Under limited supervision, acts as highest level individual contributor directly reviewing primary and excess Financial Institutions and Management Liability claims to determine nature of loss, coverage provided, and scope of claim and to make recommendations regarding settlement/disposition of clai...
A company is looking for a Claims Specialist I for a remote position. ...
Ensure that claims are being processed as expeditiously as possible, and that all inventories are regularly reviewed, and all possible actions are taken to move the claims to closure. Third-Party Claims Administrator (TPA). Audit a representative sampling of each TPA and program's claims at least on...
A company is looking for a Clinical Assistant I/Revenue Claims Specialist-Temp. ...
Revenue Integrity Analyst / Claims Review Specialist. Analyze hospital billing claims within the EHR and claim scrubber system. Understanding of Medicare/Medi-Cal claims processing guidelines. ...
A company is looking for a Claims Specialist in Commercial Bodily Injury. AEI, IIA, CPCU)Knowledge of claims investigation techniques, medical terminology, and legal aspects of claims. ...
Under limited supervision, acts as highest level individual contributor directly reviewing primary and excess Financial Institutions and Management Liability claims to determine nature of loss, coverage provided, and scope of claim and to make recommendations regarding settlement/disposition of clai...
Reviews and authorizes payment and final disposition of claims requiring adjustment and claims benefit determination for reinsurance qualification. Responsible for processing medical claims. Resolves complex, difficult or non-routine claims requiring special handling in accordance with established p...
Workers’ Compensation Claims Specialist. You’ll maintain phone and written contact with all necessary parties to verify coverage and to investigate, manage and resolve medical-only claims promptly and accurately. This is an excellent career opportunity as a Claims professional. Generally, 6 to 10 ye...
Our client, an A-rated Insurance Carrier, is seeking to add a New York Workers' Compensation TPA Claims Oversight Specialist. This person would be responsible for evaluating and reviewing New York Workers’ Compensation claims handled by Third Party Administrators (TPA) for adherence to company’s bes...
Managing assigned claims across multiple jurisdictions, as well as setting the case strategy for these claims in partnership with Regional Practice Leaders and Claims management. Senior Claims Specialist - Excess Casualty. Our experienced Claims professionals use their specialized expertise to handl...
Our client, an A-rated Insurance Carrier, is seeking to add a Workers' Compensation Claims TPA Oversight Specialist This person would be responsible for promptly evaluating and reviewing New Jersey and Pennsylvania Workers’ Compensation claims handled by Third Party Administrators (TPA) for adherenc...
Under limited supervision, acts as highest level individual contributor directly reviewing primary and excess Financial Institutions and Management Liability claims to determine nature of loss, coverage provided, and scope of claim and to make recommendations regarding settlement/disposition of clai...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...
Working under minimal supervision, the Member Experience Specialist – Claims contributes to Wawanesa’s goal of delivering an exceptional and consistent claims service experience by enhancing relationships with members through tracking and trending feedback utilizing various data sources. Works colla...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...
The client is seeking a highly motivated an experienced TEMP - Claims Resolution Specialist (Customer Service) to join our team. The Claims Resolution Specialist will be the first line of contact for the client’s providers. The incumbent will assist providers with questions related to the payment of...
The Prudential Claims Specialist role is essential in handling retirement claims and processing financial transactions on behalf of clients. The team’s focus areas include claims processing for short-term disability, long-term disability, retirement, and death claims. This position requires high mul...
The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. Assesses policy coverage for submitted claims and notifies the insured of any issues; determine...
The Claims Documentation Specialist II is responsible for creating, editing and updating documents that will provide an in-depth record of the procedures, policies and workflows used by L. ...
Analyze hospital billing claims within the EHR and claim scrubber system. Understanding of Medicare/Medi-Cal claims processing guidelines. ...
Investigates and maintains claims:Reviews and evaluates coverage and/or liability. Works toward the resolution of claims files, and attends arbitrations, mediations, depositions or trials as necessary. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handl...
Reviews and authorizes payment and final disposition of claims requiring adjustment and claims benefit determination for reinsurance qualification. Responsible for processing medical claims. Resolves complex, difficult or non-routine claims requiring special handling in accordance with established p...
The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. Assesses policy coverage for submitted claims and notifies the insured of any issues; determine...
The Property Claims Field Adjuster ll will learn apply knowledge of current Company policies, applicable regulatory standards, and procedures to investigate, evaluate and settle moderate Homeowner's property claims in a timely and efficient manner as to prevent unnecessary expense to the Company and...