37 Results for

Claims Examiner Jobs in Ohio

Jobs

Medical Claims Examiner Employ-Temps

Uniontown, OH

You can view all our jobs by copying and pasting this link in your browser: https://employtemps.com/jobs/. Demonstrate a positive and cooperative work attitude and promote teamwork.

23 days ago

Workers Compensation Claims Examiner SuretyHR

Columbus, OH

The occupant is expected to freely operate the following tools and equipment: personal computer (including word processing, spreadsheet, and database programs); printer; calculator; telephone; copier; fax machine. The Workers Compensation Claims Examiner is primarily responsible for analyzing and processing complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.

30+ days ago

Multiline Claims Examiner | Northwest Ohio King'S Insurance Staffing

Ohio

This is a unique career-building opportunity for someone who's looking to expand their claims knowledge with hands-on exposure to Commercial Auto, General Liability, and Bodily Injury claims with full training provided! This position plays a critical part in reviewing and handling liability and bodily injury claims, ensuring accurate determinations and timely resolutions in alignment with all applicable regulations.

30+ days ago

Claims Examiner, Auto | Bodily Injury Sedgwick Claims Management Services, Inc.

To analyze complex auto bodily injury claims on behalf of our valued clients by evaluating coverage, investigating liability, and managing damages, while ensuring timely resolution within service expectations, industry best practices, and specific client requirements. Education & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.

24 days ago

Workers Compensation Claims Examiner | MI, KY, IN & OH Jurisdictions | MI, IN & KY Licensing Preferred Sedgwick Claims Management Services, Inc.

Dublin, OH

Remote

$60,000–$70,000 / year

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. PRIMARY PURPOSE OF THE ROLE To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

4 days ago

Liability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims Experience Sedgwick Claims Management Services, Inc.

$63,404–$88,765 / year

To analyze GL Litigated, Premise, Auto, Bodily Injury & Product claims on behalf of our valued dedicated client to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

30+ days ago

Claims Examiner, Auto | PIP | Litigation Required Sedgwick Claims Management Services, Inc.

$75,000–$80,000 / year

PRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult Personal Injury Protection Claims to determine benefits due; to work with high exposure claims involving litigation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Skills: excellent oral and written communication, including presentation skills, PC literate including Microsoft Office products, analytical and interpretive skills, excellent negotiation skills, ability to work in a team environment and meet or exceed Service Expectations.

4 days ago

Seasonal Claims Examiner Confident Staff Solutions

Akron, Ohio

Company Overview: Confident Staff Solutions is a leading staffing agency in the healthcare industry, specializing in providing top talent to healthcare organizations across the country. Our team is dedicated to helping healthcare facilities improve patient outcomes and achieve their goals by connecting them with highly skilled and qualified professionals.

4 days ago

Claims Examiner 2 - PN 20064970 - Mansfield Highland County Joint Township District Hospital

Ontario, OH

For applicant support and additional information about employment with the State of Ohio, return to Careers. Ohio.

25 days ago

Claim Examiner-Commercial Auto/Trucking Bodily Injury (hybrid) RLI Corp

Broadview Heights, OH

$68,556–$98,036 / year

This approach rises from and is supported by our talented, ethical and smart team of employee owners united around a single purpose: to work alongside our customers and partners when they need us, in unexpected ways, with exceptional results. Our goal is to attract, develop and retain the best employee talent from diverse backgrounds while promoting an environment where all viewpoints are valued and individuals feel respected, are treated fairly, and have an opportunity to excel in their chosen careers.

9 days ago

Claim Examiner IV-Personal Umbrella (Bodily Injury Liability/Auto/Premises) RLI Corp

Broadview Heights, OH

$80,897–$115,682 / year

12 days ago

Claim Examiner Iv-Personal Umbrella (Bodily Injury Liability/Auto/Premises) RLI Corp.

Broadview Heights, OH

$80,897–$115,682 / year

13 days ago

Claim Examiner-Commercial Auto/Trucking Bodily Injury (Hybrid) RLI Corp.

Broadview Heights, OH

$80,897–$115,682 / year

9 days ago

Claim Examiner Western & Southern Financial Group Inc

CINCINNATI, OH

Examines, investigates and evaluates information from policyholders, attorneys, physicians, hospital personnel, police departments, employers, State Medicaid personnel, funeral homes, Probate courts and other professionals needed to determine the disposition of life, annuity, health and disability claims within authority limits. Requires visual acuity to read and interpret a variety of correspondence, procedures, reports and forms via paper and electronic documents, visual inspection involving small defects; small parts, and/or operation of machinery (including inspection); using measurement devices continuously.

