- MetLife (Warwick, RI)
- …degree . 3 to 5 years of related professional business experience . Individual Disability Income claims experience. Equal Employment Opportunity/ ... pending, ongoing and appeal reviews. . Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and… more
- Zurich NA (Boston, MA)
- Sr. Claims Specialist , Workman's Compensation 119585 Zurich North America is seeking an experienced Senior Claims Specialist in Workers' Compensation to ... Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in...remote applicants residing in Maine. The Senior Workers' Compensation Claims Specialist will manage claims … more
- Lincoln Financial Group (Providence, RI)
- …for this opportunity. **Requisition #:** 74082 **The Role at a Glance** As an **LTD Claims Specialist ** , you will manage a workload of Long-Term Disability ... phone and e-mail to gather information regarding Long Term Disability Claims and state and federal benefits...on the performance of the company, business unit and individual . Other rewards may include long-term incentives, sales incentives… more
- USAA (Providence, RI)
- …makes us so special! **The Opportunity** As a Insurance Property Adjuster Specialist , you will work within established guidelines and framework to investigate, ... evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will...in compliance with all state regulatory requirements. Property Adjuster Specialist focus on using technology and desk adjusting for… more
- Point32Health (Canton, MA)
- …company.Under direction of the Provider Enrollment Supervisor, the Provider Enrollment Specialist processes, maintains, and revises all components of the provider ... and facsimile and in writing regarding practitioner information. The Specialist has comprehensive knowledge of IPA (Independent Practitioners Affiliations) specifics… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …fraud, waste, and abuse and to facilitate accurate claim payments. The coding specialist will conduct pre-payment reviews of claims submitted by providers and ... persona. The position serves as a Prepayment Review Coding Specialist within the Fraud Investigation & Prevention Unit ("FIP")....to substantiate the services billed. This process allows for claims to be reviewed prior to adjudication to ensure… more
- MAPFRE Insurance (Webster, MA)
- Claim Specialist , Casualty (Hybrid) Date: Jan 12, 2025 Location: Webster, MA, US Company: MAPFRE Bring your passion and enthusiasm for Claims to our TEAM! At ... while offering top notch service to our insureds! Participate in your own Individual Development Plan (IDP) which serves as your blueprint for outlining your… more
- CVS Health (Boston, MA)
- …/ graduate in good standing will move to $18.50. Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have the ... by providing accurate and timely resolution in processing medical claims . You will be a key link in providing...**Desired qualifications** We are looking for a detail oriented individual who enjoys working in a team environment and… more
- Gilead Sciences, Inc. (Boston, MA)
- …the lives of patients with life-threatening illnesses worldwide. As a Prevention Specialist within Gilead's - Boston South territory, you will represent Gilead's ... and Drug Administration's implementing regulations, the Federal Anti-Kickback Statute, the False Claims Act, PhRMA, Corporate Code of Business Conduct and the Office… more
- TEKsystems (Boston, MA)
- RELEASE OF INFORMATION SPECIALIST Onsite - Boston, MA Core Experience: + 1+ years of leave of absence experience (administrative work, medical records, ROI, or ... insurance claims ) + good with computers- vetted with at typing test...post offer A Day in the Role: + This individual will act as the middle man for when someone… more
- GE Vernova (Foxborough, MA)
- …between approved project financial data and books + Support project close out and claims /Provide support to tenders + Oversee the planning function on the project + ... benefits include tuition assistance, adoption assistance, paid parental leave, disability insurance, life insurance, and paid time-off for vacation...and for any reason, in its sole discretion. No individual has a vested right to any benefit under… more
- GE Vernova (Foxborough, MA)
- …between approved project financial data and books + Support project close out and claims /Provide support to tenders + Oversee the planning function on the project + ... benefits include tuition assistance, adoption assistance, paid parental leave, disability insurance, life insurance, and paid time-off for vacation...and for any reason, in its sole discretion. No individual has a vested right to any benefit under… more
- GE Vernova (Foxborough, MA)
- …between approved project financial data and books. + Support project close out and claims + Oversee the planning function on the project + Ensure quality of the ... benefits include tuition assistance, adoption assistance, paid parental leave, disability insurance, life insurance, and paid time-off for vacation...and for any reason, in its sole discretion. No individual has a vested right to any benefit under… more
- Gilead Sciences, Inc. (Providence, RI)
- …roles, responsibilities, and measurable outcomes for all activities of the specialist team. Regularly measure success, document and provide feedback on performance. ... and Drug Administration's implementing regulations, the Federal Anti-Kickback Statute, the False Claims Act, PhRMA, Corporate Code of Business Conduct and the Office… more
- Fallon Health (Worcester, MA)
- …member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow ... mentoring to new employees on an ongoing basis. Identifies training opportunities, individual and team coaching needs and reports findings to management. + Maintains… more
- Point32Health (Canton, MA)
- …requirements and timelines. The Senior Manager works closely with claims , membership operations, clinical services, care management, customer relations, sales, ... to business functions, etc. + Oversee or collaborate with Product Specialist to manage Benefit Adjudication Committee meetings and other sub-workgroups as… more
- Ford Motor Company (Providence, RI)
- …with their ownership experience. + Work closely with the Ford Regional Escalation Specialist to provide oversight and direction to the California Lemon Law team ... Provide training and direction to a team of Consumer Claims Analysts located in California + Ensure that all...active employee resource groups * Paid time off for individual and team community service * A generous schedule… more