Claim Recovery Specialist

Claims Recovery Analyst Job DescriptionOverviewThe selected candidate will play a crucial role in pinpointing and rectifying significant overpayments related to processed claims across various service lines. This position will also involve supporting the execution of DOFR initiatives and associated workflows. The Claims Recovery Analyst will leverage...

Job DescriptionJob DescriptionSummaryThe successful candidate will research and identify complex and high dollar overpayments on previously processed claims for multiple product lines, assist department Leadership in DOFR implementation projects and processes. Review, request, record, and, report on claim refunds and capitation deductions from various...

Job SummaryMcGuireWoods seeks an experienced Insurance Recovery Associate to join its Insurance Recovery Practice Group. As a key member of our team, you will work closely with corporate policyholders across various industries to advise on coverage and risk management, pursue and litigate complex claims, and recover billions of dollars through trials,...

POSITION SUMMARYThe Claims Assessment Specialist plays a crucial role in ensuring the precise and prompt evaluation of both paper and electronic claims submitted in CMS 1500 and UB-04 formats. This role involves processing all claims and relevant correspondence in alignment with Medicare and Medi-Cal regulatory standards, contractual obligations, and...

Claims Assessment Specialist - Managed Care Providers Avispa Technology is looking for a skilled Claims Assessment Specialist to join our team. This role involves performing thorough reviews of claims and billing processes, managing denial resolutions, and processing various payer types including Medicare and Commercial Payers. The ideal candidate will...

POSITION SUMMARYThe Claims Processing Specialist is tasked with ensuring the precise and prompt evaluation of claims submitted in CMS 1500 and/or UB-04 formats. This role involves managing all claims and related correspondence in compliance with Medicare and Medi-Cal regulations, contractual obligations, and established operational protocols. The Specialist...

Large Loss Claims Specialist - Construction Los Angeles, CA, Atlanta, GA, Dallas, TX, Exton, PA, Chicago, IL, NYC, NY or Hartford, CT At AXA XL, we deliver on our claims promise by having the best systems, the best people and the best partnerships in place. That's where our Construction Defect Claims team comes in. Construction Defect claims can be very...

Job Description The Revenue Recovery Specialist is responsible for processing and reporting revenue recovery activities, including insured services, stop loss and third-party liability. Job Duties and Responsibilities: Reviews and pursues recoveries on all outstanding insured services monthly billings. Ensures the Insured Service data base is current with...

Claims Assessment Specialist - Managed Care Providers Avispa Technology is currently seeking a Claims Assessment Specialist to join a leading hospital and healthcare organization. This role involves conducting thorough reviews of claims and billing processes, managing denial resolutions, and processing various payer types including Medicare and...

Job OverviewThe Hospital Risk Claims Specialist plays a crucial role in managing hospital-related risk claims, ensuring compliance with external regulations and the contractual commitments of Health Plans and/or Hospitals/IPAs. This position involves thorough research, review, and communication with provider services to resolve claims-related issues...

Job OverviewClaims Review Specialist - Managed Care ProvidersA leading healthcare organization is in search of a Claims Review Specialist to perform comprehensive reviews of claims and billing processes, manage denial resolutions, and oversee transactions involving Medicare, Medi-Cal, and various Commercial Payers. The ideal candidate will possess over three...

Job OverviewOBJECTIVE:The Claims Processing Specialist is responsible for the preparation, documentation, and reconciliation of warranty claims, ensuring accurate submission to manufacturers and distributors for faulty components.KEY RESPONSIBILITIES:Evaluate warranty claims, confirming compliance with manufacturer or distributor requirements.Input necessary...

Job OverviewPosition Summary:The Claims Operations Support Specialist plays a crucial role in facilitating the daily functions of the claims department. This position is designed to assist various sub-departments within Claims Operations, ensuring seamless workflow and efficiency.Key Responsibilities:• Digitally archive claims and relevant documents into...

Job DescriptionJob DescriptionA dynamic organization supplying quality claims outsource solutions to insurance carriers, countrywide is seeking multi-line adjusters in your area. There are many competing vendors in our marketplace, but we are not your typical “vendor”. Our company was built by insurance company claims executives to support insurance...

Job OverviewThe Matian Firm, APC is seeking a Claims Settlement Specialist to enhance our Personal Injury Department. This position involves overseeing and negotiating the resolution of personal injury claims prior to litigation. The ideal candidate will possess exceptional communication and negotiation abilities, substantial experience with insurance...

Position OverviewAbout Project 180Project 180 is a leader in delivering tailored treatment initiatives for individuals involved with the justice system, collaborating closely with various County agencies including DMH, DHS, and JCOD.Role SummaryThe Recovery Support Specialist is dedicated to offering peer-based assistance and guidance to help clients reach...

Position Overview:We are seeking a meticulous and experienced Senior Claims Adjustment Specialist to join our dynamic Medical Claims Department. This role is essential in ensuring the accurate and timely processing of medical claims adjustments.About the Organization:The Motion Picture Industry Pension & Health Plans (MPI) is a distinguished multi-employer...

Join Our Team at American Family Insurance Agency Staff At American Family Insurance Agency Staff, we are undergoing a significant transformation in our claims operations, focusing on enhancing customer experiences and effectively safeguarding their aspirations during challenging times. Our mission is to leverage our extensive knowledge, innovative...

Aspire General Insurance Company, along with its associated general agent, Aspire General Insurance Services, is dedicated to providing affordable specialty auto insurance solutions while maintaining exceptional service standards. Our core values can be encapsulated in the acronym ABLE: to always act with integrity, be authentic, learn and grow, and execute...

The Motion Picture Industry Pension & Health Plans (MPI) is seeking a meticulous and organized Senior Claims Adjustment Specialist to enhance our Medical Claims Department within the Adjustments Team. Position Overview:This role is essential for ensuring the precise and timely processing of medical claims adjustments. Key Responsibilities:Evaluate and test...