Claims Service Specialist Marsh & McLennan Companies IncClaims Service SpecialistBroomfield, CO$62,400–$132,900 / yearFounded in 1998 and based in Broomfield, Colorado, ICAT is a subsidiary of Victor and a leading provider of property insurance protection to homeowners and businesses located in hurricane- and earthquake-exposed regions of the United States. The successful candidate will lead daily operations from a support and administrative level, coordinating complex logistics and task assignments for client relationship projects while ensuring effective communication and problem resolution.
Senior Claims Advisor VizanceSenior Claims AdvisorHartland, WIThe Senior Claims Advisor plays a vital leadership role within Vizance, overseeing the claims department and ensuring exceptional service delivery to our clients, associates, and insurance carrier partners. We have earned several awards, including Top Workplaces, Best Places to Work, Future 50, and Fastest Growing Firms, and we are proud to be a Minority-Owned Business Enterprise (MBE).
NewSenior Claims Account Executive Marsh & McLennan Companies IncSenior Claims Account ExecutiveAtlanta, GAAs our Senior Claim Account Executive on the commercial insurance team, you will: Act as a mentor and coach for commercial claim representatives in their efforts to manage and advise in claim matters for clients and prospects. Ability to carry out complex tasks with many concrete and abstract variables; Ability to utilize computer programs and understand their functionality to include Microsoft Word, Excel, PowerPoint, and Access.
Claims Analyst The Health PlanClaims AnalystWheeling, WVUnder the direction of the Manager of Claims, the reviewer performs initial review of claims, including HCFA 1500 and UB 04 claims. Reviews each claim flag in sequence, totally completing one at a time in accordance with established criteria/payment guidelines.
Bilingual Claims Administrator - R2710 Fort Myer Construction CorpBilingual Claims Administrator - R2710Washington, DCIf you do not mind hard work, desire job security associated with essential infrastructure projects, and want to make a difference in our communities, then please consider joining the Fort Myer Family. Summary:The Bilingual Claims Administrator manages the intake, processing, and resolution of workers compensation claims from the initial report of injury through claim closure.
Sr QA Analyst, Claims HF Management ServicesSr QA Analyst, ClaimsNorth CarolinaThe Sr QA Analyst Claims is the subject-matter-expert (SME) in Claims, test automation, test data creation automation and enterprise test strategy definition, and embodies Healthfirst’s Culture Drivers promoting and reinforcing behavior consistent with Healthfirst culture. Applicants must have a Bachelor's degree in Computer Science, Computer Information Systems, Business Administration or related field and 7 years of experience in the job offered or in a quality assurance analyst occupation.
Workers' Compensation Claims Coordinator INVO CLAIMS ADMINISTRATORSWorkers' Compensation Claims CoordinatorOak Ridge, TNYou'll be the liaison between employees, supervisors, insurance carriers, healthcare providers, and legal representatives - ensuring timely processing, regulatory compliance, and effective return-to-work programs. Associate's or Bachelor's in HR, Business Administration, Risk Management, or related field preferred.
Claims Analyst III Integrated Resources, IncClaims Analyst IIIDoral, FloridaContractorWill be utilizing Microsoft Excel heavily.*A minimum of 1-2 years' experience in claims processing with professionals or hospitals *Top 3 skills:Computer skills - Microsoft Excel (intermediate to advanced skills, i.e. pivot tables, v-look ups)Attention to detailStrong written communication skillsMust Haves:Claims backgroundKnowledge of billing guidelinesKnowledge of contract interpretationKnowledge of billing/coding - CPT & ICD-10Kind Regards,Arnab GhatakTechnical RecruiterIntegrated Resources, Inc. IT Life Sciences Allied Healthcare CROCertified MBE | GSA - Schedule 66 I GSA - Schedule 621IGold Seal JCAHO Certified for Health Care Staffing"INC 5 0 0 0 's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)
Claims Specialist II, Workers Compensation Nationwide Mutual Insurance CoClaims Specialist II, Workers CompensationColumbus, OHRemote$69,500–$129,000 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. As a Claims Specialist, you'll investigate and handle medical and/or loss-of-time workers compensation claims from multiple states to determine compensability, entitled benefits, average weekly wage and benefit rate according to applicable state workers' compensation statute.
Facets QA Lead Tata Consultancy Services LtdFacets QA LeadKansas City, MO$80,000–$100,000 / yearExperience in Member Enrollment workflows (Medicaid, Medicare, ACA). Perform EDI validation (837, 835, 834) including mock data creation.
Claims Representative Sr - Liability (P3) Country FinancialClaims Representative Sr - Liability (P3)Bloomington, IL$77,600–$106,700 / yearInitiates contact with insureds, claimants, and all relevant parties to gather basic information, obtain recorded statements (when necessary), and explain the overall claims process. Our employees and representatives serve nearly one million households with our diverse range of personal and business insurance products as well as retirement and investment services.
