- Highmark Health (Columbus, OH)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Highmark Health (Columbus, OH)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... of financial exhibits. This is an entry level position, with oversight by Senior Underwriters and/or Management until the individual is acclimated to the Company… more
- Axis (Princeton, NJ)
- …example. + Broad experience working in an accident and health, disability, stop loss or life and health claims leadership role. + Effective negotiation and ... claims management experience, including experience with TPA managed claims + Stop Loss and...as well as reporting and presenting about same to senior management. + Bachelor's degree is preferred. + Travel… more
- Dignity Health (Rancho Cordova, CA)
- …are vital to maintaining excellence in care and service. **Responsibilities** The Senior Claims Examiner responsibilities include Quality Review of Claims ... processing and the accuracy of member denial letters. The Senior Claims Examiner reviews all provider payment...overpayments and repayments associated with contractual agreements through the stop loss carrier third party liabilities health… more
- CVS Health (Lansing, MI)
- …as a liaison and subject matter expert between our internal and external clients and the stop loss administrators. Reviews and manages stop loss claim ... the amount requested and the amount reimbursed by the stop loss carrier. Required Qualifications * 1+...carrier. Required Qualifications * 1+ years of experience in claims processing background preferred * 1+ years of experience… more
- Tucson Electric Power (Tucson, AZ)
- **Risk Management Insurance Analyst I, II, or Senior ** Company **Tucson Electric Power** Location **Tucson, AZ** Requisition ID **5674** **About Us** UNS Energy ... our commitment to professional growth and leadership development means we never stop challenging ourselves to explore new possibilities. + **Active Engagement:** We… more
- CVS Health (Lansing, MI)
- …liaison and subject matter expert between our internal and external stakeholders and the stop loss administrators. Pay: $20 - $24hr Based on experience Required ... role provides exposure to virtually all aspects of healthcare claims administration , from: reinsurance/ s top l oss,...and communication skills (verbal and written) Preferred Qualifications + Stop Loss /reinsurance experience + Exposure to… more
- HUB International (East Longmeadow, MA)
- …an advanced understanding of the various funding and distribution principles of stop loss , pharmacy benefit management, and life and disability programs. ... own unique, regional culture. We currently have an opportunity for a ** Senior ** **Client Relationship Executive** . The selected employee will be responsible for… more
- HUB International (New York, NY)
- …+ Coordinate health fairs and wellness initiatives as requested by client + Secure stop - loss coverage for self-insured clients as needed **Please apply to join ... all lines of insurance. We are currently seeking a Senior Account Executive to join our Employee Benefits Department....with over 50 lives. **Specific responsibilities include:** + Resolve claims and administrative issues + Act as liaison with… more
- Medical Mutual of Ohio (OH)
- …and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage, Medicare Supplement, and ... not working properly or need to be installed so claims can be processed. Works with more senior...We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage,… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage, Medicare Supplement, and ... individual plans. Adjudicates claims for all life and disability products in the...We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage,… more
- Medical Mutual of Ohio (OH)
- …and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage, Medicare Supplement, and ... business requirements. Drives change by creating viable solutions to Claims and Customer Care. . Works independently with Information...We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage,… more
- Medical Mutual of Ohio (OH)
- …and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage, Medicare Supplement, and ... and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage, Medicare Supplement and… more
- Medical Mutual of Ohio (OH)
- …and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage, Medicare Supplement, and ... Works on various projects related to the analysis of claims , clinical and financial data, with a focus on...We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage,… more
- Medical Mutual of Ohio (OH)
- …and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage, Medicare Supplement, and ... individual plans. **Responsibilities** Senior Employer Group Consulting Analyst Design and execute analyses...We offer fully insured and self-funded group coverage, including stop loss , as well as Medicare Advantage,… more
- Portland General Electric (Portland, OR)
- …Abilities)** **Functional Competencies** Advanced knowledge of risk management concepts including claims , insurance and loss prevention, credit analyses and ... risk management efforts. The role identifies and analyzes potential sources of loss to minimize risk. Estimates the potential financial consequences of incurring a… more
- The Clorox Company (Oakland, CA)
- …This role will also work with internal business partners on evaluating loss control and prevention measures, employee safety issues, and fire risk. **In ... the various carriers via presentations, calls, and meetings that can include Clorox senior executive involvement. + Working closely with the brokers to negotiate and… more
- Air National Guard Units (Fairchild AFB, WA)
- …programs, separations based upon Medical Evaluation Board/disability separations and retirements, Stop Loss waiver requests, Selective Retention separations, and ... Prepares reports on strength accountability and provides statistics to senior staff on projected and actual losses. Coordinates with...or other documentation of proof to support your Educational claims . Additional Information - If you are a male… more
- Air National Guard Units (Bangor, ME)
- …may present problems or conditions not previously encountered. May accompany senior personnel in investigations of accidents/mishaps that include those with ... significant severity and loss . 3. Reviews and recommends revisions to standard local...When need arises, receives approval from higher authority to stop any operation that is of imminent danger to… more
- Highmark Health (Pittsburgh, PA)
- …offerings. This includes product offerings that integrate Highmark's medical, dental, vision, and stop loss capabilities, as well as the development of new ... of medical products that exceed $20 billion in annual allowed claims expense. Balancing profitability, enrollment and customer satisfaction commitments, the VP… more