- Sedgwick (Boston, MA)
- …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr . Claims Specialist Professional Liability, Public Entity ... each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it… more
- American Family Insurance - Corporate (Boston, MA)
- …based on the job level and your geographic work location._ The Product Compliance Sr . Specialist will be responsible for coordination of divisional programs for ... product portfolio, forms, systems, processes and procedures. You will report to the Senior Manager, Business Compliance. In this flex office/home role, you will be… more
- Zurich NA (Boston, MA)
- Senior Design/Construction Management Consulting Specialist 113183 Zurich is looking for a highly skilled ** Senior Design/Construction Management Consulting ... support to the Claims Department with technical assessment of complex claims (including but not limited to) Construction Professional Liability, Builders… more
- Tufts Medicine (Burlington, MA)
- …and debugs computer programs, and prepares systems documentation and training. A professional individual contributor role that may direct the work of other lower ... using specialized knowledge and skills typically acquired through advanced education. A senior level role that requires advanced knowledge of job area typically… more
- Kelly Services (Cambridge, MA)
- …3 years of experience in HRIS, Payroll, & Benefits. * Hold a SHRM Certified Professional (SHRM-CP) or SHRM Senior Certified Professional (SHRM-SCP) and/or ... opportunity. Join the Kelly(R) team as a **REMOTE HR Specialist ** to work at a premier client in **Cambridge,...of contact for employees regarding benefits inquiries, issues, and claims . * Communicating promptly with team members to respond… more
- Tufts Medicine (Tyngsboro, MA)
- …verbal form are required. 11. Ability to develop and maintain professional , service-oriented working relationships with senior leadership, patients, physicians, ... duties: Facilitates the reimbursement for clinical services provided to patients. Submits claims to health insurers, follows up with health insurers about submitted … more
- State of Massachusetts (Boston, MA)
- …Administrator contractual functions that relate to provider enrollment and credentialing, claims operations, appeals, program integrity and reporting related to the ... (TPA) contractual functions relating to provider enrollment and credentialing, claims operations, prior authorization, appeals, program integrity and reporting… more
- Highmark Health (Boston, MA)
- …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
- Commonwealth Care Alliance (Boston, MA)
- …This is an individual contributor role. Working under the direction of the Sr . Director, TPA Management and Claims Compliance, Medical/BH Reimbursement Policy ... sufficiently to ensure accurate implementation of payment rules within the Plan's claims adjudication system, including the claim editing systems (CES and Zelis).The… more
- Wolters Kluwer (Boston, MA)
- …and delivering compelling presentations. + Executive presence and comfort presenting to senior executive levels. + Self-starter and driven professional who ... increase operational efficiency and reduce costs. Corporate legal and insurance claims departments trust our innovative technology and end-to-end customer experience… more