UNKNOWN

FEED

KEY RESPONSIBILITIES: Examine and adjudicate complex or specialized claims that have pended for review across multiple lines of business by applying applicable benefit provisions, processing guidelines, reimbursement methodologies, and sound judgment to determine appropriate claim outcomes. Assist with training, mentoring, and development of Claims Examiners; Serve as a resource by providing guidance on claims processing procedures, benefit provisions, system functionality, and complex claim scenarios.

CommunityCare

Claims HMO - Senior Claims Examiner

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Company Overview: Confident Staff Solutions is a leading staffing agency in the healthcare industry, specializing in providing top talent to healthcare organizations across the country. Our team is dedicated to helping healthcare facilities improve patient outcomes and achieve their goals by connecting them with highly skilled and qualified professionals.

Confident Staff Solutions

Seasonal Claims Examiner

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Our end-to-end administrative services help streamline operations, improve productivity and strengthen cash flow to help our customers stay competitive and improve member satisfaction. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition.

NTT DATA Services, LLC

Claims Examiner Remote

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Gather and analyse information necessary to make an accurate evaluation of the claim by delivering effective resolution of claims, make decision within established authority levels and identifying settlement issues. As the Healthcare Claims Examiner, you will directly handle Commercial Healthcare Claims including Medical Malpractice and Healthcare facilities across the U.S. Key Accountabilities/Deliverables:

Core Specialty Insurance Services

Claims Examiner - Commercial Healthcare

Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for the twelfth consecutive year in a row and for the 20th time overall as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work.

YEAR

ICW Group

Claims Examiner - Workers'''' Compensation (Remote)

Identify premature conclusions, missing investigative steps, unsupported valuations, improper communications, and failures to distinguish covered damage from excluded or unrelated loss. Experience handling claims in at least one area such as property, auto physical damage, bodily injury, general liability, commercial casualty, catastrophe, or specialty claims.

HOUR

Mercor

Senior Claims Examiner - Multiline - AI Trainer

Manatal

Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. #insurancecareers #insurancejobs #claimsexaminer #WorkersCompClaims #WorkersCompensationClaims #paralegalcareers.

AIG and its member companies form one of the world’s leading insurance organizations. We provide insurance for businesses and individuals, helping individual customers plan for their futures by offering life insurance, travel insurance, product warranty, auto insurance and retirement products. Our commercial clients have come to rely upon our risk expertise and financial strength to help them address some of their most complex challenges – from huge construction projects to protecting themselves from the emerging threats to data security. We offer our people the chance to grow in a dynamic company that values teamwork, fresh perspectives, and a commitment to helping their clients.

American International Group

Senior Workers' Compensation Claims Examiner - Federal Claims

FULL_TIME

The role requires sound judgment when handling confidential information, strong customer service skills, and the ability to manage multiple claims while meeting deadlines. This includes new claims, reviewing information for accuracy, determining eligibility, calculating benefit payments, and following up on required documentation.

Remedy Intelligent Staffing

TDI Claims Examiner

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The Casualty Claims Examiner will work alongside claims management, providing direction and oversight ensuring that compliance with best practices and state/local guidelines. Management reserves the right to add to, modify, or change the work assignments of the position as business needs dictate.

AssuranceAmerica Corporation

Casualty Claims Examiner

POSITION SUMMARY/RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Childrens Health Insurance Program) according to departmental and regulatory requirements. Specific knowledge and experience in Medicaid, CHIP and commercial claim processing preferred.

University Health

Claims Examiner

Make decisions and resolve conflicts in such areas as application of coverages to submitted claims, application of laws of jurisdiction to investigatory facts, application of policy exclusions and exceptions as well as the ability to read and understand contracts, hold harmless and indemnity agreements. Volunteer opportunities to support our local communities- We have an adoration for helping others which is why we have worked hard to establish partnerships with organizations such as Children's Miracle Network and Habitat for Humanity that allow us to give back.

Swift Transportation began operations on October 10th, 1966 transporting imported steel through the ports of Los Angeles to Arizona and Arizona cotton for export back through to Southern California.

Jerry Moyes, founder, began with the same entrepreneurial, can-do spirit that is one of Swift’s core values today. The original operation was conducted under the name of Common Market. Operating authority was purchased from a descendant of the Swift Meat Packing family, hence, today’s name of Swift Transportation. Jerry, with his father, brother and a partner, grew the business, with typical start up challenges, to a $25 million annual revenue in 1984. With the passing of Jerry’s father, Carl Moyes, Jerry became the sole owner. By 1990, Swift had grown to a $125 million carrier with 800 trucks. Swift’s significant revenue growth is attributable to internal growth with existing customers as well as acquisitions. Since 1988, Swift has acquired 13 different motor carriers. Today, Swift generates over $4 billion in revenue and operates nearly 20,000 trucks.

