6 claims examiner jobs found

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 is a hybrid position until fully trained. Training will be full-time onsite. 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...

Job Type: Permanent Build a brilliant future with Hiscox   Join our dynamic and forward-thinking Claims team! Here, you’ll be part of an energetic and innovative group, with the chance to help shape insurance products and collaborate with business leaders throughout the organization. Our Complex Claims Specialist-Miscellaneous Professional Liability role is an individual contributor responsible for the handling of mid to high-severity primary Miscellaneous Professional Liability claims for the organization from inception to resolution.  This includes, but is not limited to, insurance agents, property managers, tax preparers, and various consultants. This role is responsible for all aspects of the claims and litigation process, including liaising with external and internal business partners (e.g., outside experts and/or legal counsel; underwriting) as required.  The Role: Adjusts and resolves complex mid to severity claims that include all phases of...

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 Field Adjuster ***5+ years of continuous property insurance adjusting experience involving complex loss valuation and scope analysis (homeowners & commercial property.*** PRIMARY PURPOSE :  Appraisal Assignment Execution •    Review claim files assigned to appraisal to understand the dispute parameters and valuation issues in scope. •    Perform loss inspections as necessary to evaluate disputed damages, including measurements, photo documentation, and...

This is an opportunity to join Ascot Group - one of the world’s preeminent specialty risk underwriting organizations.   Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we’re bound by a common mission and purpose: One Ascot. Our greatest strength is a talented team who flourish in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way.   The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our unique Fusion Model: Client Centric, Risk Centric, Technology Centric.   Built to be resilient, Ascot maximizes client financial security while delivering bespoke products and world class service — both pre- and...

This is an opportunity to join Ascot Group - one of the world’s preeminent specialty risk underwriting organizations.   Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we’re bound by a common mission and purpose: One Ascot. Our greatest strength is a talented team who flourish in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way.   The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our unique Fusion Model: Client Centric, Risk Centric, Technology Centric.   Built to be resilient, Ascot maximizes client financial security while delivering bespoke products and world class service — both pre- and...

Why Arbella? At Arbella, we’re focused on people. We work hard to attract and retain the best. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive salaries and benefits packages. We invest in our employees and encourage them to grow so that we, too, can grow as a company. Other perks include: • Company nurse, nutritional counseling, and mental health resources • Tuition assistance programs • Opportunities to get involved: Arbella Activities Committee, Diversity and Inclusion Council, and more • A company committed to community: volunteer opportunities, employee- led community efforts, and the Arbella Insurance Foundation • Robust training, mentorship, and professional/personal development programs • Colleagues who genuinely care about each other Arbella is committed to building a workplace that’s diverse, inclusive, and equitable for everyone. We’ve created a culture...