11 claims support representative jobs found in Bradenton, FL

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....

Reports to: Head of TPA Claims Summary/Objective : Oversees direct reports (6-7 Full Time direct reports) in determining coverage, compensability, benefits due; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; to identify subrogation of claims, clear and concise action plans, reserving and settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Review, assign and supervise all claim activity for designated claims to ensure compliance with company best practices, client specific handling instructions and in accordance with applicable laws. Responsible for oversight in assessing compensability, coverage, AWW/CR and timely payments. Reviews and approves settlement of claims within designated authority. Responsible for overseeing reserve establishment and/or oversight of...

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....

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 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,...

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...

Providing quality service and accurate results supports Ascential Care Partner’s primary mission as a trusted adviser to our clients. As Nurse Case Manager (full, or hybrid), you will be working in a fast-growing company and work environment. Your valuable role requires working closely with treating physicians/providers, employers, claim representatives, legal representatives, and the injured/ disabled person to create and implement safe and effective Return to Work plans, and facilitate appropriate and cost-effective medical services to achieve maximum medical improvement and recovery. As a member of our team, you will continue to reinforce Ascential’s mission of being a market leader and collaborative partner to current and prospective customers and partners. Job Duties: Reasonable accommodation may be provided to enable individuals with disabilities to perform the essential functions. Case Management & Application of Knowledge: Demonstrate and apply 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...

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...