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Claims Examiner I Jobs

Claims Systems Configuration Associate I - Evicore - Remote
By The Cigna Group At United States
You'll coordinate, define, and review claims system configuration to meet change requirements as approved.
2+ years of claims and health care experience required
1+ years of experience in Claims Systems Configuration required
1+ years of Microsoft Access experience is required
1+ years of experience with SQL required, ability to run SQL queries is a strongly preferred
Advanced experience with MS Office Excel is required
Remote Claims Examiner Jobs
By Firstsource Healthcare At , Remote
Multiple computer application usage experience
Health claims processing experience a plus
Knowledge in the following a plus:
Specific qualifications for this medical financial services role include:
High School diploma or GED
Ability to read and interpret general business correspondence, procedure manuals, and specific plan documents
Claims Examiner Jobs
By Firstsource Healthcare At , Remote
Health claims processing experience a plus
Multiple computer application usage experience
Work From Home Claims Analyst-(Health Care)
Here are just some of the benefits you will enjoy in this financial services role:
Specific qualifications for this medical financial services role include:
High School diploma or GED
Claims Examiner (Annuities) Jobs
By Transamerica At United States
Strong preference for prior Transamerica experience and/or knowledge of Transamerica Operations
Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims.
Associate’s degree in a business field or equivalent experience
Excellent communication and customer service skills
Organizational, problem-solving and analytical skills
Review claims and outside sources used in the review.
Default Fha Claims Qa Analyst I
By Vylla At , $22.00 - $26.75 an hour
Excellent written and oral communication, organizational and time management skills.
Ability to communicate effectively with all levels of staff and management both internally and externally.
Moderate knowledge of default claims processes for insurers and investors.
Strong interpersonal skills with a focus on teamwork and quality.
Ability to manage work in order to meet strict deadlines.
Review FHA Part A claims for accuracy within the investor/insurer timeframes.
Driver License Examiner I
By North Carolina Dept of Transportation At , $31,200 - $50,298 a year
Knowledge, Skills and Abilities / Competencies
Minimum Education and Experience Requirements
Experience working as a collaborative team player using problem-solving skills to work out solutions for delivery
Experience composing written communication using typing skills
Experience explaining policy, procedure and/or laws to educate customers or the public
Customer service experience (friendly, enthusiastic attitude who enjoy serving customers) with a diverse clientele
Claims Examiner I - Medical
By EMI Health At , Salt Lake City, 84107, Ut

EDUCATION, EXPERIENCE AND OTHER SPECIFIC QUALIFICATIONS:

LANGUAGE, MATH, COMPUTER, AND REASONING SKILLS:

