PHYSICAL, MENTAL & ENVIRONMENTAL DEMANDS: To comply with the Rehabilitation Act of 1973 the essential physical, mental and environmental requirements for this job are listed below. ul>Investigates the claim or coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimants or injured workers, witnesses and producers. Depending on the type of claim may: Communicate with internal Managed Care and Medical resources to ensure coordination with Medical providers on the development and authorization of appropriate treatment plans as well as accurate billing. Servpro Franchise employees are not employed by, jointly employed by, agents of or under the supervision or control of Servpro Industries, LLC or Servpro Franchisor, LLC (the Franchisor), in any manner whatsoever. All employees of a SERVPRO® Franchise are hired by, employed by, and under the sole supervision and control of an independently owned and operated SERVPRO® Franchise. Costa Mesa, CA30+ days ago The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Companys sole discretion, consistent with the law. The Pharmacy Investigator Senior is responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on fraudulent claims. Riverside, California27 days ago The Claims Senior Auto Adjuster supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The starting pay range for this position is: $28.93 Norco, California14 days ago Billing & Collections Specialist is responsible for ensuring accurate and timely billing, proactive collections, and consistent follow-up on outstanding accounts to support the financial health of the organization. In accordance with Company policy, perform timely and aggressive follow-up on outstanding claims, meticulously resolve denials by correcting errors, gathering necessary documentation, and resubmitting claims efficiently. p>Responsibilities: - Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners.
- Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state
s tort laws as normally acquired through a bachelors degree (or equivalent training) plus 3 to 5 years directly related work experience.
Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Candidate must possess strong communication and litigation management skills to collaborate with business partners and defense counsel to direct litigation activities and claim outcomes while considering the overall impact to the company and individual stakeholders. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management. First American reasonably believes that a criminal history may have a direct, adverse and negative relationship with the following material job duties for this position potentially resulting in the withdrawal of the conditional offer of employment: handling of confidential, proprietary or trade secret information belonging to First American or its customers, administrating or facilitating financial transactions, and the ability to meet customer-imposed criminal history requirements. As Claims Counsel at First American, you will manage matters from intake through resolution, including evaluating risk, making coverage determinations, resolving complex title claims, and collaborating with internal business partners. |