The Senior Indemnity Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating with case managers. They are responsible for negotiating settlements, managing subrogation, and ensuring compliance with state regulations and client guidelines.
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, developing treatment plans, and ensuring cost-effective care delivery.
The Indemnity Claims Specialist manages non-complex workers' compensation claims under senior supervision to ensure optimal outcomes. Responsibilities include determining claim validity, establishing reserves, authorizing payments, and maintaining clear communication with all stakeholders.
The Claims Assistant supports claims staff by setting up new workers' compensation claims and managing administrative tasks such as processing mail and payments. They also assist examiners with telephone inquiries and maintain accurate documentation within the claims system.
The Medical Only Claims Specialist manages non-complex workers' compensation claims by determining compensability and establishing reserves. They also communicate claim status to customers and clients while adhering to established guidelines.
The Client Performance Manager optimizes the client experience by managing service utilization, onboarding, and training for CareIQ ancillary healthcare services. They act as a subject matter expert, collaborating with internal product and operations teams to ensure customer requirements are met and service levels are maintained.
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 specialist manages non-complex workers' compensation claims, including determining compensability and authorizing payments within delegated authority. They also communicate claim status to stakeholders and assist senior professionals with more complex cases.
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 Permanent Northeast Floater manages complex workers' compensation claims across New York and New England, including determining compensability and managing action plans. The role involves coordinating with case managers and attorneys, overseeing subrogation, and ensuring compliance with state regulations.
The CareIQ Intake Specialist provides administrative customer service by receiving and processing ancillary healthcare referrals in a high-volume call center. They are responsible for accurate data entry, maintaining stakeholder updates, and ensuring scheduling challenges are resolved to prevent service delays.
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 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 treatment plans are appropriate and cost-effective.
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 Senior Liability Claims Specialist manages mid to complex auto and general liability claims, including handling litigated files and determining compensability. They are responsible for establishing reserves, authorizing payments, and maintaining clear communication with customers and 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 Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. They also negotiate settlements, manage subrogation and litigation, and maintain professional relationships with customers and claimants.
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 specialist manages workers' compensation claims from receipt to closure by confirming coverage, reviewing compensability, and authorizing benefit payments. They also develop strategies for claim settlement and maintain clear communication with customers, claimants, and clients.
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 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.
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 Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment. They also communicate directly with physicians to evaluate treatment plans and recommend alternative care options when necessary.
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 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 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 with case stakeholders, and manage high-volume inbound and outbound calls.
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 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 attending medical or legal appointments.
The RN Field Case Manager provides in-person and telephonic medical 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 Senior Claims Specialist manages complex Workers' Compensation claims by investigating validity, establishing reserves, and coordinating with case managers and attorneys. They are responsible for negotiating settlements, managing subrogation, and ensuring compliance with state regulations and company standards.
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 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 customers and clients throughout the claims process.
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 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.
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 Provider Relations Specialist assists providers with bill review inquiries via phone and email while documenting errors to improve team performance. They ensure compliance with company standards and provide administrative support to claimants and providers as needed.
The Data Verification Analyst manages bill review clerical functions, including data entry, scanning, and validating incoming data. They also assist the department with phone and email tasks while ensuring customer-specific rules are applied correctly.
The Medical Case Manager facilitates recovery for injured workers by assessing, planning, and implementing treatment plans in collaboration with patients, families, and medical providers. They are responsible for evaluating the medical necessity and cost-effectiveness of care while conducting in-person and telephonic case management.
The specialist manages lower-level, non-complex workers' compensation, auto, and general liability claims to achieve the best possible outcomes. Key duties include confirming policy coverage, establishing reserves, and communicating claim status to customers and clients.
The Claims Assistant supports the set-up and administration of workers' compensation claims and case management. Key tasks include processing mail, handling payments, and assisting claims examiners with provider and claimant calls.
The specialist handles precertification requests and ensures patient and provider information is accurately entered into the CareMC system. They provide administrative support to the Utilization Review and Case Management department through report typing and stakeholder communication.
The analyst is responsible for clerical functions including prepping, scanning, and verifying medical bills within the Bill Review system. They must apply customer-specific rules and maintain consistent communication with supervisors regarding workload status.
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.
Manage lower-level, non-complex workers' compensation claims by determining validity and establishing reserves. Communicate claim status to customers, claimants, and clients while adhering to carrier guidelines.
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.
Develop and execute strategic pricing models and competitive intelligence initiatives to optimize revenue. Partner with sales, legal, and product teams to refine contract terms and support new business opportunities.
