Develops and maintains corporate payment policies, and works collaboratively with the Clinical Editing Manager to ensure consistency with the Plan's adjudication system(s) Monitors DHHS, EOHHS, and CMS websites, listservs and other sources to identify existing payment practice and upcoming changes Determine the scope and impact of the change on Plan operations and seek to

Under general supervision of the Follow up Supervisor performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician specialty practice. Responsibilities Review all denied claims correct them in the system and send corrected/appealed claims as written correspondence fax or via electronic submission. Identify and analyz

CLAIMS SPECIALIST Job Locations US MA TAUNTON ID 2024 144254 Line of Business PharMerica Position Type Full Time Our Company PharMerica Overview Join our PharMerica team! PharMerica is a closed door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long term care and senior living clients. We offer a non retail pharmacy environment. Our organizati

This position is for an Auto Estimator, handling claims resulting in property damage to vehicles. You may be the first point of contact to meet with our insureds, explain coverage, estimate vehicle damage, and help them through the claims process while providing Remarkable service. This includes Utilizing automated estimating systems to prepare repair estimates Providing

You are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues experts in their fields who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciti

You are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues experts in their fields who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciti

Are you a current UMass Memorial Health caregiver? CLICK HERE to apply through your Workday account. Schedule Details Monday through Friday Scheduled Hours 8 30a 5p Shift 1 Day Shift, 8 Hours (United States of America) Hours 40 This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone

As a member of our Claims management team supervise claims staff to ensure appropriate claim outcomes through consistent execution of best claims practice. In this role utilize your prior claims and management experience to achieve business plan goals and to ensure compliance with legal statutes, policy provisions and company guidelines while fostering a culture of commun

improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well being as a team member. Join a team at the forefront of value based care and discover the meaning behind Caring. Connecting. Growing together. All of us have a

The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en

An independent Claims Handler role focused on low to mid value Employment Practices Liability claims with no significant coverage issues to help achieve the Beazley vision of being the highest performing specialist insurer. To contribute to the overall performance, development, and management of the Beazley claims function. To proactively manage claims, primarily at the i

Under general supervision of the Follow up Supervisor performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician specialty practice. Responsibilities Review all denied claims correct them in the system and send corrected/appealed claims as written correspondence fax or via electronic submission. Identify and analyz

Under general supervision of the Follow up Supervisor performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician specialty practice. Responsibilities Review all denied claims correct them in the system and send corrected/appealed claims as written correspondence fax or via electronic submission. Identify and analyz

You will investigate and resolve vehicle fire and theft claims over the phone and through written correspondence in a multi jurisdictional territory This level of adjuster will handle claims that require intense coverage or liability investigations including claims involving suspicious or unlawful activity. Investigations will include obtaining recorded statements from all

Job Location Smithfield, RI Smithfield, RI Position Type Full Time   Travel Percentage Occasional Job Shift Daytime Job Category Some Experience Description Position Overview (In office) This position is responsible to review written inquiries related to claims edit determinations that decrease claim reimbursement. This position also reviews inquiries related to denie