Oversee a team of Claims Analysts and outsourced vendor staff.
Ensure team meets quality, production, and service expectations.
Address complex claims and customer service inquiries.
Jobgether is a platform that uses AI-powered matching process to ensure applications are reviewed quickly and fairly. They identify top-fitting candidates and share the shortlist with the hiring company, while not replacing human judgement in the final hiring decisions.
Researches requests for review of resolvable claims from providers.
Compiles information related to member appeals that request an Executive Review.
Provides copies of necessary documents and submits information to the Appeals and Policy Manager for review.
PEHP Health & Benefits is a division of the Utah Retirement Systems that serves Utah’s public employees through competitively priced medical, dental, life, and long-term disability insurance plans on a self-funded basis. They embrace both a public mission and a commitment to creating customer value.
Audits FEP claims, customer service inquiries, member and group enrollment activities in accordance with Plan Incentive Program (PIP) guidelines.
Supports IA and SIU with assistance as needed.
Utilizes the internal SharePoint Audit tool to communicate findings and follow up assuring corrective action is taken and documented.
Capital Blue Cross is committed to going the extra mile for their team and community. It's why their employees consistently vote them one of the “Best Places to Work in PA.”
Oversee the daily operations of a team or multiple teams.
Play a crucial part in achieving team quality and facilitating staff development.
Provide support and guidance on complex claims and customer service inquiries.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Managing multiple claims units/teams; Requires general knowledge of workers’ compensation statutes, regulations and compliance within the jurisdictions.
Provide strategic direction for the appropriate analysis of claims ensuring they are resolved in an equitable and timely.
Ensure the early recognition of exposures and setting of appropriate case reserves to ensure that future claim costs are accurately estimated.
Crum & Forster (C&F) provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F has more than 2000 employees and they are winning recognition as a great place to work, earning several workplace and wellness awards.
Prepare documentation, review claim history, and investigate requests.
Utilize available resources to investigate claim situations for cases.
Follow-up with responsible departments and delegated entities to ensure compliance.
Centivo is an innovative health plan for self-funded employers, aiming to provide affordable, high-quality healthcare. They work with employers ranging in size from 51 employees to Fortune 500 companies and are headquartered in Buffalo, NY with offices in New York City and Buffalo.
Review, analyze, and process moderately complex to complex workers compensation claims.
Make decisions about liability/compensability and negotiate settlements.
Manage an inventory of commercial property/casualty claims.
Liberty Mutual is a fast-growing company that consistently outpaces the industry in year-over-year growth. They offer comprehensive benefits, flexible workplace options, and professional development in an inclusive environment where everyone can thrive.
Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels.
Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims.
Liberty Mutual provides insurance products and services. They aim to create a workplace where everyone feels valued and supported, offering comprehensive benefits and professional development opportunities to foster an inclusive culture where employees can thrive.
Recruit top talent through networking and screening.
Manage outside agencies and assist with training.
Maintain the HR system and update HR policy.
House Buyers of America is a national home-buying company that helps homeowners sell with confidence through a simple, transparent, and hassle-free process. Founded in 2001 and operating in 44 states, they blend real estate expertise with technology-driven operations.
You excel at bringing the right people to the table, solving issues and identifying opportunities
You understand your customer by seeing your world through their perspective, speaking their language, and expressing the voice of your customer to improve Experian's solutions
You achieve results and identify new ways to grow our business and expand current partnerships
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 23,300 people across 32 countries with corporate headquarters in Dublin, Ireland.
Answering or making calls to clients to learn about and address their needs, complaints, or other issues.
Responding efficiently and accurately to callers, explaining possible solutions, and ensuring that clients feel supported.
Engaging in active listening with callers, confirming or clarifying information and diffusing angry clients, as needed.
Iron Mountain Solutions supports a contract providing call center support for the U.S. Coast Guard (USCG) National Maritime Center’s (NMC) Contact Center (CC). They are an Equal Opportunity Employer.
Partner with recruiters, hiring teams, and clients to provide a high-touch, quality candidate experience.
Be responsible for seamlessly coordinating a high volume of complex interviews across multiple searches.
Maintain our ATS and internal tools with accurate and up-to-date information.
Imagen Technologies is building the AI-enabled teleradiology practice of the future. They operate the first vertically integrated medical practice and AI development platform focused on reducing diagnostic error. With over $200 million in funding from investors, they are rapidly expanding this platform across the U.S.
Serve as a negotiator and business partner, creating solutions that meet both Experian's business objectives and client compliance needs.
Ensure all contracts align with Experian policies, business practices, and regulatory requirements.
Collaborate with cross-functional teams including information security, compliance (internal and regulatory), sales, product marketing, legal, and finance to move deals to completion within tight timelines.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. As a FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 22,500 people across 32 countries and corporate headquarters in Dublin, Ireland.
Serve as first level system support for each assigned client
Perform ongoing audits and file reviews, ensuring data and results accuracy
Execute research and analysis to resolve participant cases
Bswift has been transforming benefits administration since 1996, making it simpler, smarter, and more human. They serve thousands of companies and millions of people nationwide, reducing administrative burdens and freeing HR teams to focus on creating thriving, people-first workplaces.
Collaborate with the sales team to give them updated sales information and data
Support the creation of decks for sales leaders projects, with a focus on new accounts, ARPD, win rates, brand direct
Assist with prospecting, for example helping with simple mocks and tweaking targeted one sheets
GumGum is a contextual-first technology leader transforming digital advertising with AI-powered, non-invasive data and media solutions. They champion effective advertising that uplifts and respects consumers. Founded in 2008, GumGum operates in 19+ markets and believes in cultivating an environment where team members can bring their authentic, whole selves to work.
Assists WC department with handling of claim tasks.
Issues medical records payments once approved by adjuster.
Maintains accurate diaries on all incident only claims.
EMC is focused on working together to create a meaningful impact. They strive to nurture growth, encourage contribution, and facilitate valuable experiences for their team members, aiming to be supportive leaders, partners, and experts.
Review searches and policies received to ensure compliance with order request guidelines.
Manage search invoices in system and check payments for workshare policies.
Assist with Attorney Title Certification Requests and requests for additional documents from vendors.
Mortgage Connect is a national mortgage service provider specializing in assisting mortgage lenders with services they need in connection with a loan. Our entrepreneurial mindset allows us to differentiate ourselves in the market through continuous improvement and innovation.
Relaying participant eligibility information to insurance carriers via email, fax or mail following standard operating practices.
Performing day-to-day data entry tasks and other clerical support tasks to facilitate the capture, transfer and maintenance of accurate and timely data/records.
Answering questions or explaining information to clients and participants, reviewing files, records and other documents to obtain information for a response to requests regarding a benefit plan or personal participant account status/activity.
HealthEquity's mission is to SAVE AND IMPROVE LIVES BY EMPOWERING HEALTHCARE CONSUMERS. They aim to make HSAs as widespread and popular as retirement accounts, providing solutions that allow American families to connect health and wealth.