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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.
$150ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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.
$24 - $33.1 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Experience advising on statutes, regulations, and guidance documents applicable to market access activities, including Medicaid, 340B program, Veterans Administration, federal and state anti-kickback statutes, state drug pricing transparency laws, OIG guidance documents and advisory opinions, the False Claims Act, and the PhRMA Code.
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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.
$100,000 - $160,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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.
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Updates water quality parameters in the model as a result of the Green Infrastructure Improvements and the removal of illicit connections to the storm drainage system. Prepares plans for sampling projects involving water, sewer and drain systems.
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Coordinate with design staff for development and infrastructure-related projects for hydraulic equipment, water distribution, sanitary sewer collection, stormwater, roadway, street, bikeway, erosion control, grading, storm drainage, dams, and reservoirs.
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For this position the Civil Aviation Engineer-EIT will perform a variety of tasks which may include assisting with the development of plans and specification for airside facilities such as runways, taxiways, and aprons, as well as landside roads, general civil/site development, storm water collection and treatment, and other related projects.
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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.
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Responsible to work claim rejections due to provider, enrollment, NPI or taxonomy related issues returned by the payor preventing claims submission or causing payor denials. Independently works on the resolution of complex claims issues, denials and appeals.
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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.
$200ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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3-10 + years of experience with casualty claims and assumed reinsurance claims. Investigate, evaluate, and dispose of moderately complex insurance and/or reinsurance claims in keeping with sound claim practices and company procedures.
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As a Claim Account Manager US Mid-Market for the Americas Claims team, you will be responsible for claim account management functions for customers in our growing US Mid-Market business unit, helping to sell AXA XL Claims value in the marketplace and managing claims-related service issues for our customers, Third Party Administrator ( TPA ) and key distribution partners.
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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.
$124,800 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Experience in the design of civil infrastructure such as site planning, roads, drainage, grading, earthworks, containments, deep excavations, ponds, storm water management and erosion and sedimentation control water systems, sanitary sewer systems and other municipal infrastructure.
$93,400 - $135,400 a yearFull-timeExpandApply NowActive JobUpdated Today
storm claims jobs in Woburn, MA
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