Health Claims Analyst - Risk & Stop-Loss Solutions
Sun Life
Sun Life U.S. is seeking a Claims Analyst in Health and Risk Solutions to review and adjudicate Stop Loss claims, interpret contracts, and manage reimbursement decisions. You will handle customer service and financial risk for an assigned block of claims in a role that balances in-office collaboration with virtual work. The incumbent will apply plan specifications and regulatory guidelines to decide on reimbursements or denials, develop action plans for each claim, and implement cost containment #J-18808-Ljbffr Sun Life
$54.1k - $81.2k
...management, life, supplemental health, medical stop-loss insurance, and healthcare... ...responsible for reviewing claims, interpreting and comparing... ...service, and the financial risk associated with an assigned... ..., persuasion, and solutions-based underwriting Ability...SuggestedContract workWork at officeLocal areaFlexible hours$79.31k - $173.04k
...We’re building a world of health around every individual — shaping a more connected, convenient... ..., and infrastructure teams to ensure IAM solutions meet business needs while maintaining... ..., enable business operations, and reduce risk. ~ Assess and interpret IT policies...SuggestedHourly payFull timeTemporary workWork experience placementLocal areaRemote work- The Hilb Group is seeking a motivated Stop Loss Analyst to join our team in a hybrid role across multiple agency locations including Canton, MA. The analyst will monitor stop loss reporting, analyze data, and coordinate with carriers and TPAs to ensure timely reimbursements...Suggested
$100k - $120k
...operations, we bring our solutions to market with our... ...Senior Actuarial Analyst to join our Global... ...Accident & Health Team, this teammate... ...-growing Employer Stop Loss product. This role... ...operations, IT, and claims, and will share... ...pricing individual risks and managing a portfolio...SuggestedTemporary workWork experience placementWork at officeFlexible hours- ...Health Actuary - Analyst III At Mercer, we make a difference in the lives of more than 110 million people every day by advancing their health... ...through a lens of innovation and impact and every idea and solution we offer. We are seeking a Health Actuary - Analyst III...SuggestedWork experience placement
$62k - $88k
Claim Representative Our employees are at the heart... ...Intact Insurance Specialty Solutions, we are experts at what... ..., backed by targeted risk control and claims... ...our Claims Accident and Health based in our Plymouth,... ...settlement value of the loss and negotiates proper settlement...Full timeWork at officeFlexible hours$77k - $202k
...Description & SummaryThe OpportunityAs a Health Actuary Consultant- Payer/Provider- Senior... ...to interpret market changes and inform solutions- Supporting project workstreams from issue... ...Statistics, Organizational Management/Behavior, Risk Management/Insurance, Science, Taxation,...Full timeH1b$212k - $318k
...needs and growth objectives. As a Senior Health Actuary, you will lead complex client engagements... ...findings and recommending strategies or solutions • Provide high-level reviews of... ...Marsh (NYSE: MRSH) is a global leader in risk, reinsurance and capital, people and investments...Minimum wageFull timeWork at officeLocal areaRemote workFlexible hours3 days per week1 day per week- ...expertly crafted Commercial Insurance and Risk Management, Private Insurance and Risk... ...minimize potential for errors and omissions claims while demonstrating strong organizational... ..., and financial risk transfer solutions in states where the firm functions. Demonstrates...Contract workWork at office
$128k - $218k
...with main partners and provide insights and solutions to address specific business concerns. •... ...annual statement exhibits related to loss and LAE expenses. • Perform the annual determination... ...that enable you to take care of your health. We also offer a competitive 401(k)...Full timeLocal areaRelocation package$77k - $129k
...is seeking a Business Analyst to support Agile software... ...clients in the Health industry. This role is... ...high-quality software solutions in an Agile environment... ...manage requirements-related risks, dependencies, assumptions... ...is not responsible for losses incurred (monetary or otherwise...Full timeFlexible hours$155k - $185k
..., Pricing, Underwriting, Claims and Finance teams to support... ..., and emerging risks. Clearly communicate complex... ...and oversight to actuarial analysts through the rate filing... ...members to help prevent losses and we create smart insurance solutions at fair prices. We aim...Full time$62k - $78k
...Actuarial Analyst At AIG, we are reimagining the way... ...customers to manage risk. Join us as an Actuarial... ...insurance and reserving losses for AIG's major insurance... ...with Finance, Claims, Operations, Marketing... ...develops commercial rating solutions for underwriting teams...$61.3k - $91.95k
...Point32Health is a leading not-for-profit health and well-being organization dedicated to... ...Point32Health. Job Summary The Actuarial Analyst I support the analysis and data needs for... ...analysis, fee schedule development, provider risk analysis, and medical cost containment...Work at officeWork from home$120k - $135k
