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Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes. Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.

Dane Street, LLC

Orthopedic Surgery- Independent Medical Examiner (Ime)

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The EOP is comprised of The White House Office, Executive Residence, Office of the Vice President, Office of the United States Trade Representatives, Office of Science and Technology Policy, Office of the National Cyber Director, Office of the National Drug Control Policy, Office of Management and Budget, Office of the Intellectual Property Enforcement Coordinator, Office of Administration, National Security Council, Council on Environmental Quality, Presidents Intelligence Advisory Board, United States DOGE Service, and Council of Economic Advisers. As a Program Examiner (Agriculture and Interior), GS-0301-9/11/12/13/14/15, your typical work assignments may include the following: Serves as a senior Program Examiner and advisor for major Federal program portfolios, directing qualitative and quantitative analyses supporting formulation, presentation, execution, and oversight of the Presidents Budget.

YEAR

Executive Office of the President

Program Examiner (Agriculture and Interior)

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Summary: Performs technical inspection work in the enforcement of municipality codes and ordinances regulating building construction, alterations, and repairs. Assists and advises architects, engineers, specialty contractors, homeowners and building owners and associates, City officials and the general public.

C A P Engineering

Building Plans Examiner and/or Inspector

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As a Senior Government Consultant I – Program Integrity Specialist, you willplay a vital role as a core team member providing expert insights on complex projects for clients, which are primarily state Medicaid and Children’s Health Insurance Program (CHIP) agencies and related state agencies responsible for Medicaid and CHIP fee-for-service and managed care programs. Participate in and lead client projects related to fraud, waste, and abuse prevention; compliance monitoring; risk assessment; and external audit coordination; Coordinate project priorities, client needs, subcontractor/vendor collaboration, deliverable development, workgroup activity, and leadership reporting.

Marsh McLennan

Senior Government Consultant I - Program Integrity Specialist

We are seeking a skilled and board-certified Family Medicine or Internal Medicine physician to join our team in Littleton, CO for an Independent Medical Examination (IME). · Prepare Reports: Deliver a detailed IME report within an expected turnaround time of 5 days.

Family Medicine/Internal Medicine - Independent Medical Examiner

Demonstrate considerable knowledge and analytical abilities by leading the development of quantitative data analysis and data mining solutions in support of forensic investigations, litigation, and/or in response to regulatory compliance-related inquiries emphasizing the development of database-driven reports to deliver high-quality services while improving client business results. Apply results of data analysis processes with knowledge of financial and emerging management concepts, accounting and operational systems, other business data, performance measures, and benchmarks to identify trends, risk/problem areas, and opportunities to deliver high-quality services or improve client business results.

Crowe

Forensic Accounting Senior Consultant

IRecruitee

Responds well to questions; Ability to read, interpret and comply with written information and documents such as safety rules, operations / procedure manuals and maintenance instructions with a high comprehension and concentration level to include the ability to meet deadlines. Estes values a diverse workforce and affirmatively promotes a company culture that embraces the concept that outcomes are improved when our workforce is made up of people with different viewpoints.

Estes Express Lines, Inc.

Processor I, Workers' Compensation Claims

Interaction with patients, family members, physicians and their office staff, hospital personnel, employers, funeral homes, various governmental agencies, third party agencies (insurance companies) in person, by telephone, fax or internet. 2. Essential Physical and Cognitive Demands, Manual Dexterity: Describes the physical efforts, manual dexterity and cognitive skills required for the job (i.e., hand/eye coordination, lifting, pulling, walking, concentration, analysis, customer sensitivity, etc.).

Montefiore Nyack Hospital

Patient Access Coordinator

Primary Location Fresno, California Facility Name Fresno Orchard Plaza Medical Offices Employee Status: Regular Worker Location: Onsite Schedule Full-time Scheduled Weekly Hours: 40 Shift Day Salary $41.08 - $43.22 / hour. Essential Responsibilities: Create and Maintain Reports: For all medical services related to treatment of industrial injuries or illnesses: Create and maintain complete industrial claim files using internal systems.

HOUR

At Kaiser Permanente, we are relentless in our pursuit of excellence. Driven by our mission to provide the highest quality preventive medicine, we are committed to eliminating health care disparities, and to making lives better through innovation, technology, and research.

Our desire to deliver the best possible care inspires us to promote wellness among our members, communities, and each other. It also fuels our belief that everyone — regardless of circumstance — deserves access to affordable care, which further drives our motivation to expand our reach.

Founded nearly 80 years ago, our unique business model sets us apart — positioning us to drive improvements across the industry and around the world.

