- Review, assess, and process claims based on benefit plans and company guidelines.
- Conduct thorough investigations and document all claim details.
- Analyze plan coverage and adjudicate claims accurately and efficiently.
- Communicate with stakeholders to facilitate claim resolution.
- Identify potential fraud in claims submissions.
- Ensure compliance and suggest process enhancements.
- Participate in training and team meetings.
- 5-7 years of experience in medical insurance claims examination.
- Proficiency in claims management platforms and Microsoft Office Suite.
- Strong analytical and problem-solving skills.
- Attention to detail and accuracy.
- Customer-centric mindset and ability to collaborate effectively.
- Adaptability to fast-paced environments.
- Set annual professional growth objectives.
- Stay updated on industry developments.
- Participate in training and skill development.
- Contribute to the evaluation process.
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Claims Examiner
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Horace Mann Addison, United States(Hybrid) Addison, TX · Hybrid work position for a Claims Examiner responsible for set-up and processing claims while providing exceptional quality service in a timely manner in an effort to build customer satisfaction and loyalty · Essential Functions Link and set-up Wellness a ...
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Tokio Marine HCC Plano, United States· Position at Tokio Marine HCC · USSIC has an exciting opportunity for an experienced Aviation Claims Examiner in our office located in Plano, Texas. · In your role as the Aviation Claims Examiner, you will be responsible for efficient claims processing, accurate payments and ...
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Aviation Claims Examiner Plano, Texas
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Tokio Marine HCC Plano, United States RegularDescription · Position at Tokio Marine HCC USSIC has an exciting opportunity for an experienced Aviation Claims Examiner in our office located in Plano, Texas. · In your role as the Aviation Claims Examiner, you will be responsible for efficient claims processing, accurate payme ...
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AllSearch Recruiting Dallas, United StatesClaims Examiner - Insurance - Base Salary to 94 k/year - Dallas, TX Our client is a national Third Party Administrator who is looking for a Claims Examiner to join their team in a remote capacity. Their company has been in business for almost 50 year Claims, Examiner, Insurance, ...
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CSI Irving, United States Contract-to-HireThe CSI Companies is actively seeking a Medical Claims Examiner for a fast-growing, international hospital system in the Irving, TX area that Forbes recently rated among the best employers in Texas · Job Summary$18-21/hour Depending on Experience · ON-SITE, Monday-Friday 8am–5pm ...
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ERISA Recovery Plano, United States**ONSITE POSITION** · ERISA Recovery, a frontrunner in the Federal ERISA appeals process for collecting complex and aged claims, seeks a proactive Denied Claims Trainer who specializes in overturning denied claims. You will develop, implement, and facilitate a claims training pr ...
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Erisa Recovery Plano, United StatesONSITE POSITION · ERISA Recovery, a frontrunner in the Federal ERISA appeals process for collecting complex and aged claims, seeks a proactive Denied Claims Trainer who specializes in overturning denied claims. You will develop, implement, and facilitate a claims training progra ...
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Select Source International Dallas, United StatesJob Description · Job Description · Job Description · Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio. · Adjust reserves or provide reserve r ...
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Select Source International Dallas, United StatesJob DescriptionJob DescriptionJob DescriptionInvestigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.Adjust reserves or provide reserve recommendations ...
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Sedgwick Irving, United StatesTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportuni ...
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Medical Claims Examiner
1 week ago
WebTPA Irving, United StatesWebTPA is looking to hire Medical Claim Examiners to join our team in Irving, TexasPrior experience in Healthcare Claim Processing is needed. Key position details:Our paid training program is scheduled to start August 5, 2024. This is a fully in office position: 8500 Freeport Par ...
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Claim Examiner
1 week ago
Crawford & Company Dallas, United StatesExcellence In Everything We Touch · Position Summary · Investigate, evaluate, negotiate, and settle moderate difficulty type claims; takes appropriate action to achieve results that have a positive impact on profitability. Settle claims for assigned lines of business promptly a ...
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Life & Health Claims Examiner
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Horace Mann Educators Corporation Addison, United StatesLife & Health Claims Examiner · We're motivated by the fact that educators take care of our children's future, and we believe they deserve someone to look after theirs. We help educators identify their financial goals and develop plans to achieve them. This includes insurance to ...
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UnitedHealth Group Dallas, United StatesReview, process and identify medical claims based on standard operating procedures on CPS. Apply appropriate processes and procedures to process claims (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS/ Medic Claims, Examiner, Processing, ...
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WebTPA Irving, United StatesWebTPA is looking to hire Medical Claim Examiners to join our team in Irving, Texas · Prior experience in Healthcare Claim Processing is needed. · Key position details: · Our paid training program is scheduled to start August 5, 2024. · This is a fully in office position: 85 ...
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Claim Examiner- Remote
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Select Source International Dallas, United StatesJob Description · Job DescriptionJob Description · Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio. · Adjust reserves or provide reserve recomme ...
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Life & Health Claims Examiner
2 weeks ago
Horace Mann Addison, United StatesLife & Health Claims Examiner · Were motivated by the fact that educators take care of our childrens future, and we believe they deserve someone to look after theirs. We help educators identify their financial goals and develop plans to achieve them. This includes insurance to p ...
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Life & Health Claims Examiner
3 weeks ago
Horace Mann Addison, United States(Hybrid) Addison, TXHybrid work position for a Claims Examiner responsible for set-up and processing claims while providing exceptional quality service in a timely manner in an effort to build customer satisfaction and loyaltyEssential FunctionsLink and set-up Wellness and Physic ...
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Senior Claims Examiner
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Crawford & Company Dallas, United StatesExcellence In Everything We Touch · Position Summary · + GREAT WORK FROM HOME OPPORTUNITY · + Offers Monthly Performance Incentive · + Generous Employee Referral Bonus Program · + Candidates must have experience in managing TX Workers Compensation Claims · + Licensing is a ...
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Workers Compensation Claims Examiner
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Managed Care Staffers Dallas, United StatesJob Description · Job DescriptionWorkers Comp Claims Examiner - Remote Work · Our client, a large claims administrator, is looking for a Workers Comp. Claims Examiner to work remotely. This position will be working to support the Anchorage, AK office. · Position is open to W-2 ca ...
Claims Examiner - Plano, United States - ManhattanLife Insurance & Annuity Company
Description
Job Description
Who We Are: ManhattanLife Insurance and Annuity Company, established in 1850, is one of the oldest and most trustworthy health and life insurance companies in the United States. With headquarters in Houston, TX, and growing presence across the nation, ManhattanLife offers extensive employee benefits from day one, including health, dental, and vision coverage, flexible schedules, free parking, professional development opportunities, and a wellness program.
Scope and Purpose: We are looking for a Claims Examiner to join our team in Plano, TX. As a Claims Examiner, your role will involve meticulously investigating, evaluating, and processing claims to ensure accurate adjudication and exceptional customer service.
Duties and Responsibilities:
Minimum Qualifications: High School Graduate or equivalent (GED).
Knowledge, Skills and Abilities:
Travel Requirements: Light travel may be required.
Professional Development:
Physical Demands: The role may involve standing, walking, typing, and occasional lifting of up to 10 pounds.
Work Environment: Office-based role using standard office equipment.
Other Duties: This job description may not encompass all responsibilities and duties.
AAP/EEO Statement: ManhattanLife is committed to diversity and equal opportunity, fostering an inclusive and respectful work environment.
