3897 claims processor 1 jobs found

Title:   Claims Processor 1   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   16 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....

Title:   Claims Processor 1   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   16 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....

Title:   Claims Processor 1   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   16 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....

Title:   Claims Processor 1   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   16 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....

Title:   Claims Processor 1   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   16 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....

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...

If you’re passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. Desired candidate will be based in the Phoenix, AZ area. Working hours: 8:30am-5:00pm AZ time. Compensation grade C3. Job Description Summary Provides technical and administrative support to underwriting and management staff. Within defined company guidelines, reviews agent, broker or program manager issued policies or sets up for internal issuance, new and renewal policies, endorsements, inspections, claims, audits and non-renewal notices. Reviews various policy maintenance items for accuracy or processing and refers as...

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:   Michigan Medicare Compliance Claim Support Processor – The Auto Club Group What you will do: The Auto Club Group is seeking prospective  Michigan Medicare Compliance Claim Support Processor  who provides support to the Claims department by completing well defined clerical tasks that require a general understanding of the Claims process, business context and the Claims department organization and workflow. In this position, day-to-day routine tasks include: Copying paper Scanning documents, Sending and receiving faxes Completing form letters Process previously approved checks Creating and coding paper and electronic claim files based on pre-determined detailed instructions.  Handling general inquiry routing calls regarding claim files.  Working requires...

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 Analyst plays a crucial role on the Formulary Strategies Team, responsible for ensuring accurate input and maintenance of formulary data in the formulary management system. This position requires a keen attention to detail, analytical skills, and an understanding of formulary design. What you will do: Formulary Data Management: •    Input and maintain formulary information in the...

Our West Trenton General Claims Legal Department is seeking a motivated, detail-oriented individual for their Litigation Processor opening.  Work from home opportunity available after successful completion of training. Job 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. Update...

Crum & Forster Company Overview Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A" (Excellent) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.   Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2024 Great Place to Work® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.   C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster, please visit our...

Job Title: Claims Processor - Casualty FLSA Status: Non-Exempt Job Family: Claims Department: Casualty Claims Location: Corporate Office (Fort Wayne, IN) JOB SUMMARY Responsible for effectively analyzing and resolving assigned minor casualty claims consistent with claims department standards and company objectives. POSITION ESSENTIAL FUNCTIONS AND RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Identify and investigate coverage, damage and reserve adequacy issues on assigned claims. Apply statutes, common law, and other applicable legal concepts. Identify liability issues and communicate this to supervisor for possible file transfer. Communicate with policyholders, agents, claimants, medical providers and other persons as needed. Direct independent...

Title: Claims Processor 3 Department: Claims Bargaining Unit: OPEIU 29 Grade: 18 Position Type: Non-Exempt Hours per Week : 40 Position Summary: Responsible for independently processing all types of health claims on an assigned Plan(s), and for assuming primary or back-up customer service responsibilities as necessary. General Duties: Independently process all types of health claims in accordance with assigned Plan(s). Perform customer service responsibilities for providers and members as needed. Generate correspondence and form letters. Maintain current knowledge of assigned Plan(s) and effectively apply this knowledge in the payment of claims. Assist other processors with claims as needed to minimize backlog. Perform other related duties and special projects as assigned. Minimum Qualifications: High school diploma or general education degree (GED); two years related experience processing all types of...

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...

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...

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...

We are a highly committed, diverse financial services organization serving hundreds of thousands of retirement plan participants, individuals, and institutions across the United States.   We provide financial piece of mind and top of class solutions, investments, administration, and service.  We are committed to the highest Ethics, Competency, Customer Service, and providing our valued clients with the best and most competent professional team. BRIEF DESCRIPTION / OVERVIEW:  We are looking for a motivated individual to join our Distribution Processing Team! Experience with the material is preferred, but not required. We are willing to train up the right individual.  Eagerness to learn and attention to detail are a must.  The Distribution Processor serves as a point of contact for the participants and school district, handling a variety of tasks for both internal and external employees and partners, such as written communications, client contact management, and incoming...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description Early Career Apprentice Program Want to work in your field and train on the job? Join our 12–24-month apprentice program! You will earn and learn on the job, receive career guidance and mentorship, all while attending school. Allstate will also provide tuition assistance and hands-on training in customer service and claims processing.   Personal Property & Liability – Customer Service Processor Apprentice Your role as a Customer Service Processor Apprentice will expose you to the fast-paced world of insurance claims and...

OBJECTIVE CELIC Claims Processor I Objective To process life claims in a timely and accurate manner in accordance with policy provisions. To assist in all office staff functions as needed to support the successful operation of the office in ensuring excellent customer service. To provide efficient adjustment, processing and settlement of claim files in accordance with established adjusting procedures. To assist with assignment program. RESPONSIBILITIES CELIC Claims Processor I Responsibilities Process life death claims and provide backup assistance for assignment funding program.   Update and maintain funeral home contact information, death claim procedures and the follow-up/review of medical records. Address outstanding issues affecting the payment of claims and/or contestable policies. Handle incoming and outgoing phone calls. Rectify outstanding death certificates and process claims meeting established company standards....

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 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value diversity and recognize the benefits gained when people from different cultures, backgrounds and experiences work collaboratively to achieve business results. We are intentionally focused on fostering an inclusive culture and know valuing diversity is an essential leadership quality. Our goal is to create a workplace where all employees feel included, empowered and enabled to perform at their best. Great American’s Excess Liability Division offers significant capacity of up to $20 million for both Lead Umbrella and Excess...