Claims Adjuster handling commercial claims for an innovative insurance startup utilizing real - time data. Collaborating with a global team and driving successful claims outcomes in a high - growth environment.
About the role
- Claims Processor reviewing and adjudicating complex claims for BlueCross BlueShield. Excels in analyzing and resolving claims issues while training new staff members in a hybrid work environment.
Responsibilities
- Reviews and adjudicates complex or specialty claims
- Determines whether to return, deny or pay claims following organizational policies and procedures
- Assists in training or mentoring new staff members
- Examines and processes complex or specialty claims according to business/contract regulations, internal standards and examining guidelines
- Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes
- Verifies that claims have been keyed correctly
- Ensures that claims are processing according to established quality and production standards
- Corrects processing errors by reprocessing, adjusting, and/or recouping claims
- Researches and resolves claims edits and deferrals
- Performs research on claim problems by utilizing policies, procedures, reference materials, forms and coordinates with various internal support areas
- Responds to routine correspondence and completes spreadsheet if applicable
Requirements
- Required Education: High School Diploma or equivalent
- Required Work Experience: 2 years of experience processing, researching and adjudicating claims
- Required Skills and Abilities: Strong organizational, analytical and judgment skills
- Strong oral and written communication skills
- Proficient in spelling, punctuation and grammar
- Proficient in basic business math
- Ability to handle confidential or sensitive information with discretion
- Required Software and Tools: Microsoft Office
- Preferred Work Experience: 2 years of claims processing experience
- Preferred Skills and Abilities: Strong time management skills
- Knowledge of mathematical and statistical concepts
- Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications
- Proficient database software skills.
Benefits
- Subsidized health plans
- Dental and vision coverage
- 401k retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
- On-site cafeterias and fitness centers in major locations
- Education Assistance
- Service Recognition
- National discounts to movies, theaters, zoos, theme parks and more
Job title
Job type
Experience level
Salary
Degree requirement
Location requirements
Claims Adjuster managing mid - and higher - level general liability claims for a global industry leader. Assessing liability, negotiating settlements, and maintaining professional client relationships.
Claims Processor assessing and logging drug requests for Canada Life in a fast - paced environment. Requires strong time management and organizational skills with a focus on customer service.
Senior Complex Claims Specialist at Hiscox optimizing claims handling and strategies for Construction Defect and Property Damage. Collaborating with legal teams and ensuring effective claims resolution processes.
Senior level Complex Claims Specialist at Hiscox adjudicating General Liability claims. Focused on early settlements and litigation management with a commitment to superior customer service.
Field Claims Representative at Auto - Owners handling insurance claims throughout Iowa. Responsibilities include investigation, evaluation, and resolution of claims in the property and casualty segment.
Field Claims Adjuster managing claims and ensuring business development opportunities for ClaimsPro in a hybrid environment. Providing high - level customer service and adjusting claims in Lloydminster area.
Internal Property Claims Adjuster assisting customers with home insurance claims. Investigating and managing claims for personal and commercial lines within a supportive team environment.
Claims Adjuster II focusing on home insurance claims while supporting customers through complex situations. Join a hybrid team dedicated to helping people recover from unexpected events.
Analista de Sinistros RE Junior managing transport claims analysis for Tokio Marine, offering diverse employee benefits and opportunities.