Claims Examiner MedMal Diedre Moire Corp.Claims Examiner MedMalPawtucket, RI$100,000–$140,000 / yearFull timeCONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #UnderwriterJobs. Described compensation is not definite nor precise and may be estimated and approximate and is negotiable depending on market conditions and candidate availability and other factors and is solely at the discretion of employers.
Field Auto Claims Adjuster Allstate Insurance CompanyField Auto Claims AdjusterProvidence, RI$26.49–$37.50 / hourAuto Insurance Claims, Business Acumen, Business Management, Claims Administration, Claims Resolution, Critical Thinking, Customer Service, Insurance Claims Investigations, Negotiation, Prioritization, Quality Management, Time Management, Training. In this role you will be responsible for preparing and/or auditing comprehensive damage estimates for first- and third-party material damage claims across Auto and Specialty lines, ensuring accurate evaluation and appropriate claim disposition.
Auto Claims Adjuster Allstate Insurance CompanyAuto Claims AdjusterRI$50,000–$74,350 / yearAuto Insurance, Auto Insurance Claims, Case Management, Claims Administration, Claims Resolution, Claims Review, Coverage Analysis, De-Escalation, Insurance Administration, Insurance Claims, Insurance Coverage, Insurance Coverage Analysis, Insurance Policies, Insurance Policy Review, Policy Interpretation, Task Management, Time Management, Time Prioritization. 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.
Auto Damage Claims Adjuster The Progressive CorpAuto Damage Claims AdjusterWarwick, RI$73,400–$89,700 / yearFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . As an auto damage claims adjuster, you'll serve as Progressive's point of contact with customers - directing and making decisions regarding the repair process from beginning to end.
TEMP-Workers'''' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers'''' Compensation Claims AdjusterRIRemote$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 Senior MedPay Adjuster AAAClaims Senior MedPay AdjusterLincoln, Rhode IslandThe Claims Senior Medpay Adjuster handles moderate to high complexity Auto claims matters involving material damage, property and / or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
Claims Senior Property Adjuster AAAClaims Senior Property AdjusterLincoln, Rhode IslandWith our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team. The position requires a higher degree of discretion and independent judgment in analysis and problem-solving to manage losses effectively.
Multi-Line Claims Adjuster - Rhode Island Provencher & Company, LLCMulti-Line Claims Adjuster - Rhode IslandProvidence, RIWe excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations.
NewAuto Adjuster (MMR Claims) Allstate Insurance CompanyAuto Adjuster (MMR Claims)Providence, RI$53,500–$86,400 / yearAnalytical Thinking, Auto Insurance Claims, Automobile Accidents, Case Management, Claims Administration, Claims Resolution, Claims Review, Customer Centricity, Customer Service, Data Representation, Desktop Management, Digital Literacy, Inclusive Leadership, Insurance Claims Investigations, Insurance Coverage, Insurance Coverage Analysis, Insurance Policies, Insurance Policy Review, Investigative Skills, Learning Agility, Negotiation, Organizing, Results-Oriented. 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.
NewClaims Complex Casualty Adjuster AAAClaims Complex Casualty AdjusterLincoln, Rhode IslandThe Claims Complex Casualty Adjuster handles complex claims involving material damage, property, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
Claims Complex Property Adjuster AAAClaims Complex Property AdjusterLincoln, Rhode IslandWith our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team. Demonstrate proficiency with assessment of personal property, property damage, coverage, loss of use, arbitration responses, damage evaluations, and claims technology and tool usage.
Injury Claims - Attorney Represented The Progressive CorpInjury Claims - Attorney RepresentedWarwick, RI$69,400–$89,800 / yearAn ideal candidate will have experience managing an inventory independently, experience assessing and evaluating liability, coverage, and damages, as well as working independently and directly with attorneys to negotiate and settle claims. For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/.
Senior Lost Time Workers Compensation Claims Adjuster - CT, NH, VT, RI, MA GallagherSenior Lost Time Workers Compensation Claims Adjuster - CT, NH, VT, RI, MAProvidence, Rhode IslandRemoteThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. As a key member of our experienced Claims Adjuster team, you will: Investigate, evaluate, and resolve complex indemnity/lost time workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution.
Senior Workers Compensation Claims Adjuster - CT, NH, VT, RI, MA GallagherSenior Workers Compensation Claims Adjuster - CT, NH, VT, RI, MAProvidence, Rhode IslandRemoteFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Investigate, evaluate, and resolve complex indemnity/lost time workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution.
TEMP- Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP- Workers' Compensation Claims AdjusterRI$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.
TEMP- Senior Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP- Senior Workers' Compensation Claims AdjusterRI$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-Senior Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Senior Workers' Compensation Claims AdjusterRI$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 AdjusterRI$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.
