- Fallon Health (Worcester, MA)
- **Overview** **The Claims Examiner position is a hybrid role working 3 days (Tuesdays, Wednesdays and Thursdays) in the office in Worcester, MA and 2 days ... us on Facebook, Twitter and LinkedIn. **Brief Summary of purpose:** The Claims Examiner should have thorough claim processing knowledge at a complex level..… more
- Sedgwick (Boston, MA)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Examiner | Remote | NE Jurisdictional Knowledge **Workers ... Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
- Sedgwick (Boston, MA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner **PRIMARY PURPOSE** : To analyze complex or technically ... difficult liability claims to determine benefits due; to work with high...to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication… more
- Sedgwick (Boston, MA)
- …Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Auto Liability Bodily Injury Claims Examiner **PRIMARY PURPOSE** : To analyze and process complex ... auto and commercial transportation bodily injury claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
- Sedgwick (Boston, MA)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- Sedgwick (Boston, MA)
- …and support systems. + Effectively communicates and builds relationships with the claims ' examiner , client, injured worker, attorney and supervisor. + Identifies ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more… more
- State of Massachusetts (Boston, MA)
- …skills and talents to serve our citizens. *_About the Role:_* The Review Examiner II performs duties of a hearing officer in connection with administrative hearings, ... findings of fact and conclusions of law. The Review Examiner II will also provide additional support to the...of which included the adjudication, examination and/or review of claims , benefits and/or taxes; the practice of law; labor… more
- Fallon Health (Worcester, MA)
- …records pertaining to FWA investigations Compare to information submitted on the claims in order to determine amount and nature of billable services Determines ... systems to assure integrity and compliance in billing and claims payment. + Develop educational materials for new hire...this work is a plus, such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or other… more
- CVS Health (Wellesley, MA)
- …investigation, or auditing + In-depth knowledge of healthcare systems, claims processing, and regulatory requirements related to healthcare fraud. **Preferred ... in a leadership role. + Relevant certifications (eg, Certified Fraud Examiner (CFE), accredited healthcare fraud investigator (AHFI) **Education:** + Bachelor's… more
- State of Massachusetts (Boston, MA)
- …Examinations, Operations units and the shared services Accounting staff. *Consider joining our examiner team if you:* * Are interested in a public position and ... processing application approvals, managing the renewal assignments, processing bond claims , examination and ATM assessment invoicing, Annual Report notifications and… more