15 workers compensation claims specialist jobs found

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)     The Medical Only Claims Specialist I is an entry level claims role. The incumbent is expected to be proficient with the Claims unit, policies, processes, procedures, and terminology.      The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision.     Primarily responsible for the investigation and management of workers’ compensation claims. Conducts a 1 to 3-point contact on the managed claims, which is dependent on either the facts of the case or the claim type; determines compensability of claims, manages the medical treatment program, and assists in the return-to-work process. This includes calling and discussing potential claim activity and work-related injuries with policyholders, claimants, providers, attorneys, agents, and state agencies....

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)   This is an entry-level position. This position leads to a Medical Only Claims Specialist I and is expected to last up to 12 months. Upon completion of the training plan the incumbent is expected to be proficient with the Medical Only Claims policies, processes, procedures, and terminology related to the job. In addition, the incumbent will be proficient in the job responsibilities and tasks of the Medical Only Claims Specialist I position description. The incumbent will be evaluated on their progress and successful completion of the training plan each quarter. Upon satisfactory completion, the incumbent will be eligible for the Medical Only Claims Specialist I position.  Medical Only Claims Associate will work with all members of the team and may receive direction, support, and instruction from the Manager or Medical Only Claims Specialists depending on the assignment....

SUMMARY Medical Bill Review Specialist I Primarily responsible for analyzing bills for multi-state Workers Compensation medical claims to determine appropriateness of services billed. Responsible for analyzing simple billings by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes. Responsible for making bill review processing determinations according to rules, regulations, and/or third-party partners. Medical Bill Review Specialist II Primarily responsible for performing technical review of more complex medical bills, including modifiers, anesthesia, & psychiatric. Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes and excessive charges. Also responsible for analyzing assigned medical bills to determine compliance with business rules, client specific requirements and multiple state rules, regulations and...

SUMMARY:  Perform production and quality audits to ensure operations are effective, consistent and in compliance with business rules and processes.  Primary focus includes, but is not limited to, auditing the Service Center teams Claims Support, Business Development, Billing Service Center.   Responsible for performing administrative and support tasks which may be highly confidential and sensitive in nature. PRIMARY RESPONSIBILITIES:  ·    Conducts and executes the production statistics and quality audits of completed work in comparison to established documented procedures to determine accuracy within the Service Center in a timely fashion while being in compliance with statutory regulations (30%). ·    Partner with management, union representatives, human resources, and team members to establish and maintain production and quality standards for Service Center teams (15%).  ·    Compile, create, prepare and review information, audits and reports for accuracy as requested or...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, this specific role could have the flexibility to work from home up to 3 days per week. Auto-Owners Insurance, a top-rated insurance carrier, is seeking motivated nursing professional to join our team. The position requires the person to: Collaborate with claims associates to provide medical expertise in the investigation, evaluation, and appropriate resolution of injury claims including workers’ compensation, personal injury protection (no fault), and liability. Evaluate medical records for relatedness to the injury and appropriate utilization of medical treatment and services. Prepare and deliver trainings to claims staff via a variety of modalities...

OBJECTIVE Complex Casualty Claims Specialist Objective To assure the consistent application of company procedures and practices in casualty claims handling and disposition of large complex casualty claims within the division. To ensure that claims are properly investigated, evaluated, and resolved within the company’s contractual and legal obligations. To provide appropriate and equitable resolution to claimants while protecting Farm Bureau insureds within the confines of the insurance policy and to aid in the retention and growth of business. RESPONSIBILITIES Complex Casualty Claims Specialist Responsibilities Investigate, control, and negotiate all casualty claims involving complex issues beyond the expertise of claim representative as such cases are discovered.   Understand and apply skills and awareness necessary to achieve effectual casualty claim settlements and remain current in the knowledge of the tools of...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   $5,000 Sign-On Bonus Payment Terms: $2,500 paid after 30 days of employment, $2500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $28,500 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  · Tuition...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   $5,000 Sign-On Bonus Payment Terms: $2500 paid after 30 days of employment, $2500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $28,500 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   $5,000 Sign-On Bonus Payment Terms: $2500 paid after 30 days of employment, $2500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $28,500 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   $5,000 Sign-On Bonus Payment Terms: $2,500 paid after 30 days of employment, $2500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $28,500 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  · Tuition...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   $5,000 Sign-On Bonus Payment Terms: $2,500 paid after 30 days of employment, $2500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $28,500 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  · Tuition...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   $5,000 Sign-On Bonus Payment Terms: $2,500 paid after 30 days of employment, $2500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $28,500 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  · Tuition...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   $5,000 Sign-On Bonus Payment Terms: $2,500 paid after 30 days of employment, $2500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $28,500 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  · Tuition...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   $5,000 Sign-On Bonus Payment Terms: $2,500 paid after 30 days of employment, $2500 paid after 90 days of employment. Join America’s most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure · UNLIMITED LEADS, at no cost · Elevated tiered commissions for the first 12 months · Annual Base Pay $28,500 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages:  · Medical, dental and vision benefits  · 401k Match  · Paid parental leave and adoption assistance   · Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays  · Paid volunteer day annually  · Tuition...