1097 claims representative jobs found

Title: Claims Representative I/II/III Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations. The Claims Representative is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How You Will Make An Impact Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and soundness. Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. Researches and analyzes claims issues. Minimum Requirements Claim Rep I - Requires HS diploma or equivalent and related experience; or any combination of...

Title: Claims Representative I (Health & Dental) Location: This position will work fully on-site . The ideal candidate will live within 50 miles of our Elevance Health PulsePoint location at 220 Virginia Ave, Indianapolis, IN 46204. This position will have on-site training and will require you to be in the Indianapolis, IN office. Hours: 8:00 am-4:30 pm EST, M-F Must have 100% attendance during the first 10 weeks of training. Start date: 12/02/2024. The Claims Representative I will be responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How You Will Make An Impact Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and...

Location: Remote, within 50 miles of an Elevance Health pulse point. Hours: An 8-hour shift, Monday - Friday, between the hours of 7 am - 6 pm EST. The Claims Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How You Will Make An Impact Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and soundness. Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. Researches and analyzes claims issues. Minimum Requirements Requires HS diploma or equivalent and related experience; or any combination of education and experience which would provide an...

Claims Representative II (Health & Dental) Must be located within 50 miles of Norfolk, VA, Tampa, FL, Houston, TX or Mason, OH. The Claims Representative II (Health & Dental) is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. How you will make an impact: Participate in claims workflow projects. Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims. Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication. May have customer/client contact. May assist with training of staff. Works without significant guidance. Minimum Requirements: Requires a high school diploma and a minimum of 2 years of the companies internal claims experience; or any combination of education and experience which would provide an...

Location: Remote, within 50 miles of an Elevance Health pulse point. Hours: An 8-hour shift, Monday - Friday, between the hours of 7 am - 6 pm EST. The Claims Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How You Will Make An Impact Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and soundness. Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. Researches and analyzes claims issues. Minimum Requirements Requires HS diploma or equivalent and related experience; or any combination of education and experience which would provide an...

Location: Remote, within 50 miles of an Elevance Health pulse point. Hours: An 8-hour shift, Monday - Friday, between the hours of 7 am - 6 pm EST. The Claims Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How You Will Make An Impact Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and soundness. Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. Researches and analyzes claims issues. Minimum Requirements Requires HS diploma or equivalent and related experience; or any combination of education and experience which would provide an...

Must be located within 50 miles of Norfolk, VA, Tampa, FL, Houston, TX or Mason, OH. The Claims Representative II (Health & Dental) is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. How You Will Make An Impact Participate in claims workflow projects. Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims. Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication. May have customer/client contact. May assist with training of staff. Works without significant guidance. Minimum Requirements Requires a high school diploma and a minimum of 2 years of the companies internal claims experience; or any combination of education and experience which would provide an equivalent background....

Location: Remote, within 50 miles of an Elevance Health pulse point. Hours: An 8-hour shift, Monday - Friday, between the hours of 7 am - 6 pm EST. The Claims Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How You Will Make An Impact Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and soundness. Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. Researches and analyzes claims issues. Minimum Requirements Requires HS diploma or equivalent and related experience; or any combination of education and experience which would provide an...

Claims Representative II (Health & Dental) Must be located within 50 miles of Norfolk, VA, Tampa, FL, Houston, TX or Mason, OH. The Claims Representative II (Health & Dental) is responsible for keying, processing and/or adjusting health claims in accordance with claims policies and procedures. How you will make an impact: Participate in claims workflow projects. Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims. Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication. May have customer/client contact. May assist with training of staff. Works without significant guidance. Minimum Requirements: Requires a high school diploma and a minimum of 2 years of the companies internal claims experience; or any combination of...

Location: Remote, within 50 miles of an Elevance Health pulse point. Hours: An 8-hour shift, Monday - Friday, between the hours of 7 am - 6 pm EST. The Claims Representative I is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How You Will Make An Impact Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and soundness. Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. Researches and analyzes claims issues. Minimum Requirements Requires HS diploma or equivalent and related experience; or any combination of education and experience which would provide an...

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. CNA is the market leader in providing Accountants Professional Liability coverage and provides best-in-class claim service. We are seeking a dynamic self-starter to join our team as a Complex Claims Representative handling claims for accounting firms nationwide. The Complex Claims Representative plays a critical role in managing and resolving complex accounting malpractice claims by evaluating coverage, assessing liability and damages, setting timely reserves, negotiating and settling claims, and directing litigation. The Complex Claims Representative will collaborate in a rich team environment including claim leadership and business partners to ensure the best possible outcome on every claim....

