The Claims User Acceptance Tester (UAT) will be responsible for validating whether all the business requirements have been fulfilled before releasing the actual product to production. The individual will perform positive and negative testing to identify and ensure any defects found are corrected prior to implementation. The Claims UAT will develop and follow a test plan w

The Claims Supervisor is responsible for the daily oversight of claims processes including but not limited to the inquiry and resolution process, adjudication process, user acceptance testing and quality assurance, training, and reporting. In addition, the position assists the claims manager with claims related queue management (i.e. claims, inquiries, refunds, adjudicati

As a Claims Adjustment Specialist I, this individual will be responsible for analyzing standard to complex post paid healthcare claims that require in depth research to determine accuracy and mitigate payment errors. The Claims Adjustment Specialist I will also be responsible for adjusting medical claims that result in overpayment or underpayment due to claim processing s

Competitive Pay! Overflowing benefit package 33 Paid days off 1st year! Responsible for ensuring optimal and timely reimbursement by maintaining accurate client eligibility information and resolving errors before claims are filed. Work closely with the COPES clinicians to improve processes, efficiencies, and productivity. Generate and complete assigned reports, adhering t

Responsible for all areas of customer service as it pertains to the acquisition and/ or retention of members for Sentara Health Plan, Inc. This includes functions associated with the administration of all group information processing of claims, interaction with members, providers and employers. Special reports and projects to include initial review and analysis, recommend

Complete field inspections, reviews and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company crop insurance policies Ensure compliant and cost effective application of crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory require

It takes a special kind of talent and attention to detail to find solutions that are fair to everyone. That's how you can make an impact here at Cox. We're hiring an Automotive Claims Specialist II to join our vehicle operations team at Cox Automotive. In this role, you'll be at the forefront of resolving customer concerns in the fast paced world of vehicle purchases. You'

Develops and maintains corporate payment policies, and works collaboratively with the Clinical Editing Manager to ensure consistency with the Plan's adjudication system(s) Monitors DHHS, EOHHS, and CMS websites, listservs and other sources to identify existing payment practice and upcoming changes Determine the scope and impact of the change on Plan operations and seek to

Inspiring healthier lives through Water Your Way. At Primo Water, we are committed to empowering associates to live our shared values and provide opportunities for our associates to grow and celebrate being part of a winning team. Our comprehensive benefits package empowers you to maximize your money, live a healthy life, and grow personally and professionally. We call it

Associate Broker, Reinsurance This is a hybrid role with the flexibility to work both virtually and from our Atlanta office Aon is in the business of better decisions At Aon, we shape decisions for the better to protect and enrich the lives of people around the world. As an organization, we are united through trust as one inclusive, diverse team, and we are passionate abo

Establishes and executes controls to assure that the quality of the work meets or exceeds standards. Reviews and analyzes processes, procedures and workflows to identify opportunities for process improvement and efficiency. May recruit, hire and recommend or initiate promotions, transfers and disciplinary action. Manages personnel administration including employee evaluat

Claims Specialist II Construction Defect Job Locations US United States Requisition ID 2024 16848 Category Claims Specialty Lines Position Type Regular Full Time Overview Amtrust Financial Services, a fast growing commercial insurance company, is seeking a Construction Defect Commercial Claims Adjuster II. This position can be located in one of our claims offices, with th

Essential Duties & Job Functions Ensure daily operation of the warehouse and property storage area, is secure and safe. Monitor purchase requisitions for accountable and expendable property purchases. Assist in issuing of expendable items from Center inventory. Assist in development of new and revised policies and procedures affecting property. Perform annual inventory of

The Advocate provides support for medical services by assisting with treatment plans; treatment plan reviews; patient assistance programs; IDP, outcomes; authorization overrides; follow ups, State paperwork and referrals. Conducts face to face visits; handles medical service related telephone calls with individuals receiving medical outpatient mental health services. Illu

Digitech is seeking a Claims Resolution Specialist (Insurance Biller) to work claims after they've been submitted to commercial insurance carriers. This position requires an individual who demonstrates strong follow through, close attention to detail, and the ability to multi task. The Sarnova Family of companies includes Digitech Computer, Bound Tree Medical, Tri anim He