Senior Manager, Insurance And Claims Advocacy Sun Life FinancialSenior Manager, Insurance And Claims AdvocacyHartford, CT$76,200–$114,300 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. You will set the vision, drive operational excellence, build scalable processes, and deliver measurable financial and experience outcomes-serving as the final escalation point for sensitive cases and establishing best practices across the organization.
Senior Manager, Insurance and Claims Advocacy Sun Life Financial IncSenior Manager, Insurance and Claims AdvocacyHartford, CT$76,200–$114,300 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Patient Reimbursement Specialist US Physical Therapy IncPatient Reimbursement SpecialistVernon, CT$25–$30 / hourAudit payments from commercial and workers compensation carriers for consistency with contracted fee schedule and follow up with carriers as appropriate to resolve underpayments. As a leading provider in the field, we strive to empower individuals with disabilities and enable them to achieve their highest level of independence and functionality.
Senior Clinical Consultant, Health and Risk Solutions Sun Life Financial IncSenior Clinical Consultant, Health and Risk SolutionsHartford, CT$78,600–$117,900 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Supv Accts Rec FollowUp Denial / PA Third Party Follow Up Hartford HealthCare CorpSupv Accts Rec FollowUp Denial / PA Third Party Follow UpFarmington, CTPosition Summary: Responsible for the daily operations of an Accounts Receivable (AR) Follow Up team, tasked with timely and accurate collection of third-party revenue cycle activities associated with outstanding insurance claims across all Hartford HealthCare Hospitals, Medical Group and Homecare to insure optimal revenue cycle performance. Job Title(s) of HHC positions reporting to this Job: Direct supervision of AR Team Lead and AR Collections Specialists in their efforts to review and resolve issues related to insurance claim denials, no response claims and payment variances including underpayments and overpayments.
NewClaim Operations Specialist The Travelers Companies IncClaim Operations SpecialistHartford, CT$45,400–$74,900 / yearCLAIM OPERATIONAL SERVICE AND PARTNERSHIPS: Partners with claim professionals in multiple departments to assist with the timely resolution of claims, which may include: Properly documents claim files, including notes and diaries, Requests reports and records, and reviews medical bills, mail and wage statements. CLAIM PAYMENTS AND EXPENSE PROCESSING: Ensures the proper handling of financial transactions to include: Processes and issues claim payments including outside vendor invoices, attorney expenses, and medical processing fees.
Claim Specialist - Complex Liability Solutions The Hartford Insurance Group IncClaim Specialist - Complex Liability SolutionsHartford, CT$107,600–$161,400 / yearWork closely with TPAs to address time limit demands, evaluate extra contractual exposure evaluations and other issues of complexity; Partnering with CLS underwriters to effectively communicate the value of the CLS claims model to prospective insureds, agents and brokers; Providing support to the CLS business unit to explain, evaluate and address claim trends and developments for both prospective and current insureds; and. As a Claim Specialist for Complex Liability Solutions in the Hartford Global Specialty (HGS) Liability Major Case Unit, you will be responsible for handling a caseload of bodily injury and non-bodily injury claims that involve complex coverage and liability issues.
Senior Claim Technical Specialist IFG CompaniesSenior Claim Technical SpecialistHartford, CT$110,000–$120,000 / yearThe Senior Claim Technical Specialist ("SCTS") is a high-impact role focused on investigating, evaluating, negotiating and settling serious injury/damage claims involving complex coverage and large loss exposures in multiple jurisdictions. It combines a specialty-carrier focus with long-term stability and thinking, while promoting a culture of underwriting rigor, collaboration, strategic thinking, superior technology and strong producer partnerships.
Claim Specialist - Complex Liability Solutions The HartfordClaim Specialist - Complex Liability SolutionsHartford, ConnecticutWork closely with TPAs to address time limit demands, evaluate extra contractual exposure evaluations and other issues of complexity; Partnering with CLS underwriters to effectively communicate the value of the CLS claims model to prospective insureds, agents and brokers; Providing support to the CLS business unit to explain, evaluate and address claim trends and developments for both prospective and current insureds; and. As a Claim Specialist for Complex Liability Solutions in the Hartford Global Specialty (HGS) Liability Major Case Unit, you will be responsible for handling a caseload of bodily injury and non-bodily injury claims that involve complex coverage and liability issues.
On-Site Services Specialist Metasys TechnologiesOn-Site Services SpecialistHolyoke, MA$19 / hourOperate bindery and finishing equipment, including paper cutters, hole drills, shrink-wrap machines, joggers, tape machines, stackers, electric staplers, scales, fax machines, postage meters, and related office equipment. The role also provides basic equipment support, document management, and light facility services while delivering excellent customer service in a fast-paced environment.
