Senior Stoploss Claim Auditor (Remote)
By BlueCross BlueShield of South Carolina At Miami-Fort Lauderdale Area, United States
Communicate effectively with carriers, vendors, and management. Provide full claims service to both phone and written inquiries.
Knowledge of group insurance, managed care and direct medical claims products.
Knowledge in COB, Medicare, HIPAA, CPT, ICD-9 and benefit plan interpretation.
Two years of medical claims and/or reinsurance claims experience.
Six years of medical claims and/or reinsurance claims experience.
Prior Stop Loss insurance experience.
Claim Operations Specialist Jobs
By The Travelers Companies, Inc. At , Charlotte, Nc $42,400 - $70,000 a year
CHANGE MANAGEMENT/RESILIENCE: Ability to remain energized and focused in the face of ambiguity, change or strenuous demands.
RELATIONSHIP MANAGEMENT: Ability to seek out, build, foster and maintain productive working relationships to meet goals and achieve results.
Experience utilizing computer technology such as Microsoft Office, e-mail, Web-enabled applications, and database software.
COMMUNICATION SKILLS: Verbal and written communication skills.
1 year of service-related work experience OR Bachelor’s Degree required.
May require lifting items up to 20 pounds (occasionally).
Pip Paralegal Jobs
By State Farm At , Fort Lauderdale, 33301, Fl
Prior litigation or paralegal experience, paralegal degree/certificate/certification, medical training, or relevant coursework or legal studies degree is required
Strong computer skills and experience working in an electronic/digital environment in particular Microsoft Word, Outlook, and Adobe Acrobat
2-5 years of civil litigation experience preferably in PIP defense or insurance defense
We are not just offering a job but a meaningful career! Come join our passionate team!
Familiarity with Court Rules and Procedures
Background in preparing and responding to discovery

Are you looking for a challenging and rewarding role in the insurance industry? We are looking for a Remote Pip Claim Specialist to join our team and help us provide excellent customer service to our clients. You will be responsible for reviewing and processing claims, ensuring accuracy and timeliness, and providing customer service to our clients. If you are an experienced professional with a passion for customer service, this is the perfect job for you!

Overview A Remote PIP Claim Specialist is responsible for processing and managing claims for Personal Injury Protection (PIP) insurance. They review and analyze claims to determine the validity of the claim and the amount of coverage that should be provided. They also provide customer service to policyholders and claimants, as well as investigate and resolve disputes. Detailed Job Description The Remote PIP Claim Specialist is responsible for processing and managing claims for Personal Injury Protection (PIP) insurance. This includes reviewing and analyzing claims to determine the validity of the claim and the amount of coverage that should be provided. The Remote PIP Claim Specialist must also provide customer service to policyholders and claimants, as well as investigate and resolve disputes. The Remote PIP Claim Specialist must have excellent communication and customer service skills, as well as a thorough understanding of the insurance industry and PIP coverage. They must be able to accurately assess claims and make decisions based on the information provided. They must also be able to effectively manage their time and prioritize tasks. Job Skills Required
• Excellent communication and customer service skills
• Thorough understanding of the insurance industry and PIP coverage
• Ability to accurately assess claims and make decisions
• Ability to effectively manage time and prioritize tasks
• Ability to work independently and as part of a team
• Ability to work in a fast-paced environment
Job Qualifications
• Bachelor’s degree in business, finance, or a related field
• At least two years of experience in the insurance industry
• Knowledge of PIP coverage
• Knowledge of state and federal regulations
• Ability to use computer systems and software
Job Knowledge
• Knowledge of PIP coverage
• Knowledge of state and federal regulations
• Knowledge of insurance industry practices and procedures
Job Experience
• At least two years of experience in the insurance industry
• Experience with customer service
• Experience with claims processing
Job Responsibilities
• Review and analyze claims to determine the validity of the claim and the amount of coverage that should be provided
• Provide customer service to policyholders and claimants
• Investigate and resolve disputes
• Maintain accurate records of all claims
• Ensure compliance with state and federal regulations
• Monitor and update claims as needed
• Communicate with other departments as needed