly manage claims by completing essential… more
- Molina Healthcare (Madison, WI)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- Sedgwick (Madison, WI)
- …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... of related experience to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI technical experience including… more
- Zurich NA (Madison, WI)
- Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am experienced Sr. Supplier Medical Process Specialist to join our team in one of ... to work/life balance, and outstanding culture. As a Sr. Supplier Medical Process Specialist , you will manage supplier performance and work product in area(s) of… more
- Molina Healthcare (Madison, WI)
- …Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members and provider (or authorized ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine Medicare appeal and claim outcomes.… more
- Molina Healthcare (Madison, WI)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions… more
- Molina Healthcare (Madison, WI)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system configurations… more
- CDM Smith (Madison, WI)
- …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs… more
- Baylor Scott & White Health (Madison, WI)
- **JOB SUMMARY** The Patient Services Specialist 2 provides administrative support in a physician office, clinic or other operational area that assists patients, to ... of patient registration procedures and documentation. Knowledge of medical insurance claims procedures and documentation. Needs to have thorough understanding of the… more
- Walgreens (Madison, WI)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Intermountain Health (Madison, WI)
- **Job Description:** The RCO Appeals Hearing Specialist is responsible for investigating, coordinating and managing legal insurance cases and represents ... ERISA, self-funded and federal and state laws around health insurance claims . + Develops and maintains collaborative relations with Intermountain legal, physicians… more
- Parexel (Madison, WI)
- …and improve patient outcomes. We are seeking a passionate and experienced **RWE** Specialist join our team and support the design and execution of clinical trials ... focus on oncology and hematology areas, but not exclusively. **Title:** RWE Specialist **Location:** Remote - US **The ideal candidate demonstrates proficiency in… more
- American Family Insurance - Corporate (Madison, WI)
- As an Advertising Compliance Specialist , you will provides a full range of compliance oversight, advice and services with specialist knowledge in support of the ... on enacted changes in legislation and regulations to assist with sales, claims or product development and maintenance. * Collaborate with various business units… more
- Carrington (Madison, WI)
- …completes the Set-up bankruptcy filings process, Motion for Reliefs, Proof of Claims , Transfer of Claims , Reaffirmations, Notice of Final Cures, Post-Petition ... the set-up bankruptcy filings, Motion for Reliefs, Proof of Claims , Transfer of Claims , Reaffirmations, Notice of Final Cures, Post-Petition Fee notices, Payment… more