30+ days ago

Claims - No-Fault Litigation Specialist I - IV Cincinnati Financial Corp

Cincinnati, OH

$60,000–$95,000 / year

166372'',''true'',''166372'',''false'',''Submission for the position: Claims - No-Fault Litigation Specialist I - IV - (Job Number: 2600596)'',''false'',''166372'',''false'',''true'',''Claims - No-Fault Litigation Specialist I - IV'',''2600596'',''US-OH-Fairfield'',''!*! '',''false'',''166372'',''166372'',''true'',''166372'',''false'',''Submission for the position: Claims - No-Fault Litigation Specialist I - IV - (Job Number: 2600596)'',''false'',''166372'',''false'',''true''.

17 days ago

Senior Construction Defect Technical Claims Specialist Argo Group International Holdings Inc

Remote

$137,496–$164,934 / year

Boston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.

30+ days ago

Insurance Claims Processor Global Channel Management

Mason, Ohio

Research insurance claim payments in the AS/400 to identify correct claim based on customer information, date of service and service/material procedure codes and related charges. Process transactions apply cash, member bills, resubmit invoices, write-offs, etc.

4 days ago

Cash Claims Processor Global Channel Management

Mason, Ohio

4 days ago

Claims Processor Global Channel Management

Mason, Ohio

Review incoming membership documents (Microsoft Excel and Word) to confirm accuracy in formatting and validity of data; includes communicating when updates are needed for successful membership enrollment and/or submission for processing. Claims Processor duties: Ø Monitor team shared Outlook mailbox for incoming membership documents sent from clients, brokers or Third Party Administrators.

4 days ago

Claims Processor Fifth Third Bank

Cincinnati, Ohio

GENERAL FUNCTION: Responsible for completing and filing investor/insurer claims within required guidelines in order to recoup 5/3's investment in the property, may include loan principal, accrued interest, and corporate or escrow advances, as well asbank incentives for timely filing, made during the life of the loan to properly protect the investors collateral interest in the property. The base salary for this position is reflective of the range of salary levels for all roles within this pay grade across the U.S. Individual salaries within this range will vary based on factors such as role, relevant skillset, relevant experience, education and geographic location.

25 days ago

Accountant/Examiner 3 (INTERMITTENT) - Multiple Positions State of Ohio

Columbus, OH

Doersam@com.ohio.gov or 614-995-7009'',''Ongoing'',''Ongoing'','''','''','''','''','''','''',''United States of America-OHIO-Franklin County-Columbus'',''United States of America-OHIO-Franklin County-Columbus'','''','''',''$25.77 per hour'',''$25.77 per hour'',''Full-time'',''Full-time'',''8:00am - 5:00pm M-F'',''8:00am - 5:00pm M-F'',''Unclassified'',''Unclassified'',''Exempt from Union'',''Exempt from Union'',''Claims Examination'',''Claims Examination'',''Regulatory Compliance, Accounting and Finance, Claims Examination, Public Relations'',''Regulatory Compliance, Accounting and Finance, Claims Examination, Public Relations'',''Attention to Detail, Decision Making, Listening, Problem Solving, Responsiveness, Verbal Communication'',''Attention to Detail, Decision Making, Listening, Problem Solving, Responsiveness, Verbal Communication'','''','''',''!*! ''140543'',''true'',''140543'',''false'',''Submission for the position: Accountant/Examiner 3 (INTERMITTENT) - Multiple Positions - (Job Number: 2600030D)'',''false'',''140543'',''false'',''true'',''Accountant/Examiner 3 (INTERMITTENT) - Multiple Positions'',''2600030D'',''Commerce'',''Commerce'',''Michael.

30+ days ago

Market Conduct Examiner (Health and PBM) RSM US LLP

Market Conduct Examiner (Health and PBM) Risk & Regulatory Consulting, LLC (Regulatory Insurance) Work from home-any US location Position Overview The Market Conduct Examiner will be responsible for performing reviews of major insurance companies operations, marketing, underwriting, mental health parity quantitative and non-quantitative treatment limits, pharmacy benefit management practices, rating, policyholder service, producer licensing, complaint handling and claims handling processes to verify compliance with states insurance statutes and regulations. This includes, but is not limited to, analyzing compliance pertaining to review of pharmacy audits conducted by PBMs, spread pricing, pharmacy reimbursement, dispensing fee requirements, annual reports, contract review, financial review, internal and external appeals, claims processing, and network adequacy.

