- Sedgwick (Providence, RI)
- …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Complex Claims Advisor | Remote **This ... manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to...preferred. **Skills & Knowledge** + Subject matter expertise in worker 's compensation claims and/or liability… more
- Sedgwick (Providence, RI)
- … Examiner **PRIMARY PURPOSE** **:** To analyze complex or technically difficult workers compensation claims to determine benefits due; to work with ... specific requirements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult claims by investigating and… more
- Sedgwick (Providence, RI)
- …based on level of experience. **PRIMARY PURPOSE OF THE ROLE:** To analyze high-level Workers Compensation claims on behalf of our valued clients to ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer New England Claims Examiner - Workers Compensation ...brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of… more
- UMB Bank (Providence, RI)
- …change to ensure the best customer experience. + Review and decide high-value and complex card fraud claims . + Prepare regular reports on card fraud ... **Duties & Responsibilities** The Manager, Card Fraud Claims , will oversee and manage the UMB card...College Degree + TSYS TS2 and/or TSYS TMS experience ** Compensation Range:** Minimum: $69,230.00 - Maximum: $179,300.00 _The posted… more
- Elevance Health (Smithfield, RI)
- …and procedures. + Investigates potential fraud and over-utilization by performing the most complex medical reviews via prepayment claims review and post payment ... and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review....in good faith believes is the range of possible compensation for this role at the time of this… more
- Sedgwick (Providence, RI)
- …and support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker , attorney and supervisor. + Identifies ... Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured worker , employer, and medical providers, create a case management strategy to facilitate… more
- State of Massachusetts (Taunton, MA)
- …network of One-Stop Career Centers that assist businesses in finding qualified workers and providing job seekers with career guidance, as well as referrals ... with agency rules, policies, procedures, and guidelines. * Oversee a complex and extensive caseload which involves maintaining ongoing customer contact (minimum… more
- Elevance Health (Smithfield, RI)
- …acceptability of insurance risks and appropriate premium rates for large, complex renewal and prospect employer groups in accordance with Corporate Underwriting ... are not limited to: + Calculates renewal rates for complex group cases based on thorough analysis of the...increments or decrements. + Communicates with sales, administration and claims to assess the rating and administrative impact or… more
- Elevance Health (Smithfield, RI)
- …operational excellence that meets/exceeds client service and satisfaction goals for a complex book of business supporting pharmacy. **How you will make an impact:** ... strongly preferred. + Experience or knowledge of Salesforce and/or claims operating systems highly preferred. + Proficient of Microsoft...in good faith believes is the range of possible compensation for this role at the time of this… more
- Lincoln Financial Group (Providence, RI)
- …preferred * Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation , Utilization Review and/or nurse case management ... reviewing, analyzing, and interpreting medical information available for disability claims . In this role you will act as a...clinical resources (ie IME, FCE, Peer Reviews) * Discuss complex medical issues with health care providers as needed… more
- MetLife (Warwick, RI)
- …strong leadership and coaching skills. Extensive knowledge of STD, group disability, Workers Compensation , ERISA, Social Security and state laws * Strong ... * Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively * Organizational and time management skills, ability… more