- CVS Health (Hartford, CT)
- …+ Distributes work assignment daily to junior staff. + Trains and mentors claim benefit specialists. + Makes outbound calls to obtain required information ... handle customer service inquiries and problems. **Additional Responsibilities** + Reviews pre-specified claims or claims that exceed specialist adjudication… more
- CVS Health (Hartford, CT)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- Prime Therapeutics (Hartford, CT)
- …+ MISCELLANEOUS DUTIES: + Provide backup support to team members (SIU Coordinator and Senior SIU Specialist ) in the performance of job duties as assigned. + ... drives every decision we make. **Job Posting Title** SIU Specialist - Remote in the California market **Job Description**...Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the… more
- The Hartford (Hartford, CT)
- Specialist Claims - CH07DESpecialist Claims CA - CH07DN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims Specialist...initiatives. + Preparing comprehensive reports and delivering presentations to senior claim leadership on case developments, policy… more
- The Hartford (Hartford, CT)
- Specialist Claims - CH07DE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... team as we help shape the future. This dynamic Claim Specialist role will be part of...initiatives + Prepare comprehensive reports and deliver presentations to senior claim leadership on: case developments, policy… more
- Zurich NA (Hartford, CT)
- Sr. TPA Specialist , Complex Claims 125068 Zurich Insurance is currently looking for a Sr TPA Specialist . This position will oversee complex Liability ... Specialist analyzes highly complex coverage situations, evaluates high exposure claims , seeks/grants authority, assigns/explains reserves to senior management… more
- The Cigna Group (Bloomfield, CT)
- …Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management + ... is Business Analytics Advisor, which is a Band 4 Senior Contributor Career Track Role. + **Summary** + Cigna...manage multiple tasks and projects + Experience working with claim data and familiarity with standard medical coding: CPT,… more
- Highmark Health (Hartford, CT)
- …months in either Life Office Management Association (LOMA) Certified Employee Benefit Specialist (CEBS), or America's Health InsurancePlans (AHIP) **Language ... structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The...type of industry, characteristics of employee groups, or past claim experience to determine what benefits can… more
- The Hartford (Hartford, CT)
- …Long Term Disability benefit determinations using vocational, medical, and financial claim management. The Senior Ability Analyst supports our mission of ... Sr Ability Analyst - C409ANAbility Specialist - C409BN We're determined to make a...applying them to meaningful work at The Hartford. The Senior Ability Analyst primarily investigates claims to… more