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.
Manage and resolve complex injury claims in litigation, specifically focusing on large loss transportation and trucking liability. This includes investigating coverage, determining settlement values, and partnering with defense counsel to achieve optimal outcomes.
Supports network development by overseeing provider data integrity and providing customer service to medical providers. Responsibilities include verifying contracts, managing credentialing protocols, and resolving provider payment disputes.
Manage complex and high-profile Workers' Compensation claims, including investigating validity, establishing reserves, and negotiating settlements. Coordinate with case managers and attorneys to develop action plans that reduce claim costs and ensure early return-to-work efforts.
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.
Lead the end-to-end product life cycle for Pharmacy Benefit Management (PBM) and Ancillary Benefit Management (ABM) offerings. Drive the development, execution, and growth of specialty network services while ensuring alignment with business objectives and regulatory compliance.
The specialist manages lower-level, non-complex workers' compensation claims to ensure the best possible outcomes. Key duties include confirming policy coverage, establishing reserves, and communicating claim status to customers and clients.
Address client and provider inquiries via email, phone, and written correspondence while adhering to contractual and state guidelines. Maintain reports and collaborate with supervisors to clarify findings and resolve inquiries.
Address client and provider inquiries via phone, email, and written correspondence while adhering to contractual and state guidelines. Maintain reports and spreadsheets and consult with supervisors to clarify inquiry responses.
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 analyst is responsible for verifying provider information and requesting documentation such as medical records and itemized bills to audit claims. They must ensure the accuracy of patient and client data while maintaining strict confidentiality of PHI and PII.
Provide telephonic first aid and treatment recommendations to injured workers using national triage protocols. Document clinical assessments and communicate care plans to customers and supervisors.
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.
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.
Provide vocational rehabilitation and medical case management to help injured workers return to gainful employment. Coordinate with clients, insurers, physicians, and employers to evaluate disability and determine suitable job goals.
The Senior Advisor conducts executive-level assessments of managed care and workers' compensation programs to identify performance gaps and cost drivers. They translate complex data into actionable strategic recommendations and presentations for executive stakeholders.
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.
The Telehealth Coordinator Lead manages client and provider inquiries while providing daily guidance and leadership to an assigned team. Key duties include reviewing medical notes, managing work queues, and recommending process improvements for workflow efficiency.
Directs the day-to-day operations of a designated department, overseeing human resources, customer service, and quality of service. Responsibilities include managing employees, reviewing operational reports, and providing clinical oversight for case management activities.
Manage lower-level, non-complex workers' compensation claims by determining validity, establishing reserves, and authorizing payments. Communicate claim status to customers, claimants, and clients while adhering to carrier guidelines.
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 role involves researching and recommending secure technical solutions and partnering with engineering teams to threat model designs. It also focuses on maturing vulnerability management processes and conducting various risk assessments to protect corporate digital assets.
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 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.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Collaborates with physicians, patients, and payers to evaluate treatment appropriateness and implement medical recommendations.
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.
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.
Manage lower-level, non-complex workers' compensation claims by determining validity, establishing reserves, and authorizing payments. Communicate claim status to customers, claimants, and clients while adhering to carrier guidelines.
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.
Manage inbound and outbound calls to support the Workers' Compensation department and assist claim adjusters. Document interactions and provide accurate claim information to claimants and internal teams.
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 Utilization Review Nurse evaluates clinical information for inpatient and outpatient admissions to certify medical necessity and determine appropriate lengths of stay. They also communicate with stakeholders, document all review activities, and ensure compliance with safety and regulatory standards.
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 Field Case Manager provides in-person and telephonic medical case management to injured workers to facilitate their recovery and ensure appropriate care. They collaborate with patients, families, and medical providers to develop effective treatment plans while managing cost-effectiveness and local travel requirements.
Design, build, and deploy scalable machine learning models and data products to support enterprise initiatives. Collaborate with engineering and product teams to integrate these solutions into production environments using cloud platforms.
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.
The ServiceNow Developer is responsible for developing, configuring, troubleshooting, and implementing baseline and custom applications to augment the ServiceNow platform. This role also involves leading development projects, maintaining platform stability, and collaborating with stakeholders to devise innovative solutions.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and medical necessity, attending provider visits, and implementing care strategies like negotiating equipment delivery.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The Claims Training Specialist develops curricula to ensure adherence to best practices, improves quality metrics, and equips the claims workforce to meet client requirements. Responsibilities include conducting classroom, virtual, and field training, developing materials, and monitoring new hires.
