- Sedgwick (Cincinnati, OH)
- …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... Inbound call center experience preferred. **Skills & Knowledge** + Knowledge of medical terminology + Understanding of claims management + Excellent oral… more
- American Family Insurance - Corporate (Boston, MA)
- You will work in the field and report to the Property Claim Manager and handle homeowner property field claims typically within the state of Massachusetts. You ... is offered for eligible candidates._ *Investigates origin and cause of claims by contacting the appropriate parties including insureds, claimants, agents, attorneys,… more
- The Whole Person (Kansas City, MO)
- GENERAL DESCRIPTION This position will primarily handle insurance claim submissions, payment posting, and researching claim rejects/denials. This position must ... other types of insurance billing guidelines. ESSENTIAL JOB FUNCTIONS + Submits claims to government and commercial payers according to timely filing requirements. +… more
- Travelers Insurance Company (Carson City, NV)
- …Openings** 1 **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader ... externally. + This position will oversee the following key areas: + Medical Claim Product Research, Strategy and Innovation: + Design and direct innovative,… more
- Robert Half Accountemps (Alhambra, CA)
- …Collections Specialist must be successful with investigating, tracking, and resolving denied medical insurance claims . The Medical Collections Specialist ... Description A Hospital in Los Angeles is seeking a Medical Collections Specialist with experience in credit balances. The Medical … more
- Sedgwick (Chicago, IL)
- …to support the claim request and documents decision rationale. + Completes medical review of all claims by reviewing medical documentation received ... medical management of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and… more
- TEKsystems (Earth City, MO)
- …mechanic looking to shift gears in your career? We are seeking a Mechanical Claims Specialist to join our expanding customer contact team. In this role, you'll ... expertise and in-depth knowledge of vehicle mechanics to assess and process mechanical claims . This opportunity offers a refreshing change of pace, allowing you to… more
- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- …to prevent fraud and ensure compliance with policy terms. + Resolve Rejected Claims : + Calculate benefit payments and approve claim settlements based on ... SUMMARY: The Adjudication Specialist manages a portfolio of rejected pharmacy claims , ensuring timely billing and maximum payer reimbursement. They prioritize… more
- Houston Methodist (Houston, TX)
- …changes are needed. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Analyzes data from various sources ( medical records, claims data, payer medical policies, etc.), ... reduce financial risk and exposure caused by front end claim edits and retrospective denial of payments for services...Integrates the payer medical policies, case specific medical documentation, and claims information into a… more
- Access Dubuque (Dubuque, IA)
- …Representative, you'll be a trusted guide for individuals navigating complex disability claims . You'll use your expertise to assess medical documentation, ... **Key responsibilities include:** **Independently evaluating and managing complex disability claims .** **Interpreting medical records and disability plans to… more