- 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
- 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 fraud claims and disputes with precision...reviews, identification of miss/near miss opportunities etc. A successful Payment Claim Specialist will be… 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...better way to determine the cost of a healthcare claim , manage payment -related data, and make the… 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...prior to presenting questions. + Utilize resources to approve claim for payment based on in good… 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)
- … cost management opportunities and refer claims for follow up + Make claim payment decisions + Process claims accurately to enhance customer satisfaction ... + Training 8:00am-4:30pm + Shift: 8am-4:30pm Claim Benefit Specialist Reviews and adjudicates claims in accordance with claim processing guidelines. … more
- Travelers Insurance Company (Houston, TX)
- …and processes out-going mail. Orders, receives and distributes supplies and/or equipment. + CLAIM PAYMENTS AND EXPENSE PROCESSING: Ensures the proper handling of ... Triage and route callers to the appropriate department; Answers claim status and payment questions. + ...financial transactions to include: Processes and issues claim payments including outside vendor invoices, attorney… more
- Trinity Health (Farmington Hills, MI)
- … Resolution, Interprets data, draws conclusions, and reviews findings with all levels of Payment Resolution Specialist for further review. Serve as a resource to ... center. Serves as part of a team of clinical payment resolution colleagues at an assigned PBS location responsible...reimbursement based upon services delivered and ensuring that the claim is paid/settled in the most timely manner possible:… 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 (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
- 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
- MyFlorida (Tallahassee, FL)
- CLAIMS PROCESSING SPECIALIST - 36000116 Date:...rules, policies and procedures. + Prepare and maintain prize payment claim files. + Answer phone calls ... Requisition No: 822431 Agency: Department of Lottery Working Title: CLAIMS PROCESSING SPECIALIST - 36000116 Pay Plan:...for payment ensuring compliance with established prize payment rules, policies, and procedures. + Review claim… more
- Zelis (Atlanta, GA)
- …other related responsibilities as assigned. Professional Experience: + 1+ years of medical claim payment review. + Adhere to established HIPAA, compliance, and ... Position Overview: The Claims Support Specialist position provides comprehensive...better way to determine the cost of a healthcare claim , manage payment -related data, and make the… more
- Crawford & Company (Brea, CA)
- …and/or clients. + Approves payments of medical bills on lost time disability claims within area of payment authority up to, but not exceeding, $2,500 after ... We Touch We are always searching for Workers Compensation Claim Examiners in the California region to join our...post. Position Summary Administers and resolves non-complex short term claims of low monetary amounts, including medical only … more
- MetLife (Tampa, FL)
- …impact in the lives of our customers and our communities. The Lead LTD Claims Specialist manages a caseload of long term disability insurance claims ... time service standards. In this role, the Lead LTD Claims Specialist will be a technical expert...regulations. Provides timely and detailed written communication during the claim evaluation process which outlines the status of the… more
- Community Clinic Inc. (Silver Spring, MD)
- …a more equitable health care system for everyone. Position Summary CCI is seeking a Claims Specialist to serve as a financial resource in support of the clinical ... services provided. The Claims Specialist will assure that services are...and efficient communication with third-party payers which achieves expeditious claim adjudication and payment . + Maintains consistent… more
- Magellan Health Services (Albuquerque, NM)
- …to be required, acting within established parameters, this role makes the appropriate payment adjustment into the claims system. Must complete duties with a ... + Completes data entry for tracking and reporting of claim disputes. + Adjudicates claims and adjustments....time). Comfortable adapting to change. General Job Information Title Claims Resolution Specialist Grade 20 Work Experience… more
- Axis (New York, NY)
- …of action, and pursue claims to conclusion * Set accurate and timely claim reserves and make referrals to senior members of the team where necessary * Obtain ... proper judgment and decision making in a best practices claim environment to promptly analyze the claim ...relevant policies, review policy wordings to validate coverage for claims and escalate any issues arising * Prepare coverage… more
- ManpowerGroup (Livingston, NJ)
- …NJ **Pay : $** 75,000 - $80,000 **What's the Job?** The Claim Specialist will be responsible for managing the claims process for clients from start ... Our client is seeking a Claims Specialist to join their team....closely with management and producers on the delivery of claim service to meet clientexpectations. + Effectively communicate with… more