- Sedgwick (Raleigh, NC)
- …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Complex Claims Advisor | Remote **This ... manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to...preferred. **Skills & Knowledge** + Subject matter expertise in worker 's compensation claims and/or liability… more
- Sedgwick (Raleigh, NC)
- … Examiner **PRIMARY PURPOSE** **:** To analyze complex or technically difficult workers compensation claims to determine benefits due; to work with ... specific requirements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult claims by investigating and… more
- Sedgwick (Raleigh, NC)
- …Remote Claims Adjuster **PRIMARY PURPOSE** **:** To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ... and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Manages workers compensation claims determining compensability and benefits… more
- Sedgwick (Raleigh, NC)
- …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Adjuster | Public Entity & MD, VA ... brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of...and inclusion. **PRIMARY PURPOSE OF THE ROLE:** To analyze Workers Compensation claims on behalf… more
- CRC Insurance Services, Inc. (Raleigh, NC)
- …This is a role focused on technical claim handling of moderate to complex general liability claims , both litigated and non-litigated. This role requires ... individual to be accountable for the handling and disposition of claims including investigation, coverage determination, reserving, negotiation and settlement or… more
- UMB Bank (Raleigh, NC)
- …change to ensure the best customer experience. + Review and decide high-value and complex card fraud claims . + Prepare regular reports on card fraud ... **Duties & Responsibilities** The Manager, Card Fraud Claims , will oversee and manage the UMB card...College Degree + TSYS TS2 and/or TSYS TMS experience ** Compensation Range:** Minimum: $69,230.00 - Maximum: $179,300.00 _The posted… more
- MetLife (Cary, NC)
- …Key Responsibilities: * Independently manage an assigned caseload of the most complex claims which consists of pending, ongoing/active and appeal reviews. ... Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time...Bachelor's degree and knowledge of STD/FML, state leave laws, worker 's compensation , ERISA, and Social Security. At… more
- Grifols Shared Services North America, Inc (Clayton, NC)
- …records including: Employee Medical Files, Industrial Hygiene Monitoring Records, Workers Compensation carrier forms, disability records, medical surveillance ... will use medical expertise combined with knowledge of the workers ' compensation system to make sure that...for assessment and coordination of medical care related to worker 's compensation injuries; manages all accepted, routine… more
- North Carolina Central University (Durham, NC)
- …**Supervise Workers Comp Analyst and Business System Analyst** + Review injury claims , worker 's compensation invoices, and TPA fee approvals, review and ... subject matter experts, and developing staff; * Experience leading complex financial systems and organizations; * Strong interpersonal and...provide recommendations for settlements of injury claims , monthly and when requested meetings with DOA to… more
- Sedgwick (Raleigh, NC)
- …and support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker , attorney and supervisor. + Identifies ... Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured worker , employer, and medical providers, create a case management strategy to facilitate… more
- Truist (Durham, NC)
- …and Account Executive, if applicable, by serving mid-sized and moderately complex clients, be knowledgeable in coverages, carrier guidelines, underwriting, and ... and staff with service questions related to administration, billing, claims issues and problem-solving, upon request. 3. Continually seek...of TIH:** All regular teammates (not temporary or contingent workers ) working 20 hours or more per week are… more
- IQVIA (Durham, NC)
- …employment policy development and implementation, wage and hour issues, worker classifications and other employee relations matters; + Coordinate with ... conduct and provide counsel regarding employment-related investigations, ensuring that claims are addressed promptly, thoroughly and appropriately; + Draft… more
- Lincoln Financial Group (Raleigh, NC)
- …preferred * Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation , Utilization Review and/or nurse case management ... reviewing, analyzing, and interpreting medical information available for disability claims . In this role you will act as a...clinical resources (ie IME, FCE, Peer Reviews) * Discuss complex medical issues with health care providers as needed… more
- Truist (Durham, NC)
- …**Primary Purpose:** Support Producer, if applicable, by serving the larger and/or more complex clients and/or be viewed as a leader and resource by colleagues and ... and staff with service questions related to administration, billing, claims issues and problem solving, upon request. 3. Continually...of TIH:** All regular teammates (not temporary or contingent workers ) working 20 hours or more per week are… more
- MetLife (Cary, NC)
- …strong leadership and coaching skills. Extensive knowledge of STD, group disability, Workers Compensation , ERISA, Social Security and state laws * Strong ... * Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively * Organizational and time management skills, ability… more