Claims Case Manager Job at NTT DATA (Lincoln)

Claims Case Manager

We are seeking a dedicated Claims Case Manager to provide comprehensive claim se...

Location

United States , Oklahoma City

Salary:

26.00 USD / Hour

NTT DATA

Expiration Date

Until further notice

Requirements

2 years in an analytical role reviewing medical benefits and claims
2 years of claims adjudication experience, preferably in life, and supplemental products (e.g., critical illnesses such as cancer, stroke, heart attack, kidney disease)
4 years of experience reviewing and assessing medical records
Experience articulating claim requirements clearly and concisely
Minimum high school diploma or GED
At least 1 year of experience working from home with proven productivity and quality
Designated quiet area for completing calls
Must live in the Continental United States
Must pass drug screen
Must pass a background check with education check and employment verification check

Job Responsibility

Gather information and initiate claims through various channels
Log and update pertinent information throughout the claim lifecycle
Communicate required medical records and claim information via email, mail, and phone
Follow up on pending claims and assist in gathering required medical records
Calculate benefit amounts and process payments through the claims system
Manage a caseload of active claims and perform end-to-end steps
Ensure accuracy and organization in logging, tracking, and reviewing claims
Identify and flag potential fraudulent activities
Work with management and team members to address service issues and concerns
Communicate with claimants with empathy and a willingness to help

What we offer

Medical insurance
Dental insurance
Vision insurance with an employer contribution
Flexible spending or health savings account
Life and AD&D insurance
Short- and long-term disability coverage
Paid time off
Employee assistance
Participation in a 401k program with company match
Additional voluntary or legally required benefits

Fulltime

Claims Case Manager

We are seeking a dedicated Claims Case Manager to provide comprehensive claim se...

Location

United States , Lincoln

Salary:

26.00 USD / Hour

NTT DATA

Expiration Date

Until further notice

Requirements

2 years in an analytical role reviewing medical benefits and claims
2 years of claims adjudication experience, preferably in life, and supplemental products (e.g., critical illnesses such as cancer, stroke, heart attack, kidney disease)
4 years of experience reviewing and assessing medical records
Experience articulating claim requirements clearly and concisely
Minimum high school diploma or GED
college degree preferred
At least 1 year of experience working from home with proven productivity and quality
Designated quiet area for completing calls
Must live in the Continental United States
Must Pass Drug screen

Job Responsibility

End-to-End Claim Management: Handle every aspect of the claim process, from intake to final decision
Status Updates: Provide frequent updates to claimants through their preferred communication channels
Document Review: Thoroughly review medical documents, claim forms, and policy notes
Communication: Interact with claimants with empathy and attention to detail
Team Collaboration: Work with team members to ensure high-quality service and resolution of issues
Record Keeping: Maintain accurate records and reports throughout the claims process
Data Analysis: Compile and analyze data to identify trends and perform root cause analysis
Claim Initiation: Gather information and initiate claims through various channels
Detailed Logging: Log and update pertinent information throughout the claim lifecycle
Omni-Channel Correspondence: Communicate required medical records and claim information via email, mail, and phone

What we offer

medical insurance
dental insurance
vision insurance with an employer contribution
flexible spending or health savings account
life and AD&D insurance
short- and long-term disability coverage
paid time off
employee assistance
participation in a 401k program with company match

Fulltime

Pre-Litigation Case Manager

Lundy Law is seeking a highly organized and client-focused Pre-Litigation Case M...

Location

United States , Philadelphia

Salary:

48000.00 - 60000.00 USD / Year

Lundy Law

Expiration Date

Until further notice

Requirements

Strong organizational and multitasking skills
Ability to manage deadlines and prioritize competing tasks
Strong communication and client service skills
Ability to work independently with minimal supervision
Experience in personal injury or legal case management preferred

Job Responsibility

Manage a caseload of approximately 60+ pre-litigation personal injury cases
Maintain accurate, organized, and up-to-date case files
Communicate regularly with clients regarding treatment updates, case facts, and next steps
File claims and communicate with insurance carriers to verify coverage and request policy limits
Schedule and coordinate PIP statements and applications
Build and maintain strong working relationships with medical providers and treatment offices
Request, track, and follow up on medical records and bills
Review medical records, police reports, and supporting documentation
Assist clients with property damage claims, medical funding/loans, and lost wage documentation
Prepare case files for demand and settlement review

What we offer

Hybrid work schedule
Supportive, team-oriented environment
Opportunity to grow within a fast-paced personal injury practice
Meaningful work helping clients through difficult times

Fulltime

New

Case Manager

Aplin is partnering with the Workers Compensation Board of Manitoba (WCB) to rec...

