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Will work with Provider Contracting, Credentialing, Claims Operations, Utilization Management, and Network Management to setup systems to ensure accuracy of payments processing. Work with provider reimbursement tools, collaborate with Claims Operations, Utilization Management, and Network Management to setup pricing methodologies.
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Applicant acknowledges, understands, and agrees that any claims, disputes, causes of action, of any kind, in contract or tort, at law or equity, related to the employment of the Applicant by [BRAND BUMBLE BEE BLINDS OF FAIRFIELD COUNTY, shall be made BUMBLE BEE BLINDS OF FAIRFIELD COUNTY, and not HorsePower Brands or its affiliates.
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In this role you’llOversee the execution of intricate projects within CLX, ensuring alignment with business goals and timely project completionBuild and maintain strong relationships with key stakeholders, including executive leaders and Product partners, to drive strategic initiatives for operational excellenceSupport comprehensive financial analysis and forecasting activities, contributing to the financial strategy of claims experience operations.
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Our team of specialist brokers, consultants and in-house claims management combine threat assessment, impact analysis and crisis management and response with individually structured insurance programs.
$150,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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This position reports to the AVP, SIU & Compliance who is located in New York, NY. As an SIU Investigator, you will be tasked with the identification, investigation, and deterrence of instances of fraud in both claims and underwriting for a multi-line, commercial carrier.
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Lead the new product development and execution process from ideation to launch including (but not limited to) developing concept/claims/storytelling, creative and pack design brief based on consumer insights and financial business case recommending cost of good and pricing targets to ultimately deliver new launches to market on time & within budget.
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We are seeking a Senior Civil Engineer with broad expertise in land development and/or site/civil/heavy construction project management to perform investigations and analyses, prepare reports, and provide expert testimony where technical knowledge, skill, experience, training and/or education are needed to help resolve civil litigation and insurance claims.
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Responsibilities:Investigate, negotiate and settle complex primary and excess policy miscellaneous professional liability claims (i.e. claims made against real estate brokers/agents, title agents, escrow agents, accountants, insurance agents and brokers, home inspectors, information technology consultants, debt collectors, medical billing consultants, utility inspectors, and other specified professionals.
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Combining both traditional and novel analytical approaches with diverse real-world data, including genomic, medical record, claims and patient-reported information, has allowed us to inform Life Science company internal decision making as well as submissions and presentations to regulators; health technology assessment authorities and payers; the medical community; and, patient organizations.
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Maintains the data entry, record-keeping and billing systems as mandated by funding sources (e.g.: Claims Conference, German Government Home Care grants, etc. Acts as liaison to Jewish Family Services and other social service agencies throughout North America regarding requests, reports, payments, reimbursements, and other program-related issues.
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With 98% of cyber insurance claims in the past five years coming from small and mid-size businesses with revenue under $2B, providing an integrated solution to help manage risk is more critical than ever.
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Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants nurse consultants, and fire or fraud investigators, and other experts.
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Handle Union issues: Taft-Hartley Requests, SAG/AFTRA P&H Audits and oversee handling of union claims with talent payroll company. Draft and negotiate various third-party agreements, including music, licensing of footage and images, artwork and recognizable structures, apps, and other third-party rights.
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Prefers specific knowledge of claims processing and customer service systems (NASCO adjustment and pend processing, UPS, UCSW, Research Station, Cognos, and Image). Requires knowledge of health insurance operations (i.e. claims, enrollment, underwriting, etc.
$102,795 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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.
$83,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago
claims tpa jobs Company: Metroplus Health Plan in Newark, NJ
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