A company is looking for a Claims Data Reporting Specialist. ...
The ESIS Senior Work Comp Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines. Informs claimants, insureds/customers or attorney of denial of claim when applicable. Authoritative tec...
Key Responsibilities:Submit accurate and timely claims to third party payersResolve claim edits and account errors prior to claim submissionContact third party payers to resolve unpaid claimsRequired Qualifications:High School diploma or equivalentOne year of medical billing/medical office experienc...
Responsible for timely, ethical, and effective handling of all assigned general liability, property, and auto claims. Investigate all claims by gathering and preserving pertinent information needed to accurately assess liability. Document all discussions, correspondence, reports and decisions that o...
A company is looking for a Claims Resolution Specialist (Claims Adjuster). Key Responsibilities:Investigate, evaluate, settle, and process claims primarily over the phone with limited in-person contactHandle various types of claims including injury, property damage, automobile physical damage, and l...
Manages, investigates and resolves assigned high severity Property Loss claims under limited supervision. May assist Customer Claims Representatives with in-person inspection/policyholder contact where necessary. Investigates, determines coverage of loss and adjusts all elements of Property Loss cla...
Casualty Claims team in Orange, CA or Walnut Creek, CA as a. This individual will handle complex general liability and excess liability and umbrella claims of all varieties. Developing and executing claim strategies as well as resolution strategies. Working with underwriters to support policy constr...
The Senior Claims Specialist will report directly to the Director of Risk Management. Ensure the timely logging of all new claims (delegate to Claims Assistant if necessary) and timely reporting to our Insurance Carrier, with guidance by the Dir of Risk Management. Review and approve the status of a...
Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company ...
Manage the claims internal audit functions, which includes audit process for adjudicated claims and encounters. Develop policies and procedures for periodic claims audits and ensure compliance with affiliated health plans, client groups, and administrative contractual agreements. Designs, plans, dir...
Our Claims Legal Specialist will act as an expert on requirements to properly resolve matters when Sentry is faced with a conditional demand from counsel for a claimant. Experience in handling conditional demands, preferably including bodily injury claims, on behalf of an insurer as an attorney, tec...
Manages, investigates and resolves assigned high severity Property Loss claims under limited supervision. May assist Customer Claims Representatives with in-person inspection/policyholder contact where necessary. Investigates, determines coverage of loss and adjusts all elements of Property Loss cla...
Manages, investigates and resolves assigned high severity Property Loss claims under limited supervision. May assist Customer Claims Representatives with in-person inspection/policyholder contact where necessary. Investigates, determines coverage of loss and adjusts all elements of Property Loss cla...
The Property Claims Field Adjuster ll will learn apply knowledge of current Company policies, applicable regulatory standards, and procedures to investigate, evaluate and settle moderate Homeowner's property claims in a timely and efficient manner as to prevent unnecessary expense to the Company and...
Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized courses of study (Associate in Claim designation, etc). Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims. Works close...
Communicating with claimants, employers and various medical professionals through phone and e-mail to gather necessary claim information, managing the claim process from the initial request to the return to work. Collaborating with fellow case managers, nurse case managers, and consulting physicians...
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. Authorizes and ensures claim disbursemen...
Our Claims Legal Specialist will act as an expert on requirements to properly resolve matters when Sentry is faced with a conditional demand from counsel for a claimant. Experience in handling conditional demands, preferably including bodily injury claims, on behalf of an insurer as an attorney, tec...
The Claims Resolution Specialist will be the first line of contact for Health providers and will assist providers with questions related to the payment of claims and resolution of claims payment issues. Seeking a highly motivated an experienced - Claims Resolution Specialist (Customer Service) to jo...
Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company p...
Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or *** Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and compa...
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. Conducts focused investigation to determ...
CVS Health is currently looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department. They will work closely with other members of the Commercial Services Operations team providing root ...
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. Conducts focused investigation to determ...
Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Zenith is a team of Workers’ Compensation Specialists com...