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Description This Lead Actuary role requires a leader who is a creative thinker and is energized to build something from the ground-up. This team will start with a blank canvas to ..
... and administer assigned Workers' Compensation Claims. Remains current on Workers' Compensation ... review of new Workers' Compensation claims in order to ensure compensability, ... of action necessary for efficient..
... high volume of third party claims and ensures that accurate information ... to correct problems that prevent claims submission and/or contacts the individuals ... the corrective action to expedite..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
... day. Retrospectively reviews payment of claims on remittances to insure maximum ... expedite the prompt payment of claims. 2.1 Utilize the computer system ... payors reflect accurate information. Submits..
Description The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description This Actuarial Analyst 2 role on the Specialty Benefits team will take ownership of our Dental and Vision commercial group (100 lives) renewal reporting and the dental trend analysis. This ..
