545 claims examiner jobs found

Location: Orange, CA Salary: $25.00 USD Hourly - $30.00 USD Hourly Description: The Judge Group is currently seeking Claims Examiners for a fantastic healthcare company in Orange, CA! This job will have the following responsibilities: The Claims Examiner Sr will be responsible for analyzing and validating claims elements and claims processing.  The incumbent will adhere to the regulatory and internal guidelines in conjunction with our Health’s policies and procedures related to claims adjudication.  The incumbent will be responsible for adjudicating more complex claims, requiring additional research or problem-solving. Qualifications & Requirements: High School diploma or equivalent required.  3 years of experience processing online claims in a managed care environment required.  An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also...

Position Summary: The role of the Liability Claims Examiner is to investigate, document, manage, direct and resolve liability, property, cargo, brokerage and subrogation claims. This includes the gathering and analyzing of claim data, the evaluation of facts as presented to determine legal responsibility and accountability for settlement and recovery in accordance with company goals and objectives. Major Responsibilities: Investigate, document, manage, direct and resolve liability, property, cargo, brokerage and subrogation claims including alleged vehicle defects. Gather and analyze claim data, evaluate facts as presented to determine legal responsibility and accountability for settlement and recovery in accordance with company goals and objectives. Resolution of coverage disputes Respond to all related requests: tender to customer’s insurance carrier, requests for productions of documents. Provide guidance to internal and external customers...

Location: REMOTE Salary: $18.00 USD Hourly - $20.00 USD Hourly Description: Our client is currently seeking a Claims Examiner (HealthRules Experience) Responsibilities: Process and adjust claims with a focus on accuracy and efficiency. Utilize HealthRules software for seamless claims management (HealthRules experience is a must have) Review, analyze, and adjudicate claims to ensure compliance with policy guidelines. Resolve discrepancies and address issues in a timely manner. Maintain a high level of precision in claims processing. Demonstrate excellent communication skills for effective collaboration. Thrive in a fast-paced environment while upholding quality standards. Contribute to a dedicated team with a proven track record in claims examination. Contact: gmoran@judge.com This job and many more are available through The Judge Group. Find us on the web at www.judge.com

Location: REMOTE Salary: $30.00 USD Hourly - $40.00 USD Hourly Description: Hi, Please review the below job details and please do let me know if you are interested moving forward:   Position: Claims Examiner- Worker's Compensation  Duration: Contract MANAGER NOTES: •California WC claims know •Min. 3 Years of experience •Remote in CA Job Description:  To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Education & Licensing - High school diploma or GED required. Skills & Knowledge Good oral and written communication PC literate, including Microsoft Office products Strong organizational skills Good...

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work® Most Loved Workplace® Forbes Best-in-State Employer...

Job Details Level Entry Job Location Atlanta - Atlanta, GA Remote Type Fully Remote Position Type Full Time Education Level High School Diploma or GED Salary Range $23.08 - $29.81 Hourly Travel Percentage Negligible Job Shift Day Job Category Insurance Commercial Auto and General Liability Claims Examiner I POSITION SUMMARY: Responsible for promptly reviewing policy information, including all relevant endorsements and vehicle schedules to determine coverage for loss/damage/injury. Conduct an efficient claim examination and investigation leading to the final resolution of liability claims, including matters in litigation. Frequent contact and interaction with involved parties, including claimants and their legal representatives, will be required. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client. DUTIES AND RESPONSIBILITIES: •Review, process, and...

Are you ready for new career opportunity? When you join American Income Life you're joining a company that values career development, collaboration, innovation, and inclusiveness. We want employees to feel proud about being part of a company that take pride to help Make Tomorrow Better. You'll have the opportunity to grow your career while developing personally and professionally. Summary: The Claims Examiner Duties include the evaluation, investigation, benefit calculation and processing of claims within the guidelines of policy contracts and Company procedures. DESCRIPTION OF DUTIES: Perform various duties with a high degree of accuracy. Duties include but are not limited to: Evaluating claims to determine eligibility for benefits in accordance with the policy contract. Independent action and judgment decisions required. Responsible for processing claims according to Company procedures and performing necessary accounting entries required to complete...

Are you ready for new career opportunity? When you join American Income Life you’re joining a company that values career development, collaboration, innovation, and inclusiveness. We want employees to feel proud about being part of a company that take pride to help Make Tomorrow Better. You’ll have the opportunity to grow your career while developing personally and professionally. Summary: The Claims Examiner Duties include the evaluation, investigation, benefit calculation and processing of claims within the guidelines of policy contracts and Company procedures. DESCRIPTION OF DUTIES: Perform various duties with a high degree of accuracy. Duties include but are not limited to: Evaluating claims to determine eligibility for benefits in accordance with the policy contract. Independent action and judgment decisions required. Responsible for processing claims according to Company procedures and performing necessary accounting entries required to complete claims processing....

