Claims Account Specialist
4 weeks ago
Job Summary:
NJM's Workers' Compensation Claims Team is seeking a Claims Account Specialist to join our team. This is a full-time position that offers a hybrid schedule after training.
Key Responsibilities:
- Contact all parties involved in the claim, gathering and securing necessary information to effectively evaluate the claim and implement an action plan to manage the claim.
- Work with and communicate to NJM policyholders, injured workers, medical providers, the NJM Medical Services Administration Department, the NJM Special Investigation Unit, WC Legal Staff, other departments within NJM, and vendors as needed.
- Recommend process improvements where applicable to improve department efficiency, work product, and service commitment to interested parties.
- Ensure quality management of claims in accordance with claims best practices and company guidelines, proactive action plans to drive positive return to work results while presenting timely, accurate documentation of claim activity.
- Administer the delivery of timely, appropriate, and accurate indemnity and medical benefits.
- Provide a high level of customer service that promotes injured worker advocacy-based principles to maximize return to work motivation and improve outcomes for all parties.
- Investigate potential fraud indicators in collaboration with the SIU team.
- Consistently question and probe all aspects of assigned claims to achieve full understanding of facts.
- Comply with, and conduct all activities within state WC claims laws and fair practices, NJM's Code of Ethics, and NJM's Best Practices and Policies.
- Build rapport with the policyholder, educate the policyholder on NJM procedures, policies, and claim practices, and evaluate the policyholder's reporting practices.
- Include accountability in managing service expectations and rapport and trust with assigned large accounts.
- Prepare, attend, and participate in Claim Reviews as needed with the Claims Supervisor.
- Participate in training programs to keep current on relevant issues/topics.
- Demonstrate a commitment to NJM's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards, and laws applicable to job responsibilities in the performance of work.
Requirements:
- Level I - 0-3 years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including basic knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system.
- Level II - 3-5 years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including strong knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system.
- Sr Level - 5+ years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including advanced knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system.
Preferred Qualifications:
- Superior customer service skills and ability to engage in business interactions with a polite, courteous, and professional manner.
- Working knowledge of Microsoft Office suite of tools (Word, Excel).
- Ability to travel for business purposes, approximately less than 10%.
- Associate's or Bachelor's degree.
NJM is an Equal Opportunity Employer:
We are committed to attracting, retaining, and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
-
Claims Account Specialist
4 weeks ago
Parsippany, New Jersey, United States NJM Insurance Group Full timeThe NJM Insurance Group is seeking a skilled Claims Account Specialist to join our team in Parsippany, NJ. This full-time position offers a hybrid schedule after training and provides an opportunity to work with various stakeholders, including policyholders, injured workers, medical providers, and vendors.The ideal candidate will have experience in workers'...
-
Claims Account Specialist
4 weeks ago
Parsippany, New Jersey, United States NJM Insurance Group Full timeNJM Insurance Group is seeking a skilled Claims Account Specialist to join our team. This is a full-time position that offers a hybrid schedule after training.The Claims Account Specialist will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary information to effectively evaluate the claim and implement an...
-
Insurance Claims Specialist
4 weeks ago
Parsippany, New Jersey, United States MAX Surgical Specialty Management Full timeInsurance Claims Specialist Job DescriptionWe are seeking a highly skilled Insurance Claims Specialist to join our team at MAX Surgical Specialty Management. As an Insurance Claims Specialist, you will play a crucial role in ensuring the accuracy and efficiency of our insurance claims process.Key Responsibilities:Claim Preparation and Submission: Prepare and...
-
Medicaid Claims Specialist
4 weeks ago
Parsippany, New Jersey, United States Teva Pharmaceuticals Full timeJob SummaryThe Medicaid Claims Analyst is responsible for ensuring the accuracy and compliance of Medicaid drug rebate processes. This includes validating, verifying, and remitting payments for assigned state Medicaid agencies, SPAPs, and Supplemental Rebates. The Analyst must submit payments within deadlines and in compliance with CMS guidelines and Teva...
-
Total Loss Claims Specialist
4 weeks ago
Parsippany, New Jersey, United States Plymouth Rock Assurance Full timeTotal Loss Claims Representative RoleThe Total Loss Claims Representative plays a crucial role in the Claims Organization, responsible for identifying, negotiating, and settling total losses with insureds and claimants. This position requires strong communication and organizational skills to effectively manage multiple tasks and prioritize claims.Key...
-
Forensic Accounting Specialist
4 weeks ago
Parsippany, New Jersey, United States MDD Forensic Accountants Full timeAbout MDD Forensic AccountantsMDD Forensic Accountants is a leading forensic accounting firm specializing in economic damage quantification calculations. With a global presence in over 40 offices across 5 continents, we provide expert services to insurance companies, independent adjustment firms, multinational corporations, government entities, and...
-
Chargeback Specialist
4 weeks ago
Parsippany, New Jersey, United States Aston Carter Full timeJob Title: Chargeback SpecialistTo succeed in this role, the individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.Key Responsibilities:Proactively analyze and process all customer claims as they are recognized.Collect all customer invoices and...
