The Senior Indemnity Claims Specialist manages complex Workers' Compensation claims, including investigating validity, establishing reserves, and negotiating settlements. They collaborate with case managers and attorneys to develop action plans that reduce claim costs and ensure compliance with state regulations.
The Bill Review Analyst is responsible for auditing medical bills to ensure compliance with state fee schedules and customer guidelines. They must perform accurate data entry while maintaining high productivity standards in a remote environment.
Supervise and develop Workers’ Compensation claims staff, ensuring quality, productivity, customer service, and compliance with applicable laws and procedures. Provide technical and jurisdictional guidance, support client claim reviews and resolutions, and assist with recruitment, onboarding, and team performance management.
Manage lower-level, non-complex workers’ compensation indemnity claims under delegated authority and close supervision, including confirming coverage, assessing compensability, setting reserves, and authorizing payments. Communicate claim status with customers, claimants, and clients, follow applicable guidelines, and support senior claims professionals with complex claims and other assigned work.
The Business Analyst will analyze complex datasets to identify trends and build Power BI dashboards to translate data into actionable business insights. They will also collaborate with cross-functional teams to define requirements, document processes, and implement automation solutions.
The Case Management Coordinator provides administrative support to case management nurses and facilitates communication between internal teams, clients, and providers. They are responsible for maintaining accurate client records, preparing reports, and ensuring compliance with HIPAA and organizational standards.
The Liability Claims Specialist manages non-complex liability claims under senior supervision, including determining compensability and establishing reserves. They communicate claim status to stakeholders while adhering to company best practices and client guidelines.
The Data Verification Specialist manages bill review clerical functions including scanning, data entry, and validating incoming medical bill data. They are also responsible for identifying customer-specific rules and maintaining consistent communication regarding workload status.
The WC Claims Supervisor manages a team of claims staff to ensure quality, productivity, and compliance with workers' compensation laws. They also provide technical guidance, handle complex claim resolutions, and assist with recruitment and training.
The Capture Center Specialist is responsible for scanning, indexing, and processing incoming mail and faxes while ensuring data accuracy and compliance with HIPAA regulations. They work closely with analysts and supervisors to meet productivity goals and maintain timely communication regarding document workflows.
The Intake Specialist manages inbound and outbound calls to process ancillary healthcare referrals while maintaining accurate documentation in proprietary systems. They ensure timely service delivery by coordinating with stakeholders and resolving scheduling challenges.
The Regulatory Compliance Supervisor leads Nevada compliance frameworks and provides governance for high-risk legal and regulatory matters. They partner with claims leadership to mitigate exposure, analyze trends, and ensure consistent execution of compliance standards.
The specialist manages non-complex medical-only workers' compensation claims, including determining compensability and establishing reserves. They also communicate claim status to customers and claimants while adhering to client and carrier guidelines.
The Medical Case Manager provides in-person and telephonic case management to facilitate the recovery of injured workers. Responsibilities include assessing patient progress, coordinating with medical providers, and ensuring cost-effective treatment plans.
The Intake Specialist provides administrative customer service by receiving and processing ancillary healthcare referrals via phone and electronic systems. They are responsible for accurate data entry, maintaining stakeholder updates, and ensuring service orders are handled with urgency and precision.
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 evaluations, developing treatment plans, and ensuring the cost-effectiveness and medical necessity of care.
The Claims Manager oversees office operations, develops long-term goals, and ensures staff compliance with Workers' Compensation laws. They are responsible for directing team performance, managing high-dollar claims, and improving operational efficiency through process and system enhancements.
The specialist manages non-complex medical-only workers' compensation claims, including determining compensability and establishing reserves. They also communicate claim status to stakeholders and assist other professionals with more complex cases.
The UR 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 role supports network development by managing provider data integrity, credentialing, and contract documentation. It also involves resolving provider disputes and conducting site surveys to ensure compliance with network standards.
Reviews medical notes and referrals, verifies and enters order information, and provides customer service through phone and email. Guides and supports the assigned team, handles escalated concerns, monitors work queues, and recommends workflow improvements.
Review medical notes and referrals to confirm orders are complete, then gather and enter information 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.
Manages non-complex medical-only and minor lost-time liability claims, including litigated files, under supervision and within delegated authority. Reviews coverage and compensability, establishes reserves, authorizes payments, communicates claim status, and follows client and carrier guidelines.
The Director of CareIQ Service Operations manages intake, medical scheduling, and vendor services coordination while overseeing product development and service level improvements. They are responsible for monitoring team performance, ensuring compliance with jurisdictional regulations, and collaborating with cross-functional partners to maintain operational alignment.
The Senior Vice President provides executive leadership for the liability claims business, overseeing operational performance, financial results, and strategic growth. This role manages Liability Claim Hubs while partnering with cross-functional teams to ensure service excellence and regulatory compliance.
The specialist manages non-complex workers' compensation claims within delegated authority to achieve optimal outcomes. They are responsible for determining claim validity, establishing reserves, and maintaining clear communication with customers and clients.
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 local travel to medical appointments.
The supervisor manages a team of workers' compensation claims staff to ensure quality, productivity, and regulatory compliance. They also assist with recruitment, training, and resolving complex claim issues for clients.
Provide in-person and telephone case management for injured workers, coordinating with patients, families, physicians, employers, and other care providers to support recovery. Assess treatment plans and progress, coordinate services and equipment, and attend medical, home, facility, and other visits as needed.
