366 claims advocate jobs found

Summary Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Description Job Description Logistics: PGBA – is a subsidiary company of BlueCross BlueShield of South Carolina. Location : This position is full-time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have flexibility work any our 8-hour shift scheduled during hours of 10AM –7PM. Training will be Monday – Friday 8:00 AM - 5:00 PM for approximately 6-8 weeks. This role is located on site at 17 Technology Circle, Columbia SC Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements : BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the...

Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Network Contracting Manager, you’ll report to the AVP, Provider Network Management. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management. This role supports the Massachusetts (MA) and Rhode Island (RI) territory. Responsibilities Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems. Build and maintain strong provider relationships to support network growth and value-based business opportunities. Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution. Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics. Work to meet unit...

Salary: $120k - 180k per year Reference: ELVPICAR Plaintiff Personal Injury Attorney Oklahoma City Position Overview We are seeking a Plaintiff Personal Injury Attorney with 5+ years of experience to join our growing firm. This is an exceptional opportunity for an experienced attorney with a passion for helping injured clients to become part of a firm that values integrity, teamwork, and client-centered advocacy. We are looking for someone with substantial plaintiff personal injury law experience who is ready to make a meaningful impact. About Our Firm Our firm has cultivated a distinctive culture built on respect, integrity, and genuine care for both our clients and our team members. We treat our employees with the highest respect and take personal investment in their successes—both personally and professionally. We hold our clients in high regard and strive as a team to give 100% to each one of them. Beyond our legal practice, we are actively involved in...

Duration: 12 months contract Shift : varying, including evenings and weekends. ~20 hours/week Description: Reporting to the Mgr, Safety & Security, the Occupational Health Nurse will provide professional and comprehensive health, wellness, safety guidance, and services to the employee population. The Nurse will act in accordance with all applicable practice standards, regulations, and company policies and procedures in various environments including manufacturing and office environments. In all elements of practice, this person will act as a resource and advocate for both the employee and the company to support holistic health, safety, and wellbeing. General Responsibilities Ensure compliance with legal and regulatory requirements, specific to the location. Adherence to Company-specific standards and expectations pertaining to Occupational Health Maintenance of complete, accurate documentation regarding regulatory and company medical record confidentiality,...

Job Summary Assist and educate patients, providers, medical office staff, and/or Health system staff with accessing services, facilitating and resolving problems, understanding navigation questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, online chat, email, etc. Adheres to established procedure and quality guidelines in support of Patient Access Services Center performance indicators, as well as Corporate values and codes of excellence. Essential Functions Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines. Professional and pleasant interactions are ongoing expectations. Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization,...

Health Advocate Solutions seeks a Healthcare Analyst in Blue Bell, PA or remote w/in USA, to use advanced SAS skills to manipulate, analyze and report on complex health care data from a variety of different sources, including administrative claims, encounters, lab, biometric screenings, HRA, etc. Provide analytical support and solutions to business decision making and product development initiatives. Validate and analyze large claims datasets from a variety of health plans and clients. Generate baseline utilization/chronic condition and risk stratification reports. Code programs that will create an online Health Information Dashboard. Requires: Master's degree (or equiv) in Statistics, Biostatistics, Public Health, Mathematics, Computer Science, or related fields, or bachelor's degree (or equiv) in the same and 2 years' experience with advanced/complex SAS programming and application development. Demonstrated ability with developing, modifying and maintaining SAS program...

Medmonk At Medmonk, our employees are at the core of everything we do. We are committed to hiring and developing exceptional individuals who are passionate about delivering high-quality service and patient care. We foster a supportive work environment that encourages achievement, success, and professional growth. This position also offers a career advancement opportunities within the company. Medmonk provides a comprehensive benefits package, including medical insurance, a 401(k) plan, paid time off, and more. Position: Patient Access Advocate Medmonk is seeking a highly motivated Patient Access Advocate with a strong sense of integrity and commitment to patient support and customer satisfaction. This is a full-time, onsite position in our Itasca, IL office. The role is available for immediate hire. The ideal candidate will have experience in specialty pharmacy or home infusion reimbursement and demonstrate a passion for helping patients overcome barriers to care, access...

NY HELP Yes Agency Veterans' Services, Department of Title Veterans Benefits Advisor 1 (NY HELPS) - VID 214398 Occupational Category Other Professional Careers Salary Grade 18 Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF) Salary Range From $66951 to $85138 Annually Employment Type Full-Time Appointment Type Contingent Permanent Jurisdictional Class Non-competitive Class Travel Percentage 30% Workweek Mon-Fri Hours Per Week 37.5 Workday From 9 AM To 5 PM Flextime allowed? No Mandatory overtime? No Compressed workweek allowed? No Telecommuting allowed? No County Steuben Street Address 76 Veterans Ave, Bldg 38 City Bath State NY Zip Code 14810 Duties Description - Assist, advise, and advocate for veterans, members of the armed services, and their families and survivors regarding federal and state veterans' benefits.- Assist in the preparation and processing of claims.- Liaise with public and private...