Claims Specialist I Jobs
By Everest Re Group, Ltd. At , Township Of Warren, 07059, Nj
Flag issues and escalate urgent matters to management
Determining and resolving workload and assignment issues to ensure effective claims processing, expense management and claims disposition
Claims experience in third party liability claims and working knowledge of the civil litigation legal process is strongly preferred
Execution: Delivering outstanding support to the organization through strong day-to-day business operations, effective project management, and careful oversight of vendors.
Strong oral and written communication skills
Strong analytical and organizational skills
Claims Support Specialist I
By Erie Insurance Group At Harrisburg, PA, United States
Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work.
401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension.
Career development. Including a tuition reimbursement program for higher education and industry designations.
Benefits That Go Beyond The Basics
Duties and Responsibilities (cont'd if applicable)
Low contributions to medical and prescription premiums. We currently pay up to 97% of employees' monthly premium costs.
Claims Service Ambassador I (Remote)
By Wawanesa Insurance At , Fort Collins, 80526, Co $21.17 - $31.76 an hour
Good time management and organizational skills with the ability to prioritize work in a fast paced, changing environment
Exceptional customer service skills demonstrating empathy and concern for customer satisfaction
Good communication skills, both written and oral
Good investigative and analytical skills
Detail oriented with a critical degree of accuracy regarding data entry
Voluntary benefit plans – accident, hospital indemnity and critical illness
Insurance Performance Examiner Trainee (Target Title: Insurance Performance Examiner I)
By State of Illinois At , Springfield, 62767, Il $3,500 - $5,000 a month
Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)
State of Illinois employees enjoy a robust benefit package, including:
Visit https://www2.illinois.gov/cms/benefits/Pages/default.aspx for more information about our benefits.
Health, Life, Vision, and Dental Insurance
13 Paid Holidays annually, 14 on even numbered years
10-25 days of Paid Vacation time annually - (10 days in year one of employment)
Claims Administrator I Jobs
By REI At United States
Supports REI’s integrated disability management program.
Apply general logic and critical thinking skills to determine investigation questions unique to the circumstances of the case.
Tracks and maintains OSHA recordkeeping requirements where applicable.
Ensures REI locations have the applicable support documentation to support compliance with REI and State WC requirements.
General knowledge of the Workers’ Compensation, Automobile, and General Liability claims processes.
Three (3) or more years Workers’ Compensation claims experience.
Claims Compliance Specialist I
By Athens Administrators At , Remote $31.84 - $42.47 an hour
Assist with the development and administration of the Learning Management System
Ensure Athens’ compliance with jurisdictional training and licensing requirements
Excellent written and verbal communication skills, including ability to convey technical details
Strong communication and interpersonal skills
Possession of independent decision-making skills and demonstrated initiative to resolve issues
Prior experience with training preferred
Remote Default Mi Claims Specialist, I
By Vylla At , $19.50 - $21.50 an hour
Continue to learn new skills and expand job knowledge to better perform assigned duties.
Come join our amazing team and work remote from home!
Prepare and file all FHA, VA, PMI, and investor claims timely and accurately according to investor/insurer/CMS guidelines and requirements.
Maintain updates in Fiserv and input the completion date on the date the action occurs.
Perform routine follow-up on a daily basis.
Document all servicing, action taken, delays, follow-up, and phone conversations in the system notes.
Claims Analyst I Jobs
By Towne Park At United States
Six to twelve months related experience and/or training; or equivalent combination of education and experience.
Ability to manage several projects simultaneously while working under pressure to meet deadlines.
The individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
Excellent written communications skills to provide any necessary correspondence with internal and external customers.
Reasonable accommodations may be made to enable individuals with disabilities to perform all functions.
High school diploma or general education degree (GED)
Claims Examiner Jobs
By CSI Companies At Jacksonville, FL, United States
Investigate claims with potential fraudulent activity and review findings with management.
Education: High School diploma or equivalent.
Stay up-to-date with related state laws, anti-fraud compliance requirements, product standards, and service standards.
Employment Type: Contract to Hire
Working Hours: Standard business hours between 8am - 5pm EST
Location: Jacksonville, FL 32256 (Fully in-office)
(Remote) Claims Examiner - Liability
By Sedgwick At Texas, United States
Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
Professional certification as applicable to line of business preferred.
Opportunity to work in a remote or agile environment.
Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
Fitness Reimbursement Examiner I (Remote, $14/Hr)
By American Specialty Health At United States
Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
Ability to effectively organize, prioritize, multi-task and manage time.
Processes reimbursement requests accurately and efficiently.
Reviews all incoming reimbursement requests to verify necessary information.
Enters reimbursement requests and information into a computerized request Processing System.
Maintains all required documentation of reimbursement requests processed and reimbursement requests on hand.
Claims Examiner Jobs
By Health Special Risk, Inc. At United States
Insurance knowledge/experience with medical terms and billing is a plus.
Knowledge of HIPPA, pre-existing conditions, and coordination of benefits required.
Ensure that all claims are handled in a timely manner to meet state-mandated requirements.
Minimum of 3 years of previous claims processing/adjudication experience. Trizetto QicLink or RIMS experience is a plus.
In-depth knowledge and ability to read and interpret medical policies to determine claim eligibility.
Strong detail-oriented and analytical skills.
Claims Examiner Jobs
By Sedgwick At Pennsylvania, United States
Coordinates vendor referrals for additional investigation and/or litigation management.
Refers cases as appropriate to supervisor and management.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Manages the litigation process; ensures timely and cost effective claims resolution.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.

Are you looking for a challenging and rewarding career as a Claims Examiner I? We are looking for an experienced professional to join our team and help us process and review insurance claims. You will be responsible for ensuring accuracy and timeliness of claims processing, as well as providing excellent customer service. If you have a passion for helping people and a commitment to accuracy, then this is the job for you!

Overview Claims Examiner I is responsible for reviewing and processing insurance claims. They must ensure that all claims are handled in accordance with company policies and procedures. They must also ensure that all claims are paid in a timely manner. Detailed Job Description Claims Examiner I is responsible for reviewing and processing insurance claims. They must review all claims for accuracy and completeness and ensure that all claims are handled in accordance with company policies and procedures. They must also ensure that all claims are paid in a timely manner. They must also investigate and resolve any discrepancies or disputes that may arise. They must also maintain accurate records of all claims and provide customer service to claimants. Job Skills Required
• Knowledge of insurance policies and procedures
• Excellent customer service skills
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Ability to handle multiple tasks simultaneously
• Attention to detail
• Ability to work in a fast-paced environment
• Computer proficiency
Job Qualifications
• Bachelor’s degree in business, finance, or a related field
• At least two years of experience in claims processing
• Knowledge of insurance policies and procedures
• Ability to work independently and as part of a team
• Computer proficiency
Job Knowledge
• Knowledge of insurance policies and procedures
• Knowledge of claims processing procedures
• Knowledge of customer service principles
• Knowledge of legal and regulatory requirements
Job Experience
• At least two years of experience in claims processing
• Experience in customer service
• Experience in problem-solving
Job Responsibilities
• Review and process insurance claims
• Ensure that all claims are handled in accordance with company policies and procedures
• Investigate and resolve any discrepancies or disputes that may arise
• Maintain accurate records of all claims
• Provide customer service to claimants
• Monitor claims to ensure timely payment
• Communicate with claimants and other parties involved in the claims process