- Donegal Insurance Group (Marietta, PA)
- …there when it matters most. Job Summary Donegal Insurance Group has an opening for a Claim Representative on our Auto Claims team. As a member of our Claims ... team, this position is responsible for handling auto claims , with a focus on non-injury general liability, in...and analytical skills with a strong technical knowledge of claim handling procedures. This position is based in our… more
- Prime Therapeutics (Boise, ID)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Claim Technical Analyst - JUDI Ops Team - Remote **Job Description** The Claims ... Technical Analyst is responsible for serving as the claims analysis resource for an assigned operations team. This role is responsible for developing queries to… more
- MetLife (Oriskany, NY)
- …* Bachelor's degree * Knowledge of system applications and Disability claims knowledge/working knowledge of FMLA/Disability/Leave procedures preferred Business ... administer Family & Medical Leave Act standalone/ADA (as well as other leave) claims and adhere to federal and state regulatory and/or company plan requirements and… 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 ... train, evaluate and coach staff to provide cost effective claim review/processing and claim service while ensuring...and meeting deadlines, and strong business knowledge. (2+ years preferred ) + Proven track record of successfully dealing with… 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
- Point32Health (MA)
- …as required by the plan. + Manually calculate and/or apply pricing to each claim when necessary. + Process complex claims adjustments as assigned by supervisor: ... while applying appropriate back out and adjustment reason codes. + While processing claim adjustment, ensure that claims maintains or is appropriately updated to… more
- Walmart (Bentonville, AR)
- …appropriately tenured case manager with the necessary skill set to achieve an optimal claim outcome. + Escalate claims to leadership based on the internal ... and regulatory requirements. + Review complex, high-exposure, and litigated claims and provide technical guidance on claim ...or relevant area OR 4 years' experience in insurance claims or related area ** Preferred Qualifications **… more
- Walmart (Bentonville, AR)
- …appropriately tenured case manager with the necessary skill set to achieve an optimal claim outcome. + Escalate claims to leadership based on the internal ... and regulatory requirements. + Review complex, high-exposure, and litigated claims and provide technical guidance on claim ...or relevant area OR 4 years' experience in insurance claims or related area ** Preferred Qualifications **… more
- AIG (Atlanta, GA)
- …and other support groups to ensure completion of acceptable contracts. + Promote use of preferred Claim Law Firms / Claims Vendors to promote greater ... role will be responsible for the management of the Claims Law Firm and Claim Vendor function...equivalent combination of experience; insurance or financial services industry preferred . + Minimum 10 years prior experience working with… more
- Medical Mutual of Ohio (OH)
- …of care. **Responsibilities** + Independently evaluates basic to complex medical claims and/or appeal cases and associated records by applying clinical, regulatory, ... approved by the Ohio State Nursing Board. Bachelor's degree preferred . + 3 years experience as a Registered Nurse...terminology and managed care processes. + Familiarity with clinical claim management including ICD 10, CPT, HCPC, and revenue… more