Location

Canada , Winnipeg

Salary:

Not provided

Aplin

Expiration Date

Until further notice

Requirements

A university degree in a related field (Commerce, Psychology, Social Work, Nursing, Physiotherapy, Occupational Therapy, etc.) and at least five years of experience making entitlement decisions while providing client services or equivalent combination of education and/or experience
Familiarity with case management, disability management, and medical terminology
The ability to analyze information, assess claims, and make informed decisions
Strong verbal and written communication to interact with diverse stakeholders
Ability to work independently and collaboratively
Comfortable working under pressure with tight deadlines
Experience using Windows-based software (Word, Excel, PowerPoint, etc.)
Willingness to travel within Manitoba as required

Job Responsibility

Manage workplace injury and illness claims, making entitlement decisions based on thorough assessments
Provide personalized support to injured workers and employers, guiding them through the recovery and return-to-work process
Identify and implement safe, modified, or alternate return-to-work opportunities
Coordinate services with medical professionals, rehabilitation specialists, and other team members
Facilitate multi-disciplinary meetings to develop and implement case plans for complex cases
Promote and support workplace disability management and return-to-work programs
Ensure compliance with The Workers Compensation Act and other relevant legislation

What we offer

competitive wages
compressed work week and flexible start times
defined benefit pension plan
100% employer-paid benefits
work from home program
paid professional development
health and wellness spending accounts
paid mental health and wellness days
staff appreciation and recognition events
respectful, diverse, and inclusive workplace culture

Fulltime

New

Plads Sr Life Case Manager

Location

United States

Salary:

65000.00 - 85000.00 USD / Year

Aflac

Expiration Date

June 15, 2026

Requirements

High School Diploma or equivalent
3 - 5 years of Life industry claims experience
Demonstrated proficiency in product specific areas of Life or Disability as well as federal and state regulations governing these products and services
Or an equivalent combination of education and experience
Strong familiarity with claim management concepts
Strong understanding of medical terminology/pathology/anatomy
Articulate verbal and writing skills, decision making, meeting deadlines, working with confidential information
Strong skills with Microsoft Office and other software applications
Ability to multi-task and prioritize
High level of attention to detail

Job Responsibility

Makes timely, accurate, and customer-focused life, accident, new and ongoing claim decisions using advanced independent discretion, guided by company procedures and regulatory standards
handles complex claims
obtains relevant medical, legal , employer, financial, and other information
compares the information to the terms, limitations, and conditions of the contract and applicable procedural documents, and renders the claim decision as quickly as possible
Documents the claims system in an accurate and comprehensive manner
prepares, updates, and utilizes a claims management plan to attain the most appropriate outcome
remains in full compliance with regulatory requirements
demonstrates an above average level of proficiency in product and claims administration techniques
remains fully compliant with operational standards
meets or exceeds claims team operational metrics

What we offer

Medical, dental, and vision coverage
Prescription drug coverage
Health care flexible spending
Dependent care flexible spending
Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee)
401(k) plans
Annual bonuses
Opportunity to purchase company stock
11 paid holidays
Up to 20 days PTO

Fulltime

!

New

Pre-Litigation Personal Injury Case Manager Paralegal

We are looking for a skilled Pre-Litigation Personal Injury Case Manager Paraleg...

Location

United States , Albuquerque

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 2 years of experience handling pre-litigation personal injury matters in a law firm or similar legal setting
Background working on plaintiff-side injury cases with an understanding of claim development and pre-suit procedures
Proficiency with case management systems, document handling tools, and standard office software, including Microsoft Excel and Adobe Acrobat
Ability to manage deadlines, maintain organized files, and handle multiple active matters with close attention to detail
Strong written and verbal communication skills for interacting with clients, providers, insurers, and internal legal teams
Experience reviewing records, coordinating claim documentation, and supporting demand or settlement preparation
Bilingual Spanish skills are highly preferred
Sound judgment, reliability, and the ability to work effectively in a fast-paced environment

