125 supervisor claims jobs found

We’re excited you’re considering joining a great place to work!  Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect and is proud to be an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to age, race, color, national origin, religion, sex, gender identity, sexual orientation, genetic information, veteran status, or any other basis protected by local, state, or federal law. About this Position At Texas Mutual Insurance Company, one of the Best Companies to Work for in Texas, we are committed to creating a stronger, safer Texas. We are looking for a dynamic and experienced Supervisor of Medical Management Claims to lead our Austin Corporate Office medical management unit. In this critical leadership role, you will bring medical knowledge and specialized expertise in medical management. You will also combine this with supervisory skills to oversee...

The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a hybrid position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff...

The Hospital Bill Audit Manager is responsible for planning, leading, and coordinating multiple teams of nurse auditors and associated billing staff in a fast paced, productivity-based environment. This role oversees auditors performing varying types of medical bill audits including, but not limited to, medical record audits, hospice, implant, and outpatient or ancillary facility claims. This team also performs onsite and remote hospital bill audits. Must be willing to travel for onsite facility audits and other meetings as needed.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Utilize nursing education, experience, and industry best practices to lead a team of registered nurses to plan, execute and deliver timely and accurate results Assist the Hospital Bill Supervisor in the training, professional development, and retention for the nurse auditors Ensure accuracy of audits through acquired knowledge of client policies, provider contract information, and other...

The Recovery Supervisor is responsible for analysis and monitoring of claims audit data across multiple platforms. The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing of internal and external requests, interdepartmental quality audits and claims processing. Additionally, the supervisor works to reduce response timeframes and mitigate future inquiries or escalations by being proactive, taking ownership of challenges, and formulating solutions to improve overall department activities while maintaining a focus on improving how we deliver service to our customers.     This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Manage team performance by setting and communicating standards and deadlines, measuring results, and providing feedback. Maintain positive morale by leading the team through example and accountability with a focus on helping each member achieve their best performance...

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 through relentless innovation to exceed our customers’ expectations while making a real impact for our company through our shared purpose.  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.  Insurance Unit Manager/Supervisor - Richardson, TX Salary: $80,000-$125,000 annually; this salary is commensurate to experience Are you a dynamic leader with a passion for empowering teams and driving results? GEICO is seeking a forward-thinking and motivated Operations Unit Supervisor / Leader to join our Claims management team. This role offers the opportunity to lead and develop associates in our...

Our Company: At AssuranceAmerica, we are more than a unique blend of insurance assets. We believe in creating a culture where every associate can learn and grow. We strive to create a work environment to meet associate needs and we are determined to achieve excellence in everything we do. This is an opportunity to join a dynamic team in a company that is a leader in the minimum limits auto insurance space and functions with a small company, entrepreneurial style. This position will require someone with an understanding that one needs to have a “roll up your sleeves” attitude to help make things happen. Job Summary: The Intake Representative I will be responsible for handling inbound calls regarding automobile insurance claims. This person will provide excellent customer service by entering new claims in the system and assigning them to the appropriate adjuster. Additionally, this role will also assist customers with existing claims and complete some administrative and...

As one of the leading writers of Federal Crop Insurance, AgriSompo North America combines industry experience, resources, capital and talent to deliver both traditional and innovative crop insurance and productivity tools to farmers, ranchers, insurers and agribusinesses in the United States. Our organization operates within a culture rooted in ethics, integrity and a belief that accountability, collaboration and agility are crucial to long-term success.  AgriSompo North America is a part of AgriSompo, Sompo International’s global agriculture platform. This platform is an integrated underwriting, technology and distribution platform delivering innovate insurance and reinsurance solutions to agriculture partners worldwide.  Sompo International, AgriSompo’s parent company, is a global organization driven by its core values, a carrier that holds promise, trust and the commitment to protect.  Through operating subsidiaries, Sompo International writes agriculture, casualty and...

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Complex Claims Liability Director, TPA Oversight to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency. How you will create an impact As Complex Claims Director – TPA Oversight, you will analyze and process bodily injury and third-party property damage claims by investigating and gathering information to determine the exposure on the claim; ensure proactive claims handling aimed at...

The Setup Team Lead is responsible for assisting and supporting   the Setup Supervisor with ensuring   the Setup Team meets protocol. This role will assist with supervisory functions when the Setup Supervisor is absent. The Setup Team Lead is responsible for ½ production. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Must maintain ½ production quota Organize and distribute claims according to established priority Provide guidance to analysts, aiding with resolution of problems or questions Process complex/problematic claims according to protocol Maintain production standards and production requirements Comply with standard protocol for processing problem claims Function as liaison between analysts and clients Professionally communicate with other offices and internal departments Train new team members Assist co-workers, supervisor and management in accomplishing production goals Maintain HIPAA compliance in all aspects of...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position will be hybrid out of our Dallas, TX or Overland Park, KS office. Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities...

