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New! YesterdayReceives claims assignments, verifies and determines applicability of coverage. Ability to interpret complex coverage issues and write appropriate reservation of rights and declination of coverage letters. Determines the method and extent of...
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New! YesterdayResponsible for collection and follow up on payment for assigned premium receivables. Review accounts receivable aging and other monthly reports to ensure compliance, and accurate and timely collections. Research billing disputes, reconcile accounts...
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New! YesterdayResponsible for billing and collection follow up on payment for assigned deductible recoverables. Review recoverable aging and other monthly reports to ensure compliance and timely collections. Determine reasons for non-pay situations and resolve...
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New! YesterdayReceives lost time and complex medical only assignments. Verifies and determines applicability of coverage. Initiates 24 hour contact with employer, employee and 48 hour contact with attending physician. Handles catastrophic claims with supervisory...
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New! YesterdayResponsible for review and analysis of underwriting data to build and maintain a profitable book of business within the Contractors segment under minimal supervision. Manages agency relationships through continued customer service and marketing...
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New! YesterdayServe as project manager for one or more large and complex projects. Responsible for meeting timelines, budget, quality and resource commitments for project(s). Manage and coordinate project direction and scope from analysis through implementation.
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New! YesterdaySupervisory functions include providing leadership and direction while coaching, training and providing work direction and feedback, and mentoring the team members; evaluating employee performance and making salary recommendations, performing all...
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New! YesterdayAnalyze complex legal and factual issues, conduct extensive and develop well-reasoned legal research. Independently create and present defense strategies on behalf of clients. Prepare complex pleadings, written discovery, depositions, petitions for...
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New! YesterdayAct as the lead underwriting contact for the Midwest Commercial D&O department, determining distribution and marketing strategy for the region. Meet profitability, retention, and written premium goals determined by the department. Manage broker...
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FeaturedNew! YesterdayWe currently have an opportunity for an Operations Director to join our Intact Insurance RSAI team in our New York, NY office or remotely nationwide. Directs the operations and management of a department(s), business unit or division within the...
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New! YesterdayHandles litigation involving either the corporation and/or its insured within established corporate guidelines and the applicable code of professional responsibility. Handles files and issues of a complex nature. Communicates with client regarding file...
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New! YesterdayAssists attorney in trial preparation. Drafts pleadings, discovery documents, motions, deposition summaries, abstracts, correspondence and legal memorandums under the supervision of an attorney. Collection in - organization, summarization...
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New! YesterdaySupports business development activities by collaborating and providing the required inputs into opportunities for prospective and existing clients, including estimation and costing. Serves as a liaison between internal and external stakeholders...
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New! YesterdayYou will maintain knowledge on current and emerging developments/trends for assigned territory and products, assessing impacts, and collaborating with management to incorporate new trends and developments in current and future solutions.
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New! YesterdayUses proprietary software tools to access and review claim documents, enter claim decisions, and create escalations when needed. Utilizes documented team processes to ensure compliance with departmental standards.
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New! YesterdayUtilize various internal systems to complete policy drafting, verify data accuracy of drafted policy, approve policy drafts within authority, set-up within our internal electronic document management system, and follow-up for underwriter approval for...
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New! YesterdayAnswers inbound calls to meet customer needs by efficiently capturing first notice of loss information, responding to questions, redirecting customers to appropriate department/claim professional or promptly escalating urgent claims according to...
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New! YesterdayAnalyze, value, and provide risk analysis around complex transactions and portfolio positions, including power generation, load contracts, complex derivatives, hedging strategies and trading assets. Develop and monitor position reports, PnL reports...
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New! YesterdayThe individual in this position works under general supervision to complete job responsibilities in applying a fundamental knowledge of principles, practices and procedures related to the negotiation of health care claims/bills and provider agreements.
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New! YesterdayThe position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. Ensure notes, codes and appropriate closure processes for...
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New! YesterdayThis role will support our Medicare Secondary Payer (MSP) clients. This is aproduction based position where the employee is responsible to make a large number of outbound calls to insurance carriers, employers & members. The individual must be able to...
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New! YesterdayAs a Claims Phone Support Representative at TII, you provide exceptional customer service to ensure our travelers receive the timely, professional attention they deserve. Using your expert phone skills, you confidently provide our insureds with...
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New! YesterdayEvaluate insurance applications and determine risk exposure. Analyze data and underwrite policies for oil & gas risks. Determine policy terms, conditions, and premiums based on risk analysis. 5+ years of experience in underwriting oil & gas risks.
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New! YesterdayThe Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...
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New! YesterdayInvestigates and evaluates moderately complex auto and casualty claims. Documents claim activities, reserve analysis, summaries of reports. Identifies, investigates, and pursues opportunities for recovery. Handles litigated files of low complexity.