Swift’s terminal network has grown to over forty full service facilities in both the continental United States and Mexico. Swift owns 100% of Trans-Mex, a Nuevo Laredo, Mexico based carrier. Swift offers border crossing services at all major Mexican border crossings. Swift maintains a presence in every Canadian province each day. Swift is unquestionably the largest full-truckload motor carrier in North America.

Swift Transportation Co LLC

Claims Examiner 5

Thorough knowledge of medical terminology, ICD-9/CPT4 Coding, and general managed care principles is required. POSITION SUMMARY/RESPONSIBILITIES Performs review, analysis, and adjudication of all claim types including coordination of benefits and DME claims.

Senior Claims Examiner

OTHER

With our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work® Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best Workplaces for Millennials, and many others. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions.

Crum & Forster

Claims Examiner, C&F Stop Loss, Remote

[AW]-iCims

In this role, you will utilize your expertise and independent judgment to interpret complex policy coverages, manage investigative activities, and direct litigation strategies. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from and its affiliates, and contracted partners.

Abacus Service Corporation

Sr Claim Examiner- WC

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Qualifications / Experience Required: A practical knowledge of commercial claims, as well as an exceptional customer service focus typically achieved through: A minimum of two years' experience adjudicating first- and third-party commercial Garage Bodily Injury claims. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate Garage Bodily Injury claims of higher technical complexity with a direct impact on departmental results.

Argo Group International Holdings Ltd.

Bodily Injury Claims Adjuster, Garage

Qualifications / Experience Required: An advanced knowledge of commercial general liability property damage claims typically acquired through: Licensed Claims Examiner (Based on state) Must be licensed or have ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims within 120 Days. Essential Responsibilities: Working under limited technical direction and within broad limits and authority, adjudicate moderately complex commercial general liability property damage claims, potentially with significant impact on departmental results.

Senior Commercial General Liability Property Damage Claims Adjuster

This Job Description indicates the general nature and level of work to be performed in this position and it is not intended to contain or be interpreted as a comprehensive inventory of all the duties, responsibilities, functions and qualifications required of the position. Complete physical activity inventory of the position includes: Work requires frequent sitting, standing, walking and use of keyboard/computer.

Circle K Stores

Incident and Intake Investigation Manager

ADAPTED_NOW

Track progress against substantiation-rate and findings-volume targets (set once POC window and initial data are confirmed). Our Client, an American Technology company, is looking for a Senior SIU Analyst - FWA Detection for their Bowie, MD location.

ICONMA&nbsp;is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.
<ul class="ic_list">
<li>Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.</li>
<li>Certified Woman-Owned Business Enterprise (WBE); certified by Women&rsquo;s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).</li>
<li>Founded in 2000</li>
<li>2000+ Employees</li>
</ul>
The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.

Iconma

Senior SIU Analyst - FWA Detection

Iconma Staffing

As a Senior Field Security Investigator, you will conduct investigations of suspected cases of fraud or other illegal activities against the Company, including interviewing, database inquiries, taking statements, and locating sources of information and witnesses. Experience handling in-person or phone statements from various parties in an investigation in a way that builds GEICO's customer base and promotes customer satisfaction through efficient, accurate, and courteous interactions.

GEICO GENERAL INSURANCE COMPANY

Senior Field Investigator

The Senior Special Investigative Unit (SIU) Auditor investigates and audits potential healthcare fraud, waste, abuse, and coding irregularities across claims, billing, documentation, and reimbursement. For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.

Claims Examiner Jobs in the United States

Claims HMO - Senior Claims Examiner CommunityCare

Seasonal Claims Examiner Confident Staff Solutions

Claims Examiner Remote NTT DATA Services, LLC

Claims Examiner - Commercial Healthcare Core Specialty Insurance Services

Claims Examiner - Workers'''' Compensation (Remote) ICW Group

Senior Claims Examiner - Multiline - AI Trainer Mercor

Senior Workers' Compensation Claims Examiner - Federal Claims American International Group

TDI Claims Examiner Remedy Intelligent Staffing

Casualty Claims Examiner AssuranceAmerica Corporation

Claims Examiner University Health

Claims Examiner 5 Swift Transportation Co LLC

Senior Claims Examiner University Health

Claims Examiner, C&F Stop Loss, Remote Crum & Forster

Sr Claim Examiner- WC Abacus Service Corporation

Bodily Injury Claims Adjuster, Garage Argo Group International Holdings Ltd.

Senior Commercial General Liability Property Damage Claims Adjuster Argo Group International Holdings Ltd.

Incident and Intake Investigation Manager Circle K Stores

Senior SIU Analyst - FWA Detection Iconma

Senior Field Investigator GEICO GENERAL INSURANCE COMPANY

Senior Special Investigative Unit (SIU) Auditor Premera Blue Cross

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