• Workers Compensation Claims

    Sedgwick (Providence, RI)
    …Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Manager | VA Jurisdiction | Remote **PRIMARY PURPOSE** : To manage the ... + Establishes policy and procedure to assure compliance to best practices, claims management services standards, state regulations and client service requirements. +… more
    Sedgwick (08/01/24)
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  • Telephonic Case Manager

    Sedgwick (Providence, RI)
    …and support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker , attorney and supervisor. + Identifies ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured … more
    Sedgwick (09/07/24)
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  • Account Service Manager

    Elevance Health (Smithfield, RI)
    **Anticipated End Date:** 2024-09-17 **Position Title:** Account Service Manager **Job Description:** **Account Service Manager ** **Location: Must be within 50 ... miles of any location listed; position has both office/ remote expectations.** AmeriBen is a proud member of the Elevance Health family of companies. We are a… more
    Elevance Health (09/06/24)
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  • CarelonRx Account Manager II

    Elevance Health (Smithfield, RI)
    **Anticipated End Date:** 2024-09-23 **Position Title:** CarelonRx Account Manager II **Job Description:** **CarelonRx Account Manager II** **Location:** This ... position will work a hybrid model ( remote and office). The ideal candidate must live within...PulsePoint locations listed on the requisition. The **CarelonRx Account Manager II** is responsible for retention and operational excellence… more
    Elevance Health (09/06/24)
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  • Auto Bodily Injury Claim Representative

    Travelers Insurance Company (West Bridgewater, MA)
    …support flexibility. This position works 3 days in the office and 2 days remote per week. #Hybrid This position is responsible for handling Personal and Business ... Insurance Auto Bodily Injury claims from the first notice of loss through resolution/settlement...and takes into consideration issues such as Social Security, Workers Compensation or others relevant to the jurisdiction. Consults… more
    Travelers Insurance Company (08/29/24)
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  • RN Hospital Bill Audit/Appeal Lead

    Elevance Health (Smithfield, RI)
    …Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from our ... of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you… more
    Elevance Health (09/06/24)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Smithfield, RI)
    …Group Clinical Validation Auditor** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one of ... Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (09/06/24)
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  • Provider Reimbursement Admin

    Elevance Health (Smithfield, RI)
    …any Elevance Health office location_ _**this position will work a hybrid model ( remote and office) which requires working in the nearest Elevance Health office 1-2 ... office**_ The **Provider Reimburse Admin** ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing… more
    Elevance Health (09/06/24)
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  • Investigator II

    Elevance Health (Smithfield, RI)
    …Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one the ... to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (09/06/24)
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  • Clinical Fraud Investigator II

    Elevance Health (Smithfield, RI)
    …Investigator II **Job Description:** **Location:** This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more
    Elevance Health (09/06/24)
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  • Auto First Party Medical Claim Representative…

    Travelers Insurance Company (West Bridgewater, MA)
    …**What Is the Opportunity?** This positions is hybrid (3 days in office, 2 days remote ) out of our New England Claim Center. Candidates must live within a commutable ... for handling Personal and Business Insurance First Party Medical claims from the first notice of loss through resolution/settlement...the inside auto business. + Works closely with Unit Manager or mentor to promptly resolve assigned claim. +… more
    Travelers Insurance Company (08/14/24)
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