-
Accounts Payable Specialist
4 weeks ago
Parsippany, New Jersey, United States Aston Carter Full timeJob Title: Accounts Payable SpecialistJob Description:As an Accounts Payable Specialist, you will be responsible for performing full cycle accounts payable processes, including matching and reviewing vouchers for appropriate approvals, and conducting weekly payment runs. You will also research and resolve invoice discrepancies and issues with vendors, assist...
-
Accounts Payable Specialist
1 month ago
Parsippany, New Jersey, United States Aston Carter Full timeJob Title: Accounts Payable SpecialistJob Description:As an Accounts Payable Specialist, you will be responsible for performing full cycle accounts payable processes, including matching and reviewing vouchers for appropriate approvals, and conducting weekly payment runs. You will also research and resolve invoice discrepancies and issues with vendors, assist...
-
Account Specialist
4 weeks ago
Parsippany, New Jersey, United States Compass Group USA Full timeJob Summary:As an Account Specialist at Compass Group USA, you will be responsible for delivering exceptional customer service and support to our clients. Your primary focus will be on daily customer calls, answering phones, and resolving any issues that may arise. You will also be responsible for order entry, invoice preparation, and back orders....
-
Collections Specialist
1 month ago
Parsippany, New Jersey, United States Garden Savings Federal Credit Union Full timeJob SummaryGarden Savings Federal Credit Union is seeking a skilled Collections Specialist to join our team. As a Collections Specialist, you will be responsible for collecting delinquent loans and overdrawn accounts, assisting members and team members with collection inquiries, and utilizing skip tracing techniques to gain contact with delinquent...
-
Accounting Specialist
1 month ago
Parsippany, New Jersey, United States Compass Group USA Full timeJob Summary:As an Account Specialist with Compass Group USA, you will be responsible for handling daily customer calls, answering phones, and resolving issues. You will also be responsible for order entry, invoice preparation, and back orders. Additionally, you will make new product suggestions and provide excellent customer service.Key Responsibilities:-...
-
Accounts Payable Operations Specialist
4 weeks ago
Parsippany, New Jersey, United States Atrium Staffing Full timeAbout Atrium Staffing:Our MissionAt Atrium Staffing, we foster an environment of collaboration, high performance, and innovation where your talents are valued, and your achievements are celebrated. Our team is built on the principles of inclusivity, respect, and open communication. We strive to make a positive impact on our clients' businesses and the...
-
Accounts Payable Specialist
1 month ago
Parsippany, New Jersey, United States Let It Grow, Inc. Full timeJob SummaryWe are seeking a highly organized and detail-oriented Accounts Payable Specialist to manage our accounts payable process, ensuring timely and accurate processing of invoices, payments, and expense reports.This role is crucial in maintaining the financial health of our construction projects. If you have experience in the construction industry, a...
-
National Account Director
4 weeks ago
Parsippany, New Jersey, United States Ferring Full timeJob Summary:As a key member of the Ferring team, the National Account Director - Government and MAC Programs will be responsible for developing and managing key government relationships/accounts to achieve access, sales, and gross-to-net maximization for Ferring Pharmaceuticals. This role will involve working closely with government affairs to evaluate the...
-
Tax and Accounting Specialist
3 weeks ago
Parsippany, New Jersey, United States SAX Full timeAbout the PositionAt Sax LLP, we are committed to delivering exceptional accounting, tax, and advisory services to our clients. As a Professional Assistant, you will play a vital role in supporting our team members and contributing to the firm's success.Key ResponsibilitiesTraining and Support: Participate in Sax trainings and serve as a point-person for...
-
Dental Insurance Coordinator
4 weeks ago
Parsippany, New Jersey, United States MAX Surgical Specialty Management Full timeAt MAX Surgical Specialty Management, we're seeking a skilled Insurance Claims Processor to join our team. In this role, you'll play a vital part in our revenue cycle management, ensuring accurate and timely claim submissions.Key Responsibilities:Claim Preparation: Prepare and submit claims with meticulous attention to detail, adhering to insurance policies...
-
Senior Pharmaceutical Account Manager
4 weeks ago
Parsippany, New Jersey, United States IQVIA INC (US10) Full timeAs a Senior Pharmaceutical Account Manager at IQVIA INC (US10), you will be responsible for managing a portfolio of assigned clients to achieve financial goals. Your geography of responsibility will include 10 – 15 Emerging Biopharma (EBP) clients.You will provide key client relationships to clients through relationships with executives and leaders in the...
-
Financial Services Specialist
1 month ago
Parsippany, New Jersey, United States Magone & Company, P.C. Full timeJob SummaryMagone & Company, P.C. is seeking a skilled Financial Services Specialist to support multiple small to mid-size business clients with their full financial picture. The ideal candidate will have 3-5 years' experience in bookkeeping, be detail-oriented, and thrive in a fast-paced environment. Responsibilities include entering financial data and...
-
Accounts Receivable Specialist
4 weeks ago
Parsippany, New Jersey, United States Marotta Controls Full timeCome grow with Marotta, one of NJ's fastest growing technology companies, and be part of an exciting team, all within a warm and welcoming environment. We specialize in the design, development, and production of precision control components and systems. Founded in 1943, Marotta has been at the forefront of Aerospace & Defense milestones for over 75 years,...