417 provider relations specialist jobs found

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

WHO WE ARE Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.   WHAT WE’RE LOOKING FOR The Claims Specialist processes and manages claims activities related to the organization’s Healthcare Center of Excellence (COE) programs, ensuring accuracy, timeliness, and compliance with established standards. The individual in this position serves as a key resource for claims investigations, payment discrepancies, billing resolution, and member support. The Claims Specialist collaborates closely with external Smart Care Centers, clients, clinical teams, and internal operations to...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* The Workforce Accommodations Specialist will work closely with the employee, healthcare provider and employer to explore accommodations that will assist the employee in performing the essential functions of their job. The Specialist reviews complex medical information for temporary and permanent accommodation requests; and works with the client to identify reasonable accommodations under the ADAAA, state law, PWFA and/or client requirements.   Duties and Responsibilities: Conduct thorough and confidential assessments of accommodation requests, including reviewing medical documentation and engaging in an interactive process with employees and their supervisors/HR Partners. Serve as the primary point of contact for employees with disabilities, providing guidance and support in requesting and implementing reasonable accommodations. Manage a caseload of open accommodation requests....

Position Summary:   The Employee Response Center (ERC) Benefits and Claims Specialist is a key role in the Financial Services Day 2-ERC Department at Higginbotham. The roles is responsible for ensuring a thorough knowledge of claims, research tools, and resources to serve employees and employers effectively. This role is centered around evaluating and reviewing claims with precision and accuracy. The individual must be meticulous to determine the claims’ validity and ensure that insurance carriers’ payments are made per policy terms and regulatory requirements. The ERC Benefits and Claims Specialist will also support as backup to the ERC Benefits Specialists, take employee calls, and respond to emails and texts as needed during non-peak and peak times. Supervisory Responsibilities:   None Essential Tasks: Maintaining documentation, spreadsheets, products, and services as requirements change Serving as a subject matter expert on reviewing and assessing insurance...

Job Responsibilities and Requirements The New Business Annuities Specialist is responsible for the review and processing of new annuity applications.  This role is responsible for reviewing incoming applications for completeness of internal forms requirements and statutory and regulatory completeness and compliance. The Specialist will report to the Manager of New Business and act as a liaison between various departments. New Business Annuity Specialists will have frequent interactions with internal and external customers. Processing Process applications and corresponding paperwork and document any outstanding requirements. Apply premium and issue contracts. Independently conduct initial review and make judgment & decisions that fall within prescribed policies and limits Primary owner for resolving any open issues for a submitted application from the time the case is submitted to the point the case is issued Process a variety of tasks and high volumes of work...

We are a passionate and dynamic team of attorneys and legal professionals. Our culture is one of teamwork and collegiality with a commitment to delivering excellent legal and compliance services. We are looking to add a Legal and Compliance Specialist to the Office of General Counsel located in Quincy. The position is a hybrid of in-person and remote working (Tuesday through Thursday in the office and Monday & Friday from home). The Legal and Compliance Specialist will provide support to the Office of General Counsel by assisting with regulatory compliance activities, policy governance, regulatory monitoring, filings, audits, and legal research. This role emphasizes accuracy, consistency, discretion, and adherence to applicable legal and regulatory requirements within a highly regulated insurance environment. Under the direction of the Director of Compliance, draft, update, and maintain compliance‑related policies and procedures in accordance with applicable laws,...

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 35 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. For over 50 years, Republic Indemnity has been a trusted partner for businesses across the western U.S., helping them effectively manage their workers' compensation costs. Our headquarters in Calabasas, California, along with additional offices in San Francisco and San Diego, serve...

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 35 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. For over 50 years, Republic Indemnity has been a trusted partner for businesses across the western U.S., helping them effectively manage their workers' compensation costs. Our headquarters in Calabasas, California, along with additional offices in San Francisco and San Diego, serve...

Introduction Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers' Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional. Overview Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents,...

If you’re passionate about being part of a dynamic organization that enables a Fortune 100 company with nearly $70 billion in annual sales to drive innovation and adopt new technologies that deliver business results, then Nationwide’s Technology 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. The F Band Specialist, Test Lead for the NF Actuarial Datamart is responsible for leading test planning, test execution, and data validation activities that support delivery of high-quality data and application solutions. This role partners closely with developers, analysts, and business partners to define effective testing scenarios, analyze data issues, manage defects, and respond to walk-up support requests. This position is a strong fit for someone with a solid testing background who also has an interest...

Position Title Senior Relationship Manager - Insurance Banking Location Nationwide, MI 48098 Job Summary The Senior Relationship Manager for our Insurance Banking team generates new business and relationships that will produce revenue from companies, sponsors, developers and businesses. Generates deal flow directly from these clients/prospects and orchestrating a team approach to the relationship. The position is supported by product specialists, portfolio managers (credit, underwriting, transaction approvals/processing) and operational support specialists but remains accountable for all aspects of the relationship. Responsible for the origination, negotiation, structuring, pricing, underwriting, and closing of loans. Manages a complex commercial loan portfolio ensuring the highest loan quality for the organization with minimal risk. Manages the on-going monitoring of portfolio quality and ensures compliance with applicable laws, regulations and guidelines. Job...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description This is a production underwriting position responsible for marketing,   underwriting   and processing assigned lines of business. Responsibilities may also include   participating   in special projects and mentoring less experienced staff.       This is a 100%   in -office position. Candidates must be able to work on-site at a designated company office during standard business hours.     Essential  Responsibilities :   Underwrite and analyze new business and renewal submissions for our assigned area.    Ensure our marketing initiatives are achieved and   that consistent...

Company Farm Family Farm Family specializes in farm and ranch protection with a wide range of products including flexible farm packages, business owner policies, commercial package, workers compensation, commercial auto and select personal auto coverage. Farm Family is a leader in serving the Northeast and Mid-Atlantic markets and is pursuing growth across the U.S. The Farm Family entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description FLSA Status: Exempt Location: In Office - Any employee, in any Clearbrook office, can apply for this opportunity and stay in their current location.   Summary: We are looking for a highly capable Senior Claims Specialist to join our team and work from our Omaha office.  Alternatively, we can fill this position in our Albany, Chicago, Los Angeles, New York City, or Richmond (VA) offices. We work together in the office five days a week in order to strengthen our culture, build team...

Company Farm Family Farm Family specializes in farm and ranch protection with a wide range of products including flexible farm packages, business owner policies, commercial package, workers compensation, commercial auto and select personal auto coverage. Farm Family is a leader in serving the Northeast and Mid-Atlantic markets and is pursuing growth across the U.S. The Farm Family entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s): Claims Specialist Employment Type: Full-Time FLSA Status: Ex empt Location: In Office | Any employee, in any Clearbrook office, can apply for this opportunity and stay in their current location.     Summary: We are looking for a highly capable Claims Specialist to join our team and work from our Omaha, NE office.  We work together in the office five days a week in order to strengthen our culture, build team connections, and drive profitability. The position reports to a...

Kick off your insurance career! Dive into real auto claims from day one, gain hands-on training, assess liability, and grow into a confident, knowledgeable claims expert. An entry-level Claims Representative position requi res a learning nature, empathy and interpersonal skills along with a strong desire to assist customers.     We're currently recruiting for a Claims Representative to work within our Motorcycle Unit   This position will be located at our Davenport, IA office following the hybrid work model —this role is NOT available for remote work.     What You'll Do   As an entry-level Claims Rep, you will :   Gain knowledge to verify coverage, compensability, and reasonable payments by thoroughly reviewing the policy, reviewing accident details, and other pertinent information related to the claim.   Develop investigative claims skills by taking and reviewing...

About Acrisure: A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more. In the last eleven years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win. Job Summary: This is an exciting opportunity to join this growing team and immediately make an impact to the overall success of the company. If you are interested in collaborating with good people who celebrate entrepreneurialism and work with commonality of purpose, Acrisure is the place for you. To...

Company Details "Berkley Aspire is passionate about making excess and surplus lines business easy to transact." Berkley Aspire is passionate about making excess and surplus lines business easy to transact. The company differentiates itself by continually innovating to bring market-leading technology and services to its agents and their clients. From direct bill with installments, to not requiring renewal applications for 80% of its small business policies, Berkley Aspire focuses on making it easy, expeditious, and efficient for agents and consumers. Berkley Aspire writes from small, minimum premium policies to accounts over six figures. The company offers General Liability, Property, Inland Marine and Excess policies through Berkley-appointed agencies in 49 states.   The Company is an equal employment opportunity employer. Responsibilities The Senior Litigation Specialist efficiently and effectively handles advanced-level,...

  The Opportunity As a Property & Casualty Client Specialist at M3, you'll be instrumental in bolstering our sales and client management endeavors. Your role is pivotal, focusing on policy accuracy and nurturing robust client relations through timely service and adept communication. Dive into a dynamic environment where your attention to detail and proactive approach will shine. Key responsibilities encompass policy management, client responsiveness, and project collaboration. If you're a detail-oriented communicator who thrives in fast-paced settings, join us and be at the forefront of shaping exceptional client experiences!   How You Will Make an Impact Provide support to our Property and Casualty service and sales teams. Ensure clients' needs are promptly and accurately addressed, fostering trust and satisfaction. Efficiently handle policy tasks such as certificates, audits, and reviews, adhering to our high service standards. Navigate our...