- GAF (Parsippany, NJ)
- …under this roof, we protect what matters most. **Job Summary** The Residential Warranty Claims Examiner position is a critical member of our Residential Warranty ... Warranty Claims Supervisor for Enhanced Warranties. The Residential Warranty Claims Examiner will be responsible for overseeing their assigned warranty… more
- Sedgwick (Newark, NJ)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - General Liability **PRIMARY PURPOSE** **:** To act as a ... department subject matter expert by providing guidance to the complex claims team to ensure consistency resolving matters optimally while creating a culture of… more
- Sedgwick (Newark, NJ)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner I NY license required I Remote **PRIMARY PURPOSE** : ... To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and… more
- Sedgwick (Trenton, NJ)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner , Bodily Injury (Auto) **PRIMARY PURPOSE** : To analyze and ... process complex auto and bodily injury claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
- Intermountain Health (Trenton, NJ)
- **Job Description:** The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims , in a timely and ... to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely… more
- Raphael and Associates (NJ)
- …a fast-paced environment. We are currently growing and are looking for a TPA Property Claims Examiner with a minimum of five years of experience in this ... Senior Property Desk Examiner (remote) Company Overview: Raphael & Associates is...(remote) Company Overview: Raphael & Associates is a third-party claims administrator and independent claims adjusting company… more
- Sedgwick (Trenton, NJ)
- …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... to advance to the next round, a recruiter will be in touch. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable range of compensation for… more
- Prime Therapeutics (Trenton, NJ)
- …and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively ... compliance with federal, state and local laws pertaining to investigations and fair claims handling practices; evaluate risk to determine how best to proceed with… more
- Prime Therapeutics (Trenton, NJ)
- … claims processing environment **Preferred Qualifications** + Certified Fraud Examiner or Accredited Health Care Fraud Investigator + National Pharmacy Technician ... and client initiatives; engage in cross functional analysis of medical and pharmacy claims ; lead FWA investigations for federal employee program + Stay current on… more
- Travelers Insurance Company (Morristown, NJ)
- …on all accounts. Under close supervision, performs risk evaluations and claims investigations on less complex accounts as assigned. Participates in individual ... equipment breakdown, and overall insurability. Investigate less complex Equipment Breakdown claims as requested by the claim department. Evaluate elements of the… more
- Highmark Health (Trenton, NJ)
- …**Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) ... (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have… more