Current jobs related to Claims Reviewer - Santa Fe - The Workforce Group
-
Claims Review Specialist
4 weeks ago
Santa Monica, United States Compu-Vision Consulting Full timeRevenue Integrity Analyst / Claims Review Specialist Location: 10920 Wilshire Blvd, Los Angeles, CA 90024 Duration: 24 week contract SHIFT: M-F 8-5 Note: This will be 99% remote, only the orientation will be onsite and a few meetings when necessary. REQUIRED EXP: 5+ yrs exp with hospital billing systems and third-party billing requirements, Bachelor's...
-
Claims Examiner
2 weeks ago
Santa Fe, New Mexico, United States Sedgwick Full timeAbout the RoleWe are seeking a highly skilled Claims Examiner - Workers Compensation Specialist to join our team at Sedgwick. As a key member of our claims team, you will play a critical role in analyzing and processing workers compensation claims to ensure timely and accurate benefits are provided to our clients.Key ResponsibilitiesClaims Analysis: Conduct...
-
Claims and Compliance Specialist
2 weeks ago
Santa Fe Springs, California, United States Samsung SDS America Full timeAbout the RoleSamsung SDS America is seeking a highly skilled Logistics Claims Attorney to join our team. As a key member of our logistics and supply chain team, you will play a critical role in identifying and resolving complex legal issues related to logistics claims.Key ResponsibilitiesDraft, Review, and Negotiate Legal Documents: You will be responsible...
-
Logistics Claims Attorney
2 weeks ago
Santa Fe Springs, California, United States Samsung SDS America Full timeAbout the RoleSamsung SDS America is seeking a highly skilled Logistics Claims Attorney to join our team. As a key member of our logistics and supply chain team, you will play a critical role in identifying and resolving complex legal issues related to logistics claims.Key ResponsibilitiesDraft, Review, and Negotiate Legal Documents: You will be responsible...
-
Logistics Claims Attorney
6 days ago
Santa Fe Springs, California, United States Samsung SDS America Full timeJob SummarySamsung SDS America is seeking a highly skilled Logistics Claims Attorney to join our team. As a key member of our logistics team, you will be responsible for identifying significant legal issues and providing technical and practical legal advice to our internal clients and stakeholders.Key ResponsibilitiesDraft, review, and negotiate a wide range...
-
Medical Claims Examiner
1 week ago
Santa Clara, California, United States Talent Search Recruitment Full timeWe are seeking a highly skilled Medical Claims Analyst to join our team at Talent Search Recruitment. As a Medical Claims Analyst, you will play a crucial role in evaluating, analyzing, and processing insurance claims.Key Responsibilities:• Review and analyze medical insurance claims to ensure accuracy and compliance with policy terms and conditions.•...
-
Medical Claim Analyst
2 weeks ago
Santa Clara, United States Talent Search Recruitment Full timeWere currently assisting one of our clients a leading insurance broker company committed to providing exceptional service and comprehensive insurance solutions to their clients. They specialize in a wide range of insurance products and services ensuring our clients receive the best possible coverage and support. Job Summary: As a Claim Analyst with a...
-
Insurance Claims Examiner
1 day ago
Santa Ana, California, United States VirtualVocations Full timeVirtualVocations is seeking a skilled Claims Adjuster 1 to join our team in Ohio. As a key member of our customer support team, you will be responsible for providing exceptional service to our clients by promptly and courteously addressing incoming calls. Your attention to detail and organizational skills will be essential in verifying contract information,...
-
Claims Processing Specialist
3 weeks ago
Santa Rosa, California, United States Hansel Automotive Group Full timeJob OverviewHansel Automotive Group is on the lookout for a Claims Processing Specialist to join our team and contribute to our outstanding customer service reputation.This role involves managing warranty claims and ensuring accurate payment processing from manufacturers. Candidates should possess at least one year of experience in warranty claims within an...
-
Claims Assistant
3 weeks ago
Santa Ana, United States Kelly Full timeWe’re seeking a Claims Assistant to work at a premier client in Santa Ana, CA. Sound good? Salary/Pay Rate/Compensation: $23 an hour. Why you should apply to be a Claims Assistant: • Competitive pay rate of $23 an hour • Monday-Friday schedule, 8:30AM-5:30PM • Room for growth and advancement within the company • Opportunity to work with a...
-
Claim Team Lead
2 weeks ago
Santa Ana, California, United States State Farm Full timeJob SummaryWe are seeking a highly skilled and experienced Claims Team Manager to join our team at State Farm. As a Claims Team Manager, you will be responsible for leading and developing a team of claims personnel to ensure they provide exceptional service to our customers.Key ResponsibilitiesFirst-line management of assigned claims personnel, including...
-
Claims Adjuster 1
3 days ago
Santa Ana, CA, United States VirtualVocations Full timeA company is looking for a Claims Adjuster 1 in Ohio Key Responsibilities: Provide inbound customer support by promptly and courteously addressing incoming calls Verify contract information, enter new claims accurately, and confirm coverage based on specific terms and conditions Review documentation, approve/deny estimates, and ensure timely...
-
Medical Office Charge Capture Specialist
6 days ago
Santa Fe, New Mexico, United States Christus Health Full timeJob SummaryChristus Health is seeking a highly skilled Medical Office Charge Capture Specialist to join our team. As a key member of our front office operations, you will be responsible for accurately and efficiently processing clinic work queues, including charge review, claim editing, and follow-up.Key ResponsibilitiesProcess and review clinic work queues...
