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Key Words: Billing, Claims, Reconcile, IHS, Indian Health Services, Tribal Liaison, Medicaid, MCO, Managed Care, Tribal, Value Added, Community, Tribal 638, Tribal Governments, TCBOs, HSD/MAD, Claims Examiner, Auditor, Claims Processor.
Starting at $40,851.44 - $88,511.46 a year depends on education, experienceFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Communicates effectively with medical providers, the assigned claims examiner, injured worker and policyholder and/or handling attorneys on any given case. TheTelephonic Nurse Case Managerwill perform clinical assessments and evaluate needs for treatment in worker’s compensation claims.
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Such person shall also be required to certify as a condition of employment that he or she is fully current on any and all debts, taxes, fees, judgments, claims, and other accounts and obligations due and owing to the Philadelphia Gas Works (PGW) or has voluntarily entered into a payment agreement with PGW.
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NaphCare, Inc. has an excellent opportunity for a Sr. Claims Adjudicator (Claims Examiner Tier II, Claims Analyst Tier II) to join our team at the Corporate Headquarters in Birmingham, Alabama.
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Workers Compensation Claims Examiner | West Hills, CA (Hybrid) PRIMARY PURPOSE: 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.
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Working Title: MEDICAL DISABILITY EXAMINER - 64006837. This is entry level professional work researching, developing, compiling, analyzing, and rendering independent decisions relative to Social Security Disability Insurance, Supplemental Security Income and/or Medically Needy disability claims filed in the State of Florida.
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Our client, an rated Insurance Carrier, is seeking to add a strong Senior Workers' Compensation Claims Examiner with strong knowledge in Nebraska Law. This would be a fully remote position.
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Claims Examiner- Workers Compensation. 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.
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Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
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Position Overview"Remote Option Available" The Sr. Group Claims Examiner, analyzes high dollar claims and determines eligibility of Group Reinsurance claims. Responsibilities Under supervision, analyzes and determines eligibility of Group Reinsurance Medical or Managed Care claims; interprets and verifies that the reinsurance claim was properly ceded to RGA Group Re and the proper provisions and limits are established on RGA Group Re’s administration system.
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Contract role for Claims Examiner –Remote f or our client. Claims Examiner –Remote- Confer with legal counsel on claims requiring litigation. Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
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Keywords: Claim, Claims, Adjuster, Examiner, Counsel, Claim Manager, Claims Specialist, Attorney, J.D., Juris, JD, Claims Attorney, Claims Counsel, Claim Counsel, Claim Attorney, GL, Liability, Commercial Claims, Litigation.
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Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized. Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.
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Together with the responsible attorney in the public and professional liability practice group, manages the defense and disposition of professional liability claims and litigation. Fiscal Management: Sets reserves based upon the total loss exposure and the probabilities of different outcomes for claims disposition.
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As part of the Property line of business, the Forensic Accountant will be responsible for providing financial consultant services to Commercial Property adjusters on claims involving loss of business income and extra expense.
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