Claims Management Specialist

**Job Description:**Sedgwick Claims Management Services is seeking a highly skilled General Liability and Disability Claims Specialist to join our team. In this role, you will work closely with our claims professionals to analyze general liability and disability claims.As a General Liability and Disability Claims Specialist, you will apply your knowledge of...

**Job Overview:**Sedgwick Claims Management Services is seeking a detail-oriented Insurance Claims Analyst Trainee to join our team. In this role, you will work closely with experienced claims professionals to analyze workers compensation, general liability, or disability claims.As an Insurance Claims Analyst Trainee at Sedgwick, you will have the...

Job SummaryA Healthcare Claims Specialist is needed at MedPOINT Management to resolve medical claims efficiently and accurately. The ideal candidate will have strong analytical and communication skills.About the Role:Review and adjust medical claims according to established guidelines and protocols.Work collaboratively with healthcare providers and insurance...

About the Role:We are seeking a skilled Claims Audit Specialist to join our team at MedPOINT Management. As a key member of our recovery services team, you will be responsible for reviewing and disputing capitation deductions received from various health plans. Your expertise will also be required to analyze retro eligibility term reports, identify...

Job OverviewMedPOINT Management is a leading provider of IPA services. We're committed to delivering exceptional value to our Members and Providers through our dedicated teams and innovative solutions.In this role, you'll have the opportunity to work closely with our IPA department to ensure seamless communication and resolution of issues. Your expertise...

About the Role:We are looking for a skilled Claims Analyst Specialist to join our team at MedPOINT Management. The successful candidate will possess expertise in healthcare financial recovery, medical claims analysis, and process improvement.Main Responsibilities:Review and analyze retro eligibility term reports to identify potential overpayments.Develop and...

Job OverviewWe are seeking a skilled Medical Claims Recovery Specialist to join our team at MedPOINT Management. The successful candidate will research and identify complex overpayments on previously processed claims for multiple product lines, assist in DOFR implementation projects, and review claim refunds and capitation deductions from various...

Job Title: Medical Claims Resolution Specialist    Company OverviewMEDPOINT MANAGEMENT is a reputable healthcare management company seeking an experienced Medical Claims Resolution Specialist to join our team. As a Medical Claims Resolution Specialist, you will play a crucial role in ensuring timely and accurate resolution of provider...

Job OverviewMEDPOINT MANAGEMENT seeks an experienced Senior Claims Operations Specialist to join our team. In this role, you will assist in various functions to maintain compliance with regulatory and contractual standards.

Job DescriptionMEDPOINT MANAGEMENT is seeking a seasoned Healthcare Operations Supervisor to lead its EDI Claims team. The ideal candidate will possess exceptional leadership and technical skills, with a proven track record of driving process improvements and delivering results.This critical role involves overseeing the end-to-end processing of electronic...

Role OverviewWe are seeking an experienced Claims Management Specialist to join our team at Ascendion. As a Claims Management Specialist, you will be responsible for managing all aspects of personal injury cases, from intake to resolution. This includes gathering and reviewing medical records, coordinating with medical providers and insurance adjusters, and...

About This OpportunityWe are seeking a Medical Claims Review Expert to join our team at MedPOINT Management. As a Risk Claims Adjuster Specialist, you will be responsible for reviewing and adjusting hospital risk claims in accordance with regulatory guidelines.Responsibilities:Review and adjudicate web portal inquiries.Assist Providers and other Departments...

Job TitleClaims Operations GeneralistAbout the RoleWe are seeking a highly skilled Claims Operations Generalist to join our team at MedPOINT Management. As a Claims Operations Generalist, you will be responsible for assisting in various functions to maintain compliance with regulatory and contractual standards.Key ResponsibilitiesAssist in claims auditing,...

About the RoleWe are seeking a highly skilled and experienced Claims Operations Generalist to join our team at MedPOINT Management. In this role, you will be responsible for assisting Claims Operations in various functions to maintain compliance with regulatory and contractual standards.The ideal candidate will have 3 years of experience as a Claims Examiner...

Job Summary:">This position serves as a key liaison between IPA and its Members and Providers, ensuring exceptional service levels.">Responsibilities:">Key responsibilities include providing multi-channel support, explaining plan details, claim processes, payment, denials, benefits clarification, eligibility verification, and claim status. The ideal...

Job OverviewMaintain regulatory and contractual standards by assisting Claims Operations in various functions. Participate in claims auditing, adjudication, adjusting, investigation/analyzing and other special projects as needed.Key responsibilities include adjudicating assigned claims, adhering to deadlines, analyzing claims based on contracts, and...

Job OverviewWe are seeking a highly skilled Hospital Claims Adjuster to join our team at MedPOINT Management.The ideal candidate will have a strong background in claims management, with experience in adjusting hospital risk claims and a keen eye for detail.

Key ResponsibilitiesThe Investigative Claims Specialist will be responsible for:Conducting thorough investigations into questionable insurance claims, including recorded statements and interviews of claimants, witnesses, and employers.Providing timely status updates to case managers and clients.Maintaining accurate and detailed documentation of claim...

About the RoleWe are currently seeking a qualified Claims Processor - Refund Management to join our dynamic team at MedPOINT Management. In this critical role, you will be responsible for managing the entire refund process from start to finish.You will receive, review, and process daily refund checks, prepare detailed reports for management, and investigate...

Job DescriptionAs a Claims Operations Generalist at MedPOINT Management, you will play a critical role in ensuring compliance with regulatory and contractual standards. You will assist in various functions, including claims auditing, adjudication, adjusting, investigation/analyzing, and other special projects as needed.Main Duties and ResponsibilitiesAssist...