Full job description Innova Solutions has a client that is immediately hiring a Warranty Claims Representative Role : Full-time: Contract Job Title: Warranty Claims Representative Job Type : 12+ Months Contract with possible extension Location: 6001 Premier Parkway Saint Peters, MO 63376 - Hybrid- on-site the first few weeks, Then remote Note : We have 5 openings for this role. Feel free to refer your friends or anyone in your circle- Looking for work Schedule: Schedule: Mon-Fri, flexible 8.5 hour shift, 8 hour shift with 30 min lunch, During training 8 am-4:30 CST Major Job Duties and Responsibilities : Resolve customers’ service or billing complaints by performing activities such as exchanging merchandise, refunding money, and adjusting bills. Contact customers to respond to inquiries or to notify them of claim investigation results and any planned adjustments. Refer unresolved customer grievances to designated departments for further...

Full job description You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. CNA is the market leader in providing Accountants Professional Liability coverage and provides best-in-class claim service. We are seeking a dynamic self-starter to join our team as a Complex Claims Representative handling claims for accounting firms nationwide. The Complex Claims Representative plays a critical role in managing and resolving complex accounting malpractice claims by evaluating coverage, assessing liability and damages, setting timely reserves, negotiating and settling claims, and directing litigation. The Complex Claims Representative will collaborate in a rich team environment including claim leadership and business partners to ensure the best...

Must-Haves: 1-3 years of experience in a workers compensation claims environment which provides the necessary skills, knowledge and abilities, such as experience in reviewing, investigating and closing workers compensation claims. Experience handling claims in multiple jurisdictions preferred Ability and proficiency in the use of computers and company standard software specific to position. Specifically Guidewire, On-Base, and Med-Data Knowledge of medical and legal terminology related to the work. Knowledge of workers compensation laws and regulations, including jurisdictional laws. Nice to Have: Bilingual (Spanish) Certification or progress toward certification is highly preferred and encouraged Education/Certifications: Bachelor s degree in a related field Continuous learning, as defined by the Company s learning philosophy, is required. Employers have access to artificial intelligence language tools...

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following...

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following...

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following...

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following...

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following...

Full job description You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity...

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following...

Job Title : Call Center Representative (Claims Dispatch and Customer Service) Location: Atlanta, GA (Onsite) Duration/Term: Long Term Contract   Position Summary: We are seeking an experienced Call Center Representative with expertise in dispatching emergency claims and handling day-to-day claims to vendors within our contract network. The ideal candidate will have excellent customer service skills, including a professional tone, effective voice inflection, and the ability to manage a high volume of claims-related inquiries. This role involves following up on requests, ensuring timely resolutions, and maintaining strong communication with both vendors and customers.   Key Responsibilities: Claims Dispatch : Manage and dispatch emergency and day-to-day claims to vendors within the established contract network, ensuring that each claim is processed efficiently and accurately. Customer Service : Provide high-quality customer service with excellent tone...

Job Family: Patient Account Representative Travel Required: None Clearance Required: None What You Will Do:   The Insurance Patient Account Representative - Hospital A/R Emphasis is an extension of a client’s business office staff. Representatives are responsible for taking in-coming and making out-going calls to patients and insurance companies to resolve account balances. All client policies and procedures are followed. Representatives will perform any and all job-related duties as assigned.   This position offers an attractive hybrid schedule working two days in the office and three days from home. Questions regarding this position, you may contact Chris Rivera (Manager, Talent Acquisition) at (424) 430-3111 Essential Job Functions Hospital Claims Account Review Appeals & Denials Medicare/Medicaid Insurance Follow-up Customer Service Billing UB-04 & CMS 1500 Duties &...

Description NOW HIRING! Amazing Opportunity in Columbus, Ohio! Join one of the city’s most prestigious facilities, featuring a state-of-the-art fitness center, a delicious cafeteria, and more! Our Fortune 500 pharmaceutical client is looking for dedicated, detail-oriented Medical Claims Representatives to join their dynamic onsite team. If you’re passionate about healthcare and skilled at navigating the complexities of medical claims, we want to hear from you! Why Work with Us? Competitive Pay: $19/hr. D.O.E. with weekly pay Career Growth: Opportunities for professional development Collaborative Environment: Enjoy a fun, supportive team atmosphere Work-Life Balance: Flexible hours, Monday to Friday (no weekends) Job Details: Title: Onsite Medical Claims Representative Location: Onsite in Columbus, OH (43222 zip code) Schedule: Full-time, day shifts available Training: Onsite with potential to transition to remote based on...