- Sedgwick (Madison, WI)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an opportunity to ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...OF THE ROLE:** To analyze mid-level Commercial General Liability claims on behalf of our valued clients to determine… more
- Sedgwick (Sun Prairie, WI)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Recovery **PRIMARY PURPOSE** **:** Processes and ... review subrogation claims across all lines of business and all jurisdictions...to company standards and industry best practices within the Claims Recovery Team. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Responsible… more
- Sedgwick (Sun Prairie, WI)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Commercial Auto Claims Representative **PRIMARY PURPOSE** : To analyze and process low ... to mid-level auto and transportation claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes auto property...+ Processes auto property damage and lower level injury claims ; assesses damage, makes payments, and ensures claim files… more
- Ryder System (Madison, WI)
- …by a professional staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues. Assists Director in ... a team of adjusters in the investigations, vehicle inspections, and resolves claims , as well as directs outside vendors, independent adjusters, experts, and other… more
- SSM Health (Madison, WI)
- …or more of the following: processing insurance payments, following up on denied claims , and resolving credit balances. May work in multiple functional areas. **Job ... component of a patient's obligation using the third party claims processing and payment rules. Bills claims appropriately. + Follows up on denied claims … more
- Humana (Madison, WI)
- …determine if something was missed? Have you ever considered yourself a detective for medical claims / member benefits? Well, if you answered yes to any of the above ... you may be a great fit for Humana's Grievances & Appeals Representative 3 role! **What we need your help with:** + Managing client medical denials by conducting a… more
- CVS Health (Madison, WI)
- …Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive claims research on ... multiple platforms to assist providers with payment questions. + Educate provider with related information to answer the unasked questions, eg, additional plan details, benefit plan details, provider self-service tools, etc. + Use customer service threshold… more
- Graybar (Madison, WI)
- Are you ready? As an Outside Sales Representative with our Industrial sales team, you will develop new prospects and maintain contacts with established customers for ... policies + Handle customer complaints promptly and effectively, and report potential claims . + Keep management informed of local competition and market conditions +… more
- Molina Healthcare (Madison, WI)
- …pharmacy prior authorization requests and/or appeals. + Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary ... information to providers, members, and pharmacies. + Assists with clerical services/tasks and other day-to-day operations as delegated. + Effectively communicates plan benefit information, including but not limited to, formulary information, copay amounts,… more
- Evolent (Madison, WI)
- …+ Answer and manage inbound inquiries regarding health plan benefits, claims , eligibility, medical procedures, billing, payments, and other related topics from ... customers in a prompt, courteous manner. + Accurately document customer interactions and transactions using the company's CRM system. + Meet performance goals established for the position in areas such as efficiency, accuracy, quality, member satisfaction, and… more
- GCG (Madison, WI)
- …guidelines and detailed manuals. These efforts will not only support warranty claims but also enhance customer satisfaction by delivering service that sets us ... user-friendly + Develop detailed manuals to assist customers with warranty claims and installation support + Provide on-site training, product demonstrations, and… more
- American Packaging (Columbus, WI)
- …all CCF credits, rework billed, and miscellaneous cash collected for freight carrier claims . + As needed, provide sales reports and assist with reconciliation. Other ... each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations… more
- UIC Government Services and the Bowhead Family of Companies (Madison, WI)
- …**Physical Conditions for Job Performance:** + The physical demands described here are representative of those that must be met by an employee to successfully ... other protected characteristics EOE/AA/M/F/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual… more
- Humana (Madison, WI)
- …between the company and members are optimized. Expanded Benefits Consumer Representative Internship provides transitioning service members that are eligible to ... client services, client administration, customer service, enrollment, and eligibility, claims processing, and call center operations. Investigates and settles … more
- Avera (Madison, WI)
- …to enhance underwriting processes and implement best practices. + Analyze claims experience and trends to inform underwriting decisions and contribute to ... speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential… more
- Prime Therapeutics (Madison, WI)
- …of network agreements and network participation requirements, historical claims analysis, contract negotiations, and performance monitoring. **Responsibilities** + ... Part D (eg, retail, mail, specialty). + Serve as primary contracting representative for assigned chain pharmacies and/or PSAOs for Medicare Part D, Medicaid,… more
- Molina Healthcare (Madison, WI)
- …or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to ... & ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed… more
- Trustmark (Madison, WI)
- …necessary. + Learns to underwrite pending files received for review and contestable claims files for underwriting. + Works with reinsurer on cases that require ... and mentoring to less experienced Underwriters. + Acts as the underwriting representative at producer VIP meetings for assigned territory. + Effectively explains… more
- CDM Smith (Madison, WI)
- …specialists when appropriate throughout the process. * Obtains the applicant representative 's agreement that all disaster-related damage was described and quantified ... projects and meets regularly on the status. * Evaluates applicant-provided cost claims for reasonableness to report to FEMA regarding claim eligibility. Participates… more