- 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
- Sedgwick (East Meadow, NY)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Specialist Sr - Professional Liability **PRIMARY PURPOSE** : ... To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate… more
- Lincoln Financial Group (Columbus, OH)
- …73193 **The Role at a Glance** We are excited to bring on a highly motivated Life Claims Specialist to staff our ever-growing claims organization. As a Life ... completeness of submitted claims . * You will escalate claims issues/concerns to senior team members and/or management. **What we're looking for** Must-haves:… more
- Lincoln Financial Group (Columbus, OH)
- …at a Glance** We are excited to bring on a highly motivated Long-Term Disability (LTD) Claims Specialist to our claims organization. As an LTD Claims ... Specialist , you will manage a workload of Long-Term Disability claims independently in accordance with established procedures and guidelines. You will be… more
- HCA Healthcare (Asheville, NC)
- …where diversity and inclusion thrive? Submit your application for our Insurance and Claims Specialist (Program of All Inclusive Care for the Elderly) Program ... (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid...may vary by location._** We are seeking Insurance and Claims Specialist PACE Program, for our team… 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
- 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 ... Claims Account Specialist will be responsible for...WC Law, medical terminology, and utilization of an automatic claims processing system. + Sr Level -… more
- MyFlorida (Tallahassee, FL)
- SENIOR CLAIMS PROCESSING SPECIALIST - 36000384 Date: May 31, 2024 Location: TALLAHASSEE, FL, US, 32301 The State Personnel System is an E-Verify employer. ... . Requisition No: 830447 Agency: Department of Lottery Working Title: SENIOR CLAIMS PROCESSING SPECIALIST - 36000384 Pay Plan: Lottery Exempt… more
- Citizens (Medford, MA)
- Description As a Fraud Claims Sr . Specialist , you'll play a pivotal role in our Fraud and Claims Operations group, one of our most critical departments ... use critical thinking skills to assist customers with existing claims and determine the best next step for the...and within other business areas. Primary Responsibilities + Review Claims - Responsible for reviewing claims filed… 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
- First Student (Cincinnati, OH)
- …daily. Proactively investigate, evaluate, and negotiate resolution of assigned Liability claims in accordance with established best practices and assure claims ... are handled within granted autonomy limits. The adjuster will primarily manage claims valued under $750k, including claims that are in litigation. **Major… more
- Axis (Los Angeles, CA)
- … Claims and Underwriting. * Makes effective recommendations for settlement/disposition of claims ; works successfully with senior Claims and Underwriting ... contributor directly reviewing primary and excess Financial Institutions and Management Liability claims to determine nature of loss, coverage provided, and scope of… more
- Axis (Red Bank, NJ)
- …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
- CRC Insurance Services, Inc. (Norfolk, VA)
- …of America) **Please review the following job description:** Analyzes and processes claims by gathering information and drawing conclusions. Acts as a liaison ... between insured and insurance carrier to report, track and manage claims process. **ESSENTIAL DUTIES AND RESPONSIBILITIES** Following is a summary of the essential… more
- NJM Insurance (Trenton, NJ)
- …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 all parties involved...manage select Catastrophic (CAT) losses assigned by the Complex Claims Supervisor for developmental purposes. This role can be… more
- BrightSpring Health Services (Taunton, MA)
- …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
- 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
- MetLife (Tampa, FL)
- …meaningful impact in the lives of our customers and our communities. The IDI Senior Claims Specialist evaluates individual disability income insurance ... and within prescribed time service standards. In this role, the IDI Senior Claims Specialist is required to exercise discretion and independent judgment… more
- Axis (Red Bank, NJ)
- …available upon request for candidates taking part in the selection process. Grade H Senior Claims Specialist , Property Salary range: Alph: $95K-130K Job ... Summary: Under limited direction, acts as highest-level individual contributor directly reviewing claims to determine nature of loss, coverage provided, and scope of… more
- Insight Global (Boca Raton, FL)
- …or a EHRimplementation specialist ) . Medical Practice management experience ( Claims specialist , accounts receivable specialist , biller, administrative ... all training methods and contributing to training initiatives as assigned by the Senior Training Consultant and/or Manager We are a company committed to creating… more