3535 claims processor 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: 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: 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...

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...

Independently processes medical, dental and/or hospital claims, including more difficult or complex claims, provides customer service, and handles special projects and complex functions, including subrogation; acts as a “lead” and resource for other claims processing positions. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Processes medical, dental and/or hospital claims; processes complex claims independently.  Provides customer service by responding to and documenting telephone and/or written inquiries. Meets quantity and quality claims processing standards.  Performs pre-authorizations, audits files, requests check tracers and stop payments, and assists with researching and preparing appeals, as applicable.   Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in the payment of claims, customer service and...

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 and partners are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. Position will work five days per week at the Nationwide Cavasson Campus in North Scottsdale (Hayden & 101). Remote work will NOT be considered for this opportunity due to the on-site processing required for this role. #LI-CL1 Job Description Summary Exceptional processing is essential to accurate claim resolution. We work in a fast-paced, interactive environment where outstanding customer service is valued. If you have a Lean approach as well as a desire to innovate and apply your technical knowledge and skills, we...

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 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 associated with claim expenses, including research to ensure no payment duplication Request 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...

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...

Overview Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett’s Berkshire Hathaway group – one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be the leading small business insurance provider nationwide.   Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company’s success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!...