...Actuarial Pricing team, working closely with actuaries, analysts, and product managers. Your work will help ensure... ...and care, we partner with our members to help prevent losses and we create smart insurance solutions at fair prices. We aim for our members to love their...Price workFull time$26.5 - $28.5 per hour
...positively impacts our members and communities About the Role As a Loss Mitigation Analyst I , you’ll support the Financial Assistance team in... ...Assist with loan modifications and other loss mitigation solutions by gathering financial documentation, tracking requirements...H1bWork at officeWork from home3 days per week$158k - $214k
...and enhance actuarial methodologies around loss ratio forecast, insurance analytics, and... ...to reinsurance, finance, distribution, claims, and growth teams. What You Need: ~... ...mindset: identify business needs and drive solutions to meet them ~ Expertise with some or all...Full timeLocal areaFlexible hours- Sun Life in Massachusetts is offering a finance reporting co-op within the Health and Risk Solutions Finance Reporting Center of Excellence. You will develop and deliver dashboards and reports using Tableau and SQL-based tools, collaborate with IT, and support management...Internship
$53.8k - $80.7k
...vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,... ...33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small...Temporary workWork at officeLocal areaFlexible hoursShift work2 days per week$30 per hour
...of Employee Laptops. Customer Service analysts deliver service and support that... ...quickly recognizes new problems and develops solutions within appropriate time scales. Decision... ..., such as immunization/occupational health mandates, and/or drug testing requirements...Hourly payTemporary workWork experience placementInternshipWorldwideFlexible hours$170k - $185k
...clients. We offer investment strategies and solutions where we believe we are positioned to add... ...can be leveraged to enhance investment risk management strategies and improve the... ...of experience in a quantitative research analyst- or financial analyst-related occupation....Full timeWork at officeRemote workWorldwideFlexible hours- ...needed. Job Summary The Governance, Risk, and Compliance (GRC) Analyst is responsible for identifying, assessing... ...Data Protection Regulation (GDPR), Health Insurance Portability and... ...as soon as possible, as the MBTA may stop considering applicants after a sufficiently...Full timePart timeInternshipLocal areaImmediate startRemote workAll shifts
- ...The Team The Analyst Governance, Risk, and Compliance, a member of the Information Security - Governance, Risk and Compliance (GRC) team,... ...requirements, workflows, and drive toward identification of solutions. Manages GRC ticket maintenance and provides guidance...Work experience placementWork at officeLocal area
$98k - $130k
...applications, and networks with innovative solutions, and a managed XDR service, to... ...and detail-oriented Senior Analyst, Security Governance, Risk & Compliance (GRC) to join our Information... ...those programs, as well maturing the health of the audit scope by leading the continued...Local areaWorldwideFlexible hours- ...employees, tackling some of the most important health industry challenges. With access to the... ...ambitions. About the role:The Senior Analyst plays a key role in forecasting Boston... ..., determine root causes and recommend solutions to continuously improve forecasting accuracy...Hourly payWork experience placementShift work3 days per week
$50k - $75k
...accrued paid time off +paid holidays each year Health insurance (medical, dental, vision) Annual40... ...… and much more! Job Summary The Total Loss Adjuster is responsible for investigating, evaluating, and resolving auto claims in which the vehicle has been deemed a total...Work experience placementWork at officeFlexible hours$161k - $231k
...expertise are solely dedicated to property risk management and the resilience of its... ...the belief that the majority of property loss is preventable, represent many of the world... ...underwriting leadership to deliver integrated risk solutions Contribute to the development of...Full timeFor contractorsWork at officeFlexible hours$91.19k - $136.78k
...leading not-for-profit health and well-being organization... ..., and reduce cyber risk. Reporting to the Cybersecurity... ...Manager, the Security Analyst will work closely with... ...Key InfrastructureData Loss PreventionMicrosoft O36... ...and supportCRM solutions/SalesforceExcellent communications...Full timeWork at officeWork from home$82.6k - $162.8k
Position Summary Cyber Security & Risk Strategy Consultant Our Deloitte Cyber team... .... Join our team to deliver powerful solutions to help our clients navigate the ever-changing... ...and event management platforms, or data loss prevention solutionsExperience with cloud...Local areaVisa sponsorship- ...our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex. Grow your career with a... ...management Budgeting Tracking rate movements within portfolio Tracking loss activity within portfolio Pipeline tracking Travels to key...Worldwide
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