3548 claims processor 1 jobs found

The Litigation Processor is responsible for providing clerical support to the General Claims Legal Department by reviewing, analyzing, and processing incoming complaints directed to the Company. Essential Duties and Responsibilities: Provide support to staff attorneys in processing complaints. Provide support to the PIP Litigation team in processing PIP arbitration demands. Provide support as needed to FNOL (First Notice of Loss) Dept in taking claims. Receive, analyze, and process complaints, determine type of lawsuit, and prepare investigation file accordingly.  Assign trail adjuster, submit complaint to staff attorney for review. Process various types of legal letters to defense firms and insureds. Maintain Legal Exchange (electronic billing site) by creating matters, closing matter and processing attorney invoices for payment. Periodic telephone communications with insureds, plaintiff counsel and defense firms regarding the status of legal pleadings....

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:   This position will be required to report in office as outlined by the management team. Candidates should expect to report in office at least once per month for job purposes. Eligible candidates should reside within a commutable distance to the ACG Administrative Office Building located at: 1 Auto Club Drive Dearborn, Michigan 48126 Michigan Claim Support Assistant I- AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Provide support to the Claim department by completing intermediate level tasks that require an understanding of claim or business functions and processes and the organization and workflow for one or more claim lines of business and multiple claim systems. Work under limited supervision to complete a set of related...

The Cross Family of Agencies welcomes you. We need your talent and expertise. Personal Lines Processor A Personal Lines Processor is primarily responsible for processing documents related to personal lines insurance and providing administrative support to the Producers and Account Managers. Standard duties of a Personal Lines Processor include but are not limited to : Understanding and following the Cross Basic Procedure Manual. Understanding and following the Personal Lines Workflow Manual. Auditing transaction to ensure that the correct Action Codes are being used. Following up and completing open suspense’s daily. Running the download reports daily. Processing the download report which includes reviewing new business, endorsements, renewals, cancellations, and reinstatements for accuracy. Invoicing all types of download transactions. Mailing new business letters to clients. Entering claims acknowledgements as received. Following up on...

Established in 2021,   Independence Pet Holdings   is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.   We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.  Pumpkin, a subsidiary of IPH, promises uncompromising care to the cats & dogs we love unconditionally. By helping prevent future health risks and ensuring access to gold-standard veterinary medicine and individualized support when it matters most–we aim to enable $1/2B in life-extending and life-saving...

Established in 2021,   Independence Pet Holdings   is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.   We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.  Pumpkin, a subsidiary of IPH, promises uncompromising care to the cats & dogs we love unconditionally. By helping prevent future health risks and ensuring access to gold-standard veterinary medicine and individualized support when it matters most–we aim to enable $1/2B in life-extending and life-saving...

There's never been a better time to join NJM! With a nationally ranked reputation for outstanding customer service and a history that spans more than a century, NJM is a leading provider of worker's compensation, automobile, and homeowners insurance in New Jersey. Our MCS (Medical Claims Services) Medical Bill Processing Department has an opening for a Bill Processor and is seeking a candidate who has excellent communication skills as well as strong organizational and time management skills. The Bill Processor (BP) is responsible and accountable for the timely audit and processing of medical bills.  Timely and accurate processing is vital to ensuring that medical bills meet all regulatory timeframes. Essential Duties and Responsibilities: Accurately audit and process standard medical bills for routine procedures within statutory timeframes, by following medical coding guidelines and department policies and procedures Verify correct payee and provider information and...

Title: Customer Service Claims Processor                                 Department: Customer Service Union: OPEIU 29                                                                               Grade: 17 Position Summary The Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides written, verbal or face-to-face customer service to members by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Resolves customer inquiries and complaints in a timely and accurate manner. Escalates issues as appropriate. Processes routine...

Title: Customer Service Claims Processor                                 Department: Customer Service Union: OPEIU 29                                                                               Grade: 17 Position Summary The Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides written, verbal or face-to-face customer service to members by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Resolves customer inquiries and complaints in a timely and accurate manner. Escalates issues as appropriate....

Title: Claims Processor Department: Claims Bargaining Unit: UFCW 555 Grade: 3 Position Type: Non-exempt Hours per Week: 40 Position Summary The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned. Minimum...

The Senior Underwriter will evaluate complex risks to ensure proper risk selection, pricing, and terms for policies generated in assigned territories.  This position will work independently within the established strategy and delegated authority to generate a profitable portfolio.  The Senior Underwriter is responsible for marketing activities to generate new business. The Senior Underwriter will be looked at as a mentor, coaching and training less experienced underwriters. Essential Duties & Responsibilities Risk evaluation . Evaluate submissions to determine acceptability of risks in accordance with company guidelines and standards.  Determine proper coverage, pricing, limits, and terms based on exposure.  Operate as a subject matter expert for the team. Guideline adherence . Understand and follow the applicable underwriting guidelines, policies, and procedures to maintain consistency and adherence to industry regulations.  Operate within assigned letter of...

