To provide Absence case management and claim adjudications, based on medical documentation and the ... Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or ...
Quick apply
To provide Absence case management and claim adjudications, based on medical documentation and the ... Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or ...
Quick apply
To provide Absence case management and claim adjudications, based on medical documentation and the ... Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or ...
... case development. * Create test cases and participate directly in Product Testing (PT) and User ... Support remote and on-site application deployments, user training, go-live execution, and post ...
... case development. * Create test cases and participate directly in Product Testing (PT) and User ... Support remote and on-site application deployments, user training, go-live execution, and post ...
Erlanger, KY · On-site +1
$62K - $116K/yr
... case development.Create test cases and participate directly in Product Testing (PT) and User ... Support remote and on-site application deployments, user training, go-live execution, and post ...
Erlanger, KY · On-site +1
$62K - $116K/yr
... case development.Create test cases and participate directly in Product Testing (PT) and User ... Support remote and on-site application deployments, user training, go-live execution, and post ...
Cincinnati, OH · Remote
$40K - $70K/yr
... Case Manager, responsible for independently analyzing information and documents, while also ... Contribute to positive team morale, even within a remote work environment. What you bring:
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Cincinnati, OH · Remote
$40K - $70K/yr
... Case Manager, responsible for independently analyzing information and documents, while also ... Contribute to positive team morale, even within a remote work environment. What you bring:
Cincinnati, OH · On-site +1
... remote considered in exceptional circumstances) Essential Functions * Lead a portfolio of analytics ... Design and execute experiments and tests (as appropriate to the use case) to evaluate interventions ...
Cincinnati, OH · On-site +1
... remote considered in exceptional circumstances) Essential Functions * Lead a portfolio of analytics ... Design and execute experiments and tests (as appropriate to the use case) to evaluate interventions ...
Cincinnati, OH · Remote
$150K - $180K/yr
... remote team. This is an opportunity to handle meaningful cases, work with a strong support team ... Case Evaluation: Analyze liability, damages, and risk to guide case direction * Client ...
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Cincinnati, OH · Remote
$150K - $180K/yr
... remote team. This is an opportunity to handle meaningful cases, work with a strong support team ... Case Evaluation: Analyze liability, damages, and risk to guide case direction * Client ...
Cincinnati, OH · Remote
$150K - $180K/yr
... remote team. This is an opportunity to handle meaningful cases, work with a strong support team ... Case Evaluation: Analyze liability, damages, and risk to guide case direction * Client ...
Quick apply
Cincinnati, OH · Remote
$150K - $180K/yr
... remote team. This is an opportunity to handle meaningful cases, work with a strong support team ... Case Evaluation: Analyze liability, damages, and risk to guide case direction * Client ...
Cincinnati, OH · On-site +1
$150K - $180K/yr
... remote team. This is an opportunity to handle meaningful cases, work with a strong support team ... Case Evaluation: Analyze liability, damages, and risk to guide case direction * Client ...
Cincinnati, OH · On-site +1
$150K - $180K/yr
... remote team. This is an opportunity to handle meaningful cases, work with a strong support team ... Case Evaluation: Analyze liability, damages, and risk to guide case direction * Client ...
... case management, member engagement, provider solutions, payment integrity, claims cost containment ... and analytics. Sagility has more than 25,000 employees across 5 countries. Job title: Licensed ...
... case management, member engagement, provider solutions, payment integrity, claims cost containment ... and analytics. Sagility has more than 25,000 employees across 5 countries. Job title: Licensed ...
Cincinnati, OH · Remote
$120K - $216K/yr
Assessment of the claims and providing an analysis to the client and carrier. * Direct client and ... Case Staffer. Qualifications: * Must be admitted to the CA state bar and comply with all ethical ...
Cincinnati, OH · Remote
$120K - $216K/yr
Assessment of the claims and providing an analysis to the client and carrier. * Direct client and ... Case Staffer. Qualifications: * Must be admitted to the CA state bar and comply with all ethical ...
