A company is looking for a Medical Claims Specialist.Key Responsibilities : Process claims and adjustments related to projects or provider disputesResearch and resolve complex claims issues and collaborate with other departmentsAct as a subject matter expert on departmental and corporate projectsRequired Qualifications : High school diploma or equivalent5+ years of experience in claims processing commercial and Medicare claims3+ years of experience in researching and resolving operational issuesEZ-CAP software experience is highly preferredPrevious visibility into Medicare and Medicare Advantage programs is highly preferred
Claims Specialist
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic indemnity claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel...
State Licensed Technical Claims Specialist
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...
Virtual Open House - Associate Claims Specialist (Workers' Compensation)
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...
Auto Claims Billing Specialist
A company is looking for a Customer Operations (Auto Claims) Specialist. ...
Complex Technical Claims Specialist II - Workers Compensation
Has developed high level knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Identifies and appropriat...
Claims Clinical Specialist - Virginia Licensed Nurse
A company is looking for a Claims Clinical Specialist - Medical Review Team. ...
Group Claims Specialist - West Coast (MST/PST)
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 ...
Claims Specialist
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic indemnity claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel...
Claims Specialist
The Claims Specialist assures that this mission is the foundation for the delivery of services and carrying out job duties. POSITION SUMMARY We are seeking a meticulous and detail-oriented Claims Specialist to join our dynamic team. This role is vital in ensuring the accuracy and timeliness of proce...
Complex Technical Claims Specialist II - Workers Compensation
Has developed high level knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Identifies and appropriat...