1577 claims specialist jobs found

Job Description Direct Hire Hybrid or Remote Schedule $20-$24 per hour The Claims Specialist position will research more complex claims, including resubmitting, reversals, reimbursements, reprocessing, and those requiring special handling. Work with internal departments and clients to resolve claim issues. Create correspondence with members, internal departments, and external agencies regarding outstanding claims. Process claims submitted by members, pharmacies, or appropriate agencies as needed. Works on special projects for the claims team. ESSENTIAL FUNCTIONS * Handle claims requiring additional research, navigate through appropriate system platforms to perform research, and resolve issues. * Work with other operational departments to research and resolve claims issues within performance agreement guidelines. * Create correspondence with members, internal departments, and external agencies regarding outstanding claims. * Compose letters to members or pharmacies for those claims...

Job Description Nevada's Premier Injury Law Firm: Workers' Compensation Claims Specialist Want to make a difference in the lives of those who have been injured? Enjoy interacting with clients? Come join our team at GGRM Law Firm and help us represent our clients with excellence and compassion. We have proudly served the Las Vegas valley for over 50 years and will continue to serve our community for many years to come. As a Firm, we are rapidly expanding into other areas of Nevada with high aspirations to become a multi-state Injury Law Firm. We are an established firm that provides stability, teamwork and a family environment. We offer a flexible schedule that allows our employees to begin working within a two-hour window. It offers the flexibility to balance a work and personal life, which is so important! Salary Range * $45,000 - $85,000 base, depending on experience Position Summary A Workers' Compensation Claims Specialist is the primary point of contact for all issues...

Job Description Claims Specialist - Hartland, WI Claims Specialists are responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. This high volume, fast-paced position requires strong multi-tasking and organizational skills, and includes a high volume of claims processing, issuance of reimbursements, status changes, enrollments, responding to client and participant inquiries, and implementation of plan setups/changes. Essential Job Duties and Responsibilities * Provide a high level of professional service to DBS clients and benefit plan participants. * Responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration software, and implementing plan changes. * Effective regular communication with clients...

Job Description We are seeking an experienced, highly motivated insurance professional to join our claims team. The BI Claims Specialist is responsible for providing superior customer service to insureds, agents, claimants and others that are encountered during general claim handling. This professional is responsible for onboarding of new clients, handling transportation liability claims, and conducting claim reviews. This is a highly visible position requiring significant business relations. Lastly, the ideal candidate will add to and bolster DMC's unique culture - a workplace built on enthusiasm, entrepreneurship, integrity, communication, proactive problem solving, and a genuine passion for helping our customers and agents. RESPONSIBILITIES * Manage a case load of approximately 125 claims * Verify and determine applicability of coverage * Conduct timely and thorough investigations per company procedures * Review files on a timely diary for reserving adequacy and resolution...

Job Description Claims Specialist - Hartland, WI Claims Specialists are responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. This high volume, fast-paced position requires strong multi-tasking and organizational skills, and includes a high volume of claims processing, issuance of reimbursements, status changes, enrollments, responding to client and participant inquiries, and implementation of plan setups/changes. Essential Job Duties and Responsibilities * Provide a high level of professional service to DBS clients and benefit plan participants. * Responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration software, and implementing plan changes. * Effective regular communication with clients...

Job Description Local third-party claims administrator is seeking a Claims Specialist in premises liability for an in-house position. Role: 1. Provide the effective adjustment of claims for premises liability cases for multi-family housing and hospitality clients. 2. Investigate, evaluate, and negotiate settlements on liability claims. 3. Establish reserves based on evaluation of liability and damages on third-party BI & PD claims. 4. Provide maximum level of excellent customer service to your account(s). 5. Manage the entire claim from start to finish. Candidate should possess the following: · 5+ years experience in handling premises liability claims · Multi-State Insurance Licensing (all 48 contiguous states preferred) · Excellent customer service, communication, sound judgment, analytical, negotiation and decision-making skills · Computer proficiency · Four-year college degree preferred Required experience: · General Liability claims adjusting · Claims adjusting for...

Job Description • 2+ years mortgage claims experience • Strong written and verbal communication skills • Mathematical aptitude a requirement • Ability to communicate effectively with internal and external customers • Attention to detail • Ability to organize, prioritize, and allocate workload for efficiency • Strong follow up skills are a necessity • Ability to multitask • Must be a self-motivated team player • Proficient computer skills - Microsoft Office, Internet • Typing 35 wpm and 10 key • Ability to work effectively under pressure The Claims Specialist I is responsible for preparing and submitting billing to the private investors for which the Company services loans. The Specialist is also responsible for monitoring and collecting the reimbursement of those outstanding advances. Responsibilities Include: * Preparing and submitting initial investor billing notification within required timelines * Monitor payment of investor billing for payment within reasonable timeliness *...