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where...

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group’s member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 35 specialty property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. For over 50 years, Republic Indemnity has been a trusted partner for businesses across the western U.S., helping them effectively manage their workers' compensation costs. Our headquarters in Calabasas, California, along with additional offices in San Francisco and San Diego, serve...

National Interstate is a member of Great American Insurance Group. As one of the leading commercial transportation insurers in the nation, we offer risk financing solutions in all 50 states tailored to meet the needs of a wide variety of transportation classes. Our offerings include traditional insurance and innovative alternative risk transfer (ART) programs, including more than a dozen group captive programs catering to niche wheels markets. We are proud to be a multiple Northcoast 99 winner and Cleveland Plain Dealer Top Workplace in Northeast Ohio. It is because of our talented and dedicated team that we are able to live out our company values of integrity, transparency, fairness, accountability, empowerment and collaboration with each transaction we make. If you are ready to join an engaging and driven team such as ours, we would love to hear from you! At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences...

WHAT WE'RE LOOKING FOR Are you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Are you a Spanish speaker looking to apply those skills in a professional environment? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers’ Compensation Claims Adjuster.   Upon successful completion of the Claims Training program, the Claims Adjuster Trainee will be responsible for management of a caseload of workers compensation claims from inception to resolution.  Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations.  This individual will continue to build on claims knowledge and claims will increase in number and complexity.     RESPONSIBILITIES Completes classroom training introducing workers’ compensation claims handling...

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.    **The ideal candidate will reside in Virginia** Oversees an assigned territory with broad and challenging agency partners driving profitable premium growth to achieve financial and operational goals.  Creates, implements and executes territory and agency strategies to achieve short term and long term goals utilizing all company programs, tools and resources in collaboration with internal business partners.   Builds and cultivates complex agency partnerships in person with agency ownership, management and frontline team members.  Establishes position as a subject matter expert while delivering product, underwriting philosophy, appetite...

The salary range for this job posting is $35,037.00 - $56,059.00 annually + bonus + benefits. Pay Type: Hourly The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. We have an opening with the primary role entering loss reports for Property and Casualty. The ideal candidate will have experience in either Workers' Compensation, Property & Casualty or a call center background. While we may prefer candidates who reside closer to our Columbus, Ohio office or Charleston, WV office that could work a hybrid or remote schedule, we will also consider candidates with the related experience who reside in any approved payroll state who can work full time remote This position will report to the...

The salary range for this job posting is $69,152.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. Encova Insurance is seeking a Property Claims Analyst. This role will have the option to work a home-based schedule, but you must reside in Ohio. Are you a Referral? If you know a current Encova Insurance associate and would like to apply as a referral, please encourage them to submit your referral information before you submit your application. You will receive an email with a direct URL link to the Job Posting of interest. Applying through this URL link will create your referral relationship for our...

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Join us in improving health care outcomes for all!  We promise to do what’s right, always. Position Summary: The Formulary Management Pharmacist plays a crucial role on the Formulary Strategies Team, by being responsible for developing and maintaining formularies as well as working cross functionally to ensure operational compliance. This position will lead Pharmacy and Therapeutics committee meetings, provide clinical recommendations across drug classes, develop utilization management protocols, and monitor the drug pipeline to forecast...

The Competitive Analyst (Hybrid) will be responsible for planning, designing, programming, and the maintenance of competitive market analysis (CMA). In addition to collaborating with line of business (LOB) colleagues, as well as partners across the organization, to provide in-depth insight into the competitive market regarding pricing, product, financial, and strategy elements, and support cross-divisional objectives with tailored competitive insight and discoveries. Duties & Responsibilities: Research, develop, and program rating engines and tier algorithms across multiple carriers in programs such as SAS and Radar. Collaborate with team members and divisional partners in a data gathering capacity to retrieve, structure, and cleanse internal and external data for competitive analysis. Run, modify, and customize existing database queries and programs against multiple data sources with various applications including Business Objects, Crystal Reports, SAS, Radar, and...

Greyling Insurance Brokerage, a division of EPIC, (“Greyling”) is a leading insurance broker and risk management consultant for architecture, engineering, construction contracting, and legal services firms. Our clients design, construct, and litigate over some of the most interesting and complex construction projects in the world. They also engage in frequent merger and acquisition activity, which requires extensive due diligence services and support. Greyling provides merger & acquisition due diligence services as they relate to property, casualty, professional, cyber, and management liability insurance.  Greyling clients request this service when the clients are acquiring another entity.   JOB OVERVIEW: This is a NEW ROLE on the team! The  Transactional Broker – Mergers & Acquisitions will be responsible for executing merger and acquisition due diligence services for our clients. This role will partner closely with the broker teams to best handle client...