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New! YesterdayThe Operations Business Analyst II is responsible for reviewing and analyzing the effectiveness and efficiency of existing managed care claims processes and systems (Facets) and participates in the development of solutions to improve or further...
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New! YesterdayCollaborates with claims leadership and claims consultants to improve workflow, consistency, accountability, and claims outcomes. Ten years of leadership experience in claims in progressively responsible roles. Bachelor's degree, preferably in a...
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New! YesterdayCollects, reviews, and enters rating information into the system to provide quotes to underwriters for complex new business, endorsements, renewals, cancellations and reinstatement. One year of underwriting support experience. Associate's degree or...
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New! YesterdayUnderstand the Claims Encounter Data requirements in detail to enable one to support efforts to ensure claims data submissions achieve the required SLAs through requested changes internally and externally.
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New! YesterdayResponsible for evaluating operations and identifying process improvement needs. Identify irregular trends with grievances and appeals; work with other areas as appropriate to identify root causes and appropriate steps for resolution.
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New! YesterdayResponsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in...
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New! YesterdaySeeking a Senior Innovation Portfolio Strategy Professional who will play a critical role in the evolution of our innovative solutions and, more broadly, in helping Humana deliver on its well-being centered mission. They will support the oversight and...
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New! YesterdayRespond to and control the disposition of all assigned Michigan No-Fault claims. Work with computer systems keying functions, including but not limited to letter composition, log entry, diary entry, report of investigation composition, and draft...
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New! YesterdayDefines and executes the supplier risk management framework for the enterprise. Provides risk advice, information and results. Develops techniques, policies and procedures for conducting and reporting, risk assessments, analysis and/or compliance audits.
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New! YesterdayThe Associate Actuary, Medicaid Trend Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems...
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New! YesterdayThis position is responsible for assisting with the support through analysis, consulting, education, and communication with Treasury Business Units (BUs) on risk activities by gathering and analyzing risk-related data, promoting an environment of risk...
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New! YesterdayPerform clinical/coding medical claim review to ensure compliance with coding practices through a comprehensive review and analysis of medical claims, medical records, claims history, state regulations, contractual obligations, corporate policies and...
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New! YesterdayThis role will have the opportunity to influence strategic direction, lead and participate in critical initiatives. Will be responsible for the development, implementation, and maintenance of underwriting guidelines, processes, procedures, and standards.
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New! YesterdayYou will use expert knowledge of surplus lines and markets to proactively identify trends and root causes that affect profit and growth. You will evaluate effect on business results and influences actions of B&A Insurance Solutions leadership and...
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New! YesterdayProvide quality claim handling and superior customer service on assigned claims while engaging in indemnity & expense management. Promptly manage Warranty claims by completing essential functions including contact, investigation, damages development...
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New! YesterdayBe responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials of payments, documenting related account activities, posting adjustments and collections from...
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New! YesterdayThis job is responsible for demonstrating proficiency in first party estimating, investigation, evaluation and negotiation at the most reasonable cost. Satisfy customer needs and ensure file quality. Applying and explaining applicable coverage to all...
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New! YesterdayHandle 1st party Property claims of moderate complexity as assigned: Complete field inspection of losses including accurate scope of damages, photographs, written estimates, and/or computer-assisted estimates. Investigate and evaluate all relevant....
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New! YesterdayDelivers consistent service quality throughout the claim life cycle, including but not limited to prompt contact, explaining the process, setting expectations, on-going effective communication, and follow-through and meeting commitments to achieve...
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New! YesterdayUnderstand the client's business needs and build strong client relationships through effective and proactive service along with efficient and accurate handling of reactive requests. Participation as a supporting member of the pre-sale process for...
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New! YesterdayWork with Case Managers to deliver Absence Management Consultation Services (AMCS) including ergonomic evaluations and return to work meetings/planning. The position will contribute to the overall profitability of Group Disability by facilitating a...
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New! YesterdayAnalyze and execute new reinsurance arrangements supporting new business strategy from RFP to final implementation and internal/external communications. Participate in research projects and reinsurance initiatives that support the division's financial...
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New! YesterdaySupport various reimbursement functions, including but not limited to Intake, data entry, benefit investigations, call triage, prior authorizations, pre-determinations, and appeals support and responds to all provider account, patient, and internal...
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New! YesterdayComplete assigned standard actuarial analysis for rate filings, legislative cost analyses, reserving, data validation, products, and research. This includes utilizing actuarial systems and programming skills to access and organize the data, performing...
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New! YesterdayAct as project leader to produce rate filings, legislative cost analyses, reserving, data validation, products, and/or research. This includes coordinating the work of project team members, utilizing actuarial systems and programming skills to access...
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