- Axis (New York, NY)
- …upon request for candidates taking part in the selection process. AXIS Capital Claims Compliance Specialist, Claims Shared Services- Job Description AXIS ... player with a can-do mindset focused on continuous improvement and will support claims compliance objectives and strategies in partnership with AXIS North… more
- AIG (Atlanta, GA)
- Claim Compliance Reviewer Join us as a Claims Compliance Reviewer to make more of your specialist expertise and experience. Make your mark in ... claim adjudication or claim operations experience for multi-line commercial claims . Claim Audit or file review experience...multi-line commercial claims . Claim Audit or file review experience is desirable. + Knowledge of key regulatory… more
- Sedgwick (Columbus, OH)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Compliance Auditor - Workers Compensation **PRIMARY PURPOSE** **:** To ... operational and technical audit requirements. + Participates in national quality review meetings. + Maintains technical claims and jurisdictional expertise.… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst will ... claims adjudication, clinical coding reviews for claims , settlement, claims auditing and/or utilization review required + 7+ years experience with… more
- Netflix (Los Angeles, CA)
- …role: Claims Management + Manage all Workers' compensation and Auto/GL claims from inception to resolution, ensuring compliance with internal and external ... high-risk cases to the Senior Manager as necessary. + Review and analyze claims for delays, denials,...communicates work restrictions, and coordinates modified duty to reduce claims costs. Compliance Oversight + Monitor … more
- AIG (Atlanta, GA)
- …of operations support and optimization + Collaborate with enabling teams, including Global Claims COEs, Claims Legal, Compliance , IT, and Claims ... of non-technical claims support to critical business activities, including business review , watch list and pipeline report, and real estate. + Drives a… more
- Insight Global (Anaheim, CA)
- …party property claims , ensuring accurate assessment of damages or losses * Review and interpret policy coverage to determine the extent of the company's liability ... satisfaction with company interests *Prepare detailed reports and documentation of claims , ensuring compliance with internal and regulatory guidelines *Maintain… more
- Sedgwick (San Antonio, TX)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (Brea, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (Brea, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (Long Beach, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... over the authority of individual PL Specialists. + Maintains periodic review of claims that are litigated, sensitive, or questionable as determined by the… more
- Sedgwick (San Diego, CA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Fedcap (South Portland, ME)
- …Accounting and Fund Management Processes. Essential Functions: + Validate Financial Claims for compliance with funding policies, procedures, and regulations. ... basic analysis to address financial trends and performance. + Validating Financial Claims for compliance with funding policies, procedures, and regulations.… more
- Elevance Health (Plano, TX)
- …Primary duties may include, but are not limited to: + Audits radiology provider claims for compliance to standard coding and billing practice guidelines. + ... specialty pharmacies, our infusion centers, and the home setting._ **Title:** Claims Coding Data Analyst - Paragon Healthcare **Location:** Candidates must reside… more
- Sedgwick (Shreveport, LA)
- …team meetings and assigns accountability for follow-up items. + Gathers important compliance / claims processing information to be presented at team meetings. + ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Team Lead Assistant - Workers Compensation (MUST RESIDE IN LOUISIANA)… more
- Prairie Ridge Health (Columbus, WI)
- …also requires corresponding with other teams on various types of errors to resolve claims needing additional review . They independently review accounts and ... insure proper and maximum reimbursement. Uses multiple systems to resolve outstanding claims according to compliance guidelines. This role supports the revenue… more
- Axis (Alpharetta, GA)
- …and Legal Bill Review , partnering with Vendor's in support of ensuring compliance with billing guidelines, as well as compliance with legal and ethical ... with key AXIS stakeholders + Collaborating and coordinating with Claims Quality Assurance and Compliance to implement...various software and insurance platforms and systems including Bill Review systems such as Legal Exchange and claims… more
- Zurich NA (Atlanta, GA)
- …Responsibilities:** + Document claims file by accurately capturing and updating claims data/information in compliance with best practices for high exposure ... as appropriate. + Establish timely reserves and perform ongoing review throughout claims cycle within authority limit...the best interests of the insured. + Ensure legal compliance by following state and federal laws and regulations… more
- Josselyn (Northbrook, IL)
- …Summary Conduct follow-up with payors, vendors, and clearinghouse on open insurance claims and balances in compliance with departmental policies and procedures. ... Resubmit primary and secondary claims Identify potential claim issues... Identify potential claim issues and escalate to management. Review , identify, and resolve root causes payor denials. Ensure… more
- Santa Clara Valley Water District (CA)
- …Job Number 01841-E Division Financial Planning and Management Services Unit Grants, Compliance , and Claims Management Unit Opening Date 11/19/2024 Closing Date ... the Classification Specification, please click here (https://s3.us-west-1.amazonaws.com/valleywater.org.us-west-1/s3fs-public/JD%20Grants%20and%20Claims%20Manager%2009-2023.pdf) Grants, Compliance , and Claims Management Unit(Position Code 1049)… more