Claims Resolution Specialist
3 weeks ago
At Independence Blue Cross, we are seeking a highly skilled Claims Resolution Specialist to join our team. This role is responsible for accurately and timely handling of claim issues for all lines of business, including bi-directional sharing, FEP, Local and Commercial PA and AHNJ, BlueCard and Government market.
The ideal candidate will have a proven track record of resolving complex claims and possess excellent analytical and problem-solving skills. They will also have the ability to work independently and as part of a team to meet departmental quality and production requirements.
The Claims Resolution Specialist will be responsible for:
- Researching and adjusting complex and/or high dollar adjustment requests received from all areas, inclusive of internal and external sources.
- Handling FEP reconsiderations accurately and timely per the FEP benefit manuals and guidelines.
- Meeting departmental quality and production requirements.
- Responding professionally to external/internal inquiries, as appropriate, while maintaining corporate and departmental standards.
The successful candidate will have a high school graduate or equivalent work experience, with at least 5 years of proven work experience in a production environment. They will also possess excellent math and comprehension skills, as well as good interpersonal skills for handling internal and external customers.
Additionally, the Claims Resolution Specialist will have proficiency with Microsoft Office, specifically Excel and Word, and the ability to research and investigate information using multiple sources, operating systems and documented guidelines.
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. We are committed to diversity and inclusion in the workplace.
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Claims Resolution Specialist
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Philadelphia, Pennsylvania, United States GB Group, LLC Full timeClaims Resolution OpportunityGB Group LLC is seeking a skilled Claims Resolution Specialist to manage liability, physical damage, and cargo claims. If you have experience handling complex claims, we want to hear from you.Key Responsibilities:· Manage liability, physical damage, and cargo claims with precision and accuracy.· Utilize strong communication and...
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Healthcare Account Resolution Specialist
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Philadelphia, Pennsylvania, United States Pennsylvania Medicine Full timePenn Medicine is dedicated to delivering exceptional patient care, conducting innovative research, and educating future healthcare leaders. As a leading academic medical center, we collaborate with top professionals across all disciplines to provide the highest level of care.At Penn Medicine, our employees play a vital role in shaping our future every day....
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Claims Specialist
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Accounts Resolution Specialist I
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Healthcare Ticket Resolution Specialist
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Philadelphia, Pennsylvania, United States Pennsylvania Medicine Full timeJob SummaryPenn Medicine is seeking a highly skilled Accounts Resolution Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for resolving patient accounts, investigating claim edits, and working with insurance carriers to obtain payment.ResponsibilitiesInvestigate and resolve patient accounts, including claim...
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Warranty Claims Specialist
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Claims Specialist Sr
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Senior Claim Specialist
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Recovery Claims Specialist
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Claims Apprentice
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Philadelphia, Pennsylvania, United States PMA Companies Full timeClaims Apprentice ProgramThe Claims Apprentice Program is an exciting opportunity for recent college graduates to launch their career as a Claims Adjuster in the Property & Casualty insurance industry.Job Responsibilities:Investigate assigned claims to determine coverage, compensability, and potential for subrogation recovery.Ensure timely denial or payment...
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Claims Manager
4 weeks ago
Philadelphia, Pennsylvania, United States Enviri Corporation Full timeJob SummaryEnviri Corporation is seeking a highly skilled Claims Manager to oversee the management of workers' compensation and automobile liability claims. The ideal candidate will have a strong background in claims handling, excellent communication skills, and the ability to drive cost-effective resolutions.Key ResponsibilitiesDirect and manage complex...
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Senior Claim Specialist-Life Sciences
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Philadelphia, Pennsylvania, United States CHUBB Full timeChubb is seeking a Senior Claim Specialist for our Life Sciences Claims team. The Life Sciences Claims Team provides claim handling with regard to some of the largest medical products manufacturers and providers of instruments with worldwide distribution on the cutting edge of innovation, research and technology.This is an individual contributor role...
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Workers' Compensation Claims Director
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Claims Operations Specialist
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Philadelphia, Pennsylvania, United States IntePros Full timeClaims Operations AnalystIntePros is seeking a skilled Claims Operations Analyst to join our team in Center City Philadelphia. As a key member of our operations team, you will be responsible for handling claims production tasks, supporting business operations, and identifying process improvements.Key Responsibilities:Claims Production: Handle written...
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Reinsurance Claims Specialist
4 weeks ago
Philadelphia, Pennsylvania, United States Chubb Full timeReinsurance Claims Analyst RoleAs a key member of the Ceded Reinsurance Services team at Chubb, the Reinsurance Claims Analyst plays a vital role in ensuring the timely and accurate processing of reinsurance claims in North America.Key Responsibilities:Verify that claims are reported in accordance with reinsurance contract terms and ensure timely billings...
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Recovery Claims Specialist
4 weeks ago
Philadelphia, Pennsylvania, United States Cozen O Connor Full timeRecovery Analyst Job DescriptionCozen O'Connor is seeking a skilled Recovery Analyst to join our team. As a key member of our National Subrogation Services (NSS) team, you will play a crucial role in reviewing and resolving complex subrogation claims.Key Responsibilities:Review and analyze complex subrogation claims to determine viability and potential for...
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Reinsurance Claims Specialist
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Philadelphia, Pennsylvania, United States Chubb Full timeJob DescriptionThis is a hybrid role following our 3/2 model (3 days in office and 2 days remote). The employee will be based out of our Philadelphia, PA office. Reporting to the Director, Ceded Reinsurance Services, this role is responsible for the day-to-day reinsurance claim operations in North America. The ceded reinsurance billings are primarily proof...
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Administrative Financial Support Specialist
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Reinsurance Claims Specialist
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Philadelphia, Pennsylvania, United States Ace American Insurance Full timeJob Summary:As a Reinsurance Claims Analyst at Ace American Insurance, you will be responsible for the day-to-day reinsurance claim operations in North America. Your primary focus will be on ensuring timely billings and collections of loss balances, while providing accurate and complete billing packages to reinsurers and brokers. You will also be responsible...