Claims Processing Associate Job at Robert Half (Rock Island)

Associate Claims Representative Liability-West

Take charge as a Claims Adjuster at The General, handling NSA claim investigatio...

Location

United States , Nashville, TN; Davenport, IA; Madison, WI; Stevens Point, WI; El Paso, TX

Salary:

Not provided

Sentry

Expiration Date

Until further notice

Requirements

Bachelor's degree or equivalent work experience
Ability to obtain and maintain state specific property and casualty claims licensing as required
Previous experience working with Auto Liability Claims strongly preferred
Solid knowledge and understanding of each phase of the claim handling process, or other equivalent knowledge
Solid knowledge and understanding of policies and endorsements related to casualty coverages, or other equivalent knowledge
Demonstrated experience handling moderately complex claims, or other equivalent experience
Demonstrated experience handling 1st and 3rd party, multi-line claims across our operating territories, or other equivalent experience
Demonstrated experience providing customer-driven solutions, support, or service

Job Responsibility

Support customers with empathy and understanding, assisting them through difficult situations and effectively communicating the claims process, the ongoing claim status, and decisions, including the reasoning behind them
Verify coverage and reasonable payments by thoroughly reviewing the policy, reviewing accident details, and other pertinent information related to the claim
Investigative claims by taking and reviewing recorded statements from involved parties and witnesses, reviewing policy reports and other pertinent evidence
Apply knowledge to evaluate claims exposure appropriately, establishing timely reserves
Comply with industry regulations, legal requirements, and internal company policies through thorough documentation of all decisions, correspondence, and discussions that occur throughout the life cycle of the claim

What we offer

401(K) plan with a dollar-for-dollar match on your first eight percent, plus immediate vesting
Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program
Generous Paid-Time Off plan
Volunteer-Time off
Group Medical, Dental, Vision, Life insurance, Parental leave, and our Health and Wellness benefits
Well-being and Employee Assistance programs
Sentry Foundation gift matching program

Fulltime

Claims Examiner Senior

The Claims Examiner Senior is responsible for reviewing, analyzing, researching,...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

Associate's degree or equivalent job-related experience required
Minimum of 3 years’ experience processing medical claims in the healthcare industry
Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies
Must have excellent written, verbal, organizational and interpersonal communication skills
Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills

Job Responsibility

Analyze medical claim information and take appropriate action for payment resolution in accordance with policies and procedures, desktops, processing guidelines, and federal regulations
Process medical claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms from facilities, physicians, Home Health, Durable Medical Equipment providers, laboratories, etc
Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes
Process provider refunds, reconsiderations, and direct member reimbursements
Process medical claim adjustments, recovery of claim overpayments, and execution of claim batch adjudication
Solve moderately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager
Assist with database improvements and testing for system upgrades, conversions, or implementation of new processes
Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management
Sets high standards of performance and promotes teamwork to achieve established team goals, while maintaining a positive, professional attitude
Contacting/responding to internal and external customers for resolution on claim issues

Fulltime

Claims Experience Specialist

The Claims Experience team is responsible for providing premium support for our ...

Location

Canada

Salary:

63000.00 CAD / Year

Airbnb

Expiration Date

Until further notice

Requirements

5+ years in a fintech or customer experience role
Minimum of 1+ years experience handling insurance claims, preferably including first and third party property damage claims
Proficiency in both English and in French (must be able to handle technical claims discussions in French)
Critical thinking skills with a proven track record in solving challenging customer problems and making claims decisions with consistency and fairness whilst adhering to policy terms and workflows
Strong verbal and written communication skills with experience interacting with customers through multiple channels including email, messaging and phone
Active listening skills to understand user needs and provide personalized recommendations and assistance
Ability to explain complex and sensitive issues to customers with confidence and clarity
Analytical skills with the ability to organize and work independently with rapidly changing priorities
Negotiation skills to ensure customer issues are resolved in a timely and efficient manner
Solution and outcome-oriented with an ability to balance fraud prevention alongside a positive user experience

Job Responsibility

Evaluate, investigate and resolve claims submitted across our AirCover products (including but not limited to Host Damage Protection claims) including claims of high value and complexity that require complex investigation and negotiations to reach satisfactory outcomes
Closely monitor for fraud detection and mitigate risks associated with bad actors to protect the Airbnb brand and community
Verify all relevant facts and evidence to determine case resolution outcomes whilst following internal policies and workflows
Go above and beyond to create personalized interactions and exceptional premium support throughout the end-to-end claims process, tailoring the experience offered whilst ensuring each user’s needs and preferences are met with the highest level of care and attention
Provide continuous education and guidance for users about our Aircover products, terms and policies to enable the seamless resolution of their requests
Work closely with stakeholders and third party claims administrators to align on case strategies and ensure a timely resolution is reached for our users
Communicate regularly with Supervisors and Manager to provide feedback on the status of claims
Maintain high levels of confidentiality whilst conducting investigations
Identify gaps in workflow, process or policy whilst striving to provide upward feedback as required to further improve the experience for our customers
Act as subject matter expert for change initiatives and/or cross functional projects taking place across the Aircover Scaled Ops and Optimization org, including assisting internal stakeholders to test, refine, ideate, and deploy new internal products and processes

What we offer

bonus
equity
benefits
Employee Travel Credits

Fulltime

Claims Processing Specialist

Robert Half is seeking a detail-oriented Claims Processing Specialist for a cont...

