Senior Claims Representative Job at Brown & Brown UK (Carmel)

Workers Comp Senior Claims Representative

National Interstate is looking for a Workers Comp Senior Claims Representative t...

Location

United States , Richfield

Salary:

70000.00 - 75000.00 USD / Year

Engage Cleveland

Expiration Date

Until further notice

Requirements

Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience
Generally, a minimum of 5 years of experience in property and casualty claims handling
Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC)
Prefer PA NJ MA state handling experience
Works within significant limits and authority on assignments of higher technical complexity and coordination
Demonstrates strong analytical, negotiation, and problem-solving skills
Demonstrates knowledge of insurance policies, coverage, and claims handling procedures
Maintains knowledge of industry laws and regulations
Demonstrates ability to organize and prioritize caseloads, ensuring timely resolution of claims
Excellent interpersonal and communication skills with the ability to build relationships and lead negotiations

Job Responsibility

Manages an inventory of claims to evaluate compensability/liability
Plans and conducts claim investigations to confirm coverage and to determine liability, compensability and damages
Determines and negotiates appropriate claim settlements/reserves within prescribed authority
May attend arbitrations, mediations, depositions, or trials
Conveys moderately complex information regarding coverage and settlements to insureds, claimants, and external partners
Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner
Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements
Performs other duties as assigned

What we offer

medical, dental, and vision coverage
wellness plans
parental leave
adoption assistance
tuition reimbursement
Paid Time Off and paid holidays
a 401(k) plan with company match
an employee stock purchase plan
commuter benefits

Fulltime

Healthcare Claims Processing Senior Representative

The Healthcare Claims Processing Senior Representative will be responsible for p...

Location

United States , Plano

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

3 year(s) hands-on experience in Healthcare Claims Processing
2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
High school diploma or GED
Previously performing – in P&Q work environment
work from queue
remotely
Key board skills and computer familiarity – Toggling back and forth between screens/can you navigate multiple systems
Working knowledge of MS office products – Outlook, MS Word and MS-Excel.

Job Responsibility

Processing of Professional claim forms files by provider
Reviewing the policies and benefits
Comply with company regulations regarding HIPAA, confidentiality, and PHI
Abide with the timelines to complete compliance training of NTT Data/Client
Work independently to research, review and act on the claims
Prioritize work and adjudicate claims as per turnaround time/SLAs
Ensure claims are adjudicated as per clients defined workflows, guidelines
Sustaining and meeting the client productivity/quality targets to avoid penalties
Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA
Timely response and resolution of claims received via emails as priority work

Healthcare Claims Processing Senior Representative

The Healthcare Claims Processing Senior Representative at NTT DATA is responsibl...

Location

United States , Plano

Salary:

18.00 USD / Hour

NTT DATA

Expiration Date

Until further notice

Requirements

1-3 year(s) hands-on experience in Healthcare Claims Processing
2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
High school diploma or GED.
Previously performing – in P&Q work environment
work from queue
remotely
Key board skills and computer familiarity – Toggling back and forth between screens/can you navigate multiple systems.
Working knowledge of MS office products – Outlook, MS Word and MS-Excel.
Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).
Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities

Job Responsibility

Processing of Professional claim forms files by provider
Reviewing the policies and benefits
Comply with company regulations regarding HIPAA, confidentiality, and PHI
Abide with the timelines to complete compliance training of NTT Data/Client
Work independently to research, review and act on the claims
Prioritize work and adjudicate claims as per turnaround time/SLAs
Ensure claims are adjudicated as per clients defined workflows, guidelines
Sustaining and meeting the client productivity/quality targets to avoid penalties
Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
Timely response and resolution of claims received via emails as priority work

What we offer

medical, dental, and vision insurance, 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, and additional voluntary or legally required benefits

Fulltime

Senior Claims Processing Representative

The Senior Claims Processing Representative role at NTT DATA involves processing...

Location

United States , Plano

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

3 year(s) hands-on experience in Healthcare Claims Processing
2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
High school diploma or GED
Previously performing – in P&Q work environment
work from queue
remotely
Key board skills and computer familiarity – Toggling back and forth between screens/can you navigate multiple systems
Working knowledge of MS office products – Outlook, MS Word and MS-Excel.