Claims Auto Adjuster AAAClaims Auto AdjusterLincoln, Rhode IslandThis entry-level position supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
Claims Senior Auto Adjuster AAAClaims Senior Auto AdjusterLincoln, Rhode IslandClaims Senior Auto Adjuster The Claims Senior Auto Adjuster supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
Claims Adjuster II, Field Property - National Catastrophe Nationwide Mutual Insurance CoClaims Adjuster II, Field Property - National CatastropheProvidence, RI$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.
Claims Representative II - REMOTE Ryder System IncClaims Representative II - REMOTEProvidence, RIRemoteCompensation 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 Analyst - REMOTE Ryder System IncClaims Analyst - REMOTEProvidence, RIRemoteCompensation 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.
NewUNIT CLAIMS MANAGER State of Rhode IslandUNIT CLAIMS MANAGERCranston, RI$65,836–$76,037 / yearREQUIRED QUALIFICATIONS FOR APPOINTMENT: KNOWLEDGES, SKILLS AND CAPACITIES: A thorough knowledge of the provisions of the Workers' Compensation Act, and the ability to apply such knowledge in the supervision of a staff of claims examiners; a working knowledge of medical terminology as it relates to injuries, occupational diseases, disabilities and rehabilitation processes and techniques; the ability to review staff and medical reports in order to make decisions through the interpretation of the Workers' Compensation Act; the ability to maintain and prepare various financial reports and records; the ability to assist injured workers, lawyers, business representatives, employers and others in understanding and functioning under the program; the ability to establish and maintain effective working relationships with officials, subordinates, employers, employees and the general public; and related capacities and abilities. GENERAL STATEMENT OF DUTIES: To plan, direct and coordinate the work of a staff of claims examiners engaged in the examination of, or preparation and processing of, Reports of Injury, Agreements of Settlement, Suspension Agreements, Workers'' Compensation and Sick Leave Schedules, and other forms, reports and/or schedules thereof relative to injuries arising out of, and in the course of, industrial employment or state employment in accordance with the provisions of the Workers'' Compensation Act; and to do related work as required.
NewRemote Claims Representative 630810 Metro Public AdjustmentRemote Claims Representative 630810Providence, RIRemoteIf you think you would be a great fit for our team, click Apply to seize this opportunity and shape your own future You will receive a link to schedule an informative interview session. Metro Public Adjustment is looking for people who are interested in helping homeowners receive the maximum amount they are entitled from their insurance claim.
Claims Unit Manager - Auto AAAClaims Unit Manager - AutoLincoln, Rhode IslandThe primary functions include effective loss and expense management, employee development and succession planning, training, staffing, performance measurements and continuous improvement. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
Claims Team Manager - Subrogation Auto AAAClaims Team Manager - Subrogation AutoLincoln, Rhode IslandWith our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team. Lead meetings in collaboration with unit management to communicate goals with direct reports and reinforce/monitor behavior that furthers technical and customer service performance expectations.
Claims Resolution Representative Hybrid Warwick, RI Gainwell Technologies LLCClaims Resolution Representative Hybrid Warwick, RIWarwick, RI$30,500–$43,500 / 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 $30,500.00 - $43,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
Claims Representative , Auto Sedgwick Claims Management Services, Inc.Claims Representative , AutoRI$50,000–$55,000 / yearProcesses auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Representative, Auto | Property Damage Sedgwick Claims Management Services, Inc.Claims Representative, Auto | Property DamageRI$50,000–$55,000 / yearProcesses auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Representative, Auto Sedgwick Claims Management Services, Inc.Claims Representative, AutoRI$50,000–$55,000 / yearProcesses auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Senior Subrogation Specialist - Inbound AAAClaims Senior Subrogation Specialist - InboundLincoln, Rhode IslandLitigation & Vendor Management: Manage and oversee all litigated subrogation files, coordinating with legal counsel to manage complex legal issues while monitoring and managing vendors for Medpay Trust, Property, Product Liability, and complex legal issues. Arbitration Prep & Filing: Prepare and file high-quality intercompany arbitration contentions through Arbitration Forums (Arb Forums) when negotiations reach an impasse, ensuring all legal theories and evidence are accurately presented.
Stop Loss Claims Analyst CVS Health CorpStop Loss Claims AnalystRI$18.50–$35.29 / hourThis role involves preparing, tracking, reconciling, and helping generate and marshal stop loss filings to completion while serving as a key liaison across internal business partners, external stakeholders, and stop loss carriers. The position offers exposure to many areas of healthcare claims administration, including stop loss and reinsurance policy, data analytics, underwriting, eligibility, finance, client management, and provider and broker relations.
Process Manager, Commercial Casualty Claims - Remote CSAA Insurance GroupProcess Manager, Commercial Casualty Claims - RemoteRIRemote$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 TimeRIEpic 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.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistRIRemote$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.
