- 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)
- …measures to assist in the claim adjudication process. * Routes and triages complex claims to Senior Claim Benefits Specialist . * Proofs claim or ... related to claim processing issues. - Routes and triages complex claims to Senior Claim Benefits Specialist . - Proofs claim or referral submission… 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 ... of our customers and our communities. The IDI Senior Claims Specialist evaluates individual disability income insurance...care providers, attorneys, brokers, and family members during the Claim Specialist 's claim evaluation. *… more
- MassMutual (Springfield, MA)
- **The Opportunity** As a **Life Claims Specialist ** you will work with beneficiaries, attorneys, trustees, executors, financial advisors, etc. through email, ... experience when it matters most. **The Impact** The **Life Claims Specialist ** role requires a willingness to...set expectations, review claim requirements, and answer claim related questions. + Adjudicate complex claims … 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 ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...partners. **What Will You Do?** + Directly handles assigned claims . + Provides quality customer service and ensures file… more
- CVS Health (Hartford, CT)
- …and Training Hours: + Training 8:00am-4:30pm + Shift: 8am-4:30pm Claim Benefit Specialist Reviews and adjudicates claims in accordance with claim ... Efficiently use multiple systems and screens to obtain and record claim information + Review claims information to determine the nature of a member's illness or… more
- City of New York (New York, NY)
- …New York employees serving in a permanent (not provisional) civil service title of Claim Specialist . Please clearly state your permanent civil service title on ... Law & Adjustment is responsible for investigating and adjusting claims filed for and against the City of New...in a permanent (not provisional) civil service title of Claim Specialist . Please clearly state your permanent… 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 ... all communications and reporting associated with the life of a claim . At Zurich North America Claims we acknowledge that work life-balance and flexibility are a… more
- CVS Health (St. Paul, MN)
- …affordable. Position Summary Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Reviews and ... May handle customer service inquiries and problems. Reviews pre-specified claims or claims that exceed specialist...applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries… more
- CVS Health (Pittsburgh, PA)
- …written correspondence related to claim processing issues. * Routes and triages complex claims to Senior Claim Benefits Specialist . * Proofs claim ... and affordable. Position Summary * Reviews and adjudicates routine claims in accordance with claim processing guidelines....and adjudicates routine claims in accordance with claim processing guidelines. * Analyzes and approves routine … more
- Zelis (Atlanta, GA)
- Position Overview: The Claims Settlement Specialist supports claim settlement with providers through post payment negotiation. The Claims Settlement ... based on Zelis data points. During this call, the Claims Settlement Specialist must understand: (1) the... must understand: (1) the procedures billed on the claim /bill; (2) the estimate of the fair value of… more
- City National Bank (Los Angeles, CA)
- **PAYMENTS CLAIM SPECIALIST ** **WHAT IS THE OPPORTUNITY?** The Payment Claims Specialist is responsible for the investigation and processing of payment ... identification of miss/near miss opportunities etc. A successful Payment Claim Specialist will be able to navigate...of actions as needed. + Perform quality checks of claims for accuracy and feedback for the claim… 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
- Travelers Insurance Company (Houston, TX)
- … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site… 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 ... information and/or correspondence to the Agent or Insurer to process claims appropriately. 6. Analyze claim coverage with insurance carriers to ensure claims … 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
- 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 ... appropriate. Key Responsibilities: * Manages overall STD block of claims and possible companion claims to include...Federal, State, Local laws * Creates and executes individual claim action plans, serves as point of contact for… more
- City of New York (New York, NY)
- …York City Comptroller's Office. BLA is seeking qualified candidates for the position of Claim Specialist 2 in the Litigation Support Unit. This position, with ... is involved in a significant amount of litigation and claims filed with the New York City Comptroller's Office....well as other DEP personnel, to provide litigation and claim support. The candidate will perform various types of… more
- City of New York (New York, NY)
- Job Description PLEASE NOTE ALL CANDIDATES MUST BE PERMANENT IN THE CLAIM SPECIALIST CIVIL SERVICE TITLE IN ORDER TO BE CONSIDERED. The NYC Department of ... is involved in a significant amount of litigation and claims filed with the New York City Comptroller's Office....BLA is seeking qualified candidates for the position of Claim Specialist in the Litigation Support Unit.… 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