- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking an experienced Complex Claim Specialist . This is a full-time position and offers a hybrid schedule after ... training. The Complex Claim Specialist will be responsible for contacting...policyholder's reporting practices + Prepare, attend, and participate in Claim Reviews as needed with the Claims … more
- CVS Health (San Antonio, TX)
- …the claim adjudication process. * Routes and triages complex claims to Senior Claim Benefits Specialist . * Proofs claim or referral submission to ... personal, convenient and affordable. Position Summary: This is a Claim Benefit Specialist will be...Routes and triages complex claims to Senior Claim Benefits Specialist . - Proofs… more
- CVS Health (Hartford, CT)
- …Shift and Training Hours: + Training 8:00am-4:30pm + Shift: 8am-4:30pm Claim Benefit Specialist Reviews and adjudicates claims in accordance with ... make health care more personal, convenient and affordable. This Claims Benefits position is Onsite at our...claim processing guidelines. Claim Benefit Specialists have the opportunity to… more
- CVS Health (St. Paul, MN)
- …- Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for ... affordable. Position Summary Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Reviews and… more
- CVS Health (Pittsburgh, PA)
- …to claim processing issues. * Routes and triages complex claims to Senior Claim Benefits Specialist . * Proofs claim or referral submission to ... and affordable. Position Summary * Reviews and adjudicates routine claims in accordance with claim processing guidelines....offers a full range of medical, dental, and vision benefits . Eligible employees may enroll in the Company's 401(k)… more
- CVS Health (Raleigh, NC)
- …to make health care more personal, convenient and affordable. Position Summary This is a Claim Benefit Specialist position and will be trained for 20 weeks ... will be offered after training. + Reviews and adjudicates claims in accordance with claim processing guidelines....offers a full range of medical, dental, and vision benefits . Eligible employees may enroll in the Company's 401(k)… more
- CVS Health (Columbus, OH)
- … claims in accordance with plan processing guidelines. - Reviews pre-specified claims or claims that exceed specialist adjudication authority or ... discrepancies, and applies all cost containment. measures to assist in the claim adjudication process.- Insures all compliance requirements are satisfied and all… more
- CVS Health (St. Paul, MN)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- MetLife (Tampa, FL)
- …demands, financial information, and any other information that may be pertinent to the Claims Specialist 's evaluation of the claim . Once telephone calls are ... impact in the lives of our customers and our communities. The IDI Senior Claims Specialist evaluates individual disability income insurance claims and makes… more
- CVS Health (Bismarck, ND)
- …Training is 12 weeks 9am-5:30pmEST + Shift: flex schedule Reviews and adjudicates routine claims on HRP system in accordance with claim processing guidelines. ... CMS and Aetna compliance and business requirements.Analyzes and approves routine claims that cannot be auto adjudicated.- Applies medical necessity guidelines,… more
- CVS Health (Hartford, CT)
- …and reworking complex claim issues. - Experience processing medical and hospital claims through the ACAS system. - Ability to work independently as well as part ... can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department. They will work closely with other… more
- Travelers Insurance Company (Pittsburgh, PA)
- …negotiating and resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim ... level included in this posting. To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/ benefits / . more
- Zurich NA (Schaumburg, IL)
- Environmental Sr. Mass Litigation Claim Specialist 114101 Zurich is currently seeking a Sr. Claims Professional to join our Latent & Environmental team in ... a company with a global footprint that offers terrific benefits including an incentive plan, 401K match and an...communications and reporting associated with the life of a claim . At Zurich North America Claims we… more
- Travelers Insurance Company (Hunt Valley, MD)
- … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... level included in this posting. To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/ benefits / . more
- CRC Insurance Services, Inc. (Brewster, NY)
- …and makes recommendation for additional activity as appropriate. 3. Determine where new loss claims should be reported. 4. Manage all claim documentation. 5. Use ... and/or correspondence to the Agent or Insurer to process claims appropriately. 6. Analyze claim coverage with...and paid holidays. For more details on TIH's generous benefit plans, please visit our Benefits site… more
- MetLife (West Hartford, CT)
- …FL or Bloomfield, CT TRAINING WILL BE IN PERSON. Role Value Proposition: Claim owner and decision-maker. Responsible for administering claims within contractual ... * Accountable for accurate financial decisions on block of claims with financial base benefit amount up...benefit amount up to $8000 per week per claim decisions made in accordance with Customer provisions *… more
- CVS Health (Lansing, MI)
- …clients and the stop loss administrators. Reviews and manages stop loss claim filings. Resolves discrepancies between the amount requested and the amount reimbursed ... carrier. Required Qualifications * 1+ years of experience in claims processing background preferred * 1+ years of experience...offers a full range of medical, dental, and vision benefits . Eligible employees may enroll in the Company's 401(k)… more
- The Hartford (Hartford, CT)
- …we help shape the future. The Claim Specialist is the highest claim handling designation within the Complex Claims Unit - Construction (CCU-CD) and is a ... Specialist Claims - CH07DE We're determined...to manage, and can involve higher exposures. RESPONSIBILITIES: The Claim Specialist must demonstrate the ability to… more
- City of New York (New York, NY)
- …is recruiting for four (4) Eligibility Specialists level II to function as a Claims Review Specialist , who will: - Review, process, determine and/or establish ... Job Description YOU MUST BE PERMANENT IN THE ELIGIBILITY SPECIALIST CIVIL SERVICE TITLTE OR IF YOU ARE HIRED...cases assigned manually or via Automated SNAP Claim System (ASCS) cases for potential SNAP … more
- Sedgwick (Columbus, OH)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Surety Claims Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically ... and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans...for this role is_ **_$110,000- $120,000_** _. A comprehensive benefits package is offered including but not limited to,… more