7 senior complex claims specialist jobs found

The 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 role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives 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 and non-problematic medical only claims and minor 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 Float 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 role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives 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 and non-problematic medical only claims and minor 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 Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established 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 Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of...

As the Provider Retention Leader , you will be responsible for ensuring best-in-class service and support for the dentists that provide the greatest value to Guardian’s proprietary network, resulting in important network continuity for our members.  This role is vital to the Guardian network foundation of retaining high-quality providers by quickly and efficiently resolving service-related inquiries, identifying and addressing pain points, and driving continuous improvement in provider experience. On day one this will be an individual contributor role, but over time you will hire and lead a small team of retention specialists focused on proactive outreach, issue resolution, and relationship management.  Strong collaboration with internal stakeholders across Network Operations, Network Recruitment, Provider Relations, Claims and Service will ensure alignment and seamless execution.    You are A strategic thinker with a passion for customer experience and operational excellence...

Company: Marsh McLennan Agency Description: Marsh McLennan Agency's East Region is a leader in the employee benefits marketplace. Our associates simplify employee health and welfare benefits and risk management for regional, national, Fortune 500 and Fortune 1000 companies. We value integrity, collaboration, passion, innovation, and accountability, and we are committed to making a difference in the moments that matter for our colleagues, clients, and communities. BRIEF DESCRIPTION As part of our Consulting Client Service Team, the Senior Benefit Specialist plays a vital role in ensuring a high degree of client satisfaction and retention, working collaboratively with a cross-functional team that includes Producers, Strategic Account Executives, and Financial Consultants. The primary responsibility of this role is to take proactive ownership of the daily client support for all services and products provided, ensuring alignment with the strategic vision of our...

A Day in the Life   Looking for variety and a challenge? Property loss prevention surveys range in size and scope. One day you may be looking at a metal working facility, the next, a university campus. The key to success isn’t about being the expert in every occupancy, it’s about building trust and cross-functional relationships with stakeholders through effective communication. After the survey is complete, it’s time to tap into your strong analytical skills. Utilizing internal and external guidelines, leading edge tools and methodologies you develop loss prevention solutions to any identified hazards. Need that occupancy expertise after all? We have a Technical Integration Group as well as a vast team with years of experience to provide training, mentorship, and collaboration. Our Field Risk Engineers receive a wide range of benefits including a company car, the freedom to manage their own schedules, ability to work from home; as well as many other company wide benefits...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Risk Control Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope,...