10 claims analyst ii jobs found in Charlotte

The Professional Review Analyst analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. Candidate must be located in the greater Charlotte, North Carolina Region and able to attend in office training for a minimum of 1 week at start of employment. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical...

The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established reserving authority limits Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of claims...

Job Description: Pacific Life is investing in bright, agile and diverse talent to contribute to our mission of innovating our business and creating superior customer experience. We’re actively seeking a talented Sr. Investment Accountant II to join our PLA&R Investment Accounting Solutions in Charlotte, NC; Newport Beach, CA. This role will be on-site. As a Sr. Investment Accountant I, you’ll play a key role in Pacific Life’s growth and long-term success by supporting accounting systems used by asset class teams to ensure the success of reporting of investments in management, IFRS, GAAP, and Statutory statements. This role will be supporting Pricing Analytics, Investment accounting and reporting process, NAIC Ratings Process, and project work. You will fill a new role that sits in a team of 16 people in Investment Accounting.   Your colleagues will include the AVP of Finance and Reporting, fellow investment accounting professionals, Operations professionals, and...

The Liability Claims Specialist (floater) assists the team with providing claims handling coverage when needed. This role aims to achieve optimal outcomes and continuity for both CorVel and our clients. The Floater handles litigated files and works with delegated limited authority for a variety of clients on a temporary basis, adhering to company best practices. This is a remote role. Candidates residing in the east coast are preferred. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Work with a variety of clients on a temporary basis to provide claims handling coverage during periods of high demand Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and liability position of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and...

The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic claims as necessary Additional duties as assigned...

CorVel is actively seeking an experienced North Carolina Auto and General Liability Claims Specialist to join our growing team. In this role, you will manage low to mid-level complex claims — including bodily injury and property damage — with a focus on achieving optimal outcomes for both CorVel and our clients. North Carolina experience and North Carolina Municipality experience is a plus. This is a remote role. Must have an active North Carolina Independent Adjuster License. Candidates located in Virginia, North Carolina or South Carolina are preferred, as occasional travel is needed to the client in Raleigh, NC. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Manages non-complex and non-problematic medical only claims and minor lost-time liability claims under close supervision Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within...

The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic claims as necessary Additional duties as assigned...

Who we are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets, manage risks and provide for retirement security.   Information Technology  At AIG, technology is at the heart of everything we do, from underwriting risks to processing claims. The Information Technology team equips our employees with the latest tools to complete their work efficiently and with the highest standards of excellence. The team is responsible for shielding the company’s systems from security risks, while designing technology strategies that enable AIG’s businesses to achieve their goals. AIG’s Information...

The 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 remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

An exciting opportunity exists to join the ProAssurance family of companies! Our mission is powerful and simple: We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance? At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, leadership, relationships, and enthusiasm—and want to build their career with a great company where they can be their authentic self and feel valued, recognized, and rewarded for their contributions. ProAssurance specializes in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. We are an industry-leading specialty insurer, with job opportunities in much of the contiguous United States. This position supports our workers' compensation line of business, Eastern...