The PACE Claims Examiner/Data Specialist is responsible for processing professional and hospital capitated full risk claims in accordance with the individual provider contract and Medicare and Medi-Cal billing guidelines and processes claims. ...
Responsibilities include determining benefits due; ensuring management of claims within internal claims management guidelines and in compliance with applicable laws; and identifying opportunities for, managing subrogation of claims, and negotiating settlements. The Workers Compensation Risk Analyst ...
Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client. To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service req...
Understand and can work claims for all major crops, policy/plan types, in all stages of growth. Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions, or trials as necessary. Ensures that claims handling is conducted in compliance with applicable statues, ...
The Claims Examiner I is in daily contact with team members, clients and providers. This position reports to the Claims Supervisor. Processes claims accurately, efficiently and within quality/quantity requirements. Has the ability to access research tools for accurate claims entry. ...
As the hub of all claims, the coordinator is responsible for speaking with the customer, ongoing customer follow up, handling service complaints, logistics of dispatching field personnel to jobs while ensures that the required Cycle Time and insurance Service Level Agreement tasks deadlines are met....
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
To analyze high-level Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Workers Compensation Claims Examiner | Long Beach...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
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...
Claims Service Representative 1 - Early Response. When you join the Auto Club as a Claims Representative, you’re bringing your expertise to a best-in-class organization that is focused on delivering quality service to our members. As a representative within our Claims department you will:. Assess cl...
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. ...
Provides prompt claim investigation, evaluation and settlement or denial of claims with minor to severe exposures. Provides empathy and understanding and explains policy coverages and claims processes to customers. Responsible for handling claims having moderately complex negligence, compensability,...
Claims Service Representative 1 - Early Response - WeekendWhat’s in it for me?. When you join the Auto Club as a Claims Representative, you’re bringing your expertise to a best-in-class organization that is focused on delivering quality service to our members. As a representative within our Claims d...
Property & Casualty (P&C) Claims Adjuster. Handle General Liability / Bodily Injury, Property, Commercial Auto Liability and/or Physical Damage, Workers Compensation, Inland Marine, Professional / Management Liability, Business Interruption, Liquor Liability, Garage/Garagekeepers Legal Liabi...
Claims Service Representative I - Early Response. When you join the Auto Club as a Claims Representative, you’re bringing your expertise to a best-in-class organization that is focused on delivering quality service to our members. As a representative within our Claims department you will:. Assess cl...
A Manager within our Disputes, Claims & Investigations group is expected to have assignments in a variety of industries. ...
Responsible for auditing and training claims staff on all Managed Care claims received from outside providers to ensure the Claims Examiners processed and adjudicated them accurately and consistently in accordance with outside Provider Contracts, State, Federal, CMS, DMHC and Health Plan contracts, ...
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...
Property & Casualty (P&C) Claims Adjuster. Handle General Liability / Bodily Injury, Property, Commercial Auto Liability and/or Physical Damage, Workers Compensation, Inland Marine, Professional / Management Liability, Business Interruption, Liquor Liability, Garage/Garagekeepers Legal Liabi...
Administer indemnity claims and handle complex claim issues. Use strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation. Accept or deny delayed claims within 90 days. Complete instruction sheets for Assis...
This position provides technical advice and guidance to claims associates on conditional demands in various states, and recommends changes in claims handling practices based on legislative action or court decisions and trends in the insurance industry. Coordinates with various claims units to provid...
Providence is seeking an Epic Applications Analyst – AP Claims, who will:. ...