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Define and set the strategy for the operating model that services underwriting and claims within Inland Marine. Experience overseeing and improving underwriting, claims and other systems and processes with an emphasis on risk processing and workflow.
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Actively engages 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, and fire or fraud investigators, and other experts.
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The Claims team is currently seeking an experienced Auto Adjuster to join in their Worcester MA - Richmond, VA - Itasca, IL or Howell, MI office location. + Be responsible for some to all aspects of each claim, including informal hearings, arbitrations and small claims litigation and maintaining a high level of productivity, confidentiality, and customer service.
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Scrum Master/Business Analyst with experience in Azure DO, Jira, Confluence, and claims experience, you are looking for a professional with a specific set of skills and knowledge. Knowledge of underwriting, claims processing, policy administration, and regulatory compliance.
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ESIS is seeking an experienced Workers Compensation Claims Specialist. Qualified candidates must possess experience in managing workers' compensation claims investigation/ adjusting, including knowledge of applicable state/local legislation.
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Job ResponsibilitiesConfirms coverage of claims by reviewing policies and documents submitted in support of claimsDirects and monitors assignments to experts and outside counsel, ensures effective vendor and litigation management on moderate to high complexity claims including demonstrable savingsAnalyzes coverage and communicates coverage positionsPrepare coverage position letters on matters typically in litigation without assistance of outside coverage counsel.
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Assists in keeping the environment safe for associates to reduce the occurrence of Workers’ Compensation claims by appropriately evaluating resident transfer and mobility needs and involving therapy services as indicated.
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Maintain licensure through completion of yearly Continuing Legal Education (CLE) requirements of the District of Columbia, to include the Court of Appeals for Veterans Claims and the U.S. Federal Circuit Court.
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The Medicaid Billing Specialist is responsible for the accurate and timely editing, preparation, submission of electronically and manually processed claims to third party payers in accordance with policies and procedures.
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Ability to collaborate with Actuarial, Claims, IT, Compliance and other divisions as needed. Identify issues and obstacles that impact ability to attain team/division goals and work in conjunction with Underwriting Manager to rectify.
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Ensure Proof of Claims, Motions for Relief, Payment Change Notices, Post Petition Fees and Costs are prepared by counsel, are accurate and all aspects of the bankruptcy are handled according to investor guidelines and timeframes.
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Negotiates disposition of claims with insureds and claimants or their legal representatives. Prompt and proper disposition of all claims within delegated authority. Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices.
$81,000 - $133,700Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Keyword Search: Medi-Cal, Cerner, Soarian, MS4, PBAR, insurance collections, accounts receivable, patient accounts, insurance, revenue cycle, patient financial, insurance verification, insurance follow up, medical billing, insurance billing, medical insurance billing, medical insurance claims, insurance claims resolution, insurance collector, claims follow up, revenue cycle specialist, revenue cycle representative.
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Experience in healthcare law, arbitration, mediation, dispute resolution or claims and appeals adjudication in healthcare. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
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Walk-through claims with an insurance adjuster and the insured, explaining our process. We provide high quality and cost-effective "hands-on" restoration services with appropriate turnaround times that contractors, claims professionals, and homeowners require.
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claims job Title: return work in Glen Allen, VA
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