- Humana (San Juan, PR)
- **Become a part of our caring community and help us put health first** The Supervisor , Claims Processing reviews and adjudicates complex or specialty ... claims , submitted either via paper or electronically. The Supervisor , Claims Processing works within thorough, prescribed guidelines and procedures; uses… more
- Providence (Mission Hills, CA)
- …the supervision of staff and for overseeing the day-to-day operations of the Claims Processing and UM Denial Letter Units. Additional responsibilities include ... Schedule:** Full time **Job Shift:** Day **Career Track:** Leadership **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills… more
- Washington Suburban Sanitary Commission (WSSC) (Laurel, MD)
- …responsible for the analysis and management of claim files within the department.The Claims Supervisor leads, trains, and monitors the activities of all ... with other teams and field staff to ensure timely and accurate claims processing and handling of customers Other Functions + Participates in claims… more
- CRC Insurance Services, Inc. (Flower Mound, TX)
- …Responsible for overseeing, managing and supporting all activities of the claims employees and operations of the department. **ESSENTIAL DUTIES AND ... change from time to time. 1. Manage the supervision and coordination of the claims department and staff. 2. Organize and disseminate information that affects the … more
- Amentum (Washington, DC)
- The CRST Project Supervisor - specific duties and responsibilities include: + Assist Claim Review Support Team Project Manager in all aspects of Claim Review Support ... This involves monitoring various claim statuses or queues and identifying claims assignable within the Special Master's guidance. + Determine individual team… more
- Commonwealth of Pennsylvania (PA)
- …A bachelor's degree;or + Two years of technical experience in evaluating or processing claims , or interviewing consumers to obtain or review financial, insurance ... unique cases and seeking guidance and direction from your supervisor on cases of abnormal complexity. Do not miss...+ Four years of technical experience in evaluating or processing claims or interviewing consumers to collect… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Master's Degree Experience Required: A minimum of 5 years of experience performing claims audits or claims processing related to Medi-Cal, Cal ... with LA Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of...capitated hospitals and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates.… more
- Crawford & Company (Hauppauge, NY)
- …members of the medical profession and other persons pertinent to the investigation and processing of claims . + Verifies policy coverage for submitted claims ... In Everything We Touch Position Summary Administers and resolves non-complex short term claims of low monetary amounts, including Fast Track and Incident Only … more
- Sedgwick (Brea, CA)
- …team meetings and assigns accountability for follow-up items. + Gathers important compliance/ claims processing information to be presented at team meetings. + ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Team Lead Assistant | Brea, CA **PRIMARY PURPOSE:** To analyze… more
- Sedgwick (Richfield, MN)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Handling Positions - Greater Minneapolis Area Are you looking for an… more
- LA Care Health Plan (Los Angeles, CA)
- …Degree in Business or Related Field Experience Required: At least 4 years of claims processing experience in a Health Plan environment. At least 3 years ... claims , Provider Disputes and Adjustments. This position works with the Claims Operations Supervisor to develop procedures ensuring the achievement of goals… more
- Kohler Co. (Kohler, WI)
- …and eligibility in accordance with the Pay Protection Plan and standard claims processing procedures. + Contact attending personal care provider (PCP) ... + Offer suggestions on more efficient work-flow procedures to supervisor and benefits personnel. Leave Administration + Maintain a...degree) - or equivalent experience + Knowledge of general claims processing procedures + Knowledge of medical… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also ... be responsible for analyzing claims and making decisions about their validity. The position...provides resolution in priority order as directed by the Supervisor + Searches for and links invoices, contracts, and… more
- Acosta Group (Charlotte, NC)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also ... be responsible for analyzing claims and making decisions about their validity. The position...provides resolution in priority order as directed by the Supervisor . + Searches for and links invoices, contracts, and… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also ... be responsible for analyzing claims and making decisions about their validity. The position...provides resolution in priority order as directed by the Supervisor + Searches for and links invoices, contracts, and… more
- Sedgwick (Columbus, OH)
- …while providing high levels of customer service. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** Claims Management and Processing : + Handle a diverse portfolio of ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Claims Specialist, Professional Liability (Cyber) **PRIMARY PURPOSE** **:** To analyze… more
- Sedgwick (Columbus, OH)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Specialist, Professional Liability **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + ... Analyzes and processes complex or technically difficult liability claims by investigating and gathering information to determine the exposure on the claim; manages … more
- Sedgwick (Columbus, OH)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Environmental Claims Specialist **Job Description Summary** To analyze complex or technically ... difficult environmental claims ; to provide resolution of highly complex nature and/or...trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. +… more
- Sedgwick (Glendale, CA)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Examiner | Glendale, CA (Agile) **PRIMARY PURPOSE** : To analyze ... complex or technically difficult workers' compensation claims to determine benefits due; to work with high...professional and timely manner. + Communicates claim activity and processing with the claimant and the client; maintains professional… more
- Adecco US, Inc. (Ontario, CA)
- …a local client in their search to fill a **Remote Worker's Compensation Claims Examiner** job opportunity but **_MUST LIVE IN STATE OF CALIFORNIA._** **Pay rate: ... months+** **PRIMARY PURPOSE:** To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure … more