504 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...

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...

Pinnacol Assurance does just one thing, and does it better than anyone: provide caring workers’ compensation protection to Colorado employers and employees. And while we may be a little biased, we believe that our work shapes communities and changes lives. We have big hearts and love big ideas. We’ve been around for more than  100 years, but don’t let that fool you. Pinnacol is committed to taking care of Colorado employers and workers in the most innovative ways. We celebrate continuous improvement, new ideas, compassion, teamwork, integrity and excellence. What you’ll do: Work with team members to strategically and proactively manage claims and claim-related issues to the most expedient, cost effective resolution; provide quality customer service to all stakeholders. Identify claims that need additional management and work with team members to resolve concerns or escalate to the appropriate level.   What you can expect: Contact stakeholders as required...

Pinnacol Assurance does just one thing, and does it better than anyone: provide caring workers’ compensation protection to Colorado employers and employees. Although employers are required by law to provide Worker’s Comp insurance, we believe our service is making a meaningful impact in worker’s lives across Colorado in their moments of need. We have big hearts and love big ideas. We’ve been around for over 100 years, but don’t let that fool you. Pinnacol is committed to taking care of Colorado employers and workers in the most innovative of ways! We celebrate continuous improvement, new ideas, compassion, teamwork, integrity and excellence. What you’ll do: Work with team members to strategically and proactively manage claims and claim-related issues to the most expedient, cost effective resolution; provide quality customer service to all stakeholders. Identify claims that need additional management and work with team members to resolve concerns or escalate to the...

The Provider Relations Specialist assists providers via phone and email with bill review questions and requests of varying complexity. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling consistent, timely delivery of our quality services. This role may be transitioned into a Knowledge Center Representative role within the first year of employment, based on business needs. While both the Provider Relations Specialist and the Knowledge Center Representative roles are customer support roles with overlapping core functions, specific responsibilities pertaining to only the Knowledge Center Rep role are marked as such in the below job description. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate clearly and...

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...

Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic.   Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities.   Our field team members are located in every state in which we operate.   Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best. Essential Job Functions and Responsibilities Evaluates and underwrites new and renewal business in accordance with Company underwriting guidelines and risk appetite. Develops and implements risk...

Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic.   Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities.   Our field team members are located in every state in which we operate.   Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best. Essential Job Functions and Responsibilities Evaluates and underwrites new and renewal business in accordance with Company underwriting guidelines and risk appetite. Develops and implements risk...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our staff counsel team is currently seeking a Lead Attorney for its Michigan office.   As an insurance defense attorney in our Michigan office, you will be part of a team providing legal representation to Hanover/Citizens’ insureds and/or Hanover/Citizens Insurance before courts and arbitration panels in all aspects of litigation. This is hybrid/full time/exempt role. Fully remote candidates may be considered.   Position Overview: Investigates and manages and tries the most complex cases in the region. This attorney’s inventory will possess the largest and most complex matters referred from claims. Other attorney’s may be assigned to work under this attorney’s direction on case-by-case basis...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our staff counsel team is currently seeking a Lead Attorney for its Michigan office.   As an insurance defense attorney in our Michigan office, you will be part of a team providing legal representation to Hanover/Citizens’ insureds and/or Hanover/Citizens Insurance before courts and arbitration panels in all aspects of litigation. This is hybrid/full time/exempt role. Fully remote candidates may be considered.   Position Overview: Investigates and manages and tries the most complex cases in the region. This attorney’s inventory will possess the largest and most complex matters referred from claims. Other attorney’s may be assigned to work under this attorney’s direction on case-by-case basis...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. Markel Group, a Fortune 500 company, is a growing family of 24 operating companies. It is supported by over 22,000 associates and generates more than $15 billion in annual revenue, with our insurance operations at the core. Our small holding company team “sits under” and supports these businesses, insuring they focus on serving their customers over the long term. Our mission is to be “the best home for our businesses,” while at the same time living the values that we call the Markel Style. We aspire to build one of the world’s great companies by creating win-win-win outcomes for our customers, associates, and shareholders. Markel Group has an attractive opportunity for a business-friendly, team-first finance leader to serve as Group Head of Finance. Markel Group is a holding company comprised of twenty-four operating companies with more than 22,000 associates and...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Remote Position Schedule / Shift: Monday-Friday 8am-5pm ET Position Summary: The Auto Club Group is seeking a highly skilled Claim Investigator who would be responsible for reviewing and investigating insurance claims to determine their validity, accuracy, and compliance with company policies and regulatory requirements. They gather and analyze evidence, interview claimants, witnesses, medical providers, and other involved parties, and examine documentation such as police reports, medical records, and property damage assessments. Their goal is to identify potential fraud, verify claim details, and support fair and timely claim resolutions. Key Responsibilities: Independently perform comprehensive assessment and investigation of personal lines property & casualty claims for the potential of claim fraud.  Maintain a thorough...

