4 professional review specialist ii jobs found

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...

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 Workers Compensation Claims Specialist within the West Region!   As a Workers Compensation Claims Specialist, you will work 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. You 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 Claims Specialist II,...

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 is responsible for investigating and confirming the facts of loss for first-party Homeowners claims. Determines coverage, evaluates damages, and adjusts and negotiates claims within assigned authority. Partners with internal resources as needed, including subrogation and fraud teams, to support claim outcomes. This position works independently, managing a caseload and prioritizing responsibilities while ensuring timely and accurate claim resolution in accordance with company policies and regulatory guidelines. Build on your property claims expertise with National General Insurance. In this...

The Capture Center Specialist is responsible for quality and process management of our processing of invoices and medical bills for our customers. Depending on the department, this processing might include picking up, receiving, and preparing customer mail for scan; scanning documents on high speed scanners; performing quality checks on the data record associated with documents; interacting with electronic documents in line with our product line expectations; ensuring our final processed work is delivered successfully to our customers; and/or making outbound phone calls to medical providers’ front desks to perform provider demographics verifications.  This is an Onsite role. This role requires driving a 2026 Isuzu 18 Foot box truck locally.  ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies and indexes all incoming faxes to the appropriate file, on a daily and timely basis Scans paper documents and completes imaging process Follows document destruction...