NewAttorney - FCA/Healthcare Fraud Enforcement JobotAttorney - FCA/Healthcare Fraud EnforcementWashington, DC$150,000–$400,000 / yearExperience representing hospitals, health systems, physician groups, Medicare Advantage organizations, managed care organizations, pharmacy benefit managers (PBMs), healthcare technology companies, or private equity-backed healthcare platforms. Demonstrated experience representing clients before the U.S. Department of Justice (DOJ), U.S. Attorney's Offices, Department of Health and Human Services Office of Inspector General (HHS-OIG), Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, and other federal or state enforcement authorities.
TEMP-Workers'''' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers'''' Compensation Claims AdjusterDCRemote$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Clearing the error involves researching to obtain the missing or misaligned information (sometimes requiring communication with the claimant or insured) and entering or correcting data in various fields in either our claims system or the state's reporting site.
Claims Adjuster I (Remote) Blue Cross and Blue Shield AssociationClaims Adjuster I (Remote)DCRemote$36,576–$67,056 / yearVerifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records. Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
NewClaims Investigative Specialist Allstate Insurance CompanyClaims Investigative SpecialistDCRemote$50,000–$74,350 / yearAs a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
NewTEMP-Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers' Compensation Claims AdjusterDC$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Rockwood has become a leading underwriter of workers' compensation for the mining industry by offering workers' compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal.
NewTEMP-Senior Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Senior Workers' Compensation Claims AdjusterDC$48.65–$57.59 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Essential Responsibilities: Working under limited technical direction and within broad limits and authority, adjudicate highly complex indemnity workers' compensation claims on assignments reflecting potentially with significant impact on departmental results.
TEMP- Claims Adjuster Argo Group International Holdings IncTEMP- Claims AdjusterDC$37.66–$44.33 / hourCalifornia outside of Los Angeles, San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Washington State, and New York State (including Westchester County) Pay Ranges: $41.44 - $48.79 per hour. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
TEMP- Senior Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP- Senior Workers' Compensation Claims AdjusterDC$48.65–$57.59 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Essential Responsibilities: Working under limited technical direction and within broad limits and authority, adjudicate highly complex indemnity workers' compensation claims on assignments reflecting potentially with significant impact on departmental results.
TEMP- Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP- Workers' Compensation Claims AdjusterDC$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Senior Claims & Insurance Operations Specialist - US Free2moveSenior Claims & Insurance Operations Specialist - USWashington, District of ColumbiaYou will evolve in an ultra-dynamic, innovative, agile, internationally-focused structure and integrate our talented teams, full of ideas and motivation and with multidisciplinary skills, at the crossroads of the digital eco-system and the fast-changing automotive sector. Born from the merger of the Stellantis Group and the start-up TravelCar, Free2move, thanks to its agility and its spirit of conquest has managed to establish itself in just few years as a reference player to revolutionize the mobility of all travellers.
Senior Claims Adjuster, TPA Oversight The Fortegra Group IncSenior Claims Adjuster, TPA OversightDC$100,000–$130,000 / yearThe Senior Claims Adjuster, TPA Oversight will provide technical expertise and handle a wide variety of severity/complex claims as well as coverage litigation within Commercial Auto, Cargo, and Crane & Rigging lines of business. Additionally, they will complement the existing Specialty Claims team that supports the Underwriting unit and will provide oversight of third parties and delegated authority referrals.
Senior Property Adjuster (Commercial Property Claims) - Washington, DC Engle Martin & Associates, Inc.Senior Property Adjuster (Commercial Property Claims) - Washington, DCDCPHYSICAL ACTIVITIES AND REQUIREMENTS: In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing property damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder. The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.
Property & Casualty Insurance Claims Operations Consultant, Sr. Associate PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, Sr. AssociateDC$77,000–$202,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members.
Claims Adjuster II, Field Property - National Catastrophe Nationwide Mutual Insurance CoClaims Adjuster II, Field Property - National CatastropheWashington$62,500–$115,500 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments.
Field Claims Adjuster III, PL Property (Flex Team) Nationwide Mutual Insurance CoField Claims Adjuster III, PL Property (Flex Team)Washington$79,500–$148,500 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. Qualifications: · 5 years of insurance field/property claims handling or adjusting experience · Solid experience/proficiency with Xactimate · Solid experience writing own estimates and handling claims start to finish · Strong customer service competency · Strong written & verbal communication skills.
Claims Representative II - REMOTE Ryder System IncClaims Representative II - REMOTEWashington, DCRemoteCompensation Information : The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees : If you are a current employee at Ryder, please click here (http://wd5.myworkday.com/ryder/d/task/1422$3.htmld) to log in to Workday to apply using the internal application process.
NewSocial Insurance Specialist (Claims Specialist) (Central Processing) Social Security AdministrationSocial Insurance Specialist (Claims Specialist) (Central Processing)Washington, DC$75,431–$98,066 / yearIndividuals applying for consideration under this authority MUST provide the applicable supporting documentation (e.g., documentation verifying marriage, copy of your spouses active military orders, DD-214, copy of a statement from the Department of Veterans Affairs or a branch of the military certifying the service members service-connected disability rating, DD-1300, etc.). PROOF OF VEOA ELIGIBILITY: Applicants for consideration under the VEOA appointment authority include those eligible for veterans preference (see below paragraph on Veterans Preference) OR have been separated from the armed forces under honorable conditions after 3 or more years of continuous service, including veterans who were separated shortly before completing the required 3-year period.
Senior Construction Defect Technical Claims Specialist Team Lead Argo Group International Holdings IncSenior Construction Defect Technical Claims Specialist Team LeadDCRemote$156,000–$187,500 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Qualifications / Experience Required: A deep knowledge of construction defect claims adjudication, along with an exceptional focus on customer service, typically achieved through: A minimum of seven years' experience adjudicating construction defect claims with exposure of $100,000 or more.
Claims Analyst - REMOTE Ryder System IncClaims Analyst - REMOTEDCRemoteCompensation Information : The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees : If you are a current employee at Ryder, please click here (http://wd5.myworkday.com/ryder/d/task/1422$3.htmld) to log in to Workday to apply using the internal application process.
Claims Counsel (Insurance Defense) Williams & Connolly LLPClaims Counsel (Insurance Defense)Washington, DC$165,000–$180,000 / yearResponsibilities include, but are not limited to:* Developing a case strategy* Answering complaints* Drafting and responding to discovery* Client communications* Handling all communications with opposing counsel* Hiring and managing expert witnesses as needed* Drafting motions and responses to motions* Conducting and defending depositions* Drafting mediation statements* Conducting mediations* Appearing in court as needed* Pre-trial preparations* Conduct trials* Drafting settlement agreements* Administrative duties related to case tracking and reporting . This position requires the ability and flexibility to manage a high-volume caseload in cooperation with firm management, partners, associates, other Claims Counsel, and firm employees in a professional manner as well as the ability to manage and prioritize a large volume of work assignments, meeting all deadlines.
Healthcare Claims Operations Team Lead - Washington, DC (On-site) Gainwell Technologies LLCHealthcare Claims Operations Team Lead - Washington, DC (On-site)DC$50,000–$55,000 / yearGainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. The pay range for this position is $50,000 - $55,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
Senior Disability Claims Examiner (LTD) (Virtual) Prudential Financial IncSenior Disability Claims Examiner (LTD) (Virtual)DCRemote$61,700–$101,900 / yearThe Long-Term Disability (LTD) Senior Disability Claims Examiner is responsible for providing excellent customer service while managing an assigned block of around 95 to 100 Long-Term Disability claims. Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication.
Claims and Finance Lead - Washington, DC - Onsite Gainwell Technologies LLCClaims and Finance Lead - Washington, DC - OnsiteDCRemote$35,900–$51,300 / yearGainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Education & Experience: Bachelor's degree (or equivalent experience) in Business, Finance, Accounting, Healthcare Administration, or a related field; 5-7+ years in claims resolution, financial operations, or related roles, including 2-3+ years of leadership experience.
