- NJM Insurance (Hammonton, NJ)
- …is a full-time position and offers a hybrid schedule after training. The Complex Claim Specialist will be responsible for contacting all parties involved in the ... the claim to final resolution. The Complex Claim Specialist will work with and communicate...policyholder's reporting practices + Prepare, attend, and participate in Claim Reviews as needed with the Claims … more
- CVS Health (San Antonio, TX)
- …measures to assist in the claim adjudication process. * Routes and triages complex claims to Senior Claim Benefits Specialist . * Proofs claim or ... related to claim processing issues. - Routes and triages complex claims to Senior Claim Benefits Specialist . - Proofs claim or referral submission… more
- Sedgwick (Columbus, OH)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Life Science Claim Specialist (REMOTE US) **PRIMARY PURPOSE** **:** To analyze complex ... investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and timely… more
- Travelers Insurance Company (Wyomissing, PA)
- …negotiating and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim ... Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is… more
- CVS Health (Hartford, CT)
- …and Training Hours: + Training 8:00am-4:30pm + Shift: 8am-4:30pm Claim Benefit Specialist Reviews and adjudicates claims in accordance with claim ... Efficiently use multiple systems and screens to obtain and record claim information + Review claims information to determine the nature of a member's illness or… more
- Samsung SDS America (Plano, TX)
- …Account Group and its Settlement subpart as well as the company's Management/Finance Group. Claims Specialist will work on a resolution of logistics claims , ... any delays or issues that arise. + Notify involved parties of claim filings and/or rejected claims and work with the claimant to understand the value of damaged… more
- MetLife (Omaha, NE)
- STD / LTD Claim Specialist City/Cities Aurora, Bloomfield, Cary, Omaha, Oriskany, Tampa State(s) Connecticut, Florida, Illinois, Nebraska, New York, North ... is a diverse team of engineers, developers, business analysts, claims analysts and project managers with the freedom to...claim decisions on STD, LTD, PML and state claims . Clarify functional capacity through independent problem solving… more
- MassMutual (Springfield, MA)
- **DI Claim Specialist , DI Claims ** **Springfield Office, Fulltime (Hybrid)** **Job Description** We're growing and our clients deserve the best. As a DI ... Claim Examiner, you will be responsible for adjudicating Individual...claims of varying complexity. **The Opportunity** As a Claim Examiner, you will collaborate with subject matter experts;… more
- CVS Health (Pittsburgh, PA)
- …written correspondence related to claim processing issues. * Routes and triages complex claims to Senior Claim Benefits Specialist . * Proofs claim ... and affordable. Position Summary * Reviews and adjudicates routine claims in accordance with claim processing guidelines....and adjudicates routine claims in accordance with claim processing guidelines. * Analyzes and approves routine … more
- CVS Health (Raleigh, NC)
- …to assist in the claim adjudication process. Routes and triages complex claims to Senior Claim Benefits Specialist .Proofs claim or ... to make health care more personal, convenient and affordable. Position SummaryFast, accurate claims payment is one of the ways we make a difference inpeople's lives.… more
- CVS Health (St. Paul, MN)
- …to complex issues. May handle customer service inquiries and problems. Reviews pre-specified claims or claims that exceed specialist adjudication authority ... affordable. Position Summary Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- CVS Health (Albany, NY)
- …handle customer service inquiries and problems. Required Qualifications - Reviews pre-specified claims or claims that exceed specialist adjudication ... and affordable. Position Summary Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines . Acts as a… 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
- Travelers Insurance Company (Orlando, FL)
- … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site… more
- CRC Insurance Services, Inc. (Brewster, NY)
- …and makes recommendation for additional activity as appropriate. 3. Determine where new loss claims should be reported. 4. Manage all claim documentation. 5. Use ... information and/or correspondence to the Agent or Insurer to process claims appropriately. 6. Analyze claim coverage with insurance carriers to ensure claims … more
- CVS Health (Bismarck, ND)
- …Training is 12 weeks 9am-5:30pmEST + Shift: flex schedule Reviews and adjudicates routine claims on HRP system in accordance with claim processing guidelines. ... CMS and Aetna compliance and business requirements.Analyzes and approves routine claims that cannot be auto adjudicated.- Applies medical necessity guidelines,… more
- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking a Claim Account Specialist . This is a full-time position and offers a hybrid schedule after training. The ... evaluate the claim and implement an action plan to manage the claim . The Claims Account Specialist will work with and communicate to NJM policyholders,… more
- City of New York (New York, NY)
- …York City Comptroller's Office. BLA is seeking qualified candidates for the position of Claim Specialist 2 in the Litigation Support Unit. This position, with ... is involved in a significant amount of litigation and claims filed with the New York City Comptroller's Office....well as other DEP personnel, to provide litigation and claim support. The candidate will perform various types of… more
- City of New York (New York, NY)
- Job Description PLEASE NOTE ALL CANDIDATES MUST BE PERMANENT IN THE CLAIM SPECIALIST CIVIL SERVICE TITLE IN ORDER TO BE CONSIDERED. The NYC Department of ... is involved in a significant amount of litigation and claims filed with the New York City Comptroller's Office....BLA is seeking qualified candidates for the position of Claim Specialist in the Litigation Support Unit.… more
- City of New York (New York, NY)
- …current City of New York employees serving in a permanent civil service title of CLAIMS SPECIALIST . The Bureau of Law & Adjustment (BLA) is responsible for ... with latitude for independent analysis, judgment and initiative, the Claims Specialist Level II responsibilities include, but...employees serving in a permanent civil service title of Claim Specialist . PREFERRED SKILLS IN ADDITION TO… more
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