Are you ready for new career opportunity? When you join American Income Life you're joining a company that values career development, collaboration, innovation, and inclusiveness. We want employees to feel proud about being part of a company that take pride to help Make Tomorrow Better. You'll have the opportunity to grow your career while developing personally and professionally. Summary: The Claims Examiner Duties include the evaluation, investigation, benefit calculation and processing of claims within the guidelines of policy contracts and Company procedures. DESCRIPTION OF DUTIES: Perform various duties with a high degree of accuracy. Duties include but are not limited to: Evaluating claims to determine eligibility for benefits in accordance with the policy contract. Independent action and judgment decisions required. Responsible for processing claims according to Company procedures and performing necessary accounting entries required to complete claims...

Are you ready for new career opportunity? When you join American Income Life you’re joining a company that values career development, collaboration, innovation, and inclusiveness. We want employees to feel proud about being part of a company that take pride to help Make Tomorrow Better. You’ll have the opportunity to grow your career while developing personally and professionally. Summary: The Claims Examiner Duties include the evaluation, investigation, benefit calculation and processing of claims within the guidelines of policy contracts and Company procedures. DESCRIPTION OF DUTIES: Perform various duties with a high degree of accuracy.  Duties include but are not limited to: Evaluating claims to determine eligibility for benefits in accordance with the policy contract. Independent action and judgment decisions required.  Responsible for processing claims according to Company procedures and performing necessary accounting entries required to complete...

*At Securian Financial the internal title for this position is Customer Benefit Payments Sr. Representative. Overview: Securian Financial is hiring a Concierge Claims Examiner to join our team at our corporate headquarters location in Saint Paul, MN. The selected candidate will join the Concierge Claims Team, which is a specialized team of professionals that handle some of our highest profile clients as part of Group Life Insurance. We guarantee very high standards of performance to our clients and strive to exceed their expectations. We are passionate about providing world-class service and have built a reputation of delivering on our promises. We are looking for an associate who possess the characteristics necessary to be successful in one of the most respected life insurance claims organizations in the industry. Individuals must be focused on the needs of the client as well as those of the beneficiaries. A commitment to excellence is a must, as well as a willingness to...

*At Securian Financial the internal title for this position is Customer Benefit Payments Sr. Representative. Overview: Securian Financial is hiring a Concierge Claims Examiner to join our team at our corporate headquarters location in Saint Paul, MN. The selected candidate will join the Concierge Claims Team, which is a specialized team of professionals that handle some of our highest profile clients as part of Group Life Insurance. We guarantee very high standards of performance to our clients and strive to exceed their expectations. We are passionate about providing world-class service and have built a reputation of delivering on our promises. We are looking for an associate who possess the characteristics necessary to be successful in one of the most respected life insurance claims organizations in the industry. Individuals must be focused on the needs of the client as well as those of the beneficiaries. A commitment to excellence is a must, as well as a willingness to...

*At Securian Financial the internal title for this position is Customer Benefit Payments Sr. Representative. Overview: Securian Financial is hiring a Concierge Claims Examiner to join our team at our corporate headquarters location in Saint Paul, MN. The selected candidate will join the Concierge Claims Team, which is a specialized team of professionals that handle some of our highest profile clients as part of Group Life Insurance. We guarantee very high standards of performance to our clients and strive to exceed their expectations. We are passionate about providing world-class service and have built a reputation of delivering on our promises. We are looking for an associate who possess the characteristics necessary to be successful in one of the most respected life insurance claims organizations in the industry. Individuals must be focused on the needs of the client as well as those of the beneficiaries. A commitment to excellence is a must, as well as a willingness to...

*At Securian Financial the internal title for this position is Customer Benefit Payments Sr. Representative. Overview: Securian Financial is hiring a Concierge Claims Examiner to join our team at our corporate headquarters location in Saint Paul, MN. The selected candidate will join the Concierge Claims Team, which is a specialized team of professionals that handle some of our highest profile clients as part of Group Life Insurance. We guarantee very high standards of performance to our clients and strive to exceed their expectations. We are passionate about providing world-class service and have built a reputation of delivering on our promises. We are looking for an associate who possess the characteristics necessary to be successful in one of the most respected life insurance claims organizations in the industry. Individuals must be focused on the needs of the client as well as those of the beneficiaries. A commitment to excellence is a must, as well as a willingness to...

