- City of New York (New York, NY)
- …New York employees serving in a permanent (not provisional) Civil Service title of Claim Specialist . To be considered for this position, PLEASE CLEARLY INDICATE ... to gather information relevant to the investigation of the claim ; 10) Investigate, identify, and report fraudulent claims...in a permanent (not provisional) Civil Service title of Claim Specialist . To be considered for this… more
- 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 (Jacksonville, FL)
- … cost management opportunities and refer claims for follow up * Make claim payment decisions * Process claims accurately to enhance customer satisfaction ... assist in the claim adjudication process. Routes and triages complex claims to Senior Claim Benefits Specialist . Proofs claim or referral submission… more
- Travelers Insurance Company (Morristown, NJ)
- …and processes out-going mail. Orders, receives and distributes supplies and/or equipment. + CLAIM PAYMENTS AND EXPENSE PROCESSING: Ensures the proper handling of ... Triage and route callers to the appropriate department; Answers claim status and payment questions. + ...financial transactions to include: Processes and issues claim payments including outside vendor invoices, attorney… more
- CVS Health (St. Paul, MN)
- …personal, convenient and affordable. **Position Summary:** In this position the Senior Claim Benefit Specialist will reviews and adjudicates complex, sensitive, ... and/or specialized claims in accordance with claim processing guidelines....May handle customer service inquiries and problems. Reviews pre-specified claims or claims that exceed specialist… more
- CVS Health (St. Paul, MN)
- … 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
- Travelers Insurance Company (Richardson, TX)
- …1 **What Is the Opportunity?** This position is responsible for providing quality claim handling of low complexity General Liability claims from the first ... notice of loss through resolution/settlement and payment process. Claim types include clear liability...available and coverage limits that will apply. + Refers claims beyond authority as appropriate based on exposure and… more
- BrightView (Blue Bell, PA)
- Job Summary + The AL/GL Claims Specialist is a key member of the risk management team and has responsibility for directly investigating and settling in-house ... claims and oversight of Third-Party Administrator Claims . This role formulates and executes claim ...(contracts, scope of work, weather reports, etc.) + Make claims payments + Recognize and identify potential… more
- First Student (OH)
- …To provide overall managerial and supervisory responsibilities of the Company's liability claim portfolio, particularly the higher exposure claims . This is done ... oversight of the liability and damage investigation of the claims ; oversight of third party administrator's claim ...whether by external TPA or internal staff, eliminating unnecessary payments and minimizing the costs of handling claims… more
- Crawford & Company (Brea, CA)
- …and/or clients. + Approves payments of medical bills on lost time disability claims within area of payment authority up to, but not exceeding, $2,500 after ... We Touch We are always searching for Workers Compensation Claim Examiners in the California region to join our...post. Position Summary Administers and resolves non-complex short term claims of low monetary amounts, including medical only … more
- Community Clinic Inc. (Silver Spring, MD)
- …a more equitable health care system for everyone. Position Summary CCI is seeking a Claims Specialist to serve as a financial resource in support of the clinical ... services provided. The Claims Specialist will assure that services are...and efficient communication with third-party payers which achieves expeditious claim adjudication and payment . + Maintains consistent… more
- Illumination Foundation (Santa Ana, CA)
- …in understanding, reading EOB's and Remittance Advice + Posting payment accurately to claims and continuing with the claim close out process (as needed). + ... Angeles County and the Inland Empire. Job Description The Claims Specialist is responsible for accuracy of...provider portals or authorization letters on Kipu prior to claim submission. + Reviewing claims prior to… more
- AIG (Atlanta, GA)
- …are reimagining the way we help customers to manage risk. Join us as a Recovery Specialist , Large Loss - Claims to play your part in that transformation. It's an ... + Corresponds with appropriate parties in accordance with established procedures regarding claim information, notice/demand of payment and related issues. +… more
- Axis (Red Bank, NJ)
- …of action, and pursue claims to conclusion * Set accurate and timely claim reserves and make referrals to senior members of the team where necessary * Obtain ... proper judgment and decision making in a best practices claim environment to promptly analyze the claim ...relevant policies, review policy wordings to validate coverage for claims and escalate any issues arising * Prepare coverage… more
- ManpowerGroup (Livingston, NJ)
- …NJ **Pay : $** 75,000 - $80,000 **What's the Job?** The Claim Specialist will be responsible for managing the claims process for clients from start ... Our client is seeking a Claims Specialist to join their team....closely with management and producers on the delivery of claim service to meet clientexpectations. + Effectively communicate with… more
- Health First (Rockledge, FL)
- …Support* **Organization:** **HRE dba HF Medical Equipment* **Title:** *DME Claims Specialist - Medical Equipment Administration* **Location:** *Florida ... expedite the billing and collections. This includes Customer Service, billing claims according to Federal/State and Managed Care rules, regulations and compliance… more
- AIG (Atlanta, GA)
- …are reimagining the way we help customers to manage risk. Join us as a Claims Recovery Specialist to play your part in that transformation. It's an opportunity ... to claimants by AIG, while ensuring recovery expenses are minimized. As a Recovery Specialist , you will be responsible for the claim recovery cases covering… more
- Modivcare (AZ)
- …drivers related to claim status, payment , and discrepancies. + Enters claim information and relevant details into the claims processing system. + Reviews ... . + Applies established guidelines and policies to determine claim eligibility and process claims accordingly. +...policies to determine claim eligibility and process claims accordingly. + Obtains missing information by using standard… more
- SCI Shared Resources, LLC (Whittier, CA)
- …vendor (American Funeral Financial) to ensure timely payment . Submit claims for Batesville rebates, process payments , research credit balances, submit ... and troubleshoot situations. Elevates problems up to the Account Claims Specialist II when unable to resolve.... claims and assist with third party insurance claims timely. + Submit total casket protection claim… more
- Illumination Foundation (Riverside, CA)
- …understanding, reading EOB's and Remittance Advice + Posting payment accurately to claims and continuing with the claim close out process. + Assist Manager ... Angeles County and the Inland Empire. Job Description The Claims Specialist is responsible for accuracy of...to date accounts receivable for both CalAIM and IFMG, claim follow-up, and must have knowledge of billing codes.… more