- Service includes shadow adjusting and acting as a liaison between the injured worker, client and TPA responsible for adjudicating workers' compensation losses.
- This involves ongoing detailed claims analysis, accident and subrogation investigation identifying red flags and potential fraud.
- dditional responsibilities include accurate reserving practices, facilitating light duty, oversight of both medical and legal management.
- bility to evaluate settlement value and coverage issues.
- Mitigating claim severity and driving positive claim outcomes by leading our TPA towards claim resolution.
- Preparing and presenting strategic claim reviews with client and/or carrier.
- Team player with exceptional customer service skills.
- High work standards, results orientation and self-motivated.
- Strong complaints handling, dispute resolution and ability to manage difficult situations.
- bility to meet deadlines and ensure all tasks are completed within service guidelines.
- bility to make sound decisions with confidence.
- Strong analytical skills with an eye for detail.
- bility to effectively coach and assist Claims Specialists and Claims Associates.
- High School/GED, some college preferred.
- 3+ years of insurance or claims work experience required.
- 1-2 years of experience in complex claims.
- Insurance or claims designation preferred.
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Claims Specialist
1 week ago
Paul Davis Restoration Jacksonville, United StatesDo you want to make an Impact in your community in a diverse and inclusive company, working in a dynamic and growing industry, while supporting your personal and professional journey in your career? · Position Summary: Paul Davis Restoration, Inc. is a national franchise organiz ...
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Claims Specialist
2 weeks ago
Paul Davis Restoration, Inc. Jacksonville, United StatesJob Description · Job Description · Do you want to make an Impact in your community in a diverse and inclusive company, working in a dynamic and growing industry, while supporting your personal and professional journey in your career? · Position Summary: Paul Davis Restoration, I ...
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Claims Analyst Specialist
1 week ago
Onslow Memorial Hospital Jacksonville, United States Full timeDescription · Claims Analyst Specialist is knowledgeable of all payers. Responsible for the tracking, review and follow-up of all outstanding patient accounts. This includes but is not limited to timely review of Patient Accounting Desktop, Clearinghouse billing list and Interme ...
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Contract and Claims Specialist
3 weeks ago
W.W. Gay Mechanical Contractor Jacksonville, United StatesBenefits:Dental insurance · Health insurance · Paid time off · Vision insurance · Essential Duties and Responsibilities: · •Ensure that all contractual agreements are in compliance with applicable laws and regulations. · •Update and maintain customer contracts in the company's ...
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Contract and Claims Specialist
3 weeks ago
W.W. Gay Mechanical Contractor Jacksonville, United StatesBenefits:Dental insurance · Health insurance · Paid time off · Vision insurance · Essential Duties and Responsibilities: · •Ensure that all contractual agreements are in compliance with applicable laws and regulations. · •Update and maintain customer contracts in the company's ...
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Contract and Claims Specialist
3 weeks ago
W.W. Gay Mechanical Contractor, Inc. Jacksonville, United StatesJob Description · Job DescriptionBenefits:Dental insurance · Health insurance · Paid time off · Vision insurance · Essential Duties and Responsibilities: · Ensure that all contractual agreements are in compliance with applicable laws and regulations. · Update and maintain custom ...
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Member Solutions Claims Specialist
13 hours ago
VyStar Credit Union Jacksonville, United StatesThe incumbent is responsible for the monitoring and daily administration of the duties associated with deceased processing on all consumer loan products, refunds, claims, payment posting, general ledger reconciliation associated with Guaranteed Asser Claims Specialist, Solutions, ...
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Sr. WC Claims Specialist
3 weeks ago
Vensure Employer Services Jacksonville, United StatesAbout Us · Vensure Employer Solutions is the largest privately held organization in the HR technology and service sector, providing a comprehensive portfolio of solutions, including HR/HCM technology, managed services, and global business process outsourcing (BPO). The company an ...
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Commercial Property Claims Specialist
2 weeks ago
Stillwater Insurance Services, Inc. Jacksonville, United StatesJob Description · Job Description Commercial Property Claims Specialist · Join our hardworking, collaborative team where your contributions will be celebrated and valued. · Why Stillwater? We're a national insurance provider that offers a full suite of insurance products and ser ...
