Long Term Care Claims Representative - Payment Servicing Genworth Financial IncLong Term Care Claims Representative - Payment ServicingSC$45,500–$66,000 / yearYou will work in a fast -paced environment across multiple products, ensuring claims handling follows policy provisions, internal guidelines, and Compliance requirements and will be responsible for the processing and payment of long-term care claims. Your experience or education has provided you with knowledge of medical terminology, diseases/diagnoses, and the ability to understand and interpret contract language, disability processes, nursing home licensing, and rehabilitative requirements.
Claims Examiner - Workers Compensation Sedgwick Claims Management Services, Inc.Claims Examiner - Workers CompensationSCRemoteMental: 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 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.
Senior Casualty Claim Representative/Claims Specialist-Specialty Human Services Great American Insurance CompanySenior Casualty Claim Representative/Claims Specialist-Specialty Human ServicesSC$80,000–$120,000 / yearSHS works with agents to address the coverage needs and loss exposures of more than 16,000 social service and non-profit organizations across the country. Since 1980, we've been Protecting Those Who Improve Your Community and were one of the first carriers to offer niche coverage solutions to nonprofit and service organizations.
Claims Attorney (Municipal Entities) HCC Life Insurance CompanyClaims Attorney (Municipal Entities)SCRemoteThe Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the "VCCLEA"), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions. The Tokio Marine HCC - Public Risk Group is seeking a self-motivated Claims Attorney to join our growing Claims Department and handle litigated and non-litigated claims primarily arising under Auto and General Liability, as well as potentially some Law Enforcement, Public Officials, and Employment Practices liability policies in various jurisdictions.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistSCRemote$137,496–$164,934 / yearBoston 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.
Unclaimed Property Claims Analyst State of South CarolinaUnclaimed Property Claims AnalystRichland County, SC$45,300–$77,000 / yearPosition requires critical thinking, research skills, detailed documentation and the ability to effectively communicate with the general public including representatives of companies that remit unclaimed property. The State Treasurer's Office is seeking an inquisitive and detail-oriented claims analyst in the Unclaimed Property Program (UPP) that is passionate about our mission of returning unclaimed property to its rightful owners.
NewClaims Customer Service Advocate II BlueCross BlueShield of South CarolinaClaims Customer Service Advocate IIColumbia, South CarolinaWe are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
NewClaims Customer Service Advocate II PGBAClaims Customer Service Advocate IIColumbia, South CarolinaWe are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
Field Claims Representative Auto-Owners Insurance CompanyField Claims RepresentativeColumbia, South CarolinaAbility to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job requires mastery of claims-handling skills and requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability.
Claims Negotiation Manager CVS Health CorpClaims Negotiation ManagerSC$66,330–$145,860 / yearDemonstrated expertise in the No Surprises Act (NSA), out-of-network reimbursement methodologies, provider billing practices, and healthcare claims adjudication, with the ability to interpret complex regulations, evaluate claim and reimbursement disputes, guide negotiation strategies, ensure compliance, and drive favorable financial and operational outcomes. Lead daily negotiation operations while partnering closely with Product, Operations, Compliance, Analytics, and Client teams to enhance negotiation strategies, support product development, drive operational excellence, and ensure compliance with federal and state regulations.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeSCEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
Senior Provider Experience Program Manager - Healthcare Claims CVS Health CorpSenior Provider Experience Program Manager - Healthcare ClaimsSC$106,605–$284,280 / yearWhat you will do: Lead enterprise delivery of multiple, highly complex business process and technology initiatives aligned to the Provider Experience / Provider NPS program, supporting all lines of business. Drive Agile delivery of Provider Experience / Provider NPS initiatives, supporting business process and technology improvements across multiple lines of business.
Claims Customer Service Representative- #26-19638 US Tech Solutions, Inc.Claims Customer Service Representative- #26-19638Columbia, SC$18 / hourRequired Work Experience: years of customer service experience including 1-year claims or appeals processing OR Bachelor's Degree in lieu of work experience. US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
Claims Customer Service Advocate I TRC Talent SolutionsClaims Customer Service Advocate IColumbia, SCTemporarySummaryThe Claims Customer Service Advocate is responsible for responding to routine written and telephone inquiries related to claims, identifying and correcting processing errors, and reviewing claims and non-medical appeals in accordance with organizational policies and procedures. This role ensures accuracy, timeliness, and quality while delivering a high level of customer service.
NewClaims Representative Internship - Summer 2027 Auto-Owners Insurance CompanyClaims Representative Internship - Summer 2027Columbia, South CarolinaThe position requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.
SIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorLexington, SC$25–$32 / hourPart timeNotary license strongly (preferred).Bilingual ability and/or degree in Criminal Justice or related field (preferred).Willingness to travel; flexible schedule (varied/irregular hours).Strong computer and internet skills. Accurately photograph evidence (accident scenes, vehicle damage, etc.).Skills & ExperienceExperience handling complex SIU/Claims cases.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistSC$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims.
Default Loan Serving Specialist - Claims - ServiceMac First AmericanDefault Loan Serving Specialist - Claims - ServiceMacUsa, South CarolinaManage loan level requirements on assigned cases by interacting and instructing various parties such as mortgagors, attorneys, investors, insurers, trustees, appraisers, clients, and any other party involved with default. This role performs a variety of default claims servicing functions within established timelines and workflow processes to ensure accurate claim filing, minimize risk, and support operational performance goals.
Senior Claim Benefit Specialist - Remote CVS Health CorpSenior Claim Benefit Specialist - RemoteSCRemote$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Medical Case Manager Crawford & CoMedical Case ManagerColumbia, SCTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual''s medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services.