Process Manager, Commercial Casualty Claims - Remote CSAA Insurance GroupProcess Manager, Commercial Casualty Claims - RemoteDCRemote$136,890–$152,100 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 21 more}. Project management experience and skills to accurately complete detailed data assignments and to understand and interpret broad operational concepts and their application to the business unit and CSAA.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeDCEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
EPIC Applications Analyst (1-4): Professional Billing Admin and Professional Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Professional Billing Admin and Professional Billing Claims - IT Services - Full TimeDCEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
Stop Loss Claims Specialist Marsh McLennanStop Loss Claims SpecialistWashingtonThe primary role of the Stop Loss Claims Analyst role is to manage the stop loss claims process for the MMA Stop Loss Center of Excellence including establishing the claims submission process in accordance with vendor processes, overall tracking and auditing to assure timely payment of eligible stop loss claims managed by the Center of Excellence. REQUIRED EDUCATION AND EXPERIENCE: Minimal of High School Graduate with Associate’s Degree in Risk Management & Insurance, Actuarial Science, Mathematics and/or other related field is preferred or equivalent experience preferred; Minimum of two years prior work experience the Benefits Brokerage, Consulting, or Insurance industry; Strong background in self-funding, stop loss or claims administration required.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&ODC$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Manager, Claims & Risk Management HITT Contracting IncManager, Claims & Risk ManagementDCIndependent claims handling and shared coordination with direct reports for the major lines of coverage including but not limited to auto, general liability, workers' compensation, builder's risk, pollution liability, and professional liability. Bachelor's degree in Risk Management, Business, Finance, Economics, Safety, or related fields preferred, but not required; in lieu of a degree, additional work experience is acceptable.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistDCRemote$137,496–$164,934 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
NewLiability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims Experience Sedgwick Claims Management Services, Inc.Liability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims ExperienceDC$63,404–$88,765 / yearTo analyze GL Litigated, Premise, Auto, Bodily Injury & Product claims on behalf of our valued dedicated client to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
NewClaims Consultant - Physicians & Surgeons (Mideast Region) The Medical Protective CompanyClaims Consultant - Physicians & Surgeons (Mideast Region)DCService to insureds, assist where possible in sales and retention efforts of sales force. Confirm coverage and then manage claims and suits brought against policyholders in our Dental Division.
Claims Consultant - Healthcare Professionals The Medical Protective CompanyClaims Consultant - Healthcare ProfessionalsDCProvide service to insureds, assist where possible in sales and retention efforts of sales force. Confirm coverage and then manage claims and suits brought against policyholders.
California Workers' Compensation Claims Examiner | Remote King'S Insurance StaffingCalifornia Workers' Compensation Claims Examiner | RemoteWashingtonRemoteOur client, a highly respected A-rated Workers' Compensation carrier, is looking to add an experienced California Workers' Compensation Claims Examiner to join their growing team. The successful candidate will be comfortable managing a full caseload independently while partnering with employers, medical providers, attorneys, and internal stakeholders to drive claims toward successful resolution.
ServiceNow Claims Lead Engineer The Fortegra Group IncServiceNow Claims Lead EngineerDC$120,000–$180,000 / yearThe platform leverages ServiceNow Customer Service Management (CSM), App Engine, and Integration Hub with extensive scripted customizations and complex integrations across policy administration, financial systems, and enterprise data platforms. This role is focused on architecture, design, and hands-on development, working closely with engineering leadership, product stakeholders, and a Software Integrator (SI) to deliver scalable, high-quality solutions.
NewDirector , Product Management - AI Claims Platform CVS Health CorpDirector , Product Management - AI Claims PlatformDC$144,200–$288,400 / yearThis is a rare opportunity to own a flagship AI product in healthcare from strategy through delivery - partnering closely with Business executives, Operations teams, Enterprise technology, Data science and Engineering, with strong visibility to senior leadership. A&BC leverages advanced analytics, machine learning, modeling, and a hypothesis-driven approach to transform data into actionable, customer-centric insights to drive growth, improve health outcomes and access to health care across all our businesses in CVS Health.
Claims Recovery Specialist II (Remote) Blue Cross and Blue Shield AssociationClaims Recovery Specialist II (Remote)DCRemote$42,624–$78,144 / yearSpecialist will assist to maximize recovery amounts due to refund of payments made in error to members and/or providers, retro terms and/or focused provider audits. ESSENTIAL FUNCTIONS: Under supervision, reviews, audits, and/or initiates recovery efforts for medical, and/or dental claims to recover overpayments, ensuring all parts of the process are documented properly.
SIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorWashington, DC$25–$32 / hourPart timeOur leadership team brings over 25 years of field experience and is committed to fostering a professional, results-driven environment. Join Lemieux & Associates, a trusted leader in investigative services, and make an impact with your surveillance expertise.
Senior Resolute PB Claims Consultant Deloitte Touche Tohmatsu LtdSenior Resolute PB Claims ConsultantWashington, DC$121,000–$143,000 / yearThe wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. Communicate regularly with Engagement Managers (Directors), project team members, and representatives from various functional and / or technical teams, including escalating any matters that require additional attention and consideration from engagement management.
NewSupervisory Veterans Claims Examiner/Assistant Director U.S. Department of Veterans AffairsSupervisory Veterans Claims Examiner/Assistant DirectorWashington, DC$154,757–$197,200 / yearSpecific duties include: Serves as primary advisor to the Deputy Executive Director of Operations, Compensation Service (CS) on all programs and major missions falling under the purview of the Training Management Staff-such as the VIP training (or any future equivalent), Warrior Training Advancement Class (WARTAC), National Training Curriculum (NTC), and Competency Based Training (CBT). Planning and Evaluating - Organizes work, sets priorities, and determines resource requirements; determines short- or long-term goals and strategies to achieve them; coordinates with other organizations or parts of the organization to accomplish goals; monitors progress and evaluates outcomes.