Job Description About Acrisure Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters, including Insurance, Reinsurance, Cyber Services, Mortgage Origination and more. Acrisure employs over 17,000 entrepreneurial colleagues in 21 countries and have grown from $38 million to $4.3 billion in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win. Responsibilities: Provide clients with customer service such as answering claims related questions, discussing claims processes and following up with the client at the conclusion of the claim to ensure all issues were addressed Contact clients and gather all appropriate information to...

Claims Manager Reports to: Personal Lines Vice President Location: Biddeford, ME Why Us At Rousseau Insurance Agency, we’re more than a workplace—we’re a third-generation, family-owned agency that believes in meaningful work, lasting client relationships, and a healthy work-life balance. If you thrive in a collaborative, supportive environment and enjoy helping people, we want to hear from you! Why This Role We are seeking a Claims Manager to report directly to the Personal Lines Vice President. In this full-time role, you will lead the charge in facilitating efficient claims resolutions (80%) while providing specialized loss control support to clients (20%). This role combines problem-solving, relationship management, and real impact. In this role, you will: · Guide clients through the claims process in a timely manner with empathy and expertise · Advocate for clients on coverage denials, Reservation of Rights letters and high-exposure settlements · Build...

Job Position: Customer Care Advocate Location: Milwaukee, Wisconsin - HQ Remote Type: Hybrid (3 days in office, 2 days remote) Position Overview: This role is key in meeting the needs of our OEM and distribution customers by handling routine and overflow calls and inquiries from customers and field sales representatives. This position is responsible for processing orders, advising on pricing, delivery, lead-time, terms and conditions guidelines and policies, credit/debits, etc. Key Responsibilities: Perform basic daily account management tasks: Respond to email and phone inquiries Process customer orders Process customer claims Complete daily reports Research and process customer credits and debits Assisting in writing department SOPs and work instructions and coaching other CSR’s on SOP and work instruction creation Triage and process customer orders Utilize CRM, Oracle, OTIS, DDM, Excel, Word, PPT, and O365 to address...

The Executive Office of Veterans Services (EOVS) is the Commonwealth of Massachusetts primary support and advocate for Veterans and their families. The mission of EOVS is to advocate on behalf of all the Commonwealth’s veterans. EOVS is actively recruiting for a new Veterans National Service Officer (NSO) to join their team! The NSO at the Executive Office of Veterans Services is a dynamic and impactful role focused on providing essential assistance and counseling to veterans, their dependents, and survivors. This role involves navigating the complexities of DVA benefit entitlements and services as per federal laws governing the Veterans Benefits Administration. The NSO will maintain a crucial advocacy liaison with Federal, State, and Municipality Agencies to ensure top-notch representation and support for the Veteran Community. Their responsibilities include overseeing the processing of claims, supervising representation before various boards and hearings, ensuring due...

Summary The Natural Resources Section has one of the most dynamic and complex practices in the Environment and Natural Resources Division of the Department of Justice, representing virtually every federal agency in federal district courts, the Court of Federal Claims, and state courts in novel litigation arising under more than 80 natural resource, environmental, and cultural resource statutes. The Natural Resources Section seeks experienced litigators in Washington, DC and Denver, Colorado. Learn more about this agency This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Clarification from the agency U.S. citizens or nationals Duties Much of our work involve challenges under the Administrative Procedure Act or the Just Compensation Clause of the Fifth Amendment to the United States Constitution. NRS has a dynamic practice with a diverse docket and attorneys may choose to focus on brief...

Title: Customer Care Advocate Department: Customer Service Union: UFCW 1546 Colorado Grade: 21 Position Summary The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions. Provides written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Updates files, including documenting system notes of conversations or action taken. Performs tasks associated with the administration of retirement and health and welfare benefits such as; Processing and/or sending mailers...

Discover a Career That Empowers You — Join HUB International! At HUB International, we’re more than just an insurance brokerage firm — we’re a thriving community of entrepreneurs driven by purpose and passion. Every day, we help individuals, families, and businesses protect what matters most by providing a broad array of insurance, retirement, and wealth management products and services. But we don’t stop there — we also invest deeply in our people. Here, your career is in your hands. You’ll be empowered to learn, grow, and truly make an impact. Whether you're supporting a local business or helping a national client navigate complex risk, you’ll be backed by the strength of a global firm and the heart of a regional team. As one of the world’s largest insurance brokers — and a proud Stevie Award-winning workplace — HUB offers a unique blend of big-company resources and entrepreneurial spirit. With over 20,000 professionals across 570+ offices in North America, we bring...

