- Responsible for accurate and timely handling of claim issues for all lines of business, including bi-directional sharing, FEP, Local and Commercial PA and AHNJ, BlueCard and Government market. Applies and maintains knowledge of claims processing and support systems.
- Research inquiries received from all areas, inclusive of internal and external sources (e.g. other plans, providers, legal, Sales); as required, perform member or provider payable claim payment adjustments when appropriate following the correct processing guidelines.
- Meet departmental quality and production requirements
- Respond professionally to internal and external inquiries, as appropriate, while maintaining corporate and departmental standards.
- Research claims that are paid incorrectly; recover overpaid and underpaid claim dollars from multiple sources and ensure all necessary transactional steps are taken to accurately process claim adjustments.
- Provide response to general questions within expected departmental standards of initial inquiry; provide daily feedback, status updates and targeted resolution dates for more complex issues.
- Complete special projects and participate in work groups as assigned.
- Perform other duties as necessary
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Content Claims Specialist
2 weeks ago
Crawford & Company Philadelphia, United States Regular Full timePosition Summary · The role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key areas of edjuster's content claims handling operations: · Acting/operating as a third party, intermediary between the Insurance Company's property ...
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Content Claims Specialist
3 weeks ago
Crawford & Company Philadelphia, United StatesExcellence In Everything We Touch · Position Summary · The role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key areas of edjusters content claims handling operations: · + Acting/operating as a third party, intermediary b ...
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Content Claims Specialist
2 weeks ago
Crawford & Company Philadelphia, United StatesExcellence In Everything We Touch · Position Summary · The role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key areas of edjusters content claims handling operations: · + Acting/operating as a third party, intermediary b ...
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Sr Claims Specialist
5 days ago
Munich Re Philadelphia, United StatesSr Claims Specialist Company Munich Re America Location Philadelphia , United States · Claims Specialist · We're adding to our diverse team of experts and are looking to hire those who are committed to building a culture that enables the creation of innovative solutions for ...
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Content Claims Specialist
6 days ago
Crawford & Company Philadelphia, United StatesExcellence In Everything We Touch · Position Summary · The role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key areas of edjusters content claims handling operations: · + Acting/operating as a third party, intermediary b ...
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Content Claims Specialist
3 weeks ago
Crawford & Company Philadelphia, United StatesExcellence In Everything We Touch · Position Summary · The role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key areas of edjusters content claims handling operations: · + Acting/operating as a third party, intermediary b ...
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Content Claims Specialist
3 weeks ago
Crawford & Company Philadelphia, United StatesExcellence In Everything We Touch · Position Summary · The role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key areas of edjusters content claims handling operations: · + Acting/operating as a third party, intermediary b ...
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Content Claims Specialist
1 week ago
Crawford & Company Philadelphia, United StatesExcellence In Everything We Touch · Position Summary · The role of Content Claims Specialists is a multi-faceted role, which focuses primarily in the following four key areas of edjusters content claims handling operations: · + Acting/operating as a third party, intermediary b ...
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Claims Specialist-, Jersey Village
2 weeks ago
Flooring Services Jersey Village, United StatesJob Description · Job DescriptionFlooring Services has continued to be a trusted and respected industry leader in the home building industry since 1983. Our family of companies bring the Family Advantage, and we conduct our affairs with integrity while demonstrating respect for o ...
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Claims Specialist
1 week ago
Contemporary Staffing Solutions Moorestown, United StatesJob Description · Job DescriptionContemporary Staffing Solutions is seeking a detail-oriented and organized Data Verification Specialist to join our client in Moorestown, NJ As a Data Verification Specialist, you will be responsible for ensuring the accuracy and completeness of a ...
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Claims Specialist
2 weeks ago
Biogensys Trenton, United StatesJob Description · Job DescriptionWe are hiring a Claims Specialist (Worker's Compensation) for one of our clients in Trenton, NJ. · Job Description: · Under the direction of a supervisor, determines compensability of Workers Compensation claims filed by State government employees ...
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claims specialist
2 days ago
Randstad Malvern, United Statesclaims specialist. · malvern , pennsylvania · posted 1 day ago · job details · summary · $ $20 per hour · temp to perm · associate degree · category office and administrative support occupations · referenceAB_ · job details · Are you passionate about facilitating seaml ...
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Claims Specialist
1 week ago
Randstad Malvern, United StatesJob Description · Job DescriptionAre you passionate about facilitating seamless transitions and ensuring customer satisfaction? Join our team and become an integral part of our operations. You will be able to provide clients with a seamless transition process when their life even ...
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Claims Specialist
1 week ago
Randstad Malvern, United StatesJob Description · Job DescriptionAre you passionate about facilitating seamless transitions and ensuring customer satisfaction? Join our team as a Change of Ownership Associate and become an integral part of our operations. You will be able to provide clients with a seamless tran ...
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Complex Claim Specialist
1 week ago
NJM Insurance Group Trenton, United States Full timeNJM's Workers' Compensation Claims Team is seeking an experienced Complex Claim Specialist. This is a full-time position and offers a hybrid schedule after training. · The Complex Claim Specialist will be responsible for contacting all parties involved in the claim, gathering, an ...
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Claims Account Specialist
1 week ago
NJM Insurance Group Trenton, United States Full timeNJM's Workers' Compensation Claims Team is seeking a Claim Account Specialist. This is a full-time position and offers a hybrid schedule after training. · The Claims Account Specialist will be responsible for contacting all parties involved in the claim, gathering, and securing a ...
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Specialist, Appeals Claims
3 weeks ago
Lincoln National Corporation Broomall, United StatesWe are excited to bring on an Appeals Specialist to join our Appeal Review Department in a fully remote environment. Appeal Specialists conduct reviews, investigation, and analysis of an assigned caseload of Short-Term Disability appeals. The role is Claims, Appeals, Specialist, ...
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Specialist, Appeals Claims
2 weeks ago
Lincoln Financial Group Wayne, United StatesAlternate Locations: US All Regions; US Midwest; US Northeast; US Southeast; US Southwest; US West; Work from Home · Work Arrangement · Remote : Work at home employee residing outside of a commutable distance to an office location. · Relocation assistance: is not available for ...
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Senior Claims Specialist
2 weeks ago
CorVel Enterprise Comp, Inc. Norristown, United StatesJob Description · Job DescriptionThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers an ...
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Senior Claims Specialist
14 hours ago
AXA XL Ltd Exton, United StatesSenior Claims Specialist - Construction Professional Liability · New York, New York / USA · Our Claims team sets us apart. Our experienced Claims professionals use their specialized expertise to handle even the most complex claims seamlessly. How do you make a good thing bette ...
Claims Specialist - Philadelphia, United States - Independence Blue Cross
Description
•High School graduate or equivalent work experience.
Experience
•1 - 3 years proven work experience in a production environment.
Knowledge, Skills, Abilities
Demonstrated math and comprehension skills required.
Good interpersonal skills for handling internal and external customers.
Well-developed listening, verbal and written communication skills.
Proficiency with Microsoft Office, specifically Excel and Word is required.
Ability to research and investigate information using multiple sources, operating systems and documented guidelines.
Must have strong organizational skills and problem solving ability.
Must be detail-oriented
