- NJM Insurance (Trenton, NJ)
- …+ Prepare, attend, and participate in Claim Reviews as needed with the Claims Supervisor + Participate in training programs to keep current on relevant ... needed. This position may manage select Catastrophic (CAT) losses assigned by the Complex Claims Supervisor for developmental purposes. This role can be based in… more
- University of Rochester (Rochester, NY)
- …(Fidelis Medicaid Managed Care and Medicare Part B) clearinghouse software, third party claims systems (ePaces, Omnipro) and various payer web sites. **Typical ... up on unpaid accounts + For unpaid accounts, check claim status on appropriate payer system or...supervisor or manager on trends of incorrectly paid claims from specific payers + Work with supervisor… more
- Travelers Insurance Company (Overland Park, KS)
- …and resolving, assigned Auto and Homeowner related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...in accordance with department guidelines. + Utilizes diary management system to ensure that all claims are… more
- Travelers Insurance Company (Las Vegas, NV)
- …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...by adhering to quality standards. + Utilizes diary management system to ensure that all claims are… more
- Travelers Insurance Company (Irvine, CA)
- …negotiating and resolving assigned General 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...quality standards and trend analysis. + Utilizes diary management system to ensure that all claims are… more
- The Cigna Group (Bloomfield, CT)
- …Cigna Group is hiring several System Configuration Associates. For this essential fast-paced Claims Systems role, you'll manage simple to complex Claims ... do to make a difference:** + Work from ticket system to correct Claims System ...Supervisor and Quality Assurance Associates + You'll work claims systems configuration tasks independently with configuration… more
- University of Washington (Seattle, WA)
- …Practice Plan Services (FPPS)** has an outstanding opportunity for a **full-time, day shift, CLAIMS SUPERVISOR .** **WORK SCHEDULE** + 40 hours per week + Day ... Shift + This position is Remote **POSITION HIGHLIGHTS** The Claims Supervisor is responsible for the coordination...is responsible for the coordination and control of the Claim Specialist Team, ensuring that effective operations run smoothly… more
- Dignity Health (Bakersfield, CA)
- …Services Organization (Dignity Health MSO) is to build a system -wide integrated physician-centric full-service management service organization structure. We offer ... accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care… more
- The Mount Sinai Health System (New York, NY)
- …schedule that is assigned. + Prepares all downloads of billing files from Mainframe System to Clearing House. Transmits all clean claims daily to Clearing House ... preferred) + Edits unbilled/unprocessed accounts (billing) using PFS HIS Systems , Clearing House Claim Scrubber and/or any...Claim Scrubber and/or any payer websites available for claim correction of billed accounts. + Bill claims… more
- System One (Fairfax, VA)
- …a leading health insurance customer. The individual will review and adjudicate paper/electronic claims , also use automated system processes to send pending ... procedures allowing timely considerations to be generated using multiple systems . Pay rate $22.50/HR 100% Remote Contract to hire...100% Remote Contract to hire ESSENTIAL FUNCTIONS + Performs claims adjudication for complex medical claims . +… more
- City of New York (New York, NY)
- …Review, process, determine and/or establish cases assigned manually or via Automated SNAP Claim System (ASCS) cases for potential SNAP benefit overpayment. This ... Office was enhanced by the addition of the Supplemental Nutrition Assistance Program- Claims and Recovery (SNAP-CR). SNAP-CR establishes SNAP claims for the… more
- Henry Ford Health System (Detroit, MI)
- … system role in workers compensation and employers liability claims review, investigation, management and disposition, including financial mitigation of indemnity ... payment and claim defense costs and management of System ...+ Oversees and coordinates internal/external investigation and resolution of claims , and lawsuits and acts as a system… more
- Allied Universal (Durango, CO)
- …claims with red flags that suggest fraudulent behavior In relation to an Insurance claim . The Claims / SIU Specialist must use their extensive knowledge of ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic… more
- NJ Transit (Newark, NJ)
- …TRANSIT from notice of claim to final resolution This Position Supervises: + Supervisor , Claims Admin + Director Risk Management & Insurance + Director ... injury to third parties (involving both bus and rail systems ) and damage to both NJ TRANSIT property and... Review Committee Meetings for third party and FELA claims . + Presents Claim Board Items, the… more
- City of New York (New York, NY)
- …Review, process, determine and/or establish cases assigned manually or via Automated SNAP Claim System (ASCS) cases for potential SNAP benefit overpayment. - ... and centralized data reporting. The areas are Centralized Data Entry (CDE), Claims & Collections (C&C), Division of Financial Review and Processing (DFRP), Office… more
- Catholic Health Initiatives (Omaha, NE)
- …the overall claim process through submission of both electronic and paper-based claims , resolution of claim -form edits and validation of data integrity. Work ... requires an understanding of detailed billing requirements, claims attachments and claim rejections, as well...in a timely and accurate manner. 3) Resolves all claim edits, in both the billing system … more
- Publix (Lakeland, FL)
- …against third parties. + entering claim details into the Risk Management claims system . + Reviewing and analyzing negotiation/settlement claim details, ... Claims Specialist works closely with and reports to a Represented Claims Supervisor and Manager. Additional responsibilities include: + analyzing,… more
- Kelsey-Seybold Clinic (Houston, TX)
- …and Contractual Payment Rates. Position will work closely with Supervisor and Claim Services to complete request for claims adjustments via CRM Module. ... interpret regulatory guidelines (ie TDI, CMS, HIPAA, etc.) Strong knowledge of Claims Services and Claim Review Processes. Preferred: N/A **Other** Required:… more
- Guidehouse (Lewisville, TX)
- …Reconciliation **Duties and Responsibilities** + Performs daily download and reconciliation of claims from patient accounting system to electronic billing ... system . + Transmits or releases claims at a minimum daily. + Works all assigned claims daily by resolving edits, validating claim , or placing on… more
- Acosta Group (Jacksonville, FL)
- …. + Searches for and links invoices, contracts, and Proof of Performance to claims as needed. + Uses systems , reports, and Standard Operating Procedures to ... work assigned claim steps and gather supporting claims information....provides value added solutions. + Escalates appropriately to the supervisor when needed to get information or handle complex… more