- HCA Healthcare (Campbell, CA)
- …must reside in the San Jose, CA market* Do you have the career opportunities as a Senior Claims Examiner you want with your current employer? We have an ... of colleagues. Do you want to work as a(an) Senior Claims Examiner where your...Customer Service and Provider Services to assist on large claim projects and adjustments. + Assist with benefit/plan interpretation… more
- AIG (Atlanta, GA)
- …we are reimagining the way we help customers to manage risk. Join us as a Senior Claims Examiner , International Casualty Home Office to play your part in ... in Germany? This position may be for you. This Senior Claims Examiner position in... location. They may also be required to conduct Claim Reviews of foreign claims and will… more
- ICW Group (Las Vegas, NV)
- …team members with opportunities to contribute, develop, and belong. **PURPOSE OF THE JOB** The Senior Claims Examiner handles moderate to complex claims ... an equitable conclusion within Company standards and best practice guidelines. The Senior Claims Examiner works with a sense of urgency, understands… more
- AIG (Atlanta, GA)
- Senior WC Claims Examiner Join us as a Senior Claims Examiner to grow your experience in Claims . Make your mark in Claims Our Claims ... technical expertise in directing and resolving Federal Workers' Compensation claims in accordance with best claim practice...Workers' Compensation claims in accordance with best claim practice guidelines. + Utilize investigation, claim … more
- Lowe's (Mooresville, NC)
- … Claims Examiners on issues that cannot be satisfactorily resolved by the Claims Examiner , this position investigates complaints made by customers or stores ... claimants and witnesses, obtaining official reports, and by comparing claim information with evidence + Serves as an escalation...GED and 5-7 Years 6 Years Experience as a Claims Examiner or materially relevant knowledge, skills… more
- Crawford & Company (Las Vegas, NV)
- …CAREER OPPORTUNITY! + Seeking candidates with experience managing California Workers Compensation claims ! + SIP is a requirement! + Bonus Opportunities! + Multiple ... Employee Discounts! Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority… more
- AIG (Atlanta, GA)
- …we are reimagining the way we help customers to manage risk. Join us as a Senior Workers Compensation Claims Examiner to play your part in that ... mark in Federal Workers Compensation. Join us as a Senior Workers Compensation Claims Examiner ...technical expertise in directing and resolving Federal Workers' Compensation claims in accordance with best claim practice… more
- Veterans Benefits Administration (Muskogee, OK)
- Summary The Senior Veterans Claims Examiner works as a member of one of the teams in the Education Division at the Regional Processing Office. Explains ... Virtual: This is not a virtual position. Position Description/PD#: Veterans Claims Examiner (Education); 37815A Relocation/Recruitment Incentives: Not Authorized… more
- New York State Civil Service (Schenectady, NY)
- …full-time experience described in #1. Duties Description Under the direction of the Senior Workers Compensation Examiner , Examiner 's duties will include but ... NY HELP No Agency Workers' Compensation Board Title Workers' Compensation Examiner , WCB Items #2361 Occupational Category No Preference Salary Grade 14 Bargaining… more
- HCA Healthcare (Nashville, TN)
- …Highschool diploma required; Bachelor's degree preferred + 4 - 5 years' experience as a Senior Claim Examiner in a managed care environment, required + ... and IPA organizations with the primary function to ensure examiner payment accuracy of all claims processing...all levels. + Review routine random sampling audit of examiner processed claim (s) for accuracy and provides… more
- CHS (Clearwater, FL)
- **Overview** **Health Insurance Medical Claims Examiner ** **(Initial Training on Site - 30 days - Remote after training)** **Must live within a reasonable ... FL** **Monday-Friday Schedule with daytime hours** **Responsibilities** **Summary:** The Medical Claims Examiner adjudicates medical claims based on… more
- Amazon (Bellevue, WA)
- …Management and Legal (internal and external), and employs best practices to control claim costs. . Lead logistic complex claims management, develop and refine ... all of its various use cases. Amazon's Last Mile Claims team is seeking a talented claims ...a successful candidate will support and report to a Senior Risk Manager and be enthusiastic about driving change,… more
- Wells Fargo (Wilmington, DE)
- …Fargo is seeking a Senior Lead Analytics Consultant within Fraud & Claims Management (FCM) as part of Consumer and Small Business Banking Operations (CSBBO). ... work; interpreting and presenting results of analyses and recommendations to senior management + Ensure adherence to data management/data governance regulations and… more
- McAfee, Inc. (San Jose, CA)
- **_Job Title:_** Senior Payments Manager, Fraud and Disputes - Remote **_Role Overview:_** The Senior Payments Manager, Fraud and Disputes with the Payments team ... to find areas for improvement to reduce first-party misuse and fraud claims . Manage multiple projects focused on preventing disputes and first-party misuse fraud… more
- CVS Health (Wellesley, MA)
- …Manager to lead our new ASO investigations team. The Healthcare Fraud Senior Manager is responsible for overseeing and managing fraud detection, investigation, and ... and external stakeholders and ensuring compliance with regulatory requirements. The Senior Manager develops strategies to mitigate fraud risks, analyzes complex data… more
- Sharp HealthCare (San Diego, CA)
- …requirements for the position, and employer business practices. **What You Will Do** The Senior Fraud, Waste and Abuse Specialist at Sharp Health Plan is a critical ... ensuring compliance with regulatory, accreditation and contract standards. The Senior FWA Specialist will manage day-to-day anti-fraud activities, coordinate with… more
- Fallon Health (Worcester, MA)
- …LinkedIn. **Brief summary of purpose:** Under the general direction of the Senior Internal Audit Manager, theAnalyze and interpret patient medical records pertaining ... to FWA investigations Compare to information submitted on the claims in order to determine amount and nature of...appropriateness of billing and reimbursement Documents findings for each claim line Summarize findings in a written report Abstracts… more
- JB Hunt Transport (Lowell, AR)
- …role in the legal process by thoroughly investigating, reviewing and assessing claims and legal cases to ensure compliance with applicable laws and regulations. ... and other legal professionals to support the successful resolution of claims and litigation matters. **Job Description:** **Key Responsibilities:** * Analyze and… more
- Meijer (Grand Rapids, MI)
- …program will allow for interaction with other interns and Meijer senior leaders._ _The internship program includes:_ + _Challenging and impactful projects_ ... + _Final presentations delivered to senior executives_ + _Executive speaker series_ + _Professional development...here at Meijer. They will gain experience working with claims management systems, complex insurance programs and communicating with… more
- State of Massachusetts (Boston, MA)
- …skills and talents to serve our citizens. *_About the Role:_* The Review Examiner II performs duties of a hearing officer in connection with administrative hearings, ... findings of fact and conclusions of law. The Review Examiner II will also provide additional support to the... II will also provide additional support to the Senior Management Team regarding home improvement contractor, or other… more