Perform other duties as assigned by the Claims Quality Manager or Director of Claims Quality. The Claims User Acceptance Tester (UAT) will be responsible for validating whether all the business requirements have been fulfilled before releasing the actual product to production. The Claims UAT will de...
Direct management of claims including the investigation, analysis and evaluation of coverage liability and damages, within best practices. Collaborating across disciplines and business units, including: the general counsel team overseeing errors and omissions issues arising from claims. Formulating ...
A Senior Manager or Director within our Disputes, Claims. ...
A company is looking for a Health Claims Specialist. ...
But what happens when a transaction goes wrong? The Manager, Product Management, for Claims Experience will be responsible for supporting our end to end claims lifecycle needs and the primary point of contact with our external vendors. Manager, Product Manager - Claims Servicing. ...
Key Responsibilities:Maintain knowledge of DMEOPS CPT and ICD-10 codesReview and resolve unpaid, short paid, and denied claimsFollow up with insurance companies, submit corrected claims, and file appealsRequired Qualifications:High school education or equivalent5+ years of related experience in insu...
It is the responsibility of the Casualty Claims Risk Consultant to deliver tactical, client tailored, claims advocacy on construction accounts and identify opportunities to match AGRC service offerings to clients and prospects with an emphasis on New York Labor Law and associated risk transfer. Appr...
A company is looking for a Team Lead, Provider Data Claims Support. ...
Perform complex compliance claims audits or clinical reviews on pended claims to investigate, research, and analyze CPT and HCPCS claims data. Minimum five (5) years senior level, progressive experience in medical outpatient claims adjudication, clinical coding reviews for claims, settlement, claims...
Insurance claims consultant professionals provide strategic direction for the Claims Practice with exceptional leadership skills. Candidate has deep understanding of claims processes, operating models, regulations, and emerging trends in the space. Minimum 3 years' experience of demonstrated deep ex...
We are seeking a Senior Claims Counsel, CML to join our Insurance Claims. This role will manage claims arising from or involving policies issued from Sompo’s US Commercial Management Liability (“CML”) and Financial Institutions (“FI”) teams. This position handles US CML and FI (D&O) high exposur...
Minimum of 3 years related claims and/or auditing experience requiredExperience working in a TPA or HMO or managed care environment preferredKnowledge of Medicare and Medicaid claims requiredPrior training and knowledge of DRG, ICD9 and CPT4 requiredProficient PC skills, including Microsoft Windows ...
Experience with handling Specialty Lines claims and/or coverage including E&O, D&O, Cyber, Crime/Fidelity, EPL and Fiduciary claims or commercial multi-line P&C. D&O / Professional Liability Claims Counsel. The ideal candidate will be responsible for the delivery of claims value proposition to custo...
Significant knowledge of 3rd Party No-Fault claims process, including the investigation, adjustment and disposition of claims, and the Comptroller's Office's role in the adjusting and settlement of claims2) Strong analytical and negotiation skills. In resolving claims before litigation is commenced,...
Manages an inventory of low to mid complexity and exposure Private D&O and EPL claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Establishes and maintains working rel...
As a Commercial/Specialty Casualty Adjuster, you will be responsible to resolve all aspects of 1st and 3rd party injury claims of low to moderate complexity for personal lines as well as our commercial claims. Handle 1st party exposures to include Medical Payment coverage, PIP, Uninsured Motorists, ...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
Business Analyst - Managed Care / Claims. Three or more years of experience Business Analyst or related experience in Member, Managed Care, Claims (Third Party Liability (TPL) and Financial preferred) . ...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
Performing claims oversight on claims with an expected value over $50,000 for guaranteed cost policies and at 50% of the retention for deductible and self insured business. Completing claims audits at TPA branch claims offices or online. The Claims Division is seeking a team member to join the Natio...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
As a direct report to the Head of TPA & Programs Claims,the candidate should possess the ability to handle Surety in the short term and, over time, develop a sophisticated team of claims professionals handling and managing Surety Claims. Developing and maintaining relationships with internal and ext...
Confirms coverage of claims by reviewing policies and documents submitted in support of claims. Presents at roundtables to senior claims leaders and underwriters on cases going to trial and provides advice/insight on others claims going to trial. Ability to influence claims stakeholders and to effec...
Vista Aircraft Maintenance Baden Baden is now looking for an Administrator Warranty and Claims to join their growing team, reporting directly to our Head of Logisitics. Process all approved claims invoices. ...
In this highly visible, mission critical role, you will report directly to the Global Head of Specialty Claims and have supervisory oversight and coordination of the Specialty Claims portfolio supporting the Global Head of Specialty Claims and team including large loss, attritional claims and enhanc...