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A minimum of 1-2 years of Pennsylvania Workers’ Compensation experience with direct adjudication, supervision, and administration of workers’ compensation claims with an insurance company, TPA or self-insured company.
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Participates in the policy and procedure development, maintains internal and external relationships (wholesalers, Covered Entities, and third-party administrator [TPA] vendors) as needed, 340B rules/guidance surveillance, assist in 340B off site audits as necessary, contract management/implementation, reporting/analyzing, and program enhancement/ optimization projects including annual budgeting.
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Prepares, completes, and forwards the Supplemental Report of Injury (DWC-6) to HISD’s TPA for submission to the Texas Department of Insurance, Division of Workers Compensation. This form must be completed and sent to the TPA within 7 days of adjuster’s request.
$46,134 - $76,122Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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We have assignments available to help our insurance carrier or Third-Party Administrator (TPA) clients in Property & Casualty (P&C) Commercial Claims Adjuster or Examiner positions. P&C Commercial Claims Adjuster - Carrier or TPA - REMOTE.
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Job Description & Requirements Registered Nurse – Emergency Room - Travel - (ER RN) StartDate: 4/29/2024 Available Shifts: 12 N Pay Rate: $2239.00 - $2468.00 Level 3 Trauma Center Age Group of Patients: Infant, Pediatric, Adolescent, Adult, Geriatric Top 10 Diagnosis/Procedures: Stroke-TPA, Multisystem Trauma, Pneumonia, CHF, RSV, DKA, ALOC, Orthopedic injury.
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Handle General Liability / Bodily Injury, Property, Commercial Auto Liability and/or Physical Damage, Workers Compensation, Inland Marine, Professional / Management Liability, Business Interruption, Liquor Liability, Garage/Garagekeepers Legal Liability or Umbrella claims.
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TPA operates venues on the UT campus including Austin's largest theater, Bass Concert Hall. Its public programs include Broadway in Austin; a curated season of international dance, theater, and music; and presentations of national touring artists.
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Responsible for managing all communications and relationships between KPH and all Covered Entities and their designated 340B TPA within the program. In conjunction with the VP of Managed Care Contracting & Payor Relations/legal department, reviews and negotiates any new 340B contracts and renegotiation of existing transaction fees.
$65,000 - $85,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Insurance Claims Specialist will be responsible for the daily management and coordination of Workers’ Compensation claims between the third-party claims administrator (TPA) and Operations. Identify and analyze problems regarding workers’ compensation claims; Recommend investigation and surveillance on employees through a third-party administrator (TPA); Monitor attendance and medical appointments of employees on workers’ compensation.
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The Specialist will work closely with Operations, insurance TPA and various stakeholders to ensure an efficient and comprehensive claims administration process. Certified Professional Claims Adjuster (CPCA) or Certified Claims Adjuster (CCA) Certified Workers' Compensation Professional (CWCP) or Associate in Claims (AIC) would be beneficial.
$75,000 - $90,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Divisional Operational Risk and Data Management: including Divisional Operational Risk, electronic discovery and ESI management (EEM), divisional records information management (RIM), third-party risk management (including TPA process for legal vendors)Work as a peer-to-peer partner with the Division’s Chief of Staff to, among other things, set priorities and allocate resources in alignment with corporate objectives and the strategic plan.
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Proactively maintaining ongoing case evaluations and litigation management, including the selection and monitoring of counsel in accordance with department litigation guidelines; directing and advising Third Party Administrator (TPA) regarding claim handling and reporting.
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Continually monitors 340B regulations to ensure federal compliance, staying up to date on all rule changes, including HRSA/OPA, Medicaid and manufacturer changes. Regularly communicates with all staff involved with the 340B program to ensure that processes remain efficient and to address any problems or suggestions for improvement.
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Follow the status of workers' compensation claims with a third-party administrator (TPA); serve as liaison with departments, legal counsel, and the TPA; make recommendations for settlement; and coordinate return to work and modified duty programs.
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WHAT WE ARE SEEKINGWe have assignments available to help our insurance carrier or Third-Party Administrator (TPA) clients in Property & Casualty (P&C) Commercial Claims Adjuster or Examiner positions.
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