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

Senior Claims Analyst, GL New York Labor Law Full time Remote & Hybrid Opportunities Available It's an exciting time to join Rockville Rockville, a wholly owned subsidiary of the RiverStone Group, is a growing third party claim administrator, setting a new standard of service excellence in the insurance services industry. We handle diverse claims with unique and interesti

Handles property/inland marine claims for assigned region with availability to assist as needed in all other regions. Evaluates property related damages of $100,000 (aggregate) and above. Handles complex Business Income losses. Responds to catastrophe claims handling in accordance with company CAT plan. Responsible for all coverage determinations, negotiations, reserving

Claims Analyst, CD Full time Hybrid & Remote Opportunities Available It's an exciting time to join Rockville Rockville, a wholly owned subsidiary of the RiverStone Group, is a growing third party claim administrator, setting a new standard of service excellence in the insurance services industry. We handle diverse claims with unique and interesting problems to conquer, pr

Review loss notices; confirm and interpret policy coverages; establish adequate reserves; and investigate and handle claims involving primary and excess coverages Responsible for assignment to and control of work of defense counsel, assignment of expert witnesses, and interfacing with peer carriers, including design and execution of defense and indemnity contracts, evalua

Under the direction of the Branch Manager or Field Leader, the Mobile Examiner's primary responsibility is to provide coverage in the field ensuring that mobile exams are completed accurately and on time. Maintain a safe and professional environment for applicants, clients, and employees, perform with confidence all aspects of an insurance exam, including specimen collect

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

As a not for profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a manage