Hospital Risk Claims Specialist

Job SummaryWe are seeking a highly skilled Construction Defect Claims Specialist to join our team at AXA XL. As a key member of our Construction Defect Claims team, you will be responsible for handling and resolving complex, highly specialized, and high exposure Primary and Excess Construction Defect claims.Key ResponsibilitiesInvestigate and evaluate...

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 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...

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...

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...

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...

Allstate Insurance Company is a leader in the insurance industry, dedicated to meeting the evolving needs of our customers through innovative solutions. We provide a comprehensive range of insurance products, including home, auto, and health insurance, alongside specialty niche offerings, through a robust network of independent agents and direct-to-consumer...

Job DescriptionTrigent Software is seeking a highly skilled Insurance Claims Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely claims processing.Key Responsibilities:Claims Processing: Review and resolve claim edits in the billing scrubber for all government and non-government...

Job SummaryWe are seeking a highly skilled Construction Defect Claims Specialist to join our team at AXA XL. As a key member of our Construction Defect Claims team, you will be responsible for handling and resolving complex, highly specialized, and high exposure Primary and Excess Construction Defect claims.Key ResponsibilitiesInvestigate and evaluate...

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...

Position Overview:We invite you to explore an exciting opportunity with MedPOINT Management as a Claims Examiner. This role is essential for ensuring the accurate processing and evaluation of provider specialty claims.Role Summary:The Claims Examiner will be responsible for the meticulous review, input, and adjudication of provider specialty claims,...

Job OverviewSummary:Effectively manage, evaluate, and process provider specialty claims, including UB04 forms, in accordance with external regulations, internal protocols, and contractual obligations. A solid grasp of medical terminology is essential. Extensive knowledge of Commercial, Medicare, and Medi-Cal coding is required. Basic computer proficiency is...

Job OverviewThe Claims Correspondence Specialist will collaborate closely with the Personal Injury Division. This role demands exceptional attention to detail, the ability to manage multiple tasks efficiently, and the capacity to thrive in high-pressure situations. Additionally, the Claims Correspondence Specialist may undertake special assignments as...

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...

Job SummaryOrigin is seeking a highly skilled Insurance Fraud Investigator to join our team. As an Investigator, you will be responsible for conducting thorough investigations into suspected fraudulent insurance claims. Your duties will include assessing claimants' backgrounds, verifying incident details, and documenting findings.Key...

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...

Position OverviewHanna, Brophy, Maclean, Mcaleer & Jensen, LLP is a prominent legal firm focusing on workers' compensation defense. We are currently on the lookout for a Claims Resolution Specialist to enhance our team. In this role, you will be tasked with overseeing and resolving lien cases through proficient communication, legal documentation, and...