Content Claims Specialist Field Level I Requisition ID 2024 24911 Job Locations US MA Boston Position Type Regular Full Time Category Claims Business Unit CUS_Loss Adjusting US Excellence In Everything We Touch Position Summary The role of Content Claims Specialists is a multi faceted role, which focuses primarily in the following four key areas of edjuster's content clai

Reporting the Unit Manager, this role will be responsible for direct handling of multi line commercial claims including Auto, General Liability and Construction Defect claims. Duties include investigation and evaluation of coverage, liability and damages issues. The role will be responsible for claim evaluation, establishment/recommendation of adequate reserves, litigatio

Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Service Authorization Specialist is responsible

The Sr. Claims Auditor utilizes CPT and ICD 10 coding to review physician claims and medical records for coding accuracy. Internal auditing functions focus on "desktop reviews" of claims, design and quality control of future audits, and other auditing related functions. Review clinical notes and claims submitted to verify the appropriateness of codes billed based on servi

Why This Role is Important to Us Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Service Authorization Specialist is responsible

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

Senior Claims Analyst, GL New York Labor Law Full time Remote & Hybrid Opportunities Available It's an exciting time to join Rockville Rockville, a wholly owned subsidiary of the RiverStone Group, is a growing third party claim administrator, setting a new standard of service excellence in the insurance services industry. We handle diverse claims with unique and interesti

Handles property/inland marine claims for assigned region with availability to assist as needed in all other regions. Evaluates property related damages of $100,000 (aggregate) and above. Handles complex Business Income losses. Responds to catastrophe claims handling in accordance with company CAT plan. Responsible for all coverage determinations, negotiations, reserving

Claims Analyst, CD Full time Hybrid & Remote Opportunities Available It's an exciting time to join Rockville Rockville, a wholly owned subsidiary of the RiverStone Group, is a growing third party claim administrator, setting a new standard of service excellence in the insurance services industry. We handle diverse claims with unique and interesting problems to conquer, pr

Review loss notices; confirm and interpret policy coverages; establish adequate reserves; and investigate and handle claims involving primary and excess coverages Responsible for assignment to and control of work of defense counsel, assignment of expert witnesses, and interfacing with peer carriers, including design and execution of defense and indemnity contracts, evalua

Claims Specialist ID 2024 7722 Job Location Location US MA Boston Type Regular Full Time Category/Department Claims Additional Locations US FL Tampa | US FL West Palm Beach | US NY New York Overview About Suffolk Suffolk is a national enterprise that builds, innovates, and invests. Suffolk is an end to end business that provides value throughout the entire project lifecyc

Insurance Coordinator is responsible for proactive management of the insurance authorization process. Supports clinicians by managing insurance authorizations/certifications (initial/ongoing) process. Assists patients with the financial and authorization issues related to their care. Supports all ambulatory PT/OT practice sites. Proactively, effectively and efficiently ma

Review assigned accounts by contacting Medicare to ensure timely resolution of accounts. Create updates and document information relating to the financial status of accounts in the hospital billing systems. Contact patients and/or other third party representatives to secure additional information pertaining to reimbursement of accounts. Process rejected/adjusted claims th

As a not for profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a manage

We're saving lives, building careers, and reimagining healthcare. We can't wait to grow alongside you. Location Onsite at Tufts Medical Center Hours 40 hours per week; Monday through Friday from 8 00 AM to 4 30 PM Job Profile Summary This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this r