Current jobs related to Claims Representative - King of Prussia - Sedgwick

  • Home Care PFS Accounts Representative

    2 weeks ago

    King of Prussia, Pennsylvania, United States MetaSense Inc Full time

    About the RoleThe Accounts Receivable Representative will play a crucial role in ensuring the timely and accurate collection of payments from patients and third-party payers. This position requires strong organizational and communication skills, as well as the ability to work effectively in a fast-paced environment.Key ResponsibilitiesReview and analyze...

  • Bilingual Insurance Customer Service Representative

    4 days ago

    King of Prussia, Pennsylvania, United States Staff My Agency Full time

    Customer Service Representative OpportunityWe are seeking a highly motivated and customer-focused individual to join our team as a Bilingual Insurance Customer Service Representative. As a key member of our team, you will be responsible for providing exceptional customer service to our clients, ensuring their needs are met and exceeded.Key...

  • Global Service Center Representative

    2 weeks ago

    King of Prussia, Pennsylvania, United States Worldwide Insurance Services Full time

    Job DescriptionOverviewAt Worldwide Insurance Services, we're committed to delivering exceptional customer experiences. As a Global Service Center Specialist, you'll play a vital role in ensuring our members receive the highest level of service and support.Key ResponsibilitiesCustomer Service: Provide timely and effective resolution to customer inquiries,...

  • Prior Authorization Specialist

    1 month ago

    King of Prussia, United States PeopleShare Inc Full time

    Do you have prior authorization experience? Are you super organized and detail oriented? If so, this is the position for you!PeopleShare is seeking a Prior Authorization Specialist to work for a growing Global Mental Health and Technology Leader in King of Prussia, PA.Job Details of the Prior Authorization Specialist: Pay Rate: $18-20/hour Hours:...

  • Client Relationship Executive

    3 weeks ago

    King of Prussia, Pennsylvania, United States Reliance Matrix Full time

    Job Responsibilities and Requirements The Client Relationship Executive is accountable for overseeing dedicated client portfolios that encompass between 500 to 2,000 lives. This role serves as the primary liaison for clients, providing consultative support on contracts, plan configurations, financial inquiries, renewal processes, and the resolution of...

  • Patient Access Representative

    2 weeks ago

    King of Prussia, Pennsylvania, United States Ensemble Health Partners Full time

    About Ensemble Health PartnersWe are a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. Our comprehensive suite of point solutions supports clients across the country.Our MissionWe recognize that healthcare requires a human touch, and we believe that every...

  • Client Manager

    4 months ago

    King of Prussia, United States Reliance Matrix Full time

    Job Responsibilities and Requirements Assume overall responsibility for managing dedicated client accounts ranging from 500 to 2,000 lives. The Client Manager is the main contact for the client for ongoing service and is the customer’s resource for consultative advice on contracts, plan structure, financial and renewal questions, escalation of...

  • Revenue Cycle Specialist

    2 months ago

    King of Prussia, United States Genomind Inc. Full time

    Job DescriptionJob DescriptionJob Summary: Primary job duties are billing including resolution of any issue preventing the claim from billing, claim follow up, denial management including appeals, timely and accurate posting and adjustments, obtaining prior authorizations, patient collections, and resolving patient billing issues. The Revenue Cycle...

  • Revenue Cycle Specialist

    2 months ago

    King of Prussia, United States Genomind Inc. Full time

    Job DescriptionJob DescriptionJob Summary: Primary job duties are billing including resolution of any issue preventing the claim from billing, claim follow up, denial management including appeals, timely and accurate posting and adjustments, obtaining prior authorizations, patient collections, and resolving patient billing issues. The Revenue Cycle...

  • Home Care PFS Accts Rec Rep

    4 months ago

    King of Prussia, United States Becker Health Full time

    JOB SUMMARY The primary focus of the accounts receivable representative is to provide consistent follow up on the open account receivables. Responsible to review payments received for services rendered and to determine contractual compliance. Responsible to provide payment disputes to third parties in a timely manner per payor, contractual and regulatory...

  • Accts Rec. Healthcare billing

    3 weeks ago

    King of Prussia, United States US Tech Solutions Full time

    Duration: 3+ months Temp to perm Job Description: The primary focus of the accounts receivable representative is to provide consistent follow up on the open account receivables. Responsible to review payments received for services rendered and to determine contractual compliance. Responsible to provide payment disputes to third parties in a timely...

