Senior Clinical Risk Consultant - Medical Claims & Costs
Sun Life Assurance Company of Canada
Sun Life U.S. is seeking a Senior Clinical Risk Consultant to review medical claims, coordinate with claims and underwriters, and identify cost-saving opportunities while ensuring appropriate care. Hybrid model in contiguous states plus AK; non-patient facing role. The ideal candidate holds an active RN license with 5+ years of clinical nursing experience and is versed in medical stop loss or complex clinical case management within health insurance. Strong service orientation required. #J-18808-Ljbffr Sun Life Assurance Company of Canada
$78.6k - $117.9k
...life, supplemental health, medical stop‑loss insurance, and healthcare... .... The opportunity: In the Senior Clinical Risk Consultant role, you will use prior... ...what treatments would cost. You will use your extensive... ...experience to review claims, underwriting prospects and...SeniorMedicalClaimsWork at officeLocal areaFlexible hours- Sun Life U.S. is seeking a Senior Clinical Risk Consultant to leverage medical knowledge to review claims, underwriting prospects and renewals, and determine cost-effective care options. This non-patient-facing role requires understanding of medical insurance and collaboration...SeniorMedicalClaims
- ...leading benefits provider delivering comprehensive medical and stop‑loss coverage across the United States. The Senior Clinical Risk Consultant role integrates medical knowledge with claims review to determine prudent, cost-effective care paths in a non-patient facing...SeniorMedicalClaims
- ...highly skilled and motivated Senior HRIS Analyst to join our Human... ...and your life. Our plans are cost-effective, convenient and provide... ...Bonus, Stock Purchase, Medical Plans, Prescription Drugs, Dental... ...earn competitive benefits, plus claim part ownership? It’s this unique...SeniorMedicalClaimsTemporary workInternshipLocal areaFlexible hours
$77.4k - $116.1k
...disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We... ...with a Work Is Healthy (WisH) approach for disability claims management. As a Clinical Consultant within our Clinical Services team, you will apply...MedicalClaimsWork at officeLocal areaFlexible hours2 days per week- ...your family, and your life. Our plans are cost-effective, convenient and provide... ...Annual Performance Bonus, Stock Purchase, Medical Plans, Prescription Drugs, Dental, Vision... ...relationships, earn competitive benefits, plus claim part ownership? It’s this unique ownership...SeniorMedicalClaimsTemporary workInternshipLocal areaFlexible hours
- ...be. Who You Are:The Insurance and Risk Management Analyst is responsible for... ...insurance budgets and monitor costs; periodically report on cost and claim trends; regularly explore cost-saving... ...competitive benefits package that includes: medical, dental, vision, life, and...MedicalClaimsFor contractorsImmediate start
- ...presence at least 2 days per week. The Clinical Consultant role sits within Clinical Services, applying clinical expertise to disability claims management without hands-on care, using... ...phone/fax communication. You will evaluate medical documentation, provide insights on...MedicalClaimsWork at office2 days per week
- ...truly special place to be. The Senior Development Accountant... ...relates to budgeting, construction costs, product development, office furniture... ...fits package that includes: medical, dental, vision, life, and... ...any complaint or discrimination claim.The "Know Your Rights" Poster...SeniorMedicalClaimsWork at office
$71k - $104k
...ESIS Senior Claims Representative, WC Depending on line of business,... ...current exposure and future risk. Build and maintain strong... ...principles. Knowledge of WC cost containment programs and strong... ...and physical disability, medical condition, genetic information...SeniorMedicalClaimsContract workWork experience placementLocal area- ...Position Details The Risk Analyst at Stella-Jones is responsible... ...and oversight of delegated claims, and the overall risk... ...reporting of insurance premium cost allocation, claims expenses, and... ...total benefits package with 3 medical plans to choose from Several...MedicalClaimsWork experience placementInternshipWork at officeVisa sponsorship3 days per week
- ...communities. We help businesses evaluate their risks and develop solutions tailored to their... ...of excellence. Role Summary The Senior Risk Consultant Risk Services is responsible for staff... ...risk is desirable Knowledge of claims management processes and workers compensation...SeniorClaimsFull timeLocal areaNight shift
- ...Senior Claim Examiner We are seeking experienced professionals to join our Workers' Compensation... ...claims by contacting injured workers, medical providers, and employer representatives.... ...policyholders and medical providers. Consult with attorneys regarding litigation...SeniorMedicalClaims
- ...fully realize your potential. The Senior DevOps Engineer is an... ...designing scalable, secure, and cost-aware solutions across compute... ...retirement savings plan with match Medical, prescription drug, dental,... ...submission, PCG does not recognize any claim on a candidate by a third...SeniorMedicalClaimsFor contractorsFlexible hours
