Reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. Work is closely managed. Works on projects/matters of limited complexity in a support rol ...e. Typically requires 0-2 years of related experience.More Show Less
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About us. Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system. About the role. Under management direction, responsible for reviewing and processing all types of medical and facility claims from contracting and non-contracting providers and from subscribers and enrollees for payment in an accurate and timely manner. Responsible for applying correct contract benefi...
THE POSITION. Do you thrive on helping others and have a sharp eye for detail. If so, the Pennsylvania Treasury Department is calling. We are looking for a motivated and meticulous professional to join our Bureau of Unclaimed Property as a Claims Examiner in our Scranton Office. In this role, you will be part of a passionate team dedicated to reuniting Pennsylvanians with their lost assets. From verifying claims to delivering top-tier customer se...
Job Description. We are currently looking for a Claims Examiner to join our team The Claims Examiner processes the notification of death claims, ensures state regulations are being maintained in the follow up process, reviews and adjudicates claims, and provides assistance to the beneficiaries through calls and written correspondence. Job Responsibilities. Review and process death claims. Create payments and letters to settle claims. Correspond w...
Job Description. We are currently looking for a Claims Examiner to join our team. The Claims Examiner processes the notification of death claims, ensures state regulations are being maintained in the follow up process, reviews and adjudicates claims, and provides assistance to the beneficiaries through calls and written correspondence. Job Responsibilities. Review and process death claims. Create payments and letters to settle claims. Correspond ...
Job Description. We are currently looking for a Claims Examiner to join our team. The Claims Examiner processes the notification of death claims, ensures state regulations are being maintained in the follow up process, reviews and adjudicates claims, and provides assistance to the beneficiaries through calls and written correspondence. Job Responsibilities. Review and process death claims. Create payments and letters to settle claims. Correspond ...
Job Summary. The claims auditor is responsible for providing customer service to policy holders and beneficiaries and facilitating the claims process. Essential Functions. Receive notification of death of policyholder. Process death benefits for life and annuity claims. Order and review policyholder files. Complete worksheet of policy information. Send information about requirements and options for payment of benefits to beneficiary or appropriat...
Claims Examiner I Under Close Supervision, The Claims Examiner I Will Perform Accurate Review, Entry And Processing Of All Claims Received For Payment By HPSM. Position Overview Essential Functions. Research rejected claims as necessary and re-adjudicated them when resolved. Claims entry of all standard claim forms. Correspond as required to resolve rejected claims. Review reports, verifying accurate data and making corrections as appropriate. Re...
Summary. Under general supervision, the Claims Examiner I is responsible for reviewing, auditing, and processing medical and facility claims from both contracted and non-contracted providers. This role ensures that claims are processed accurately and in a timely manner, following established benefits, policies, and procedures. Key Responsibilities. Review and process medical claims for accuracy and completeness. Resolve system-suspended claims fo...
