Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits. Technical claims investigations/settling experience with 4-8 years experience in Claims or similar organization. Interprets and makes decisions using independent judgment on more complex a...
Ensure claims are handled appropriately within the National Claims Guidelines and successfully resolved, including retention of outside defense counsel, in-house resolution, monitoring of legal fees, costs and settlement expenses, attendance at court proceedings, provision of claims analysis in lead...
Review and process hospital claims and complicated claims to assist claims examiners I, and II. Claims processing to ensure quality (in/out patient hospital claims, Medi-cal, Commercial, and Medi-care claims). Extensive knowledge of claims processing and claims data analysis. Years of Medical Claims...
The Claims Investigator-Examiner contributes to AHF's mission by ensuring accurate and timely and payment of claims and providing a positive experience to providers and internal staff. The Claims Investigator-Examiner enhance the experience of providers and the organization by being knowledgeable, f...
PRIMARY PURPOSE** : 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 specifi...
JOB TITLE: Claims Examiner - Days LOCATION: 9557 Greenleaf Avenue, Whittier, CA SHIFT: Monday - Friday - 07:00am - 03:30pm PLEASE NOTE ORIENTATION TIME MAY DIFFER THAN SHIFT TIMES LISTED DURATION - 13 weeks *** 2 YEARS EXPERIENCE REQUIRED - MUST BE ABLE TO VERIFY HS DIPLOMA or GED or HIGHER EDUCATIO...
Workers Compensation Claims Examiner | Long Beach, CA. PRIMARY PURPOSE OF THE ROLE:** To analyze high-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 ...
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...
Remote Claims Examiner - Workers Compensation. Analyze complex or technically difficult workers' compensation claims to determine benefits due. Work with high exposure claims involving litigation and rehabilitation. Ensure ongoing adjudication of claims within service expectations, industry best pra...
Similar Jobs (3) Workers Compensation Claims Handling Positions - California Jurisdiction - (Hybrid) locations 13 Locations time type Full time posted on Posted 15 Days Ago Claims Examiner - Workers Compensation - Hybrid Schedule locations Pasadena, CA time type Full time posted on Posted 19 Days Ag...
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...
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 requirements; and to identify subrogation of claims and negotiate settlements. Analyzes and processes c...
General Liability & Auto Claims Examiner III. Review, process and conclude assigned claims including investigation and evaluation mid-level exposure to complex Auto and/or General Liability Casualty Claims. Responsible for the prompt review of claims to determine coverage for loss/damage/injury. Con...
The Claims Examiner I is in daily contact with team members, clients and providers. This position reports to the Claims Supervisor. Processes claims accurately, efficiently and within quality/quantity requirements. Has the ability to access research tools for accurate claims entry. ...
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 Third Party Administrator, is looking for multiple Workers' Compensation Examiners to join their team. California Workers' Compensation Indemnity Claims Experience. Ability to handle claims from initial report to final settlement. ...
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...
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...
A Claims Examiner is responsible for analyzing and the adjudication of medical claims as it relates to managed care. Resolve claims payment issues as presented through Provider Dispute Resolution (PDR) process or from claims incident/inquiries. Identifies root causes of claims payment errors and rep...
The Claims Examiner is responsible for accurately and consistently adjudicating claims in accordance with policies, procedures and guidelines as outlined by the company policy. Three (3) years of experience with processing all types of specialty claims such as Chemotherapy, Dialysis, OB and drug and...
Ensure claims are handled appropriately within the National Claims Guidelines and successfully resolved, including retention of outside defense counsel, in-house resolution, monitoring of legal fees, costs and settlement expenses, attendance at court proceedings, provision of claims analysis in lead...
Workers Compensation Claims Examiner | Long Beach, CA. To analyze high-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 requirem...