JOB DESCRIPTION The Brandywine Claim Director is responsible for all aspects of claim handling on a book of complex..., remediation experts, counsel and others to gather all claim facts. Negotiate cost sharing agreements with carriers/policyholders...
Job Category: Claims Adjusting Job Description: The Brandywine Claim Director is responsible for all aspects... of claim handling on a book of complex asbestos, long term exposure and environmental claims from first notice through...
communities and residents and to support the safety net required to achieve that purpose. Job Summary The Director, Claims... Director has ownership of claims regulatory compliance and audit readiness. This position oversees daily production, inventory...
Director for our West Region. The successful applicant will be managing high complexity California claims, ensuring all aspects... working from the Los Angeles Office. Duties & Responsibilities: Display advanced claim handling skills on claim...
to less experienced Claim Professionals. May perform additional duties as assigned. Reporting Relationship Director.... We currently have an opening for a Complex Claims Consulting Director focused on Healthcare Professional Liability for CNA...
patterns, and upstream causes. Shares responsibility with the Director, EDI for operational oversight of EOB generation..., validation, and data flow. Ensures EOB output files reflect accurate benefit application, share of cost, accumulation, claim...
City, Omaha, Richmond (VA), Rockwood (PA), or Springfield (MO). This individual will report to the Director of General... and improved claim management Identifying, assigning, and coordinating the assignment and coordination of expertise resources...
of hospital billing and revenue operations. As the Director of Patient Business Services, you will lead systemwide billing..., workflow optimization, and process redesign Oversee daily operations to ensure timely, accurate, and compliant claim...
Optum is seeking a Medical Director for utilization management review to join our team. Optum is a clinician-led care... with medical director teams focusing on outpatient and inpatient care management, clinical coverage review, member appeals clinical...
communities and residents and to support the safety net required to achieve that purpose. Job Summary The Director, Payment... inappropriate spend, and strengthens preventive and detective controls across all lines of business. The Director oversees clinical...
Optum is seeking a Medical Director for utilization management review to join our team. Optum is a clinician-led care... quality and promote evidence-based medicine through outpatient utilization management review Work with medical director teams...
. We are currently seeking a Utilization Management Medical Director to join our Clinical Performance team. This team is responsible... is provided at the right time for each member Work with medical director teams focusing on inpatient care management, clinical...
. We are currently seeking a Utilization Management Medical Director to join our Clinical Performance team. This team is responsible... is provided at the right time for each member Work with medical director teams focusing on inpatient care management, clinical...
A large and prestigious business management firm seeks a Music Audit Director to join their dynamic team.... This is an excellent opportunity for an audit professional with music industry experience. Responsibilities: The Audit Director...
) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director, on requests... transfers based on clinical data presented and established criteria/guidelines, escalating to the medical director...
to claim initiatives or strategies, are being met. Recommends strategies to meet or exceed goals. Tracks, analyzes... with and supports the Director, EHS and VP, Environment Health Safety and Quality refining return-to-work (RTW) standard operating...
and regulations. Informs appropriate Manager(s), Director(s), VP(s) or Corporate when obvious inappropriate business practices... of edit, claim, provider, and system issues. Analyzes system data and reports to make recommendations to improve system...
of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialist provides revenue cycle support services...-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. This position is 100% remote. Responsible...
, supervise and review staff test work Prepare written audit report complete with supporting schedules and claim calculations... Communicate effectively with staff, auditees and other third parties Assist with the audit settlement process Assist Director...
sales plans and frequently partner with your Managing Director (MD) to develop region/group sales plans. May assist in the... of underwriting, claim, operations, risk assessment, actuarial, sales, product, or finance experience. What Is in It...