Claims Resolution Professional

Oscar Health's Claims Resolution Professional plays a critical role in ensuring that our company remains compliant with all relevant laws and regulations. As a member of our Payment Integrity team, you will be responsible for analyzing claims data to identify potential overpayments, communicating with healthcare providers to recover these overpayments, and...

Position Summary:Russell Tobin is seeking an experienced No-Fault Claims Adjuster to join their team. This role requires extensive knowledge of New York's no-fault claims process, including Regulation 68 and arbitration procedures.Key Responsibilities:Review and process no-fault claims, ensuring accuracy and compliance with regulatory...

Job DescriptionWe are looking for a skilled Medical Claims Resolution Expert to join our team. This individual will play a crucial role in ensuring the efficient and timely resolution of unpaid and partially paid claims, focusing on EOB discrepancies and researching refunds.Key Responsibilities:* Monitor and ensure collections, net, gross, and days in...

Job Summary: We are seeking a skilled Healthcare Claims Resolution Specialist to join our team at Centers Plan for Healthy Living. In this role, you will be responsible for handling incoming inquiries from healthcare providers regarding claim decisions and payments. You will thoroughly gather claim information, assess and fulfill the callers' needs, and...

AZBY Brokerage Inc is a leading insurance brokerage firm, dedicated to providing exceptional service to our clients.As an Insurance Clerk, you will play a vital role in supporting our commercial department, working closely with our team to achieve success.Key responsibilities include:Investigating claims and determining liabilityConducting interviews with...

We are looking for a talented Bodily Injury Adjuster to join our team at Allstate Insurance Company. As a key member of our claims resolution team, you will be responsible for managing and resolving complex claims, including those involving bodily injury, UM/UIM, and CPL claims.Your primary focus will be on investigating and analyzing claims data, conducting...

**About the Role**We're looking for a highly skilled Complex Claims Resolution Expert to join our team in Chicago or New York City offices. As a key member of our claims team, you'll provide technical guidance on major cases in litigation, working closely with senior management to ensure timely resolution and best financial outcomes.You'll have the...

About the JobAs a Claims Resolution Expert at Mount Sinai Health System, you will be responsible for resolving EOB discrepancies and researching refunds. You will work closely with payer and provider representatives to negotiate higher rates for claim payments and ensure that collections, gross, days in A/R, and net collection ratios are met.Key...

Our TeamWe are a dynamic and collaborative team dedicated to delivering exceptional results for our customers. Our team members are passionate about their work and committed to making a positive impact in the lives of our customers. We value diversity, equity, and inclusion, and we strive to create a workplace that is welcoming and inclusive for all...

Join Our Team:We are seeking a highly skilled Medical Claims Resolution Expert to join our growing team at Gallagher Bassett. As a key member of our Claims Adjuster team, you will play a crucial role in investigating and resolving complex liability claims in various specialty areas.About the Role:This position offers fully remote work options and involves...

**Job Summary:**We are seeking a highly organized and detail-oriented Medical Claims Resolution Specialist to join our team at Mount Sinai Health System. In this role, you will be responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner.Main Responsibilities:Resolves EOB discrepancies and researches...

About UsCenters Plan for Healthy Living (CPHL) is a Managed Care Organization servicing members with Medicare and/or Medicaid. Our goal is to provide members and all those involved in their care with the guidance and health plan choices they need for healthy living.We are committed to providing quality, coordinated healthcare to some of the most honored and...

About the RoleWe are looking for a seasoned professional with a minimum of 7 years' experience in construction defect claims adjudication, preferably with exposure to claims exceeding $100,000. Your expertise will enable you to navigate complex claim scenarios, build lasting relationships with clients and stakeholders, and drive profitable outcomes for Argo...

We are looking for a skilled Claims Management & Coverage Counsel to join our team. The ideal candidate will have a strong background in insurance law, excellent analytical and communication skills, and the ability to work effectively in a fast-paced environment.The role involves managing a claims caseload, analyzing complex claims, and developing effective...

Key ResponsibilitiesThe successful candidate will be responsible for:Adjudicating complex construction defect claims with minimal oversight, working under broad management direction;Conducting thorough investigations, analyzing claims forms, policies, and client instructions to determine policy coverage;Negotiating settlements and managing claims in...

Key ResponsibilitiesThe Property Loss Resolution Manager at Genesis Resources is responsible for handling and resolving complex claims related to high-value assets. This role is based in Manhattan, NY, with some travel required for large losses or catastrophe events.This is an excellent opportunity for an experienced professional with a strong background in...

We're looking for a talented Insurance Claims Adjuster to join our team at Argo Group. As an Adjudicator of Workers' Compensation Claims, you will be responsible for resolving complex claims and providing excellent customer service.About the Job:Work under technical direction to adjudicate workers' compensation claims.Analyze claims data to identify trends...

About This OpportunityAs a highly skilled attorney with claims management and coverage counsel experience, you will join our dynamic team and contribute to the success of our national team. You will have the flexibility to work remotely and participate in regular collaboration with other attorneys and partners. In this role, you will focus on developing...

Job SummaryCenters Plan for Healthy Living (CPHL) is seeking a Healthcare Claims Specialist to join our team. As a Claims Resolution Coordinator, you will be responsible for handling incoming inquiries from providers regarding claim decisions and payments across all CPHL product offerings. Key Responsibilities:Professionally handle incoming inquiries via...

Argo Group is seeking a skilled Workers' Compensation Claims Adjuster to join our team. As an Insurance Claims Adjuster Professional, you will play a critical role in ensuring the fair and timely resolution of workers' compensation claims.About the Position:Responsible for managing workers' compensation claims from initial receipt to final resolution.Analyze...