Perform Medicare claims processing, claims reviews, and the adjudication of provider claims to administer and monitor contracts with Medicare contractors. Review and provide analysis for claims/transactions processing activities, claims reviews, and program claims related processing systems used to ...
As a Commercial/Specialty Casualty Adjuster, you will be responsible to resolve all aspects of 1st and 3rd party injury claims of low to moderate complexity for personal lines as well as our commercial claims. Handle 1st party exposures to include Medical Payment coverage, PIP, Uninsured Motorists, ...
Manages disposition of claims and issues appropriate payments on all assigned claims. Berkley Financial Specialists, a member of. Management Liability/Fidelity Claim Specialist. Investigates all assigned claims and analyses coverage applicability/limitations. ...
As a Health Insurance Specialist (Claims Processing & Systems), GS-0107-13, you will perform claims processing and systems work related to national health insurance programs, such as Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and private health insurance. Perform Medicare cl...
Claims Clinical Specialist – Medical Review Team. The Claims Clinical Specialist role is an excellent opportunity for a Registered Nurse seeking a career change. You will be responsible for working within a structured environment with established Standard Operating Procedures to ensure consistency o...
A recognized healthcare organization in Maryland is currently seeking a new Medical Economics Specialist to join their team in a Remote capacity. Collaborating with a group of Healthcare Economics professionals, the Medical Economics Specialist will be responsible for supporting the organization’s g...
The Medical Economics Specialist will:. Experience with analysis of Healthcare Claims data. Background in Managed Care / Health Plan claims. ...
The Claims Specialist will assure that services are promptly and accurately processed in accordance with all applicable Federal, State, and local regulations and guidelines, that claims are adjudicated in a timely manner, and customer’s needs are met in a professional and courteous manner. Pos...
As a National Catastrophe (NATCAT) Field Claims Specialist primarily supporting our Personal Lines (PL) business, you'll investigate and resolve personal lines property damage claims on the phone and/or in person. Maintains and develops current knowledge of assigned insurance lines, court decisions ...
Responsible for Billing and Coding, Pre Certification and Credentialing. Has knowledge of commonly-used concepts, practices, and procedures within the Medical Billing and Medical Insurance field. Maintain open communication with the insurance verification team, billing department and office support ...
The Senior Principal Product Manager represents the perspective of the customer focusing on operational efficiency, standard operating procedure, RCM and Claims best practices, change management, and end-user experiences. The Senior Principal Product Manager supports the development of product strat...
Claims Adjuster page is loaded **Claims Adjuster**. PRIMARY PURPOSE:** To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and nego...
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?. INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!. Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry ...
Maxim Healthcare Corporate Services' is currently seeking an Open Credit Specialist that will research payment credits and takes appropriate actions based on type or status. ...
To analyze and process low to mid-level auto and transportation claims. Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Performs coverage, liability, and damage ana...
Our client has been experiencing continued growth and seeking to add (2) Senior Auto Liability/Bodily Injury Claims Examiners for their Baltimore office. This person would be responsible for handling moderate to complex Auto Liability and Bodily Injury claims for losses throughout the Mid-Atlantic r...
A comprehensive level of knowledge of workers' compensation law, insurance claims procedures and claims' investigation as acquired in two to three years of related experience. Under general supervision, processes employee workers' compensation claims and benefits, including preparation of legal form...
The Field Claims department is currently seeking Field Claims Representatives to service the territory surrounding:. This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure ac...
The Field Claims department is currently seeking Field Claims Representatives to service the territory surrounding:. This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure ac...
No Customer Service Representative Agent experience needed. Customer Service Representative Agent Work From Home - Part Time Remote Focus Group Panelists. Customer service representative agent experience is not necessary. If you are a customer service representative agent or someone just looking for...
Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level. To analyze mid- and higher-level general liability claims to determine ben...
We are seeking a dedicated Manager Claims Operations – Field APD. Manages and is accountable for auto, property, and other claims operations member service employees who are responsible for serving our members, and providing appropriate solutions as they investigate, evaluate and negotiate the claim...
Complies with Unfair Claims Practices Acts and ensures handling of claims in good faith. At American Family Insurance Claims Services (AFICS, Inc. The Claim Manager is the first line management position responsible for providing the leadership direction of a Claim Team and achieving desired company ...
Auto Liability Bodily Injury Claims Examiner. To analyze and process complex auto and commercial transportation bodily injury claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages. Processes complex auto commercial and personal line claims...
We pride ourselves on our exceptional customer base and are dedicated to providing outstanding service and sales support. Establish customer relationships and follow up with customers, as needed. Use a customer-focused, needs-based review process to educate customers about insurance options. Develop...