3601 claims processor jobs found

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 claims. Basic knowledge of benefits...

Job Description Claims Processor L1     Build the future with us Are you driven by delivering exceptional customer service and eager to contribute to a company that helps its clients feel confident and secure about their future? As a Claims Processor L1 , you will play a key role in supporting our contract holders and dealer partners by accurately adjudicating claims and ensuring a smooth, supportive customer experience. This position is a great opportunity to showcase your skills and fully realize your potential within a caring and trustworthy company. Here, people and their development are at the heart of our priorities, fostering an environment that encourages collaboration and innovation. What you’ll accomplish with us As a Claims Processor L1 , you’ll be at the core of our mission. Here are the main responsibilities: Answer at least 40 inbound calls per day from technicians, customers, and dealer partners Gather all...

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...

Job Description Gap Claims Representative Build the future with us Are you driven by delivering exceptional service and supporting clients with accuracy, empathy, and professionalism? Are you eager to contribute to a company that helps its clients feel confident and secure about their future? As a Gap Claims Representative , you will play a key role in reviewing documentation, resolving GAP claims, and ensuring a seamless and positive customer experience. This position is a great opportunity to showcase your attention to detail, communication skills, and ability to thrive in a fast‑paced environment. Here, people and their development are at the heart of our priorities, fostering an environment that encourages collaboration and innovation. What you’ll accomplish with us As a Gap Claims Representative , you’ll be at the core of our mission. Here are the main responsibilities: Answer incoming calls from the queue and resolve GAP claims in accordance...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Processes and delivers incoming and outgoing mail per established procedures and deadlines. Enters data and check information into designated computer systems. Maintains confidentiality at all times. Performs all duties in a safe...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Processes and delivers incoming and outgoing mail per established procedures and deadlines. Enters data and check information into designated computer systems. Maintains confidentiality at all times. Performs all duties in a safe...

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....

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...

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...

Join NJM Insurance Group’s Medical Claim Services (MCS) team as a Business Process Operations Analyst, where you will play a key role in driving process improvement and support business continuity and technology initiatives. The primary purpose of this role is to provide consistent support to business users in both technology and non-technology operations, including incident management, production support, and departmental activities and assist in the seamless operationalization of new processes and technology solutions, ensuring smooth transitions and effective change management for business users. This position requires subject matter expertise (SME) in Personal Injury Protection (PIP), Workers’ Compensation, and/or General Claims. The ideal candidate will have a strong understanding of current business processes and the ability to identify, design, and implement effective improvements. Essential Duties and Responsibilities: Support Strategic Plan, Leadership, and...

Job Responsibilities and Requirements The Sr. Middle Market Client Manager serves as the primary strategic advisor for assigned middle market clients, delivering expert guidance on benefit plans, contracts, and service issues. This role builds strong client relationships, drives client growth, and ensures operational excellence through proactive engagement, strategic problem-solving, and cross-functional collaboration on Disability, Life, FML, State Leaves, Company Leaves (Paid and Unpaid) and ADA cases. This senior role ensures operational excellence through proactive engagement, advanced problem-solving, and cross-functional leadership. Client Relationship Management Serve as the main contact for assigned clients, delivering consultative advice on contracts, plan structure, renewals, and escalated issues. Build and maintain strong, proactive relationships through regular face-to-face meetings and strategic communications. Navigate complex client challenges,...

A career at Concord Insurance Group is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description This job analyzes, documents, tests, and communicates business needs for the creation of new or the maintenance of existing systems and related database and interface systems. This position coordinates and implements projects. Work is performed under general supervision. This position is considered hybrid; however, you must be able to work on-site and attend in-person group meetings occasionally. Responsibilities Develop business requirements and related business rules based on business needs. Work closely with the business subject matter experts to define, train on, implement, and support business requirements. Define requirements through interviews, workshops, surveys, and existing system documentation or procedures. Evaluate information...

The HR Assistant provides administrative and operational support to the AVP of HR and the broader HR team. This role supports the efficient execution of HR processes and initiatives by coordinating schedules, maintaining employee records, and assisting with onboarding, benefits, and employee communications. The HR Assistant helps ensure smooth day-to-day operations and helps support the seamless delivery of HR programs and employee support. Responsibilities Provide administrative support to the AVP of HR and HR team, including calendar management, meeting coordination, and preparation of materials Coordinate onboarding and offboarding processes to ensure smooth and consistent employee experience Maintain accurate and up-to-date employee records and HR systems (HRIS) Assist with benefits administration, including enrollments, changes, and employee inquiries Support recruitment activities such as scheduling interviews and communicating with candidates Track and support HR...

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...

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. The Crop Division of Great American has been helping generations of farmers take control of their risks since 1915. The D​ivision is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI...

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...

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 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 Custom, an underwriting division of Great American Insurance Group, dedicates itself to serving client needs and delivering outstanding service. We have made a name for ourselves as a full-service underwriting organization focused on long-term client relationships and...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Investigate, evaluate, provide defense if appropriate, negotiate and resolve assigned property damage and bodily injury claims reported under affiliated Companies' insurance contracts, in accordance with those contracts and applicable law, within documented authority. What will you do? CLAIM INVESTIGATION: Investigate assigned claims reported under insurance contracts provided by affiliated Companies, including identification of information and documents needed to evaluate claims, assignment and direction of independent adjusters and review of public and other records and documents. Contact...