Location: Quincy, MA
Company: Retail Business Services
Primary responsibilities include investigation of Workers Compensation claims to determine either compensability of the claim. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals.
This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Principle Duties and Responsibilities: Claims Management Manage WC caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory
and legal obligations. Monitor and ensure timely execution of all statutory deadlines or legal filings as needed. Analyze fact of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines.
Identify fraud indicators and actively pursue subrogation opportunities. Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks. Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors,
healthcare providers, outside attorneys) customers. Financial Impact Administration Manage book of claims business (up $1 million WC) with authority to settle/negotiate a single claim within their authority of up to $50,000 (Corporate Authority policy) Communicate ongoing causes of WC injuries to Safety and Brands.
Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications. Basic Qualifications: Licensed adjuster or ability to obtain license (as appropriate by jurisdiction) Bachelor's degree or 4 years WC claims experience Thorough knowledge of rules, regulations, statutes and procedures pertaining to workers' compensation claims.
Knowledge of medical terminology involved in complex claims Strong negotiation skills. Skills and Abilities: Demonstrates -relationship building and communication skills, both written and verbal. Highly self-motivated, goal oriented, and works well under pressure. Customer focused solid understanding of WC legal procedures, processes, practices and standards in the handling of complex claims Ability to identify problems and effectuate solutions Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail Able to apply critical thinking when solving problems and making decisions.
#LI-SM1 #LI-Hybrid Retail Business Services currently provides services to five omnichannel grocery brands, including Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Retail Business Services leverages the scale of the local brands to drive synergies and provide industry-leading expertise, insights and analytics to local brands to support their strategies.
We are committed to diversity, equity and inclusion and we foster a community of belonging where everyone is valued. Retail Business Services is an equal opportunity employer. We comply with all applicable federal, state and local laws. Qualified applicants are considered without regard to interaction, race, color, ancestry, national origin, citizenship status, religion, age, marital status (including civil unions), military service, veteran status, pregnancy (including childbirth and related medical conditions), genetic information, interactionual orientation, gender identity, legally recognized disability, domestic violence victim status or any other characteristic protected by law.
We provide reasonable accommodations to applicants and employees with disabilities. As important as what we do is how we do it. Our team embodies our values of Courage, Care, Teamwork, Integrity and Humor in everything that they do. We have a culture of care that values and celebrates the qualities and perspectives that make us all unique. If you have a disability and require assistance in the application process, please contact our Talent Acquisition Department at xyz X@. For more information, visit . Job Requisition: 355603_external_USA-MA-Quincy_1292023
is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About Anders Group WHY ANDERS? Anders Group is a Joint Commission accredited staffing agency and stands out from other agencies by our commitment to making sure our travelers are given the best customer service.
Our team works hard to find the best jobs with the most aggressive rates! Anders Group offers rewarding assignments and competitive compensation packages, nationwide! We offer the following benefits from day one: Health Insurance, Including a Buy-up Option Dental Insurance Vision Insurance Life Insurance 401(k) Licensure Reimbursement Premium Pay Packages CEU
Reimbursements Daily Per Diems Travel Reimbursements Rental Car Allowances Continuing Education Resources Referral Bonus And Many More! THE ANDERS DIFFERENCE You're committed to providing exceptional healthcare.
We're committed to you. Anders Group was founded by a team of healthcare recruiters who had built strong relationships with healthcare facilities and professionals nationwide. As staffing firms shifted their focus to numbers and margins, these recruiters saw a need for a company to take a different approach to staffing. Anders Group was founded in 2010 to do just that. We focus on individual and facility goals to make quality placements. Great people working with great facilities
make for the best placements. Through our focus on providing the best experience to Allied and Nursing health care professionals, Anders Group has grown to be a top staffing firm in Healthcare.
We look forward to working with you! Benefits Medical benefits Dental benefits Vision benefits Life insurance 401k retirement plan License and certification reimbursement Continuing Education Referral bonus For more details: jobs-search. org/technology_weymouth-c434648/job_i1971736181
bonus 401k retirement plan Medical benefits Dental benefits Vision benefits Referral bonus Voca Job ID #13954676. Pay package is based on 12 hour shifts and 36.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined.
