Software Engineering - Fraud disputes and claims. We are looking for a Director software Engineering to lead our modernization journey of Fraud disputes and claims processing. ...
Pharmacy Claims Analyst- Hybrid (Quincy, MA). Under the direction of the Director of Pharmacy Technology and Informatics or designee, the Pharmacy Business System will drive operational excellence within the team by ensuring the accurate processing of pharmacy claims within a real time system. Prefo...
Software Engineering - Fraud disputes and claims. We are looking for a Director software Engineering to lead our modernization journey of Fraud disputes and claims processing. ...
Prepare file within Compulink for electronic claims; provide Claims Coordinator with rejected claims for rebilling. This position is responsible for discussing outstanding balances with patients, identifying accounts for collection, processing refunds, reviewing claims, and preparing files for elect...
Under the direction of the Director of Pharmacy Technology and Informatics or designee, the Pharmacy Business System will drive operational excellence within the team by ensuring the accurate processing of pharmacy claims within a real time system. Preform analytics within the claims processing syst...
Prepare file within Compulink for electronic claims; provide Claims Coordinator with rejected claims for rebilling. This position is responsible for discussing outstanding balances with patients, identifying accounts for collection, processing refunds, reviewing claims, and preparing files for elect...
This Claims Team Manager will lead a team of Claims Specialists who manage a portfolio of Commercial Auto and General Liability claims to achieve the best possible outcomes and deliver an exceptional customer experience. Supervises the day-to-day operations for the claims staff by establishing prior...
Investigate, evaluate, and dispose of moderately complex insurance and/or reinsurance claims in keeping with sound claim practices and company procedures. Analyzes claims of a basic to intermediate nature and makes payment determination. Confirms that claims fall within the terms of the policy, trea...
The Claims team is currently seeking an experienced Auto Adjuster to join in their Worcester MA - Richmond, VA - Itasca, IL or Howell, MI office location. Responsible for the investigation, negotiation, and resolution of claims in accordance with policy provisions, business expectations, and jurisdi...
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?. INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!. Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry ...
Reviews incoming documentation and new claims notifications of a complex nature or for large and/or complex clients, informs all relevant parties of any potential problems or contentious claims, and refers to Claims Advocates as needed. Liaises with clients, and third parties as necessary such as at...
Come join our amazing team and work remote from home!The Sr Claims Recovery & Analysis Analyst is responsible for performing financial reconciliation on all liquidated loans. Take on department projects from start to completion that falls within the scope of the Claims Recovery & Analysis Department...
The Claims Team Lead researches and resolves disputes (contracts, corrected claims, filing limits, authorization and payer policy for providers, members and internal customers; coaches and mentors claims resolution coordinators, manages and distributes work as designated, and assists with centralize...
Client is looking for System / Claims Analyst with encounter processing background (heavy claims processing experience) Job Description:Responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. Good working knowledge of claims and products,...
Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Establishes and maintains working relati...
You will work in a fast -paced environment across multiple products, ensuring claims handling follows policy provisions, internal guidelines, and Compliance requirements and will be responsible for the processing and payment of long-term care claims. Long Term Care Claims Representative – Payment Se...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
Under limited supervision, investigate and resolve first and third party material damage, PIP, and BI claims which may involve coverage, liability, damage and legal issues. Inputs and retrieves information using the automated claims system, requests checks, form letters and other . Will assist in th...
Analyzes claims of a basic to intermediate nature and makes payment determination. Confirms that claims fall within the terms of the policy, treaty, or facultative certificate under which they are being submitted, and that appropriate back-up documentation has been provided. Analyzes the nature of a...
Document information related to the claim and make decisions consistent with claims standards and local laws. Evaluate and handle claim payments and resolution of claims without payments. ...
The Senior Claims Representative handles complex and mid-to-high exposure bodily injury and property damage claims under Ryder's self-administered liability program. This position investigates and adjusts claims, as well as directs defense counsel, independent adjusters, experts, and other vendors i...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
Claims Auditor performs accurate and timely reviews of medical claims for internal audits. Claims Auditor reviews detailed medical claims data, medical records, reference materials, provider contracts, medical policies, and payment policies. Claims Auditor utilizes CPT and ICD-10 coding to review ph...
Candidates should possess a minimum of 7-10 years of relevant claims experience and be adept at communicating expertise effectively, adding immediate value to the E&S claims department. Serve as a leader and mentor to the claims team offering technical guidance regarding adjustment of claims while p...
Supervises a team of liability adjusters who handles complex litigated liability claims arising from commercial and personal liability policies throughout the United States to ensure claims efficiency. Claims Supervisor-Commercial General Liability. Appropriately identify significant claims to the m...