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The Senior Director of Enrollee Services & Claims Operations is responsible for the day to day oversight and direction of management staff responsible for the Claims Operations, Enrollment, and Customer Care departments. The Senior Director works closely with Finance, IT and Clinical services to ensure the organization meets or exceeds quality standards. The position will identify process impr
Posted 2 days ago
Exponent is a leading engineering and scientific consulting firm. Our multidisciplinary team of scientists, engineers, physicians, and regulatory consultants brings together more than 90 different disciplines to solve complicated problems facing corporations, insurers, government entities, associations and individuals. Our approximately 1100 staff members work in 30 offices across the United State
Posted 9 days ago
As an Insurance Risk Interviewer, you will complete interviews in a call center environment on life insurance, medical, and financial matters via telephone through outbound calls for multiple client companies. This customer service representative position is ideally suited for a self motivated and career minded individual that is seeking a strong start in the healthcare industry and is excited by
Posted 11 days ago
As an Insurance Risk Interviewer, you will complete interviewsin a call center environment on life insurance, medical, and financial matters viatelephone through outbound calls for multiple client companies. This customerservice representative position is ideally suited for a self motivated andcareer minded individual that is seeking a strong start in the healthcareindustry and is excited by beati
Posted 11 days ago
Furnishing reports with supporting information necessary to resolve disputes or defend against the claims Preparation and assembly of appeal files Participation in meetings or negotiations with claimants Appearance in legal proceedings Preparation of cost estimates for use in claims negotiations Preparation of risk assessments/analyses relative to claim exposures Preparation of findings of fact an
Posted 19 days ago
Apprio
- Washington, DC
Analyzes and reviews claims received from a variety of sources for accuracy and compliance with provider contracts in place May receive, process, approve and calculate claims payments As necessary requests and receives additional documentation from providers May receive phone/email inquiries from providers and respond accordingly Investigates discrepancies and resolves in accordance with pricing r
Posted 19 days ago
Apprio
- Washington, DC
Analyzes and reviews claims received from a variety of sources for accuracy and compliance with provider contracts in place May receive, process, approve and calculate claims payments As necessary requests and receives additional documentation from providers May receive phone/email inquiries from providers and respond accordingly Investigates discrepancies and resolves in accordance with pricing r
Posted 19 days ago
Are you someone who excels at working with computers and people? Do you like helping others understand how technical applications work and helping others advance their business goals? We are looking for an energetic, team player to join our dynamic 4 person team in aiding educational institutions implement online risk resiliency training. Nestled within the risk management department of United Edu
Posted 26 days ago
Under the direction of the Director of Risk Management and Patient Safety, the Risk Management Consultant leads risk identification and mitigation activities through collaboration with a system Patient Safety Officer, system Medication Safety Officer, Quality Coordinators, clinicians, administrators, and leadership that address opportunities for improvement in delivery of high quality care, mitiga
Posted 13 days ago
Under the direction of the Director of Risk Management and Patient Safety, the Risk Management Consultant leads risk identification and mitigation activities through collaboration with the Patient Safety Officer, quality coordinators, clinicians, administrators, and leadership that address opportunities for improvement in delivery of high quality care, mitigate risk exposure, and enhance patient s
Posted 18 days ago
The Claims Resolution Analyst is responsible for coordinating the resolution of claims issues by actively researching and analyzing systems and processed that cross multiple operational areas. Primary duties include, but are not limited to Investigates and facilitates the resolution of claims issues, including incorrectly paid claims, by working with multiple operational areas and health plans an
Posted 27 days ago
At Amazon Web Services (AWS), Security is our highest priority. The AWS Security Assurance team is responsible for demonstrating the security controls of services offered by AWS. Within AWS Security Assurance, the AWS Enterprise Risk Management team is responsible for "looking around corners" and helping business teams proactively think about business risks in a holistic way. We partner with our b
Posted 5 days ago
Beacon Hill Legal is seeking qualified candidates with IP litigation experience for an exciting temp to hire opportunity at an international law firm located in DC! Bachelor's degree required. 4+ years' of prior work experience within a large law firm setting or in house legal department required. Must have knowledge of ITC rules and regulations. If interested, please submit your resume today! Com
Posted 14 days ago
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