A company is looking for a Claims Examiner to evaluate insurance claims and determine compensation for policyholders.Key ResponsibilitiesReview insurance claims for validity and adherence to policy termsConduct investigations and analyze policy coverage to determine liability and settlement amountsCommunicate with claimants and stakeholders to explain the claims process and provide updatesRequired QualificationsHigh School diploma or equivalent requiredHealth claims processing experience preferred, including use of claims processing softwareKnowledge of medical terminology, ICD-9 / ICS-10, CPT, and HCPCS coding preferredBasic computer skills requiredAbility to pass a pre-employment background investigation
Commercial General Liability Claims Examiner
A company is looking for a GL Claims Examiner, Commercial to handle moderate to complex commercial general liability claims. ...
Subrogation Claims Examiner
The position exists to review claims with subrogation potential, analyze the potential for recovery, file claims with responsible parties and their carriers, and negotiate settlement in accordance with statutory and case law as well as pertinent regulations. This role will determine when litigation ...
Claims Examiner
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. ...
Workers Compensation Claims Examiner | Long Beach, CA
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...
Claims Examiner - Managed Care
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...
Cyber Claims Examiner
Are you passionate about cyber security and risk management? Do you have a knack for unraveling complex claims and delivering superior customer service? We are seeking a highly skilled and experienced Cyber Claims Examiner to join our dynamic team. A minimum of 5 years of experience in cyber claims,...
Tpa Claims Examiner
Join our team at SGD as a TPA Claims Examiner, working remotely. Are you a detail-oriented and enthusiastic claims professional?. You will play a crucial role in evaluating insurance claims and facilitating the resolution process for our clients. This position requires excellent communication skills...
Workers Compensation Claims Examiner - Long Beach, CA (Hybrid)
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...
General Liability & Auto Claims Examiner III
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...
Claims Examiner - Workers Compensation
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 specific c...