Liability Claims Associate | Remote (Central or Eastern Time Zone) | NY or HI Licensing Preferred Sedgwick Claims Management Services, Inc.Liability Claims Associate | Remote (Central or Eastern Time Zone) | NY or HI Licensing PreferredRIRemoteMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Workers Compensation Claims Examiner | Dedicated Client | NY Jurisdiction Knowledge & NY Licensing Required Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Dedicated Client | NY Jurisdiction Knowledge & NY Licensing RequiredRI$90,000–$95,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Workers Compensation Claims Examiner | CT, MA, NH, RI, VT Jurisdictional Knowledge | Remote Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | CT, MA, NH, RI, VT Jurisdictional Knowledge | RemoteRIRemote$80,000–$85,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Liability 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 ExperienceRI$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.
Liability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims Experience | Remote Sedgwick Claims Management Services, Inc.Liability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims Experience | RemoteRIRemote$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.
NewRemote Revenue Cycle Analyst - Claims & Billing Cardinal HealthRemote Revenue Cycle Analyst - Claims & BillingProvidence, RIRemoteThis role involves handling medical billing processes, ensuring the accuracy of submissions, and following up on unpaid claims. Candidates need at least 2 years of experience in Revenue Cycle Management and proficiency in Microsoft Excel.
Director , Product Management - AI Claims Platform CVS Health CorpDirector , Product Management - AI Claims PlatformRI$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.
Senior Manager, Fraud & Claims Quality Control (QC) Citizens Financial Group IncSenior Manager, Fraud & Claims Quality Control (QC)RIThis leader is accountable for driving a robust, forward-looking QC program that not only identifies risk but shapes operational improvements, enhances control effectiveness, and enables better business outcomes. The Senior Manager, Fraud & Claims Quality Control (QC) is responsible for the end-to-end leadership, strategy, and execution of the Fraud & Claims QC program.
Fraud & Claims Call Monitoring Lead Citizens Financial Group IncFraud & Claims Call Monitoring LeadRIThe Fraud & Claims Call Monitoring Lead is responsible for leading quality assurance and control activities while driving business outcomes, supporting team performance, and acting as a key liaison between frontline QC staff and leadership. The Call Monitoring Lead operates with minimal oversight, leads critical initiatives, and ensures alignment between QC activities and broader business, risk, and customer impact objectives.
Medical Claim Analyst CVS Health CorpMedical Claim AnalystRI$18.50–$35.29 / hourThis function includes, but is not limited to the following: Review provider re-submissions of ClaimsXten, Clinical Validation, Prospective Claim Accuracy, Novologix and DRG claims and resolve or prepare them for review by an Aetna clinician. The Medical Claim Analyst will be part of the Provider Coding and Reimbursement (PCR) team who reviews provider coding and reimbursement denial disputes from providers.
Claim Auditor Payment Integrity (44544) Neighborhood Health Plan of Rhode IslandClaim Auditor Payment Integrity (44544)Smithfield, RIClaim payment accuracy will be recognized through sound audit review methods and practices, including but not limited to; claim payment evaluation, medical chart review, claim payment data analysis and assessment of established organizational contractual parameters. The Claim Auditor in Payment Integrity will address problematic and complex audit assignments to identify claim overpayments in accordance with established billing and coding parameters.
NewSenior Analyst Claim Reporting and Special Services Qureos IncSenior Analyst Claim Reporting and Special ServicesWoonsocket$46,988–$112,200 / yearPosition Summary : We are looking for a highly motivated candidate who can effectively and accurately oversee and coordinate rework projects, work closely with other members of the Commercial Services Operations team providing project management, root cause analysis and precise resolution of affected claims. The candidate will serve as a Project Lead for rework projects/issues for a specific network or large-scale rework projects generated as a result of Plan Sponsor issues, release fallout and/or legal/regulatory/compliance concerns.
Senior Analyst Claim Reporting and Special Services CVS Health CorpSenior Analyst Claim Reporting and Special ServicesRI$46,988–$112,200 / yearPosition Summary: We are looking for a highly motivated candidate who can effectively and accurately oversee and coordinate rework projects, work closely with other members of the Commercial Services Operations team providing project management, root cause analysis and precise resolution of affected claims. The candidate will serve as a Project Lead for rework projects/issues for a specific network or large-scale rework projects generated as a result of Plan Sponsor issues, release fallout and/or legal/regulatory/compliance concerns.
Bodily Injury Litigation Adjuster (Homeowner Liability) Allstate Insurance CompanyBodily Injury Litigation Adjuster (Homeowner Liability)Providence, RI$56,000–$82,500 / yearAutomobile Accidents, Automobile Accidents, Case Management, Casualty Insurance, Claims Administration, Claims Litigation, Claims Resolution, Claims Review, Commercial General Liability Insurance, Commercial Liability, Complex Claims, Fractures, General Liability Claims, General Liability Insurance, Homeowners Claims, Homeowners Insurance, Homeowners Insurance Claims, Insurance Claim Handling, Insurance Litigation, Insurance Policies, Liability Insurance, Litigation, Litigation Management, Litigation Support, Negotiation {+ 2 more}. 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.