The ideal candidate will possess a comprehensive understanding of training methodologies, quality assurance procedures, and claims processing guidelines. Lead and coach claims recovery collectors to make contact with carriers and providers in order to drive document and payments recoveries on behalf...
A deep knowledge of claims adjudication is typically achieved through a minimum of seven years' experience adjudicating general liability claims with exposure of $100,000 or more. Licensed Claims Examiner (Based on state) Must possess or have ability to quickly obtain a license in each jurisdiction ...
Review, process and identify medical claims based on standard operating procedures on CPS. Apply appropriate processes and procedures to process claims (e. Weekly/monthly goal of batches including meeting and maintaining a 95% quality standard and production standard of 90+ claims per day. Manually ...
The SVP of Casualty Lines Claims reports directly to the Chief Claims Officer located in New York City and manages the entire Casualty sub-function of US Claims. Partners with Chief Claims Officer and other senior Claims Management to establish, refine and evolve best-in-class claim management progr...
Hancock Claims Consultants is the nation’s leader in claims resolution service. Essential Duties and Responsibilities: FIELD OPERATIONS: Liaise between Hancock Claims Consultants, carrier/clients, and independent roof sub-contractors Develop and maintain strong relationships with carrier...
Team Lead - Medicare Specialist.This position is responsible for providing support in developing, implementing, managing, and meeting or exceeding the operational goals of our clients and Company.The Team Lead will and may work closely with their team, project supervisors, operations managers, and t...
To analyze high-level commercial general liability 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. Agile) Claims Examiner - Liability / Bodi...
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...
Join our team as a Coding and Claims Specialist and play a vital role in ensuring the accuracy and efficiency of our medical billing processes. Perform Quality Assurance checks to maintain the integrity of medical data in the claims process. Correct rejected claims efficiently and effectively. Provi...
Sentry is looking for a highly experienced claims handler, who’ll be responsible for handling litigated and non-litigated claims with complex coverage, liability, and damages issues. You’ll provide prompt claim investigation, evaluation and settlement or denial of claims with moderate to high comple...
Performs review, analysis, and adjudication of all claim types including coordination of benefits and DME claims. ...
Review, process and identify medical claims based on standard operating procedures on CPS. Apply appropriate processes and procedures to process claims (e. Weekly/monthly goal of batches including meeting and maintaining a 95% quality standard and production standard of 90+ claims per day. Manually ...
IT IS TIME FOR A CAREER CHANGE! Independent Insurance Claims Adjusters Needed Now! Are you actively working as a Licensed Claims Adjuster? Do you have 100 claims or more under your Belt? If you do Great, If you don’t, No Problem! Let us help you on your career path as a Licensed Independent Claims A...
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...
The CLAIMS analysts analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Community First Health Plans (partnered with University Health) i...
The Personal Lines Property Claims Team Leader will manage and direct claim investigation, compensability determination, disposition and settlement, in compliance with corporate claim settlement policies and procedures. Oversee the completion and execution of the investigation, disposition and settl...
To analyze low-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. Agile) Claims Associate - Workers Compensation | S...
You will be responsible for promptly analyzing and evaluating injury claims to determine coverage, securing statements and managing correspondence between all parties involved, setting reserves and settling claims in a timely manner. Our client is a growing and top-rated Workers Compensation Claims ...
Humana”) offers competitive benefits that support whole-person well-being.Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.Among our benefits, Humana provides medical, dental and...
Commercial and/or Personal Lines Claims Representative positions. Prepare and submit First Report of Claims to carriers. Document, track, and facilitate claims assignments. Work in agency management system to document communications and track claims. ...
In short, as a Claims Adjuster, you will use your knowledge of vehicle systems and repairs to validate, approve, and authorize payment for repair recommendations on warranty claims. DriveTime Family of Brands includes SilverRock, which provides quality warranty and ancillary products, and a customer...
Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff in complex claim issue resolution. Five years HMO/P...
Oversees inventory related to prior authorization, claims review, and concurrent review inventory and regulatory timeframes. Utilizes care management electronic documentation system, claims system, and provider EMR to locate requested information, determine member eligibility, and to assess informat...
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...
Evaluate and settle property claims, mostly in the DFW area. ...