*At Securian Financial the internal title for this position is Customer Benefit Payments Sr. Representative. Overview: Securian Financial is hiring a Concierge Claims Examiner to join our team at our corporate headquarters location in Saint Paul, MN. The selected candidate will join the Concierge Claims Team, which is a specialized team of professionals that handle some of our highest profile clients as part of Group Life Insurance. We guarantee very high standards of performance to our clients and strive to exceed their expectations. We are passionate about providing world-class service and have built a reputation of delivering on our promises. We are looking for an associate who possess the characteristics necessary to be successful in one of the most respected life insurance claims organizations in the industry. Individuals must be focused on the needs of the client as well as those of the beneficiaries. A commitment to excellence is a must, as well as a willingness to...

*At Securian Financial the internal title for this position is Customer Benefit Payments Sr. Representative. Overview: Securian Financial is hiring a Concierge Claims Examiner to join our team at our corporate headquarters location in Saint Paul, MN. The selected candidate will join the Concierge Claims Team, which is a specialized team of professionals that handle some of our highest profile clients as part of Group Life Insurance. We guarantee very high standards of performance to our clients and strive to exceed their expectations. We are passionate about providing world-class service and have built a reputation of delivering on our promises. We are looking for an associate who possess the characteristics necessary to be successful in one of the most respected life insurance claims organizations in the industry. Individuals must be focused on the needs of the client as well as those of the beneficiaries. A commitment to excellence is a must, as well as a willingness to...

*At Securian Financial the internal title for this position is Customer Benefit Payments Sr. Representative. Overview: Securian Financial is hiring a Concierge Claims Examiner to join our team at our corporate headquarters location in Saint Paul, MN. The selected candidate will join the Concierge Claims Team, which is a specialized team of professionals that handle some of our highest profile clients as part of Group Life Insurance. We guarantee very high standards of performance to our clients and strive to exceed their expectations. We are passionate about providing world-class service and have built a reputation of delivering on our promises. We are looking for an associate who possess the characteristics necessary to be successful in one of the most respected life insurance claims organizations in the industry. Individuals must be focused on the needs of the client as well as those of the beneficiaries. A commitment to excellence is a must, as well as a willingness to...

Claims Examiner Fulltime! Monday-Friday 8-5! This Jobot Job is hosted by: Andres Jimenez Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $25 - $25 per hour A bit about us: We are a prominent healthcare network in San Antonio, Texas, dedicated to providing comprehensive healthcare services. Our team of experienced healthcare professionals strives to deliver high-quality care to our diverse patient population. Why join us? Competitive Base Salary! Generous Benefits Package including medical, dental, vision, life! Great Opportunity for Growth! Matching 401k Job Details We are seeking a highly skilled and motivated Contract Claims Examiner to join our dynamic team in the fast-paced medical industry. As a Contract Claims Examiner, you will play a crucial role in ensuring the accuracy and efficiency of our claims processing procedures. This position requires a deep understanding of HIPAA 5010, claims examination,...

INTRODUCTION The Illinois Municipal Retirement Fund (IMRF) provides death, disability, and pension retirement benefits to employees of local governments and school districts in Illinois (with the exception of the City of Chicago and Cook County). As is the second largest-and best funded-statewide public pension system in Illinois, IMRF serves approximately 2,900 municipal employers in the State. We are an award-winning organization, located in Oak Brook. IMRF is looking for top talent, for a direct hire opportunity that is benefit eligible. If you are passionate about Disability Claims Examiner Duties and meet the requirements, we want to hear from you. SUMMARY This position is responsible for reviewing applications, and supporting documents, for disability benefits, and inputting the correct information into the claim processing system to begin the processing of disability benefits. This position is responsible for using manual processing procedures to resolve most...

Provider Dispute Resolution Claims Examiner Contract Duration 12+ months Pay ranges from $29- $36/hr Summary The Provider Dispute Resolution Claims Examiner II is responsible for: The accurate analysis and resolution determination of Provider Disputes from all sources. Assist in the resolution of eligibility, benefit, contracting, and payment schedule issues. Handle and document resolution to escalated telephone and written appeals. Ensuring all PDR documents are processed timely with timely submission of all acknowledgment and resolution letters Timely processing of complex PDR claims for all lines of business Auditing claims for excessive charges, duplicates, unbundling, and medical upcoding Maintaining department databases used for report production and tracking ongoing work Assisting management with in-house and on-site training as offered to employees and providers. Duties Processing claims for all products. Claims will be accurately...