The VP of Claim Quality Assurance is responsible for leading and developing claims handling standards and compliance, as well as providing oversight and direction on quality claims handling to field leadership. Develop claims handling standards and compliance, providing oversight and direction on qu...
Sr Representative Claims - CH08BE. Handle higher complexity Workers’ Compensation claims requiring timely investigations, financial accuracy, effective benefit oversight, appropriate file disposition, and adherence to statutory guidelines. Plan, recommend, and execute the investigation and dispositi...
Workers Compensation Claims Manager | VA Jurisdiction | Remote. Establishes policy and procedure to assure compliance to best practices, claims management services standards, state regulations and client service requirements. Must have experience handling claims in the VA jurisdiction. Eight (8) yea...
The Hartford is currently seeking an Ocean Marine Cargo Claims Adjuster to join our claims group. The Adjuster will be responsible for the analysis, investigation, evaluation, negotiation, and resolution of minimal to moderately complex claims requiring thorough investigations including telephone co...
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 re...
Acts as a main point of contact for claims specific questions for the case managers. Conducts manager reviews/ audits of claims as necessary to ensure overall quality. ...
Supervise the daily operations of the Claims Scrubber Team. Experian Claims Scrubber background and Athena IDX Experience. ...
This position will be responsible for the resolution of moderate to high complexity and moderate to high exposure claims. Experience handling moderate to high exposure general liability BI and PD claims and/or a legal background as a practicing attorney with litigation or coverage experience is requ...
Autonomously research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances (claim(s) paid more than expected by payer); actions included but not limited to initiating refund packets, retractions, and/or adjustments to claims. Navigate through various...
Analyzes coverage and settles moderately complex claims in one or more of Client’s specialty claims areas. Lead Claims Practice Specialist- Product Liability Life Sciences. Generally, incumbent does not work on workers compensation claims. Able to manage the full-life cycle of all assigned cla...
Litigation Team, you will be responsible for managing outside counsel on litigated claims files, conducting legal research, assisting non-litigated claims teams with jurisdictional and claims related matters as well as assist with organizational improvement activities. How does a Claims Attorney mak...
Are you looking for an opportunity to join a claims team with a fast-growing company that has consistently outpaced the industry in year-over-year growth? Liberty Mutual has an excellent claims opportunity available for a Claims Specialist within our Commercial Lines division!. The Claims Specialist...
Investigate all aspects of assigned claims from cradle to grave including coverage determination, resolving informally postured claims directly, working with defense counsel where defense obligation exists, issuing reservation of rights letters where coverage does exist, issuing coverage declination...
Our client is expanding their Workers' Compensation Department and seeking to add Workers' Compensation Claims Adjusters to their California operations. These positions would be responsible for handling California Workers' Compensation Indemnity claims from inception to close. Handle moderate to com...
Data Entry Specialist (Claims Processing). In this role, you will be responsible for accurately processing claims through our data management systems. ...
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 re...
This is a contingent position - Senior level professional performs high-level medical record and claims review for Medicare, Medicaid, or other claims data in order to ensure that proper guidelines have been followed and acts as a facilitator as well as a case manager regarding potential overpayment...
Stout is seeking a Manager or Senior Manager to join our Intellectual Property practice within our Disputes, Claims, and Investigations group. ...
This positions is contingent upon CMS funding approval - Mid-level professional performs medical record and claims review for Medicare, Medicaid, and/or other claims data in order to ensure that proper guidelines have been followed. As a member of an investigative team, may act as a facilitator as w...
Provides billing and/or claims management support to the Baptist Health Medical Group revenue management team. Complies with payer filing deadlines by utilizing all available resources to resolve held claims, Assures all known regulatory, contractual, compliance, and BHSF guidelines are adhered to w...
This Claims Team Manager will lead a team of Claims Specialists who manage a portfolio of Commercial Auto and General Liability claims to achieve the best possible outcomes and deliver an exceptional customer experience. Supervises the day-to-day operations for the claims staff by establishing prior...
The Unemployment Claims Appeals Specialist will work within the Risk & Insurance team to assist with resolving vendor inquiries, and remitting information to state agencies. As a Unemployment Claims Appeals Specialist, how results are achieved is paramount for your success and ultimately result in o...
As one of the largest independent providers of insurance claims services in North America, we provide property, auto, heavy equipment, and casualty claims management services. Commercial Property Desk Claims Adjuster. Alacrity Solutions is a full end-to-end provider delivering streamlined insurance ...
With minimal supervision, the Claims Officer, Cyber Claims independently handles a book of specialty lines claims throughout the entire claim's life cycle. Utilizes Global Claims Center to document claims and to diary future events or follow-up. Responsible for conducting investigations, setting ade...
Plans, conceptualizes, configures, and builds solutions that solve Claims Configuration and Provider Data challenges within the business by using technological tools or programs. Provide solutions to Provider Data and Claims Configuration challenges such as new implementations and process improvemen...