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Claims Advocate Jobs

Claims Customer Service Advocate I
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Good verbal and written communication skills
Good spelling, punctuation, and grammar skills
Identify incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines
Examine and process claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines
Enter claims into the claim system after verification of correct coding of procedures and diagnosis codes
Ensure claims are processing according to established quality and production standards
Claims Clerk Jobs
By Safeway Insurance At ,

This position is responsible for maintaining an efficient flow of work within the claims office by performing such tasks as processing drafts, answering the phone, taking loss reports, maintaining ...

Claims Customer Service Advocate Ii
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Continuing education funds for additional certifications and certification renewal
401(k) retirement savings plan with company match
Subsidized health plans and free vision coverage
Paid annual leave – the longer you work here, the more you earn
On-site cafeterias and fitness centers in major locations
Wellness programs and healthy lifestyle premium discount
Director, Claims Jobs
By New York University At , New York, 10012, Ny $135,000 - $175,000 a year

Required Skills, Knowledge and Abilities:

Preferred Skills, Knowledge and Abilities:

072811-Claims Pa2 Jobs
By Capgemini At , , Tx

Visit us at www.capgemini.com . People matter, results count.

Fcmb Claims Customer Service Advocate Ii (Part-Time)
By BlueCross BlueShield of South Carolina At Myrtle Beach, SC, United States
Identify and report potential fraud and abuse situations
Complete projects and/or assignments related to claims processing and customer service functions in the department
High School Diploma or equivalent
Ability to follow policies and procedures
Ability to review claims and appeals
Subsidized health plans, dental and vision coverage
Claims Clerk Jobs
By Canon Business Process Services At O'Fallon, MO, United States
H.S. Diploma or equivalent No prior experience required
Requires good computational math skills. Must be familiar with personal computers and possess good keyboard skills
Must have good communication, comprehension and interpersonal skills
Must be detail oriented and have good organizational skills
Interfaces with Adjuster, Agent and insured to obtain information to assure completeness of information and update client systems
Prepares reports and insurance claim forms for damage or loss
Claims Customer Service Advocate Iii (Remote)
By BlueCross BlueShield of South Carolina At South Carolina, United States
Provide feedback to management regarding customer issues.
Follow through on complaints until resolved or report to management as needed.
Maintain knowledge of procedures and policies.
Good verbal and written communication skills.
Good spelling, punctuation, and grammar skills.
One year of call center experience.
Fcmb Claims Customer Service Advocate Ii
By BlueCross BlueShield of South Carolina At Florence, SC, United States
A proven curriculum providing the knowledge you need to excel.
Our Comprehensive Benefits Package Includes
Best-in-class call center training program.
Peer coach to observe you.
Peer coach for you to observe.
A training lab where you take live calls with a training supervisor close by to answer questions.
Fcmb Claims Customer Service Advocate Ii (9-6)
By BlueCross BlueShield of South Carolina At Florence, SC, United States

10% Completes projects and/or assignments related to claims processing and customer service functions in the department.

Claims Advocate Jobs
By Lyft At Greater Seattle Area, United States
Strong jurisdictional knowledge and litigation claim management experience.
10+ years of coverage and litigation and claims management, with an emphasis on auto liability
Deep technical claims and legal knowledge, experience with RMIS systems a plus
Experience evaluating and negotiating large loss casualty claims valued from $100K - $250K
Proven experience working at an insurance company in a multi-state environment, a self-insured entity, or a third party administrator
Excellent listening, communication, verbal, and writing (documentation) skills
Director Of Claims Jobs
By Minnesota Counties Computer Cooperative At Saint Paul Church, MN, United States
At least three years of supervisory/management experience
Solid understanding of electronic claims system capabilities from a management and adjustment perspective
Ensures compliance with claim handling/claim management philosophy, policies, protocol and standards
Conduct research regarding risk management and liability issues and prepare and present reports as needed
Work in conjunction with the Claim Managers and staff counsel to identify panel of approved legal counsel
Offer direction regarding selection of appropriate defense counsel
Vp, Claims Jobs
By BerkleyNet (a Berkley Company) At Manassas, VA, United States
10+ years of management experience with employees both in-person and remote
Develop and implement policies and procedures which meet the needs of the company, customers, regulatory requirement, and audit controls.
Develop and manage relationships with outside vendors, consultants, contractors, and other Berkley companies in line with company policies and guidelines.
Ensuring compliance requirements are met through Large Loss Reporting to the WRB organization and reinsurers.
15+ years of multi-jurisdictional workers compensation insurance claim experience; multi-line experience a plus.
Possess a working knowledge of all functional aspects of insurance company and third-party administrator (i.e. claims, underwriting, marketing, loss control, etc.)
Claims Clerk Jobs
By Canon Business Process Services At Rocklin, CA, United States
H.S. Diploma or equivalent No prior experience required
Requires good computational math skills. Must be familiar with personal computers and possess good keyboard skills
Must have good communication, comprehension and interpersonal skills
Must be detail oriented and have good organizational skills
Interfaces with Adjuster, Agent and insured to obtain information to assure completeness of information and update client systems
Prepares reports and insurance claim forms for damage or loss
Claims Pa2 Jobs
By Capgemini At , , Tx

About Capgemini Capgemini is a global leader in consulting, digital transformation, technology and engineering services. The Group is at the forefront of innovation to address the entire breadth ...