- ...us at: Position Details The Risk Analyst at Stella-Jones is responsible... ...and oversight of delegated claims, and the overall risk... ...reporting of insurance premium cost allocation, claims expenses, and... ...total benefits package with 3 medical plans to choose from Several...MedicalClaimsWork experience placementInternshipWork at officeVisa sponsorship3 days per week
$61.05k - $98.33k
...Description Job Description The Senior Indemnity Claims Specialist handles complex... ...manager to reduce overall cost of the claim Coordinates... ...Careers | Opportunities in Risk Management In general,... ...regular employees and includes Medical (HDHP) w/Pharmacy, Dental,...SeniorMedicalClaimsMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours$57k - $69k
...Description The Machine Shop seeks a Senior Specialist to serve as a team... ...forimproved performance, cost-effectiveness, and ease... ..., one of Kansas City’sbiggest claims to fame is its food, especially... ...nearUniversity Health Truman Medical Center and Children’s MercyHospital...SeniorMedicalClaimsTemporary workCasual workWork at officeVisa sponsorship$75k - $95k
...Overland Park, KS is seeking an experienced Workers' Compensation Claims Adjuster to manage a caseload across IA, KS, MN, MO, ND, NE, SD... ...' compensation/indemnity claims, strong knowledge of laws and medical terms, and excellent communication and negotiation skills. The...SeniorMedicalClaims$135.85k - $159.5k
...DeSimone? At DeSimone Consulting Engineering, you’... ...— including medical, dental, vision, disability... ...the Role: The Senior Project Manager (... ..., they handle cost and personnel estimation... ...critical project risks, and lead teams... ...by a third party claiming to represent us, please...SeniorMedicalClaimsContract workFor contractorsWork experience placementLocal areaFlexible hours- WHO YOU ARE:The Senior Financial Reporting Analyst is responsible for the coordination and... ...Genetic Information & Testing, Family & Medical Leave, protected veteran status, or any other... ...of any complaint or discrimination claim.The "Know Your Rights" Poster is included...SeniorMedicalClaims
- ...ineducation, hospitality, senior living, camps, and... ...holidays. Competitive medical, dental, and vision insurance... ...availability, quality, cost, and delivery... ...status updates and elevate risks that may delay service... ...returns, exchanges, warranty claims, and vendor credits....SeniorMedicalClaimsFull timeTemporary workWork at officeLocal areaImmediate startMonday to FridayFlexible hours
- ...seeking a detail-oriented and strategic Senior Manufacturing Cost Analyst to oversee and manage... ...propose strategies for reducing warranty claims. Freight & Logistics Cost Control: Manage... ...efficiency. Why Join Mattr? Medical, dental & vision coverage with HSA contributions...SeniorClaimsImmediate startRemote work
- Luminare Health is seeking a Senior Claims Analyst to support a Claim Unit and vendor staff, and act as a liaison for internal departments... ...Qualified candidates have a high school diploma or GED, 3 years of medical claim processing, and strong communication, analytical, and...SeniorMedicalClaims
- The Dearborn Group is seeking a Senior Claims Analyst to support a Claims Unit and vendor staff, serving as a liaison for internal departments. Responsibilities include adjudicating medical, dental, and vision claims and processing related inquiries in compliance with plan...SeniorMedicalClaims
$180.2k - $355.1k
...is adding an Actuarial Senior Manager to our Insights... ...strategic and technical consulting services to help... ...issues for drivers of cost and reimbursement and formulate... ...on investment for medical management initiatives... ...modeling, underwriting, and risk analysis methodologies...SeniorMedicalLocal areaVisa sponsorship- ...WHO YOU ARE:The Senior Financial Reporting Analyst is responsible for the coordination and... ...Genetic Information & Testing, Family & Medical Leave, protected veteran status, or any other... ...of any complaint or discrimination claim.The "Know Your Rights" Poster is included...SeniorMedicalClaims
$75k - $95k
5+ years of experience handling Workers Compensation/Indemnity Claims for IA, KS, MN, MO, ND, NE, SD, WI and WY. Must have experience... ...Strong knowledge of workers' compensation laws, regulations, and medical terminology. Excellent communication, negotiation, and customer...SeniorMedicalClaimsRemote jobPermanent employmentTemporary work$90k - $150k
...Errors & Omissions, Directors & Officers, Medical Malpractice, and Transactional Risk. Key responsibilities include: Ensure high costing adequacy in treaty pricing across all... ...to cross-functional deal teams and senior management, ensuring clarity and actionable...SeniorMedicalFull timeContract workTemporary workWork at officeRemote workFlexible hours3 days per week$85k - $100k
Our client is seeking to add a Senior Workers' Compensation Claims Examiner to their Midwest team. This would be a fully remote position and will consist... ...and ability to work remotely Extremely competitive Medical, Dental, Vision and Life plans #J-18808-Ljbffr King's...SeniorMedicalClaimsRemote workFlexible hours$100k - $115k
...Position Summary Strategic Comp is seeking an experienced Senior Claims Specialist to manage Kansas and Missouri workers' compensation... ...on litigation strategy and claim resolution. Partner with medical case managers, surveillance vendors, and other external resources...SeniorMedicalClaimsFull timePart timeRemote work
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