Posted job title: Allied Health Professional: CT Technologist,07:00:00-19:00:00 About Voca As a Voca Traveler, you will gain new clinical skills, visit amazing places and meet awesome healthcare professionals. As a travel health professional, your experience and dedication to patient care is in high demand throughout the United States. Whether you are a veteran traveler looking for your next opportunity, or you are looking to travel for the
first time, Voca is here to support you. Voca’s experienced and dedicated travel team works in concert with you every step of the way. Our long-standing partnerships with some of the most respected and recognized healthcare organizations in the country allow us to identify career opportunities to help you increase your knowledge and experience while working with some of the best physicians and healthcare professionals in the world.
At Voca, we strongly believe a better career results in a happier you. We are here to help you find a position that is professionally and personally rewarding. Benefits Holiday Pay 401k retirement plan Referral bonus Medical benefits Dental benefits Vision benefits Retention bonus Weekly pay For more details: jobs-search. org/technology_weymouth-c434648/job_i1971664809
is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About Uniti Med Uniti Med meticulously matches your talents to our open needs to ensure the ultimate travel experience. Tell us where you want to go and let our experienced staff lead the way!
Benefits Referral bonus Employee assistance programs For more details: jobs-search. org/technology_weymouth-c434648/job_i1971659568
claim processing system. The work includes, but is not limited to, creating project documents, including business and technical design document, preforming updates to system configuration list as a part of both new and maintenance projects. This position will also review data files to ensure accuracy and correct processing, preform system testing, and completing analytics.
Responsibilities ESSENTIAL FUNCTIONS: • Work with business sponsors, stakeholders, technical team and vendor staff on the design and execution of system changes and updates, including but not limited to the creation of design documents, tracking of development progress, execution of testing and post release monitoring.
• Identify, develop, and establish key performance metrics to ensure successful data exchanges within the shop solution, as well as data exchanges with external sources• Work with both internal and external data submitters to process and correct any problems within their data and establish timelines for subsequent files.
• Be a subject matter expert within the system and be a point person for the creative solutioning of business and operational needs. • Ensure ongoing accuracy of systems documentation. • Develop and execute test plans and test cases that comprehensively test software changes as needed. • Manage the data exchanges between POPS and other organizations including but not
limited to EOHHS, UMASS, Managed Care Entities, and various contracted entities to ensure quality and completeness.
• Establish and maintain communications between the various entities that comprise the shop program and within EOHHS as directed, including but not limited to the POPS Vendor, UMMS IT, EOHHS, and Managed Care Entities. • Creation and monitoring of operational schedules• Perform file maintenance of business parameters• Alert leadership of operational issues, and resolution recommendations• Be able to work independently to solve problems and present finding to other subject matter experts. • Ability to work within a highly matrixed multi-stakeholder environment.
• Prepare responses and perform work related to Federal and State audits of Mass Health. • Participate in annual POPS Disaster Recovery exercises. • Preform analytics within the claims processing system and other systems as required using a variety of analytics tools such as Business Objects, Excel and Cognos. • Performs other related duties as assigned. Qualifications REQUIRED QUALIFICATIONS: • Bachelor’s degree. • 2 years of related experience. • Excellent oral and written communication skills. • Demonstrated ability to work in complex environment. • Demonstrated strong problem-solving skills with an ability to take ownership of tasks.
• Demonstrated innovation, flexibility, and creativity. • Ability to travel to off-site locations. PREFERRED QUALIFICATIONS: • Experience working on IT projects, including in a claim adjudication environment. • Experience with medial claim processing. • Experience with process flow and process flow documentation. • Experience within the healthcare system, ideally shop experience. • Demonstrated understanding of data warehousing and data reconciliation. • Experience working with federal and state agencies preferred. Additional Information#LI-VG1 For more details: jobs-search.
org/technology_quincy-c434660/shop-claims-analyst-hybrid-quincy-ma-quincy_i1971242111