Job Responsibility

Oversee a pre-litigation personal injury caseload, tracking each matter from initial intake through settlement preparation and follow-up
Communicate regularly with clients, insurance carriers, medical offices, and other parties to gather updates, request records, and move claims forward
Prepare and organize case documentation, including demand packages, correspondence, medical records, liens, and supporting claim materials
Maintain accurate case files, deadlines, and activity notes using case management software and calendaring tools
Review incoming documents for completeness and accuracy, then route information appropriately to support timely claim handling
Assist with billing-related tasks, record management, and administrative coordination tied to personal injury plaintiff matters
Use tools such as Adobe Acrobat, Microsoft Excel, and legal research platforms to compile, analyze, and manage case information
Support attorneys and legal staff with pre-suit case development, status reporting, and resolution planning

What we offer

Medical, vision, dental, and life and disability insurance
401(k) plan

Fulltime

Eligibility Case Manager

Why join DXC Technology DXC's Insurance Software and BPS (ISB) helps insurers a...

Location

Australia , Any City

Salary:

Not provided

DXC Technology

Expiration Date

Until further notice

Requirements

A qualification or certification in a health or business-related field (highly desirable)
Minimum of 3-5 years of experience in workers' compensation case management, preferably in a self-insured environment
Previous experience in assessing claim eligibility and determining liability in line with applicable legislation and internal policies
Proven ability to review and approve Pre-Injury Average Weekly Earnings (PIAWE) and Weekly Compensation calculations
Background in investigating claims, including gathering and analysing evidence to make informed liability decisions
Experience working collaboratively in a multidisciplinary team, including with case managers, payroll, and legal advisors
Strong analytical and problem-solving skills, with the ability to interpret complex information and provide clear, evidence-based decisions
High attention to detail and accuracy in both documentation and decision-making process
Excellent written and verbal communication skills, with the ability to deliver complex information clearly, empathetically, and professionally
Strong interpersonal and influencing skills with the ability to engage and collaborate effectively across all levels

Job Responsibility

Assess new workers' compensation claims to determine eligibility in accordance with relevant State legislation, regulations and self-insurer guidelines
Conduct investigations into claims where liability is unclear, including gathering factual evidence, reviewing medical reports, consulting with stakeholders, and where necessary, commissioning independent assessments
Review and approve the initial calculation by the PIAWE specialist of Pre-Injury Average Weekly Earnings (PIAWE) and Weekly Compensation entitlements
Coordinate the timely and smooth transition of accepted claims to ongoing Case Managers with all relevant information and context
Liaise with payroll to verify earnings data and ensure accuracy in compensation payments
Provide timely responses to inquiries regarding eligibility and claim status to injured team members through the early stages of the claim process, ensuring they understand their rights and obligations
Communicate claim decisions to injured team members, employers, and other stakeholders in a professional, clear, and empathetic manner
Deliver a high standard of service that promotes trust and transparency
Ensure strict compliance with all applicable workers’ compensation legislation, self-insurance requirements, and organisational policies
Maintain accurate claims data, documentation and up-to-date file notes by consistently recording all relevant information in Assure to support claims decisions and regulatory compliance

What we offer

Extensive resources to support your onboarding and continual development including DXC University
Rewards for referring friends and family to work at DXC
Flexible leave options, including purchased leave
Charitable and emergency services volunteer days
Employee Assistance Program
Novated leasing
Discounted health insurance
Paid parental leave
Many other discounts

Fulltime

Case Manager Nurse-RN

We are seeking Case Manager Nurse, RN, to join our team part-time. As a Case Man...

Location

United States

Salary:

36.00 - 38.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

Graduation from an accredited Registered Nursing (RN) program
Possession of a current California RN license
a multi-state license will also be required
Minimum of five (5) years medical/surgical or acute care experience, including two years’ experience in case management, or an equivalent combination of education and experience
Prior case management experience, emergency room, critical care background or other relevant clinical care experience pertinent to case management
Knowledge of medical claims and ICD-10, CPT, HCPCS coding
Ability to critically evaluate claims data and determine treatment plan, discharge planning experience
Ability to work independently making decisions and problem solving
Knowledge of community resources and alternate funding programs
Computer proficiency or working knowledge of Microsoft Office Suite

Job Responsibility

Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs
Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs
Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals
Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner
report measurable outcomes that record effectiveness of interventions
Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care
Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs
provide patient/family with emotional support and guidance
Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis
Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports

What we offer

Part-time schedule designed around your availability and life priorities
Access to learning and development opportunities alongside full-time colleagues
Mentorship and skill-building that translates to career advancement
Competitive hourly compensation that values your expertise
Technology and equipment support to set you up for success

Parttime

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Claims Case Manager

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