Claim Health jobs

Manager Patient Safety UNAVAILABLE, UNAVAILABLE, UNAVAILABLE Where You'll Work Founded in 1926, Dignity Health - Glendale Memorial Hospital and Health Center is a 334-bed, acute care, nonprofit hospital. Serving over 70,000 patients annually, the hospital offers a full complement of services including a Level III NICU, heart care, wound care and surgical services. Additionally, Glendale Memorial Hospital has been recognized as an LGBTQ+ Healthcare Equality High Performer by the Human Rights Campaign Foundation. It is a Joint Commission-certified Thrombectomy-Capable Stroke Center and a SRC Center of Excellence for Robotic Surgery and Colorectal Surgery. One Community. One Mission. One California. Job Summary and Responsibilities As our Manager of Patient Safety and Risk at Glendale Memorial Hospital and Health Center, you will oversee the facility's Patient Safety Program, including the Patient Safety Plan requirements for the collection, analysis and reporting of events and patient safety data, investigation of events and near misses, and will ensure all accreditation and regulatory requirements for patient safety are fully met. Every day, you will participate in system office initiatives and programs to mitigate identified risks which result in reduced costs, reduced adverse patient outcomes, and safer patient care. You will also coordinate claim team requests and collaborate with other key stakeholders to implement learnings from claims. You will also spearhead the the coordination of all legal documents related to hospital liabilit

Patient Insurance Navigator - Float PA - York posted: Posted 15 Days Ago

Revenue Cycle Analyst Remote, USA Omada Health is on a mission to bend the curve of chronic disease. Job overview: Omada Health is seeking a Revenue Cycle Analyst to execute, document, and continuously improve Omada's Revenue Cycle Management (RCM) function. The Analyst will be expected to understand Omada's RCM framework and work with the RCM team in developing effective methods and tools to process data and drive cash collections. You will work directly with both internal and external stakeholders to ensure robust billing and efficient collection processes are in place to support our mission. Your work will ensure that Omada recovers its claims in a timely fashion, our payers are impressed with our service, and our participants can focus on improving their health. This position will be at the forefront of refining the company's processes and practices to further Omada's financial growth. Your impact: Process and Systems Implementation - Assist team on a smooth end-to-end billing process - Assist with any new RCM payer implementations - Assist with communication to Omada's clearinghouse on new connections and any claims management issues - Participate in cross-functional efforts to increase efficiency and effectiveness of RCM systems and processes - Identify and propose enhancements to workflows based on data, trends, and user feedback - Support testing, validation, and rollout of new or updated RCM processes to ensure accuracy and compliance Documentation, training, and ongoing communication - Work with payers to integrate with Omada's unique billing model and educate internal stakeholders - Maintain clear, up-to-date

Nurse Practitioner

Physical Therapist Outpatient Banner Churchill Comm Hosp (801 E Williams Ave) posted: Posted 4 Days Ago

Senior Sales Executive Remote This is a fully remote opportunity. Gradient AI: Gradient AI is revolutionizing Group Health and P&C insurance with AI-powered solutions that help insurers predict risk more accurately, improve profitability, and automate underwriting and claims. Our SaaS platform taps into one of the industry's largest data lakes-tens of millions of policies and claims-to deliver deep, actionable insights. Trusted by leading carriers, MGAs, TPAs, and self-insured employers, Gradient AI has grown rapidly since our founding in 2018. Backed by $56M in Series C funding, we're scaling fast-and it's an exciting time to join the team. About the Role: We are searching for a hands-on consultative Senior Sales Executive, Health to join our team and sell our SaaS underwriting and analytics solutions to the health insurance industry. This individual will understand the customer's business objectives, the technical components of our solutions, and utilize a deliberate sales methodology in achieving sales objectives. The successful candidate will demonstrate software sales expertise, desire to hunt and build your own pipeline, and have experience selling into the health insurance space. They will come with their own strategies, approaches, and have very strong self-motivation. How you will make an impact: - Build your own book of business from the ground up with a strong pipeline of prospective customers through direct prospecting, relationships, and referrals - Lead all aspects of the consultative sales process including new business development, client research, objection handling, demoing, closing, and follow up - Draft statements of work and pricing proposals

Behavioral Health Utilization Care Manager Remote Arizona posted: Posted Yesterday

Claims Supervisor CMX, Mexico Claims Supervisor

Senior Workers' Compensation Claims Examiner - Federal Claims 9 Locations posted: Posted 22 Days Ago

Patient Account Representative - Physician Claims US - Remote (Any location) posted: Posted 28 Days Ago

Claims Consultant / Claims Executive - Motor and Liability London - Tower Place West posted: Posted 30+ Days Ago

