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Virtual Claims Resolution Specialist Jobs

Medical Claims Resolution Specialist (Remote)
By MultiPlan Inc. At , Remote $19.83 an hour
JOB REQUIREMENTS (Education, Experience, and Training):
Knowledge of general office operations and/or experience with standard medical insurance claim forms
Address counter-offers received and present proposal for resolution while adhering to client guidelines and policy and procedures
Provider education to providers online provider portal services available for proposal review and approval
Good Communication (verbal, written and listening) teamwork, negotiation and organizational skills
Ability to use software and hardware related to job responsibilities, including MS Word and MS Excel spreadsheets and database software
Claims Specialist I, Virtual - Material Damage
By Nationwide At , Remote
Education: Undergraduate degree or equivalent experience preferred.
Other criteria, including leadership skills, competencies and experiences may take precedence.
May perform other responsibilities as assigned.
Reporting Relationships: Reports to Claims Manager or Supervisor. Individual contributor role.
License/Certification/Designation: State licensing where required. Successful completion of required claims certification schools/classes.
Evaluates vehicle repair costs, parts costs, etc. to determine whether specific damage is related to an accident.
Claims Resolution Coordinator Jobs
By GAIUS Networks (Flipped.ai) At United States
Answercustomer service lines as necessary and responds toprovider inquiries either byphone, email,or in person regardingclaims-related questions.
Reviews, researches, and workswith various departments to resolve complex providerinquiries, appeals, and grievances.
ProcessesCIFs and adjustments as needed.
Writesand runsreports in Business Objects to obtain needed claim data.
Tracksand analyzesprovider trends with denials and CIFsto provide support toproviderswith an opportunity to improve.Distributesprovider scorecards.
Trackscomplaints, appeals, and grievances by the program. Reportsactivities on a quarterlybasis to IQI, PHC Compliance Coordinator,and Claims Director.
Medicare Claims Resolution Specialist - Remote -Digitech
By Sarnova At United States
Handle all correspondence via mail, email and any necessary refunds; perform other duties as assigned by management
Strong computer skills. Basic understanding of MS Outlook, Word and Excel.
Experience in an environment where calls were monitored and scored as well as metrics applied to individual performance is helpful.
Excellent communication skills, both written and verbal. Able to present information and solutions in a professional and courteous manner.
Shift M-F 830am-5pm EST. Fully Remote. Work from the comfort of your home.
Review claims that have been put on hold, working to identify causes and address issues causing them to remain on hold
Claims Resolution Specialist Jobs
By Impresiv Health At Orange, CA, United States

The Claims Resolution Specialist provides assistance in resolving provider claims payment status issues, provider payment disputes, eligibility, and authorization verification. The incumbent will be ...

Claims Resolution Spec, Apd
By Liberty Mutual Insurance At United States
Reports coverage denials to manager.
General knowledge of contract language, including regulatory and policy differences, legal liability and general insurance policy coverage
Excellent oral, written and interpersonal communication skills, and the capacity to multi-task in a structured work environment, are required
Associates degree or equivalent training plus generally two or more year's auto non-injury claims handling experience
Requires frequent coverage research and analysis resulting in final coverage decision.
Negotiates coverage and liability decisions with insured, claimant, claimant carrier.
Patient Billing - Medical Claims Resolution (Remote)
By PeopleScout At Edmond, OK, United States

Location : Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift : Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Wfh)
By PeopleScout At Bethany, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Wfh)
By PeopleScout At Piedmont, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution
By PeopleScout At Moore, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Wfh)
By PeopleScout At McLoud, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Wfh)
By PeopleScout At Moore, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Remote)
By PeopleScout At Piedmont, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Patient Billing - Medical Claims Resolution (Remote)
By PeopleScout At Bethany, OK, United States

Location: Primarily this position will be remote but the new hire would be required to work in office in Oklahoma, City, OK, 2 days a month.Shift: Flexible start 6AM-9AM Central Time, Monday-Friday, ...

Claims Resolution Specialist Jobs
By Ascension At , Nashville, 37201, Tn From $20.80 an hour
Strong Knowledge of healthcare claims, Medicaid, Medicare, Pharmacy benefits, etc.
Schedule: Full-Time, 8am - 5pm, Mon-Fri, fully remote
Facility: Automated Benefit Services (ABS)
Complex Medical Claims experience, preferred
5 years of healthcare experience, preferred
Review and respond to escalated internal and external calls and emails from participants, providers and provider reps.
Complex Rehab Billing & Claims Resolution Specialist
By ACU-Serve At , Akron, 44308, Oh
Performs other related duties as assigned by management
Ability to work with all levels of management.
Strong organizational, problem-solving, and analytical skills; able to manage priorities and workflow.
Dependability – Follows instructions, responds to management direction, completes tasks on time or notifies appropriate person of alternative plan.
Knowledge of Complex Rehabilitative Equipment including but not limited to coding, modifiers, narrative information, parts, repairs, and loaner equipment.
Ability to analyze and/or gain knowledge to interpret Commercial, Medicaid, Medicare, and Medicare Advantage Plan Local Coverage Determinations and Policy Guidelines.
Claims Resolution Specialist - Remote | Wfh
By Get It Recruit - Healthcare At Camp Hill, PA, United States

We are looking for an enthusiastic Accounts Receivable Specialist to join our team! As an Accounts Receivable Specialist, you will be responsible for investigating and following up on all open ...

Executive Resolution And Payment Claims Analyst
By Early Warning Services At , Scottsdale, 85260, Az
Supports the company’s commitment to risk management and protecting the integrity and confidentiality of systems and data.
Own the consumer experience for all Early Warning Products, including Zelle and FCRA
Calling the consumer immediately to listen to their experience and recommend a solution to the problem
Proven record of payments fraud analysis experience in a consumer facing team environment
Excellent interpersonal and communication skills.
Understand the importance of decision making and the impact to regulatory requirement
Senior Claims Resolution Specialist, Commercial Bi
By Liberty Mutual At , Remote $73,600 - $97,700 a year
Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status.
Manages, investigates, and resolves claims.
Strong written and oral communications skills required.
Strong interpersonal, analytical, negotiation and investigative skills required.
Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels.
Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.
Sr. Claims Resolution Specialist Iii, Commercial Bi
By Liberty Mutual At , Remote $92,700 - $140,600 a year
Recommends ultimate resolution on assigned cases in excess of their authority to local claims management and Home Office.
Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status.
May be involved in special projects and/or mentoring at the direction of local management.
Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed procedures and authority.
May assist in the absence of the Claims Team Manager, representing the company on matters involving state or federal regulatory agencies.
Must have an expert knowledge of coverage, liability, and complex claims handling procedures.