2 jobs found in Suwanee

Description The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim’s management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.   This is a hybrid position. Candidates residing within 50 miles of the following offices are quired to report onsite twice a month: Suwanee, GA; Irving, TX; Boston, MA; and Plano, TX. Please note this is subject to change.    The starting salary for the role is $56,000. The actual compensation for this role will depend on the candidate’s geographic location,...

Description Review, analyze and process basic to complex medical bills for relatedness and appropriateness. (Complexity is based on dollar amount of bill and treatment received/coding used) Applies technical knowledge and judgment to make accurate, timely, and compliant payment decisions while meeting production requirements. Uses advanced data entry skills and multiple applications simultaneously., Responsibilities Audit medical bills for relatedness and appropriateness for WC or Auto claims, using critical thinking skills to make accurate, timely, and compliant payment decisions while meeting production requirements Identifies and resolves discrepancies in transactions/documents reviewed. Refers difficult or questionable transactions to Supervisor for assistance in resolution. Maintains appropriate transaction records and generates activity reports. Provides guidance and assistance to internal customers, providers, claimants, and/or policyholders on...