Current jobs related to Claims Specialist - Dallas, Texas - MSIG North America
-
Claims Specialist
4 days ago
Dallas, Texas, United States CorVel Career Site Full timeThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.This is a hybrid position in Dallas,...
-
Claims Resolution Specialist
5 days ago
Dallas, Texas, United States Medical City Healthcare Full timeIntroductionDo you want to join an organization that invests in you as a Claims Resolution Specialist? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.BenefitsParallon offers a total rewards package that supports the health, life, career and...
-
Dallas, Texas, United States Phaxis Full timeWe're Hiring: Billing & Coding Specialist (Hospital Claims Analyst)Dallas, TX (ONSITE)$60,000-$80,000/year + Bonus (up to $15-20K)Looking for your next opportunity inhospital billing, coding, and claims resolution? This is ahigh-paying, research-intensiverole with incredible perks — perfect for an experienced professional who loves digging into complex...
-
Dallas, Texas, United States Portfolio Full time:At Portfolio, we pride ourselves on our responsive, innovative, efficient, and sincere service standards (R.I.S.E).We are seeking dedicated professionals who are passionate about delivering exceptional service and making a difference in the claims process.In addition to offering a hybrid work schedule, Portfolio offers a comprehensive benefits package:Paid...
-
Accounts Receivable Specialist- Collections
2 weeks ago
Dallas, Texas, United States Rheumatology Alliance LLC Full timeThe Accounts Receivable Specialist is responsible for managing and collecting outstanding payments from insurance companies and patients. This role ensures accurate claim follow-up, resolves denials and submits appeals, and maintains compliance with billing and collection policies. The ideal candidate has strong communication skills, attention to detail,...
-
Medical Billing Specialist
13 hours ago
Dallas, Texas, United States HCA Healthcare Full time*Description*IntroductionThis Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).Experience the HCA Healthcare difference where colleagues are trusted, valued...
-
Medical Billing Specialist
6 days ago
Dallas, Texas, United States Medical City Healthcare Full timeIntroductionThis Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).Experience the HCA Healthcare difference where colleagues are trusted, valued members of our...
-
Billing Specialist
6 days ago
Dallas, Texas, United States Koya Medical Full timeKoya is always looking for curious and passionate individuals who want to join a fast- paced team for a career in transforming venous and lymphatic care through innovative people-centric technologies that improve lives and empower self-care. Koya values integrity, humility, hard-work, camaraderie, and fun. We offer a base + bonus compensation package, and a...
-
Patient Services Specialist 2
2 weeks ago
Dallas, Texas, United States Baylor Scott & White Health Full timeJOB SUMMARY The Patient Services Specialist 2 provides administrative support in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care. Duties include patient relations, check-in or check-out, scheduling, insurance verification and answering phones. May assist in training and mentoring...
-
Premium Audit Specialist
6 days ago
Dallas, Texas, United States Chubb Insurance Full timePremium Audit Specialist – Dallas, Texas | Open to All Locations (Work From Home)Chubb is seeking a Premium Audit Specialist with a strong and extensive background in completing Workers' Compensation audits for Professional Employer Organization (PEO) program accounts. This role involves extensive data management and analysis, as well as collaboration with...
Claims Specialist
2 weeks ago
MSIG USA continues to grow
Company Overview:
MSIG USA
is the US-based subsidiary of
MS&AD Insurance Group Holdings, Inc.
, one of the world's top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business's unique risks.
Summary/Job Purpose:
This position is responsible to conduct thorough investigations and evaluate and negotiate complex claims including litigation and coverage issues. Accountable to ensure compliance with MSMM Claim Handling Guidelines, including reserving and payment practices, regulatory requirements and Fair Claims Practices Acts.
Essential Functions:
Investigates, researches and analyzes highly complex or severe claims, including coverage issues and legal issues affecting liability and damages.
Establishes appropriate case reserves, completes settlements and case resolutions within established reserve and settlement authorities. Recommends reserve and settlement values on assigned cases in excess of established reserve and settlement authority.
Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claim practices and company policy and procedures.
Attends pre-trials, trials, settlement conferences and mediations on assigned cases as required
Assigns the defense of lawsuits to approved defense counsel; directs and monitors quality and performance of defense counsel. Maintains compliance with all requirements of the company's Litigation Management Program. Reviews and adjusts, where appropriate, fee bills and legal expenses for accuracy and reasonableness.
Services the claim needs of our customers including insureds, claimants, brokers, etc., in accordance with company policy and procedures, and attends client visitations with underwriters and other parties to conduct presentations and reviews.
Maintains ongoing communication with all customers throughout the claims process in an effort to provide timely and appropriate claim status as appropriate and/or required by statutory regulations.
Completes timely and accurate data reports to state reporting agencies to ensured full compliance with MSMM and regulatory requirement.
Maintains full compliance with all regulatory Fair Claim Practices Acts and state and federal regulations.
Maintains full compliance with all state licensing and continuing education requirements to ensure current and appropriate filing/standing of all adjuster licenses.
Maintains regular reporting of case status, developments and direction to Home Office staff and other appropriate parties as necessary. Ensures timely and appropriate file reports and system documentation as required by company claim manuals and procedures.
Participates and/or manages special projects and assignments as needed.
Supervisory Responsibilities:
This position has no supervisory responsibilities.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience Required:
Diploma/Degree & Experience
- High School Degree or G.E.D. is required. Bachelor's degree preferred
- 7+ years related experience handling complex Liability or Workers' Compensation Claims
It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group
It is the policy of MSIG USA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG USA will provide reasonable accommodations for qualified individuals with disabilities.
