15 jobs found in Bradenton

PRIMARY PURPOSE :   To provide support to the claim staff in document management, mail and general clerical support. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Accurately opens, preps, stamps and scans documents for indexing Indexes incoming claim documents to correct claim file according to folder/document type. Prints copies of forms, letters and various documents for mailing May assist with metering outgoing mail. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). QUALIFICATIONS Education & Licensing High school diploma or GED required. Experience One year of clerical or customer service experience or equivalent combination of education and experience required. Skills & Knowledge Excellent oral and written communication PC literate,...

SUMMARY: Participates in the processing of insurance claims by performing the following administrative duties. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following; other duties may be assigned. Review insurance claim forms and related documents (e.g., medical records) for required information. Enter new claim setup information into claims management system (ClaimsXPress). Maintain existing files in claims management system. Print and prepare outgoing letters and forms on behalf of claims adjusters. Scan and sort incoming daily mail. Pay claim-related expenses as authorized. Handle incoming calls. Make outgoing calls as specifically required. Assist Claims Support Specialists with special research and daily projects as needed. Assist Team Leads with special training projects as needed. Execute special projects for adjusters and supervisors as needed, including file research and preparation. Execute temporary and ongoing special projects for clients,...

PRIMARY PURPOSE :   To provide assistance to the claim staff by performing a variety of administrative tasks based on jurisdictional requirements.    Responds to customer inquiries.    ESSENTIAL FUNCTIONS and RESPONSIBILITIES Prepares file for legal defense referrals or subpoena responses. Prepares variety of letters, reports and forms Schedules physician appointments and sends appropriate letters and records Edits and organizes a variety of records for Utilization or Legal Review Answers phone related inquiries Makes outbound calls to request information and follow up Prepares various letters, reports and forms. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). Education & Licensing High school diploma or GED required. Relevant work experience can be substituted for required education. Experience One year of clerical or customer service experience or...

Overview: It is the responsibility of a workers' compensation claims adjuster to receive and organize all documents related to the employee and the injury in order to make a determination regarding the claim. Workers' compensation claims adjusters abide by company guidelines when making claim determinations. This role requires excellent communication and customer service skills, strong motivation and works in a team environment.   Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Responsibilities: Investigates and maintains worker’s compensation claims.  Reviews and evaluates coverage and/or liability.  Secures necessary information (i.e., reports, policies, releases, statements or other documents) in the investigation of claims. Works toward the resolution of claims files, and attends arbitrations, mediations or trials as necessary. Takes full charge of claim from start to resolution. Will affect...

About Acrisure A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions. Bringing cutting-edge technology and top-tier human support together, it connects clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services and more. In the last eleven years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in 21 countries. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win. Job Summary : Acrisure, a leading company in the insurance and fintech space, is seeking a dedicated and highly skilled Corporate Trainer specialized in Workers Compensation to join our team. The ideal candidate will design, implement, and manage training programs aimed at enhancing the knowledge and skills of our employees, ensuring...

Job Title: Sr. Lost Time Adjuster About Acrisure A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions. Bringing cutting-edge technology and top-tier human support together, it connects clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services and more. In the last eleven years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in 21 countries. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win.   Overview: The Workers’ Compensation Claims Adjuster must be knowledgeable of  California laws and administration of claims.  It is the responsibility of a Workers' Compensation Claims Adjuster to receive and organize all documents related to the employee and the injury to make a determination...

Overview: The Workers’ Compensation Claims Adjuster must be knowledgeable of the California Labor Code and administration of claims. It is the responsibility of a Workers' Compensation Claims Adjuster to receive and organize all documents related to the employee and the injury to make a determination regarding the claim. The Claims Adjuster is responsible for the prompt and efficient examination and investigation of claims. Workers' Compensation Claims Adjusters abide by company guidelines when making claim determinations. This role requires excellent communication and customer service skills, strong motivation and organizational skills. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Responsibilities: • Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud, and claim resolution. • Complete quality investigations by gathering pertinent information....

