Remote Claims Resolution Specialist

Job DescriptionWe are seeking a Claims Resolution Specialist to join our team. This role involves reviewing, researching and resolving claims for health plans, commercial customers and government entities.As a Claims Resolution Specialist, you will be responsible for analyzing and identifying trends and providing reports as necessary. You will also ensure...

The Claim Resolution Specialist plays a versatile role in the claims workflow, tasked with submitting appeals to overturn denials and trigger payments or determining whether further action, such as additional appeals or account closure, is required. Specialists in this role may prioritize tasks based on claim complexity and workload, ensuring optimal...

Job SummaryA Claims Resolution Specialist is responsible for reviewing and evaluating customer claims, ensuring their accuracy, eligibility, and compliance with company policies. This involves investigating claims, determining validity, and customer settlement amounts while maintaining detailed records and communicating with team leads for approval.Key...

Delegate CX is seeking a highly skilled and detail-oriented Claims Representative to join its team.Job Description:The role of the Claims Representative will be to investigate and resolve customer claims related to branded and imprinted merchandise.Responsibilities:Investigate incoming customer claims related to promotional product orders.Collaborate with...

Role Summary:As a Dental Claims Specialist, you will play a critical role in delivering exceptional service to our customers. You will be responsible for managing and processing claims, resolving issues, and providing support to our clients while upholding our commitment to quality and integrity.Follow-up status of outstanding insurance claims, ensure all...

Medical Billing Specialist OpportunityWe are seeking a detail-oriented Medical Billing Specialist to support the revenue cycle operations of our healthcare client.This role is primarily focused on reducing claim denials and recovering aging or stale claims.You will be working directly in our clients billing system, managing claim queues, and communicating...

Healthcare Claims AnalystWe are seeking a skilled Healthcare Claims Analyst to join our team. In this role, you will be responsible for reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities.You will analyze, identify trends and...

Auto Glass Warranty Claims SpecialistThe ideal candidate will be responsible for handling all incoming warranty claims related to auto glass, ensuring timely and accurate resolutions. Strong communication skills are essential to interact with customers and technicians.Responsibilities:Manage all warranty claims strictly related to auto glass, investigating...

Job Overview:This role entails reviewing and resolving provider disputes in accordance with regulatory requirements and internal policies.Key Responsibilities:Investigate and resolve provider disputes related to denied, underpaid, or incorrectly processed claims.Analyze claims history, adjudication data, and notes using EZCap.Interpret health plan policies,...

The role of a claims handler involves the review and evaluation of claims assigned to this position. It is essential to attend to inquiries from insured clients and walk-in customers at the assigned location. Additionally, the claim handler must approve LOA within the assigned authority limit if applicable.Maintaining knowledge of claim documentation is also...