A company is looking for a Claims Specialist I to resolve medical claims that are not automatically adjudicated.Key ResponsibilitiesProcess and resolve pended claims, including data entry and benefit eligibility determinationConduct investigations and communicate with internal staff and medical providers to obtain necessary informationMaintain knowledge of processing procedures and stay current with changes in benefits and systemsRequired QualificationsHigh School diploma or equivalentMinimum two years of college coursework in a related field or one year of relevant office experienceMust pass company proficiency test : Claims AssessmentKnowledge of anatomy, medical terminology, and related subjects is preferredMust adhere to security and confidentiality standards as outlined in company policies
Revenue Cycle Claims Specialist
A company is looking for a Revenue Cycle Claims Client Billing Specialist-Temp. ...
Excess and Surplus Claims Specialist
Excess and Surplus Claims Specialist. AmTrust Financial Services, a fast growing commercial insurance company, is seeking an experienced Claims Specialist III for a role in Excess and Surplus Lines (E&S) General Liability. Minimum of five (5) years of experience in the handling of litigated and non-...
Complex Property Claims Specialist
Key ResponsibilitiesAct as the primary contact for escalated mitigation and repair issues, including workmanship and warranty claimsReview contractor estimates for accuracy and compliance with industry guidelinesMonitor and track the status of escalated issues and warranty claims to ensure timely re...
Claims Legal and Regulatory Compliance Specialist
Claims Legal and Regulatory Compliance Specialist. Partners with Claims L&D to identify, analyze, improve, and implement targeted training solutions. ...
Senior Claims Specialist - CA Licensed
A company is looking for a Senior Claims Specialist to adjust complex or high exposure construction defect claims. ...
Senior Claims Technical Operations Specialist
Senior Claims Technical Operations Specialist. The Technical Operations Specialist position will work with internal and external stakeholders and will report to the AVP of Claims Operations. It will require the individual to possess an excellent understanding of the (LOB) Claims business functions, ...
Executive Claims Specialist, Cyber Executive Risk (Remote)
The Executive Specialist will handle a regular diary of Cyber claims and must have experience handling first-party Cyber claims. The Executive Specialist will be expected to handle Incident Response and must analyze and resolve claims from coverage determination through resolution—including Incident...
Patient Claims Specialist
ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, clai...
Claims Clinical Specialist – Medical Review Team
Claims Clinical Specialist – Medical Review Team. The Claims Clinical Specialist role is an excellent opportunity for a Registered Nurse seeking a career change. You will be responsible for working within a structured environment with established Standard Operating Procedures to ensure consistency o...
Medical Malpractice Claims Specialist
The Doctors Company is seeking an experienced Claims Specialist to join our Claims Team in Florida. The Claims Specialist independently and pro-actively manages the medical malpractice claims for assigned members. Monitors and reviews all new claims for designated members and establishes a plan of a...