Vaco Boston has partnered with our client to help fill a Claim Adjuster role. Responsibilities Inspect property and physical damage Analyze complex information from different sources Examine claim liability Prepare and process claim reports Consult with specialists (e.g. physicians, engineers) Calculate benefits and payments Negotiate settlements with claimants Examine po

The Charge Data Specialist is responsible to complete the services of charges posted for areas of Children's National Health System. The Charge Data Specialist provides financial analysis, guidance, and advice to management consistent with standard charge posting practices. The Charge Data Specialist will ensure accurate and timely charge capture and quality assurance pro

The Financial Coordinator is part of a team who handles the direct interaction with patients and their families during difficult times, providing financial insurance and payment information to assist them in planning and managing their account balances related to specific services performed in the clinic. The Financial Coordinator educates patients on the various sponsors

This position supports the Risk Management Department in directing the worldwide Risk Management Property and Casualty insurance programs for asset protection and strategic advantage. Essential Duties and Responsibilities Manage process and performance to obtain optimal outcomes involving a claims portfolio of approximately 10 million of annual cash outflows, and other as

Ensures functions performed in accordance with system wide policies, procedures, and governing organizations Defines individual and team goals Monitors staff and department performance and productivity levels and proposes ways to improve effectiveness, efficiency, and productivity Analyzes and identifies problem areas and adjust processes and staffing priorities Collabora

Load, process, and summarize various data types and files using MATLAB or similar program. Further organize, clean, sort, and analyze data using SPSS, R, SAS, or related data analysis programs and interpret meaningful findings in tables, graphs, and written form. Conduct casualty assessment using currently available high rate blast data and published computational models.

Claims Quality Auditor is responsible for reviewing claims to determine if payments have been made correctly. This position analyzes data used in settling claims to determine the validity of payment of claims and reports overpayments, underpayments and other irregularities based upon benefit configuration, compliance with provider contract agreements, and Federal, State a

Your Role The Case Management team performs and case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members care including clinical nurses and treating MDs.. The Case Management Nurse, Senior will report to the Manager, Care Management. In this role you will determine, develop and imp

The Data Analyst leads the technology process for the end to end Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) data flow and works within key regulator guidelines for acceptable data submission. Using SQL and SAS programs lead the gathering of data for submissions Risk Adjustment. As the senior analyst of data, will be responsible fo

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination o

of Position We are seeking a talented Grievance & Appeals Specialist who will be responsible for responding to written/verbal grievances, complaints, appeals, and disputes submitted by members and providers in accordance with NCQA, CMS, State, and other regulations. They will process appeals and grievances to facilitate the accurate administration of benefits and clinical

Attend virtual meetings and corporate/court onsite meetings Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federa

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

Commercial Claims Processing Associate, Claims Examiner Headquarters Office, 625 State Street, Schenectady, New York, United States of America Rochester Office, 220 Alexander Street, Rochester, New York, United States of America Req #1169 Monday, June 27, 2022 Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is ful

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