- Travelers Insurance Company (Hartford, CT)
- …for investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling ... case . + Work with Manager on use of Claim Coverage Counsel as needed. + Directly investigate each...and thus the technical expertise to evaluate severe and complex claims . + Able to make independent… more
- The Cigna Group (Bloomfield, CT)
- …management, case management, network, contracting, pharmacy, and service operations ( claims ). This is an entry to mid-level position for a physician interested ... and required results:** + Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information,… more
- Aflac (Farmington, CT)
- …manage multiple priorities. * Strong presentation skills with the ability to convey complex information in a clear and concise manner. * Proficiency in process ... products to include Absence & Disability. + LAD operational processes or LAD claim processes and tech partner integration connectivity . Or an equivalent combination… more
- Evolent (Hartford, CT)
- …with value-based care and programs - Preferred + Working knowledge of Medicare claims , episode and condition groupers, case /episode and risk adjustment, patient ... health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek… more
- CDM Smith (Hartford, CT)
- …solicitations, teaming agreements, contracts, subcontracts and other agreements. * Resolving major subcontractor issues, including claims . * Advising division ... budget. * Overseeing the development of cost and pricing proposals for complex projects. * Developing pricing strategy and conducting cost negotiations for … more