- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- AIG (San Francisco, CA)
- Claims Complex Director - Healthcare Professional... portfolio of the most complex and high exposure medical malpractice (and some GL) claims at ... Liability (HPL) Join us as a Claims Complex Director to take on key...+ Keeps abreast of significant changes in the law, claims and industry trends (not limited to medical… more
- MTA (Brooklyn, NY)
- …internal reports as needed. + Develop and implement ongoing training programs for claims management and non-managerial staff in areas relevant to their ... Director , Claims Investigations & Adjustments Job...to claims managers and/or outside vendors, reserving claims , evaluating medical records and working with… more
- AON (Chicago, IL)
- Aon is looking for an Associate Director , Claims Advocate in Reinsurance, hybrid in Chicago, IL.; 1-2 days in office per week. What the day will look like: In ... documents and policies. #LI-KD1 #LI-HYBRID 2548521 Aon is looking for an Associate Director , Claims Advocate in Reinsurance, hybrid in Chicago, IL.; 1-2 days… more
- Banner Health (Tucson, AZ)
- …objectives while coordinating tasks in a complex matrix environment partnering with IT, Claims , Encounters, Medical Management , FWA, G&A, Network, Analytics, ... by offering remote and hybrid work settings. As a Director , Claims Recovery Unit, you will lead... Recovery Unit (CRU) is designed to help reduce medical costs of pre and post payment claims… more
- AIG (Atlanta, GA)
- … and legal aspects of assigned claims using available resources which include medical management services to manage medical treatment and coordinate use ... help customers to manage risk. Join us as a Complex Federal Work Comp Claims Director to play your part in that transformation. It's an opportunity to grow your… more
- Alight (SC)
- …with Regulatory Compliance and Risk Committees. **Requirements** + Experience of 10 years in claims and 7 years leadership in absence management . + Have advanced ... and Great Place to Work! Do you have advanced experience in absence management leadership? **Our Story** At Alight, we believe a company's success starts with… more
- Sedgwick (Miami, FL)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director - Complex Claims **PRIMARY PURPOSE** **:** To be responsible for ... negotiation, mediation, arbitration, or ADR skills on higher value complex claims . Management experience preferred. Specific jurisdictional expertise required.… more
- Mass Markets (Wichita, KS)
- …trusted partner in the industry. We are seeking an experienced Insurance Call Center Claims Director experienced in Property and Casualty and Life insurance to ... will professionally represent the company and its customers. Other Director Qualifications Include: + Requires 10+ years of insurance...and Life insurance programs and a proven track record claims management + Bachelor's Degree in … more
- Elevance Health (Atlanta, GA)
- **Business Change Director - Claims /Payment Integrity Use-Case Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates ... 50 miles of a PulsePoint location. The **Business Change Director - Claims /Payment Integrity Use-Case Lead** is responsible for...continue to improve on the process. The Business Change Director is responsible for working with management … more
- Premera Blue Cross (Mountlake Terrace, WA)
- … Operations Director ** to join our team and oversee our claims management organization. This position offers an exceptional opportunity to contribute ... expertise will play a crucial role in enhancing the quality and efficiency of our claims processes. In this capacity, you will lead a strong claims team, drive… more
- Aspen Dental (Albany, NY)
- …ensure proper handling of all claims . Under the general direction of the Director of Risk Management , the Claims Manager is responsible for mitigating, ... in three distinct categories: Dental care, urgent care, and medical aesthetics. Working in partnership with independent practice owners...a Claims Manager. **Job Summary:** The Risk Management Claims Manager will manage the administration… more
- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for...and Analytics + Direct and relevant experience with HCFA/UB-04 claims management , coding rules and guidelines, and… more
- Whitney Young Health Center (Albany, NY)
- …Apply Description GENERAL RESPONSIBILITIES: Responsible for reviewing medical claims prior to submission and ... complex or problem claims or insurance types as designated by the Director . Reviews payer coding policies and procedures to ensure that the department remains in… more
- AON (IL)
- …analytical, excellent communication, interpersonal and organization skills. + Proficiency with claims management systems and reporting tools. + Understanding of ... analytical, excellent communication, interpersonal and organization skills. + Proficiency with claims management systems and reporting tools. + Understanding of… more
- AON (Fort Wayne, IN)
- …look like As a Claims Litigation Analyst, you will report directly to the Claims Manager and/or Claims Director working in the challenging and rewarding ... Fair Chance ordinances. Nothing in this job description restricts management 's right to assign or reassign duties and responsibilities... Litigation Analyst, you will report directly to the Claims Manager and/or Claims Director … more
- CommuniCare Health Services Corporate (Charleston, WV)
- …posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management , and others. The CBO claims validation staff will strive to always ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...of benefit options from life and disability plans to medical , dental, and vision coverage from quality benefit carriers.… more
- University of Utah Health (Murray, UT)
- …years of experience collecting, organizing and maintaining health insurance and processing medical claims , enrollment, and familiarity with medical coding, ... that are integral to our mission. EO/AA_ + This position is responsible for auditing claims and customer service calls for UUHP. + The Claims and Customer… more
- GuideOne Insurance (Chicago, IL)
- …etc.), submits monthly reports detailing unit activity and results to line of business director and senior claims management as requested. + Responsible for ... to use commonly-used concepts, practices and procedures within the claims and management fields. + Complete formal...and AD&D, long-term disability and short-term disability insurance + Medical , dental and vision plans to meet your unique… more
- University of Utah Health (Salt Lake City, UT)
- …**University of Utah Health is seeking a new and experienced leader as an Associate Director for Risk Management Claims .** This position is responsible for ... to reduce risk and improve patient care systems, litigation support, clinical risk management , claims management , program administration and risk … more
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