CrawlJobs Logo

Claims Specialist

personifyhealth.com Logo

Personify Health

Location Icon

Location:
Bosnia and Herzegovina , Tuzla

Category Icon
Category:

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

Not provided

Job Description:

Ready to Process Claims That Directly Impact Member Care? We're looking for a dedicated professional who understands that efficient claims processing is essential to member satisfaction and healthcare access. As our Claims Specialist, you'll perform critical daily activities that ensure timely, accurate processing for our clients while maintaining the highest standards of quality and compliance.

Job Responsibility:

  • Process claims efficiently: Handle daily claims processing activities for Personify Health clients, ensuring accuracy and timeliness in all transactions
  • Maintain quality standards: Work in high-paced office environment while focusing on tasks and consistently performing in compliance with policies and procedures
  • Meet production requirements: Adhere to work schedule and regularly attend work to meet client and production requirements while managing assigned deadlines
  • Support team success: Interact professionally with coworkers, clients, and customers while contributing to positive, collaborative work environment
  • Demonstrate reliability: Maintain ability to work on computer, multitask effectively, and consistently perform tasks according to established standards

Requirements:

  • High school diploma or equivalent required
  • Computer literacy with knowledge of Windows and Microsoft Office environment
  • Proficiency in Word and Outlook (Excel and insurance database systems experience a plus)
  • Ability to read and interpret documents, instructions, correspondence, and memos
  • Capability to write routine reports and correspondence
  • Skills to present information effectively in one-on-one and small group situations
  • Ability to compute rate, ratio, and percent and interpret bar graphs
  • Capacity to apply common sense understanding to written, oral, or diagram instructions
  • Problem-solving abilities for standardized situations involving concrete variables
  • Excellent interpersonal and communication skills with strong customer orientation
  • Ability to work in high-paced call center environment
  • Professional demeanor and collaborative approach to teamwork

Nice to have:

Excel and insurance database systems experience a plus

Additional Information:

Job Posted:
January 16, 2026

Work Type:
On-site work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Claims Specialist

Claims Experience Specialist

The Claims Experience team is responsible for providing premium support for our ...
Location
Location
Canada
Salary
Salary:
63000.00 CAD / Year
airbnb.com Logo
Airbnb
Expiration Date
Until further notice
Flip Icon
Requirements
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
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
What we offer
  • bonus
  • equity
  • benefits
  • Employee Travel Credits
  • Fulltime
Read More
Arrow Right

Property Claims Specialist

We’re working with a global broker known for handling complex risk. They’re look...
Location
Location
United Kingdom , Leeds
Salary
Salary:
40000.00 GBP / Year
https://www.lawesrecruitment.co.uk Logo
Lawes Consulting Group
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Proven track record of managing claims end-to-end
  • Familiar with domestic and/or commercial property policies
  • Experience with CMS platforms and Microsoft Office
Job Responsibility
Job Responsibility
  • Manage a portfolio of property claims from notification to resolution
  • Accurately assess policy coverage and determine liability
  • Liaise with loss adjusters, contractors, and customers
  • Ensure claims are settled efficiently, fairly, and within SLA
  • Maintain clear, accurate, and professional documentation
  • Escalate complex cases as needed, supporting a team-focused approach
  • Handle incoming claims and guide policyholders through the process
  • Investigate commercial property damage claims
  • Communicate regularly with stakeholders to keep claims moving
  • Collaborate with internal teams (underwriting, risk, customer care)
  • Fulltime
Read More
Arrow Right

Construction Engineer (Construction Claims Specialist)

The Honolulu Authority for Rapid Transportation (HART) is the public transit aut...
Location
Location
United States , Honolulu
Salary
Salary:
72520.00 - 103210.00 USD / Year
honolulutransit.org Logo
Honolulu
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's degree in Engineering from an accredited college or university. Degrees in related disciplines demonstrating equivalent knowledge may also be considered
  • Minimum of 10 years' experience in construction management
  • At least 3 years of experience demonstrating substantive knowledge of contract management, change orders, or construction fieldwork
  • Experience on major public transit construction projects or within legal departments/law firms is preferred but not required
  • Strong written and oral communication skills
  • Proficiency in Microsoft Office applications (Word, Excel, PowerPoint)
  • Candidates must meet the health and physical condition standards necessary to perform the essential duties of this position effectively
Job Responsibility
Job Responsibility
  • Review contracts, project documentation, and correspondence to identify potential claims issues
  • Analyze contractor claims for validity and prepare detailed reports with findings and recommendations
  • Interpret terms and conditions in proposals, awards, and contracts
  • Communicate with HART project managers and staff to gather project documentation and facts relevant to claims
  • Prepare reports, chronologies, summaries, and other documents to support HART's position on claims
  • Collaborate with construction management staff and experts to evaluate and monitor claims
  • Develop correspondence, task orders, and other claims-related documents
  • Create reports using Word, Excel, PowerPoint, and other software as required
  • Organize claims materials and files to ensure appropriate access for all stakeholders
  • Strategize with project managers, corporate counsel, or other involved parties to provide litigation support for claims
What we offer
What we offer
  • Medical, prescription drug, vision, dental, and life insurance plans
  • Generous vacation and sick leave, earning up to 21 days per year
  • 13 paid holidays annually (14 days during election year)
  • Retirement plan contributions through the Employees' Retirement System (ERS)
  • Deferred compensation options to invest pre-tax income for retirement
  • Flexible spending accounts for health and dependent care expenses
  • Pre-tax transportation benefits, including TheBus and vanpool options
  • Access to confidential counseling services through the Employee Assistance Program (EAP)
  • Additional perks include training opportunities and employer-funded Holo Card for eligible employees to use on public transit
  • Eligibility for the public Service Loan Forgiveness (PSLF) program, supporting employees dedicated to public service
  • Fulltime
Read More
Arrow Right

