At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best protecting and restoring their dreams when they need us most. We're leveraging our expertise, technology and new ways of working to actively reinvent one of America's largest industries creating

IMA's Private Equity and M&A Practice provides buyers and targets with a range of insurance, benefits and retirement products and services designed to assist them throughout the life cycle of the M&A transaction. For M&A activity, IMA's in house Transactional Liability Practice, Project Managers and Due Diligence Specialists bring depth and experience to address financial

Review assigned accounts by contacting Medicare to ensure timely resolution of accounts. Create updates and document information relating to the financial status of accounts in the hospital billing systems. Contact patients and/or other third party representatives to secure additional information pertaining to reimbursement of accounts. Process rejected/adjusted claims th

The Sr. Claims Auditor utilizes CPT and ICD 10 coding to review physician claims and medical records for coding accuracy. Internal auditing functions focus on "desktop reviews" of claims, design and quality control of future audits, and other auditing related functions. Review clinical notes and claims submitted to verify the appropriateness of codes billed based on servi

The Claims Settlement Specialist supports claim settlement with providers through post payment negotiation. The Claims Settlement Specialist will be responsible for handling provider telephone calls regarding the payment amount paid to a provider by a payor based on Zelis data points. During this call, the Claims Settlement Specialist must understand (1) the procedures bi

Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable) Alert Supervisor and Special Investigations Unit to potentially suspect claims Ensure timely denial or payment of benefits in accordance with jurisdictio

Content Claims Specialist Field Level I Requisition ID 2024 24911 Job Locations US MA Boston Position Type Regular Full Time Category Claims Business Unit CUS_Loss Adjusting US Excellence In Everything We Touch Position Summary The role of Content Claims Specialists is a multi faceted role, which focuses primarily in the following four key areas of edjuster's content clai