13 claims intern jobs found in Syracuse, NY

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This role is available for remote, onsite and hybrid work arrangements. 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 terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in...

The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer Collects data and analyzes information to make decisions regarding certification or denial of treatment Documents all work in the appropriate manner Promotes utilization review services with stakeholders Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have thorough knowledge of both CPT and ICD coding Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Assistant | Syracuse, NY | Entry Level Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?  A stable and consistent work environment in an office setting  Career development and promotional growth opportunities through increasing responsibilities  A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs...

You have a clear vision of where your career can go. And we have the leadership to help you get there.  At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.  Under general direction manages a team of claims professionals for a specific line of business. Responsibilities include overseeing all claim resolution activities of the team to ensure accurate and timely disposition of claims in accordance with company protocols. This position works within broad authority limits and is accountable for implementing company initiatives and driving overall team results. JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Oversees the work activities of a team of claims professionals and has full management responsibility by setting and communicating expectations,...

CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy , creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com .   The Role CCC is now hiring in the Syracuse NY area for a Vehicle Inventory Rep & Auditor with target compensation of $275 per month with the potential to earn more plus mileage and new hire incentives. This is a piece rate role compensated based on...

The Workers’ Compensation Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The WC Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises WC claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional...

The Subrogation Specialist identifies subrogation potential within company standards and best practices and handles recovery for Workers Compensation and Property/Auto damage. This role prepares lien notice letters, negotiates settlements, and provides customer service to all stakeholders. This role is available for remote, hybrid and onsite work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify subrogation potential based on facts of loss, working closely with Workers' Compensation Claims Specialists or Liability Claims Specialists (property/auto) Contact liability insurance carriers or third-party attorneys to negotiate settlements Identify at fault parties and send lien notice letters of recovery rights via mail/email Maintain diary to follow up on claims status and Third Party settlements Negotiate recovery of clients’ damages Communicate claim status with claimant and clients' risk management Adhere to client guidelines & participate...

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early...

We’re thrilled that you are interested in joining us here at the Amynta Group! As a member of Oryx Insurance Brokerage, Inc claims team, utilize knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex construction nature in order to achieve appropriate outcomes. In this position you will administer and resolve Workers Compensation claims in a timely manner in accordance with legal statues, policy provisions and carrier guidelines. Responsibilities: Promptly investigate all assigned claims with minimal supervision, including those of a more complex Construction nature. Determine coverage, compensability, potential for subrogation recovery, and other offsets  (when applicable). Alert Supervisor and carriers Special Investigations Unit to potentially suspect claims. Ensure timely denial or payment of benefits in accordance with jurisdictional requirements. Establish appropriate reserves with documented...

The WC Disability Claims Specialist manages within company best practices workers’ compensation claims to best possible outcome, supporting the goals of claims department and of CorVel. This role manages the claims toward closure and looks for settlement opportunities throughout reviews. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim Reviews for validity and compensability of the claim Reviews and revises reserve and authorizes payments within reserving authority limits Ensures timely and accurate payment of WC claim benefits, including indemnity and medical Initiates investigations, including alive and well checks as needed to confirm continued payment of benefits Manages workers’ compensation claims toward closure (targeted case load is 250–300 files) Develops strategies and pursues settlement and/or claim closures, whenever possible Communicates claim status...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts with the...

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...

We’re thrilled that you are interested in joining us here at the Amynta Group! As a member of Oryx Insurance Brokerage, Inc claims team, utilize knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex construction nature in order to achieve appropriate outcomes. In this position you will administer and resolve Workers Compensation claims in a timely manner in accordance with legal statues, policy provisions and carrier guidelines. Responsibilities: Promptly investigate all assigned claims with minimal supervision, including those of a more complex Construction nature. Determine coverage, compensability, potential for subrogation recovery, and other offsets  (when applicable). Alert Supervisor and carriers Special Investigations Unit to potentially suspect claims. Ensure timely denial or payment of benefits in accordance with jurisdictional requirements. Establish appropriate reserves with documented...