The specialist manages non-complex workers' compensation claims within delegated authority while adhering to company and client guidelines. They are responsible for determining claim validity, establishing reserves, and maintaining clear communication with all involved parties.
The Claims Supervisor manages a team of workers' compensation staff to ensure quality, productivity, and compliance with regulatory standards. They also assist with recruitment, training, and providing technical guidance on complex claims and litigation.
The Liability Claims Specialist manages non-complex liability claims under the supervision of a senior professional to achieve optimal outcomes. Responsibilities include confirming policy coverage, determining claim validity, establishing reserves, and communicating status updates to clients and claimants.
The Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care with patients, families, and medical providers. Responsibilities include conducting in-person and telephonic assessments, developing treatment plans, and ensuring cost-effective care through regular site visits.
The Field Case Manager provides in-person and telephonic medical case management to facilitate the recovery of injured workers. Responsibilities include evaluating treatment plans for medical necessity and cost-effectiveness while collaborating with patients, physicians, and employers.
The Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment. They communicate directly with physicians to evaluate treatment plans and ensure medical necessity while managing patient progress.
The Scheduling Coordinator provides administrative support by scheduling ancillary healthcare appointments for claimants and providers. They manage high-volume inbound and outbound calls while ensuring accurate data entry and timely case updates.
The Regional Account Manager acts as a strategic liaison to manage client relationships, drive revenue growth, and ensure service excellence. They are responsible for overseeing account implementations, leading stewardship meetings, and managing contract renewals.
The Claims Manager oversees office operations, develops long-term goals, and ensures staff compliance with Workers' Compensation laws and regulatory requirements. They are responsible for directing team performance, managing high-dollar claims, and improving operational efficiency through process optimization.
Review medical notes and referrals, gather and verify information, and enter accurate details into the system to submit orders and schedule appointments, especially X-rays. Respond to client, patient, and provider inquiries by phone, email, fax, and written correspondence while resolving issues and following contractual, state, and client requirements.
The Claims Assistant supports claims staff by setting up new workers' compensation claims and managing administrative tasks. Responsibilities include processing mail, handling files, inputting data, and assisting examiners with provider and claimant communications.
The Senior Liability Claims Specialist manages mid to complex Auto and General Liability claims, including investigating validity and determining compensability. They are responsible for establishing reserves, authorizing payments, and maintaining clear communication with clients and claimants throughout the claims process.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care with patients, families, and medical providers. Responsibilities include conducting in-person and telephonic assessments, evaluating treatment plans for medical necessity, and managing care delivery.
Supervise and develop workers’ compensation claims staff, ensuring quality, productivity, customer service, and compliance with applicable laws and procedures. Provide technical guidance on complex claims, support client reviews and resolutions, and assist with recruitment, onboarding, and team performance management.
Handle complex Workers' Compensation claims from initial coverage confirmation and investigation through reserving, payment authorization, recovery, and resolution. Coordinate with case managers, attorneys, customers, and claimants; manage subrogation and litigation, negotiate settlements, and ensure compliance with applicable guidelines and regulations.
The Billing Specialist completes invoicing processes by reviewing vendor and provider bills and ensuring payment accuracy. They also provide professional telephonic support to customers and vendors regarding billing inquiries.
Manage strategic customer accounts, ensuring retention, satisfaction, contractual service delivery, and revenue growth through expanded services. Coordinate implementations and internal teams, oversee account issues and receivables, lead stewardship meetings, and manage renewals and customer communications.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care with patients, families, and medical providers. Responsibilities include conducting in-person and telephonic assessments, evaluating treatment plans for medical necessity, and managing long-term care strategies.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment. They evaluate treatment plans for medical necessity and communicate directly with physicians to recommend alternative care options.
The Medical Case Manager provides in-person and telephonic case management to facilitate the recovery of injured workers. Responsibilities include evaluating treatment plans for medical necessity and coordinating care with physicians, employers, and families.
The Data Analyst will interpret complex data sets to provide strategic insights and creative solutions for business decision-making. They are responsible for developing data collection systems, building dashboards, and collaborating with business teams to optimize statistical efficiency.
The Senior Claims Specialist manages complex Workers' Compensation claims by determining compensability, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Liability Claims Specialist manages non-complex liability claims under senior supervision, including determining compensability and authorizing payments. They also communicate claim status to stakeholders and collaborate with team members on more complex files.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. They evaluate treatment plans for medical necessity and communicate directly with physicians to recommend appropriate care options.
The Vocational Case Manager provides vocational rehabilitation and medical case management services to individuals following workplace injuries. They are responsible for evaluating client disability, determining job goals, and coordinating with medical providers, employers, and insurers to facilitate a return to work.
The Case Manager gathers demographic and clinical information to certify medical necessity and assign appropriate lengths of stay for patient admissions. They also communicate with stakeholders, document all work, and promote utilization review services.