Kaiser Permanente

Industrial Report Billing

Collaborates with internal business partners, compliance, legal, provider and payment integrity teams, and external agencies to coordinate investigative activities, support corrective actions, recoveries, and case resolution efforts. 2+ years Fraud, waste, and abuse investigations, healthcare investigations, claims audits, payment integrity, healthcare compliance, law enforcement investigations, or a related investigative field required.

Centene Management Company

SIU Investigator

The ideal candidate has recent administrative experience, strong computer skills, and excellent proficiency in Microsoft Excel. We are seeking a detail-oriented Administrative Claims Processor to review, verify, and process claims while ensuring accuracy and compliance with applicable requirements.

Alpha Rae Personnel Inc

Administrative Professional III 14249

jobdiva

Coordinates the safe and efficient operation of the service and driving safety components of OCO’s Transportation Services Program focusing on 5310 Mobility Management and compliance with New York State Department of Transportation (NYSDOT) and the Federal Transit Administration (FTA) regulations. Coordinates the Agency Vehicle Accident Review Team (VART) and Vehicle Incident Review Team (VIRT) for assessment of preventable accidents/incidents, training gaps and obtaining information for claims management; maintains related procedures.

Mobility Operations Manager

Develop and maintain collaborative and liaison relationships with Blue Cross Blue Shield Association (BCBSA), Blue Cross Blue Shield (BCBS) Plans, HHS OIG, other carriers' anti-fraud professionals, law enforcement and regulatory agencies. May attend webinars and conferences like BCBSA, National Health Care Anti-Fraud Association (NHCAA), and Association of Certified Fraud Examiners (ACFE) to keep apprised of developments in health care fraud.

Premera Blue Cross

Investigator III

Only full-time employees are eligible for benefits Benefits: · Dental insurance · Employee assistance program · Health insurance · Life insurance · Paid time off · Retirement plan · Vision insurance Schedule: · 8-hour shift · Full Time - Day shift 7:45 a.m.-4:15 p.m. Research, verify and process documents for titles and registrations on vehicles, boats and recreational vehicles.

Dealer Services Network

Courier / Title Clerk / Notary - Bossier City, LA

Estes Express Lines Inc

Processor I, Workers'' Compensation Claims

Recognized on Fortune magazine\''s list of the "World\''s Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").

MetLife Inc

Group Life Claim Reviewer

You will partner closely with engineering and architecture leaders responsible for modernization of underlying legacy platforms, ensuring those strategies enable the future Claims processing model while maintaining operational stability for mission-critical processing. As the technical visionary for this initiative, you will define the architectural roadmap for the Claims Automation ecosystem; establish how intelligent automation, decisioning, workflow, processor experiences, and core claims capabilities work together; and guide engineering organizations toward a cohesive target state.

<p>CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all. </p>

CVS Health

Distinguished Architect, Software Development – Claims Automation and Processor Enablement

By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals.

AAA Southern New England

APD Claim Representative II - TEMP

The candidate will serve as a medical/hospital claim processor for rework projects, compliance, and complex issues for a specific provider/network or large-scale rework projects generated as a result of plan sponsor issues, release fallout and/or legal/regulatory/compliance concerns. CVS Health is currently looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department.

CVS Health Corp

Claim Benefit Specialist

POSITION SUMMARY: Under the oversight of the Area Manager, the Claims Examiner III - Team Leader reports to the Claim Supervisor and/or Area Manager and is responsible for managing all aspects of Auto Liability and PIP/No-Fault claims from inception through resolution, within established authority and company guidelines. Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally): Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms.

Claims Examiner Jobs in the United States

Orthopedic Surgery- Independent Medical Examiner (Ime) Dane Street, LLC

Program Examiner (Agriculture and Interior) Executive Office of the President

Building Plans Examiner and/or Inspector C A P Engineering

Senior Government Consultant I - Program Integrity Specialist Marsh McLennan

Family Medicine/Internal Medicine - Independent Medical Examiner Dane Street, LLC

Forensic Accounting Senior Consultant Crowe

Processor I, Workers' Compensation Claims Estes Express Lines, Inc.

Patient Access Coordinator Montefiore Nyack Hospital

Industrial Report Billing Kaiser Permanente

SIU Investigator Centene Management Company

Administrative Professional III 14249 Alpha Rae Personnel Inc

Mobility Operations Manager OCO

Investigator III Premera Blue Cross

Courier / Title Clerk / Notary - Bossier City, LA Dealer Services Network

Processor I, Workers'' Compensation Claims Estes Express Lines Inc

Group Life Claim Reviewer MetLife Inc

Distinguished Architect, Software Development – Claims Automation and Processor Enablement CVS Health

APD Claim Representative II - TEMP AAA Southern New England

Claim Benefit Specialist CVS Health Corp

Commercial Auto liability, PIP/No Fault Team Leader TRISTAR Insurance Group, Inc

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