  • Home Care PFS Accts Rec Rep

    3 weeks ago

    King of Prussia, United States Maxonic, Inc. Full time

    JOB SUMMARYThe primary focus of the accounts receivable representative is to provide consistent follow up on the open account receivables. Responsible to review payments received for services rendered and to determine contractual compliance. Responsible to provide payment disputes to third parties in a timely manner per payor, contractual and regulatory...

  • Financial Clerk

    4 weeks ago

    King of Prussia, United States Portnoff Full time $25

    Job DescriptionJob DescriptionEstablished in 1989, Portnoff Law Associates, Ltd. is a law firm that limits its practice to the collection of unpaid real estate taxes and municipal utility fees. PLA now represents more than 200 municipal clients throughout Pennsylvania, with offices in King of Prussia, Allentown, and Aliquippa. CareersPLA is on the lookout...

  • Residential Roofing Inspector

    3 weeks ago

    King of Prussia, Pennsylvania, United States Best Choice Roofing of Southeast Pennsylvania Full time

    Join Our Team as a Residential Roofing Inspector at Best Choice Roofing of Southeast PennsylvaniaAre you seeking a fulfilling career with significant earning potential? Look no further! Best Choice Roofing, a leading name in the residential roofing sector, is on the lookout for enthusiastic individuals to fill the role of Residential Roofing Inspector.About...

  • Home Care PFS Accts Rec Rep

    4 weeks ago

    King of Prussia, United States MetaSense Inc Full time

    Job DescriptionJob DescriptionDuties:JOB SUMMARYThe primary focus of the accounts receivable representative is to provide consistent follow up on the open account receivables. Responsible to review payments received for services rendered and to determine contractual compliance. Responsible to provide payment disputes to third parties in a timely manner per...

  • Bilingual Customer Support Specialist

    3 weeks ago

    King of Prussia, Pennsylvania, United States Staff My Agency Full time

    Position Overview: A successful independent insurance agency is in search of a qualified professional for the role of Bilingual (Spanish/English) Insurance Customer Service Representative. Candidates must possess an active Property and Casualty license or be willing to obtain one.Key Responsibilities:Develop and maintain customer relationships while...

  • Home Care PFS Accts Rec Rep

    3 weeks ago

    King Of Prussia, United States MetaSense Inc Full time

    Duties:JOB SUMMARYThe primary focus of the accounts receivable representative is to provide consistent follow up on the open account receivables. Responsible to review payments received for services rendered and to determine contractual compliance.  Responsible to provide payment disputes to third parties in a timely manner per payor, contractual and...

  • Claims Repair Specialist

    2 months ago

    City of Industry, United States Ardmore Home Design Full time

    Job DescriptionJob DescriptionAbout the CompanyArdmore Home Design (AHD), founded in 2008, is a privately-owned manufacturer and wholesaler of luxury home décor headquartered in eastern Los Angeles County. We operate under the following key wholesale brands: Made Goods (our flagship highly-regarded brand in home furnishings), Pigeon & Poodle (home...

  • Bilingual Customer Support Specialist

    3 weeks ago

    King of Prussia, Pennsylvania, United States Staff My Agency Full time

    Overview: A successful independent insurance agency is in search of a qualified professional for the position of Bilingual (Spanish/English) Insurance Customer Service Representative. Candidates must possess an active Property and Casualty license or be willing to obtain one.Role Expectations: We are looking for a dynamic individual who is eager to...

  • Bilingual Customer Support Specialist

    3 weeks ago

    King of Prussia, Pennsylvania, United States Staff My Agency Full time

    Overview: A reputable insurance agency is seeking a dedicated professional for the position of Bilingual (Spanish/English) Insurance Customer Service Representative. Candidates must possess an active Property and Casualty license or be willing to obtain one.Role Expectations: We are looking for a dynamic individual who is passionate about enhancing our...

Claims Representative

4 months ago

King of Prussia, United States Sedgwick Full time

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®

Most Loved Workplace®

Forbes Best-in-State Employer

Claims Representative - Workers Compensation
- PRIMARY PURPOSE: To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
- ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
- Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
- Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
- Administers subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Ensures claim files are properly documented and claims coding is correct.
- May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
- Maintains professional client relationships.
- ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
- QUALIFICATIONS
- Education & Licensing
- Bachelor's degree from an accredited college or university preferred.
- Experience
- Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
- Skills & Knowledge
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations
- WORK ENVIRONMENT
- When applicable and appropriate, consideration will be given to reasonable accommodations.
- Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
- Physical: Computer keyboarding, travel as required
- Auditory/Visual: Hearing, vision and talking
- NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
- The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
- As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in _this job posting only, the range of starting pay for this role is 40K-60K. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.