- Providence (Mission Hills, CA)
- **Description** The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, ... case rate etc.) and adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance issues as they relate… more
- Axis (Red Bank, NJ)
- …request for candidates taking part in the selection process. Job Description: AXIS is seeking a Senior Claims Specialist - Excess Claims to join our ... as well as reporting and presenting about same to senior management * In-depth knowledge of claims ,...to senior management * In-depth knowledge of claims , litigation, arbitration, and trial processes as well as… more
- Axis (Princeton, NJ)
- …direction, acts as highest level individual contributor directly reviewing excess casualty claims to determine nature of loss, coverage provided, and scope of claim ... and to make recommendation regarding settlement/disposition of claims . Please note this role is Hybrid/3 days in...transfer to the claim * Prepares required reports to senior management * Travels to mediations or settlement conferences… more
- Axis (New York, NY)
- …Heights, NJ, Princeton, NJ * Highest level individual contributor directly reviewing claims to determine nature of loss, coverage provided, and scope of claim ... for the timely evaluation, reserving and disposition of assigned claims * Documents coverage, investigation, damages, reserve rationale, negotiations, etc.… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …of Ward's Top 50 and rated A++ by AM Best. Duties We are looking for a Senior Claims Specialist - Professional Liability to join our team. Summary - ... and settle more complex first and third party insurance claims . A typical day will include the following: Evaluates...appropriate. Investigates circumstances of routine as well as complex claims to determine if and to what extent coverage… more
- Axis (Alpharetta, GA)
- …and coverage. * Timely makes recommendations regarding resolution strategy for such claims including reserve adequacy; executes such strategy on behalf of the ... damages issues in connection with complex primary and excess claims and maintaining appropriate documentation * Analyzes insurance coverage...letters * Collaborates in the defense and resolution of claims * Evaluates full pending of claims … more
- Medical Mutual of Ohio (Centerville, OH)
- **_The SDC - Claims /Customer Care Specialist - TPA position allows you the flexibility to work at home as long as you reside within a 50-mile radius of an Ohio ... performance expectations, service philosophy, and service level agreements. **Responsibilities** **SDC- Claims /Customer Care Specialist I** . Utilizing multiple… more
- NJM Insurance (Hammonton, NJ)
- Job Description The Claim Resolution Specialist 1 will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary ... action plan to manage the claim. The Claim Resolution Specialist 1 will work with and communicate to NJM...seek authority as needed. This role will manage litigated claims of low complexity for further development within this… more
- Axis (New York, NY)
- …analyze the claim exposure, determine the proper course 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...relevant policies, review policy wordings to validate coverage for claims and escalate any issues arising * Prepare coverage… 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...people who could be pretending to be recruiters or senior professionals at Zelis. As the leading healthcare payments… more
- Zurich NA (Columbus, OH)
- RCIS CROP Claims Employee Development Specialist 112483 We are excited to announce an opening in our Rural Community Insurance Services (RCIS) Crop organization. ... for this exciting opportunity will engage leaders and executive stakeholders in Crop Claims and the RCIS organization to lead the planning, execution and measurement… more
- BrightSpring Health Services (Honolulu, HI)
- …focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh ... come join our team and apply today! Responsibilities TheClaims Specialist - 3rd Party: + Manages and identifies a...+ Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing… more
- Randstad US (St. Paul, MN)
- senior claims specialists. + st paul , minnesota + posted 3 days ago **job details** summary + $27 - $27.82 per hour + temp to perm + high school + category ... + referenceAB_4521218 job details Randstad is looking to hire Senior Claims Specialists for a large financial...send your resume to ###@randstadusa.com with the subject "Sr Claims Specialist - Minnesota" for immediate consideration.… more
- Medical Mutual of Ohio (Brooklyn, OH)
- **_The Claims /Customer Care Specialist - TPA position allows you the flexibility to work at home as long as you reside within a 50-mile radius of the Brooklyn, ... in accordance with established performance expectations and service philosophy. **Responsibilities** ** Claims /Customer Care Specialist I - TPA** . Processes… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Property Claims Manager (State Risk Adjuster 6) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4476650) Apply Property Claims Manager ... information about this posting, please contact: Erica R. Gay HR Specialist Division of Administration/Office of Human Resources email: ###@la.gov Qualifications… more
- Allied Solutions (Plano, TX)
- Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This ... will involve the initial processing and investigation of 20-40 claims per day. This position ensures that all claim...Total Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; +… more
- Zelis (Boston, MA)
- …we're looking for a skilled Technical Writer to join our team as a specialist within our Price Optimization, Claims Editing organization. As a Technical Writer, ... creating clear and concise documentation to explain the intricacies of our claims editing processes. Responsibilities include developing and maintaining a library of… more
- Zurich NA (Rancho Cordova, CA)
- Senior Claim Specialist Construction Defect 112105 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when ... Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims...Overland Park, Parsippany, Rancho Cordova or Schaumburg. As a Senior Claim Specialist Construction Defect you will… more
- EMCOR Group (El Cajon, CA)
- **Description** **Job Title:** **Sr. Insurance and Contracts Specialist ** **Reports to:** **CFO** **FLSA Status:** **Exempt** **Department:** **Corporate** ... Inc. (UMEC) is currently seeking an experienced Sr. Insurance and Contracts Specialist for our southern California operations, based out of our San Diego… more
- PruittHealth (Norcross, GA)
- …all Medicaid billing services by final/higher level auditing, correcting, and submitting claims . Ensures that billing services are timely, accurate, and allow for ... appropriate reimbursement. Conducts all claims -related follow up on payment delays, taking corrective action(s) to finalize account disposition and/or referring … more