Job Description Claims Specialist As a Claims Specialist you will be responsible for handling all at fault- claims in the Claims Department. Serving as the initial point of contact for calls to the Claim Department; obtaining necessary information accurately and efficiently, responding to inquiries and resolving disputes. Must be familiar with Microsoft office and enjoy learning new software, possess problem-solving skills, and demonstrate critical thinking. Must have the ability and willingness to adapt to change, be a team player, meet and exceed deadlines all while working in a demanding fast-paced environment. ** Must be "onsite" in Fort Lauderdale, FL HQ Office ** $20.40/hour (Plus Monthly/Commission Bonus) Key Tasks and Responsibilities * Collect all necessary documents and information in relation to damage files * Review and ensure accuracy of all documentation associated with damage files * Contact at-fault individual(s) to attempt to collect on damages to Sixt vehicles *...

Job Description The Unemployment Service Specialist will, under moderate supervision, provide client support, including education on the UE claims process. Gather and compile documents, prepare written responses to state agencies and work with client contacts to conduct necessary research for detailed facts. Meeting deadlines and compliance per state specific regulations in all 50 states. Essential Duties and Responsibilities The essential functions include, but are not limited to the following: * Provide excellent client support, including education on the claims process. * Daily telephone communication with clients to gather separation details, prepare case, and submit to back to state, meeting state specific regulations and deadlines. * Provide client consultation on rules and regulations. * Provide client training on response platforms, as necessary. * Organize data and utilize established tracking mechanisms to ensure compliance with all 50 state agencies. * Work as an...

Job Description A-Line Staffing is actively searching for Multiple Pharmacy Billing Specialists for a major healthcare company located in Pittsburgh, PA surrounding area. This is an exciting opportunity with a client that is looking to move fast for the right candidate. Please contact Brad Zidek at bzidek@alinestaffing.com for immediate consideration! Or call at 412-823-2500. Job Description: Billing Specialist I will be responsible for qualifying, preparing and submitting claims to Medicare Part B, Major Medical and Medicaid. Individual must work with LTC facility staff, er offices, third party payers, patients and/or their responsible parties and claim processors. This position requires work within several different operating systems and web based programs to retrieve document images, collect supporting or additional information on fills and work claims through to resolution to ensure compliant, timely and accurate billing practices Experience: Minimum (Required) Qualifications:...

Job Description Claims Specialist - Hartland, WI Claims Specialists are responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. This high volume, fast-paced position requires strong multi-tasking and organizational skills, and includes a high volume of claims processing, issuance of reimbursements, status changes, enrollments, responding to client and participant inquiries, and implementation of plan setups/changes. Essential Job Duties and Responsibilities * Provide a high level of professional service to DBS clients and benefit plan participants. * Responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration software, and implementing plan changes. * Effective regular communication with clients...

Job Description Claims Specialist - Hartland, WI Claims Specialists are responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. This high volume, fast-paced position requires strong multi-tasking and organizational skills, and includes a high volume of claims processing, issuance of reimbursements, status changes, enrollments, responding to client and participant inquiries, and implementation of plan setups/changes. Essential Job Duties and Responsibilities * Provide a high level of professional service to DBS clients and benefit plan participants. * Responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration software, and implementing plan changes. * Effective regular communication with clients...

Job Description Claims Specialist - Hartland, WI Claims Specialists are responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. This high volume, fast-paced position requires strong multi-tasking and organizational skills, and includes a high volume of claims processing, issuance of reimbursements, status changes, enrollments, responding to client and participant inquiries, and implementation of plan setups/changes. Essential Job Duties and Responsibilities * Provide a high level of professional service to DBS clients and benefit plan participants. * Responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration software, and implementing plan changes. * Effective regular communication with clients...

Job Description Claims Specialist - Hartland, WI Claims Specialists are responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. This high volume, fast-paced position requires strong multi-tasking and organizational skills, and includes a high volume of claims processing, issuance of reimbursements, status changes, enrollments, responding to client and participant inquiries, and implementation of plan setups/changes. Essential Job Duties and Responsibilities * Provide a high level of professional service to DBS clients and benefit plan participants. * Responsible for day-to-day plan administration of pre-tax benefit plans for an assigned group of clients. Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration software, and implementing plan changes. * Effective regular communication with clients...

