- Robert Half Accountemps (Raleigh, NC)
- …parties regarding claim -related issues. Requirements * Proven experience in medical claims processing and reconciliation. * Familiarity with payer portals ... Description We are looking for a detail-oriented Medical Claims Analyst to join our...skills in handling claim denials and rejected claims . * Knowledge of medical billing procedures… more
- Sedgwick (Raleigh, NC)
- …assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to ... + Calculates and assigns timely and appropriate reserves to claims ; monitors reserve adequacy throughout claim life....benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Brighton Health Plan Solutions, LLC (NC)
- …or leadership role. + Advanced knowledge of Excel. + Strong knowledge of contracts, medical terminology, and claims processing and procedures. + 5+ years of ... About the Role The Claims Supervisor is responsible for supervising a staff of Claim Examiners and Claim Team Leads, 12-20 direct reports. The expectations… more
- Sedgwick (Charlotte, NC)
- …properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and ... claims ' action plans to resolution, coordinates return-to-work efforts, and approves claim payments. + Approves and processes assigned claims , determines… more
- Lincoln Financial (Raleigh, NC)
- …and applying knowledge. You will analyze and manage a caseload of appeals claims . You will review, investigate, and make claim determinations regarding coverage, ... experience. + Effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims … more
- Sedgwick (Raleigh, NC)
- …FUNCTIONS and RESPONSIBILITIES** + Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional ... Fortune Best Workplaces in Financial Services & Insurance Complex Claims Advisor | Commercial GL and Auto | Remote...for line of business and key jurisdictions on complex claim issues. + Uses knowledge of all aspects of… more
- Cognizant (Raleigh, NC)
- …regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing ... information, and updating information to claim file about claims ...for this position, subject to applicable eligibility requirements: * Medical /Dental/Vision/Life Insurance * Paid holidays plus Paid Time Off… more
- Sedgwick (Fayetteville, NC)
- … claims ' action plans to resolution, return-to-work efforts, and approves claim payments. + Approves and processes assigned claims , determines benefits ... pursuant to the claim or client contract. + Administers subrogation of claims and negotiates settlements. + Communicates claim action with claimant and… more
- Sedgwick (Raleigh, NC)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Leader - Liability **PRIMARY PURPOSE** : To supervise the operation of… more
- Sedgwick (Fayetteville, NC)
- …FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims , including bodily injury and ensures claim files are properly ... and commercial line auto policies, coverage's, principles, and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge… more