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Claims Admin Support Specialist
1 week ago
Landstar System, Inc. Jacksonville, United States Part timeWhat is Landstar? · Landstar stands for safe, secure and reliable transportation services delivered by our unique network of small business owners. Independent agents and capacity providers operating under the Landstar umbrella enjoy the strength and support of one of the industr ...
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Baptist Health Jacksonville, United StatesJob Posting Summary · Baptist Health is looking to add a Claims Resolution Specialist III to our Physician Billing team at Baptist Metro Square. This is a Full-Time Days opportuntiy. · The Claims Resolution Specialist III should have expertise in the following areas within the ...
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Baptist Medical Center Jacksonville Jacksonville, United StatesBaptist Health is looking to add a Claims Resolution Specialist III to our Physician Billing team at Baptist Metro Square. · This is a Full-Time Days opportuntiy. · The Claims Resolution Specialist III should have expertise in the following areas within the revenue Cycle: Regist ...
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Baptist Health System Jacksonville, United StatesBaptist Health, founded in 1955, is North Florida's most comprehensive health care system and the area's only non-profit, mission-driven, locally governed health care provider. Baptist Health has over 200 points of care throughout the Northeast Flori Physician, Specialist, Claims ...
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Pap Specialist
2 weeks ago
Adapt Health LLC Jacksonville, United States: · At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives - out of the hospital and in their homes. We are actively recruiting in your area. If you are passionate about making a profound impact on the qualit ...
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Help Desk Specialist
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Revenue Cycle Specialist
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Reliant Management Jacksonville, United StatesReliant Management is a revenue cycle management company passionately committed to revitalizing patient care. With a steadfast focus on professionalism, customer-centricity, and support, we empower healthcare providers to navigate the complexities of revenue management seamlessly ...
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PAP Specialist
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AdaptHealth Jacksonville, United States· AdaptHealth Opportunity - Apply Today · At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives - out of the hospital and in their homes. We are actively recruiting in your area. If you are passionate about ...
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Insurance Follow-Up Representative
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Center for Orthopedic and Research Excel Jacksonville, United StatesJob Description · Job DescriptionINSURANCE FOLLOW-UP REPRESENTATIVE · NON-CLINICAL | BUSINESS OFFICE | FULL-TIME | JACKSONVILLE, FL | $16-19/HOUR | BENEFITS PACKAGE · Established in 2001, Southeast Orthopedic Specialists is a regional leader in musculoskeletal medicine. We are de ...
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Auto Injury Program Specialist
3 weeks ago
Southeast Orthopedic Specialists Jacksonville, United StatesEstablished in 2001, Southeast Orthopedic Specialists is a regional leader in orthopedic medicine. We are dedicated to growing with our patients. Our reach will continue to expand to meet the needs of all patients, present and future. It is our wish to make industry-leading five- ...
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Surgical Authorization Specialist
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Southeast Orthopedic Specialists Jacksonville, United StatesSURGICAL AUTHORIZATION SPECIALIST · Established in 2001, Southeast Orthopedic Specialists is a regional leader in orthopedic medicine. We are dedicated to growing with our patients. Our reach will continue to expand to meet the needs of all patients, present and future. It is our ...
Sr. WC Claims Specialist - Jacksonville, United States - VensureHR
Description
About UsVensure Employer Solutions is the largest privately held organization in the HR technology and service sector, providing a comprehensive portfolio of solutions, including HR/HCM technology, managed services, and global business process outsourcing (BPO). The company and its service providers collectively serve over 95,000 businesses and process over $135B in annual payroll. As "One Employer Solution" headquartered in Chandler, Arizona, Vensure helps thousands of businesses streamline and grow their operations with custom strategies that benefit both employers and employees. Find out more by visiting .
Position Summary
Senior Worker's Compensation Claims Specialist position is responsible for servicing our Elite-level clients workers' compensation claims with minimal to no supervision required. This role requires that the associate monitor their assigned employers' workers' compensation claims, from inception thru closure, to ensure that all salient aspects of claim adjudication are being effectively and efficiently performed.
Essential Duties and Responsibilities
