CAP seeks a Claims Specialist (II or III/Senior), for its San Diego office, to perform technical and administrative duties to manage assigned claim files; assumes increased workload of highly complex claims. Manage medical malpractice claims, including the assignment, direction, and control of defen...
We are currently seeking an entry-level Claims Loss Reporting Specialist to support our auto claims operations. Claims Loss Reporting Specialist. Explain and evaluate benefits, coverages, and claims process involving glass claims. It's an ideal entry point for individuals without prior claims experi...
Senior Claims Specialist - Casualty Claims. As a Toronto-based Claims Specialist- Casualty, you will play a critical role in AXA XL's claims for the Casualty team. Our experienced Claims professionals use their specialized expertise to handle even the most complex claims seamlessly. Consulting with ...
In addition to ensuring essential administrative functions run smoothly, you may also interact with customers and medical providers by phone or in person when applicable.High School diploma/GED equivalent or higher and a minimum of one year of administrative or clerical support experience .OR} one y...
Manages an inventory of moderate to high complexity and exposure Healthcare 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...
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. Calculate benefit payments and approve payment of Claims ...
The Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; documenting activities; conveying information regarding claims and/or benefits; and providing testimony in be...
Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims. Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized courses of study (Associate in Claim designation, etc). Makes decis...
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...
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. Vice-Versa the adjuster can commun...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...
Under limited supervision, effectively evaluate and manage high exposure Workers Compensation claims including catastrophic loss, specified serious injury and other complex claims. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or mult...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...
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...
DaVita is currently looking for a Patient Account Specialist. Identify trends and perform root cause analysis on unpaid and underpaid claims. ...
Claims Resolutions Specialist Job Description . The Claims Resolution Specialist will be the first line of contact for health providers. The incumbent will assist providers with questions related to the payment of claims and resolution of claims payment issues. Responds and researches issues on prov...
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...
A Managerr within our Disputes, Claims & Investigations group is expected to have assignments in a variety of industries. We believe in timely and proactive performance excellence, ongoing 360 feedback, clear performance expectations at each level, and quarterly check-ins with your manager ensure yo...
The Workers Compensation Claims Manager is responsible to supervise activities within the worker compensation lost time claims department. Workers Compensation Lien Manager, Claims. AmTrust Financial Services, a fast growing commercial insurance company, has an immediate need for a Workers' Compensa...
The Workers’ Compensation Claims Adjuster must be knowledgeable of the California Labor Code and administration of claims. The Claims Adjuster is responsible for the prompt and efficient examination and investigation of claims. It is the responsibility of a Workers' Compensation Claims Adjuster to r...
The main function of a call center/customer service specialist is to interact with customers to provide information in response to inquiries about products and services and to handle and resolve complaints. Role: Customer Service Representative. A typical customer service specialist is responsible f...
As a Supervisor, you'll lead a team of 7, including 5 Claims Adjusters and 2 Claims Assistants, providing guidance, mentorship, and performance feedback to ensure exceptional claim handling and adherence to company standards and regulations. Workers' Compensation Claims Supervisor - Lead a Dynamic T...
Claims assistant, Insurance claims. Will assist in setting up claims, requesting checks, sending out letters based on direction given, follow up on in status of pending matters, as needed and designated by the staff. ...
Summary: The main function of a Workers' Compensation Claims Adjuster is to investigate, analyze, and determine the extent of insurance company's responsibility for lost wages, medical benefits, and permanent impairment. Workers Compensation handling California Claims. ...
As the Customer Relations Account Specialist, this role is responsible for delivering excellence in service and contributing to the mission of protecting businesses, people, and time. Enter high volumes of data into the various systems timely and accurately for billing purposes. Adjust and handle bi...