The Vocational Case Manager conducts vocational assessments, transferable skills analyses, and labor market surveys to assist individuals recovering from workplace injuries. They are responsible for developing vocational plans, providing employment counseling, and preparing detailed reports on case activity.
The Case Management Supervisor directs department operations, including human resources, customer service, and clinical oversight. They are responsible for managing staff performance, ensuring service quality, and overseeing daily operational reports and metrics.
The Senior Claims Specialist manages complex Workers' Compensation claims, including investigating validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Liability Claims Specialist manages non-complex liability claims, including litigated files, under the supervision of a senior professional. They are responsible for determining compensability, establishing reserves, and maintaining clear communication with clients and claimants.
The Liability Claims Specialist manages non-complex liability claims, including litigated files, under the supervision of a senior professional. They are responsible for determining claim validity, establishing reserves, and maintaining clear communication with customers and clients.
The Senior Liability Claims Specialist manages mid to complex Auto and General Liability claims, including litigated files and bodily injury cases. They are responsible for determining compensability, establishing reserves, and communicating claim status to all relevant parties.
The Liability Claims Supervisor manages a team of claims staff to ensure quality, productivity, and compliance with Workers' Compensation regulations. They also assist with recruitment, training, and providing technical guidance on complex claims and litigation.
The Senior Claims Specialist manages complex Workers' Compensation claims, including investigating validity, establishing reserves, and negotiating settlements. They coordinate with case managers and attorneys to ensure optimal claim outcomes while adhering to state regulations and company standards.
The Director oversees enterprise-wide service excellence, including client performance, provider relations, and vendor governance to ensure operational efficiency. They are responsible for driving strategic growth, optimizing service delivery, and implementing AI-driven efficiencies across all CareIQ service lines.
The Case Management Supervisor directs department operations, including human resources, customer service, and clinical oversight. They are responsible for managing staff performance, ensuring service quality, and overseeing case management activities.
The Bill Review Analyst is responsible for auditing and entering medical bills to ensure compliance with state fee schedules and customer guidelines. They must maintain high accuracy standards while working independently or within a team environment.
The specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating with case managers to reduce costs. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Permanent Northeast Floater manages complex workers' compensation claims across New England, ensuring compliance and optimal outcomes. This role involves investigating claims, establishing reserves, coordinating return-to-work efforts, and managing litigation and subrogation.
The Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Medical Case Manager facilitates recovery for injured workers by coordinating care with patients, families, and medical providers. Responsibilities include conducting in-person evaluations, developing treatment plans, and ensuring cost-effective, appropriate care.
The Lien Specialist negotiates and resolves medical treatment liens to facilitate the expedited closure of claim files. They also participate in WCAB litigation, prepare legal documents, and analyze defenses for claims adjusters.
The Indemnity Claims Specialist manages non-complex workers' compensation claims by determining validity, establishing reserves, and authorizing payments. They also communicate claim status to customers and clients while adhering to company and carrier guidelines.
The Senior Indemnity Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Service Coordinator provides administrative support and customer service to claimants and providers regarding ancillary healthcare services. Responsibilities include managing case files, verifying documentation, and maintaining regular communication with all case stakeholders.
The representative is responsible for addressing client and provider inquiries via various communication channels while adhering to state and contractual guidelines. They must also maintain accurate records, review provider history, and collaborate with internal departments to resolve issues.
The Customer Service Representative addresses client and provider inquiries via various communication channels while adhering to contractual and state guidelines. They are responsible for maintaining accurate records, consulting with supervisors, and managing provider history documentation.
The Intake Specialist provides administrative support by handling precertification calls, managing files, and completing forms. They are responsible for accurately entering patient and provider data into the CareMC system while maintaining professional communication with stakeholders.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care with patients, families, and medical providers. Responsibilities include conducting in-person evaluations, developing treatment plans, and ensuring cost-effective, high-quality care delivery.
The Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment. They evaluate treatment plans for medical necessity, communicate with physicians, and provide recommendations to payers to ensure optimal patient outcomes.
The Claims Assistant supports claims staff by setting up new workers' compensation claims and managing case administration tasks. Responsibilities include processing mail, handling files, inputting system notes, and assisting examiners with provider and claimant communications.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care with patients, families, and medical providers. Responsibilities include conducting in-person and telephonic assessments, developing treatment plans, and ensuring the medical necessity and cost-effectiveness of care.
The Bill Review Analyst is responsible for auditing and data-entry of medical bills to ensure compliance with state fee schedules and customer guidelines. The role requires maintaining high accuracy standards and meeting specific keystroke performance metrics.
