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Three plus years of hands-on experience with Epic Resolute Billing in a real-time environment with Claims as they relate to the Resolute Module. Claims certification preferred. The Sr. Epic Resolute Revenue Cycle Analyst works with leadership to establish priorities for the Epic billing module, assisting systems analysts in implementing Epic Resolute updates and establishing Epic Resolute best practices and procedures.
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QualificationsEstimating knowledge using CoreLogic and/or Xactimate is required, along with the ability to navigate within Corelogic suites and guidewire claims handling platforms. Collaborates and consults with our Inland Marine/Builders Risk Underwriting and Engineering partners to determine liability and identify risk conditions to drive continuous improvement toward claims handling and risk management excellence.
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Your Role:As a Senior Auto Claims Adjuster, your responsibilities include handling complex non-injury auto claims. We are actively hiring for a Senior Auto Claims Adjuster! 2+ years of adjusting complex auto claims experience required.
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Diverse Legal Portfolios : get exposure to civil law, including legal assistance (estate planning, family law, tax matters); tort claims (represent interests of the U.S. in tort issues such as Federal Tort Claims Act/Military Claims Act); labor law (arbitration and equal opportunity); and contract law (legal review of multi-billion dollar contracts of military technologies and supplies.
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Litigation management of Cyber and Technology Errors and Omissions (E&O) liability claims including: retention of counsel, strategy planning and analysis that may include alternate dispute resolution, direct negotiations and/or trial management.
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Provide support to the Project Management, Purchasing, Production, Engineering, and Drafting team post-award starting with project transfer to Engineering Submittals preparation, system production, and through field installation, startup, commissioning, and operations including performance testing and warranty claims.
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The Fleet Safety Director will play a critical role in ensuring the safety of our drivers, vehicles, and operations, while also managing regulatory compliance, insurance claims, oversee the hiring of qualified CDL drivers, manage employee disciplinary issues, and company safety policies.
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Respond/report to guest claims of property damage relating to guest parking/garage. Investigates allegations of guest(s), non-guest(s) property and employee losses, theft, injury or complaints/incidents.
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Assist members with PCP selection as well as locating providers and vendor within plan’s network. Process ImprovementsDevising solutions in response to member dissatisfaction/ complaints/issues to support ongoing organizational improvement efforts.
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Understanding of provider network operations, including data management, credentialing, contract management, and claims processing. As a member of the Network Development leadership team, the Manager of Network Operations will participate in the successful implementation of provider data management tools at Texicare.
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Partner with and collaborate across functions on analytics and strategic initiatives, including, but not limited to, Underwriting, Actuarial, Reinsurance, Claims, and Operations. Experience with and exposure to various operational disciplines (underwriting, claims, IT, etc.
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The BSI Claim Counsel team conducts thorough investigation, analysis, evaluation, and disposition of claims and claim litigation to achieve superior customer service and to optimize claim results.
$105,100 - $173,400Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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The primary responsibilities, include but are not limited to, answering customer calls, proactively working to resolve our members and providers questions and concerns, responding to and documenting all customer encounters, intaking complaints, conducting outreach and retention efforts, assisting with PCP selections and handling all provider inquiries related to eligibility, claims and authorizations.
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Medical claims, Medicaid and HEOR database search. Observational data, MarketScan, Optum, Market Clarity, EMC- Claims databases. Open to remote for experienced candidates with Medical Claims and EMR experience.
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This is a full-time on-site role as an Auto Damage Adjuster at Blue Star Brothers in the New York City Area. The Auto Damage Adjuster will be responsible for handling car insurance claims, property damage assessments, and analyzing auto claims to determine coverage eligibility, along with basic clerical work, such as filing, scheduling, and assisting with parts order.
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claims complaints locating jobs Company: Metroplus Health Plan in Newark, NJ
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