- Travelers Insurance Company (Melville, NY)
- … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site...mail. Orders, receives and distributes supplies and/or equipment. + CLAIM PAYMENTS AND EXPENSE PROCESSING : Ensures the… more
- CVS Health (Franklin, TN)
- …Description **A Brief Overview** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. **What ... timely support. + Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing...Minimum Requirements** + 2+ years of experience with medical claim processing . + 2+ years of experience… more
- Trinity Health (Livonia, MI)
- …behavior. **MINIMUM QUALIFICATIONS** Must possess a comprehensive knowledge of liability claims processing and administration. High school diploma plus a ... coordinating claim process activities, opening and closing claim files, securing medical records for claims ...closing claim files, securing medical records for claims and incidents, tracking claim expenses and… more
- Highmark Health (Topeka, KS)
- …and adjudicates claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim information to TPAs, ... **EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience processing 1st dollar health… more
- Sedgwick (Miami, FL)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim ...depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client;… more
- NJM Insurance (NJ)
- …and use of sound decision-making capabilities + Working knowledge utilizing an automated claim processing system and Microsoft Office tools including Word and ... transparent, empathetic support and collaborative engagement during the life of a claim . The WC Claims Department takes pride in being a key component in the… more
- Allied Solutions (Plano, TX)
- Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. ... others as assigned. This position will involve the initial processing and investigation of 20-40 claims per...claims per day. This position ensures that all claim documentation is thoroughly reviewed and assessed for coverage… more
- Caterpillar, Inc. (Peoria, IL)
- …errors and corrections * Review data, identify trends and make recommendations for claim processing improvements * Provide reporting and feedback to warranty ... Claim Review & Validation)** , you'll facilitate the claim review and validation process ensuring that claims... claim review and validation process ensuring that claims adhere to policies. This is accomplished through detailed… more
- Sedgwick (Coralville, IA)
- …asbestos) by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate ... + Calculates and assigns timely and appropriate reserves to claims ; monitors reserve adequacy throughout claim life....depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client;… more
- Sedgwick (San Antonio, TX)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim ...depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client;… more