A company is looking for a Technical Claims Specialist in Worker's Compensation. Key Responsibilities:Provide technical oversight to high-risk and complex workers compensation claimsServe as the primary point of contact for critical national initiatives and manage complex projectsDevelop WC guidelin...
Amtrust Financial Services, a fast growing commercial insurance company, is seeking a Construction Defect Commercial Claims Specialist II. This position can be located in one of our claims offices, with the possibility of working remotely. The successful candidate will directly handle Construction r...
SGA), is searching for a Claims Review Specialist for a Contract assignment with one of our premier Healthcare clients in Los Angeles, CA. ...
A company is looking for an Insurance Claims Specialist PB. 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 eq...
Chubb is currently seeking a Workers' Compensation Senior Claims Specialist for our West Region. Partner with underwriting, claims business consultants, and claims teams to enhance and manage marketing initiatives and customer service commitments. The successful applicant will be managing moderate-t...
Ensure that claims are being processed as expeditiously as possible, and that all inventories are regularly reviewed, and all possible actions are taken to move the claims to closure. Third-Party Claims Administrator (TPA). Audit a representative sampling of each TPA and program's claims at least on...
Reviews and authorizes payment and final disposition of claims requiring adjustment and claims benefit determination for reinsurance qualification. Responsible for processing medical claims. Resolves complex, difficult or non-routine claims requiring special handling in accordance with established p...
Are you looking for an opportunity to join a claims team with a fast-growing company that has consistently outpaced the industry in year-over-year growth? Liberty Mutual offers an exciting opportunity for a Technical Claims Specialist II within our Complex Workers' Compensation division. You have de...
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...
The Claims Training Specialist is primarily responsible for designing and conducting training programs using established departmental guidelines. This position is responsible for providing ongoing training on the core processing system, claims processing procedures, communicating regulatory changes ...
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...
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 ...
Analyze hospital billing claims within the EHR and claim scrubber system. Understanding of Medicare/Medi-Cal claims processing guidelines. ...
The client is seeking a highly motivated an experienced TEMP - Claims Resolution Specialist (Customer Service) to join our team. The Claims Resolution Specialist will be the first line of contact for the client’s providers. The incumbent will assist providers with questions related to the payment of...
Chubb is currently seeking a Workers’ Compensation Senior Claims Specialist for our West Region. Partner with underwriting, claims business consultants, and claims teams to enhance and manage marketing initiatives and customer service commitments. The successful applicant will be managing moderate-t...
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...
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...
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...
The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. Assesses policy coverage for submitted claims and notifies the insured of any issues; determine...
Managing assigned claims across multiple jurisdictions, as well as setting the case strategy for these claims in partnership with Regional Practice Leaders and Claims management. Loss Claims Specialist - Excess Casualty. Our experienced Claims professionals use their specialized expertise to handle ...
Experience in handling conditional demands, preferably including bodily injury claims, on behalf of an insurer as an attorney, technical specialist, claims manager or similar role sufficient in one more of the following states to develop a high degree of technical expertise: CA, FL, TX, GA, or SC. O...
As a Construction Defect Large Loss Claims Specialist, you will be responsible for handling and resolving complex, highly specialized, and high exposure Primary and Excess Construction Defect claims, through investigation, evaluation and disposition. Large Loss Claims Specialist - Construction. At A...
Reviews and authorizes payment and final disposition of claims requiring adjustment and claims benefit determination for reinsurance qualification. Responsible for processing medical claims. Resolves complex, difficult or non-routine claims requiring special handling in accordance with established p...