77 claims administrator jobs found

Title: Claims Processor 1                             Department: Claims Union: OPEIU 29                                               Grade: 16 Position Summary The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers’ Compensation, or disability.  May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned....

Title:   Claims Processor 2   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   17 Position Type:   Non-Exempt   Hours per Week:   40 Position   Summary The Claims Processor 2 provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key   Duties   and   Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries....

Title: Claims Processor 3                             Department: Claims Union: OPEIU 29                                               Grade: 18 Position Summary: Responsible for independently processing all types of health claims on an assigned Plan(s), and for assuming primary or back-up customer service responsibilities as necessary. General Duties: Independently process all types of health claims in accordance with assigned Plan(s). Perform customer service responsibilities for providers and members as needed. Generate correspondence and form letters. Maintain current knowledge of assigned Plan(s) and effectively apply this knowledge in the payment of claims. Assist other processors with claims as needed to minimize backlog. Perform other related duties and special projects as assigned. Minimum Qualifications: High school diploma or general education degree (GED); two years related experience processing all types of group health and/or dental...

 LOCATION: Remote, California  Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and “bring it” every day, EPIC is always looking for people who have “the right stuff” – people who know what they want and aren’t afraid to make it happen. Headquartered in New York City and founded in 2007, our company has over 4,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees.  Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in your...

LOCATION: Remote in California  Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and “bring it” every day, EPIC is always looking for people who have “the right stuff” – people who know what they want and aren’t afraid to make it happen. Headquartered in New York City and founded in 2007, our company has over 4,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees.  Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in your...

Position Summary:   The primary functions of an Account Coordinator are to coordinate workflow with Account Managers for clients and to establish depth in the client relationship. A self-starter who shows motivation, confidence, ambition, resilience, embraces challenges, sets goals, sets higher expectations, focused on successfully outcomes, promotes teamwork, promotes, and shares best practices, willingness to help others. Must have experience and/or exceed expectations for promotion for a period for proven success record. Relies on extensive experience and judgement to plan work and accomplish department goals.  Some supervision necessary. Supervisory Responsibilities:   None Essential Tasks: The essential functions include but are not limited to the following: Coordinate management of client accounts with Account Executive. Mentor to Account Coordinator I and II. Prepare group meeting and enrollment materials for clients. Conduct group meetings and employee...

Position Summary The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions. Provides written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Updates files, including documenting system notes of conversations or action taken. Performs tasks associated with the administration of retirement and health and welfare benefits such as; Processing and/or sending mailers or required forms as requested by members. Processing and/or sending correspondence related to member or claims...

Primary Details Time Type: Full time Worker Type: Employee The Opportunity: This position will assist in the delivery of a compliance quality control function by performing compliance reviews and identifying and mitigating potential risks. Location: o California o Council Bluffs, Iowa o Fargo, North Dakota o Eau Claire, Wisconsin o North Carolina • Work Arrangement: This role will be remote unless you are within 50 miles of a NAU office, which then you will be required to work on a hybrid schedule. • The salary range for this role is: o California ($28.00 - $42.00) o Council Bluffs, Iowa ($25.50 - $38.25) o Fargo, North Dakota ($25.50 - $38.25) o Eau Claire, Wisconsin ($25.50 - $38.25) o North Carolina ($25.50 - $38.25) Your new role Use established guidelines to review, analyze and make recommendations regarding basic RMA (Risk Management Agency) required compliance reviews and make necessary corrections to insured’s Schedule of Insurance, acres, yield, etc....

Title:   Supervisor, Claims   Department:   Claims Bargaining Unit:   NBU   Grade:   N/A Position Type:   Exempt   Hours per Week:   40 Position   Summary The Supervisor, Claims provides daily leadership and supervision to a Claims team in accordance with Company guidelines, client needs, and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key   Duties   and   Responsibilities Provides daily leadership and supervision to staff consistent with Company values and mission. Assigns, distributes, and monitors quality and quantity of work produced, ensuring employees are held accountable for consistently meeting quality and production requirements. Develops staff through performance management, goal setting, training, and effective employee relations. Maintains current knowledge of assigned...

Title:  Customer Care Advocate  Department:  Customer Care Union:  Teamsters 853  Grade:  3 FLSA:  Non-exempt  Hours per week:  40 Position Summary The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions. Provides written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Updates files, including documenting system notes of conversations or action taken. Performs tasks associated with the administration of retirement and health and welfare benefits such as; Processing and/or...

ABOUT HUB: In a rapidly changing world, HUB advises businesses and individuals on how to prepare for the unexpected. As one of the worlds' largest insurance brokers, our focus is dedicated to providing our customers with the peace of mind that what matters most will be protected-through unrelenting advocacy and tailored insurance solutions that put our clients in control. Our growing team of professionals across North America represents a broad, deep and one-of -a kind aggregation of entrepreneurs and leaders recognized for their excellence throughout the insurance community. THE OPPORTUNITY: The Property & Casualty Claims Advocate facilitates a smooth interaction between the client and the carrier regarding property & casualty issues including claim reviews and ongoing claim issues. Monitors ongoing property & casualty activity and alerts HUB Producer team to any potential claim or potential loss control issues. DUTIES & RESPONSIBILITIES...

The Quality Assurance Nurse is responsible for case management quality assurance and mentorship of operations staff, providing tools and calibrating processes, while ensuring consistent delivery of CorVel’s case management services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Develop, implement, and provide ongoing quality assurance calibration of processes as well as a case management mentoring, both managed and delivered at the operational level Educate and equip operations with performance measurement and reporting tools that can be used to objectively measure and grow operations Provide national account and regulatory quality oversight As applicable, provide oversight and management of URAC compliance and renewals Work with executive, general and case management department management to ensure the case management department successfully implemented and is adhering to CorVel standards (including quality assurance, reporting, and...

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 Litigation Counsel | Public Entity Pooling | Hybrid Are you looking for an opportunity to join a close-knit collaborative team working for a global industry leader?   Enjoy flexibility and autonomy in your daily work, your location, and your career path. Hybrid setting 2 days in the Sacramento, CA Sedgwick office, and 3 days' work at home. Approximately ~5% travel in San Francisco Bay Area. PRIMARY PURPOSE OF THE ROLE: The Designated Litigation...

The Baldwin Group is an award-winning entrepreneur-led and inspired insurance brokerage firm delivering expertly crafted Commercial Insurance and Risk Management, Private Insurance and Risk Management, Employee Benefits and Benefit Administration, Asset and Income Protection, and Risk Mitigation strategies to clients wherever their passions and businesses take them throughout the U.S. and abroad. The Baldwin Group has award-winning industry expertise, colleagues, competencies, insurers, and most importantly, a highly differentiated culture that our clients consider an invaluable expansion of their business. The Baldwin Group (NASDAQ: BWIN), takes a holistic and tailored approach to insurance and risk management. The Benefits Technology Specialist works alongside the technology team and the Employee Benefits business segment by configuring and maintaining the benefits eligibility management system offered to clients. The Benefits Technology Specialist is responsible for ensuring...

For more than 75 years, Colonial Life & Accident Insurance Company has had one mission: to help America’s workers preserve and protect the vitally important things they work so hard to build. Headquartered in Columbia, South Carolina, we offer a wide range of financial protection options, helping more than 3.7 million people in over 86,000 companies. In addition to our personal benefits counseling expertise, we’re a pioneer of payroll deduction and innovator of enrollment technology. Our end-to-end capabilities and commitment to going above and beyond enable us to provide unmatched customer service. With more than 10,000 sales representatives and more than 1,000 home office professionals, we’re here to help during life's most challenging times. General Summary: General Summary This position is responsible for providing training and development support to new 1099 sales managers and reps across their specified territory. This includes driving territory prospecting...

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our  journey as we strive to transform the insurance  carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible. Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our  internal and external communities better everyday! Learn more...

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 Office Assistant | Ontario, CA Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.  Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.  Take advantage of a variety of professional...

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 Team Lead I is responsible for managing complex and occasionally highly complex vendor relationships, assessing vendor training needs, and monitoring vendor performance. The individual monitors staffing levels and workloads, provides coaching and mentoring, and participates in performance reviews. Key Responsibilities • Oversees complex and occasionally highly complex claims involved in appraisal, arbitration, or mediation • Oversees complex and occasionally highly complex specialized claims (e.g., business interruption, loss of income, E&O policies) • Oversees complex and occasionally...

ABOUT HUB: In a rapidly changing world, HUB advises businesses and individuals on how to prepare for the unexpected. As one of the worlds' largest insurance brokers, our focus is dedicated to providing our customers with the peace of mind that what matters most will be protected-through unrelenting advocacy and tailored insurance solutions that put our clients in control. Our growing team of professionals across North America represents a broad, deep and one-of -a kind aggregation of entrepreneurs and leaders recognized for their excellence throughout the insurance community. THE OPPORTUNITY: The Benefits Technology Specialist is responsible for Benefits Administration system configuration, testing, ongoing service, annual renewal changes and presentation of the system to clients. The Benefits Technology Specialist partners with account service teams to support and exceed client expectations with the delivery of HUB’s benefits technology solutions. DUTIES &...

Why Join GEICO? At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.   Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive on relentless innovation to exceed our customers' expectations while making a real impact on local communities nationwide.   Founded in 1936, GEICO is a member of the Berkshire Hathaway family of companies and one of the largest auto insurers in the United States. When you join our company, we want you to feel valued, supported, and proud to work here. That's why we offer the GEICO Pledge: Great Company, Great Culture, Great Rewards, and Great Careers. At GEICO Technology Solutions , we are on a journey to revolutionize the Insurtech space with our technology offerings in the Insurance market and provide excellent service with better efficiency to our Customers and Associates. To...