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Join our team as a Claims Quality Assurance Specialist and take the helm in ensuring our claim operations meet and exceed industry standards. Bring 5+ years of combined automobile claim experience, including expertise in Physical Damage, Casualty, and PIP claims.
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Handles investigation regarding all aspects of advanced auto claims (coverage, liability and damages) with the exercise discretion and independence within increased level of authority. For claims involving injuries (if handled), learns how to review, evaluate, and negotiate basic to moderate injury claims.
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We have openings for full time and part time roles for a Claims Specialist at VantagePoint Benefit Administrators located in Lynbrook, NY. The Claims Specialist will be responsible for managing and handling claims for FSA/TPA/HSA/HRA/COBRA etc., liaising with clients, analyzing claim data, working with insurance providers, and communicating with internal and external stakeholders.
$45,000 - $55,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Additional Responsibilities DAY-TO-DAY: Experience in establishing new Bodily Injury claims, processing No-Fault applications, managing settlement packages, loss wages, property damage claims, mileage reimbursement, and appointment scheduling.
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As an Auto Claims Examiner, you will be responsible for accurately assessing and processing auto insurance claims. - Review and analyze auto insurance claims to determine coverage, liability, and the extent of damage.
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A minimum of 1-3 years of auto claims appraisal experience. Must have a valid New York State Auto Damage Appraiser License. The Auto Damage Appraiser/Crashbuster is responsible for preparing physical damage estimates on vehicles where a claim has been submitted for first or third party damages in the Brooklyn and Queens, NYC regions.
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Experience with the following areas of law: commercial law, procurement law, employment & labor relations, claims/litigation management and anticorruption, logistics contracts, finance law. Support litigation and environmental claims, including working effectively with outside counsel.
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Interface with Information Technology, Human Resources, Accounting, Legal, Lancer Underwriting, Claims and Customer Service Departments regarding creation and implementation of changes to systems, procedures and forms.
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Demonstrated knowledge of SAP/OPUS, claims, supply chains, Customs & Border Patrol (CBP) and compliance/FMC/PGA s. · Evaluate and process insurance claims if required. Demonstrated knowledge of SAP/OPUS, claims, supply chains, Customs & Border Patrol (CBP) and compliance/FMC/PGA s.
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MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
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Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor. Assists TPA with provider compensation configuration by creating and testing compensation grids used for reimbursement and claims processing.
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Assists with the coordination and testing of system updates prior to live implementation, coordinates and responds to internal and external audits requests relative to accounts receivable, processes claims through clearing house platform(s) to determine completeness of billing and correct missing charges, refiles cases in 3M coding system for APC / APG calculation as needed, and performs other receivables assigned duties.
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Wright Public Entity serves as a management company providing claims administration, risk management & loss control, underwriting & marketing, and client services in New York for the NY Schools Insurance Reciprocal (NYSIR: '' rated by Best), NY Municipal Insurance Reciprocal (NYMIR: '' rated by Best) and Statewide Schools Health Plan. We also act as a TPA for Workers Compensation for various self-insured schools & municipalities in New York.
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Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. Identifies and refers claims with Major Case Unit exposure to the manager.
$63,700 - $105,100Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Try and/or arbitrate cases and prepares motions in liminie and summary documents Draft post-trial motions Prepare for and participate in appeals Provide legal opinions to claims clients Investigate and pursue subrogation litigation as appropriate Second chair cases with Trial Attorneys and Senior Trial Attorneys as needed.
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claims mhp jobs Company: Metroplus Health Plan in Springfield Gardens, NY
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