Content Lifecycle Management: Oversee creation, review, and distribution of compliant content, including digital asset management and claims management. Extensive experience with Veeva Vault Digital Asset management (DAM.

Full ownership and accountability for all Quality Controls Assurance programs, activities and reviews, including claims reviews; call center and digital communications reviews; Medicare Risk Adjustment, HCC, clinical and coding reviews; DRG and medical records reviews; technology/systems and coding upgrade and implementation reviews (e.g. final user acceptance testing, etc.

The Claims Manager supports medical insurance customers (including administrators, MGUS, brokers) by confirming eligibility, determining insurance coverage, examining and resolving medical stop loss claims, documenting actions, maintaining quality customer service, ensuring compliance.

Expert knowledge of Medicare, MassHealth and commercial insurance pre-claims requirements, regulations and guidelines. Our onsite patient-facing Patient Financial Coordinators play a vital role in the Dental School’s revenue cycle management, ensuring patient services payments in full, which has a direct impact on the Dental School’s clinical services financial and claims outcomes success.

1-3 years of experience with Optum Claims Manager or similar rule-based claim scrubbing engine (or demonstrated aptitude based on prior EDI claims experience) Leverage knowledge of medical claims, coding, and insurance payers to design and support robust solutions that favor automation and work efficiency over manual workflows.

Ensures the uniqueness of the product experience delivers upon the brand strategy, collaborating closely with marketing on the positioning to support claims, building value analysis into every new development.

Implement quality control measures to ensure accuracy and consistency in warranty claim handling, maintaining high standards of service delivery and categorization of warranty claims. Ensure compliance with warranty regulations and company policies, mitigating risks associated with warranty claims and minimizing potential liabilities.

Evaluate claims and coverage disputes, conduct legal research, and draft coverage opinions and coverage position letters. Handle a diverse caseload of civil litigation matters, including but not limited to commercial disputes, personal injury claims, employment litigation, and contract disputes.

You'll facilitate student-led discourse, teaching students to use evidence to make sophisticated claims, and to synthesize and evaluate arguments and rhetoric. We achieve this by offering strong academic, co-curricular, and social-emotional learning that prepares students for success in college and beyond.

Assists the Billing Supervisor with the resolution of complex claims issues, denials, appeals and credits. Reviews and corrects all claims/charge denials and edits that are communicated via Epic, Explanation of Benefits (EOB), direct correspondence from the insurance carrier or others and uses information learned to educate PFS and office staff to reduce future denials and edits of the same nature.

The Vertex Companies, LLC (VERTEX) is a leading multidisciplinary engineering and consulting firm that provides forensic consulting, engineering design, construction management, claims & dispute resolution, and environmental solutions to insurance carriers, sureties, law firms, real estate owners, property managers, public agencies, and commercial clients.

The Claims Resolution Specialist is responsible for the investigation, evaluation and disposition of first and third party personal auto property damage claims as well as for providing an outstanding experience to our Customers and Agents while you assist them through claims process.

You'll conduct a deep exploration of daily content in order to guide students to analyze books by authors like James Baldwin, Toni Morrison, F. Scott Fitzgerald, William Shakespeare, and Yaa Gyasi; books that ignite a passion for literature, sharpen a critical eye for examining the world, and deepen students’ intellectual identity.

CONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare DiedreMoire JobSearch JobHunt JobOpening Hiring Job Jobs Careers Employment jobposting InsuranceJobs UnderwriterJobs DISCLAIMER: We will make every effort to consider applications for all available positions and shall use one or more of the contact methods and addresses indicated in resume or online application.

CLF's Strategic Litigation team works on groundbreaking environmental law cases, currently including climate-change liability claims against the world's largest oil and gas producers and cases that will reduce nutrient pollution that fuels toxic algae outbreaks.