Location

United States , Honolulu

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Associate degree required
bachelor’s degree preferred
Prior experience in insurance, claims processing, benefits administration, or related office support preferred
Strong data entry, organizational, and administrative skills
High attention to detail and accuracy
Ability to manage a high volume of work and meet deadlines
Strong written and verbal communication skills
Ability to work independently with minimal supervision
Proficient in Microsoft Office, including Excel, Word, and Outlook
Comfortable learning and working within internal systems and office technology

Job Responsibility

Provide back-office support for the processing of disability-related claims
Review claim documentation for completeness and accuracy
Enter and update claim information in the appropriate systems
Verify eligibility requirements based on established guidelines
Assist with benefit calculation and payment processing support
Track and follow up on missing or outstanding documentation internally
Help reduce claims backlog by processing work efficiently and accurately
Maintain confidentiality and exercise sound judgment with sensitive information
Support internal claims operations and administrative tasks as needed

What we offer

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

Construction Disputes Senior Associate

A top 50 leading UK law firm is seeking a talented Senior Associate to join thei...

Location

United Kingdom , Greater London

Salary:

95000.00 - 120000.00 GBP / Year

Douglas Scott

Expiration Date

Until further notice

Requirements

A strong academic background and at least 4 years of PQE in construction disputes or professional indemnity claims
Experience in policy interpretation and a solid understanding of court and dispute resolution processes
Excellent drafting, negotiation, and communication skills
A proactive, team-focused approach and an enthusiasm for client engagement and business development

Job Responsibility

Defend professional indemnity claims against construction professionals, main contractors, and other professionals
Advise clients on insurance policy coverage and interpretation, including complex wording issues
Provide specialist advice on claims defense strategies and scope of policy cover
Work closely with experienced partners and a dynamic team in a collaborative environment

What we offer

A competitive salary and comprehensive benefits package
Recognition as one of the UK’s best workplaces for over 20 years, with Platinum Investors in People status
Opportunities for professional growth, flexible working arrangements, and a strong emphasis on work-life balance
A firm-wide commitment to diversity, sustainability, and innovation

Fulltime

Associate Director

A multidisciplinary consultancy with global experience, Blake Newport has been s...

Location

United Kingdom , Leeds

Salary:

Not provided

Blake Newport Associates

Expiration Date

Until further notice

Requirements

MRICS Qualified or equivalent
A minimum of 10 years post Degree qualification experience
Preferably hold or be working towards a Construction Law MSc or Post Graduate Diploma (or equivalent)
In depth knowledge of dispute resolution procedures and the principles of contract law
Extensive experience of major construction and engineering projects
Proficient in preparing, assessing and interrogating construction costs
Experience in preparing Adjudication documentation
Preferably experience in preparing (or assisting with) Expert Witness Reports
Exceptional communication skills in English (both oral and written)
Proven ability to generate new business and maintain client relationships

Job Responsibility

Developing and expanding business opportunities through established and new networks
Forensic analysis of tender, contract and claims documentation
Independent preparation of claims for loss and expense
Independent preparation of adjudication documentation
Draft written reports, setting out process, conclusions and recommendations
Experience of and ability to operate Standard Forms of Contract (JCT/NEC/FIDIC)
Provision of strategic advice at all stages of the construction life cycle

What we offer

Medical Insurance
Life Assurance
Discretionary bonus scheme
Professional fees paid
Hybrid working (home/office)
Additional holidays for long service
Buy / sell holiday scheme
Pension salary sacrifice
Further education sponsorship

Fulltime

HC & Insurance Operations Associate

The Healthcare & Insurance Operations Associate role involves processing claims,...

Location

India , Coimbatore

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

1-3 years of experience in processing claims adjudication and adjustment process
Experience of Facets is an added advantage
Experience in professional (HCFA), institutional (UB) claims (optional)
Both under graduates and post graduates can apply
Good communication (Demonstrate strong reading comprehension and writing skills)
Able to work independently, strong analytic skills

Job Responsibility

Process Adjudication claims and resolve for payment and Denials
Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations
Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
Organizing and completing tasks according to assigned priorities
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
Resolving complex situations following pre-established guidelines

Fulltime

Hc & Insurance Operations Associate

Location

India , Chennai

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

1-3 years of experience in processing claims adjudication and adjustment process
Experience of Facets is an added advantage
Experience in professional (HCFA), institutional (UB) claims (optional)
Both under graduates and post graduates can apply
Good communication (Demonstrate strong reading comprehension and writing skills)
Able to work independently, strong analytic skills

Job Responsibility

Process Adjudication claims and resolve for payment and Denials
Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations
Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
Organizing and completing tasks according to assigned priorities
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
Resolving complex situations following pre-established guidelines

Fulltime

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Claims Processing Associate

Job Description

Job Responsibility

Requirements

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