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Claims Intregrity Specialist Jobs

Claims Specialist Jobs
By Innova Solutions At Alpharetta, GA, United States
• Assists Management in reviewing existing and future processes to ensure best practices are implemented and followed
Work Arrangement: - Hybrid (3 days onsite and 2 days remote)
• Four (4) or more years claims clerical experience required.
• Excellent communications (telephone, e-mail and interpersonal) skills as required.
• Strong analytical and organizational skills
• Knowledge of various claim systems and claim processing.
Claims Experience Specialist Jobs
By Faye At United States
Ability to display great time management and prioritize workload while remaining organized and efficient
Effectively manage customer contacts across various channels of communication, including phone, e-mail and chat.
Efficiently handle customer complaints with empathy, knowledge and understanding.
Excellent verbal & written communications skills
Proven experience in claims, assistance or comparable roles
Handle claims arising from travel insurance products
Priority Claims Specialist Iii
By Hanger, Inc. At , Remote $17.95 - $26.93 an hour
Retrieve and properly identify any document received from Revenue Cycle Management (RCM) system
4 years of related experience in payor policies to include all areas of reimbursement, medical policy and payor appeal requirements.
Demonstrated ability to pull data and migrate into online records management systems such as OnBase;
Develop and manage relationships with colleagues in a professional
Prepare complex claims reimbursement submissions in a managed care environment
Serve as an advocate and resource to clinic administration in the areas of reimbursement and managed care
Claims Specialist Jobs
By Safely At Atlanta, GA, United States
Educate clients on best practice techniques and other underwriter requirements for smooth claim processing
Manage complex ambiguous client situations that require cross-departmental collaboration
At least 2 years of experience in a B2B Customer Success and claims processing experience
Software skills: web-based databases, Microsoft Word and Excel, and HubSpot or a similar CRM
Strong business acumen and communication skills, both written and verbal
Friendly, patient and personable demeanor with excellent phone skills
Claims Specialist Jobs
By UnifyWork At , Cleveland
Click "Apply Now" to get started.
*Career coach available during business hours only (EST).
*Our employer partners are equal opportunity employers.*
Claims Specialist - Claims Processing
By Providence At , Mission Hills, 91345, Ca

Check out our benefits page for more information about our Benefits and Rewards.

Claims Specialist - Claims Processing

Claims Specialist Jobs
By UnifyWork At , Cleveland, Oh
Click "Apply Now" to get started.
*Career coach available during business hours only (EST).
*Our employer partners are equal opportunity employers.*
Claims Specialist Jobs
By Veterans of Foreign Wars (VFW) At Yakima, WA, United States

This position involves conducting in person and telephone interviews with military veterans about required elements and supporting evidence to file a disability claim to the Department of Veterans ...

Claims Specialist Jobs
By Veterans of Foreign Wars (VFW) At Seattle, WA, United States

This position involves conducting in person and telephone interviews with military veterans about required elements and supporting evidence to file a disability claim to the Department of Veterans ...

Claims Specialist Jobs
By MATRIX Resources At California, United States
Please See Posting for Hourly Rate + Benefits Offered
Processes special claims payments specifically accident benefits and orthodontic.
Must come with Medi-Cal / Denti-Cal Billing experience OR experience working with other dental or medical claims.
A high school diploma or GED is preferred, but candidates with proven experience will not be excluded from consideration.
A minimum of 2 years' experience in a dental office.
Strong analytical, organizational and multi-tasking skills.
Claims Specialist Jobs
By CyberCoders At Valley Stream, NY, United States

If you are a Litigation Adjuster with experience, please read on! Top Reasons to Work with Us Excellent Company Culture Full Benefits What You Will Be Doing Claims Specialist, you are ...

Claims Specialist Jobs
By CyberCoders At Brooklyn, NY, United States

If you are a Litigation Adjuster with experience, please read on! Top Reasons to Work with Us Excellent Company Culture Full Benefits What You Will Be Doing Claims Specialist, you are ...