Stop Loss Claims Resolution Consultant Sun LifeStop Loss Claims Resolution ConsultantKansas City, MissouriThis role combines deep technical expertise as a Stop Loss Health Claims Analyst with responsibility for managing end-to-end inquiry resolution, including research, claim determination support, documentation review, and clear customer communication. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
Claims Adjuster The Remas CompanyClaims AdjusterFort Lauderdale, FloridaCoordinates the gathering of formal evidence by taking photographs, preparing diagrams and making measurements at accident scene; arranges for witnesses to appear at legal proceedings, and prepares accident reports. Reviews and analyzes reports of accidents including property damage and bodily injury to determine liability; reviews and analyzes Liability and/or Workers' Compensation claims and recommends appropriate action.
Claims Negotiation Analyst (Out of Network Mandates) Horizon Healthcare ServicesClaims Negotiation Analyst (Out of Network Mandates)Newark, New JerseyPrepares written responses including negotiation outcomes by completing a written justification on how Horizon BCBSNJ adjudicated the initial and adjusted claim, but not limited to, benefits, contracts, payment and pricing methodology, proof of plan and providing explanation of benefits within regulated timeframes. $58,029 - $77,074 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.
Supplemental Health Claims Manager American FidelitySupplemental Health Claims ManagerOklahoma City, OklahomaWork with Supervisors, highly skilled Colleagues and other departmental or divisional leadership to set and manage goals and performance expectations which support accurate, fair service and the timely claim processing which comply with state and federal regulations. *Actively manage staff and plans for the appropriate allocation and use of resources; analyze past workloads to determine future needs and identify service trends which may detract from providing quality service to the Customer.
Claims Processer IconmaClaims ProcesserDes Moines, IA$19–$20 / hourOur Client, an IT Services and Consultant company, is looking for a Claims Processer for their Des Moines location (will be working remotely but must be located in Iowa). Documentation: Record claim activity, maintain audit trails, and prepare reports for management.
Claims Adjuster Epitec StaffingClaims AdjusterPortland, OR$47–$52 / hourStrong communication and interpersonal skills to effectively interact with claimants, customers, insureds, brokers, attorneys, etc., in a positive manner regarding losses. Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
Medical Record Review Registered Nurse 22nd Century Technologies, Inc. (TSCTI)Medical Record Review Registered NurseHarrisburg, PA$40–$45 / hourFull timeAssignments will consist of a combination of ongoing process responsibilities, standing workgroup participation, and time-limited projects related to the management and operations of all aspects of the Pennsylvania Medicaid program, including but not limited to: Evaluation and implementation of system enhancements for provider enrollment, provider inquiry, and medical review; Evaluation of current processes and implementation of recommended process improvement; Consult with senior staff to outline major operational issues and develop resolutions based on sound data analysis; Act as a liaison between the Client and external stakeholders (individuals and/or groups); Assist in determining if any changes should be made to criteria or regulations to better serve clients; Review certain claims, analyze, and process through the payment system; Provide operational input for claims processing decisions; Assist with coding and procedure code groupings; Participate in the yearly coding updates and assist in updating the system according to the reviewed and accepted codes for the PA Medical Assistance Program; Perform other related duties as assigned by the managerial staff; Consultant will report to the state supervisor staff. Be available as a full-time consultant, approximately 37.5 hours per week; Possess an active Pennsylvania Registered Nurse license; Possess a documented work history of five (5) or more years of experience with claims review/coding or processing; be familiar with HCPCS II, CPT, or Dental coding; Possess computer skills, including familiarity with Microsoft Office programs, including Microsoft Excel/Word/PowerPoint; Possess prior experience with PROMISe or similar claims processing system; Possess prior experience with Medicare or Medical Assistance coding rules; Possess prior experience with researching medical policies, out of state comparison, participation in studies or projects.
Medical Biller AtriumMedical BillerPark Ridge, NJOur client is a boutique medical billing company based in Bergen County, New Jersey, specializing in out-of-network (OON) insurance billing for a wide range of healthcare providers and facilities. With a new orthopedic account coming onboard, the company is expanding and seeking a Medical Biller to support claim processing, insurance follow-up, and accurate billing operations.
NewCorporate Insurance & Risk Management Specialist Rausch CompaniesCorporate Insurance & Risk Management SpecialistGreenland, ARDescription: Reporting to the Corporate Insurance and Risk Manager, the Corporate Insurance & Risk Management Specialist is responsible for the day-to-day management of insurance compliance, renewal data workstreams, and initial claims processing, ensuring the organization’s risk/insurance portfolio remains accurate. Duties & Responsibilities Renewal Data Management: Lead the annual collection of underwriting values (property schedules, vehicle lists, payroll, and revenue) across departments to assist Director of Risk Management in building comprehensive submissions for brokerage partners.