30+ days ago

Accountant/Examiner 3 (Intermittent) - Multiple Positions State of Ohio

Columbus, OH

This includes taking reports of unclaimed funds that result when an account becomes dormant and the business no longer has contact information for the account owner, holding these funds for safekeeping and working aggressively to track down the rightful owner. Or completion of undergraduate core coursework in business administration, economics, computer science or related field; 16 semester or 24 quarter hours in accounting.

30+ days ago

Examiner Physician Assistant Loyal Source

Westerville, OH

$139,859–$169,852 / year

The role involves reviewing the claim, performing focused assessments of claimed injuries, reviewing medical records, and potentially rendering a medical opinion based on the record review and completed Compensation & Pension (C&P) exam. Conduct Comprehensive Medical Disability Examinations: Perform thorough and focused medical evaluations of Veterans, including reviewing their medical history, conducting physical examinations, and assessing the impact of disabilities on their daily life and functional abilities.

27 days ago

Examiner Nurse Practitioner Loyal Source

Westerville, OH

$139,859–$169,852 / year

27 days ago

Certification/Licensure Examiner 1 State of Ohio

Reynoldsburg, OH

Prepares files for data entry by records management section; files applications, records & reports; drafts, types & files correspondence pertaining to testing; utilizes database for retrieval of information; logs examination results & maintains records related to testing of applicants. Receives training in application review process (e.g., Licensed Practical Nurses (LPNs), Registered Nurses (RNs), Advanced Practice Registered Nurses (APRNs), Certified Medication Aides (CMAs), Community Health Workers (CHW's), Dialysis Technicians (DTS) and Doulas.

3 days ago

Data Entry/Claims Processor Globalchannelmanagement

Mason, Ohio

Review incoming membership documents (Microsoft Excel and Word) to confirm accuracy in formatting and validity of data; includes communicating when updates are needed for successful membership enrollment and/or submission for processing. Data Entry/Claims Processor duties: Monitor team shared Outlook mailbox for incoming membership documents sent from clients, brokers or Third Party Administrators (TPA's).

4 days ago

Workforce Absence Team Lead Sedgwick Claims Management Services, Inc.

Dublin, OH

$57,064–$59,000 / year

PRIMARY PURPOSE: To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.

30+ days ago

SIU Investigator III (Health Plan experience required) CareSource

$72,200–$115,500 / year

CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. Job Summary: The Special Investigations Unit (SIU) III is responsible for investigating and resolving high complexity allegations of healthcare fraud, waste and abuse (FWA) by medical professional, facilities, and members.

18 days ago

Audit - Dealer Auditor Lancesoft

Streetsboro, OH

$48.27

The Dealer Auditor will also play a key role in addressing recurring violations by providing consistent, ongoing communication of findings, conducting root cause analysis, and recommending possible corrective actions to stakeholders at both the dealership and corporate levels. Additionally, the Dealer Auditor will maintain oversight of warranty expenses by continually reviewing policies and procedures related to warranty repairs, as well as other controlling rules, to identify trends and other noncompliance risks.

30+ days ago

Commercial Property Adjuster - Cleveland, OH Engle Martin & Associates, Inc.

Cleveland, OH

PHYSICAL ACTIVITIES AND REQUIREMENTS: In addition to the working conditions and associated physical activities and requirements above, the incumbent may be required to climb, balance, stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, finger, grasp, or feel, especially in the course of investigating and assessing property damage; these requirements may include the need to lift weights of up to 50 pounds, including a ladder. The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties.

30 days ago

Auditor/Investigator II Qlarant Quality Solutions Inc

Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Essential Functions: Conducts routine and impartial audits/investigations from start to closure into customer claims, ensuring accurate and fair assessments of claims validity.

30+ days ago

Estimate Review Specialist Sr. (Repair Solutions) Sedgwick Claims Management Services, Inc.

$55,000–$57,000 / year

PRIMARY PURPOSE: To review all estimates and supporting documentation submitted by contractors/adjusters, using Xactimate, Symbility, and other estimating applications; to ensure estimates follow client and regulatory requirements and meet Sedgwick Repair Solutions' guidelines while replacing a field adjuster if needed, and to serve as a subject matter expert on property restoration scope. Required/Preferred Experience: Candidates should have experience in one or more of the following areas: interior and exterior property restoration, roofing, water mitigation, mold remediation, fire and smoke damage restoration.

10 days ago

(USA) Technician, Facility Services, Exterior Services-DOT Walmart Inc

TROY, OH

$19–$35 / hour

Able to successfully complete a DOT physical and secure medical certification during pre-hire contingency and be able to maintain a minimum of a 90 day Medical Examiner's Certification (MEC) card, Associate's degree or equivalent in Engineering, Maintenance, Construction Management, or related area., Role summary: The (USA) Technician, Facility Services, Exterior Services-DOT, is responsible for managing exterior facility operations, ensuring compliance with safety and environmental regulations.