Claims Experience Specialist

The Claims Experience team is responsible for providing premium support for our ...
Location
Location
Japan
Salary
Salary:
Not provided
airbnb.com Logo
Airbnb
Expiration Date
Until further notice
Flip Icon
Requirements
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
  • 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
  • Calm and Empathetic with ability to adapt to any situation by personalizing responses and educating our community whilst remaining level headed in challenging situations
Job Responsibility
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
  • Fulltime
Read More
Arrow Right

Employee Relations Specialist

As an Employee Relations Specialist, you will be leveraging your skills in Claim...
Location
Location
United States , Beaverton
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • At least three years of experience in an Employee Relations Specialist role or a similar position
  • Proficiency in Claim Administration
  • Excellent Communication skills
  • Demonstrated experience in Complaint Handling
  • Familiarity with Compliance procedures and regulations in employee relations
  • Proven ability in Disciplining Employees in a fair and consistent manner
  • Experience in conducting Employee Relations Investigations
  • Experience in designing and delivering Employee Training programs
  • Experience in dealing with Union Grievances
  • Knowledge of NeoGov software is a plus
Job Responsibility
Job Responsibility
  • Conduct thorough investigations related to employee relations matters
  • Address and resolve employee relations issues efficiently
  • Provide expert guidance on labor and employment matters
  • Support in developing innovative workforce policies related to employee relations
  • Assist in the creation and implementation of training programs for employees
  • Handle complaints and administer claims related to employee relations
  • Ensure adherence to compliance and disciplinary measures
  • Manage and resolve union grievances
  • Use NeoGov for efficient process management
  • Prepare and maintain detailed investigation reports
What we offer
What we offer
  • Medical, vision, dental, and life and disability insurance
  • Eligibility to enroll in company 401(k) plan
  • Fulltime
Read More
Arrow Right

Ancillary Specialist

The Ancillary Specialist will review and adjudicate claims for our GAP product. ...
Location
Location
United States
Salary
Salary:
Not provided
drivetime.com Logo
DriveTime Automotive Group
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High School diploma required
  • Bachelor or Associate degree is preferred
  • Knowledge of GAP and/or Insurance Claims background preferred
  • Passionate and goal-oriented
  • Excellent verbal and written communication skills
  • Agile in a fast-paced environment
  • Works well in a time crunch
  • Fantastic problem solver
  • Positive emotional resilience
  • Plays well with others
Job Responsibility
Job Responsibility
  • Review and adjudicate claims for our GAP product
  • Verify multiple documents to ensure the correct amount is applied to the loan or returned to the customer
What we offer
What we offer
  • Medical, dental, and vision
  • 401(K)
  • Company paid life insurance policy
  • Short and long-term disability coverage
  • Growth Opportunities
  • Tuition Reimbursement
  • Wellness Program
  • Competitive pay
  • Consistent Work Schedule
  • Game Room
  • Fulltime
Read More
Arrow Right

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join a team i...
Location
Location
United States , King of Prussia
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • At least 1 year of experience in medical billing, claims, or collections
  • Proficiency in accounting software systems and electronic health record (EHR) systems
  • Familiarity with Medicaid processes and commercial insurance claims
  • Strong understanding of accounts receivable, denial management, and appeals
  • Experience working with billing and authorization functions
  • Ability to accurately input and manage billing data
  • Excellent communication skills to collaborate with team members and external payors
  • Knowledge of compliance policies related to medical billing and collections
Job Responsibility
Job Responsibility
  • Process and submit primary and secondary claims for both commercial insurance and Medicaid
  • Investigate and resolve claim denials, performing appeals as necessary to ensure proper reimbursement
  • Manage accounts receivable by following up on claims through resolution, including correcting billing errors and addressing rejections
  • Input and review billing data for accuracy, ensuring compliance with company policies and procedures
  • Collaborate with the Billing Manager and clinic teams to ensure accurate and timely billing
  • Track and verify Medicaid status for clients while maintaining relationships with payors to facilitate successful claims processing
  • Assist intake teams with Medicaid documentation for new clients and those requiring reassessment
  • Utilize various insurance portals and systems, including Waystar, to handle denial responses and claims follow-ups
  • Ensure adherence to compliance standards in all billing and collections activities
  • Perform other tasks as assigned by the Billing Manager or Director
What we offer
What we offer
  • Medical insurance
  • Vision insurance
  • Dental insurance
  • Life insurance
  • Disability insurance
  • 401(k) plan
  • Fulltime
Read More
Arrow Right

Medical Reimbursement Specialist

We are in search of a Medical Reimbursement Specialist to join our team. Station...
Location
Location
United States , Princeton
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum of 3 years of experience in a similar role
  • Proficient in benefit functions
  • Demonstrated expertise in billing functions
  • Experience in claim administration
  • Familiarity with collection processes
  • Ability to handle and resolve medical denials
  • Comprehensive knowledge of Medicare
Job Responsibility
Job Responsibility
  • Analyze and categorize outstanding claims based on payer, denial reason, and claim value
  • Investigate and take corrective action on unpaid, denied, or underpaid claims
  • Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
  • Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
  • Submit corrected claims and formal appeals as required
  • Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
  • Maintain comprehensive records of all payer interactions
  • Identify the root causes of denials and implement best practices to prevent future issues
  • Suggest changes to workflow to enhance claim submission accuracy and speed
  • Conduct training for in-house billing teams on claim recovery strategies
What we offer
What we offer
  • medical, vision, dental, and life and disability insurance
  • eligibility to enroll in company 401(k) plan
  • Fulltime
Read More
Arrow Right