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Assist in the measurement of small and large losses commercial insurance claims and other assignments. Claims include property damage, product recall, liability, theft/fidelity, and business interruption/lost profits.
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Individual contributor responsible for direct handling and management of a variety of nation-wide high exposure and complex claims involving loss types such as sexual abuse, talc, PFAS/AFFF, product exposures involving multiple claimants, pollution, and other general liability claims that span multiple policy periods.
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Fraud Detection or Claims Experience. 2 years experience in Fraud/Claims, Support, or Leadership role. View the LA County Fair Chance Ordinance. Key responsibilities include utilizing a variety of systems such as Excel, SAS, SQL, Tableau, and other relational data bases to provide analytical support on strategies, ensure goals are met, and propose policy and procedural changes within segmentation structures to produce optimal results.
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Job Opportunity: Berkshire Hathaway Specialty Insurance (BHSI) has an exciting opportunity for an analytical and technically minded Water Resources (Flood) Engineer with expertise in inland and coastal flood risk modeling (including storm surge) to join the Catastrophe Engineering and Analytics (CAT E&A) team.
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Actively participate in and/or manage various aspects of the utilization management process, including: Concurrent review of all hospital admissions (observation and inpatient) with the Interdisciplinary Team driving efficient and timely transitions of care, retrospective review of inpatient admissions under 48 hours, and claims submitted inconsistent with the service authorization.
$100,000 a yearExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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4 years experience with Guidewire Cloud Claims migration. 4 years of experience working in one of the following sub service areas: Insurance Products, Underwriting, Claims, Billing & Payments, Policy Administration or Distribution.
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General Description: Manages medical aspects of workers compensation and disability claims for Third Party Administration (TPA) accounts by coordinating with patients, physicians, other health care providers and employers to facilitate positive patient outcomes, timely return to work if applicable and efficient claims resolution.
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We utilize a plethora of open source and industry accepted technologies for our big data problems such as Apache Spark, Apache Storm, Amazon Web services, and Apache Kafka. e Apache Spark or Apache Storm or Celery.
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Responsible for 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.
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As a Field Auto Damage Adjuster, you will play a crucial role in our Auto claims handling process by writing estimates directly at customer homes, repair shops, or tow yards. We’ve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection.
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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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RoleThe desired candidate's primary day-to-day role will assist Kleinfelder's technical planning and design staff with the implementation of adaptation and resiliency strategies for climate-related hazards, including (but not limited to): coastal and inland flooding, sea level rise and storm surge, and extreme heat.
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Under the general direction of the Manager of Payment Integrity, the Sr. Claims Auditor performs accurate and timely reviews of medical claims for internal audits. The Sr. Claims Auditor utilizes CPT and ICD-10 coding to review physician claims and medical records for coding accuracy.
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We are currently seeking an auto claims representative to join our growing Personal Lines Auto team. In this position you will be responsible for the investigation, evaluation and disposition of first- and third-party personal auto property damage claims.
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Subject matter expert advising on statutes, regulations, and guidance documents applicable to commercial, development, and medical affairs activities, including: research and interpretation of the Food, Drug, and Cosmetic Act; FDA regulations and guidance; federal and state anti-kickback statutes; OIG guidance documents and advisory opinions; the False Claims Act; and the PhRMA Code.
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storm claims jobs in Wakefield, MA
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