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New! YesterdayProvide your expertise to financial professionals and Clients in the review of documents being submitted for processing and provide instruction to ensure accurate completion of all applicable sections.Accurately answer and research/resolve enquiries.
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New! YesterdayDevelop and implement AML policies and procedures for a variety of products and services. Provide expert guidance to partners and teams on AML and fraud compliance. Implement procedures around set-up and use of AML & Fraud software, and manage the...
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New! YesterdayQuickly analyze account history and provide accurate information to assist in resolving the customer issue, utilizing resources to ensure first call resolution. Perform insurance verification via outbound phone calls and internet. Maintain complete and...
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New! YesterdayIdentifies credit balances due to electronic or manual insurance overpayments, patient overpayments, and adjustments resulting from denials or contractual allowances. Investigates and resolves assigned credit balance accounts by ticketing system...
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New! YesterdayAnalyses, negotiates, and declines or approves SBA loans and servicing plans. Assesses credit risks and establishes appropriate grades. Ensures loan decisions are consistent, objective, and compliant while meeting Bank and customer needs. Communicates...
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New! YesterdayOwn and manage an individual caseload of in-process life insurance applications, beginning with creating and sending the application to the client and continuing through underwriting approval, and into policy release, and inforce client assistance.
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New! YesterdayCollect information to identify threats, and generate intelligence which provides clients with situational awareness involving physical threats discovered through the digital world. The Physical Security Analyst will have an investigative background...
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New! YesterdayAssist underwriting staff and underwriting managers in obtaining and evaluating underwriting information for new and renewal accounts by working directly with appointed brokers and their support staff. Provide quality review and act as communication...
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New! YesterdayPlay a pivotal role in supporting the insight generation process through research and analysis, including the collection of data from external research, client data, and expert interviews, while also being the in-house expert on QMS.
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New! YesterdayOwn the resolution of customers' and partners' inquiries throughout multiple channels. Create an ongoing collaboration with the Team Lead to identify improvements to existing customer service processes. Own the communication with all relevant...
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New! YesterdayAppeal the denials or reduction of reimbursements by the stop loss carrier. Communicate appropriately funding information and requirements to clients. Assemble weekly or daily funding request information for clients. Handle releasing payments to...
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New! YesterdayBring best-in-class thinking to the audit function relative to risk assessment, utilization of audit technology, development of the audit process, and execution of the audit plan. Will have a proven background in audit, including information technology...
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New! YesterdayLeads the development of and the conduction of compliance reviews and provides oversight of legal entities, business units, and processes. Maintains documentation and reports to management regarding compliance and potential issues. Provides requested...
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New! YesterdayYou will be responsible in managing your Sales Support Representatives to achieve key performance metrics while creating a positive customer experience. You will coach and guide your representatives to listen and assist customers regarding their...
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New! YesterdayObtains information for insurance authorization. Faxes information to companies as requested. Follows up to obtain authorization responses. Reports results to Care Manager and puts in computer. Advises clinicians of need for Auth action/completion.
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New! YesterdayPlay a key role in assisting patients to access essential medical services, secure durable medical equipment, and connect individuals to vital community resources. Your critical thinking, problem solving abilities, and unwavering tenacity in seeking...
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New! YesterdayResponsible for compiling and analyzing claims data and perform related duties including tracking trends, noting patterns, and detecting any irregularities as it relates to aged Accounts receivable and claims processing trends.
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New! YesterdayProviding estimates for Hospital and Health Park elective services. Answering patient phone calls. Providing customer service. EPIC experience. Entering patient information. Reviewing insurance information.
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New! YesterdayThis position reviews client accounts to ensure appropriate information and documentation is present for principal approval. Examines new account documentation and sources any missing information. Evaluates securities and insurance transactions...
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New! YesterdayThe Specialist is responsible for identifying and securing public and private insurance contracts; reviews and organizes existing contracts. Assist with the development of potential relationships with strategic partners and creates measurable business...
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New! YesterdayReview and process living life insurance claims. Investigate claims. Evaluate investigation results and authorize payments. Summarize, when necessary, to substantiate reason for payment or denial of claim. Monitor the course of claims' investigations...
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New! YesterdayResearch/rectify third-party denials/edits, requests for information and other related correspondence. Process a variety of Third Party Administrator (TPA) payments. Willingness to learn different claim platforms within eviCore and also client claims...
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New! YesterdayReview all medical insurance claims for resolution and payment. Resolve any incoming inquiries or payment denials from insurance providers for payment. Research, compile, and respond to documentation requests from insurance carriers in a timely basis.
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New! YesterdayOversee the development, implementation, administration, and maintenance of Compliance and Privacy programs. Identify compliance-related legal and regulatory developments and trends which may impact the institution and assist in strategizing...
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New! YesterdayAnswer premium billing questions from individual subscribers, group contacts, and internal sources via phone, email and customer service tickets. Process the monthly billing cycles and validate prior to release to third-part vendor.
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FeaturedNew! YesterdayWe now seek action-oriented, problem-solving and self-motivated individuals to join us and showcase their customer service and related data entry skills as part of our healthcare team. You may be involved in claims adjudication and/or provider...