Job Responsibility

Processing of Professional claim forms files by provider
Reviewing the policies and benefits
Comply with company regulations regarding HIPAA, confidentiality, and PHI
Abide with the timelines to complete compliance training of NTT Data/Client
Work independently to research, review and act on the claims
Prioritize work and adjudicate claims as per turnaround time/SLAs
Ensure claims are adjudicated as per clients defined workflows, guidelines
Sustaining and meeting the client productivity/quality targets to avoid penalties
Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA
Timely response and resolution of claims received via emails as priority work

New

Clinic Patient Representative Senior - Vascular Surgery

Greets, instructs, directs and schedules patients and visitors. Serves as a liai...

Location

United States , Texarkana

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Knowledge of managed care preferred
Ability to operate 10 key calculator by touch, telephone, computer, copier, and fax machine
Excellent interpersonal and communication skills and good math knowledge essential
Some College Preferred
Three or more years of experience in a health care organization
ICD9 and CPT coding (advanced skills) Preferred
Experience with charge posting or collections Preferred

Job Responsibility

Maintains flow of patient check-in, verifies demographic and insurance information and enters into computer database. Assures that information in patient account is accurate
Assists with answering phones, taking messages and assisting with patient and staff inquiries
Responds to CBO requests for patient account corrections and/or maintenance, in a timely manner
Schedules appointments for patients in accordance with physician guidelines
Collects time of service payment amounts
collects prior balance amounts and/or arranging payment plans as requested
Checks in patients, verifies and updates necessary information in the medical record. Assists patients with completing all necessary forms
Scheduled appoints according to clinician template and follows office scheduling policies
Assists front office lead/supervisor with other administrative duties such as front end duties, denials, work queues and correct any errors to ensure clean claims
Screens visitors and responds to routine requests for information

Fulltime

New

Clinic Patient Representative Senior - Rheumatology

Greets, instructs, directs and schedules patients and visitors. Serves as a liai...

Location

United States , Tyler

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Knowledge of managed care preferred
Ability to operate 10 key calculator by touch, telephone, computer, copier, and fax machine
Excellent interpersonal and communication skills and good math knowledge essential
Some College Preferred
Three or more years of experience in a health care organization
ICD9 and CPT coding (advanced skills) Preferred
Experience with charge posting or collections Preferred

Job Responsibility

Maintains flow of patient check-in, verifies demographic and insurance information and enters into computer database
Assists with answering phones, taking messages and assisting with patient and staff inquiries
Responds to CBO requests for patient account corrections and/or maintenance, in a timely manner
Schedules appointments for patients in accordance with physician guidelines
Collects time of service payment amounts
collects prior balance amounts and/or arranging payment plans as requested
Checks in patients, verifies and updates necessary information in the medical record
Assists front office lead/supervisor with other administrative duties such as front end duties, denials, work queues and correct any errors to ensure clean claims
Screens visitors and responds to routine requests for information
Follows the CHRISTUS Health guidelines related to HIPAA

Fulltime

New

Clinic Patient Representative Senior - Multi Specialty

Greets, instructs, directs and schedules patients and visitors. Serves as a liai...

Location

United States , Corpus Christi

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Knowledge of managed care preferred
Ability to operate 10 key calculator by touch, telephone, computer, copier, and fax machine
Excellent interpersonal and communication skills and good math knowledge essential
Some College Preferred
Three or more years of experience in a health care organization
ICD9 and CPT coding (advanced skills) Preferred
Experience with charge posting or collections Preferred

Job Responsibility

Maintains flow of patient check-in, verifies demographic and insurance information and enters into computer database. Assures that information in patient account is accurate
Assists with answering phones, taking messages and assisting with patient and staff inquiries
Responds to CBO requests for patient account corrections and/or maintenance, in a timely manner
Schedules appointments for patients in accordance with physician guidelines
Collects time of service payment amounts
collects prior balance amounts and/or arranging payment plans as requested
Checks in patients, verifies and updates necessary information in the medical record. Assists patients with completing all necessary forms
Scheduled appoints according to clinician template and follows office scheduling policies
Assists front office lead/supervisor with other administrative duties such as front end duties, denials, work queues and correct any errors to ensure clean claims
Screens visitors and responds to routine requests for information

Fulltime

Patient Financial Representative Senior - Patient Financial Services

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred.

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Responds to all types of account inquiries through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution
Meets or exceeds customer expectations and requirements, and gains customer trust and respect
Compliant with all CHRISTUS Health, payer, and government regulations

Fulltime

Select Country

Senior Claims Representative

Job Description

Job Responsibility

Requirements

What we offer

Looking for more opportunities?