Top 293 Claims Representative I Jobs

Claim Specialist I - IV (New York WC Claims)
MEMIC —Remote
- $65,000 - $98,500 a year
- Remote
- Microsoft Word
- Mid-level
- Driver's License
- Paid parental leave
- Health savings account
Claims Customer Service Representative I
Partnership HealthPlan of California —Fairfield, CA
- $29.95 - $35.19 an hour
- Full-time
- Computer literacy
- Research
- High school diploma or GED
Claims Analyst I
Healthcare Legal Solutions LLC —Washington, DC
- $50,000 - $60,000 a year
- Microsoft Excel
- Bachelor of Science
- Writing skills
Quick Apply
Patient Services Representative I - Remote - Nationwide
Vituity —Sacramento, CA
- $17.12 - $19.04 an hour
- Overtime
- Remote
- Spanish
- Basic math
- Windows
- Profit sharing
- Wellness program
(Remote) Account Follow-Up Representative I
Harris Computer Systems —Tennessee
- $18 - $26 an hour
- Full-time
- Remote
- Basic math
- HIPAA
- Research
- Health insurance
- Dental insurance
Appeals Representative I
Federal Hearings And Appeals —Wilkes-Barre, PA
- $40,000 - $45,000 a year
- Full-time
- Customer service
- Writing skills
- HIPAA
Quick Apply
Health Navigator I
Moda Health —Milwaukie, OR
- $21.30 - $23.96 an hour
- Full-time
- Microsoft Outlook
- Writing skills
- Research
- Paid holidays
- Health insurance
Quick Apply
Payer Compliance Specialist I - Remote
US Anesthesia Partners, Inc. —Dallas, TX
- $16.49 - $26.39 an hour
- Full-time
- Microsoft Word
- Writing skills
- Basic math
8d
Claims Services Representative I
RAS Companies —Sioux Falls, SD
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
Customer Care Representative I
First Choice Health Network Inc —Seattle, WA
- $19 - $22 an hour
- 8 hour shift
- Spanish
- Google Workspace
- Writing skills
- Profit sharing
- Wellness program
Quick Apply
1d
Customer Support Representative Tier 1
Synapse Health —Skokie, IL
- $17.00 - $21.65 an hour
- Remote
- Writing skills
- Mid-level
- Microsoft Office
- Disability insurance
- Health insurance
Quick Apply
9d
Auto Liability Specialist I
First Acceptance Services Inc —Lawrenceville, GA
- Full-time
- Remote
- Basic math
- Windows
- High school diploma or GED
- Continuing education credits
Call Center Representative I
MetroPlus Health Plan —New York, NY
- $48,791 a year
- Full-time
- Hybrid work
- Sales
- Research
- High school diploma or GED
Government Programs Appeal Coordinator I
Moda Health —Milwaukie, OR
- $21.30 - $23.96 an hour
- Overtime
- Hybrid work
- Writing skills
- Research
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
Customer Service Representative I
Priwils, Inc —Chicago, IL
- Full-time
- High school diploma or GED
- 1 year
- Associate's degree
Quick Apply
Client Relations Specialist I (CRS I)
Prestige Veteran Medical Consulting —Texas
- From $17 an hour
- Full-time
- Remote
- Background check
- Continuous improvement
- Organizational skills
- Paid holidays
- 401(k)
Quick Apply
6d
Content Claims Specialist - Field - Level I
E-djuster USA Inc. —Los Angeles, CA
- $21 - $25 an hour
- Full-time
- Hybrid work
- Background check
- Microsoft Outlook
- High school diploma or GED
- Paid parental leave
- Health savings account
Quick Apply
Member Services Representative I
Alterwood Health —Maryland
- $20 - $23 an hour
- 8 hour shift
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
5d
PATIENT ACCOUNT REP I CORPORATE
Covenant Health —Knoxville, TN
- Full-time
- HIPAA
- High school diploma or GED
- Computer skills
Provider Relations Representative I (Hybrid)
CareFirst BlueCross BlueShield —Baltimore, MD
- $49,464 - $98,241 a year
- Full-time
- Microsoft Word
- Microsoft Access
- Up to 50% travel
Quick Apply

I want to receive the latest job alert for Claims Representative I

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

Claims Representative I jobs near

Compliance Officer jobs in Dallas, TX

Automotive Technician jobs in Lawrenceville, GA

Patient Services Representative jobs in Sacramento, CA

Call Center Representative jobs in New York, NY

Customer Relations Representative jobs in Baltimore, MD

Patient Accounts Representative jobs in Knoxville, TN

Claims Specialist jobs in Remote

Customer Service Representative jobs in Chicago, IL

Claims Representative jobs in Sioux Falls, SD

Customer Service Representative jobs in Fairfield, CA

Client Relations Specialist jobs in Remote

Claims Specialist jobs in Los Angeles, CA

Compliance Officer jobs in Long Beach, CA

Compliance Officer jobs in Orange County, CA

Loan Officer jobs in Jacksonville, FL

Correctional Officer jobs in St. Louis, MO

Compliance Officer jobs in Durham, NC

Compliance Officer jobs in Raleigh, NC

Automotive jobs in Dallas, TX

Health Information Technician jobs in Texas

Claim Specialist I - IV (New York WC Claims)

