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Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor. Assists TPA with provider compensation configuration by creating and testing compensation grids used for reimbursement and claims processing.
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You will report to the Workers’ Compensation Claims Manager- TPASHARE your talentWe’re looking for someone who has these abilities and skills:·Advanced level claim handling experience involving high value/complex claim management and litigation management.
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Responsibilities also include attending hearings, arbitrations, court conferences, drafting arguments and motions; negotiating settlements of pending cases; overseeing outside counsel and directing claims personnel with respect to legal action plans implemented on claims.
$101,253 - $132,894 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Coordinates all collateral assignments, death or disability claims, and fund allocation changes with the assistance of the Relationship Manager. We're a recognized Elite Agency award winner and a leading property and casualty broker, benefits consultant, wealth manager, and retirement plan advisor.
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Position Overview The Claims Compliance Remediation Analyst will support the Director of Claims Support to ensure claims rules, guidelines, documents, policies and procedures, reporting, job aides, training, and other key components are compliant with CMS and NYSDOH regulatory entities and maintained within a central repository.
$81,000 - $91,000 a yearFull-timeExpandApply NowActive JobUpdated 4 months ago - UpvoteDownvoteShare Job
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Key Responsibilities: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.
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About the teamTreasury and Risk Management organization oversees cash management, investments, foreign exchange, capital structure, financing, sanctions screening, global risk and claims management, and internal audit functions for Amazon.
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Detailed technical knowledge of general liability claims handling with the ability to advise Casualty Claims Examiners on the handling of complex injury and coverage cases. Ten plus (10+) years working experience in the insurance industry managing a team supporting commercial accounts for high exposure Casualty claims, litigation, and coverage.
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The Vertex Companies, LLC (VERTEX) is a leading multidisciplinary engineering and consulting firm that provides forensic consulting, engineering design, construction management, claims & dispute resolution, and environmental solutions to insurance carriers, sureties, law firms, real estate owners, property managers, public agencies, and commercial clients.
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The successful candidate should have a background in preparing multi-states sales and use tax refund claims, indirect tax returns, performing tax research, strong organization and time-management skills, good written and verbal communication skills, and be committed to delivering excellent service to internal and external business partners.
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Organizes and reviews financial and utilization data, including insurer claims, eligibility, hospital and physician billing data, payer’s fee schedules, Medicare RBRVS fee schedule and Medicaid APG and ordered ambulatory fee schedules.
$67,771.14 - $90,535.23 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 the BronxCare Health System (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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Experience working with Actuary, ERM, Claims, CAT modeling, CededRe, etc. Experience working with Actuary, ERM, Claims, CAT modeling, CededRe, etc. Remains informed on key issues and nuances of the commercial property insurance market at a macro level and be able to communicate that with our brokers, clients and more junior underwriters.
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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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We provide high quality and cost-effective “hands-on” restoration services with appropriate turnaround times that contractors, claims professionals, and homeowners require. As we strive to accommodate our customers and their restoration needs, Prism Specialties expanded into art restoration, document restoration, and textile restoration.
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claims mhp jobs Company: Metroplus Health Plan in Manhattan, NY
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