398 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...

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...

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...

SUMMARY The Senior Commercial Insurance Field Underwriting Specialist (internal title: Senior Business Development Specialist) drives profitable growth, retention, and agency engagement for Accident Fund Commercial Markets Small Business across Western to Mid-Michigan. This field-based role develops and manages independent agency relationships, evaluates and underwrites complex commercial insurance risks within assigned authority, and identifies new business opportunities. Working closely with internal partners, the specialist delivers responsive solutions, supports territory strategy, and serves as a key market representative through regular agency visits and business development activities. ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned. Evaluates prospective and existing accounts for eligibility, insurability, exposure, and pricing; prepares quotations and accepts or declines business within assigned underwriting...

Plans and delivers safety/risk management services to insured customers and internal associates. We are currently seeking a risk control professional that is technically proficient, self-motivated and results driven to fill an open position within our East Shared Services division. You will conduct comprehensive safety and risk management assessments, provide our Underwriting teams with a strong analytical opinion of risk to support our goal of profitable growth within variety of middle to large premium market segment for Dealerships, Construction, Manufacturing, Wholesale Trade, Retail, Commercial Real Estate and Service industries.  In addition, the successful candidate will develop close relationships with our agents and policyholders, conducting selected safety seminars and training, to build the value-added service that Sentry is known for.   The ideal candidate's preferred location would be in or around the Hartford, CT area. We are searching for an individual who is...

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 Middle Market department is seeking a Senior Sales Underwriter to join our growing team for our Central/Western Michigan territory .   This is a Full-time, Exempt role.   This is a Hybrid position.     Position Overview/Summary: Responsible for identifying, soliciting, underwriting and selling new and renewal Middle Market accounts that drive profitable growth and align with Industry Segments, appetite and mix goals. Apply advanced technical, sales and analytical skills to provide insurance solutions that help Hanover’s customers manage risk. Demonstrates a thorough understanding of Hanover’s strategies and appetites and will use internal and external data to make...

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 Middle Market department is seeking a Senior Sales Underwriter to join our growing team for our Central/Western Michigan territory .   This is a Full-time, Exempt role.   This is a Hybrid position.     Position Overview/Summary: Responsible for identifying, soliciting, underwriting and selling new and renewal Middle Market accounts that drive profitable growth and align with Industry Segments, appetite and mix goals. Apply advanced technical, sales and analytical skills to provide insurance solutions that help Hanover’s customers manage risk. Demonstrates a thorough understanding of Hanover’s strategies and appetites and will use internal and external data to make...

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 defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   This is primarily a remote position reporting to an office roughly once every 6 weeks, in addition to any required in-person court appearances.    Associate Attorney – AAA/The Auto Club Group Reports to: Supervising Practice Leader Under moderate supervision, handle litigation and cases of intermediate-level exposure and complexity in which the insured or the Company is a defendant.  Able to transition from courts of limited exposure to courts of unlimited exposure.  Develops and applies skills to control all aspects of litigation, including trial preparation, discovery, negotiation, presentation and appeals from District to Circuit Court.  To support those duties, we are applying a monthly cap on new case assignments. Primary Duties and Responsibilities (details of the basic job functions): Reviews and analyzes files, insurance policies, all allegations and pertinent...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: After in office training is completed, this position may be required to report to an office 1-2 times per month. Position Schedule Monday- Friday 9am-5pm Position Summary: Uses advanced specialized knowledge to handle complex to highly complex litigation of cases of unlimited exposure in which the insured or the Company is a defendant. Controls all aspects of litigation, including trial preparation, discovery, negotiation, presentation and appeals from District to Circuit Court.  Exercises discretion and judgment in performing all functions with minimal supervision. To support those duties, we are applying a monthly cap on new case assignments. Key Responsibilities: Case Analysis and Preparation Analyzes, files, reviews all allegations, and renders legal opinions to Claims personnel regarding evaluation and disposition of injury cases....

Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Why Choose a Career with the AAA The Auto Club Group (ACG) · Established brand that has been around for over 100 years. Our members know and trust us! · Branch Offices house travel, membership, insurance sales and support employees · You will be challenged to drive new business with competitive products and help retain The Auto Club Group's 14+ million members. Excellent Opportunities to Build a Career Pat h: The Branch Customer Service Representative can be the start of a long-term career with The Auto Club Group. Your position could lead to a rewarding career and opportunities to grow and pursue other ACG roles such as: · Other Branch positions – Field Insurance Sales Agent, Travel Agent or · Other Departments such as: · Call Centers (ERS, Sales and Service, etc.) · Automotive Services · Claims · Underwriting and more A DAY IN THE LIFE of a Branch Customer...

As a team member in Finance at Nationwide, a Fortune 100 company with nearly $70 billion in annual sales, the opportunities are endless! Let Nationwide help create your career journey! 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. We are seeking an experienced HVAC Service Building Manager to lead maintenance and service operations for commercial properties throughout the Arena District in Columbus, Ohio. This role combines hands-on technical expertise with people leadership, operational oversight, and a commitment to delivering exceptional customer service. The ideal candidate brings extensive HVAC experience, strong troubleshooting capabilities, and a proven ability to develop and lead high-performing teams. Preferred Qualifications Extensive experience servicing and maintaining commercial HVAC systems....

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Advocacy Coordination Team Specialist PRIMARY PURPOSE:   Actively researches, resolves, and administers escalated inquires for all lines of business, including but not limited to Family Medical Leave (FMLA), complex paid and unpaid state, military, and company-specific leaves, accommodations, disability and statutory claims. Provides excellent customer service displaying care and empathy to callers regarding claims and executes technical and jurisdictional requirements...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. One80 Intermediaries is seeking an  Accounts Payable Specialist  to join our growing team!          The Accounts Payable Specialist is responsible for reviewing and processing accounts payable areas as assigned. Responsible for processing payments to vendors, insureds, and external commission payments timely and ensuring proper documentation is received before payments are processed.     How You Will Contribute:      Review all incoming invoices and check requests for accurate documentation, paperwork, and approvals, and enter data into the system for check and ACH processing.   Responsible for processing payments via physical check and ACH/Wire to various types of external vendors, including timely commission payments to brokers, refunds to insureds, vendors, and carriers.   Responsible for...

Job Title: Supervisor - Placement, Commercial – Small Location:  Florida (South) Reports To: Director of Placement        Summary:      The Supervisor, Placement, Commercial –Small reports to the Director of Placement and will serve as a direct contributor to the overall efficiency and optimization of our organization through development and deployment of all placement activities and projects. Scope:      This role is responsible for managing carrier placement team members and supporting Commercial – Small internal rating process with select insurance carriers; serve as a partner for North American Specialty (Wholesure) and International; liaison for insurance carriers relationship management; facilitate the placement of accounts within Acrisure; facilitate out-bound marketing of select programs and surplus lines placement. This position is also responsible for carrying the organization’s reputation and professional manner of conducting business into dealing...

Job Description Job Title: Supervisor - Placement, Commercial – Small Location:  California -West Reports To: Director of Placement Summary:      The Supervisor, Placement, Commercial –Small reports to the Director of Placement and will serve as a direct contributor to the overall efficiency and optimization of our organization through development and deployment of all placement activities and projects.   Scope:      This role is responsible for managing carrier placement team members and supporting Commercial – Small internal rating process with select insurance carriers; serve as a partner for North American Specialty (Wholesure) and International; liaison for insurance carriers relationship management; facilitate the placement of accounts within Acrisure; facilitate out-bound marketing of select programs and surplus lines placement.  This position is also responsible for carrying the organization’s reputation and professional manner of conducting...

Description Summary: We are looking for a self-starter who wants to grow with us! The Consumer Loan Servicing Specialist 3 position works under minimum supervision in a fast-paced, highly regulated environment and performs a variety of assignments that are more complex requiring knowledge of daily operations within Consumer Loan Servicing’s Cash Processing group. This position oversees and supports the daily workflow of incoming payments, payoffs, MSP tasks, suspense oversight, and other mortgage and line of credit cashiering related processes. The Specialist 3 serves as a subject matter expert and point of contact for escalated, complex or exception-based requests. In addition, this position is responsible for identifying and implementing process improvements, monitoring service levels, and maintaining up-to-date departmental procedures. Positions in this job family must adhere to written policies and procedures...