A company is looking for a Specialist, Claims Quality Regulatory Operations to join their Claims Quality team. ...
We are currently seeking an entry-level Claims Loss Reporting Specialist to support our auto claims operations. Claims Loss Reporting Specialist. Explain and evaluate benefits, coverages, and claims process involving glass claims. It's an ideal entry point for individuals without prior claims experi...
A company is looking for a Claims Specialist to provide customer service for inbound claims and manage the claims process. ...
In addition, the Claims Specialist is also responsible for keeping up to date accounts receivable for both CalAIM and IFMG, claim follow-up, and must have knowledge of billing codes. Follow up on claims on hold and bill when claims are determined ready to bill. Ensure claims meet the standards of ou...
A company is looking for a Customer Operations (Auto Claims) specialist to handle high-volume claims management for healthcare providers. ...
This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protoc...
Elevates problems up to the Account Claims Specialist II when unable to resolve. File and process funeral insurance claims and assist with third party insurance claims timely. Process funeral insurance claims (Global Atlantic and TruStage) and follow up with third party insurance vendor (American Fu...
Chance to develop strong relationships with customers and business partners while resolving complex claims. Deliver exceptional service to commercial customers and agents/brokers through empathetic and efficient claims management. Manage vendor relationships and negotiate resolutions for complex com...
California Workers Compensation Claims Specialist Opportunities!. Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims. Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized c...
Claims Operations Specialist 2 We are seeking a Claims Operations Specialist 2. In this role you will provide oversight and subject matter expertise in support of the Claims business unit goals and objectives, as well as leadership in developing proc Operations Specialist, Claims, Operations, Specia...
Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Establishes and maintains working relati...
Under moderate supervision performs administrative duties of moderate technical complexity in support of the Claims function. Manage and update the Claims, Medical Legal weekly staffing agenda. Claims administrative support experience preferred with preference given to experience gained in Workers’ ...
Manages an inventory of moderate to high complexity and exposure Healthcare claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Establishes and maintains working relati...
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...
Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Establishes and maintains working relati...
Manage the claims internal audit functions, which includes audit process for adjudicated claims and encounters. Develop policies and procedures for periodic claims audits and ensure compliance with affiliated health plans, client groups, and administrative contractual agreements. Designs, plans, dir...
Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of Claims ...
The Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; documenting activities; conveying information regarding claims and/or benefits; and providing testimony in be...
The Senior Claims Specialist will report directly to the Director of Risk Management. Ensure the timely logging of all new claims (delegate to Claims Assistant if necessary) and timely reporting to our Insurance Carrier, with guidance by the Dir of Risk Management. Vice-Versa the adjuster can commun...
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...
Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims. Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized courses of study (Associate in Claim designation, etc). Makes decis...
Claims Resolutions Specialist Job Description . The Claims Resolution Specialist will be the first line of contact for health providers. The incumbent will assist providers with questions related to the payment of claims and resolution of claims payment issues. Responds and researches issues on prov...
Communicating with claimants, employers and various medical professionals through phone and e-mail to gather necessary claim information, managing the claim process from the initial request to the return to work.Collaborating with fellow case managers, nurse case managers, and consulting physicians ...