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Claims manager • madison wi

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Claims Specialist

Claims Specialist

ArteraMadison, Wisconsin, USA
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Manage all claims while under the general supervision of the Claims Director.Provide monthly updates and reporting.Coordination and database management. and other projects as assigned by the manage...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Specialist, Claims Recovery (Remote)

Specialist, Claims Recovery (Remote)

Molina HealthcareMadison, WI, United States
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JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpaym...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Field Claims Adjuster

Field Claims Adjuster

EAC Claims Solutions LLCMadison, Wisconsin, United States
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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
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Claims Legal Specialist - Conditional Demands

Claims Legal Specialist - Conditional Demands

Sentry InsuranceMadison, WI, US
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Subject matter expert on requirements to properly resolve matters when faced with a conditional demand and assist in the development and implementation of claims standards.Our Claims Legal Speciali...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Claims Representative

Claims Representative

Auto-Owners Insurance CoMadison, WI, United States
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A career at Auto-Owners is challenging and rewarding.Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.Job Descripti...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Indemnity Claims Specialist

Indemnity Claims Specialist

CorVel Enterprise Claims, Inc.Madison, WI, US
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The Indemnity Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best poss...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Claims Analyst

Claims Analyst

ACRISUREMIDDLETON, WI, 8215 Greenway Boulevard
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The Claims Analyst, Senior Claims Analyst independently adjudicates multi-state workers’ compensation indemnity, EL and subrogation claim files that are generally non-catastrophic in nature.Receive...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Senior Product Manager - Claims Solutions

Senior Product Manager - Claims Solutions

Gradient AIMadison, WI, US
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Senior Product Manager - Claims Solutions.Gradient AI is revolutionizing Group Health and P&C insurance with AI-powered solutions that help insurers predict risk more accurately, improve profitabil...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Claims Representative

Claims Representative

ICONMAMadison, WI, United States
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Our client, a Business Solutions company, is looking for a Claims Representative for their remote location.Responsibilities include processing low level workers compensation claims, determining com...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Specialist, Claims Recovery (Remote)

Specialist, Claims Recovery (Remote)

Wisconsin StaffingMadison, WI, US
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Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider com...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Claims Legal Specialist - Conditional Demands

Claims Legal Specialist - Conditional Demands

SentryMadison, WI, United States
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Subject matter expert on requirements to properly resolve matters when faced with a conditional demand and assist in the development and implementation of claims standards.Our Claims Legal Speciali...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Manager of Tech - Claims

Manager of Tech - Claims

MedicaMadison, WI, United States
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Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences an...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Indemnity Claims Specialist

Indemnity Claims Specialist

CorVel CorporationMadison, WI, USA
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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
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Remote Claims Writer

Remote Claims Writer

Metro Public AdjustmentMadison, Wisconsin, United States
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Job Description : The position we are hiring for is customer / client relations.In this position you will be writing claims and submitting the paperwork. Duties can be performed remotely.Company Inform...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Claims Representative

Claims Representative

Auto-Owners InsuranceMadison, WI, US
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A career at Auto-Owners is challenging and rewarding.Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.Auto-Owners I...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Specialist, Claims Recovery (Remote)

Specialist, Claims Recovery (Remote)

Remote StaffingMadison, WI, US
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serp_jobs.job_card.full_time
Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider com...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Senior Insurance Claims Specialist (Remote)

Senior Insurance Claims Specialist (Remote)

WVU MedicineMadison, WI, US
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Responsible for managing patient account balances including accurate claim submission, compliance with all federal / state and third party billing regulations, timely follow-up, and assistance with d...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
AVP Claims

AVP Claims

SedgwickQBE, Sun Prairie, Wisconsin, 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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100% Remote Disability Claims

100% Remote Disability Claims

Axelon Services CorporationMadison, WI, US
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Max pay rate : $27 / hr Location : Remote Start date will be 10 / 6 / 2025.Training duration will be 1-2 weeks, workers cannot take time off during that timeframe. Hours information (Part-time) : 1.What hour...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Claims Specialist

Claims Specialist

ArteraMadison, Wisconsin, USA
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Description

JOB PURPOSE :

Manage all claims while under the general supervision of the Claims Director. Provide monthly updates and reporting. Coordination and database management; and other projects as assigned by the management team.

ESSENTIAL RESPONSIBILITIES :

  • Receive initial notification of claims and guide employees on how to properly manage the circumstances.
  • Investigate claims for cause, compensability, and liability.
  • Track the receipt of the appropriate paperwork for all claims, set up claim files, and enter information into the Risk Management Information System (RMIS) upon receipt.
  • Oversee reporting of automobile, general liability, property, and worker's compensation claims to Miller Pipeline's insurance carriers and TPAs. Forward necessary information to insurance carriers and maintain accurate documentation of claims by placing copies of all related paperwork in RMIS.
  • Actively track open claims and interface with Miller Pipeline's insurance carriers, physicians, and other third parties to ensure that claims are being managed aggressively.
  • Collaborate with the adjusters on insured claims during investigation, reserving and settlement consults.
  • Negotiate, settle, process payments and pursue subrogation for nominal claims.
  • Responsible for managing all third-party subrogation claims for which the company is not liable.
  • Manage and coordinate Return to Work program for injured workers.
  • Prepare operations and risk reports for management analysis. Provide benchmarking information as necessary.
  • Analyze and classify risks as to frequency and potential severity and measure the financial impact of risk on the company.
  • Respond to inquiries and complaints from customers, regulatory agencies, and members of the business community.
  • Identify trends and collaborate with Safety Department to identify which safety issues are driving frequency and severity in company's auto, worker's compensation, and property damage losses.
  • Participate in the quarterly claim reviews with the insurance carrier.
  • Provide Quarterly claim updates to Regional Operations.
  • Attend Safety incident review meetings and update the RMIS accordingly.
  • Attend Claim Summits, Safety Meetings and Compliance Trainings as needed to present field personnel with information regarding damage reporting.
  • Participate in the Claims Presentation during Foreman Leadership Training.
  • Other duties as assigned.

QUALIFICATIONS :

Education and Certifications

  • Required : High school diploma. Significant post-secondary course work.
  • Preferred : Bachelor's degree from accredited universityand / or 5+ years' experience, Adjuster's License and / or Insurance / Claims Designation or willing to obtain.
  • Experience

  • Required : 3+ years' experience in multi-line claims. Data Entry - MS Office experience.
  • Preferred : Multi-state worker's compensation, auto, and general liability claims
  • Functional / Technical Competency Requirements

  • Required : Working knowledge of auto, general liability, property and worker's compensation coverage. Knowledge of medical terminology and treatment protocols along with laws, legal codes, court procedures, precedents, government regulations, executive orders and agency rules. Read, analyze and interpret common scientific and technical journals, financial reports, and legal documents. Sense of urgency in responding to inquiries and complaints. Effectively present data to management team, public groups, and / or boards of directors.
  • CORE COMPETENCY REQUIREMENTS :

  • Management
  • Leadership
  • Business Expertise
  • Sound Judgment
  • Presentation Skills
  • Communication
  • ESSENTIAL FUNCTIONS :

    While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel objects, tools, or controls; and reach with hands and arms. The employee is occasionally required to stand, walk, climb or balance and talk or hear. The employee is occasionally required to lift up to 20 pounds.

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

    Federal Labor Standards Act designation -Exempt

    Miller Pipeline retains the discretion to add to or change duties of this position at any time. This position description should not be considered all-inclusive.