- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Claims Auditor III Job... Plan Audits. Annually performs audits of LA Care's Specialty Health Plans . Plans ... appropriate claims and financial compliance criteria for specialty health plans . These audits... Plan Partners (PP), Preferred Provider Groups (PPG), Specialty Health Plans (SHP) and… more
- Henry Ford Health System (Flint, MI)
- …Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan . ... with Word and Excel. Additional Information + Organization: HAP ( Health Alliance Plan ) + Department: CLAIM PROCESSING...- from primary and preventative care to complex and specialty care, health insurance, a full suite… more
- Mount Sinai Health System (New York, NY)
- …**_Ground breaking science. Advancing medicine. Healing made personal._** **_Roles & Responsibilities:_** The Health Plan Claims Analyst I is responsible for ... multiple components of specific health plan operations. He/she is responsible for...**Qualifications** + 2 years experience in medical billing or health claims , with experience in IDX billing… more
- Stanford Health Care (Palo Alto, CA)
- …a thorough understanding of SMP claims adjudication policies and procedures. + Facilitate Health plan claims audits as well assist with other external ... overall claims adjudication is in accordance with State, Federal and Health plan regulatory requirements and guidelines. Develop training programs for … more
- HUB International (Brentwood, TN)
- …holding company under which our subsidiaries reside: + Avant Underwriters (AU + Avant Specialty Claims (ASC) + Avant Brokerage (AB) + Avant Supermarket Group ... Occupational Accident Claims Adjuster to join Avant Specialty Claims , a Third-party administrator. We are...and/or appraiser and evaluate, make judgments and formulate action plans to carry claim to final disposition. * Evaluate… more
- Billings Clinic (Billings, MT)
- …Risk Management Plan that organizes both risk prevention measures and claims processing and management systems for Billings Clinic and regional affiliate sites. ... here. About Us Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including… more
- Providence (Renton, WA)
- …Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi- specialty health care network with 9 outpatient clinics and more ... Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi- specialty health care network with outpatient clinics and primary and… more
- Axis (Alpharetta, GA)
- …this, we offer a comprehensive and competitive benefits package which includes medical plans for employees and their families, health and wellness programs, ... join AXIS Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand apart for...Alpharetta, GA. * Highest level individual contributor directly reviewing claims to determine nature of loss, coverage provided, and… more
- Axis (Red Bank, NJ)
- …the claims of his/her direct reports. + Close collaboration with the Specialty Complex Claims team with regard tocoverage disputes, including litigation and ... join AXIS Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand apart for...a comprehensive and competitive benefits package which includes medical plans for employees and their families, health … more
- Hartford HealthCare (Hartford, CT)
- …determine claims exposure and recommend appropriate settlement strategies and action plans . The Claims Attorney will work in a collaborative environment in ... oral and written communication, and develops new areas of sub- specialty as needs may arise * Utilize excellent judgment,...of relevant experience with emphasis on resolving professional liability claims * Knowledge of federal and state health… more