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Experienced in several of the following domains: biomedical informatics, outcomes and health services research, clinical trials, clinical decision support, population health and claims analytics, quality metrics and reporting, data security, privacy and regulatory compliance, and data governance.
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Zurich North America is currently looking for a VP, Financial Lines Technical Claims Director. At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move.
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Deep background in medical billing, coding, or auditing of insurance claims and medical records. Clear documentation of inconsistencies with claims billed vs health plan payments. You will be responsible for reviewing and analyzing medical claims, patient medical records, and automatic claim audit results to help train our machines that will deliver automated audit results.
$60,000 - $70,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Contribution and participation includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement (CQI) teams, consistent adherence to the specific rules and regulations of Bronx-Lebanon Hospital Center (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient and Customer Service.
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If you are interested in the exciting, high paying and rewarding career of an Independent Claims Adjuster, apply now; and we will send you an immediate email with more details. Our focus is to assist you by training you for Success as a Licensed Independent Claims Adjuster.
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MCS reviews other clinical documents with the purpose of facilitating the translation of Target Product Claims into a fully-supported proposed product label, and to improve communication quality of documents.
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You have 5+ years of experience selling healthcare data research assets (medical claims, prescription claims, EMR, lab data, etc.) You are a seasons consultative seller successful at uncovering and developing sales opportunities across HEOR, EPI and Commercial.
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Work with Home Office Human Resources and Security Departments to develop safety and workers compensation programs to address: property-level claims management, reduction in claims frequency, reduction in lost work days, reduction in claim severity, return to work program, preventative training, workplace Safety/OSHA compliance.
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This includes but is not limited to work updates, establishing publisher relationships, acting as a liaison between members, PROs and Legal Counsel to resolve conflicting claims, reconciling our data with external PROs, submission of royalty-based adjustments, and compiling income data to account for high value transactions.
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Manage and lead the revenue cycle management team and processes, including benefits verification, claims submission, payment posting, denials management, and revenue optimization. You will be responsible for managing and optimizing the end-to-end revenue cycle operations, including benefits verification, claims submission, payment posting, denials management, and revenue optimization.
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Experience with Labor Law 200, 240(1), and 241(6), premises liability claims. 3+ years defending personal injury claims venued in NY Supreme Courts. Please consider joining our team by sending your credentials to AttorneyRecruiting@wilsonelser.com and putting "NYC Personal Injury Defense Attorney " in the subject line.
$115,000 - $160,000 a yearFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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As a Claims Specialist, you'll investigate, evaluate and negotiate claims to successful resolution. Reporting Relationships: Reports to Claims Director, Freedom SpecialtyTypical Skills and Experiences:Education: College degree preferred.
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Possesses at least 6+ years recent experience with Medicare and/or Medicaid Part A, B, & DME claims, coding, and reimbursement procedures, service and coverage policies, coordination of benefits, as well as provider and beneficiary eligibility.
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Develop and foster relationships with reinsurance brokers and reinsurance markets to facilitate placements, execution of contract wording, timely claims payments and gain market intelligence. Work with Underwriting, Finance, Actuarial and Claims to gather data to assist in reinsurance submission preparation (data to be provided to a broker who will prepare submissions.
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In conjunction with Underwriting Associate, retain key assigned renewals and lead coordination of Loss Control and Claims Service plans for service level accounts. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
$80,500 - $137,000 a yearFull-timeExpandApply NowActive JobUpdated Today
claims job Company: Metroplus Health Plan in College Point, NY
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