In addition to ensuring essential administrative functions run smoothly, you may also interact with customers and medical providers by phone or in person when applicable.High School diploma/GED equivalent or higher and a minimum of one year of administrative or clerical support experience .OR} one y...
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...
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...
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...
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...
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...
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...
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...
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...
CAP seeks a Claims Specialist (II or III/Senior), for its San Diego office, to perform technical and administrative duties to manage assigned claim files; assumes increased workload of highly complex claims. Manage medical malpractice claims, including the assignment, direction, and control of defen...
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...
DaVita is currently looking for a Patient Account Specialist. Identify trends and perform root cause analysis on unpaid and underpaid claims. ...
A Managerr within our Disputes, Claims & Investigations group is expected to have assignments in a variety of industries. We believe in timely and proactive performance excellence, ongoing 360 feedback, clear performance expectations at each level, and quarterly check-ins with your manager ensure yo...
The Workers Compensation Claims Manager is responsible to supervise activities within the worker compensation lost time claims department. Workers Compensation Lien Manager, Claims. AmTrust Financial Services, a fast growing commercial insurance company, has an immediate need for a Workers' Compensa...
We are seeking a motivated Medical Billing Specialist to join our growing and dynamic team. In addition, the Medical Billing Specialist will be responsible for ensuring that information is processed accurately, payments are posted, and denials are resubmitted in a timely manner. This individual will...
We are seeking a detail-oriented and knowledgeable Remote Dental Billing Specialist to manage our billing operations. As a PPO-only practice, we provide top-quality dental care and are looking for a billing expert to ensure our claims and payments are processed efficiently. Ensure compliance with de...
Handle incoming customer service calls. Accept customer calls and return customer. This position will work with multiple clients throughout the day providing outstanding service and product knowledge. Dispatch incoming customer phone calls. ...
The Customer Service Representative (CSR) is the first line of contact for Clerk-Recorder customers. CUSTOMER SERVICE REPRESENTATIVE. This position provides customer service in an office setting, which includes, but is not limited to, the following: greeting and assisting customers in person, email ...
We are seeking a Part Time Customer Service Representative to join our team at IST Management Services in Irvine, CA!. Ideal candidates will have relevant experience in mail operations, customer service and a desire to grow their professional career in business services. We provide a range of servic...
Claims Examiner in an IPA, Medical Group, or Health Plan and knowledge of HIPAA and AB1455. IPA setting claims processing experience. CLAIMS PROCESSING CA HERITAGE SERVICES. ...
Physical Requirements for employees in the Crop Business Unit/Crop Claims General Adjuster. Great American is currently seeking Seasonal Crop Adjusters, q. Understand and can work claims for all major crops, policy/plan types, in all stages of growth. Works toward the resolution of claims files, and...
Workers Compensation Claims Examiner | Orange, CA (Agile Schedule). Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensur...