Claims Specialist
3 weeks ago
Claims Specialist - NYThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role.Essential Functions & Responsibilities:Receives claims, confirms policy coverage and acknowledgment of the claimDetermines validity and compensability of the claimEstablishes reserves and authorizes payments within reserving authority limitsManages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervisionCommunicates claim status with the customer, claimant and clientAdheres to client and carrier guidelines and participates in claims review as neededAssists other claims professionals with more complex or problematic claims as necessaryAdditional duties as assignedKnowledge & Skills:Excellent written and verbal communication skillsAbility to learn rapidly to develop knowledge and understanding of claims practiceAbility to identify, analyze and solve problemsComputer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheetsStrong interpersonal, time management and organizational skillsAbility to meet or exceed performance competenciesAbility to work both independently and within a team environmentEducation & Experience:Bachelor's degree or a combination of education and related experienceMinimum of 1 year of industry experience and claims management preferredState Certification as an Experienced ExaminerPay Range: $51,807 - $83,551CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
-
Claims Resolution Specialist
2 weeks ago
Washington, United States Advantia Health Full timeClaims Resolution Specialist Advantia is seeking a Claims Resolution Specialist to join our team! As a Claims Resolution Specialist, you will be essential in ensuring the accuracy and timeliness of billing and reimbursement for medical services. This important role demands a solid understanding of medical terminology, coding, and billing procedures. This...
-
Absence Claims Specialist
3 weeks ago
Washington, United States ComPsych Full timeAbsence Claims Specialist Absence Claims Specialists are responsible for processing medical certifications in a high production environment while answering emails and corresponding with customers. This individual will report to a Claims Team Lead and must have strong attention to detail, clerical/administrative experience, and commitment to quality. Primary...
-
Absence Claims Specialist
3 weeks ago
Washington, United States ComPsych Corporation Full timeAbsence Claims SpecialistAbsence Claims Specialists are responsible for processing medical certifications in a high production environment while answering emails and corresponding with customers. This individual will report to a Claims Team Lead and must have strong attention to detail, clerical/administrative experience, and commitment to quality.Primary...
-
Senior Claim Benefit Specialist
1 week ago
Washington, United States Remote Staffing Full timePosition Summary At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven...
-
Claims Specialist
5 days ago
Washington, DC, United States Healthcare Legal Solutions Full timeSUMMARY: This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously...
-
Claims Specialist
1 week ago
Washington, DC, United States Healthcare Legal Solutions Full timeSUMMARY: This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously...
-
Claims Specialist
1 week ago
Washington, DC, United States Healthcare Legal Solutions Full timeSUMMARY: This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously...
-
Health Care Claims Specialist
1 week ago
Washington, DC, United States Crowell & Moring Full timeCompany DescriptionJob Description Crowell & Moring LLP is an international law firm with offices in the United States, Europe, MENA, and Asia that represents clients in litigation and arbitration, regulatory and policy, intellectual property, and transactional and corporate matters. The firm is internationally recognized for its representation of Fortune...
-
Health Care Claims Specialist
2 weeks ago
Washington, DC, United States Crowell & Moring Full timeCompany DescriptionJob Description Crowell & Moring LLP is an international law firm with offices in the United States, Europe, MENA, and Asia that represents clients in litigation and arbitration, regulatory and policy, intellectual property, and transactional and corporate matters. The firm is internationally recognized for its representation of Fortune...
-
Health Care Claims Specialist
1 week ago
Washington, DC, United States Crowell & Moring Full timeCompany DescriptionJob Description Crowell & Moring LLP is an international law firm with offices in the United States, Europe, MENA, and Asia that represents clients in litigation and arbitration, regulatory and policy, intellectual property, and transactional and corporate matters. The firm is internationally recognized for its representation of Fortune...
