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Claims assistant • phoenix az
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Conducts medical claims review using current claims processing guidelines and established clinical criteria e.CDST and policy keys, to evaluate medical necessity, appropriateness of care and progra...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
AmTrust Financial Services, a fast growing commercial insurance company, has an immediate need for a Workers' Compensation Claims Manager.
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IAT Insurance Group has an immediate opening for Casualty Claims Specialist to work out of one of the listed locations below.
This role works a hybrid schedule from one of the above listed IAT Offic...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Introduction Indulge your passion for problem-solving and embrace the thrill of addressing risk head-on at Gallagher's global brokerage team.
Join a family of diverse minds, united by a relentless p...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Kemper is one of the nation's leading specialized insurers.Our success is a direct reflection of the talented and diverse people who make a positive difference in the lives of our customers every d...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
A company is looking for a Liability Claims Assistant.Key Responsibilities Sets up new claims in the system, ensuring all documentation is present and correct Prepares, schedules, and processes ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
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At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading h...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Claim Operations provides administrative support to all claim lines of business and partners with the operations team to assist with the following responsibilities.
Receive new losses and verifies a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Medical Claims Coordinator - Hybrid.Cranial Technologies is the only company in the world completely dedicated to researching, diagnosing, and treating plagiocephaly (commonly called flat head synd...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
CorVel is seeking a Senior Liability Claims Specialist.The Senior Liability Claims Specialist manages within company best practices complex and non-complex Auto and General Liability claims.Additio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Job Responsibilities and Requirements.Obtains and analyzes information to make claim decisions and payments on LTD, Voluntary disability, and Waiver of Premium claims.
The goal of the position / role ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
CorVel is seeking a Senior Liability Claims Specialist.The Senior Liability Claims Specialist manages within company best practices complex and non-complex Auto and General Liability claims.Additio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency.Join us in delivering exceptional service while upholding the highest standards of professionalism and co...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Team Lead, Long-Term Disability Claims.At Prudential, we believe talent is key to achieving our vision.When you join Prudential, you'll unlock a motivating and impactful career all while growing y...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
N Central Ave, Phoenix, Arizona 85004 United States of America.Repwest Insurance is seeking a Claims Adjuster to handle Truck, Trailer and Storage property damage claims.
This is an in-office positi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE / COE, Auto, and Homeowners.
SIU experience is highly desired, but not require...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
The Senior Claims Examiner's primary job function includes efficiently and effectively handling intermediate-level, commercial first-party property and / or third-party general liability losses in a ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Rapidly growing healthcare technology company is looking for outgoing, energetic, and motivated individuals to join our team of Claim Analysts.
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Job Description
Job Description
Job Tittle : Claims Reviewer
Job ID : 75861
Location : Arizona - Remote
What you will be doing :
Conducts medical claims review using current claims processing guidelines and established clinical criteria e.g. CDST and policy keys, to evaluate medical necessity, appropriateness of care and program benefits, exclusions and limitations.
Validates medical determinations through research of resources including regulatory manuals, computer files, and documentation.
Prepares cases program payment or medical director review as indicated.
Validates all appropriate data is supplied with program invoice.
Reviews claim data for process improvements related to all aspects of claims payment.
Ensures contract compliance for timelines regarding resolution of medical claims.
Communicates effectively with management and peers.
Consistently meets medical claims processing quotas.
Identifies and reports any potential quality or fraud issues to management, Quality Management, or Program Integrity as needed.
Provides support regarding clinical and coding questions.
Performs other duties as assigned.
Regular and reliable attendance is required.
What you must have :
High School Diploma or GED
2+ years of claims review experience
Knowledge of all types of Medical claims review
Nice to have :
Claim coding experience
Knowledge of behavioral health claims review