Claims Case Manager Job at NTT DATA (Oklahoma City)

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

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
At least 1 year of experience working from home with proven productivity and quality
Designated quiet area for completing calls
Must Pass Drug screen
Must Pass a background check with Education check and employment verification check

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 with an employer contribution
dental insurance with an employer contribution
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

New

Insolvency Insurance Case Manager

We are looking for an experienced Insolvency Insurance Case Manager to join our ...

Location

United Kingdom , Leeds

Salary:

Not provided

EDDISONS

Expiration Date

Until further notice

Requirements

Minimum 3 years’ experience within the insurance sector
Previous experience in case management, claims, or insurance administration
Strong organisational skills with the ability to manage multiple cases simultaneously
Excellent communication and stakeholder management skills
High attention to detail and accuracy
Ability to work independently whilst contributing to a team environment
Confident liaising with external stakeholders, including insurers and clients
Experience within insolvency or financial services (desirable but not essential)

Job Responsibility

Manage a portfolio of insolvency insurance cases from initial setup through to conclusion
Act as the primary point of contact for clients, providing proactive updates and maintaining strong relationships
Liaise with insurers to obtain quotations, negotiate terms, and progress policies
Coordinate all case documentation, ensuring accuracy and compliance
Monitor case progress to ensure deadlines and service standards are met
Raise and manage invoices in line with completed work
Work closely with the wider specialist insurance team to ensure efficient case handling
Identify opportunities to improve processes and enhance client experience

What we offer

Flexible and hybrid working arrangements
Supportive and collaborative culture aligned to BTG Eddisons’ values of being agile, ambitious, and approachable
Career development within a well-established and respected national business
Structured training provided
30+ offices nationwide
Bespoke MyBenefits platform

Fulltime

New

Technical Medical Claims Manager - Travel

Join Our Team as a Technical Claims Manager! We are thrilled to announce an exci...

Location

United Kingdom , Cardiff

Salary:

Not provided

Admiral Group Plc

Expiration Date

Until further notice

Requirements

A minimum of three years' experience handling medical claims within a travel claims context
Preferably possess CII or equivalent qualifications, demonstrating commitment to continuous learning
Strong experience in travel insurance claims, especially medical assistance
Solid understanding of medical claims validation and policy application
Experience managing external medical suppliers and influencing performance
Excellent analytical skills for assessing complex cases and identifying trends
Ability to use performance data to improve outcomes and control costs
Outstanding communication skills for collaboration with stakeholders
Capable of sharing technical knowledge and mentoring team members
Confident in making technical decisions on complex claims

Job Responsibility

Oversee large-value medical claims beyond supplier authority, reviewing coverage and collaborating with medical providers
Handle emergency calls for claims decisions after hours, ensuring readiness for significant decisions on high-value claims
Conduct audits on supplier claims processes to ensure effective management, providing feedback and challenging as needed
Identify cost-saving opportunities during case management, pursuing innovative approaches to stand out from competitors
Stay updated on travel insurance market developments, attending conferences to identify challenges and competitors
Share market knowledge and expertise with colleagues to support their development
Manage communication with stakeholders on high-value claims for informed decision-making and optimal outcomes

What we offer

Up to £3,600 of free shares each year after one year of service
33 days holiday (including bank holidays) when they join us, increasing the longer you stay with us, up to a maximum of 38 days (including bank holidays)
Option to buy or sell up to an additional five days of annual leave

Fulltime

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
enrollment in company 401(k) plan

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 , Remote

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

Insolvency Insurance Case Manager

We are looking for an experienced Insolvency Insurance Case Manager to join our ...

Location

United Kingdom , Leeds

Salary:

Not provided

EDDISONS

Expiration Date

Until further notice

Requirements

Minimum 3 years' experience within the insurance sector
Previous experience in case management, claims, or insurance administration
Strong organisational skills with the ability to manage multiple cases simultaneously
Excellent communication and stakeholder management skills
High attention to detail and accuracy
Ability to work independently whilst contributing to a team environment
Confident liaising with external stakeholders, including insurers and clients
Experience within insolvency or financial services (desirable but not essential)

Job Responsibility

Manage a portfolio of insolvency insurance cases from initial setup through to conclusion
Act as the primary point of contact for clients, providing proactive updates and maintaining strong relationships
Liaise with insurers to obtain quotations, negotiate terms, and progress policies
Coordinate all case documentation, ensuring accuracy and compliance
Monitor case progress to ensure deadlines and service standards are met
Raise and manage invoices in line with completed work
Work closely with the wider specialist insurance team to ensure efficient case handling
Identify opportunities to improve processes and enhance client experience

What we offer

Flexible and hybrid working arrangements
Supportive and collaborative culture
Career development within a well-established and respected national business

Parttime

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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