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Conducts sophisticated data analysis, modeling, prescriptive/diagnostic insight generation and data storytelling across all facets of the Retrospective Claims Auditing business. 5+ combined years experience in management consulting, investment banking, business strategy, operational excellence/process improvement, and/or Finance.
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Experience with Claims Processing , Medical Plan Benefit Configuration (Facets platform a plus) " At least 5+ years experience with health plans or medical claims. Serve as a Sr. Configuration Analyst on the Government production team, responsible for leading initiatives to set-up Government/Medical-Surgical benefits in our core administration system.
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Thorough understanding of Facets claims adjudication process and pricing logic, troubleshoot, identify root cause, and resolve claims processed in the Facets UI. 5+ years of experience working with TriZetto Facets Application especially expertise knowledge on Enrollment, Providers, Claims and UM modules.
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Assists defense counsel in all facets of trial preparation, coordinates trial strategy by evaluating exposure, planning and organizing expert witness selection, and testimony regarding high value cases.
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We are seeking Full-Time Medical Billing Manager to provide supervisory oversight and management of all facets of the billing team. Perform full-cycle revenue management including: Submitting claims, follow-ups, dispute, correction, and resolution of denied/rejected claims.
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In this role, the Complex Claims Director will have a unique opportunity to handle and adjust all facets of Architects & Engineers Professional Liability claims in a highly collaborative team environment, dedicated to best in class claims handling.
$140,000 - $165,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Two (2) years professional experience, preferably in the administration of a medium-large public pension system with broad knowledge and understanding of Internal Revenue Codes and how they affect pension and deferred compensation or three (3) years experience in accounting and financial reporting for pension plans and other facets of pension fund administration, the last two (2) years of which includes supervisory experience.
$4,551.73 - $7,215.87 a monthFull-timeExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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This position is a great opportunity for practicing lawyers looking to transition out of a law firm as well as claim professionals with professional liability claims experience. Manage and adjust Architects & Engineers Professional Liability claims impacting primary and excess policies while ensuring the highest level of customer service and technical claim file quality.
$125,000 - $140,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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A minimum of 5 years experience handling professional liability claims and/or construction claims, or matching equivalency; and be able to demonstrate technical competence in the handling of specialized claims.
$125,000 - $140,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Successful candidates have had prior business experience in the following industries: Non-underwriting insurance experience, such as sales, claims handling Financial services, such as banking, mortgage underwriting, financial consulting, asset management, business analyst Legal services, such as attorney, paralegal We are looking for people who can think, make good decisions and communicate clearly.
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Thorough understanding of health plan claims adjudication processes as well as the operational processes involved with the supporting system - Facets. Provide recommendations to modification of service IDs, supplemental tables, and service definitions based on claims issues presented by the health plan or as needed for new products.
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Required Skills Technical Skills- Facets - Membership, Facets - Claims, Facets - Billing, Facets Domain Skills- Enrollement. Seeking a highly experienced Product Consultant with 6-10 years of experience in Facets, Billing, Claims, and Membership.
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Registration Clerk ensures patient satisfaction in multiple facets including admissions, patient accounting, insurance claims and the Indigent and Charity Program. Follows insurance claims for filing to completion.
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Under the guidance of Sr. HR Director, work with the legal department to respond to EEOC claims and other employment-related legal matters as they arise. We are seeking an experienced HR professional who is able to effectively influence, lead and execute across multiple facets of HR to include recruitment, engagement and retention, coaching and counseling, employee relations, policy and procedure administration and HR compliance.
$77,388 - $113,427 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Prepare pertinent renewal information to include Experian data, SAFER data, OSHA data, claims data, RAMP data, and pricing data. The Associate Underwriter will learn all facets of the underwriting job and be trained to be an Underwriter.
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