- Sedgwick (Charleston, WV)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Claims Specialist Professional Liability, Public Entity **PRIMARY PURPOSE** **:** ... entity; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within Company standards, industry best practices… more
- Lincoln Financial Group (Charleston, WV)
- …73468 **The Role at a Glance** We are excited to bring on highly motivated Voluntary Claims Specialist I to staff our ever-growing claims organization. As a ... administering, processing, and adjudicating Accident, Critical Illness, and Hospital Indemnity claims for our members. You'll complete a thorough training to develop… more
- Lincoln Financial Group (Charleston, WV)
- …**The Role at a Glance** We are excited to bring on a highly motivated **Group Claims Specialist ** to support our ever-growing claims organization in a work ... support our west coast employer groups. _Background details_ As a Group Claims Specialist , you will support our Short Term Disability or Integrated Absence… more
- Trustmark (Charleston, WV)
- …colleagues, clients and communities. Responsible for reviewing and processing claims including, identifying irregularities and reviewing for accuracy, and ... Critical Care. **Key Accounabilities:** + Demonstrates strong understanding and performs claims handling processes and procedures related to Wellness, Hospital and… more
- Allied Universal (Beckley, WV)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... programs, and exclusive perks. Allied Universal(R) is hiring a Surveillance / Claims Investigator. Surveillance / Claims Investigators validate the facts of… more
- Elevance Health (Charleston, WV)
- **eCOB Specialist II** **Location:** Hybrid, within 50 miles of an Elevance Health Pulse Point location. **Hours:** Monday - Friday, 6am - 6pm EST The **eCOB ... Specialist II** is responsible for researching and investigating other...enrolling in Medicare. + Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well… more
- Zurich NA (Charleston, WV)
- Senior Design/Construction Management Consulting Specialist 113183 Zurich is looking for a highly skilled **Senior Design/Construction Management Consulting ... Specialist ** within Risk Engineering and our Zurich Resilience Solutions...prospect/existing customer base. + Providing periodic support to the Claims Department with technical assessment of complex claims… more
- Walgreens (Martinsburg, WV)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- American Water (Kearneysville, WV)
- …* West Virginia American Water* has an opportunity for a* Senior Health & Safety Specialist * to join our team in *Kearneysville, WV*. Safety is at the core of ... as a utility leader. The Senior Health & Safety Specialist will be a vital role to help lead...* Investigating incident and automobile and Workers Compensation insurance claims . * Conducting thorough incident investigations to determine the… more
- Healthfirst (WV)
- …complaints, and member and provider appeals. The end-to-end process requires the Specialist to independently: + Research issues + Reference and understand HFs ... Work within a framework that measures productivity and quality for each Specialist against expectations + Additional duties as assigned **Minimum Qualifications** +… more
- Travelers Insurance Company (Charleston, WV)
- …of the scene and to provide technical advice and consultation to attorneys and claims staff associated with the loss. + Conduct research and testing, prepare reports ... (verbal and written), and to aid the claims and legal staff with the scientific aspects of...needed to support the overall functions of Risk Control, Claims Services, and Underwriting. Such materials may include newsletters,… more
- Sutherland Global Services (Charleston, WV)
- …sent to Legal. This will include: + Conducting collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or ... PPO, IPA and Capitation and how these payers process claims + Knowledge of Managed Care contracts, Contract Language...billing form requirements (UB04) and HCFA 1500 + Medical claims and/or hospital collections experience + Minimum high school… more
- ManpowerGroup (Scott Depot, WV)
- …full-time Job?** A Company in Frazier's Bottom, WV is seeking a Quality Control Specialist that is hardworking and motivated to join their growing team! What's in it ... QC Inspection work Manage In-line Defect Parts Qty Manage Warranty claims Communicate/work with customers/suppliers regarding QC related items Create, prepare, and… more
- CROSSMARK (Morgantown, WV)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **Qualifications** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- Elevance Health (Charleston, WV)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... HS diploma or equivalent and a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Guardian Life (Charleston, WV)
- …The Vocational Rehabilitation Consultant provides assessment of LTD, STD and Life claims , to determine claimants' level of functionality and provide evaluation of ... of RTW. Serve as educational resource on vocational rehab aspect of claims . Educate parties involved in claim management regarding the extent of functional… more
- Highmark Health (Charleston, WV)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Wolters Kluwer (Charleston, WV)
- …increase operational efficiency and reduce costs. Corporate legal and insurance claims departments trust our innovative technology and end-to-end customer experience ... and achieving new business growth. As an Enterprise Software Sales Industry Leader Specialist this role will play a pivotal role in driving new business development… more
- Zurich NA (Charleston, WV)
- …and customer satisfaction. + Participating in leadership team meetings to provide specialist guidance and enable the implementation of policies, projects and change ... industryOR + Bachelor's Degree with 20 or more years of experience in Claims or Underwriting Support area within the Commercial Insurance industryAND + Experience in… more
- SMX (Charleston, WV)
- …+ Serves as the liaison with vendors and brokers to resolve employee claims . + Provides coaching and responds to escalated 401(k) inquiries from employees relating ... and/or benefits administration in government contracting + Certified Employee Benefits Specialist (CEBS) or related Human Resources certification a plus. + Knowledge… more