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This position is responsible for reviewing and approving claims processed by the Third Party Administrator (TPA), resolving outstanding billing issues with providers, ensuring accurate resolution to provider inquiries, entering authorizations into the TPA's system and resolving service provision issues, handling provider refunds and appeals, assisting with state and federal Encounter Reporting, au
Full Time / High School or Equivalent Required
Posted Today
Excellent career opportunity with local employee owned agency.
Diversified Insurance Solutions is one of Wisconsin's largest employee owned insurance brokerages, providing a wide range of risk consulting services including Employee Benefits, Commercial Property and Casualty, 401k, Human Resources, Personal Insurance, Executive Benefits and Risk Management/Safety services. Diversified provides innovative group benefit and risk management solutions that ena
Full Time / Bachelor's Degree Required
Posted Today
Respond to crop claims by completing field inspections, communicating with involved parties, performing investigations, determining appropriate adjustments and administering insurance policies to ensure compliance with state and federal regulations. Primary responsibilities Complete field inspections, reviews and adjustments by reading maps and aerial photos, measuring fields and storage bins, and
Full Time / Associate Degree Required
Posted 14 days ago
Must have large loss commercial remediation and restoration experience to apply! The Large Loss Senior Project Manager will manage all facets of high cost commercial catastrophic events such as fires, floods, and other property losses. The ideal candidate will have extremely strong problem solving and communication skills, be highly detail oriented to juggle multiple tasks at all time, and have st
Full Time
Posted 1 day ago
Increasing liabilities in the medical/healthcare field necessitates BHD to have an onsite expert in healthcare risk management to mitigate exposure to malpractice and adverse events. Mitigation, staff education and training in prevention of occurrences requires a medically trained clinical risk and improvement professional to focus on the protection of the patients, employees, and financial assets
Full Time / Bachelor's Degree Required
Posted 11 days ago
The Corporate Compliance Analyst interfaces with all functions and areas of CUNA Mutual Group and its subsidiaries to enable the company to make ethical, compliant, and resilient choices which align with corporate strategy, goals, and values. Framework General Profile and Scope Requires knowledge and experience in own discipline/department; still acquiring higher level knowledge and skills. Builds
Full Time / Bachelor's Degree Required
Posted Today
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
Full Time / Associate Degree Required
Posted Today
Q.B.E North America - 
Itasca, IL / Plano, TX / San Francisco, CA / 5 more...
Provide deep analysis and actionable insights to Claims leadership through data and analytics. Provide tools that allow Claims leaders to optimize resources and improve operational effectiveness. Coordinate and manage specialized claims department initiatives by planning and guiding project implementation and collaborating with key stakeholders to support department operations and contribute to ac
Full Time / Bachelor's Degree Required
Posted 27 days ago
Q.B.E North America - 
Itasca, IL / Chandler, AZ / New York, NY / 2 more...
Manage Claim portfolios handled by outsourced Claims Service Third Party Administrators (TPA's) on Claims for assigned lines of business. This role will be responsible for the oversight of day to day claims handling related to assigned lines of business and the performance and implementation of initiatives within the TPA's. Lines of business may include Workers Compensation, Auto, Liability, Prope
Full Time / Bachelor's Degree Required
Posted 28 days ago
Job Summary Our Claims Representative answers telephone, written and in person inquiries from beneficiaries, providers, and government/military agencies or affiliated organizations regarding eligibility, benefit determinations, claims adjudication questions, and problems relating to Military and Veterans Health (MVH) overseas military beneficiaries and dependents. This role translates or coordinat
Part Time / High School or Equivalent Required
Posted 25 days ago
The head count will be responsible for supporting the creation and delivery of the Research, Development and Engineering (RD&E) claims strategy for the Home Cleaning business, supporting product claims and developing signature sensory attributes. He/she will also be a change catalyst supporting the Claims Director, partnering to raise the game for claims capabilities and influencing the developmen
Full Time / Bachelor's Degree Required
Posted 1 month ago
Analyzes claims to determine extent of insurance carrier's liability in accordance with policy provisions regarding third party liabilities. Training of adjudicators and processors as assigned by manager. Respond to questions from adjudicators and processors. Create Standard Operating Procedures for new products as assigned by manager. Review and update existing Standard Operating Procedures on a
Full Time / Associate Degree Required
Posted Today
We are currently looking for (10) EXPERIENCED FIRE & WATER RESTORATION TECHS with at least 1 year of experience for either temp to perm or possible DIRECT HIRE opportunity with Multiple Restoration Firms looking to HIRE NOW! Multiple opportunities in Milwaukee New Berlin St.Francis Wauwatosa Waukesha (Certs needed) Ideal candidate will have a min of 1 year of Fire/Water Restoration experience
Full Time
Posted 12 days ago
Our client located in Verona, WI is seeking an entry level Claims Data Entry Specialist to be responsible for providing general claims support of prepping, organizing, scanning, reviewing, and entering claims. Ideal candidates will have experience in a data entry role, be detailed in their work, and flexible and open to new ideas. This is a great opportunity to get your foot in the door at
Full Time / High School or Equivalent Required
Posted 21 days ago
Our client, a Premier (National) Leader in the Fire & Water Restoration Industry is looking for an " Experienced " ESTIMATOR Ideal candidate will have SOLID WORK HISTORY Minimal of 5 to 5 + “Current” years of Industry related Estimating via the use of Xactimate in both Commercial and Residential Losses A Book of Business relevant to the job Ability to see Projects thru fr
Full Time / Certification or Vocational Required
Posted 16 days ago
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