- Kohler Co. (Kohler, WI)
- **Sr. Disability Claims Examiner ** _Work Mode: Hybrid_ **Location: ** Hybrid - Kohler, WI **Opportunity** The Sr. Disability Claims Examiner is ... If a Claim or Leave is approved, the Sr. Disability Claims Examiner then updates internal documentation and systems, coordinates appropriate payments with… more
- Sedgwick (Madison, WI)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Bodily Injury Claims Examiner | Remote | Dedicated Client | Complex Claims ... some of the world's best brands? + Apply your examiner knowledge and experience to adjudicate complex customer ...examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
- Sedgwick (Sun Prairie, WI)
- …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 general 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 (Sun Prairie, WI)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner , Bodily Injury **PRIMARY PURPOSE** **:** To analyze mid- ... and higher-level general auto claims to determine scope of damages; to ensure ongoing...determine scope of damages; to ensure ongoing adjudication of claims within company standards and industry best practices; and… more
- Sedgwick (Madison, WI)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner , Bodily Injury **PRIMARY PURPOSE** : To analyze and process ... complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
- Sedgwick (Wausau, WI)
- …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 (Sun Prairie, WI)
- …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 (Madison, WI)
- …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
- Molina Healthcare (WI)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...for at least one core operations function + Previous examiner , Adjuster/ processing experience in at least two +… more
- Molina Healthcare (Kenosha, WI)
- …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
- Humana (Madison, WI)
- …investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated formal or informal people management + Excellent PC ... of two years of leadership experience + CFE (Certified Fraud Examiner ) or AHFI (Accredited Healthcare Fraud Investigator) **Additional Information** + Benefits… more
- Molina Healthcare (WI)
- …Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation pertinent to investigations. + Detects ... Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all current Molina employees: If you are interested in… more