UNKNOWN

FEED

Detailed working knowledge of basic computer operations and systems, i.e. Web-based search engines, Windows, and Microsoft Office products. Effectively researches and resolves cash application issues using appropriate systems and with internal teams as needed.

Globalchannelmanagement

Office/Cash Claims Processor

Manatal

BRIEF DESCRIPTION OF DUTIES: This position assists workers' compensation specialists with reviewing and evaluating medical-only workers' compensation claims, processing and paying medical and legal bills associated with workers' compensation claims and reviewing workers' compensation First Report of Injury forms. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.

YEAR

Government of Florida

SENIOR WORKERS COMPENSATION EXAMINER - 43000562

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Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. PRIMARY PURPOSE OF THE ROLE To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

Sedgwick Claims Management Services, Inc., is a leading global provider of technology-enabled risk and benefits solutions. At Sedgwick, caring countsSM; the company takes care of people and organizations by delivering cost-effective claims, productivity, managed care, risk consulting and other services through the dedication and expertise of nearly 15,000 colleagues in some 275 offices located in the U.S., Canada, the U.K and Ireland. Sedgwick facilitates financial and personal health and helps customers and consumers navigate complexity by designing and implementing customized programs based on proven practices and advanced technology that exceed expectations. Sedgwick’s majority shareholder is KKR; Stone Point Capital LLC, La Caisse de dépôt et placement du Québec (CDPQ) and other management investors are minority shareholders.

Sedgwick Claims Management Services, Inc.

Workers Compensation Examiner | Jurisdictions: NJ & PA | Dedicated Client & Capped Caseloads

The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties. Handles moderate to large FTC losses up to $150,000.00 pending file reviews by the leader to assess the Transportation Examiner's ability regarding coverage analysis, damage assessment and proper reserving: initial reserve authority level set at $75,000.00.

Who Is Engle Martin & Associates, Inc. In 1997, Engle Martin & Associates, Inc. was formed with a comprehensive business philosophy: to provide the best insurance claim adjustment results in the industry, present the most talented personnel, retain an innovative and professional management team, and develop client-focused technology. Today, with 43 offices and 325+ employees, Engle Martin & Associates, Inc. is a national company that continues to set new standards for the industry. By fully engaging with our clients, we develop customized, result-oriented solutions that not only satisfy, but also surpass the industry's claims needs. Our broad range of services enables us to provide a variety of claims solutions including the following: <ul> <li> EMA: Property and Casualty Loss Adjusting</li><li> EMCAS: TPA/Claims Management - Including Program, Captive, and RRG Claims Management</li><li> EMC: Claims Auditing and Consulting Services.</li>

Engle Martin & Associates, Inc.

Transportation Examiner

The work requires close visual acuity, with or without correction, to prepare reports containing words, symbols, and numerical figures; the incumbent is required to view a computer terminal, use a keyboard, read printed documents, make detailed visual inspections, perceive color, perceive depth, and have a sufficient field of vision to carry out all inspection and related duties. Handles moderate to large FTC losses up to $150,000.00 pending file reviews by the leader to assess the Transportation Examiner’s ability regarding coverage analysis, damage assessment and proper reserving: initial reserve authority level set at $75,000.00.

Synergy Adjusting

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Requesting Information About the AEDT - NYC Local Law 144: Candidates who reside in New York City and are subject to NYC Local Law 144 may request information about the AEDT, including details on the type of data collected, the sources of such data, and our data retention policies. The Manager also leads confidential reviews of suspected misconduct, including false invoicing, procurement abuse, expense reimbursement misuse, vendor misconduct, asset misappropriation, payroll irregularities, and other activities that may expose the organization to financial loss.

FirstService Corp

Financial Risk & Controls Manager

Deep working knowledge of §101 subject matter eligibility and a record of getting software claims allowed — you can articulate why a claim recites a technical improvement rather than an abstract idea, and you draft specifications that support that argument from the start. Draft and prosecute U.S. and international applications covering machine learning architectures, training and inference systems, and software platforms, with claim and specification strategy built to withstand subject-matter eligibility challenges under §101.

Hark

Patent Agent, Software

ADAPTED_NOW

Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years 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.

ICW Group

SIU - Senior Investigator

Sutter Health

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees.

HOUR

Moda Health

Dental Claims Processor I

Brightmove

Responsible for utilizing resources efficiently for the accurate and timely entry, review, and resolution of simple to moderately complex medical claims in accordance with policies, procedures, and guidelines as outlined by the company. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.

