- CVS Health (Monroeville, PA)
- …has an opportunity available for a full time Medical Claims Refund Specialist . This role ensures timely credit balance resolution via refunds to patients, ... parking. Role Overview + Schedule: Monday-Friday 8:00AM-4:30PM (Flex Start after training) + Hybrid Role What you will do + Responsible for reviewing the validity of… more
- The Hartford (Hartford, CT)
- Specialist Claims - CH07DE We're determined...a well-reasoned analytical focus, and a clear strategy for resolution . The Claim Specialist must also be ... team as we help shape the future. The Claim Specialist is the highest claim handling designation within the...to customers and business partners in the management and resolution of claims * Respond to inquiries… more
- Zurich NA (Schaumburg, IL)
- General Liability Litigation Claims Specialist 110492 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority ... Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing...should be expected. Zurich is currently looking for a ** Claims Specialist II** to report out of… more
- 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 ... an action plan to manage the claim to final resolution . The Complex Claim Specialist will work...manage select Catastrophic (CAT) losses assigned by the Complex Claims Supervisor for developmental purposes. This role can be… more
- Randstad US (Itasca, IL)
- claims auto adjuster - hybrid . +...collaborative environment that fosters development and growth. As an claims resolution specialist , you will ... and its customers. As a member of the Auto Claims team, you will work in a dynamic and...goals and metrics that drive the success of the claims organization. You will take part in an accelerated… more
- The Hartford (Hartford, CT)
- Specialist Claims - CH07DE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... team as we help shape the future. As a Claims Specialist , you will be responsible for...authority above established authority levels; + Developing and implementing resolution strategies to achieve high quality outcomes; + Proactively… more
- Randstad US (Malvern, PA)
- claims specialist . + malvern , pennsylvania +...thru Thursday in office Please Note: This is a hybrid role, combining work from home and office presence. You ... download speed (1000mbps) and at least 30 Mbps upload speed + Great Problem Resolution and Time Management skills + Tech-Savvy The essential functions of this role… more
- St. Luke's University Health Network (Allentown, PA)
- …with optimal goal of receiving accurate payments and maximum reimbursement. + Statuses claims resolution , appeals and corrected claims via payer websites ... ability to pay for health care. The Accounts Receivable Specialist I is responsible for the billing and collection...I is responsible for accurate and timely submission of claims to third-party payers, intermediaries and guarantors in accordance… more
- State of Indiana (Indianapolis, IN)
- Resolution Specialist Date Posted: Jun 6, 2024...of this role could include: + Serves as a claims specialist and subject matter expert for specific ... thrive in a changing economy. Role Overview: As the Resolution Specialist , you will review and determine...applicant's entitlement to benefits related to UI and TRA claims . Communicates and collaborates with claimants, employers, federal and… more
- Penn Medicine (Philadelphia, PA)
- …Market Street, Philadelphia** **Hours: Full-Time; Hybrid ** Summary: + The Account Resolution Specialist I reports to the Supervisor of Billing; primary ... responsibilities are to facilitate activities necessary to a successful resolution of accounts. This position will work out of assigned work queues handling claim… more
- State of Colorado (Denver, CO)
- …+ Professional experience working with Medicaid Prior Authorizations and Medicaid claims troubleshooting and resolution . + Professional experience working with ... Community Living Data & Claims Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4533291) Apply Community Living Data & Claims … more
- Martin's Point Health Care (Portland, ME)
- …Work" since 2015. Position Summary Job Description Position Summary: The Appeals Specialist (Medicare or US Family Health Plan) is responsible for ensuring ... provider pre-service appeals in a timely and compliant manner. The Specialist communicates and collaborates with Case Managers, Medical Directors and Compliance… more
- Ramsey County (St. Paul, MN)
- …hire other vacancies in the department or County. To perform the daily claims management function for resolution of tort, auto, property/casualty, and subrogated ... , gathering relevant information, and coordinating with stakeholders to ensure timely resolution . + Update and maintain claims management workflows to align… more
- Houston Methodist (Katy, TX)
- …our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** **. ( Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position ... events as well as the accountability of ensuring completion with corrected claims , and/or data extraction in preparation of audits. **PEOPLE ESSENTIAL FUNCTIONS** +… more
- AIG (Cincinnati, OH)
- …+ Accurate and consistent policy interpretation. What we're looking for + Basic specialist knowledge in (LoB) technical claims topics; + Policy language skills ... This is a hybrid role in Cincinnati Ohio requiring 3 to...About the role Will handle a portfolio of Liability claims of lower complexity claims from coverage… more
- New York State Civil Service (White Plains, NY)
- NY HELP Yes Agency Workers' Compensation Board Title Compensation Claims Referee (NY HELPS), WCB Item #3625 Occupational Category Legal Salary Grade 28 Bargaining ... making temporary appointments. When the Civil Service commission adopts the NY HELPS resolution , if a temporary NY HELPS employee is satisfactorily performing in the… more
- Fallon Health (Worcester, MA)
- …ancillary provider inquiries and requests for services associated with the resolution of provider complaints relating to operational concerns, policy and procedures ... and resolve issues. + Monitor status of QNXT cases thru to resolution status. Maintain detailed documentation within QNXT cases. Conduct proactive follow-up… more
- Acosta Group (Jacksonville, FL)
- …Customer Service Supervisor, Business Managers, and Customer Managers. + Perform resolution procedures outlined in static help file. + Investigate rules engine ... (Word, Excel, and Outlook). + Proficient in document management software. + Proficient in claims management software. + Type a minimum of 60 wpm. Acosta Sales &… more
- Zurich NA (Schaumburg, IL)
- …your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to ... Specialist 114101 Zurich is currently seeking a Sr. Claims Professional to join our Latent & Environmental team...of our Mass Litigation team, you will manage a claims caseload from assignment through resolution , with… more
- Johns Hopkins University (Baltimore, MD)
- …Cycle Specialist III_** responsible for the collection of unpaid third-party claims and independent resolution of complex appeals, using various JHM ... payers to resolve issues and facilitate prompt payment of claims . Communicates with providers regarding appeals and medical policy...and expertise using Epic Resolute for A/R functions and resolution of revenue cycle issues in an academic medicine… more