3819 claims processor jobs found

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...

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...

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...

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...

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.  Pets Best is seeking a Claims Processing Specialist who will report to the Supervisor, Claims. Claims Processing Specialists are responsible for reviewing invoices and pet medical documents and determining coverage in compliance with the current Underwriter’s policy.   Job Location: Remote – USA...

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.  Pets Best is seeking a Claims Processing Specialist who will report to the Supervisor, Claims. Claims Processing Specialists are responsible for reviewing invoices and pet medical documents and determining coverage in compliance with the current Underwriter’s policy.   Job Location: Remote – USA...

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 Claim Support Processor - Meemic *** Candidates must reside within 50 miles of Auburn Hills, MI for hybrid purposes. What you will do: The Auto Club Group is seeking prospective Claim Support Processor who can provide daily support to the Claim 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. Day-to-day routine tasks include: Research and proper routing of mail, data entry of key information into claim systems for proper routing of documents including summons and complaints Oversight for exception process of RPA functions, ordering police reports and paying low dollar, high volume invoices, generally...

Position Summary We are seeking an experienced and detail-oriented Senior Accident and Health Claims Auditor to join our team. The ideal candidate will have extensive knowledge of insurance claims processes, auditing standards, and regulatory requirements related to accident and health insurance. The Senior Auditor will play a key role in ensuring the accuracy, compliance, and integrity of claims processed, identifying potential areas of improvement, and providing leadership in audit initiatives. Essential Duties and Responsibilities Claims Audit: Conduct thorough audits of accident and health insurance claims to verify accuracy, policy compliance, and proper adjudication. Compliance Verification: Ensure claims adhere to company policies, industry regulations, and legal requirements, including HIPAA. Data Analysis: Analyze claims data to identify patterns, discrepancies, and opportunities for process improvement. Reporting: Prepare detailed audit reports and...

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 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. Great American Employer Health Solutions combines financial stability with innovative underwriting. Through our team’s deep expertise and flexible program design, we make premium healthcare coverage accessible to small and midsize businesses. Great American Employer Health...

The Document Processor is responsible for handling incoming documents, storage and data entry to keep operations running smoothly. They process incoming mail, faxes, and electronic documents, including image, video and audio files from internal and external customers. They prepare documents for scanning, scan documents, and index according to classification categories. They distribute documents and packages throughout the office and pick-up outgoing mail. Duties & Responsibilities:  Open envelopes, removing and sorting contents according to procedures. Review documents to make sure they are accurate and complete, research as needed. Prepare documents for scanning to include prepping functions for specific documents. Separate documents to comply with company formatting standards to meet deadlines. Scan verified and complete documents. Operate and maintain scanning machines.  Securely store documents, images, videos, and audio files and discard obsolete...

Our West Trenton General Claims Legal Department is seeking a motivated, detail-oriented individual for a PIP Appeal and Litigation (PAL) Processor Processor role. Reporting to the designated supervisor and accountable for efficiently collecting and organizing pertinent information of appeal, litigation/arbitration process for adjusters and defense counsel. Essential Duties and Responsibilities: Receive, analyze, and process complaints/arbitration demands, create litigation matters, and assign to appropriate PAL adjuster for review. Assist PAL Adjusters and supervisors by accurately entering pertinent information into Claim Center, OnBase, and AgilePoint.  Provide support as needed to FNOL First Notice of Loss (FNOL) Dept in taking claims. Review the investigation file material, select appropriate information, and electronically send to defense firms. Provide support to PAL Adjusters with document requests and information needed for pertinent matters. Process monthly...

Our employees are at the heart of what we do: helping people, businesses and society prosper in good times and be resilient in bad times. When you join our team, you are bringing this purpose to life alongside a passionate community. Feel empowered to learn and grow while being valued for who you are. At Intact, we commit to supporting you in reaching your goals with tools, opportunities, and flexibility. It’s our promise to you.  Who we are At Intact Insurance Specialty Solutions, we are experts at what we do in protecting what makes businesses unique. Our deep understanding of the specialty insurance market is the foundation for our customized solutions, backed by targeted risk control and claims services. Our employees are passionate about providing insurance coverage that’s aligned to our targeted customer groups. Intact’s Global Specialty Lines business spans across more than 20 verticals in four distinct markets: U.S., Canada, UK and Europe. The following...

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 one day weekly as outlined by the management team. 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 tasks to accomplish an objective. Review and interpret facts in a claim-oriented...

Description This role will support the USRM Claims Special Investigations Unit and is critical to helping SIU in our pursuit of Best in Class. This position owns the SIU Major Case value stream, extending from sourcing new cases via models and intelligence to supporting effective case and related claim investigations. The person is responsible for delivering large scale projects in our financial plan and is a thought leader helping shape our sourcing and investigation strategies. Experience in claims handling and leadership is required, along with 3+ years' experience in a Process/Project Management role. Own and manage processes deployed within the Claims organization that drive operational excellence and create competitive advantage for Liberty Mutual. Acts as a change champion to define and build for the future with a focus on achieving a balance between loss, expense, employee, and customer needs. Creates best in class customer experiences while...

About the Role   We are seeking a skilled Senior Account Manager to join our dynamic Insurance team in South Barrington, IL. Key Responsibilities Include   Serve as primary day-to-day client contact; Manage client service needs ; Present custom solutions to clients and prospects in a clear and professional manner   Communicate client needs to account management team and coordinate client services, including but not limited to:   Claims reviews   Insurance training   Kick of meetings   Stewardship meetings   Renewal strategy meetings   Analyze client risk profile and develop marketing strategy with team and client   Analyze all client documents (including quotes, binders, policies, endorsements), recommending changes or amendments for improvement   Cultivate local carrier relationships to support company visibility and...

Summary  In conjunction with the Director of Program Accounting, the Accounting Manager is responsible for the monthly close for the insurance entities. This includes creating month end journal entries, internal management reporting, including the analysis and interpretation of data, systems and data flows, maintenance of the general ledger and support of the finance control environment.  Principal Duties and Responsibilities Oversee the month end close and manage the preparation of monthly journal entries and account reconciliations Prepare monthly transfers Review general ledger items for accuracy and completeness Review, analyze, report, and interpret financial reports Prepare and approve monthly Blackline reconciliations  Assist with preparation of audit work papers Perform various projects and analysis as required Work collaboratively with the actuary, underwriting and claims departments Assist in general staff training and development Other responsibilities...