Join us for an exciting career with the leading provider of supplemental benefits! O ur Promise Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. The UI and Middleware Integrations Developer is responsible for building and maintaining user‑facing application components and the middleware services that connect them to backend systems. This role ensures that front‑end interfaces, middleware logic, and system integrations work seamlessly to deliver reliable, scalable, and efficient workflows. The developer will collaborate closely with Integrations & Data, Cadence Development, and Production Support to ensure alignment across end‑to‑end systems. Functional: 10+ years of software development experience Deep knowledge of API development, SQL, .NET, React, or similar enterprise platforms....

At ABB , we help industries run leaner and cleaner—and every person here makes that happen. You’ll be empowered to lead, supported to grow, and proud of the impact we create together. Join us and help run what runs the world. This position reports to: MONM Division General Counsel __ The work model for the role is: Hybrid #LI-Hybrid Your role and responsibilities: In this role, you will have the opportunity to provide strategic legal advice and uphold the highest standards of integrity within ABB. Each day, you will ensure compliance with applicable laws, regulations, and ethical standards. You will also showcase your expertise by effectively managing legal risks and fostering a culture of integrity across the organization. Our Team Dynamics   Our teams support each other, collaborate, and never stop learning. Everyone brings something unique, and together we push ideas forward to solve real problems. Being part of our team means your work matters...

Description The WTW Alternative Asset Insurance Solutions (AAIS) group provides a full spectrum of commercial insurance, employee benefits and transactional services for private equity firms and their portfolio companies. The AAIS engagement with a client begins with due diligence support in evaluating the costs, liabilities and exposures of potential acquisitions. After close, WTW manages the portfolio company’s insurance program through the private equity firm’s hold period and beyond. This senior level position supports AAIS Producers by overseeing the entire lifecycle of a portfolio company from initial engagement, conversion of the portfolio company to a WTW client, management of the portfolio company programs post-closing, and supporting post-closing placement and ongoing operational needs. This senior level role is critical to the stewardship of our key private equity relationships. The Role – Private Equity Portfolio Manager Support our AAIS team in...

Summary The Health System Specialist serves as a leader who translates organizational policies, and priorities into effective partnership with the Deputy/Chief of Staff, Pentad, Service Chiefs, and staff. This role drives adaptability and change while overseeing critical decisions. Responsibilities include planning and allocating resources such as FTE, salary and supply budgets, equipment and space contracts, and overtime to ensure the organization operates efficiently. Learn more about this agency This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Career transition (CTAP, ICTAP, RPL) Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants. Clarification from the agency ALL US CITIZENS DIRECT HIRE AUTHORITY: This position is being filled using Direct-Hire Authority (5 CFR 337.205) for this occupation. Duties...

The Claims Support Coordinator (Prior Authorization) is responsible for ensuring that specific workers compensation claim prescriptions are processed accurately and in a timely manner in order to increase cash flow and meet or exceed production goals. This position demands strong communication skills, quality customer service, heavy telephone interaction, problem solving skills and strong attention to detail while working in a fast-paced team environment. What You’ll Do Documents all communication with insurance carriers, physicians, law firms, account managers and patients in the approved format Follow all department policies and procedures to obtain authorization and pertinent information Review all letters and medical documents in regard to prior authorization Serves as a liaison between departments and outside parties to ensure that customers receive their medication in a timely manner Obtaining prior authorization for pending medications in states which this...

Achieving our goals starts with supporting yours. Grow your career, access top-tier health and wellness benefits, build lasting connections with your team and our customers, and travel the world using our extensive route network. Come join us to create what’s next. Let’s define tomorrow, together. Description Find your future at United! We’re reinventing what our industry looks like, and what an airline can be – from the planes we fly to the people who fly them. When you join us, you’re joining a global team of 100,000+ connected by a shared passion with a wide spectrum of experience and skills to lead the way forward. Achieving our ambitions starts with supporting yours. Evolve your career and find your next opportunity. Get the care you need with industry-leading health plans and best-in-class programs to support your emotional, physical, and financial wellness. Expand your horizons with travel across the world’s biggest route network. Connect outside your team...

Our story At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight."We are passionate about connectingpurposewith impact.Alightempowersclientsto builda healthierandmorefinancially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing,navigation, andabsence management. Our Benefits With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and visioncoveragesstartingDay One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities - all within a thriving global organization. Flexible Working So that you canbeyour best at work and home, we consider flexible working...

Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at...

Our story At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight."We are passionate about connectingpurposewith impact.Alightempowersclientsto builda healthierandmorefinancially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing,navigation, andabsence management. Our Benefits With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and visioncoveragesstartingDay One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities - all within a thriving global organization. Flexible Working So that you canbeyour best at work and home, we consider flexible working...