Position Title Closing Specialist II - Credit Products Location Nationwide, MI 48098 Job Summary The Closing Specialist II - Credit Products handles all aspects of the loan closing process for standard and at times, complex transactions. This role serves as the liaison between sales associates, credit associates, legal, and third-party providers. The role requires expertise in legal documentation, due diligence, and regulatory compliance. The Closing Specialist II ensures full alignment with credit approval terms and leads coordination of all activities leading to successful loan funding and booking. Job Responsibilities: Closing Oversight – Transaction Management & Legal Documentation Closing standard and at times, complex transactions. Review documents and workflows to ensure compliance with approval terms. Independently manage a portfolio of loan closings. Review and negotiate legal documents and commitment letters; ensure all terms align with credit...

Position Title Homebuilder Finance Underwriter/Credit Products Portfolio Manager II Location Nationwide, MI 48098 Job Summary The HBF Credit Products Specialist II plays a key role in structuring and underwriting complex commercial credit transactions while managing an assigned loan portfolio. This position is responsible for independently analyzing credit risk, negotiating loan terms, and providing strategic recommendations to relationship and credit teams. By proactively monitoring portfolio performance and identifying emerging risks, this role ensures sound credit decisions and long-term client success. The position also supports the professional development of junior team members by sharing expertise and best practices. Job Responsibilities: JOB RESPONSIBILITIES Credit Structuring & Underwriting : Lead underwriting efforts for complex loan requests, assessing creditworthiness and recommending risk-mitigating structures.  Portfolio & Risk...

Position Title Business Banking Specialist   Location Work From Home MI, MI 48098   Job Summary The Business Banking Specialist is a critical client-facing role within Flagstar's Business Banking division, responsible for client onboarding, ongoing servicing, and operational support for business clients within the $10M–$50M annual revenue segment. This role operates within a collaborative pod structure alongside a Business Development Officer (BDO) and Relationship Manager (RM), ensuring clients receive a seamless, high-quality banking experience from day one. The BBS serves as the operational backbone of the pod—coordinating across internal teams to deliver exceptional service, resolve client needs efficiently, and support the overall health and growth of the portfolio.   Job Responsibilities: JOB RESPONSIBILITIES Client Onboarding & Account Setup Lead the end-to-end client onboarding process for newly acquired business banking relationships Coordinate...

Position Title Senior Credit Products Analyst - Oil & Gas   Location Houston, TX 77079   Job Summary The Senior Commercial Credit Analyst - Oil & Gas is a highly experienced credit professional responsible for complex financial analysis, portfolio monitoring, and risk assessment. This role partners closely with Credit Products Specialists, Relationship Managers, and senior leadership to evaluate loan opportunities, recommend risk mitigations, and drive credit policy improvements. The Senior Analyst is expected to mentor junior analysts, lead due diligence efforts, and provide expertise on credit structuring for high-value commercial clients.   Job Responsibilities: JOB RESPONSIBILITIES Credit Risk Management & Portfolio Oversight : Collaborate with Credit Product Specialists with financial analysis for complex commercial loan portfolios. Lead in the preparation of financial projections,  repayment analyses and /or enterprise value analysis as...