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Claims Specialist

Claims Specialist

Healthcare Legal Solutions LLCWashington, DC, US
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This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents. researching using hospital and insuran...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Auto Claims Adjuster

Auto Claims Adjuster

SedgwickWashington, DC, US
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By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your c...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Insurance Claims Environmental

Insurance Claims Environmental

Diedre Moire Corp.Chillum, Maryland, United States
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Associate Claims Counsel - Asbestos Litigation Management - Chillum, MD Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard _.RE...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Claims Auditor

Claims Auditor

VirtualVocationsAlexandria, Virginia, United States
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A company is looking for a Claims Auditor who will conduct audits across various employer groups and product lines to ensure claims processing integrity. Key Responsibilities Perform auditing of c...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Claims Consultant

Claims Consultant

Pop-Up TalentBethesda, MD, US
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The Claims Consultant will be responsible for conducting impact analysis, analyzing risk on complex projects, and performing forensic schedule and cost analysis consisting of identifying critical p...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Claims Analyst / Lead Claims Analyst / Senior Claims Analyst (Full-Time)

Claims Analyst / Lead Claims Analyst / Senior Claims Analyst (Full-Time)

McDonough Bolyard PeckWashington, DC, US
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Claims Analyst / Lead Claims Analyst / Senior Claims Analyst.MBP is looking for Claims Analyst / Lead Claims Analyst / Senior Claims Analyst in Tampa, FL, Raleigh, NC, or Washington DC areas, with signific...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Claims Adjuster - Crop

Claims Adjuster - Crop

QBE InsuranceWashington, DC, US
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In this role you will respond to crop claims by completing field inspections, communicating with involved parties, performing investigations, determining appropriate adjustments and administering i...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Claims Analyst

Claims Analyst

Edenbridge Health LlcWashington, DC, US
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Organization : Edenbridge PACE at Skyland.Mission : To allow frail elderly people to age in the location of their choosing and continue to lead connected, meaningful lives. The Claims Analyst reviews,...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Claims Resolution Specialist

Claims Resolution Specialist

Vets HiredArlington County, Virginia, USA
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The Claims Resolution Specialist is responsible for ensuring accurate and timely billing and reimbursement for medical services. This role requires strong knowledge of medical terminology coding ins...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Commercial Claims Counsel

Commercial Claims Counsel

GEICOChevy Chase, MD, United States
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At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.Every day we honor our iconic brand by offering quality coverage to millions of customers and being the...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Claims Adjuster, Subrogation

Claims Adjuster, Subrogation

Pie InsuranceWashington, DC, US
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Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie.We leverage technology to transform how small businesses buy and experience comme...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Claims Analyst, Asbestos (Asbestos Claims Handling Experience Required)

Claims Analyst, Asbestos (Asbestos Claims Handling Experience Required)

The Riverstone GroupWashington, DC, US
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RiverStone is seeking individuals to join a growing and dynamic team tasked with changing the future of the national mass tort and pollution litigation through thoughtful, creative claim handling, ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Health Care Claims Specialist

Health Care Claims Specialist

Crowell & MoringWashington, DC, US
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Crowell & Moring LLP is an international law firm with offices in the United States, Europe, MENA, and Asia that represents clients in litigation and arbitration, regulatory and policy, intelle...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Medical Claims Processor

Medical Claims Processor

Pyramid ConsultingWashington, DC, US
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Immediate need for a talented Medical Claims Processor.This is a 04+ months contract opportunity with long-term potential and is located in Denver, CO (Remote). Employee benefits include, but are no...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Claims Manager

Claims Manager

GT IndependenceSilver Spring, MD , US
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Work for a company where you make a difference in people's lives every day!.At GT, we know that our people are at the heart of our success. If you love your work, enjoy collaboration, and want to le...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Healthcare Claims Manager

Healthcare Claims Manager

Personify HealthWashington, DC, US
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Manager Of Healthcare Claims Ingestion & Data Integration.Ready to create a healthier world? Personify Health is on a mission to simplify and personalize the health experience to improve health and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Auto Claims Adjuster

Auto Claims Adjuster

Phenom PeopleWashington, DC, US
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We are Farmers! We are more than just your favorite commercials.We are a passionate, award winning, equal opportunity employer, committed to the strength of a diverse workforce.We are dedicated to ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Claims Analyst, Asbestos (Asbestos Claims Handling Experience Required)

Claims Analyst, Asbestos (Asbestos Claims Handling Experience Required)

The RiverStone GroupWashington, DC, United States
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RiverStone is seeking individuals to join a growing and dynamic team tasked with changing the future of the national mass tort and pollution litigation through thoughtful, creative claim handling, ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Claims Specialist - NY

Claims Specialist - NY

CorVelWashington, DC, US
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The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, un...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Claims Specialist

Claims Specialist

Healthcare Legal Solutions LLCWashington, DC, US
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Job Description

Job Description

SUMMARY :

This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously submitted appeals.

DUTIES AND RESPONSIBILITIES :

  • Investigates Claims Denials.
  • Handles large volumes of documents, including accurately scanning and mailing documents.
  • Utilizes increased knowledge of the industry, hospital revenue cycle, and payers / insurance companies to document the account and provide information and details to support paralegal’s / attorney’s pursuit for additional reimbursement.
  • Works within the client’s Patient Accounting system, payer portals and / or websites, and will utilize proprietary software to research accounts in the work queue.
  • Is comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals.
  • Opens, sorts, and imports incoming correspondence into the office database.
  • Navigates through various computer systems and applications to find information about insurance claims.
  • Greets and assists onsite guests.
  • Answers calls for Claim status and Appeal status.
  • Performs any other administrative duties as may be necessary.
  • Performs other related duties as assigned by management.

QUALIFICATIONS :

  • Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and / or training, or equivalent combination of education and experience.
  • Other skills required :
  • Previous experience in office administration or another related field.

  • Basic working knowledge of the US healthcare system.
  • Ability to prioritize and multitask.
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office, including Word and Excel.
  • Highly attentive to detail.
  • Excellent organizational and time management skills.
  • Clear, concise, and logical writing style.
  • Computer-savvy, able to learn new applications / software quickly.
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    COMPETENCIES : Select which competency categories are necessary for this position. We strongly recommend diversity and ethics to be included in each job description. Then select an additional 3-5 of the most critical competencies for the specific job title.

    Please note : You may remove complete statements and complete sub-title sections however the verbiage / content may not be altered nor can wording be inserted as this is standard in all ADP Job Descriptions and are compliant.

    COMPETENCIES :

  • Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
  • Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
  • Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
  • Business Necessity – The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
  • Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
  • Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results.
  • Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
  • Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
  • Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
  • Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
  • Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
  • Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
  • Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
  • Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
  • Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.