Cincinnati, OH · Remote
$100K - $175K/yr
Analyze facts, patterns, and complex legal issues to provide sound legal advice * Prepare ... case processing software * Contribute to positive team morale, even within a remote work ...
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Cincinnati, OH · Remote
$100K - $175K/yr
Analyze facts, patterns, and complex legal issues to provide sound legal advice * Prepare ... case processing software * Contribute to positive team morale, even within a remote work ...
Cincinnati, OH · Remote
$115K - $200K/yr
Analyze facts, patterns, and complex legal issues to provide sound legal advice * Prepare ... case processing software * Contribute to positive team morale, even within a remote work ...
Quick apply
Cincinnati, OH · Remote
$115K - $200K/yr
Analyze facts, patterns, and complex legal issues to provide sound legal advice * Prepare ... case processing software * Contribute to positive team morale, even within a remote work ...
Provide oversight of the ethics reporting program, including hotline operations and case management ... Strong analytical and problem-solving skills, with the ability to identify underlying issues in ...
Provide oversight of the ethics reporting program, including hotline operations and case management ... Strong analytical and problem-solving skills, with the ability to identify underlying issues in ...
Cincinnati, OH · On-site +1
$76K - $104K/yr
Remote work options may be considered on a case-by-case basis and if approved by the Company ... Provide scientific and operational leadership for statistical planning, data analysis, data ...
Cincinnati, OH · On-site +1
$76K - $104K/yr
Remote work options may be considered on a case-by-case basis and if approved by the Company ... Provide scientific and operational leadership for statistical planning, data analysis, data ...
Cincinnati, OH · On-site +1
$76K - $104K/yr
Remote work options may be considered on a case-by-case basis and if approved by the Company ... Provide scientific and operational leadership for statistical planning, data analysis, data ...
Cincinnati, OH · On-site +1
$76K - $104K/yr
Remote work options may be considered on a case-by-case basis and if approved by the Company ... Provide scientific and operational leadership for statistical planning, data analysis, data ...
Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... Case Studies: Apply your knowledge to real-world scenarios and collaborate with peers to analyze ...
Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... Case Studies: Apply your knowledge to real-world scenarios and collaborate with peers to analyze ...
Cincinnati, OH · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Reconcile figures and case counts across report sections and data sources, identifying and ...
Cincinnati, OH · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Reconcile figures and case counts across report sections and data sources, identifying and ...
Cincinnati, OH · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Reconcile figures and case counts across report sections and data sources, identifying and ...
Cincinnati, OH · Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Reconcile figures and case counts across report sections and data sources, identifying and ...
... to business case development and executive-level recommendations. This role requires strong ... Conducting market research and qualitative and quantitative analysis to inform target ...
... to business case development and executive-level recommendations. This role requires strong ... Conducting market research and qualitative and quantitative analysis to inform target ...
For individuals assigned and/or hired to work in a Remote role, Deloitte is required by law to ... each case. A reasonable estimate of the current range is $82,600 to $162,800. You may also be ...
For individuals assigned and/or hired to work in a Remote role, Deloitte is required by law to ... each case. A reasonable estimate of the current range is $82,600 to $162,800. You may also be ...
$38.5K - $47K
16% of jobs
$51.7K is the 25th percentile. Wages below this are outliers.
$47K - $55.6K
16% of jobs
$55.6K - $64.1K
6% of jobs
$64.1K - $72.7K
6% of jobs
The median wage is $79.1K / yr.
$72.7K - $81.3K
6% of jobs
$89K is the 75th percentile. Wages above this are outliers.
$81.3K - $89.8K
26% of jobs
$89.8K - $98.4K
4% of jobs
$98.4K - $106.9K
1% of jobs
$106.9K - $115.5K
1% of jobs
$115.5K - $124K
0% of jobs
$124K - $132.6K
16% of jobs
$38.5K
$81.5K
$132.6K
The top searched job categories for Remote Case Analyst jobs in Edgewood, KY are:
Full-time
PTO
Re-posted yesterday
Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employer’s guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned
Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.