4015 claims processor jobs found

Primary Details Time Type: Full time Worker Type: Employee The Opportunity: The purpose of this role is to support internal and external customers by responding to claims file inquiries, typically low cost and/or low complexity claims, escalating issues as necessary, maintaining accurate documentation and following established guidelines to ensure alignment with corporate objectives and achieve department success. •Location: Woodland, California •Work Arrangement: This role will require 5 days/week in our Woodland, CA office while training for the role. The hours for this role are 7:30am-4:15pm PST Monday through Thursday, and 7:30am-12pm PST on Fridays. •The starting salary range for this role is between $23.25/hour and $35.00/hour depending on experience. Your New Role: •Provide basic claims customer service support by answering inbound calls as needed, responding to basic claims file inquiries and escalating issues to appropriate claims...

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...

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 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 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 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...

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...

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....

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 Qualifications High school diploma or GED. Six months of experience processing health and welfare...

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...

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...

Position Summary The Policy Processing Supervisor is responsible for overseeing the processing of insurance policies, ensuring accuracy, efficiency, and compliance with company policies and regulatory requirements. The role supervises a team of policy processing professionals, provides training and guidance, reviews, and approves policy documents, resolves escalated issues, and collaborates with other departments to streamline processes. They maintain up-to-date knowledge of insurance regulations, implement quality control measures, and participate in audits and process improvement initiatives. What will your job entail? Job Responsibilities: • Oversees a team of policy processing specialists providing guidance, support, and training to members, sets performance goals and conducts regular performance evaluations. • Identifies policy type and determines appropriate action needed for complex policies, makes appropriate updates to client database to meet regulatory...

Overview As Claims Technical Analyst in Individual Markets Claims, you will play a key role in supporting the Life Insurance claims processing, product and system configuration on Claims management platform and integration with systems like policy administration, databases etc. This role will offer a depth and breadth of knowledge of claims processing systems including integration points, data and reporting, and configuration management. The role will work closely with the claims Operations and Technical teams to identify and document requirements and design and develop solutions to support those requirements. The position may act independently and/or collaboratively with product management, product configurators, policy admin users, solution architects, development teams, DevOps engineers and cross-functional stakeholders to support the daily care and feeding of the applications and associated infrastructure, as well as respond to end user requests and break/fix items. You are...

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...

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...