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Most of the work we do is on large-scale, enterprise-wide systems (both commercial and government)—this project, in particular, will modernize a legacy claims processing platform that impacts millions of Americans.
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Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
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Indian Tribe" means an Indian Tribe, band, nation, or other organized group or community, including any Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 668; 43 U.S.C. 1601) which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.
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To supervise the operation of multiple teams of examiners and technical staff for workers compensation 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.
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Investigate, analyze, evaluate and settle insurance claims involving liability issues and bodily injury losses. Determine validity of claims, verify coverage, establish value of losses and negotiate settlements within limits of authority, consistent with established procedures and legal and contractual obligations.
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Deliver prompt and accurate claims service to policyholders and agents for both multi-peril crop insurance (MPCI) and crop hail claims by completing field inspections, communicating with involved parties, performing investigations, determining appropriate adjustments and administering insurance policies to ensure compliance with state and federal regulations.
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As a Field Auto Adjuster, you will play a crucial role in our Auto claims handling process by writing estimates directly at customer homes, repair shops, or tow yards. We've been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection.
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The Mechanical Claims Specialist (MCS) role at Ally is perfect for those who love working with cars but are tired of the manual labor and retail hours that go along with it! Actual Job Title: Mechanical Claims Specialist (MCS.
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Requires a HS diploma or equivalent and a minimum of 2 years of claims processing and customer service and 2 years COB experience that required using NAIC & CMS COB guidelines; or any combination of education and experience which would provide an equivalent experience.
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Review non-grievance records as requested for Legislative Claims cases for KDOC. Collaborate with State Epidemiologist as needed. Evaluate and monitor the Behavioral Healthcare performance in cooperation with Behavioral Healthcare colleagues under the direction of the Office of Health Care Compliance Behavioral Health Director.
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The primary responsibility of the Marketing Specialist is to support the Brand, Shopper Marketing and Digital Marketing teams in performing crucial commercial processes such as documenting packaging and advertising claims, communicating and maintaining marketing databases, and handling inventories for promotional assets.
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3 years’ experience in financial advising, claims processing, collections, customer service, revenue cycle positions that including: admitting, patient accounting, prior authorizations, or pre-registration.
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Handling reinsurance claims of medium to high complexity. Communicating with management, reinsurers, customers, and high-level representatives from other departments (e.g., Claims, Actuarial, Finance.
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Design Return on Investment (ROI) Analyses for new Value Based Payments (VBP) using multiple data sources, including prior authorizations, healthcare claims, Admit/Discharge/Transfer (ADT) data, HEDIS data, etc.
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Responsible for monitoring emerging medical, pharmacy, and LTSS claims compared to forecast and revenue. Provides guidance to Controller for month close related to membership and claims impacts to emerging MER and trend.
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claims job in Topeka, KS
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