- BrightSpring Health Services (Taunton, MA)
- Our Company PharMerica Overview Step Into a Rewarding Role as a Claims Specialist with PharMerica! Are you ready to make a real impact in a growing organization? ... Join our PharMerica team as a Claims Specialist , where you'll play a key role in ensuring our long-term care and senior living clients receive the pharmaceutical… more
- Sedgwick (Providence, RI)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Claims Specialist Professional Liability, Public Entity **PRIMARY PURPOSE** **:** ... entity; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within Company standards, industry best practices… more
- Lincoln Financial Group (Providence, RI)
- …73468 **The Role at a Glance** We are excited to bring on highly motivated Voluntary Claims Specialist I to staff our ever-growing claims organization. As a ... administering, processing, and adjudicating Accident, Critical Illness, and Hospital Indemnity claims for our members. You'll complete a thorough training to develop… more
- Lincoln Financial Group (Providence, RI)
- …**The Role at a Glance** We are excited to bring on a highly motivated **Group Claims Specialist ** to support our ever-growing claims organization in a work ... support our west coast employer groups. _Background details_ As a Group Claims Specialist , you will support our Short Term Disability or Integrated Absence… more
- Humana (Providence, RI)
- …a part of our caring community and help us put health first** The Claims Financial Recovery Coding Specialist /Medical Coding Coordinator 2 for the Financial ... claims procedures, contract provisions, and CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical...CMS guidelines. The Claims Financial Recovery Coding Specialist / Medical Coding Coordinator 2 + Maintains required… more
- Trustmark (Providence, RI)
- …colleagues, clients and communities. Responsible for reviewing and processing claims including, identifying irregularities and reviewing for accuracy, and ... Critical Care. **Key Accounabilities:** + Demonstrates strong understanding and performs claims handling processes and procedures related to Wellness, Hospital and… more
- Northeast Family Services (Warwick, RI)
- Northeast Family Services is currently seeking a Billing Specialist to join their growing team! This position REQUIRES you to be able to access our Warwick RI or ... are currently looking for a passionate and dedicated Billing Specialist to join our team. The Billing Specialist...variety of daily tasks, including preparing clean and timely claims submissions, resolution of denials from payers, posting of… more
- Sedgwick (Providence, RI)
- …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Return-to-Work Specialist **PRIMARY PURPOSE** : To negotiate, facilitate and monitor successful ... Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) efforts through negotiation with… more
- Zurich NA (Providence, RI)
- Senior Design/Construction Management Consulting Specialist 113183 Zurich is looking for a highly skilled **Senior Design/Construction Management Consulting ... Specialist ** within Risk Engineering and our Zurich Resilience Solutions...prospect/existing customer base. + Providing periodic support to the Claims Department with technical assessment of complex claims… more
- Citizens (Riverside, RI)
- Description The Consumer QA QC Sr Specialist will be part of the Colleague Coaching and Development (CCAD) team and will be responsible for quality assurance ... oversight for the Collections & Recovery, Fraud & Claims , and Mortgage phone colleagues. The QA QC Sr..., and Mortgage phone colleagues. The QA QC Sr specialist will be responsible for driving a differentiated customer… more
- State of Massachusetts (Taunton, MA)
- …emerging labor market needs of the Commonwealth, now and in the future. The Job Specialist IV assists in the operation of a unit of Employment Counselors, DVOP, and ... to clients designated as members of "special applicant groups". The Job Specialist provides guidance and instruction regarding laws and regulations and DCS and… more
- Walgreens (Providence, RI)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Dunkin (Providence, RI)
- **Summary:** The Payroll and Benefits Specialist is responsible for overseeing and managing payroll processes and employee benefits programs. This role ensures ... programs such as health insurance, retirement plans, and leave policies. The specialist also provides support to employees regarding payroll and benefits inquiries… more
- Philadelphia Insurance Companies (Bridgewater, MA)
- …50 and rated A++ by AM Best. Duties We are looking for a Business Solutions Specialist / Sr. Specialist to join our team! Summary - Analyzes company operations, ... the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an… more
- Travelers Insurance Company (Providence, RI)
- …of the scene and to provide technical advice and consultation to attorneys and claims staff associated with the loss. + Conduct research and testing, prepare reports ... (verbal and written), and to aid the claims and legal staff with the scientific aspects of...needed to support the overall functions of Risk Control, Claims Services, and Underwriting. Such materials may include newsletters,… more
- Sutherland Global Services (Providence, RI)
- …sent to Legal. This will include: + Conducting collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or ... PPO, IPA and Capitation and how these payers process claims + Knowledge of Managed Care contracts, Contract Language...billing form requirements (UB04) and HCFA 1500 + Medical claims and/or hospital collections experience + Minimum high school… more
- Travelers Insurance Company (West Bridgewater, MA)
- …professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and diaries, ... and prepares claim documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site storage. Receives, sorts,… more
- BrightSpring Health Services (Taunton, MA)
- …PharMerica Overview Our Point of Sale Adjudicators are crucial to our 3rd Part Claims activities and our business. This is an excellent opportunity to move from a ... pharmacy to office environment for those who are willing to learn claims , billing and insurance processing. Pharmacy Technician experience and/or knowledge of… more
- Guardian Life (Providence, RI)
- …The Vocational Rehabilitation Consultant provides assessment of LTD, STD and Life claims , to determine claimants' level of functionality and provide evaluation of ... of RTW. Serve as educational resource on vocational rehab aspect of claims . Educate parties involved in claim management regarding the extent of functional… more
- Elevance Health (Smithfield, RI)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... HS diploma or equivalent and a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more