- USAA (Phoenix, AZ)
- …Relocation assistance is not available for this position. What you'll do: Inspect and review quality of claim files and provide feedback to employees as ... what truly makes us special and impactful. The Opportunity As a dedicated Manager, Claims Operations, you will lead and be accountable for auto, and other claims… more
- Chubb (Southfield, MI)
- …your authority limits and recommend reserve adjustments to the Team Leader. Regularly review claim progress with the Team Leader, identifying challenges and ... to a brighter future for employees everywhere! We are seeking a skilled Senior Claims Representative to enhance our team. Reporting to the Claims Team Leader,… more
- GameStop (Grapevine, TX)
- …policy renewals, deductibles, and self-insurance programs. Maintain insurance and claims -related documentation, dashboards, and reports for executive review . ... claims . Drive early intervention and return-to-work strategies, including medical provider coordination and accommodation oversight. Lead OSHA reporting and… more
- Unknown (Lakewood, NJ)
- …to ensure timely and fair claim settlements. Duties and responsibilities: Review and analyze workers' compensation claims to determine eligibility and ... About the role: Leading provider of innovative solutions claims handling and Risk Management in the Healthcare space seeks a Work Comp Claims professional to… more
- USI Holdings Corporation (Blue Bell, PA)
- …and tailor claim service plan to address adverse trends and mitigate claim duration, severity and costs using claims management solutions. Advocate on behalf ... negotiating optimal coverage position. Assist client with evaluation and reporting of complex claims . Review reserving accuracy on specific claims . Develop… more
- The Jonus Group (Alpharetta, GA)
- …Communicate effectively with insureds, claimants, attorneys, vendors, and internal teams Review medical records, incident reports, contracts, and other evidence ... We are seeking an experienced Senior General Liability Claims Manager to join our client's claims...to support claim decisions Accurately document claim activity and… more
- Insurance Recruiting Solutions (Chapel Hill, NC)
- …is a strong plus. Key Responsibilities Serve as the go-to expert for field claims teams on high-exposure losses Review and provide direction on policy limit ... Home Office Claims Director Location: Jersey City, NJ; Alpharetta, GA;... Director to oversee and elevate complex general liability claim outcomes across the enterprise. This strategic role will… more
- Kemper Corporation (Mcallen, TX)
- …Responsibilities: Take statements from insureds, claimants, and witnesses Obtain and review evidence, reports, and medical records Investigate losses and ... in-depth auto coverage for non-standard claims preferred Commercial auto claims handling experience a plus Claim -related computer systems experience… more
- Utica National Insurance Group (Charlotte, NC)
- …independent basis with limited supervision in handling/settling a high volume of claims within assigned authority. Submit reports within specified time frames as ... required by the Claims Technical Manual or as required by supervisor or...Plan for full time employees that include the following: Medical and Prescription Drug Benefit Dental Benefit Vision Benefit… more
- Strategic Staffing Solutions (Burlington, VT)
- …continued service authorization. Identifies questionable cases and refers to superior or a medical director for review .' Required experience: Must have 5+ years ... authorizations for appropriateness and make determination on benefit level based on medical necessity. Provide timely and accurate review for procedure/service… more
- MetroPlusHealth (New York, NY)
- …development of a strategic roadmap to recover, eliminate, and prevent unnecessary medical -expense spending and support the execution for a comprehensive claim ... will optimize pre/post claim editing, auditing, and claim recovery programs that will drive incremental value year...strategies to prevent future occurrences, with the ability to review impacts holistically. Assist in the development of a… more
- UHS (Riverside, CA)
- …supervisor as requested. 2. Review , adjust, and/or mail out all assigned tracer claims 3. Initiate claim review and/or appeals, as indicated on assigned ... status and/or responsible party to settle account. b. Review Explanation of Medical Benefits to verify...other parties. 13. Track and follow up on unpaid claims and/or incomplete documentation. 14. Review account… more
- Mount Sinai Hospital (New York, NY)
- …need to be escalated to insurance providers or legal entities for resolution. * Review hospital and professional claims processes to identify gaps and ... to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The… more
- Naval Air Systems Command (San Diego, CA)
- …non-ionizing radiation and chemicals). You will be required to participate in medical surveillance programs. This position may require travel from normal duty ... individuals under this specific hiring authority. However, if you claim veteran's preference, you will be required to submit...Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the… more
- Regal Medical Group, Inc. (Northridge, CA)
- … claims review nurse team (nurses/coders), who work with the claims department to assist in making medical necessity determinations of submitted ... the prior authorization nurse case managers and support staff (coordinators), professional claims review nurses and UM compliance staff to promote quality,… more
- GetixHealth (Lakeland, FL)
- …efficient billing processes. This role requires experience consistently following up with medical insurance providers to resolve claim issues and secure ... our required speed test. Position Responsibilities: Follow-up with insurance companies on billed claims regarding claim status and resolution of payments in a… more
- Community First Medical Center (Chicago, IL)
- …complaints or billing issues. Ensure proper submission and adjudication on all claims submitted to third party carriers, Medicaid, Medicare. Respond to all inquiries ... and federal billing regulations. 5. Complete the follow-up of claims when an error is identified and account follow-up...follow-up goals. 6. Submit the necessary re-bill for the claim , monitor and expedite by contacting the assigned payor… more
- Quadax (Cleveland, OH)
- …accounts receivable balances. Call payers and patients as needed to resolve claim rejections. Respond to payer correspondence. Draft appeals for denied claims ... Treasury for resolution. Monitor and notify management of payer trends and/or claim processing issues. Investigate electronic claim rejections. Research claim… more
- BAART Programs (Lewisville, TX)
- …to analyze, audit, and document actions taken on each account Submit and review outstanding claims , contact insurance carrier(s) for resolution Reconcile various ... and detail oriented Billing Specialist to manage billing processes and claims submissions. Additionally, the billing specialist is responsible for reporting… more
- Kaiser Permanente (San Diego, CA)
- …corrective action plan for areas of improvement identified through utilization review , clinical records audit, claim denials, patient satisfaction surveys, ... others to increase their regulatory knowledge. Manages others to review and act on results of data analysis, monitor...analyzing and managing the process flow of investigations and claims for potential errors, red flags, and areas of… more
