The Indemnity Claims Specialist manages non-complex workers' compensation claims by determining compensability, establishing reserves, and authorizing payments. They also communicate claim status to customers and clients while adhering to company and carrier guidelines.
The Vice President of Carrier Partnerships is responsible for establishing, maintaining, and growing key relationships with Enterprise Claims carriers. This role involves managing contract negotiations, conducting stewardship meetings, and collaborating with internal stakeholders to ensure service expectations are met.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, physicians, and employers. They conduct in-person and telephonic assessments to ensure treatment plans are medically necessary and cost-effective.
The Contract Administrator is responsible for reviewing, interpreting, and managing contract terms while ensuring pricing accuracy and compliance. They coordinate with internal teams to resolve conflicts, analyze potential risks, and maintain accurate records of customer setups.
The 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 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 Utilization Review Intake Specialist handles precertification requests and maintains accurate patient and provider information within the CareMC system. They provide administrative support by typing reports, managing files, and communicating professionally with stakeholders.
The Hospital Bill Audit Nurse reviews medical records to verify the accuracy of charges against industry guidelines and payor contracts. They are responsible for identifying billing discrepancies, documenting findings, and traveling to provider locations to conduct onsite audits.
The Senior Liability Claims Specialist manages mid to complex auto and general liability claims, including bodily injury and property damage. They are responsible for investigating claims, determining compensability, establishing reserves, and handling litigated files in accordance with company best practices.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment. They assess treatment appropriateness, communicate with physicians, and negotiate the delivery of medical services to ensure optimal patient outcomes.
The Field Case Manager provides in-person and telephonic medical case management to facilitate the recovery of injured workers. Responsibilities include assessing treatment plans for medical necessity and cost-effectiveness while collaborating with patients, families, and medical providers.
Direct the day-to-day operations of a designated department, supervise employees, and ensure the quality of service. Depending on qualifications and unit needs, oversee clinical case management activities, perform case management duties, and handle related human resources, reporting, and limited sales or marketing responsibilities.
Provide in-person and telephone medical case management for injured workers, coordinating with patients, families, physicians, employers, and other care providers. Assess progress and treatment plans, support discharge and long-term care planning, and arrange services and equipment while traveling locally to meet workers' needs.
Gather and assess demographic and clinical information for inpatient admissions and outpatient treatment, then determine medical necessity, certify or deny treatment, and assign an appropriate length of stay. Document reviews, communicate concerns to claims staff and other stakeholders, and support the goals of the Case Management department.
The specialist manages non-complex medical-only workers' compensation claims by determining compensability and establishing reserves. They also communicate claim status to customers and clients while adhering to established guidelines.
The Bill Review Analyst is responsible for auditing, reviewing, and performing data entry for medical bills in accordance with state fee schedules and customer guidelines. The role requires maintaining high accuracy standards and meeting specific keystroke-per-hour targets.
The role supports network development by managing provider data integrity, verifying credentials, and ensuring compliance with national standards. It also involves resolving provider contract disputes and assisting with network marketing and orientation programs.
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 cost-effectiveness, and conducting in-person evaluations within a defined jurisdiction.
The Permanent Northeast Floater manages complex workers' compensation claims across New York, assuming temporary responsibility for diverse caseloads as business needs arise. This role involves investigating compensability, coordinating return-to-work efforts, managing litigation, and ensuring compliance with state regulations.
The specialist manages non-complex workers' compensation claims within delegated authority, ensuring accurate policy coverage and timely payments. They communicate claim status to customers and clients while supporting senior professionals with more complex cases.
The Intake Specialist provides administrative customer service by receiving and entering new ancillary healthcare referrals into proprietary systems. They ensure accurate data entry, maintain regular updates for case stakeholders, and manage high-volume inbound and outbound calls.
The Medical Case Manager provides in-person and telephonic case management to injured workers, facilitating recovery through collaboration with medical providers and families. Responsibilities include evaluating treatment plans for medical necessity and cost-effectiveness while conducting home and facility visits.
The Vice President of Claims is responsible for executing strategic goals, managing staff, and overseeing claims quality and operational performance. They will also lead sales presentations, ensure regulatory compliance, and drive business growth through effective leadership and resource allocation.
The specialist manages non-complex workers' compensation claims within delegated authority 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 Claims 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 role focuses on designing and refining PowerPoint presentations for sales, leadership, and marketing teams while maintaining a library of branded templates. Additionally, the designer will create engaging visual content for social media channels and support broader marketing design needs.
The Client Performance Manager collaborates with internal stakeholders to ensure claim practices meet business objectives and client standards. They are responsible for client stewardship, identifying improvement opportunities, and providing technical guidance to claims staff.
The Liability Claims Supervisor manages a team of claims staff to ensure quality, productivity, and compliance with regulatory requirements. They also assist with recruitment, training, and providing technical guidance on complex claims and litigation.
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 Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment. They assess treatment appropriateness, communicate with physicians, and recommend alternative care options to ensure timely recovery and return to work.
The Field Case Manager provides in-person and telephonic medical case management to injured workers to facilitate their recovery and treatment plans. Responsibilities include evaluating treatment appropriateness, attending medical appointments, and coordinating care with physicians, employers, and families.
The RTW coordinator facilitates safe and timely return-to-work outcomes by collaborating with clients, injured employees, and healthcare providers. They monitor status, clarify medical restrictions, and identify job modifications to ensure successful reintegration.
Monitor closing processes, run queries, maintain reports, track file completion, and provide final quality control for analyst files. Train new Closing Analysts, keep training materials current, support analysts with questions and escalations, track errors, and assist with closing files and team projects.
The specialist manages non-complex workers' compensation claims under the supervision of a senior professional to ensure optimal outcomes. Responsibilities include determining claim validity, establishing reserves, authorizing payments, 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 resolving complex claim issues while acting as a liaison for clients.
The Service Coordinator provides administrative support and file management for healthcare services, ensuring accurate data entry and timely communication with stakeholders. They handle high-volume inbound and outbound calls while managing scheduling and documentation to prevent service delays.
The specialist manages non-complex medical-only workers' compensation claims, including determining compensability and establishing reserves. They also communicate claim status to customers and clients while adhering to established guidelines.
The HR Coordinator will support leave and accommodation programs, including system maintenance and communication with leadership. Additionally, the role provides administrative support to the VP of HR and manages general HR inquiries.
The Intake Specialist provides administrative customer service by receiving and entering new ancillary healthcare referrals into proprietary systems. They ensure accurate data entry, manage inbound and outbound calls, and coordinate with case stakeholders to prevent scheduling delays.
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 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 durable medical equipment and services.
The specialist manages non-complex medical-only workers' compensation claims, including determining compensability and establishing reserves. They also communicate claim status to customers and clients while adhering to established guidelines.
The Medical Case Manager provides in-person and telephonic case management to facilitate the recovery of injured workers. Responsibilities include assessing patient progress, collaborating with medical providers, and ensuring cost-effective treatment plans.
The Nurse Trainer is responsible for developing, assessing, and administering training materials for clinical staff to ensure triage program standards are met. They also monitor quality assurance trends, provide remedial training for struggling nurses, and coordinate onboarding for new hires.
The Telephonic 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 recommend alternative care options while ensuring medical necessity.
The Claims Specialist manages non-complex workers' compensation claims within delegated authority while ensuring adherence to client and carrier guidelines. They are responsible for determining claim validity, establishing reserves, and maintaining clear communication with customers and claimants.
The 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 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 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 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 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.
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.
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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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.
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.
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.
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.
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.
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.
