Senior Property Claims Adjuster (Complex, Large Loss Claims) HCC Life Insurance CompanySenior Property Claims Adjuster (Complex, Large Loss Claims)LARemoteThe Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the "VCCLEA"), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions. In this role, you will handle claims from initial investigation through resolution, applying advanced coverage knowledge and strong analytical judgment to deliver fair, timely outcomes while providing exceptional service to our insureds and partners.
Crop Claims Representative (Eastern Iowa) Great American Insurance Group (DBA)Crop Claims Representative (Eastern Iowa)Iowa, LARemote$48,000–$65,000 / yearThe Division is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI policies. Conveys routine to moderately complex information regarding coverage and settlements to insureds, claimants, and external partners.
Property Claims Adjuster HCC Life Insurance CompanyProperty Claims AdjusterLARemoteThe Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the "VCCLEA"), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions. Working under the supervision of the Claims Manager, this role will investigate claims, evaluate coverage and damages, establish appropriate reserves, and negotiate settlements within approved authority.
Oncology Claims Analyst 2 FMOL HealthOncology Claims Analyst 2Baton Rouge, LAReviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients. Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc to manage proper clean claims and decrease likelihood of claim denial.
Senior Consultant, Federal Healthcare Fraud, Waste, and Abuse Forensics & Investigations Deloitte Touche Tohmatsu LtdSenior Consultant, Federal Healthcare Fraud, Waste, and Abuse Forensics & InvestigationsNew Orleans, LA$95,600–$188,400 / yearServing federal, state, & local government clients as well as public higher education institutions, our team of professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities.
PFS Specialist I IBERIA MEDICAL CENTERPFS Specialist INew Iberia, LAIberia Medical Center (IMC) in New Iberia, LA is looking for team members who will help advance our vision to be the premier hospital of choice for patients, physicians and employees. Otherwise ensures that all monies due from insurance companies are received within acceptable timeframes, and in accordance with any contractual arrangements that may exist with payors.
Pharmacy Technician Non-Certified Costco Wholesale CorporationPharmacy Technician Non-CertifiedCovington, LouisianaAssists Pharmacists in filling prescriptions by bringing stock bottles, counting, pouring, re-stocking, labeling, and pricing prescriptions under direct Pharmacist’s supervision. Answers phones and provides prompt and courteous member service including answering questions at pharmacy windows, directing members to product location.
Pharmacy Technician-Certified Costco Wholesale CorporationPharmacy Technician-CertifiedCovington, LouisianaAssists Pharmacists in filling prescriptions by bringing stock bottles, counting, pouring, re-stocking, labeling, and pricing prescriptions under direct Pharmacist’s supervision. Answers phones and provides prompt and courteous member service including answering questions at pharmacy windows, and directing members to product location.
Senior Consultant, Federal Healthcare Fraud, Waste, And Abuse Forensics & Investigations DeloitteSenior Consultant, Federal Healthcare Fraud, Waste, And Abuse Forensics & InvestigationsNew Orleans, LA$95,600–$188,400 / yearServing federal, state, & local government clients as well as public higher education institutions, our team of professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities.
Claims Examiner, Auto | Bodily Injury Sedgwick Claims Management Services, Inc.Claims Examiner, Auto | Bodily InjuryLA$70,000–$80,000 / yearTo analyze complex auto bodily injury claims on behalf of our valued clients by evaluating coverage, investigating liability, and managing damages, while ensuring timely resolution within service expectations, industry best practices, and specific client requirements. Education & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
NewClaims Representative, Auto | Property Damage Sedgwick Claims Management Services, Inc.Claims Representative, Auto | Property DamageLA$50,000–$55,000 / yearProcesses auto and general liability property damage 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, AutoLA$50,000–$55,000 / 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. Processes 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.
CLINIC CODER Elite Health SolutionsCLINIC CODERShreveport, LAThis individual will work closely with the clinics billing team to help ensure claims and patient accounts are handled accurately and efficiently. This is an excellent opportunity for someone who understands the basics of medical billing and is eager to learn, grow and become a valuable part of a specialized retina clinic.
Surveillance Investigator Allied UniversalSurveillance InvestigatorAlexandria, LouisianaThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Investigator Ethos Risk ServicesInvestigatorLake Charles, LAFull timeCONDITIONS:While we aim to keep assignments within a 2-hour drive of your residence, occasional further travel and overnight stays (covered by the company) may be requiredMost surveillance cases start at 6:00AM. REQUIREMENTS:Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports.
Medical Canvassing Specialist Ethos Risk ServicesMedical Canvassing SpecialistLafayette, LARemoteFull timeKey Responsibilities:Contacting medical facilities (via outbound calls) to gather essential patient and treatment informationDocumenting findings and information in Ethos' client databasePartnering with colleagues and clients to resolve and guide ongoing insurance claims and fraud investigationsQualifications:Education: High School Degree/GED (required). Skills: Proficiency with Microsoft Word, Interpersonal Skills, Microsoft Word, Time Management, Organization Bonus: Fluent in Spanish and EnglishWorking Conditions:This position is remote with preference for candidates in CST or EST timesone.
Provider Data Specialist TriWest Healthcare AllianceProvider Data SpecialistBaton Rouge, LARemoteFull timeTechnical Skills: Proficient with key databases, including FoxPro, Claims Systems, Medical Management Systems, and Provider Data Management Systems; working knowledge of VA policies and procedures, current knowledge of claims, reimbursement methodology; healthcare or managed care experience. • Communicate clearly through both written and verbal forms of communication and follow up with various parties to ensure tasks are completed within the allotted timeline or issues are escalated appropriately.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistLA$17–$31.30 / hourThe candidate will serve as a medical/hospital claim processor for rework projects, compliance, and complex issues for a specific provider/network or large-scale rework projects generated as a result of plan sponsor issues, release fallout and/or legal/regulatory/compliance concerns. CVS Health is currently looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department.
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 TimeLAEpic 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.
NewMarketing Admin Coordinator Wyndham Hotels & ResortsMarketing Admin CoordinatorNew Orleans, LouisianaAccuracy in reporting allows for needed visibility on the performance of all marketing programs and provides the leadership team with information needed for effective profit driven business decisions. Supports lead generation and processing initiatives by maintaining referral paper lead slips, processing leads provided, and tracking all leads sent and received.