Emergency Department Physician Essential Healthcare Solutions LLCEmergency Department PhysicianHampton, MA$255–$370 / hourCoastal Virginia: beaches, low cost of living, military-friendly community, easy access to Norfolk, Virginia Beach, Williamsburg, and the Outer Banks. EHS is pursuing a contract to provide board-certified or board-eligible Emergency Medicine physician coverage at the Hampton VA Medical Center in Hampton, Virginia.
NewSenior Plan Coordinator Consultant -Employee Assistance Program CVS Health CorpSenior Plan Coordinator Consultant -Employee Assistance ProgramCT$18.50–$38.82 / hourPartners with key stakeholders, including Sales, Account Management, and other internal business teams, to proactively identify, resolve, and prevent issues while consistently meeting or exceeding customer expectations. This individual will support the implementation and ongoing maintenance of client plans by accurately translating benefit design and pricing information into a custom Aetna EAP system for member and plan sponsor servicing, claim processing, and billing purposes.
Pharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistHartford, ConnecticutSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
Medical Receptionist - Springfield Orthopedic & Podiatry Specialist Practice Trinity HealthMedical Receptionist - Springfield Orthopedic & Podiatry Specialist PracticeSpringfield, MAAccurately registers patients ensuring that the information required is obtained confirming identity, address, phone numbers, PCP, insurance, co-pay and other pertinent information in order to complete patient registration. In this role, you'll welcome patients, manage registration and co pays, schedule appointments, and keep the office running smoothly-all while being a key part of an engaged, collaborative team.
Pharmacy Benefit Verification Specialist Onco360 PharmacyPharmacy Benefit Verification SpecialistHartford, ConnecticutSkills/Knowledge: Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. Pharmacy Benefit Verification Summary The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs.
Contract Compliance & Financial Operations Specialist RSM US LLPContract Compliance & Financial Operations SpecialistFarmington, CT$95,400–$163,900 / yearBy supporting partners and senior members of the RRC leadership team, executing key processes, guiding support staff, and contributing to financial and risk-mitigation efforts oversight, this role enhances engagement execution, improves team efficiency, and supports the firm's ability to deliver high-quality client service to its clients. Other responsibilities may include: Support the proposal process, when necessary, and perform QA reviews to ensure message quality, format, and content meet the stated objectives and are consistent with internal communication guidelines; serve as a backup to assist proposal team in a hands-on capacity, when required.
Medical Receptionist - Springfield Orthopedic & Podiatry Specialist Practice Trinity Health CorporationMedical Receptionist - Springfield Orthopedic & Podiatry Specialist PracticeSpringfield, MAAccurately registers patients ensuring that the information required is obtained confirming identity, address, phone numbers, PCP, insurance, co-pay and other pertinent information in order to complete patient registration. In this role, you'll welcome patients, manage registration and co pays, schedule appointments, and keep the office running smoothly-all while being a key part of an engaged, collaborative team.
Neurology Account Specialist (Hartford E, CT) (Field Based) Eisai USNeurology Account Specialist (Hartford E, CT) (Field Based)Hartford, CTExperience working with U.S. healthcare industry (including delivery of care, market access and reimbursement landscape, and key stakeholders that influence decision-making within local markets and healthcare systems). Skills:Clinical Acumen (AD), Critical Thinking & Agility, Focus On Customers & Partners, Sales Ops & Data Analytics, Sells Effectively & Makes Impact, Territory/Account Management.
Neurology Account Specialist - (Hartford W, CT) (Field Based) EisaiNeurology Account Specialist - (Hartford W, CT) (Field Based)Hartford, ConnecticutExperience working with U.S. healthcare industry (including delivery of care, market access and reimbursement landscape, and key stakeholders that influence decision-making within local markets and healthcare systems). E-Verify is an Internet based system operated by the Department of Homeland Security in partnership with the Social Security Administration that allows participating employers to electronically verify the employment eligibility of all new hires in the United States.
Neurology Account Specialist (Hartford E, CT) (field based) EisaiNeurology Account Specialist (Hartford E, CT) (field based)Hartford, ConnecticutExperience working with U.S. healthcare industry (including delivery of care, market access and reimbursement landscape, and key stakeholders that influence decision-making within local markets and healthcare systems). Skills:Clinical Acumen (AD), Critical Thinking & Agility, Focus On Customers & Partners, Sales Ops & Data Analytics, Sells Effectively & Makes Impact, Territory/Account Management.