The Senior Claims Specialist manages complex Workers' Compensation claims by determining compensability, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating with case managers to reduce costs. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Data Scientist will design, build, and deploy scalable machine learning models and data products to support enterprise initiatives. They will collaborate with engineering and product teams to integrate these solutions into production environments while ensuring performance and reliability.
The Claims Specialist manages non-complex workers' compensation claims, including determining compensability and authorizing payments. They also communicate claim status to customers and clients while adhering to company and carrier guidelines.
The supervisor manages a team of workers' compensation claims staff to ensure quality, productivity, and regulatory compliance. They also assist with recruitment, training, and providing technical guidance on complex claims and litigation.
The Senior Liability Claims Specialist manages mid to complex auto and general liability claims, including investigating validity and determining compensability. They are responsible for establishing reserves, authorizing payments, and maintaining clear communication with clients and claimants throughout the claims process.
The Clinical Auditor performs DRG validation reviews of medical records to ensure billing accuracy and regulatory compliance. They also assist the quality control team and medical director with appeals and rebuttals while identifying potential reimbursement savings.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, families, and medical providers. Responsibilities include conducting in-person evaluations, developing treatment plans, and ensuring cost-effective care through regular site visits.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care with patients, families, and medical providers. Responsibilities include conducting in-person and telephonic assessments, evaluating treatment plans for cost-effectiveness, and attending medical or legal appointments.
The Case Manager gathers clinical information to certify medical necessity and determine appropriate lengths of stay for patient admissions. They also communicate with stakeholders, document all review activities, and ensure compliance with safety and regulatory standards.
The Claims Training Specialist develops and delivers training curricula to ensure adherence to best practices and improve claims outcomes. They are responsible for identifying training needs, monitoring new hire progress, and maintaining an eLearning library to support operations.
The Medical Case Manager provides in-person and telephonic case management to facilitate the recovery of injured workers. Responsibilities include evaluating treatment plans for medical necessity, coordinating with healthcare providers, and conducting home visits.
The Case Management Supervisor directs daily department operations, including staff supervision, human resources matters, and quality of service. They may also oversee clinical case management activities, manage reports, and participate in limited marketing and sales functions.
The Medical Case Manager facilitates the recovery of injured workers by coordinating with patients, families, and medical providers. They are responsible for assessing treatment plans, ensuring medical necessity, and conducting in-person or telephonic evaluations.
The Administrative Assistant performs diverse administrative tasks including answering phones, managing calendars, and coordinating travel arrangements. They are also responsible for preparing reports, presentations, and assisting with basic accounting functions.
The supervisor manages a team of claims staff to ensure quality, productivity, and compliance with Workers' Compensation laws. They also assist with recruitment, training, and resolving complex claim issues for clients.
The Network Relations role supports network development by overseeing provider data integrity and managing provider contracts. Responsibilities include resolving provider disputes, conducting site surveys, and maintaining accurate provider databases.
The Bill Review Analyst is responsible for auditing, reviewing, and performing data entry for medical bills across various states and business lines. They must ensure all bills adhere to state fee schedules, customer guidelines, and PPO discounts while maintaining high accuracy standards.
The EDI Specialist is responsible for the timely and accurate submission of First and Subsequent Reports of Injury in compliance with state workers' compensation requirements. They will analyze claim documentation, resolve transaction errors, and communicate with internal stakeholders to ensure data accuracy and regulatory adherence.
The Itemization Review Nurse analyzes medical facility charges on UBIB forms to ensure billing accuracy. They are responsible for documenting conclusions and maintaining compliance with HIPAA regulations.
The Bill Review Analyst is responsible for auditing, reviewing, and performing data entry for medical bills to ensure compliance with state fee schedules and customer guidelines. The role requires maintaining high accuracy standards and meeting specific keystroke productivity targets.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care with patients, families, and medical providers. They are responsible for assessing treatment plans for medical necessity and cost-effectiveness while conducting in-person and telephonic case management.
The Medical Only Claims Specialist manages non-complex workers' compensation claims, including determining compensability and authorizing payments. They also communicate claim status to customers and clients while adhering to established guidelines.
The Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Data Science Manager will develop advanced quantitative modules and predictive assessments to support business decision-making. They are responsible for managing a team of data scientists and communicating complex analytical results to stakeholders.
The Claims Specialist manages non-complex workers' compensation claims within delegated authority while adhering to company and client guidelines. They are responsible for determining claim validity, establishing reserves, and maintaining clear communication with all involved parties.
The Salesforce Administrator will manage day-to-day configuration, support campaign operations, and maintain system integrity across Salesforce and Marketing Cloud. They will collaborate with cross-functional teams to translate business requirements into scalable, well-governed system solutions.
The Email Marketing Specialist will develop, execute, and optimize email campaigns while managing audience segmentation and lead lifecycle initiatives. They will also collaborate with cross-functional teams to ensure content alignment and monitor performance metrics to provide actionable insights.
