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WPS Health Solutions
- Hampton, VA / Marion, IL / Kansas City, MO / 16 more...
The Director Claims Operations will develop and implement strategic direction. This includes overseeing processes required to meet Defense Health Agency standards for the Eastern Region contract. East Region is responsible for employee activities, production, and budget for approximately 180 250 employees at multiple sites. Oversight includes all outside involvement with Primes, DHA, Department of
Posted Today
Change Healthcare
- Baltimore, MD / Lexington, KY / Cheyenne, WY / 49 more...
Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact. As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities. Here at Change Healthcare, we're using our influence to drive positive changes across t
Posted 1 day ago
Our Claims department is seeking a Sr. CAT Adjuster to join our growing team in Michigan. Sr. CAT adjusters handle property claims requiring field investigations and/or inspections. They must establish rapport with our insureds and maintain relationships with our agents, underwriters, contractors, restoration vendors, and experts. They are expected to know their territory, including the geography;
Posted 1 day ago
Sr Examiner, Claims (1902956) Job Description Job Summary Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards. Knowledge/Skills/Abilities Meets and consistently maintains production standards for Claims Adjudication. Supports
Posted 3 days ago
Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards. Knowledge/Skills/Abilities Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding,
Posted 3 days ago
/Skills/Experience Requirements Ensures customer care and selling are #1 priority Practices operation invitation and positive customer interaction by smiling and greeting every customer that comes within working area Interacts with customers to determine and meet customer needs, provide assistance and support and ensure a positive shopping experience Understands the store layout, services and loca
Posted 12 days ago
/Skills/Experience Requirements Ensures customer care and selling are #1 priority Practices operation invitation and positive customer interaction by smiling and greeting every customer that comes within working area Interacts with customers to determine and meet customer needs, provide assistance and support and ensure a positive shopping experience Understands the store layout, services and loca
Posted 12 days ago
Rep, Provider Claims Disputes (1902362) Job Description Job Summary Molina Health Plan Operations jobs are responsible for the development and administration of our State health plan's operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provid
Posted 27 days ago
This position offers an opportunity to support the growing Ally DP&S Reinsurance and Financial Structure programs. The role includes responsibilities involving analytics, data management, reporting, and process improvement. Occasional dealer facing interaction is required. Additionally, this position will participate in special projects and ad hoc analyses that support business initiatives. Job Re
Posted 1 month ago
Risk Control Consultant Constuction (RIS0000HY) Job Summary Individual contributor responsible for the overall risk control assessment evaluation consulting and technical support on complex issues/assignments focused in construction. Recognized as a technical expert in a product line of class of business specialty. Under general management direction works within broad limits of authority requiring
Posted 4 months ago
Location Admin McNamara [DTWADM12] DETROIT, MI Summary The Field HR Generalist is responsible for supporting efforts to effectively administer HR policies and procedures in a branch or multiple branches. The position bridges the gap between strategic and tactical HR functions, initiatives, and processes. This pivotal role uses judgment and discretion to provide problem solving advice and counsel t
Posted 8 months ago
Statement Provide quality investigation and analysis to adjust claims to proper conclusion. ­Generally works independently, handling the most complex matters, in one or more lines. Has settlement and draft authority of up to $75,000.00. Represents and advances the success of the organization through their relationships with agents, policyholders and insured. Essential Tasks/Major Duties Conduc
Posted 30 months ago
Statement Provide quality investigation and analysis to adjust claims to proper conclusion. ­Receives moderate supervision and generally handles a wide variety of matters of moderate to high complexity, in one or more lines. Has settlement and draft authority of up to $50,000.00. Represents and advances the success of the organization through relationships with agents, policyholders, insureds
Posted 30 months ago
Statement Under moderate supervision, manages and reconciles the daily operational tasks necessary to assure proper submission and acceptance of required EDI statistical claims data to insurance regulators. Monitors and collects internal statistical data to ensure timeliness and quality of data for transmission. Reviews data for quality prior to submission in order to avoid fines and penalties. Co
Posted 30 months ago
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