Medical Claims Processor I

KNOWLEDGE & SKILLS: " Data entry and claims processing knowledge " Has a working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet " Some basic working knowledge of software programs, specifically Excel and Access " Understands third party benefits and administration " Strong customer service focus " Ability to work well under pressure and multi-task. Please review the updated guidelines below and attached work instructions: " All Positions: OIG/GSA/OFAC screenings must be completed prior to placement/start date.

Mindlance

Office/Administration - Claims Processor

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PRIMARY PURPOSE OF THE ROLE To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Supervises multiple teams of examiners, multiple bodily injury and property damage examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.

Claims Team Lead | Auto | Property Damage & Bodily Injury

PRIMARY PURPOSE: To supervise the operation of the property team and technical staff for property claims of our clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.

Claims Team Lead Property

PRIMARY PURPOSE: To supervise the operation of a team of workers compensation claims examiners and technical staff for workers compensation claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. The ideal candidate brings strong technical knowledge of California workers' compensation claims, experience supervising claims examiners and support staff, and the ability to provide guidance on complex and high-exposure matters.

Claims Team Lead - Workers Compensation | CA Claims Exp. Required

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PRIMARY PURPOSE: To supervise the operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within the teams including frequent diaries on complex or high exposure claims. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.

Workforce Absence Team Lead - Claims Assistant Team

PRIMARY PURPOSE OF THE ROLE: To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Skills & knowledge: thorough knowledge of claims management processes and procedures for multiple product lines, excellent oral and written communication, including presentation skills, PC literate, including Microsoft Office products, leadership/management skills, analytical and interpretive skills, ability to work in a team environment, and the ability to meet or exceed Performance Competencies.

Claims Team Lead, Auto

Position Summary: Performs a variety of customer service and routine administrative tasks to ensure efficient and courteous operations in the Purchased Referred Care Department. Demonstrates ability to relate to diverse cultures and specifically the Gila River Community and/or other Native American cultures and community health services.

Gila River Health Care

Claims Processor Clerk-HHK-Sacaton

Specialized experience is characterized by an overall knowledge of all VA benefit programs for purposes of interviewing veterans and their representatives, resolving issues, and obtaining required evidence to settle a claim, to include representing and protecting the rights and interests of mentally disabled adult and minor beneficiaries and their families. Exercises a high degree of judgment in addressing work issues--where the nature of work itself requires the ability to analyze, interpret, and apply judgment--so that consistently correct actions are accomplished in a situation where existing guidelines do not readily yield identical decisions on even somewhat similar facts.

U.S. Department of Veterans Affairs

Supervisory Field Examiner (Assistant Coach)

A typical day will include the following: Evaluates each claim in light of facts; Affirm or deny coverage; investigates to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.

Philadelphia Insurance Companies

Sr. Claims Examiner - PIP

This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. The primary purpose of this job is to handle claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis, to timely and accurate resolution; ensuring mitigation of indemnity and expense exposure while communicating developments and outcomes as necessary to all internal and external stakeholders.

Claims Examiner Jobs in the United States

Office/Cash Claims Processor Globalchannelmanagement

SENIOR WORKERS COMPENSATION EXAMINER - 43000562 Government of Florida

Workers Compensation Examiner | Jurisdictions: NJ & PA | Dedicated Client & Capped Caseloads Sedgwick Claims Management Services, Inc.

Transportation Examiner Engle Martin & Associates, Inc.

Transportation Examiner Synergy Adjusting

Financial Risk & Controls Manager FirstService Corp

Patent Agent, Software Hark

SIU - Senior Investigator ICW Group

Dental Claims Processor I Moda Health

Medical Claims Processor I Moda Health

Office/Administration - Claims Processor Mindlance

Claims Team Lead | Auto | Property Damage & Bodily Injury Sedgwick Claims Management Services, Inc.

Claims Team Lead Property Sedgwick Claims Management Services, Inc.

Claims Team Lead - Workers Compensation | CA Claims Exp. Required Sedgwick Claims Management Services, Inc.

Workforce Absence Team Lead - Claims Assistant Team Sedgwick Claims Management Services, Inc.

Claims Team Lead, Auto Sedgwick Claims Management Services, Inc.

Claims Processor Clerk-HHK-Sacaton Gila River Health Care

Supervisory Field Examiner (Assistant Coach) U.S. Department of Veterans Affairs

Sr. Claims Examiner - PIP Philadelphia Insurance Companies

Senior Claims Examiner Markel Group Inc

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