Claims Examiner – Spinnaker Job Title : Claims Examiner – Partner Programs Location: Austin, TX / Dallas, TX / Bedminster, NJ Reports To: Claims Program Manager or Claims Manager About Hippo Hippo exists to protect the joy of homeownership. We believe that insurance should protect the things you treasure through an intuitive, modern experience. We provide tailored insurance coverage and preventative maintenance plans that keep you protected throughout your homeowner journey. We’ll also help you find coverage for everything life brings—from auto to flood—reimagining how you care for your home. About The Role: The Claims Examiner – Partner Programs is responsible for the timely and accurate review and approval of claims exceeding the TPA’s/Claim Administrator’s authority, in accordance with company guidelines, regulatory requirements, and best claim practices. This role analyzes coverage, authority requests for reserves and payment on claims through...

JOIN THE ASSURANCEAMERICA TEAM Do you want to be part of an organization where you are valued, and your ideas and opinions have an impact? Join the AssuranceAmerica team. For more than 25 years, AssuranceAmerica has provided superior property and casualty insurance products through contracted independent agents and directly to customers. Our team succeeds through diversity of thought, experiences, skills, and backgrounds.   Liability Adjuster I The Liability Adjuster I is responsible for the initial handling of claims involving straightforward coverage and liability issues. This role involves managing a caseload of non-complex claims and conducting thorough investigations to determine liability, assess damages, and identify any potential injury exposures. Leveraging a solid understanding of policy language, the adjuster will make informed coverage determinations under the guidance and support of a supervisor.   About the ROLE Each day at...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown   is   seeking   Workers Compensation Senior Adjuster     to join our growing team in   Plano, TX!     The Workers Compensation Senior Adjuster will direct and monitor litigation and more complex claims under the Texas Workers Compensation Act. Provide expertise and recommendations for file handling to produce the most beneficial outcomes for external and internal customers. Provide customer service to internal and external customers in a professional manner.     How You Will Contribute:     Be a leader within the WC Unit Fill some of supervisor duties when supervisor is out Aid in training of staff Follow CSI for Anchor Clients Interpretation and understanding of Texas WC statutory rules, laws, and regulations Establish reserve adequacy on files Direct and...

The Procurement Team Lead position is 50% production and 50% assisting and supporting direct supervisor with ensuring the team meets protocol, as well as performing supervisory duties during the supervisor's absence. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Monitor/Audit and reports for Procurement and clients Monitor/Audit files in Procurement staffs individual service queues via Management Console Tool for accuracy and timely claim processing Assist with Procurement QC queue tickets during high volume times Assist team members with all questions and concerns Answer emails and phone calls from both Procurement and other internal departments and also externally from Clients/Providers regarding any claims processing concerns Additional duties as assigned   KNOWLEDGE & SKILLS: Exceptional organizational skills Ability to work independently and in a team environment Ability to work in a fast paced/production...

The Payment Integrity Supervisor is responsible for the daily activities of payment integrity team related to quality assurance and provider appeals. The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing of internal and external requests, interdepartmental quality audits and appeals. Additionally, the supervisor works to reduce response timeframes and mitigate future inquiries or escalations by being proactive, taking ownership of challenges, and formulating solutions to improve overall department activities while maintaining a focus on improving how we deliver service to our customers.  This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Supervises all daily activities of payment integrity team related to quality assurance and provider appeals Ability to assist team with problem-solving, payer policy and clinical questions regarding audits performed by CERIS Ability to...

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Complex Claims Director – TPA Oversight to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency. How you will create an impact As Complex Claims Director – TPA Oversight, you will analyze and process bodily injury and third-party property damage claims by investigating and gathering information to determine the exposure on the claim; ensure proactive claims handling aimed at the...

Overview The Claims Specalist is responsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process for General liability claims within BI. Responsibilities Maintains appropriate financial accountabilities (reserving) and controls loss adjustment expenses Responsible for handling moderate-to-high complexity commercial general liability losses, including litigated claims. Makes timely and appropriate contacts with interested parties, including, but not limited to the insured, claimant/attorney, witnesses and producers.  Determines, reviews and analyzes coverages that may or may not apply to the claim; Plans, executes and reviews investigations-coverage, liability and/or damages – including the securing...

Who is Federated Insurance? At Federated Insurance , we do life-changing work, focused on our clients’ success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we’re looking for employees who want to make a difference in others’ lives, all while enhancing their own.   Federated’s culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect.  We strive to create a work environment that embodies our values and commitment to diversity and inclusion.  We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities.  Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values. What Will You Do?...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned KNOWLEDGE & SKILLS: Ability to work independently...

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Commercial Liability Claims Adjuster, TPA Oversight to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make your mark in TPA Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency. How you will create an impact Analyze and process first party property damage claims by investigating and gathering information to determine the exposure on the claim; ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through...