Overview: The Workers’ Compensation Claims Adjuster must be knowledgeable of the California Labor Code and administration of claims.  It is the responsibility of a Workers' Compensation Claims Adjuster to receive and organize all documents related to the employee and the injury to make a determination regarding the claim. The Claims Adjuster is responsible for the prompt and efficient examination and investigation of claims.  Workers' Compensation Claims Adjusters abide by company guidelines when making claim determinations. This role requires excellent communication and customer service skills, strong motivation and organizational skills.  Reasonable accommodations may be made to enable individuals with disabilities to perform the  essential functions. Responsibilities: • Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud, and claim resolution.  • Complete quality investigations by gathering pertinent information....

Job Purpose: Ensuring all projects follow Case Management Standards of Practice Promotes and restores individuals' health and wellbeing by completing “a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s comprehensive health needs through communication and available resources to promote quality cost-effective outcomes.” ~CMSA Standards of Practice Essential Functions · Review treatment requests from medical professionals for adherence to state mandated guidelines · Make determinations on which referrals can be authorized at the nurse level, and which will be sent for physician review · Perform all necessary paperwork and billing from open to close of the UR review within state mandated and/or URAC turnaround time requirements · At full-time status, the UR nurse will process a minimum of 12 reviews daily · Document medical treatment requests and associated medical...

The Special Investigator, DIU is responsible for the day to day in-house investigations of potentially fraudulent workers’ compensation claims. Utilizing a combination of designated investigative tools, public records, and open-source web data, the individual is expected to complete desktop investigations with efficiency and attention to detail. Entry level, repetitive tasks, additional compensation opportunities, growth potential 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. Wage Range: $15.00-$17.00 per hour plus commission of up to $3.00 per hour depending on the services. ESSENTIAL DUTIES AND RESPONSIBILITIES: Performs desktop investigations such as background checks, social media searches,...

The  Operations Manager, FIU is responsible for managing the daily activity of field investigators and will act as a liaison between investigators and insurance claims staff. Utilizing a combination of designated investigative tools and an understanding of field operations, the individual is expected to review new cases, determine action plan, and oversee the investigative and reporting process to include editing and quality control. ESSENTIAL DUTIES AND RESPONSIBILITIES: Performing intensive review of newly assigned cases and formulates a strategy for field investigations Selecting and scheduling appropriate investigators based on investigative requirements and logistics Communicating with Digital Intelligence Unit (DIU) to appropriately interpret desktop findings necessary for quality field results QUALIFICATIONS AND REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed...

Overview: The Workers’ Compensation Claims Adjuster must be knowledgeable of the California Labor Code and administration of claims. It is the responsibility of a Workers' Compensation Claims Adjuster to receive and organize all documents related to the employee and the injury to make a determination regarding the claim. The Claims Adjuster is responsible for the prompt and efficient examination and investigation of claims. Workers' Compensation Claims Adjusters abide by company guidelines when making claim determinations. This role requires excellent communication and customer service skills, strong motivation and organizational skills. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Responsibilities: • Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud, and claim resolution. • Complete quality investigations by gathering pertinent information....

About Acrisure      A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more.    In the last eleven years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win.     Job Summary:    We’re seeking a motivated and detail-oriented Report Analyst who thrives on problem-solving, data exploration, and continuous learning. This position is ideal for someone who enjoys diving into SQL data, building...

Reports to: Senior Lead, Document Management PRIMARY PURPOSE: To provide support to the claim staff in document management, mail and general clerical support. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · Accurately opens, preps, stamps and scans documents for indexing · Indexes incoming claim documents to correct claim file according to folder/document type. · Prints copies of forms, letters and various documents for mailing · May assist with metering outgoing mail. ADDITIONAL FUNCTIONS and RESPONSIBILITIES · Performs other duties as assigned. · Supports the organization's quality program(s). QUALIFICATIONS Education & Licensing High school diploma or GED required. Experience One year of clerical or customer service experience or equivalent combination of education and experience required. Skills & Knowledge ·...

PRIMARY PURPOSE :   To provide assistance to the claim staff by set up of new notices of loss in the system, validating coverage, responding to customer inquiries and performing a variety of administrative tasks.     ESSENTIAL FUNCTIONS and RESPONSIBILITIES Enters claim related information into system received electronically and by phone. Researches and validates coverage and class codes through numerous system look ups. Determines claim type using both criteria and judgement. Follows up with client for missing or incomplete information. Completes Notice of Loss and acknowledgement letters according to state jurisdiction. Completes variety of data changes Researches legal and other documents received to determine need to set up new claim Answers phone related inquiries ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's service standard and quality program(s). Education & Licensing High...