The Medical Case Manager facilitates the recovery of injured workers by coordinating with patients, families, and medical providers. Responsibilities include conducting in-person and telephonic assessments, evaluating treatment plans for medical necessity, and managing care strategies.
The Utilization Review Intake Specialist provides administrative support by handling precertification requests, managing files, and completing forms. They are responsible for accurately entering patient and provider data into the CareMC system while maintaining professional communication with stakeholders.
The Account Manager is responsible for managing client relationships, driving revenue growth, and ensuring high levels of customer satisfaction through consultative service. They must oversee stewardship reporting, handle collections, and coordinate internal implementations to meet client expectations.
The Claims Quality Assurance lead evaluates claim handling quality, accuracy, and compliance with industry standards while developing quality improvement strategies. This role also involves creating and presenting training sessions and reporting on operational performance to senior leadership.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. They evaluate treatment plans for medical necessity and communicate directly with physicians to recommend appropriate care options.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, families, and medical providers. They are responsible for assessing treatment plans for medical necessity and cost-effectiveness while conducting in-person and telephonic case management.
Supervise a team of Workers' Compensation claims staff to ensure quality, productivity, and compliance with regulatory requirements. Provide technical guidance on complex claims and act as a liaison for clients and employees regarding claim resolutions.
The Senior Claims Specialist manages complex Workers' Compensation claims, focusing on investigation, reserving, and settlement negotiations. The role involves coordinating with case managers and attorneys to reduce claim costs and ensure optimal outcomes for customers.
The Care Advocate Nurse assesses the severity of injured workers' injuries and evaluates prescribed treatments to support claims management. They act as a nurse consultant, coordinating between injured workers, employers, and medical providers to secure documentation and monitor return-to-work status.
Manages mid to complex Auto and General Liability claims, including bodily injury and property damage. Responsibilities include investigating claims, establishing reserves, and handling litigated files to achieve optimal outcomes.
The specialist analyzes and monitors claims audit data to ensure accurate reimbursement for healthcare providers. Key duties include identifying payment variances, repricing claims according to contracts, and producing statistical reports on revenue cycle data.
The Account Executive is responsible for selling new services, managing executive-level client relationships, and increasing market share. Key duties include conducting sales calls, managing opportunities in Salesforce, and responding to RFPs.
Leads the Policy and Payment Integrity team by reviewing pre and post-pay claim audits based on CMS and industry guidelines. Oversees team quality, provides training, and performs internal audits and appeals to ensure claim accuracy.
Leads the Policy and Payment Integrity team by reviewing pre and post-pay claim audits for accuracy based on client and CMS guidelines. Oversees team productivity, conducts quality assurance reviews, and implements best practices for payment policies.
Develop and implement a comprehensive content marketing strategy to drive brand awareness and customer engagement. Manage the company's LinkedIn presence and create high-quality materials such as blog posts, white papers, and case studies.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
The representative handles client and provider inquiries via email, phone, and written correspondence while adhering to contractual and state guidelines. Key tasks include reviewing provider history in internal systems and maintaining reports and spreadsheets.
The analyst is responsible for auditing and data-entry of medical bills to ensure adherence to state fee schedules and customer guidelines. The role involves reviewing bills for multiple states and lines of business while maintaining high accuracy and keystroke speed.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
Identify subrogation potential for workers' compensation and property/auto claims and negotiate settlements with insurance carriers and attorneys. Manage a queue of 250-300 claims while maintaining professional relationships with stakeholders and adhering to client guidelines.
Supervise a team of Workers' Compensation claims staff to ensure quality, productivity, and compliance with regulatory requirements. Provide technical guidance on complex claims and act as a liaison for clients and employees regarding claim resolutions.
The analyst is responsible for conducting pre- and post-pay claim audits based on client policies and CMS guidelines. This includes reviewing itemized bills and DRG validations while providing professional written communication for audits and appeals.
The Senior Corporate Paralegal prepares, reviews, and negotiates a high volume of customer-facing and corporate agreements. They partner with internal stakeholders to manage the contract lifecycle and drive process efficiency through standardized templates and workflows.
Directs the day-to-day operations of a designated department, overseeing human resources, customer service, and clinical case management activities. Responsible for ensuring quality of service and managing reports, invoices, and limited sales activities.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, families, and medical providers. They are responsible for assessing treatment plans for medical necessity and cost-effectiveness while conducting regular in-person visits.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, physicians, and employers. Responsibilities include conducting in-person and telephonic assessments, evaluating treatment plans for medical necessity, and managing local travel to provider and home visits.
The Claims Supervisor manages a team of workers' compensation staff to ensure quality, productivity, and regulatory compliance. They also assist with recruitment, training, and providing technical guidance on complex claims and litigation.
