22 claims examiner i jobs found

Amazing opportunity for career progression. Globe Life Family Heritage Division is looking for an Claims Examiner I to join their team in the Claims Health FHL department for our corporate location in Broadview, Ohio. This is a full time opportunity working on-site with the possibility to work remote based on performance. We offer a competitive salary with a great benefits package, including 401(K) match, medical, dental, and vision health plans, short - term and long-term disability, paid time off, tuition reimbursement and other career development opportunities. Come join our team! Job Duties Prompt and timely processing of supplemental accident, health and life claims accurately within deadlines Follow required department procedures and guidelines to ensure compliance with HIPAA, legal and insurance laws and regulations, and state specific policy and benefit contract provisions Phone correspondence with medical facilities, providers, policyholders, and agents Review...

Amazing opportunity for career progression. Globe Life Family Heritage Division is looking for an Claims Examiner I to join their team in the Claims Health FHL department for our corporate location in Broadview, Ohio. This is a full time opportunity working on-site with the possibility to work remote based on performance. We offer a competitive salary with a great benefits package, including 401(K) match, medical, dental, and vision health plans, short - term and long-term disability, paid time off, tuition reimbursement and other career development opportunities. Come join our team! Job Duties Prompt and timely processing of supplemental accident, health and life claims accurately within deadlines Follow required department procedures and guidelines to ensure compliance with HIPAA, legal and insurance laws and regulations, and state specific policy and benefit contract provisions Phone correspondence with medical facilities, providers, policyholders, and agents Review...

SUMMARY OF INSURANCE GROUP HEALTH CLAIMS ADJUSTER: Our client is in search of a Group Health Claims person for their Near West Suburban Chicago Office. DUTIES & RESPONSIBILITIES: Independently process routine Medical, Dental and/or Hospital claims Obtain additional information regarding claims from providers and members when necessary Meet quality claims processing standards THIS IS A FULL-TIME PERMANENT POSITION WITH BENEFITS Job Requirements: REQUIREMENTS OF INSURANCE GROUP HEALTH CLAIMS: 2+ years of Group Health Claims Experience within an Insurance Company, Union or TPA environment Knowledge of Current Procedure Terminology (CPT), ICD-9 and ICD-10 Codes Customer service experience Helpful Strong interpersonal skills Excellent oral and written communication skills RELATED TERMS:   Claims Adjuster, Claims Examiner, Insurance Claims, Health Claims Adjuster, Group Health Claims, Group Health, Benefit Claims, Medical...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team Supervisor...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team...

The ideal candidate will be experienced in Bodily Injury Claims and live in the PST or MST states. Primary Purpose: Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. Essential Duties and Responsibilities: Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. Establish an investigative plan; initiate investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves and adjust or opens hidden exposures as necessary Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to manager for approval Evaluate settlement alternatives by reviewing regulatory compliance and fair claims practices;...

The ideal candidate will be experienced in Bodily Injury Claims and live in the PST or MST states. Primary Purpose: Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. Essential Duties and Responsibilities: Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. Establish an investigative plan; initiate investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves and adjust or opens hidden exposures as necessary Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to manager for approval Evaluate settlement alternatives by reviewing regulatory compliance and fair claims practices;...