38 bill review analyst i jobs found

The Bill Review Analyst is responsible for reviewing, auditing and data-entry of medical bills for multiple states and lines of business. This is a hybrid position requiring in person at Folsom, CA office for minimum of 90 days. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts May consult reference materials in the auditing process Based upon situation or state-specific cases, meet 98% accuracy, 10,000+ keystrokes per hour Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of medical terminology, workers’ compensation billing guidelines and fee schedules Knowledge of CPT/ICD/HCPS coding Knowledge of UBO4/DWC-9/DWC-10 and CMS 1500 form types preferred Strong interpersonal skills and commitment to customer service Ability to work independently and in a team...

The Vice President of Claims will execute on the strategic goals and vision of the company. This includes the management and Development of staff and revenue. This role requires a high level of analytical, interpersonal, and organizational skills and will be responsible for claims quality, customer satisfaction and retention. The VP of Claims will also identify, facilitate and participate in essential strategic projects for operational improvement as well as support and directly participate in sales presentations/RFP responses and the development of opportunities to promote the company’s overall growth.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Position shares responsibility for meeting and exceeding market profit and revenue goals annually Position shares responsibility to grow market share through accountability for customer satisfaction and retention Participates in Marketing and Sales presentations of prospective clients and cross...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description Responsible for investigating and confirming the facts of loss for advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Candidates local to our office in Ontario, California will start and train in-office. Hybrid/remote options available within 6-12 months. Every claim presents a new challenge. This role is ideal for someone who enjoys problem-solving, analyzing information, and making confident decisions while supporting customers and internal partners. Key Responsibilities • Applies increased...

The Senior Corporate Paralegal is responsible for supporting the Legal Department in the preparation, review, and management of customer-facing and corporate agreements. This role partners closely with internal business stakeholders to facilitate efficient contract execution, ensure compliance with applicable laws and company policies, and support the organization’s commercial operations under the direction of the VP of Legal Services. This is a hybrid or remote role in the Irvine, CA or Downers Grove, IL office.    ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Prepare, review, and negotiate a high volume of customer contracts, including master service agreements, amendments, and related commercial documents Draft, review, and manage non-disclosure agreements (NDAs), letters of intent (LOIs), and other preliminary business arrangements Partner with internal departments to support contract lifecycle management and ensure alignment with business objectives Coordinate...

Together we fight for everyone’s opportunity for a better financial future. We will do this together — with customers, partners and colleagues. We will fight for others, not against: We will stand up for and champion everyone’s access to opportunities. The status quo is not good enough … we believe every individual and every community deserves access to financial opportunities. We are determined to support both individuals and communities in reaching a better financial future.  We know that reaching this future depends on our actions today. Like our Purpose Statement, Voya believes in being bold and committed to action.  We are committed to a work environment where the differences that we are born with — and those we acquire throughout our lives — are understood, valued and intentionally pursued. We believe that our employees own our culture and have a responsibility to foster an environment where we all feel comfortable bringing our whole selves to work. Purposefully...

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 position. 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...

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.  JOB DESCRIPTION: For over three decades, CNA has been a trusted provider of insurance solutions for technology companies of all sizes, from emerging startups to global enterprises—across software, IT services, hardware, media, and telecommunications. Our Global Technology Practice delivers specialized coverage including Technology Errors & Omissions (Tech E&O), Cyber Liability, comprehensive international solutions, to complement our traditional Property & Casualty lines. With deep industry expertise, flexible capabilities, and a collaborative approach, we craft innovative insurance programs tailored to the unique needs of each client. CNA remains the carrier of choice...

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.  JOB DESCRIPTION: Grow your underwriting career at a company that offers access and collaboration with the home office, ample promotional opportunities and evolving underwriting centers that allow you to focus on larger accounts. The Life Sciences Underwriter is responsible for using technical, sales and analytical skills to provide insurance solutions that help CNA’s customers manage risk. The Underwriter will have a thorough understanding of CNA’s strategies and appetites and will use internal and external data to make appropriate individual and portfolio risk decisions. Essential Duties and Responsibilities: Underwriting Expertise ·   Reviews applications and financial...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description The Investigative Specialist will work through interesting and unique claims files to verify the validity of the claims. They will also be responsible for investigating and confirming the facts of loss for basic to advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. This position supports our West Coast claims team. The ideal candidate will be located in the Pacific Time Zone; however, candidates outside the Pacific Time Zone may be considered if they are able to work Pacific Time Zone hours. Every claim...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description National General Insurance is currently hiring an experience Bodily Injury Telephone Adjuster. The ideal candidate will be based in one of the following Pacific time zone states: California, Nevada, Oregon, Arizona, and possess experience in handling homeowner, commercial, or auto liability claims. Candidates must be able to work 8am--5pm Pacific time zone hours. Litigation experience may be necessary for this role. The ideal candidate will possess strong analytical skills, excellent attention to detail, and the ability to effectively manage and negotiate claims. Responsible for investigating and...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description Responsible for investigating and confirming the facts of loss for advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Every claim presents a new challenge. This role is ideal for someone who enjoys problem-solving, analyzing information, and making confident decisions while supporting customers and internal partners. Key Responsibilities • Applies increased experience in the Adjuster II level or a rotation into a specialty position (Coverage, Investigation Specialist, Total Loss, Initial Handler,...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description This role utilizes analytical skills to create a comprehensive estimate of damages for 1st and 3rd party material damage claims leading to the proper disposition. National General is seeking a Field Auto Appraiser to join our Santa Rosa, CA Claims team . This is a remote, territory-based role that will service the corridor between Satna Rosa, CA and San Rafael, CA. The ideal candidate will have experience managing a variety of auto claims, conducting vehicle inspections, and using CCC ONE estimating software to prepare accurate damage estimates while working closely with repair...

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 position. 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...

Description Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers an exciting opening for a Senior Workers Compensation Claims Specialist within the West Region!   The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads.   Depending on your overall skills and experience, you may be considered as a Senior Claims...

The Senior WC 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 position. 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...

The Workers’ Compensation 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 Workers’ Compensation 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 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...

The Lien Resolution Team Lead works together with the Claims Adjusters, Supervisors and Manager to facilitate expedited closure of claim files. The Team Lead will negotiate and resolve medical treatment liens in a timely and cost-effective manner while assisting the Lien Resolution Supervisor with guiding, monitoring and conferring with the other Lien Specialist. Under the direct supervision of Management, position supports the goals of their department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Thoroughly review claim files and provide detailed analysis of defenses to claims adjuster Make and receive calls to lien claimants to obtain documents for review Attempt to resolve treatment liens via telephonic or e-mail negotiations Prepare hearing packets for lien hearings Attend lien conferences at WCAB, remotely and in-person as needed   Review/approve invoices from Specialists...

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 position. Candidate must reside in California. 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...

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 position. 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...

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 position. 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...