A company is looking for a Virtual Property Claims Specialist. ...
CCMSI is growing and we are seeking an experienced Workers' Compensation Claim Specialist to join our team in a fully remote capacity, dedicated to managing claims for a single client within the California jurisdiction. Authorize and make payments of claims in accordance with claim procedures utiliz...
A company is looking for a Customer Operations (Auto Claims) Specialist. ...
Casualty Claims team in Orange, CA or Walnut Creek, CA as a. This individual will handle complex general liability and excess liability and umbrella claims of all varieties. Developing and executing claim strategies as well as resolution strategies. Working with underwriters to support policy constr...
A company is looking for a Claims Resolution Specialist I- Remote. ...
The ESIS Senior Work Comp Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines. Informs claimants, insureds/customers or attorney of denial of claim when applicable. Authoritative tec...
Responsible for timely, ethical, and effective handling of all assigned general liability, property, and auto claims. Investigate all claims by gathering and preserving pertinent information needed to accurately assess liability. Document all discussions, correspondence, reports and decisions that o...
Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company ...
Our Claims Legal Specialist will act as an expert on requirements to properly resolve matters when Sentry is faced with a conditional demand from counsel for a claimant. Experience in handling conditional demands, preferably including bodily injury claims, on behalf of an insurer as an attorney, tec...
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 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...
CVS Health is currently looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department. They will work closely with other members of the Commercial Services Operations team providing root ...
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...
Manages, investigates and resolves assigned high severity Property Loss claims under limited supervision. May assist Customer Claims Representatives with in-person inspection/policyholder contact where necessary. Investigates, determines coverage of loss and adjusts all elements of Property Loss cla...
Our Claims Legal Specialist will act as an expert on requirements to properly resolve matters when Sentry is faced with a conditional demand from counsel for a claimant. Experience in handling conditional demands, preferably including bodily injury claims, on behalf of an insurer as an attorney, tec...
Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or *** Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and compa...
Manages, investigates and resolves assigned high severity Property Loss claims under limited supervision. May assist Customer Claims Representatives with in-person inspection/policyholder contact where necessary. Investigates, determines coverage of loss and adjusts all elements of Property Loss cla...
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...
Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and/or health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company p...
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...
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...
We are seeking a dedicated and detail-oriented Medical Claims Specialist to join our team. The ideal candidate will be responsible for managing the claim follow-up process to ensure accuracy, efficiency, and compliance with healthcare regulations. Accurately review and respond to payment rejections ...
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...
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...
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...