Healthcare Claims Analytics Senior Consultant US - Remote (Any location) posted: Posted Yesterday

Warranty Claims Adjudicator Warranty Claims Adjudicator Domain Lead We are seeking a meticulous and detail-oriented Warranty Claims processing adjudicator to join our team in back-office operations. The primary responsibility of this role is to validate and approve warranty claims submitted by dealers globally. The ideal candidate will possess strong analytical skills, a deep understanding on Automobiles/heavy earth moving and equipment machinery and the ability to ensure adherence to warranty policies and guidelines. Responsibilities - Valid Property and Causality adjuster license for handling insurance claims for all 50 states (USA) should have at least licenses for Min states and should be able to get for rest as per requirement. - Review and analyze warranty claims submitted by dealers, and service centers for accuracy, completeness and compliance with warranty policies - Working knowledge on Automobiles/heavy earth moving and equipment machinery. - Verify the authenticity of claims by examining repair orders, service records, and supporting documentation. - Collaborate with technicians, engineers, and other stakeholders on a need basis to understand technical aspects of claims and ensure accurate assessment. - Evaluate warranty claims against established criteria and guidelines to determine eligibility for coverage. - Make decisions on approving or deferring warranty claims based on findings and analysis. - Document findings, decisions and actions taken in the claims management system or database. - Communicate with stakeholders, including dealers, and internal teams, customer service Manager (CSM) regarding claim status, decisions and additional information required. - On a necessary basis provide support and guidance to dealers and

Senior Claims Specialist (Construction Liability Claims) Plano, TX, US; Suwanee, GA, US; Hoffman Estates, IL, US; Westborough, MA, US; Remote, UNAVAILABLE, US Description If you're looking for a claims role where you can make a real impact-not just manage a desk-this is it. Our Construction Liability team handles moderate to high-exposure claims for some of the largest owner/developers, general contractors, and subcontractors across the country. From NY Labor Law and OCIP/CCIP programs to road construction losses, underground utility strikes, and major liability exposures tied to active job sites across the Country, the work is challenging, fast-moving, and meaningful. The Senior Claims Specialist works within a Claims Team navigating some of the most challenging construction claims in the industry. You will work in a team of claims professionals who may work in office or remote depending on their location. You will partner with a strong leadership team that values accountability, collaboration, and growth. If you enjoy working along top talent, making tough decisions, and being part of a team that takes pride in doing the right thing at the right time, this is a place where you can build something bigger than just your next role. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads. This is a remote position.

Intake RN Carolina Dunes Behavioral Health posted: Posted 15 Days Ago

Technical Claims Specialist, Workers Compensation ${34271}-Remote), UNAVAILABLE, Hidden (${12781}; Carson City, NV, US; Las Vegas, NV, US; Reno, NV, US; Crystal Bay, NV, US Description ************* NV Workers' Compensation Claims Experience required. NV residence is also preferred, but not required. ******************* Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Responsibilities Investigates claims to determine whether coverage is provided, establish compensability and verify exposure. Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. Identifies and appropriately handles claims with third party subrogation potential, SIF and MSA exposure. Establishes and maintains accurate reserves on

Branch Director, Home Health Independence, MO posted: Posted 30+ Days Ago

RN - Day One Benefits USA - OK - Oklahoma City posted: Posted 30+ Days Ago

Claims Manager MD - Baltimore WhiteMarsh The Claims Manager is responsible for the overall operation of a designated office. The Claims Manager participates in formulating and administering company best practices as well as developing long-term goals and objectives, analyzing costs, activities and operations, supporting the goals of the Claims Department and CorVel.

Patient Financial Services Representative Fort Collins Banner Med Grp (4700 Lady Moon Dr) posted: Posted Today

Senior Claims Specialist - WA and OR Jurisdiction Experience Lake Oswego, OR, US; Las Vegas, NV, US; Rocklin, CA, US; Orange, CA, US; Chandler, AZ, US; Meridian, ID, US; Honolulu, HI, US; Anchorage, AK, US Description The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads. Responsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Refers to claim to subrogation group or Special Investigations Unit as appropriate. Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim. Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. Coordinates t

Registered Respiratory Therapist Banner Desert Med Ctr (1400 S Dobson Rd) posted: Posted 30+ Days Ago

Claims Advisor - Commercial Insurance Albuquerque, New Mexico, United States of America Embrace the role of a Claims Advisor and manage complex commercial insurance claims, from property and liability to construction and workers compensation. Leverage your expertise in claims management, policy interpretation, and client communication to deliver tailored solutions and ensure a seamless claims experience for high-profile clients. Grow your career with HUB International.

Medical Representative (ETC - Nutrition) - Ha Noi Vietnam - Hanoi posted: Posted 10 Days Ago