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

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

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

CLAIMS SPECIALIST 3RD PARTY Job Locations US MA TAUNTON ID 2024 142158 Line of Business PharMerica Position Type Full Time Pay Min USD $19.00/Hr. Pay Max USD $21.00/Hr. 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

Job Location Smithfield, RI Smithfield, RI Position Type Full Time Education Level Bachelors Degree   Travel Percentage Occasional Job Shift Daytime Job Category Professional / Experienced Description Position Overview The Member Advocate ensures the interests of the company's members are understood, promoted and addressed by the organization and the larger health car

At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best protecting and restoring their dreams when they need us most. We're leveraging our expertise, technology and new ways of working to actively reinvent one of America's largest industries creating

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

IMA's Private Equity and M&A Practice provides buyers and targets with a range of insurance, benefits and retirement products and services designed to assist them throughout the life cycle of the M&A transaction. For M&A activity, IMA's in house Transactional Liability Practice, Project Managers and Due Diligence Specialists bring depth and experience to address financial

Insurance Coordinator ID 2024 7863 Job Location Location US MA Boston Type Regular Full Time Category/Department Risk Management Overview Suffolk is a national enterprise that builds, innovates and invests. Suffolk is an end to end business that provides value throughout the entire project lifecycle by leveraging its core construction management services with vertical ser

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

The Claims Settlement Specialist supports claim settlement with providers through post payment negotiation. The Claims Settlement Specialist will be responsible for handling provider telephone calls regarding the payment amount paid to a provider by a payor based on Zelis data points. During this call, the Claims Settlement Specialist must understand (1) the procedures bi

Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable) Alert Supervisor and Special Investigations Unit to potentially suspect claims Ensure timely denial or payment of benefits in accordance with jurisdictio

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

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

Under general supervision of the Radiology Financial Clearance Manager, the Insurance Coordinator/ Financial Clearance Specialist f unctions as primary interface between MGB Imaging sites, MGB Patient Service Center, insurance companies, patients, and referring practices. The incumbent performs all tasks related to obtaining insurance authorizations for diagnostic imaging