MEMIC -
Remote

Apply Now

Job Details

$65,000 - $98,500 a year

Benefits

Paid parental leave
Health savings account
AD&D insurance
Paid holidays
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Paid time off
Flextime
Parental leave
Employee assistance program
Vision insurance
401(k) matching
Life insurance
Pet insurance

Qualifications

Workers' compensation insurance knowledge
Driver's License

Full Job Description

CANDIDATES MUST HAVE NY CLAIMS EXPERIENCE

The Claim Specialist I - IV investigates, evaluates, negotiates, and resolves lost time claims within settlement and reserving authority up to stated maximum. (Supervisor will determine actual individual authority up to the stated maximum). Based on experience and proven ability, an expanded and more difficult caseload will be expected, requiring a lesser degree of supervision.

Principal Duties and Responsibilities
1. Communicates with insureds, injured workers, agents, brokers, witnesses, attorneys, loss prevention, and underwriters to obtain and relate necessary information to determine coverage/compensability, facts of loss, and degree of liability/exposure. Maintains contact throughout the life of the file as needed.
2. Administers the delivery of timely, appropriate and accurate indemnity and medical benefits.
3. Evaluates claim exposure, negotiate and resolve claims. Works closely with defense counsel on litigated cases and attend mediation, arbitration, and hearings, as necessary. Develops litigation plan with defense counsel and tracks adherence to plan in order to control legal expenses and assure effective resolution.
4. Works closely with insureds and employees making visitations and presentations as needed to facilitate partnership approach to claims handling.
5. Maintains quality claim files in accordance with appropriate best practices, and other company procedures.
6. Implements Managed Care strategies, coordinate rehabilitation or medical management, process bills, review all mail through Image Right, and monitor progress as appropriate.
7. Interacts with State and Federal Boards and Commissions, while establishing and maintaining proper reserves, as appropriate.
8. Serves as a mentor and helps prepare/train the less experienced Claim Department representatives.
9. Keeps up-to-date on State laws and Company procedures relating to various claims; educates injured worker and/or insured on same.
10. Prepares and presents files for Agent/Broker Reviews and Insured File Review.
11. Understands medical terminology and standard medical procedures as they pertain to worker's compensation, U.S. Longshoreman's and Jones Act claims.
12. Participates in in-house and outside training programs to keep up-to-date on relevant issues/topics.
13. Maintains a working knowledge of all computer systems currently in use.
14. Travels throughout States as required to handle claims inventory assigned.
15. Continues education in claims through Associate in Claims or Claims Law (AEI) courses.

Minimum Knowledge, Skills and Abilities
1. One to four years of workers' compensation lost time claim handling experience preferred.
2. Bachelor's degree preferred.
3. Computer skills, Word, Excel and Image Right preferred.
4. Must have a valid driver's license.
5. Strong attention to detail and strong communication skills both verbal and written.
6. Adaptable/flexible and self-directed with the ability to manage time, multiple priorities and other resources wisely.
7. Must have the ability to work effectively with other organizational team members.

Our comprehensive benefits package includes all traditional offerings such as:

Health Insurance options, Dental Insurance options and Vision Insurance
Employee Life Insurance/AD&D and Dependent Life Insurance options
Short-term & Long-term Disability
Health Savings Account with potential employer match
Flexible Medical and Dependent Care Account
Accident Insurance
Critical Illness Insurance
Employee Assistance Program
Legal/Identify Theft Insurance options
Long Term Care Insurance
Pet Insurance
401 (k) Retirement Plan with match up to 6%, plus annual bonus based on individual & company performance.
5 weeks of Paid Time Off (PTO)
11 paid holidays

We also offer other benefits to help foster a healthy, balance lifestyle such as:

Flextime schedules
Paid Parental Leave
Student loan paydown and refinancing assistance
Educational assistance for job related courses, seminars, certifications or degrees
One paid day every year to volunteer for your non-profit of choice
Sit-Stand desks & daily stretch breaks

Salary Range for this position is $65,000-$98,500 depending on experience.

MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law.

Apply Now

Refine Your Search

Claims Representative I jobs

Claim Specialist I - IV (New York WC Claims)

Claims Customer Service Representative I

Claims Analyst I

Patient Services Representative I - Remote - Nationwide

(Remote) Account Follow-Up Representative I

Appeals Representative I

Health Navigator I

Payer Compliance Specialist I - Remote

Claims Services Representative I

Customer Care Representative I

Customer Support Representative Tier 1

Auto Liability Specialist I

Call Center Representative I

Government Programs Appeal Coordinator I

Customer Service Representative I

Client Relations Specialist I (CRS I)

Content Claims Specialist - Field - Level I

Member Services Representative I

PATIENT ACCOUNT REP I CORPORATE

Provider Relations Representative I (Hybrid)

I want to receive the latest job alert for Claims Representative I

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected