6 claims examiner associate jobs found

Company Details   Preferred Employers Insurance, A Berkley Company specializes in providing workers’ compensation insurance to California business owners. The company serves three major Product/Client Segments: Small Business, Mid-Larger Businesses and Group Association Members (Programs). The company’s distribution partners (agents & brokers) number just under 400 locations throughout the state. Preferred serves thousands of policyholders and provides medical claims handling and claims management as needed to care for injured workers. The company is rated A+ Superior by industry-rating organization, AM Best & Company.   Company URL:      https://www.peiwc.com   The company is an equal opportunity employer. Responsibilities Preferred Employers Insurance is entering an exciting chapter of growth, and our Claims team will play a pivotal role in shaping our success in the year ahead. We’re looking for...

Company Details Preferred Employers Insurance, A Berkley Company specializes in providing workers’ compensation insurance to California business owners. The company serves three major Client Segments: Small Business , Mid-Larger Businesses and Programs (Groups & Association Members). The company’s distribution partners (agents & brokers) number 400 locations throughout the state. Preferred serves 11,000 policyholders and provides medical claims handling and claims management for policyholders as needed to care for injured workers. The company is rated A+ Superior by industry-rating organization, AM Best & Company. Responsibilities The Associate Claims Examiner (ACE) utilizes general understanding of department’s operation and objectives.  They are responsible for entering claim indemnity payments, SROI filing, issue Benefit Notices, complete void/stop payment, and reissuing of checks with a 99%...

The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.   This is a remote position in CA. 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 Utilize clinical and/or technical expertise to address the provision of medical care and identify inappropriate billing practices and errors, such as: duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time...

Job Description TITLE:                          Senior Property Adjuster DEPARTMENT :            EMA Loss Adjusting REPORTS TO:               Claims Manager STATUS:                       Regular, Full-Time, Exempt This is a field position in the Los Angeles, CA market. SUMMARY OF JOB PURPOSE :  The Senior Property Adjuster effectively determines and communicates the extent of loss or damage associated with commercial property claims in a variety of business classes. The Senior Property Adjuster is typically assigned loss or damage assessments in a moderate cost range, based on incumbent’s experience and demonstrated ability for handling larger or more complex claims. PRIMARY JOB RESPONSIBILITIES : Investigates insurance claims in any of a variety of settings, including, but not limited to, retail establishments, private or public office buildings, commercial habilitation, hospitality, corporate facilities, transportation sites, manufacturing sites,...

Argo Group International Holdings, Inc .  and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. (“BWS”), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions. Job Description Business Title(s):   Senior Commercial General Liability Bodily Injury Claims Adjuster   Employment Type:   Full-Time   FLSA Status:   Exempt   Location:   In-Office     Summary:    We are looking for a highly capable Senior Commercial General Liability Bodily Injury Claims Adjuster to join our team and work from any   one of   the our   offices in Albany, Chicago, Los Angeles, New York City, Omaha, Richmond (VA),...

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 remote position. 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 Microsoft Office applications Technical...