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New! YesterdayAnalyze, clarify and resolve intermediate policy and account-related questions from internal and external customers. Reviews problems and communicates with appropriate personnel to obtain information when necessary. Responds to customer inquiries...
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New! YesterdayResearch laws, court decisions, documents, opinions, briefs, or other information related to cases. Analyze legal issues and apply appropriate legal principles to determine applicable defenses, relevant arguments and litigation strategy. Prepare briefs...
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New! YesterdayHandles investigation regarding all aspects of the most complex auto claims (coverage, liability and damages) with the exercise discretion and independence within increased level of authority. Applies advanced understanding of insurance policies...
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New! YesterdayInitiates auto and homeowner claims by obtaining preliminary loss information from agents, insureds and third parties. Provide customers with an explanation of the claim process. May authorize services such as roadside assistance and rental cars.
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New! YesterdayLead the day-to-day claims activities, including claims actions, emails, and payments. Own the assessment and approval of new claims and complicated cases, whenever, within the authority. Build rapport with customers to speed up claim s resolution and...
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New! YesterdayThis role will have responsibility for managing the commuter benefit programs in parts of EMEA and APAC. The scope of this role includes leading strategy, development, and compliance of employee commuter benefit programs in their regions. They will be...
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New! YesterdayBecome a licensed expert on our term life insurance products through independent onsite training and cross-team collaboration. Ensure a seamless and transparent customer experience with regular status updates and an emphasis on customer retention via...
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New! YesterdayThis position is responsible for providing professional administrative support for the account management team to deliver great work to the client consistently and efficiently. You have strong organizational and interpersonal skills, ability to support...
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New! 2 days agoThe position is responsible for answering complex customer inquiries on currently marketed health products (re-rate, complex claims) as well as currently marketed life products. The representative acts as a resource, takes complex calls as defined by...
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New! 2 days agoWorks with claims leaders and independently to identify & provide data support to recognize opportunities. Collaborates with other departments in Claims & other divisions of the company (Product, U/W, IT Domain Teams, etc.) on implementing solutions.
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New! 2 days agoIdentify and analyze high-risk customers and other identified accounts for unusual and suspicious activity. Provide accurate documentation of the suspicious activity and recommends appropriate actions. Prepare and file Suspicious Activity Reports (SARs).
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New! 2 days agoContribute to strategy and business growth initiative within Investment Services; including the implementation of a new data warehouse. Collaborate with technology and business partners to assess & troubleshoot issues; giving way to improved processing.
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New! 2 days agoProvides technical guidance on unusual or complex claim cases. Troubleshoots and resolves complex claims. Makes decisions under conditions of uncertainty, sometimes with incomplete information, that produce effective end results. May oversee...
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New! 2 days agoManagement and oversight of all Risk Management SOPs, Policies, and related tasks. Develop improved Risk Management systems and approaches. Manage agency clinical risk management practices, policies, and procedures for effectiveness and current...
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New! 2 days agoRegularly communicate with clients to assess their evolving insurance requirements and address any concerns. Evaluate client insurance portfolios to identify coverage gaps, recommend enhancements, and tailor policies to fit clients' specific risks.
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New! 2 days agoElectronic claims submission according to payer contracts, governmental and/or third-party guidelines. Timely follow-up on claim denials, submission of corrected claims and written appeals, ongoing follow-up of appeal submissions. Utilize the accounts...
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New! 2 days agoLead the development and tracking of portfolio, product, and client level strategies that minimize both the company and the CareCredit markets credit risk, while continuing to grow the portfolio and balancing the risk-reward tradeoff. Fully remote.
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New! 2 days agoDirectly cultivate and manage relationships with the most important founders, investors, operators, senior executives, and partners in your ecosystem so you can prospect and close new business. Help lead the development of our Community and Demand...
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New! 2 days agoYou'll also prepare legal pleadings, motions, statements, trial briefs and be involved in negotiating settlements. Additionally, you'll work closely with clients and claims partners to prepare timely reports on litigation, ensuring all appropriate...
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New! 2 days agoAssist with analysis, medical claims research, development of reports, dashboards, and modeling tools. Drive collaboration and be the link between the product and development teams to gather/document requirements and provide clarity related to assigned...
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New! 2 days ago10+ years of experience in network contracting and development or other relevant payor leadership-facing field. Experience with ACOs is a plus. Operational leadership experience is required; a plus if this includes experience in the Medicare Advantage...
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New! 2 days agoGenerate initial assessment review reports for AI/ML models, outlining their intended use and assessing associated risks. Create model validation reports as needed, evaluating model design choices, training results, and determining model suitability.
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New! 2 days agoGathering evidence from flagged transaction data. Use of company values to investigate the nature of suspicious transactions with empathy and attention to detail over the phone and via chat. Use of company values to reassure and support customers...
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New! 3 days agoDevelop / maintain efficient and effective operational discipline in your area of responsibility. Demonstrate strong personal engagement and service mentality. Measurably reduce contracting cycle time.Mentor and guide junior member(s) in the team.Lead...
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