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In this role you will o versee, monitor, and manage production supervisors and agents to ensure accurate and timely claims processing. MCI is seeking an experienced Insurance Call Center Claims Manager experienced in Property and Casualty and Life insurance to support complex business process outsourcing accounts.
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Proven analytical/technical aptitude evidenced by at least 5 years of successful experience in a quantitative role as a Business Analyst, Data Analyst, Programming Analyst, Claims processing, encounter processing.
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Experience in managing complex projects, workers' compensation claims and/or occupational nurse. The EHS Manager role at the Manawa location is directly responsible for overseeing the environmental, health, safety and security (EHS&S) programs, policies and initiatives in supporting our food processing facilities, DC and office areas.
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Resolve claim processing issues in a timely manner, evaluating problem claims to the appropriate managerial personnel with the insurance carrier's organization to quickly resolve delinquent claims or contacting patient or third party payers in compliance with established policies and procedures.
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Expert knowledge of current HMO claims processing protocols and regulatory guidelines. Experience with Epic AP Claims claim processing system. Extensive knowledge of Epic AP Claims, CPT, ICD, ASA and HCPCS coding.
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Process Return Apparatus Tags (RAT) involving warranty claims and verify Warranty and Maintenance automatic scale/wrapper credits. Will maintain a parts inventory and may process warranty claims.
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A strong knowledge of the SAG-AFTRA and AFM; owned important relationships with the Screen Actors Guild (SAG-AFTRA) and the Joint Policy Committee (JPC), ensuring that we are mitigating risk of any union claims.
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1 to 2 years of Claims processing experience. As a Claims Adjuster in our Claims Administration Department, you will be part of a special team that plays a critical role in our claims process.
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Maintains the Sales Floor in Tire and Battery Center in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise, and identifying shrink and damages.
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Responsible for facilitating communication between insurance company and the patient to resolve issues holding up claims processing, such as: incorrect demographic information or coordination of benefits.
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In this role, you will act as the primary point of contact to our director of claims and the MCI operations and shared services team. Requires 5+ years of insurance experience building and managing Property and Casualty and Life insurance programs and a proven track record claims management.
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Two years (2) claims processing including Medi-Cal and Medicare. Four (4) years auditing claims in a managed care environment including contract and financial DOFR interpretation.
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Assist the Manager and provide guidance to staff with day to day System Application and Products (SAP) activities for processing provider claims payments, incentives, Capitation payments and Member out-of-pocket refunds for all Lines of Business(LOBS) are processed in accordance with LA Care regulatory policies and Generally Accepted Accounting Principles (GAAP) regulatory requirementsDaily workflow and leading the work of assigned staff.
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Minimum of three (3) years of account management experience for a government or private sector client in health care with two (2) years of Pharmacy claims processing point of sale (POS)systems experience.
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Reporting to the Benefits Administrator, the Assistant Benefits Administrator manages the NYS Disability and the NYS Paid Leave claims process, ensuring employees' benefits information is accurate, the extension of benefits under various State and Federal laws, retiree health insurance administration, disability plan administration, while working within Research Foundation policy guidelines and in compliance with legal requirements.
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