11 medical case manager ii jobs found

The Case Management Supervisor is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, and limited sales management. This is a remote role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for directing a designated group of employees in their day-to-day operations Responsible for quality of service provided Responsible for human resources matters directly related to department supervised May be required to travel overnight and attend meetings May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses May be responsible for limited marketing and sales activities May be required to oversee case management clinical activities (dependent on whether or not unit manager is an RN) For Supervisors who are not RN’s, the clinical oversight and direction will be performed by a designated RN with a nationally...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Fremont Property Desk Claims Specialist- AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create additional sub-claims if needed.  Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Eligible candidates for this role should reside within a commutable distance of Saginaw, Michigan. Job Title- Field Property Claim Specialist Reports to: Claim Manager II What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create additional sub-claims if needed.  Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Michigan Medicare Claim Representative II - The Auto Club Group What will you do: The Auto Club Group is seeking prospective Claim Representative II who will work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units. Resolve coverage questions, take statements and establish clear evaluation and resolution plans for claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim, and initiating documentation in the claim handling system. Complete coverage...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   For this opening, employees will perform daily work duties on a remote basis with any in office visits outlined by management. This position will be required to report in office as outlined by the management team at minimum for team meetings and specific assignments. Candidates must reside within the state of Michigan for hybrid purposes. Michigan APD Claim Representative II – The Auto Club Group Reports to: APD Claim Manager I What you will do: (Primary Duties & Responsibilities) The Auto Club Group is seeking an Auto Claim Representative II who works under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units.  Resolve coverage...

Job Description About Acrisure    A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more.       In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.   Job Summary: We are seeking a highly experienced and motivated Senior GRC Analyst to join our dynamic team.  The ideal candidate will have between 10 to 25 years of experience in responding to client/prospect compliance...

The Doctors Company has an opportunity for a Senior Underwriter to be part of our Region II team. This is a hybrid opportunity at our office in East Lansing, MI, or Mechanicsburg, PA. Position Mission Reporting to the Director of Underwriting, you will act within underwriting guideline and authority granted, appropriately apply underwriting principals and demonstrate sound judgment in the production, selection, pricing, control and servicing of assigned business.  You will have the opportunity to assist management in training of other underwriting staff.  You will interact with employees, company managers, policyholders, agents, patient safety, claims and legal professionals, and members of the general public. Ability to travel as needed. Qualifications INS, RPLU or CPCU designation, or progress in obtaining such designation, is preferred. Associate’s degree (2 years college) or equivalent, is preferred. Five (5) years Medical Professional or commercial insurance;...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Position Description Paralegal II – The Auto Club Group What you will do: This role is Hybrid, with training occurring in office. Once training is complete, the role will move to 3 days Work From Home, 2 days in office. Schedule and Hybrid status subject to change based on business need. Under direction and guidance of the organization’s attorneys, performs a variety of intermediate to complex law-related tasks in support of legal matters.  Conducts legal research, investigate issues and drafts/prepare legal documents to support attorneys and contract administrators.  Supports all aspects of document discovery, including e-discovery, document management, the litigation hold process, and document production.  Assists counsel with the coordination of responses to...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Eligible candidates for this role must reside in the state of Michigan. Job Title- Michigan Homeowners Claim Rep II Reports to: Claim Manager I What you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss....

The Doctors Company has an opportunity for an Underwriter to be part of our Region II  team. This is a hybrid opportunity at our office in East Lansing, MI, or Mechanicsburg, PA. The Underwriter manages an assigned book of business including risk analysis of new and renewal business, policy changes and general servicing of accounts. Qualifications Bachelor’s degree (4 years of college) preferred INS, RPLU or CPCU designation, or progress in obtaining such designation, is preferred. Four or more years underwriting experience. Medical malpractice underwriting or other healthcare background preferred. Ability to analyze and interpret complex documents. Strong oral and written communication skills including the ability to lead discussions Responsibilities Revenue Growth and Profitability Management Maintains an assigned book of business. Collaborates with manager and colleagues in other departments to achieve growth goals and retention targets....

The Professional Review Specialist provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills to determine appropriateness of medical care.      ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Requires regular and consistent attendance Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP) Additional duties as assigned   KNOWLEDGE & SKILLS: A Certified Professional Coder (CPC) with the America Academy of Professional Coders (AAPC)...