- The Hartford (Lake Mary, FL)
- …and successfully investigating, reserving, recommending and implementing strategies to resolve claims consistent with corporate claim standards, policies and ... strategies including investigation, valuation, disposition and settlement of assigned claims , in a manner consistent with corporate claim...within the US and work their own time zone hours . Start Date: Open Hours : 8:00 AM-… more
- CVS Health (Austin, TX)
- …and more compassionate. And we do it all with heart, each and every day. ** Claim Benefit Specialist** Reviews and adjudicates claims in accordance with claim ... use multiple systems and screens to obtain and record claim information + Review claims information to...Degree **Education** High School diploma or GED **Anticipated Weekly Hours ** 40 **Time Type** Full time **Pay Range** The… more
- CVS Health (Tallahassee, FL)
- …non-participating providers. Additionally, they will assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues. as well as ... Field Analyst** works with the grievance and appeal and claims operations department to trend provider claim ...8am-5pm EST, with the flexibility to work beyond core hours as needed. **Preferred Qualifications** + Excellent verbal and… more
- Zurich NA (Schaumburg, IL)
- …and management of all communications and reporting associated with the life of a claim . At Zurich North America Claims we acknowledge that work life-balance and ... Sr. Pollution Claim Specialist 125621 Zurich is currently seeking a Sr. Claims Professional to join our Latent & Environmental team in Schaumburg, IL. This is an… more
- CRC Insurance Services, Inc. (ID)
- …and makes recommendation for additional activity as appropriate. 4. Determine where new loss claims should be reported. 5. Manage all claim documentation. 6. Use ... and/or correspondence to the Agent or Insurer to process claims appropriately. 7. Analyze claim coverage with...computer and office skills 12. Ability to work extended hours when necessary **Preferred Qualifications:** 1. New York adjuster… more
- CVS Health (Lansing, MI)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Molina Healthcare (Warren, MI)
- …to providers. **Job Duties** + Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which ... United States. Work Schedule Monday to Friday - operation hours 6 AM to 6 PM (Team will work...schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical… more
- CVS Health (Austin, TX)
- …we do it all with heart, each and every day. **Position Summary** The Senior Claim Benefit Specialist serves as a quality champion and advocate for the business by ... conducting routine audits and claim testing related to PPO network creation. This role...to test plan development. + Analyze and resolve complex claims scenarios within established timeframes. + Respond to internal… more
- CVS Health (Hartford, CT)
- …all with heart, each and every day. **Hybrid in Hartford, CT required** ** Claim Supervisor:** Responsible for the overall supervision of Medical Claim Processing ... + Develop, train, evaluate and coach staff to provide cost effective claim review/processing and claim service while ensuring compliance and quality… more
- CVS Health (Augusta, ME)
- …day. **Position Summary** -Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and ... staff for review. -Organized and prioritizes work to meet regulatory and claim turn-around times -Promotes communication, both internally and externally to enhance… more