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Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
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A multinational organization with 52 offices in 20 countries and the possibility to work abroad. Scrum Master/Business Analyst with experience in Azure DO, Jira, Confluence, and claims experience, you are looking for a professional with a specific set of skills and knowledge.
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The Claims team is currently seeking an experienced Auto Adjuster to join in their Worcester MA - Richmond, VA - Itasca, IL or Howell, MI office location. + Be responsible for some to all aspects of each claim, including informal hearings, arbitrations and small claims litigation and maintaining a high level of productivity, confidentiality, and customer service.
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Job ResponsibilitiesConfirms coverage of claims by reviewing policies and documents submitted in support of claimsDirects and monitors assignments to experts and outside counsel, ensures effective vendor and litigation management on moderate to high complexity claims including demonstrable savingsAnalyzes coverage and communicates coverage positionsPrepare coverage position letters on matters typically in litigation without assistance of outside coverage counsel.
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Assists in keeping the environment safe for associates to reduce the occurrence of Workers’ Compensation claims by appropriately evaluating resident transfer and mobility needs and involving therapy services as indicated.
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Maintain licensure through completion of yearly Continuing Legal Education (CLE) requirements of the District of Columbia, to include the Court of Appeals for Veterans Claims and the U.S. Federal Circuit Court.
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The Medicaid Billing Specialist is responsible for the accurate and timely editing, preparation, submission of electronically and manually processed claims to third party payers in accordance with policies and procedures.
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Work with local Inland Marine managers to manage the business work flow across the product line including office support, deskside IT support, and office infrastructure (all offices) including physical plant, computing and telephony.
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Ensure Proof of Claims, Motions for Relief, Payment Change Notices, Post Petition Fees and Costs are prepared by counsel, are accurate and all aspects of the bankruptcy are handled according to investor guidelines and timeframes.
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Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims. Utilizes diary management system to ensure that all claims are handled timely.
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Experience in healthcare law, arbitration, mediation, dispute resolution or claims and appeals adjudication in healthcare. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
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Respond to claims assigned by insurance companies. Walk-through claims with an insurance adjuster and the insured, explaining our process. We provide high quality and cost-effective "hands-on" restoration services with appropriate turnaround times that contractors, claims professionals, and homeowners require.
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Assists the VP Finance & Administration with organizational Human Resources support including administration; disability claims; unemployment; and Workers' Compensation claims/ premium audits.
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The Investigator – you’ll confidently and independently investigate claims by performing detailed reviews of damage and interpreting policies to determine coverage. The Effective Communicator – you’ll use phone, emails and sometimes even video chat with customers to help them through a fast, fair, and easy claims process.
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Directs and monitors assignments to experts and outside counsel, ensures effective vendor and litigation management on moderate to high complexity claims including demonstrable savings.
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claims job Title: return to work in Glen Allen, VA
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