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This professional level claim specialist conducts the review and investigation, liability determination, and management of short term and long term disability claims. This position acts independently and autonomously managing the claim by conducting a thorough review and investigation, determining what additional resources (medical consults, TSAs, IMEs, etc.) are appropriate to be utilized, and de
Posted 4 days ago
If you are a dependable, motivated, and detail oriented individual who has strong communication skills and experience working in insurance, then we have a position for you as a Policy Production Associate! This position evaluates underwriting information received, issues policies and endorsements, and ensures regulatory compliance. Headquartered in Brookfield, WI, Old Republic Risk Management (ORR
Posted 2 days ago
At HJI, you’ll enjoy working on a friendly and supportive team where your strengths are valued, your
Posted 10 days ago
Rural Mutual Insurance Company has a great opportunity for an experienced multi line claims adjuster to join our team. We are seeking a highly motivated, ambitious, experienced, and outgoing claims adjuster that will be equipped to work from home throughout northwest Wisconsin (Eau Claire, Menomonie, River Falls). Rural Mutual has been recognized by the Ward Group as one of the top 50 property &am
Posted 5 days ago
Process warranty claims within the time frame established by management. Insure presence of defect by reviewing text, photos, or failed parts. Verify that parts and labor requests are appropriate for the repair. Refuse/return claims when necessary. Maintain Flat Rate Tables to insure proper labor compensation as well as vendor bill back. Receive and inspect failed parts to verify defect, and ident
Posted 12 days ago
Vizance, Inc., formerly RC Insurance Services, Inc. is currently seeking motivated and ambitious sales professionals to join our energetic team. Consider joining a firm with a history of strong performance that is the recipient of the following awards Top Workplaces Best Places to Work Fastest Growing Firms Future 50 We are a growing organization that is committed to building the best team possib
Posted 16 days ago
Where is your claims career taking you? If you see nothing but the daily grind of a claims desk for years to come – and that terrifies you – we want to talk about your future. As a Client Claim Advocate at Integrated Risk Solutions, you’ll Have real, measurable impact on clients’ cost of risk Guide innovative resolutions to unique claims Have the latitude to use your insura
Posted 17 days ago
Not a desk job, real field activity and every day is different!
Posted 23 days ago
The Investigator/Adjuster investigates and brings to a conclusion all claims filed against the City for bodily injury and/or property damage arising from a general liability or vehicular accident. Essential Functions Process a high volume of claims filed against the City, from initial contact of claimant to settlement or denial. Draft correspondence and write denial letters to claimants and their
Posted 1 day ago
Independently interpret utilization reports to detect patterns and potential areas of fraud, waste or abuse. Query data to conduct comprehensive drill down data analysis to detect patterns and trends of under and over utilization. Investigate provider and member fraud and abuse in assigned markets. Manage multiple clients and associated provider networks related to fraud, waste and abuse investiga
Posted 1 day ago
Appeals Resolution Investigate and resolve provider and dental home (TX only) appeals in accordance with State and/or Plan guidelines. Respond to Level 1 requests (TennCare only) Coordinate and resolve HICS cases received via HICS system Establish and maintain professional communications with provider offices. Manage workflow to meet department, Plan, State, and company goals and deadlines Resolve
Posted 1 day ago
Complaint/Grievance/Appeal Resolution Monitor shared mailboxes and department e mails to ensure cases are properly entered into department tracking system, and that requests are acknowledged and resolved timely and accurately. Manage workflow to meet department, Plan, State, and company goals and deadlines. Investigate and resolve complaints, grievances, and member appeals in accordance with State
Posted 1 day ago
This position tests configuration and maintenance activities of the Navitus Benefit Systems Architects (BSA) who are responsible for the smooth functioning of Navitus' pharmacy claims processing system. This position's primary functions involve performing the necessary configuration testing ensuring Navitus is able to set up and maintain a versatile claims adjudication system. This position is als
Posted 1 month ago
AllianceStaff, LLC
- Mequon, WI / Milwaukee, WI / Waukesha, WI
The ACA is here to stay for awhile. Large well connected brokerage firm looking to add another EB Account Service Rep to their group. In this position, the organized and friendly licensed (L&H) account would service a book of Wisconsin clients. In this position, the acct manager would have complete responsibility to service the accounts, help with open enrollments, look for ways to help the cl
Posted 4 days ago
The QTI Group is looking to hire multiple full time Claims Processors for a temporary project expected to last between two to three months. To be successful in this role, applicants must be able to accurately and efficiently recognize, enter and process claims and identify opportunities and recalculate claim with other insurance and pre pricing benefits. This role will also require applican
Posted 1 day ago
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