-
Medical Office Charge Capture Specialist
4 days ago
Santa Fe, New Mexico, United States Christus Health Full timeJob SummaryWe are seeking a highly skilled Medical Office Charge Capture Specialist to join our team at Christus Health. As a key member of our front office operations, you will be responsible for ensuring accurate and timely processing of clinic work queues, including charge review, claim edit, and follow-up.Key ResponsibilitiesProcess and review clinic...
-
Financial Analyst
1 day ago
Santa Fe, New Mexico, United States State of New Mexico Full timeJob SummaryThis position is responsible for assisting in the preparation and review of accounting documents and fiscal reports for accuracy, compliance with laws, regulations, and accounting procedures. The incumbent will ensure that expenditures are within authorized budgets.Key ResponsibilitiesPrepare clean claims for MRU according to insurance...
-
Medical Office Charge Capture Specialist
2 days ago
Santa Fe, New Mexico, United States Christus Health Full time{"POSITION SUMMARY": "As a Medical Office Charge Capture Specialist at Christus Health, you will play a critical role in ensuring the accurate and timely processing of clinic work queues, including charge review, claim editing, and follow-up. You will be responsible for communicating issues and trends among front office staff, providers, clinic management,...
-
Risk Management Specialist
6 days ago
Santa Fe Springs, California, United States C&D Technologies Full timeJob SummaryWe are seeking a highly skilled and experienced professional to join our team as a Sr. Workers Compensation Administrator. This role will be responsible for leading our workers compensation claims program, managing fire protection insurance, and assisting with EHS metrics and audit reporting.Key ResponsibilitiesLead the workers compensation claims...
-
Physician Telecommute Medical ReviewStream TN
4 months ago
Santa Fe, United States Concentra Full timeOverview Are you an accomplished Board Certified physician in one of the below specialties? Are you passionate about your work/life balance? We are seeking flexible and experienced physicians for our medical reviewstream division. This telecommute role provides the ability for you to customize your schedule and caseload within a Monday - Friday...
-
Medical Office Charge Capture Specialist
4 days ago
Santa Fe, United States Christus Health Full timeDescriptionPOSITION SUMMARY: Responsible for accurate and timely processing of clinic work queues, including charge review, claim edit and follow up. Responsible for communicating issues and trends among front office staff, providers, clinic management and revenue cycle. Assisting in all clinic workflows leading to submission of clean claims and...
-
Medical Office Charge Capture Specialist
1 month ago
Santa Fe, United States Christus Health Full timeDescriptionPOSITION SUMMARY: Responsible for accurate and timely processing of clinic work queues, including charge review, claim edit and follow up. Responsible for communicating issues and trends among front office staff, providers, clinic management and revenue cycle. Assisting in all clinic workflows leading to submission of clean claims and...
Claims Reviewer
4 months ago
Summary:
The Claims Reviewer will provide technical in support to the FEMA Hermit's Peak/Calf Canyon Claims Office in Sante Fe, New Mexico. This position involves receiving, evaluating, and processing claims for compensatory damages for injuries resulting from the Hermit's Peak/Calf Canyon fires. With 325,340 acres burned and 900 homes/structures destroyed, the role requires meticulous attention to detail and adherence to FEMA guidelines. Utilizing Xactimate software, the claims reviewer will objectively review, investigate, process, and evaluate third-party claims.
Location: Sante Fe, New Mexico
Duties and Responsibilities:
- Provide technical assistance and expertise in support of the Hermit's Peak/Calf Canyon Claims Office (Claims Office), by receiving, evaluating, and processing claims for compensatory damages for injuries from the Hermit's Peak/Calf Canyon Fire.
- Communicate directly with claimants and/or claimant representatives to expedite claim processing, as requested by FEMA Navigators.
- Collaborate with local, state, and federal officials to identify eligible response, recovery, and mitigation activities.
- Advise clients on FEMA Public Assistance policy and documentation requirements.
- Prepare project damage descriptions, scope of work, and supporting documentation.
- Conduct site assessments in the field and prepare project documentation and cost estimates as required.
Qualifications:
Bachelor's degree with 5 years of experience in property inspection/assessment or a related field, OR 10 years of experience in a related field with at least 2 years' experience using Xactimate software.
- Thorough knowledge of FEMA Public Assistance program, eligibility criteria, laws, regulations, and policies, as well as familiarity with other FEMA programs (e.g., Individual Assistance, Hermit's Peak Program, etc.).
- Policy Interpretation: Ability to interpret complex insurance policy language, including exclusions, endorsements, and coverage limits.
- Damage Assessment: Proficiency in assessing property, flooding, and/or fire-related damage accurately, including understanding the extent of damage, required repairs, documentation, and associated costs.
- Clear and Effective Communication: Excellent written and verbal communication skills, with the ability to explain policies and regulations to claimants, FEMA Navigators, and other stakeholders effectively.
- Use of Technology: Proficiency in using Xactimate claims management software and other databases, technology tools to facilitate claim processing, documentation, and communication.
About Us:
The Workforce Group (WFG) is a Great Place to Work®-Certified company. We are a team of dedicated professionals that pull together to meet the needs of communities, partnering with federal, state, and local governments. We are an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, color, sex, national origin, age, protected veteran status, or disability status.
Job Posted by ApplicantPro