Claims Specialist Jobs
By ProAssurance At Indiana, United States
Proven leadership, communication, and writing skills, strong interpersonal, and relationship management expertise.
5% - Perform special projects as directed by management.
Bachelor's degree required. Advanced degree or certification in the medical, legal or insurance field preferred.
Minimum two years’ experience in the legal or medical field, with a high degree of specialized and technical competence.
Excellent interpersonal communications and negotiation skills.
Strong analytical skills in order to analyze and interpret information.
Claims Adjudication Specialist (Overnight)
By Trupanion At Seattle, WA, United States
Ability to provide an expeditious and delightful member experience
At least one year of experience providing customer service over the phone
French bilingual skills are a plus!
Full medical, dental, and vision benefits at no cost to the employee
Review medical records to make claim outcome decisions against received invoice(s) as aligned with the Trupanion policy
Enter data from medical records into the database
Claims Specialist Jobs
By CELSIUS Holdings, Inc. At Boca Raton, FL, United States
Provide detailed bullet points of desired education, experience, and specific skills & qualifications required and desired.
Perform special projects as assigned including, but not limited to, tracking company incident statistics, incident investigation file management, etc.
Work with other departments or vendors, and management to provide claim status updates.
Recognizes claims trends and provides analysis to Claims Manager
Communicate with customers to resolve claims.
Identify issues that may require the use of independent experts or vendors.
Lead Ltd Claims Specialist
By MetLife At United States
Essential Business Experience and Technical Skills:
•Bachelor’s degree and knowledge of STD/FML, state leave laws, worker’s compensation, ERISA, and Social Security.
MetLife maintains a drug-free workplace.
Claims Specialist Iii Jobs
By LoanCare At United States
Maintain clear records and reports for management review regarding claims filed and non-recoverable items
Minimum of 4 years work experience in the legal field or default mortgage servicing
Working knowledge of accepted business practices in the mortgage industry and or strong understanding of claims process
Good analytical, written and verbal communication skills
LPS-MSP (Mortgage Servicing Platform) experience preferable, but not necessary
Knowledge of Microsoft office- Excel and Word
Ltl Claims Specialist Jobs
By TRAFFIX At United States
Provide claim resolution details to management, customer service, and finance/accounting
Bachelor's degree in supply chain and/or insurance/finance field or equivalent combination of education and experience preferred
Goal oriented, always willing to seek knowledge and improve upon skills in order to drive new ideas
Set up new customers with a filing template, and weekly reporting to their specific requirements
1-3 years LTL claims OS&D experience required
Strong communication skills, professional demeanor on phone calls and in emails to a wide variety of professionals at all levels
Claims Specialist Jobs
By StaffChase At United States

Job Summary: We are seeking a skilled and experienced Customer Care Representative with at least one year of experience in both inbound and outbound calling to join our team. As a Customer Care ...

Claims Specialist Jobs
By IGS Energy At Ohio, United States
Maintain satisfactory knowledge of service agreements.
Achieves all customer experience and sales standards set for the department by following the established departmental goals, policies and procedures.
Additional duties and responsibilities as assigned.
Experience with customer service in a phone center environment.
Strong reasoning, decision making, and communication skills.
Organized and detail oriented with excellent problem solving abilities.

Are you looking for an exciting opportunity to use your expertise in claims integrity to make a real difference? Join our team as a Claims Integrity Specialist and help us ensure that our customers receive the best service possible. You'll be responsible for reviewing and analyzing claims data to identify potential fraud and abuse, and then developing strategies to prevent it. With your keen eye for detail and commitment to integrity, you'll be a key player in keeping our customers safe and secure.

Overview:

A Claims Integrity Specialist is responsible for ensuring that all claims submitted to an insurance company are accurate and compliant with applicable laws and regulations. They review claims for accuracy and completeness, investigate discrepancies, and recommend corrective action when necessary. They also provide guidance and support to other departments within the organization.

Detailed Job Description:

Claims Integrity Specialists are responsible for reviewing and verifying the accuracy of claims submitted to an insurance company. They review claims for accuracy and completeness, investigate discrepancies, and recommend corrective action when necessary. They also provide guidance and support to other departments within the organization. They must be able to identify and resolve problems quickly and efficiently. They must be knowledgeable of all applicable laws and regulations and be able to interpret and apply them to the claims process.

What is Claims Intregrity Specialist Job Skills Required?

• Knowledge of insurance laws and regulations
• Excellent communication and interpersonal skills
• Ability to analyze and interpret data
• Ability to identify and resolve problems quickly and efficiently
• Attention to detail
• Computer proficiency
• Ability to work independently and as part of a team

What is Claims Intregrity Specialist Job Qualifications?

• Bachelor’s degree in a related field
• Previous experience in claims processing or insurance
• Certification in claims processing or insurance

What is Claims Intregrity Specialist Job Knowledge?

• Knowledge of insurance laws and regulations
• Knowledge of claims processing procedures
• Knowledge of medical terminology
• Knowledge of coding and billing

What is Claims Intregrity Specialist Job Experience?

• Previous experience in claims processing or insurance
• Experience in customer service
• Experience in data analysis

What is Claims Intregrity Specialist Job Responsibilities?

• Review and verify the accuracy of claims submitted to an insurance company
• Investigate discrepancies and recommend corrective action when necessary
• Provide guidance and support to other departments within the organization
• Identify and resolve problems quickly and efficiently
• Ensure compliance with applicable laws and regulations
• Monitor and analyze claims data for trends and patterns
• Prepare reports and presentations on claims data