Job Description We are seeking independent, ambitious, positive, and dependable individuals to work as virtual property damage inspectors. This is a part-time or full-time position with flexible hours and unlimited earning potential. You will perform virtual walk-throughs of properties, photograph and document any damage, and complete paperwork. Our company represents the property owner to ensure they receive fair treatment and payment from their insurance companies. Responsibilities: * Perform virtual walk-throughs of properties to identify potential damage * Photograph and document any damage accurately * Complete all necessary paperwork in a timely manner Requirements: * Must be 18 or older * No experience necessary - we provide training * Self-motivated and able to work independently * Access to a reliable computer and internet connection * Reside in any US state except AK, AL, AR, CT, DE, FL, IA, KS, LA, MA, MI, MS, NY, SD, TN, TX, WA We offer great pay, a flexible schedule,...

Job Description THIS IS NOT A REMOTE POSITION. You must have reliable ways to commute to office. AMAZING benefits! Great pay! Great culture and company! About ITHBF: * Health Insurance and Pensions * In office Monday to Friday 8:00am to 5:00pm Benefits : Health, Dental, Vision, Pension, Vacation, Personal Time. Qualifications: * Most have recent experience processing / adjudicating claims and great customer service. * Computer Skills: * Proficiency using software programs such as MS Word, ACCESS, PowerPoint, Excel and Outlook * Most have recent experience processing / adjudicating claims and great customer service. Essential Duties and Responsibilities: * Reviews and adjudicates medical claims based on health policy provisions and established guidelines * Requests additional information from members and providers as needed * Initiates and completes claim investigations when indicated including pre-existing conditions, accidents, medical necessity and appropriateness, eligibility...

Job Description We are seeking independent, ambitious, positive, and dependable individuals to work as virtual property damage inspectors. This is a part-time or full-time position with flexible hours and unlimited earning potential. You will perform virtual walk-throughs of properties, photograph and document any damage, and complete paperwork. Our company represents the property owner to ensure they receive fair treatment and payment from their insurance companies. Responsibilities: * Perform virtual walk-throughs of properties to identify potential damage * Photograph and document any damage accurately * Complete all necessary paperwork in a timely manner Requirements: * Must be 18 or older * No experience necessary - we provide training * Self-motivated and able to work independently * Access to a reliable computer and internet connection * Reside in any US state except AK, AL, AR, CT, DE, FL, IA, KS, LA, MA, MI, MS, NY, SD, TN, TX, WA We offer great pay, a flexible schedule,...

Job Description Must have Medical Device Experience within EU MDD and/or EU MDR 1. Coordinate the defined cadence of the EU MDR program work for claims with other copy review workstreams such as active CAPAs. When executing up-dates of marketing materials, the aim is to maximize efficiency, minimize unnecessary re-work and make sure that different workstreams are not blocking each other. 2. Update global Surgical Technique Guides and promotional materials to all standards using compliant communication process 3. Lead and manage routings including STG, promotional materials and claims 4. Create and approve claims collection and substantiation and approval 5. Manage all asset edits with vendor and create proof within stated budget and timeline 6. Complete and approve associated F-S813 (Design Evaluation Form) to support EOS routing 7. Manage EOS routing and complete approval process for STGs, promotional materials and claims 8. Store and redistribute final approved assets

Job Description Processes Industrial Injury reports, issues First Report of Injury to Third Party Administrators, schedules appointments with medical provider when needed • Coordinates evidence of injuries and illnesses, maintains file and tracks cases in accordance with District policies and procedures • Coordinates structured Return to Work of injured employees and job analysis with District management, legal counsel, Third Party Administrator, Health and Safety staff and others • Coordinates the District's Interactive Process for accommodating employee disabilities • Communicates with employees and/or their representatives regarding claim procedures and related laws, completion of proper forms, and status of claims • Provides assistance to Third Party Administrators by obtaining required job descriptions, claimant information, and coordination with District management • Schedules evaluations with medical providers for Return to Work Examinations within applicable laws and...

Job Description We are looking for a Claims Processor/Bookkeeper to join our team! You will be responsible for preparing assisting the Administrative Duties to include Processing Claims and Bookkeeping duties with preparing and analyzing financial records for our company. Responsibilities: * Process Claims for Sponsored Child Care Centers in preparing materials required for Reimbursements to Child Care Centers * Utilize web-based computer system to process claims, payments and other fiscal actions * Create, update and maintain computerized and manual files and filing systems. * Provide information and assistance to visitors and telephone callers and/or refer them to other staff members as appropriate * Work closely with child care centers to ensure correct information is processed correctly, center is training appropriately. * Respond to inquiries from child care centers regarding payments * Prepare and examine accounting records, financial statements, taxes, and other financial...