11 days ago

Program Integrity Investigator IV CareSource

Ohio WFH, OH

$83,000–$132,800 / year

Review reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques that will reveal intelligence for identification of any associative or causal relationships pertaining to Fraud Waste and Abuse and Error, providing management level summaries that explain key findings and providing documentation for use during Audits. Utilizes a variety of data analytics platforms to mine large volumes of data to identify and mitigate fraudulent claim activity, discover patterns and anomalies in billing behavior and develop metrics around transactional and operational data to report on fraud attempts, losses and trends.

30+ days ago

Construction Consulting Engineer City of Cleveland

Cleveland, OH

$85,000–$95,000 / year

Coordination of planning, design and construction activities with other City of Cleveland divisions and departments including City Planning, Traffic Engineering, Real Estate, Architecture and Site Development, Economic Development, Community Development, Public Works, and Public Utilities (CWD, WPC, CPP). Cleveland Public Power (Electrical): Bachelors Degree in Electrical Engineering or closely related field from an ABET accredited four-year college or university (or equivalent as determined by the Ohio Board of Registration of Professional Engineering and Surveyors) required; a Masters Degree is preferred.

29 days ago

Manager, Special Investigations Unit CVS Health Corp

$54,300–$159,120 / year

This leader plays an important role in translating investigative priorities into clear team direction, monitoring case progress, identifying risks, and elevating significant findings to leadership and stakeholders as appropriate. The Manager of the Special Investigations Unit is responsible for leading investigative work related to potential fraud, waste, and abuse across health care claims, provider activity, and related operational and/or compliance concerns.

4 days ago

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Claims Examiner Jobs in Ohio

Medical Claims Examiner Employ-Temps

Workers Compensation Claims Examiner SuretyHR

Multiline Claims Examiner | Northwest Ohio King'S Insurance Staffing

Claims Examiner, Auto | Bodily Injury Sedgwick Claims Management Services, Inc.

Workers Compensation Claims Examiner | MI, KY, IN & OH Jurisdictions | MI, IN & KY Licensing Preferred Sedgwick Claims Management Services, Inc.

Liability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims Experience Sedgwick Claims Management Services, Inc.

Claims Examiner, Auto | PIP | Litigation Required Sedgwick Claims Management Services, Inc.

Seasonal Claims Examiner Confident Staff Solutions

Claims Examiner 2 - PN 20064970 - Mansfield Highland County Joint Township District Hospital

Claim Examiner-Commercial Auto/Trucking Bodily Injury (hybrid) RLI Corp

Claim Examiner IV-Personal Umbrella (Bodily Injury Liability/Auto/Premises) RLI Corp

Claim Examiner Iv-Personal Umbrella (Bodily Injury Liability/Auto/Premises) RLI Corp.

Claim Examiner-Commercial Auto/Trucking Bodily Injury (Hybrid) RLI Corp.

Claim Examiner Western & Southern Financial Group Inc

Claims - No-Fault Litigation Specialist I - IV Cincinnati Financial Corp

Senior Construction Defect Technical Claims Specialist Argo Group International Holdings Inc

Insurance Claims Processor Global Channel Management

Cash Claims Processor Global Channel Management

Claims Processor Global Channel Management

Claims Processor Fifth Third Bank

Accountant/Examiner 3 (INTERMITTENT) - Multiple Positions State of Ohio

Market Conduct Examiner (Health and PBM) RSM US LLP

Accountant/Examiner 3 (Intermittent) - Multiple Positions State of Ohio

Examiner Physician Assistant Loyal Source

Examiner Nurse Practitioner Loyal Source

Certification/Licensure Examiner 1 State of Ohio

Data Entry/Claims Processor Globalchannelmanagement

Workforce Absence Team Lead Sedgwick Claims Management Services, Inc.

SIU Investigator III (Health Plan experience required) CareSource

Audit - Dealer Auditor Lancesoft

Commercial Property Adjuster - Cleveland, OH Engle Martin & Associates, Inc.

Auditor/Investigator II Qlarant Quality Solutions Inc

Estimate Review Specialist Sr. (Repair Solutions) Sedgwick Claims Management Services, Inc.

(USA) Technician, Facility Services, Exterior Services-DOT Walmart Inc

Program Integrity Investigator IV CareSource

Construction Consulting Engineer City of Cleveland

Manager, Special Investigations Unit CVS Health Corp

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