TEMP-Claims Adjuster Argo Group International Holdings IncTEMP-Claims AdjusterDC$37.66–$44.33 / hourCalifornia outside of Los Angeles and San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Houston metro area, New York State (including Westchester County) and Washington State Pay Ranges: $41.44 - $48.79 per hour. Rockwood has become a leading underwriter of workers' compensation for the mining industry by offering workers' compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal.
NewAnalyst, Forensics and Compliance - Disputes, Claims & Investigations Stout Risius RossAnalyst, Forensics and Compliance - Disputes, Claims & InvestigationsWashington, District of ColumbiaBoth our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Working closely with senior team members, you will help analyze financial information, organize data, and prepare client-ready work product in high stakes environments.
Experienced Outside Property Claim Representative - DC The Travelers Companies IncExperienced Outside Property Claim Representative - DCDC$67,000–$110,600 / yearDetermines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies.
Senior Claim Benefit Specialist - Remote CVS Health CorpSenior Claim Benefit Specialist - RemoteDCRemote$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Crop Insurance Adjuster ProAg ManagementCrop Insurance AdjusterWashingtonRemote$45,000–$85,000 / yearAs an insurance company, we comply with certain federal, state and local laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which restricts our ability to employ individuals with certain types of criminal convictions. You will work with our customer to complete field inspections, read maps and aerial photos, measure fields and storage bins, collecting production records of farm commodities, all the while assessing damage or loss.
General Liability Property Damage Adjuster - Washington DC/Baltimore Engle Martin & Associates, Inc.General Liability Property Damage Adjuster - Washington DC/BaltimoreDCYour EMpact: Determine appropriate methods and extent of needed investigation for all assigned claims, including conducting investigations through field visits and phone contact; obtaining contracts, job files, and appraisals; conducting insured, witness, and claimant interviews and/or statements, complete site inspections; scope, measure and write estimates, and using other fact-finding methods to evaluate liability, damages, and proper coverage. Investigate insurance claims in a variety of settings including, but not limited to: retail establishments, office buildings, residences, condominiums, apartments, hotels, corporate facilities, governmental facilities, schools, clinics, or hospitals; assess loss or damage resulting from various events including, but not limited to, inclement or catastrophic weather, construction defect, and fire.
Insurance Examiner U.S. Department of Homeland SecurityInsurance ExaminerWashington, DC$108,173–$163,062 / yearThis job is open to: Status Candidates; DRRA Eligibles; Former Overseas Employees; CTAP; ICTAP; VEOA; 30% or More Disabled veterans; Schedule A; Military Spouses; Peace Corps; Americorps; Vista; Land/Base Management; Boren Awardees; and, Interchange Agreement Eligibles. You may need to upload multiple SF-50s, one that shows your competitive eligibility and another for time in grade: Competitive Eligibility: Submit an SF-50 that demonstrates your current or previous appointment to a permanent or conditional competitive service position, including your current or highest grade level, career or career conditional tenure and status in the competitive service, or proof of permanent appointment if applying based on an interchange agreement.
Investigator Ethos Risk ServicesInvestigatorWashington, DCPart timePrevious Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports. This role involves performing both stationary and mobile surveillance, obtaining video and photographic evidence, and preparing thorough, detailed reports for clients.
Billing Director Hillcrest Children CenterBilling DirectorWashington, DC$95,000–$110,000 / yearThis position will lead our revenue cycle operations is responsible for proactively alerting executive leadership to potential write-offs, developing cross-departmental workflows to minimize errors, and aggressively pursuing appeals when appropriate to safeguard and optimize organizational revenue. By managing a highly diverse payer mix, you will engage in intellectual problem-solving every day, build a robust professional network across the healthcare industry, and enjoy the creative freedom to design an optimized, modern revenue cycle department.
Medical Billing Specialist AudigyMedical Billing SpecialistWashingtonLeveraging your strong attention to detail and at least three years of experience in billing for primary care or specialty medicine, you will be responsible for managing accounts receivable, investigating and resolving insurance claims, and supporting our commitment to outstanding customer service. Participates in educational activities and enhances knowledge and skills to keep up to date of current coding changes, fee schedules, and applicable state and federal programs as they relate to claim submission.