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...
Eight (8) years of casualty claims experience or equivalent combination of education and experience required to include three (3) to five (5) years of experience handling complex claims and experience in negotiation, mediation, arbitration or ADR skills on higher value complex claims. Subject matter...
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 negotiate settlements. Manages workers compensation claims determining comp...
The Claim Examiner II obtains and analyzes information to make claim decisions and payments on Long Term Disability “LTD” and Waiver of Premium “WOP” claims. Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor,...
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. ...
Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collectio...
Our real estate litigation and title claims litigation group has extensive experience representing the title insurance industry and insured purchasers and lenders in all aspects of title insurance coverage and related title claims litigation. Seeking Lateral Partner in Real Estate & Title Claims Lit...
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...
AR Specialists are responsible for accurately identifying insurance claims denials and/or claims processing errors to resolve accounts. Qualified candidates must have at least 1-2 years medical claims experience. Resolve unpaid/denied claims by leveraging proprietary software system, making phone ca...
This role reports to the Chief Claims Officer for Markel Specialty, and is responsible for driving the strategic direction of the casualty claims department, ensuring efficient and effective claims handling, and maintaining the highest standards of customer service and business support. Represent Ca...
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...
As a Claims Specialist, you will be responsible for handling a caseload of complex, high exposure, auto and general liability claims throughout the claim’s life cycle. As these claims are often in litigation, experience handling litigated matters and managing defense counsel is required. ...
As a member of the Cross-LOB Analytics team, you will play an important role in helping Claims meet its strategic objectives. You will deliver actionable and valuable analytical insights, collaborate regularly with stakeholders, assist in the evaluation and prioritization of high-value strategic eff...
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...
Stout is seeking a Manager or Senior Manager to join our Intellectual Property practice within our Disputes, Claims, and Investigations group. ...
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...
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...
Act as a designated subject matter expert and business owner for claims data and claims implementation, as well as optimization projects for the way we implement and support our connectors. This role reports to the Director of Data Integration and will involve leading a team of 3-8 data engineers re...
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...
The Claims Quality Inspector is responsible for the thorough and accurate review of adjudicated claims and Enrollment entry against established corporate guidelines and protocols specific to claim adjudication and Enrollment entry. Ideal candidates will maintain a broad knowledge of corporate claims...
This is a visible and important role within our Complex Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims Specialist, you will be responsible for handling a caseload of higher complexity, higher exposure, construction defect and construction related property damage claim...
This role is responsible for providing guidance to the Accounting, Finance, Information Technology and Claims operation functions, as well as Pharmacy Networks and Government Programs. ...
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...
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...