The Medical Claims Examiner will ensure all claims received comply with all health plan, regulatory, contractual, compliance, and Alivi billing guidelines and processes. This position is intended to provide billing and claims management support to Alivi Specialty Networks and Business Process Outsou...
A company is looking for a Claims Examiner Level 1. ...
Our client is seeking to add a Senior Workers' Compensation Claims Examiner to their California operations. This role will consist of handling moderate to complex Workers’ Compensation Lost Time claims throughout the state of California from inception to close. Handle mid to complex Workers' Compens...
Key Responsibilities:Review claim submissions for completeness and accuracyCommunicate with TPAs and other parties regarding claimsDevelop and enhance claim procedures for Employer Stop Loss businessRequired Qualifications:3-4 years of claims experience (ESL claims experience a plus)College degree o...
Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices. Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits. Technical claims in...
Property Claims – Desk Adjuster. Investigate, measure, and adjust homeowner property insurance claims, in-office, at Stillwater’s Jacksonville, Florida headquarters. Determine claim values based upon claims handling experience, acquired documentation, legal liability, causation, jurisdictional matte...
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...
Our Client, a leading Personal Auto Insurance Company, is seeking to add (2) detail-oriented and knowledgeable PIP Claims Examiners to join their growing Florida team. This person will be responsible for handling moderate to complex personal injury protection (PIP) claims within the state of Florida...
Process claims via our phone and portal systems using Web Warranty/Web Claims program. Review claims for approvals, distribution of authorizations or sending of denial letters. Adjudicate, investigate and/or deny claims by verifying submitted information, coverage issued, and other pertinent informa...
Proactively communicate and set accurate claims expectations with customers throughout the Claims process while providing high quality customer service. Research, analyze, and interpret policy language and state law as it applies to submitted claims. Negotiate and settle claims in accordance with Sl...
Workers Compensation Claims Examiner - Insurance Agency - Base Salary to 75k/year - West Palm Beach, FL. Our client, a close-knit, family-owned agency who specializes in structuring insurance programs for non-profits, has an immediate need for a Workers Comp Claims Examiner to join their team. Revie...
Responsible for working closely with the Claims Supervisor and Manager of Claims Operations to ensure that claims received are adjudicated in a timely manner and accurately. Diligently reviewing all system-generated edits which have been applied to claims in the Examiner’s assigned queues prior to r...
Position Summary:The Senior Liability Claims Examiner provides prompt, courteous and fair claim service on homeowners and commercial general liability property damage, bodily injury, personal injury and medical payments claims from initial claim set up through claim resolution, including litigation....
The Auto Claims Examiner position will be responsible primarily for the adjustment of third-party bodily injury and significant property damage claims arising from general liability and auto liability coverages. The company and its predecessor companies have been providing underwriting, claims, risk...
Commercial Auto, BI, Liability Claims Examiner III. Working closely with the Claims Supervisor, manages all aspects of automobile, general liability, and first-party property claims, handling from inception to conclusion within established authority and guidelines. This position requires considerabl...
Job Summary The Commercial Claims Examiner position handles commercial property insurance claims on insured risks located in various states including but not limited to FL, LA, TX, MS, AL. Responsibilities Investigate and evaluate coverage, liability, and damages on assigned claims Determine appropr...
Property Claims - Desk Examiner. Property Claims - Desk Adjuster. Investigate, measure, and adjust homeowner property insurance claims, in-office, at Stillwater's Jacksonville, Florida headquarters. Determine claim values based upon claims handling experience, acquired documentation, legal liability...
Limits are larger than those allowed for Claims Examiner I and Claims Examiner II. Workers' Compensation Claims Examiner III. This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; ther...
Commercial Auto and General Liability Claims Examiner - Insurance Agency - Base Salary to 75k/year - West Palm Beach, FL. Our client, a close-knit, family-owned agency who specializes in structuring insurance programs for non-profits, has an immediate need for a Commercial Auto and General Liability...
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...
Proactively communicate and set accurate claims expectations with customers throughout the Claims process while providing high quality customer service. Research, analyze, and interpret policy language and state law as it applies to submitted claims. Negotiate and settle claims in accordance with Sl...
To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages. Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are proper...
Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria. Minimum of one-year experience working closely with health claims or in a claims processing/adjudication environment; required. Authorize claim ...
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...