- 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
- 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 (Raleigh, 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
- 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 (Raleigh, 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
- Truist (Wilson, NC)
- …Policy is responsible for working with our Enterprise Fraud Management Detection and Claims teams to achieve desired business goals. These goals included, but are ... Responsible for leading and deploying new initiatives and executing on complex operational processes. 2. Recommends procedures, establishes, modifies documents, and… 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