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Measures and reports key performance measures; and oversees back-office operations relating to licensure and training records, drug testing, insurance reporting, workers compensation claims, accident claims and subrogation, workplace safety, and employee health and safety.
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This role will be primarily responsible for providing regulatory compliance support and monitoring of the Guardian Group Benefits Product, Claims and State Filing areas, with significant and specialized focus on support and oversight of Guardian's Absence Management and Paid Family and Medical Leave services, Group Disability and Supplemental Health products.
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4 years of experience working in one of the following sub service areas: Insurance Products, Underwriting, Claims, Billing & Payments, Policy Administration or Distribution. Minimum 4 full life cycle implementations of Large-Scale System Delivery Experience preferably for Policy Administration, Billing Systems and/or Claims Systems.
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Responsible for administration and enforcement of collective bargaining agreements, including researching, processing and resolving claims on behalf of performers under SAG-AFTRA contracts. Investigate, research, conciliate and resolve claims initiated by performers or their representatives.
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Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company (NM) and its subsidiaries in Milwaukee, WI. Sarah Adams is a General Agent of NM. Managing Directors are not in legal partnership with each other, NM, or its subsidiaries.
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Design and execute observational and economic research studies using real-world data, including insurance claims, registry, or EMR data, for clinical and/or pre-clinical product portfolio decisions, marketing, regulatory agency submissions, and product reimbursement strategies to drive patient access.
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Act as liaison with Insurance tracking vendor, reconcile and process hazard and flood insurance bills for payment, including follow-up with customers to obtain bills, resolving billing discrepancies, disbursing escrow funds, preparing and mailing checks and documenting payments in loan file.
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Assists in processing paperwork associated with clinical care including: insurance claims, disability forms, and medical equipment forms. Provides information to the patient regarding the need for insurance referral(s), and refers calls as appropriate.
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Working knowledge of energy management systems (EMS), battery cell technologies, power conversion systems (PCS), system integration, and long-term service agreements (LTSA)Working knowledge of large-scale, front-of-the-meter edge solutions and requirements for meeting NERC CIP compliance.
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5+ years of Facets Claims Processing System. Working under the direction of the Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery Analyst will assist in the development of a strategic roadmap to recover, eliminate, and prevent unnecessary medical expense spending and support the execution for a comprehensive claim accuracy program.
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Communicates with insurance companies to expedite and/or manage delays with authorization for post-acute care and services. ·Secures DME and oxygen for post-acute needs; maps insurance and geography to identify appropriate vendors: assesses insurance benefits and coordinates the necessary paperwork with the external vendors and medical team for approval for equipment, such as letters of medical necessity, medical record documentation, and prescriptions.
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For your physical and mental wellness we offer competitive Medical and Dental programs through Anthem Blue Cross Blue Shield as well as Vision insurance programs through EyeMed.Our Vacation, Sick and Holiday programs are available for you to rejuvenate with time off.
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The Principal Technical Product Manager role focuses on driving process maturity enhancements and leading the development of key components and business capabilities within the Dassault Enovia PLM system.
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E web, service, data, and infrastructure) and insurance specific (i.e. Guidewire, EIS, Duck Creek, etc.) Insurance technologies such as Guidewire, EIS, Duck Creek; As part of our team, you'll help clients harness technology systems in financial services focusing on areas such as insurance, sales performance management, retirement and pension, asset management, and banking & capital markets.
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Steward Health Care works with Blue Cross Blue Shield of Massachusetts to provide affordable health insurance for our employees in benefit-eligible positions. About Steward Health CareOver a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness.
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system insurance claims jobs in Saugus, MA
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