The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlem...
Patient Account Representative.Timely and accurately resolves credit balances.Process internal and external refund requests.Identify trends and escalate where appropriate.Maintain accurate, clear, concise and complete account notes and other relevant information.Respond to requests for information a...
A company is looking for a Third Party Liability (TPL) Claims Specialist. ...
The Senior Technical Claims Specialist determines coverage, investigates complex and highly complex commercial casualty claims, determines liability, sets and adjusts reserves, evaluates the claim, negotiates a settlement, authorizes and resolves the claim. As the claim's owner, determines coverage,...
A company is looking for a Claims Recovery Specialist. ...
With minimal supervision, handles a book of specialty lines claims, throughout the entire claim's life cycle. Responsible for conducting investigations, recommending adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed auth...
A company is looking for a Claims Specialist - TEMPKey Responsibilities:Receives and confirms policy coverage for claimsDetermines validity and compensability of claimsManages non-complex workers' compensation claims under supervisionRequired Qualifications:Bachelor's degree or equivalent experience...
Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accidental and weather-related claims for homeowners, commercial properties, and large losses. Minimum of 5 years experience as a Property Field Inspection Claim Specialist in the insurance industry...
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...
If you enjoy working in a fast-paced, team-oriented environment from the comfort of your own home, please read on!Learn more about a Day in the Life () of a Claims Specialist at Lincoln Financial Group!What you'll be doingCommunicating with claimants, employers and various medical professionals thro...
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...
Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company policies...
As a Claims Service Specialist, you will collect facts about the accident, investigate claim details, and collect statements from involved parties. Claims Service Specialist – San Diego, CA. Many associates see a base salary increase of 10% within their first year as a Claims Specialist. Claim your ...
Working under minimal supervision, the Member Experience Specialist – Claims contributes to Wawanesa’s goal of delivering an exceptional and consistent claims service experience by enhancing relationships with members through tracking and trending feedback utilizing various data sources. Works colla...
Team Lead - Medicare Specialist. ...
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...
As a Claims Service Specialist, you will collect facts about the accident, investigate claim details, and collect statements from involved parties. Claims Service Specialist - San Diego, CA. Many associates see a base salary increase of 10% within their first year as a Claims Specialist. Claim your ...
Key Responsibilities: Conduct on-site inspections and assessments of property damages for both residential and commercial claims Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently May occasionally require interacting with...
Under moderate supervision performs administrative duties of moderate technical complexity in support of the Claims function. Incumbent must achieve a quality claim product on an ongoing basis by consistently applying best practices within expected timeframes completing the following tasks. Manage a...
Responsible for providing customer service and supporting the insured and broker with commercial property claims. Communicates with vendors, producers, policy holders, clients and insurance companies to communicate claim status;. Reports to authorities as applicable, providing updates on litigated c...
Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accidental and weather-related claims for homeowners, commercial properties, and large losses. Minimum of 5 years of experience as a Property Field Inspection Claim Specialist in the insurance indus...
Our client is seeking an experienced Commercial Auto and General Liability Claims Adjuster with litigation experience to join their California Claims division. Commercial Auto and General Liability Claims Adjuster, you will be managing complex claims involving commercial auto and general liability, ...
Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized courses of study (Associate in Claim designation, etc). Works closely with claimants, witnesses and members of the medical profession and other persons pertinent to the investiga...
CLAIM OPERATIONAL SERVICE AND PARTNERSHIPS: Partners with claim professionals in multiple departments to assist with the timely resolution of claims, which may include: Properly documents claim files, including notes and diaries, Requests reports and records, and reviews medical bills, mail and wage...
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...