The Business Analytics Sciences Insights & Strategies (BASIS) organization of UnitedHealthcare delivers analytic services and solutions which support all aspects of UHC Medicaid and Medicare operations from claims, finance, identification of fraud/waste/abuse, improved member/provider experience, clinical intelligence, and more.

Review and analyzes claims against the City with claims administrator for loss control and corrective action; manages activities of liability claims administrator to ensure effective claims processing.

Complete employer intake for disability claims. Assist with Leave of Absence management of using 3rd party leave administrator. Complete market data inquiries from HR Business Partners and provide applicable market pricing information to Sr Compensation Manager as needed.

Private Investigator / Claims/SIU Investigator. Claims Investigators investigates auto, property, Workers Compensation, and liability claims of varying complexity in which specific indicators have been identified; and coordinates with law enforcement and / or the state fraud bureaus for regulatory compliance and criminal prosecutions.

The Risk Analyst performs statistical analyses related to Risk Management, Insurance Portfolio Development, Third Party contract and Insurance administration, loss development trend analysis, Workers' Compensation and General Liability claims administration, Industrial Injury Lost Time and Return to Work analysis, and other programs as assigned.

Knowledge and demonstrated ability in Duck Creek including Duck Creek Policy, Billing, Claims and/or Insights, Duck Creek Author, Express, Server, User Admin and TransAct, Duck Creek Manuscript configuration, Duck Creek API / Duck Creek Integrations, Duck Creek user interface development, Duck Creek Data shredding, SQL Server, XML.

8+ years of experience with general HR operations and preferably with: full-cycle recruitment, employment law, WC claims, and employee relations preferred. Coordinate Workers Compensation claims as a liaison between employee, healthcare provider and carrier.

Administration of the US health and welfare benefits programs including medical, dental, vision, COBRA, BTA, death claims, and long-and-short term disability and leave of absence programs including vendor management, plan compliance, contracts, renewals, and vendor payments.

The Project Estimator position will work closely with insurance companies, insurance adjusters, clients, customers, and all other parties involved in claims, to produce accurate estimates and determine appropriate plans to get the affected loss back to pre-loss condition as quickly as possible.

May specialize in liability, property or catastrophe claims and may be assigned to either a desk or field adjusting team. At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best - protecting and restoring their dreams when they need us most.

Experience within Medicaid Management Information Systems (MMIS), Medicaid or Commercial Health Care claims, Provider Management and/or Eligibility data. We advise on, design, implement, and deploy solutions that are focused on government health agencies "heart of the business" issues including claims management, electronic health records, health information exchanges, health analytics, and health case management.

Use strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation. They will also utilize their strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation.

POSITION PURPOSE Under the supervision of a fiscal manager, the Accounting Technician performs full-charge bookkeeping or paraprofessional level accounting work in reviewing, entering, and maintaining program information, claims, reports, budget, and expenditure review and analysis for program contracts, and provides financial reports on contract and program performance.

Negotiates restoration services and insurance claims settlements. Writes scope of work for water damage emergencies and mold remediation. Utilizes Xactimate software to estimate residential and commercial water, fire, wind, and mold restoration projects, including the reconstruction.

We are a nationwide risk mitigation company seeking private investigators to conduct surveillance for clients who suspect fraudulent insurance claims. Ethos is looking for an experienced Field Investigator in the San Jose, CA area.