The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic no-fault claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel....
Exercises critical thinking, proper judgment and decision making in a best practices claim environment to promptly analyze the claim exposure, determine the proper course of action, and pursue claims to conclusion. Work closely with Insureds, Claimants, attorneys and brokers ensuring a premier and b...
A company is looking for a Senior Claims Operations Specialist. ...
Serves medical insurance customers by determining insurance coverage; examining and resolving medical claims; documenting actions; maintaining quality customer services; ensuring legal compliance. ...
A company is looking for a Claims Specialist I, ERBI. ...
Please note this role can be based in any of these Axis office locations: Alpharetta, GA, NYC, Princeton, NJ *• Exercises critical thinking, proper judgment and decision making in a best practices claim environment to promptly analyze the claim exposure, determine the proper course of action, and pu...
A company is looking for a Priority Claims Specialist III. Key Responsibilities:Maintain knowledge of DMEOPS CPT and ICD-10 codesReview and resolve unpaid, short paid, and denied claimsFile appeals, communicate with partners, and resolve outstanding accounts receivable problemsRequired Qualification...
Healthcare Risk Advisors is seeking a medical malpractice Claims Specialist to join our claims team. This position is responsible for performing investigations, evaluations, negotiations, and settlements to equitably resolve claims. Claims Investigation / Analysis. Litigation Management & Claims Res...
The Professional Liability Claims Specialist/Claims Counsel will be responsible for oversight and day-to-day supervision of professional liability claims including Employment Practices Liability, Section 42 USC 1983 litigation/civil rights, Police Professional, Educators Legal Liability, Public Offi...
The Senior Claim Specialist, under the direction of a Claims Supervisor, investigates and settles Property claims promptly, equitably and within established best practices guidelines in the New York City area. Effectively evaluate claim facts and negotiate claim settlements. Analyze first reports an...
Claim Specialist Job Description:*For the Claims Specialist role, the ideal candidate will be a proactive and meticulous critical thinker, willing to work long hours, as necessary. Input, analyze, maintain, and monitor claims data. Education / Experience:** Bachelor’s Degree* 2+ years of experience ...
As a Commercial/Specialty Casualty Adjuster, you will be responsible to resolve all aspects of 1st and 3rd party injury claims of low to moderate complexity for personal lines as well as our commercial claims. Handle 1st party exposures to include Medical Payment coverage, PIP, Uninsured Motorists, ...
Prudential’s Group Insurance, Claim Operation is seeking an experienced and highly motivated individual to join our team as a Senior Complaints Resolution Specialist. This position is a multifaceted role requiring disability claims expertise and close collaboration with departmental management, comp...
Provide support to various departments related to claim status, claim adjudication questions, and any basic questions related to the adjudication of an inpatient medical claim. Prior experience with claim adjudication systems, grouping and pricing software, and other claim adjudication and claim pri...
With moderate direction, this position handles single and multi-party personal or commercial line claims of moderate to high exposure and complexity within specific limits of authority by following established protocols to ensure that claims are handled in the most efficient, effective way while del...
Under limited supervision, acts as highest level individual contributor directly reviewing primary and excess Financial Institutions and Management Liability claims to determine nature of loss, coverage provided, and scope of claim and to make recommendations regarding settlement/disposition of clai...
Be responsible for reviewing claims processed by the outside vendor, including resolving provider appeals/disputes. Initiates and follows through with resolution of all pended claims. Reviews and investigates claims to be adjudicated by the TPA, including the application of contractual provisions in...
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. Conducts focused investigation to determ...
PLEASE NOTE ALL CANDIDATES MUST BE PERMANENT IN THE CLAIM SPECIALIST CIVIL SERVICE TITLE IN ORDER TO BE CONSIDERED. BLA is seeking qualified candidates for the position of Claim Specialist in the Litigation Support Unit. The Claim Specialist will need to become familiar with DEP’s Databases to effec...
Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collectio...
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim value, and following company's claim handling protocols. Authorizes and ensures claim disbursements wi...
Managing assigned claims across multiple jurisdictions, as well as setting the case strategy for these claims in partnership with Regional Claims Practice Leaders, Claims Legal and Claims management, as warranted. As a Construction Professional Liability Claims Specialist, you will play a critical r...
The candidates will review and adjudicate claims in accordance with ACAS claim processing guidelines. We are looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department. They will work ...
Maketimely claims payments and adjustments; communicateclaim action/processing with claimant and client. Work proactively towards claims resolution with defense counsel and clients, while adhering to audit requirements and resolving claims in a timely manner. Ensureclaim files are properly documente...
Operations - Insurance Operations.When you join Prudential, you’ll unlock a motivating and impactful career – all while .Departments, or Executive Offices.The current employee work arrangement for .While this position does not require your on-site presence on a regular basis, depending on business p...