- Harbor Health Services, Inc. (Mattapan, MA)
- …request of utilization or finance department. Works with UM RNs and Senior Medical Director to deny claims when appropriate. Attends IDT meetings on routine ... Harbor Health operates two Elder Service Plan Programs of All-Inclusive Care for the...management including UM/CM, Grievance and Appeals, inpatient and outpatient services , medical policy, and clinical claims review… more
- Boston Mutual Life Insurance (Canton, MA)
- …courteous. + Leave our customers and associates "better than where we found them." The Director - Claim Services plays a pivotal role within Boston Mutual, ... for managing and overseeing of all aspects of the Claims Service team for Life and Accident...policies. + Stay informed about changes in regulations affecting Claim services . + Develop and implement risk… more
- Ryder System (Boston, MA)
- …liability, property, and cargo claim . This position reports to the Senior Director of Claims and requires little supervision and is considered a liability, ... clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Director Claims directs activities within the General and… more
- Ankura (Boston, MA)
- …and extra expense losses, building financial models, and guiding clients through claim settlement processes, both in standard insurance claims and litigation ... Overview: Join our FAICC practice as a Senior Managing Director to develop business and lead first-party claims...executives + Oversee project teams and ensure exceptional client service delivery + Develop thought leade LI-MB1 * Ankura… more
- Elevance Health (Woburn, MA)
- ** Director I, Digital Claims Operations (Dir I Digital Ops)** Location: This role requires associates to be in-office **3 days per week** , fostering ... resides within a commutable distance from an office._ The ** Director I, Digital Claims Operations** will lead...plans and objectives. + Provides a broad range of services needed by operational & technology teams to satisfy… more
- Humana (Boston, MA)
- …outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or ... **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Boston, MA)
- …outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or ... **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided… more
- Zurich NA (Boston, MA)
- Senior Professional Liability Claims (Attorney), Claims Construction 129572 **Zurich North America is expanding its nationwide Construction Professional ... Liability Claims Team with the addition of a dedicated ...expertise and strategic coordination. + Accurately update and document claim files in accordance with best practices, ensuring data… more
- HUB International (Wilmington, MA)
- …: + Provides advocacy for small, middle market, and high-profile clients by reporting claims . + Participate in the claim after hours program as part of ... in-house resource and communicates proactively with clients, production and service staff, claims team and management. +...mentor team associates and training as assigned by Manager/ Director + Attend claim reviews/ meetings with… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic and policies… more
- Commonwealth Care Alliance (Boston, MA)
- …states will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. ... the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible… more
- State of Massachusetts (Boston, MA)
- …or other mission-based organizations * Experience interacting directly with individuals seeking services or assistance * Experience in claims processing and/or ... the Commonwealth are supported and empowered through access to high-quality services that are trauma-informed, culturally responsive, and reflective of diverse… more
- Beacon Mobility (Chelmsford, MA)
- …13,000+ vehicles at 200+ locations from New England to New Mexico. Reporting to the Director of Claims , the Region Claims Analyst provides oversight and ... management skills while delivering analytical support to operations, safety and claims leadership. Support to locations will require compliance with applicable… more
- Evolent (Boston, MA)
- …health outcomes and a more connected care journey. We are hiring for a Managing Director , Actuarial Services to join our Finance Team. The candidate selected for ... to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication to key… more
- Dana-Farber Cancer Institute (Boston, MA)
- … to support and grow the Institute's research, clinical, and business missions. The Director of AI Operations and Services leads the development and delivery of ... solutions that support research, clinical, and operational goals. The Director serves as a subject matter expert in AI...a $3-5M budget and oversee AI and data-science core services , including service level agreements with Informatics… more
- CenterWell (Boston, MA)
- … Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary Care work assignments involve moderately complex ... The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more
- Travelers Insurance Company (Boston, MA)
- …needed to the Claim Field organization. + Provide input into to claim practices, marketing strategy and customer services as appropriate to anticipate, ... Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is… more
- Commonwealth Care Alliance (Boston, MA)
- …team. Cross-Functional Collaboration * Work closely with network contracting, credentialing, claims , IT, customer service , compliance, and quality teams to ... 011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider… more
- Zurich NA (Boston, MA)
- …experience in the Claims or Underwriting Support are OR AVP, Underwriting Director - Energy, Oil, Gas and Chemicals Requirements: + High School Diploma or ... AVP, Underwriting Director - Energy, Oil, Gas & Chemicals 128378...years. By providing a broad array of products and services , we work with our customers to support their… more
- Zurich NA (Boston, MA)
- AVP, Underwriting Director - Core Contract Surety 124285 Zurich Insurance is currently looking for an **Executive Underwriter OR AVP, Underwriting Director - Core ... role will be filled at either the Executive Underwriter OR AVP, Underwriting Director level. The hiring manager will determine the appropriate level based upon the… more