Claims Customer Service Advocate I
By BlueCross BlueShield of South Carolina At Greenville, SC, United States
One year of medical claims experience.
Knowledge of Microsoft Office applications.
Our Comprehensive Benefits Package Includes
A high school diploma or equivalent.
Self-paced learning and instructor led training.
401(k) retirement savings plan with company match.
Claims Director Jobs
By Doctors HealthCare Plans, Inc. At Coral Gables, FL, United States
7-10 claims leadership experience in health benefits specific environment.
Knowledge of claims practices as well as technical expertise.
Excellent oral and written communication skills.
Knowledge of current Medicare Advantage operational and regulatory guidelines established by CMS, AHCA and other federal and state regulatory guidelines.
Ability to work well under pressure and difficult situations Advance knowledge of industry best practices and medical terminology
Provide strategic leadership in the development, execution and monitoring of policies, procedures and initiatives that align with corporate goals and strategy.
Claims Advocate Jobs
By Arthur Lawrence At United States
3+ years of insurance claims experience
BS / BA or equivalent or an Associate degree
Proficiency with technology: Zendesk, CRM systems, Slack, Origami, and other systems
Arthur Lawrence is urgently looking for Claims Advocate in Washington for their hybrid role.
Director, Operations-Claims Jobs
By MedCost At United States
5 years’ experience with leadership responsibilities in administration of self-funded TPA (or comparable) healthcare and managed care plans.
Experience with code editing rules/systems, claim integrity methodology, stop loss management, flexible spending, HRA/HSA administration
Experience with vendor data connectivity management
Oversee the day-to-day claims processes including inventory management of claims, claim adjustments, recoupments, and refunds to meet quality and timeliness standards
Responsible for continuous quality improvement and assuring adherence to the MedCost Quality Management Program.
Responsible for financial management of designated Operational department budget and corporate fiscal responsibility.
Director, Claims Jobs
By Turner Construction Company At San Antonio, TX, United States
Strong organizational management skills, capable of directing, managing, and developing remote teams
Construction industry or related risk management experience, highly preferred
Self-starter with strong project management skills and capable of managing concurrent complex projects and tasks successfully to completion
Proficient in computer skills, Microsoft suite of applications, MS Outlook, and insurance-based risk management information systems
Provide direction of work, assign claims, and serve as regional escalation point for Claims Manager and Analysts.
Actively participate in and provide thorough and reliable guidance to Claims Managers for crisis response within assigned region and assigned clients.

Are you looking for a job that allows you to help people in need? We are looking for a Claims Advocate to join our team and help our clients get the compensation they deserve. If you have a passion for problem-solving and a desire to make a difference, this could be the perfect job for you!

Overview A Claims Advocate is a professional who works with insurance companies and policyholders to ensure that claims are processed and settled in a timely and accurate manner. They are responsible for providing advice and assistance to policyholders, negotiating with insurance companies, and ensuring that claims are settled in accordance with the terms of the policy. Detailed Job Description Claims Advocates are responsible for providing advice and assistance to policyholders in the event of a claim. This includes providing advice on the best course of action, negotiating with insurance companies, and ensuring that claims are settled in accordance with the terms of the policy. They must also be knowledgeable about the legal aspects of insurance claims and be able to provide advice on the legal implications of any settlement. Claims Advocates must be able to effectively communicate with both policyholders and insurance companies. They must be able to explain the terms of the policy and the process for filing a claim. They must also be able to negotiate with insurance companies to ensure that claims are settled in a timely and accurate manner. Skill Requirements
• Knowledge of insurance policies and legal aspects of insurance claims
• Excellent communication and negotiation skills
• Ability to explain complex information in a clear and concise manner
• Ability to work independently and as part of a team
• Ability to handle difficult situations and remain calm under pressure
Qualifications
• Bachelor’s degree in business, law, or a related field
• Relevant experience in the insurance industry
• Professional certification, such as a Chartered Insurance Professional (CIP) or Chartered Property Casualty Underwriter (CPCU)
Knowledge
• Knowledge of insurance policies and legal aspects of insurance claims
• Knowledge of the claims process and the ability to explain it to policyholders
• Knowledge of negotiation techniques and strategies
• Knowledge of relevant laws and regulations
Experience
• Previous experience in the insurance industry
• Experience in customer service or a related field
• Experience in claims processing and settlement
Responsibilities
• Provide advice and assistance to policyholders in the event of a claim
• Negotiate with insurance companies to ensure that claims are settled in accordance with the terms of the policy
• Explain the terms of the policy and the process for filing a claim
• Monitor the progress of claims and ensure that they are settled in a timely and accurate manner
• Ensure that all relevant documents are collected and submitted to the insurance company
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