Top 33 Claims representative Jobs in Pensacola, Fl

Claims - Support Representative, Claims
Wellcove —Pensacola, FL
- Full-time
- Remote
- Basic math
- HIPAA
- Mid-level
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2d
Billing Representative
Ascension —Pensacola, FL
- Full-time
- High school diploma or GED
- 1 year
- Cardiology
- Disability insurance
- Health insurance
Contact Center - CSR-1 - Customer Service Representative 1
Wellcove —Pensacola, FL
- Full-time
- Remote
- Background check
- Computer literacy
- Basic math
Quick Apply
9d
Insurance Follow Up Representative I- Remote
Baptist Health Care, Inc. —Pensacola, FL
- $15 - $17 an hour
- Full-time
- Remote
- Background check
- High school diploma or GED
- Entry level
Quick Apply
Customer Service Representative - State Farm Agent Team Member
Will Rentschler - State Farm Agent —Pensacola, FL
- $55,000 - $70,000 a year
- Full-time
- High school
- Office
- Communication skills
- Disability insurance
- Health insurance
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Insurance Verifier Representative I
Baptist Health Care Corporation —Pensacola, FL
- Full-time
- Background check
- Hospital
- Customer service
Quick Apply
10d
Customer Service Representative - State Farm Agent Team Member
Eric Cabaniss - State Farm Agent —Milton, FL
- $40,000 - $60,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Profit sharing
- Paid time off
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Customer Service Representative - State Farm Agent Team Member
Allen Miller - State Farm Agent —Navarre, FL
- $45,000 - $65,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- Dental insurance
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Customer Service Representative - State Farm Agent Team Member
Blake Thomas - State Farm Agent —Gulf Breeze, FL
- $40,000 - $46,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
- Opportunities for advancement
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Customer Service Representative - State Farm Agent Team Member
Edward Dominey - State Farm Agent —Cantonment, FL
- $40,000 - $50,000 a year
- Full-time
- Office
- High school diploma or GED
- Communication skills
- Health insurance
- Paid time off
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Registration Representative I- Emergency Department/Brent Lane
Baptist Health Care Corporation —Gulf Breeze, FL
- Full-time
- Background check
- High school diploma or GED
- ER
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Customer Service Representative - State Farm Agent Team Member
Jenny Roberts - State Farm Agent —Navarre, FL
- $40,000 - $50,000 a year
- Full-time
- Bachelor of Science
- Office
- Communication skills
- Paid holidays
- Paid time off
Quick Apply
Commercial Lines Account Manager
HUB International —Pensacola, FL
- Full-time
- English
- Mid-level
- High school diploma or GED
- Wellness program
- Continuing education credits
11d
Life Insurance Position - State Farm Agent Team Member
Will Rentschler - State Farm Agent —Pensacola, FL
- $45,000 - $100,000 a year
- Full-time
- High school
- Office
- Communication skills
- Disability insurance
- Health insurance
Quick Apply

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Claims - Support Representative, Claims

Wellcove
Pensacola, FL

Quick Apply

Job Details

Full-time
2 days ago

Qualifications

Customer communication
Basic math
Health insurance policy knowledge
Presentations for conferences or internal meetings
High school diploma or GED
Data integrity and documentation
Insurance policy review
Policy Development

Full Job Description

Who We Are
Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs.

Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

Job Title Claims Support Associate
Department Claims / Operation
Client/Function Prudential
Reports to Claims Manager / Billy Pribble
FSLA Status Non-exempt
PTO Tier 1
Management No
EEO Job Category Administrative support workers

Job Summary

This position is responsible for the administrative support duties of most levels of claims in accordance with policy, company, state, and federal guidelines. This position is for Long Term Care Insurance Plans administered by Prudential.

Supervisory Responsibilities:
This job has no supervisory responsibilities.

Duties/Responsibilities:

Interact professionally with other business units to gather and analyze data needed to properly adjudicate claims and documentation of claims files.
Review requests involving Power of Attorney, Guardianship and Authorizations to Release Information.
Assist the Claims team in requesting medical documentation to adequately adjudicate long-term care eligibility. Reviewing the documents received to determine if complete and accurate.
Assist Claims Management with assigning work activities to associates within our workflow.
Respond professionally and timely to customer inquiries.
Ensure service calls are made in a timely, efficient and knowledgeable manner.
Follow up on any outstanding documentation with additional correspondence, reviewing fax failures, and reviewing any returned mail.
Contact providers and customers to obtain accurate contact information.
Maintain current knowledge of federal, state, and insurance regulations and requirements.
Maintain working knowledge of all company and services pertaining to business segment.
Maintain working knowledge and proficiency in company claims and administrative software systems as well as Microsoft applications.
Maintain client and company quality and production standards.
Maintain knowledge of applicable company policies and procedures
Operate within company regulations regarding HIPAA, fraud, confidentiality, and private health information.
Other duties may be assigned

Required Skills/Abilities:
To perform this job successfully, the individual must be able to perform each essential duty effectively. The individual must possess advance product knowledge, comprehensive understanding of insurance terminology and definitions, core knowledge of company and department processes and procedures related to the ability to complete job responsibilities /duties in a proficient and professional manner.

Ability to read, analyze, and interpret complex documents; ability to respond effectively to the most sensitive inquiries or complaints; ability to write policies and procedures; ability to make effective presentations; ability to exhibit excellent verbal and written communication skills
Customer Service; Work Standards; Decision-Making; Communication; Interpersonal Skills; Integrity/Honesty and Adaptability/Flexibility
Must have the ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals; Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form; Ability to deal with problems involving several concrete variables in standardized situations.

Education and Experience:
High School diploma required and previous experience in the Long-Term Care insurance industry and/or administrative preferred but not required.

Physical Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms; climb or balance; and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, and ability to adjust focus.

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

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Refine Your Search

claims representative jobs in pensacola, fl

Claims - Support Representative, Claims

Billing Representative

Contact Center - CSR-1 - Customer Service Representative 1

Insurance Follow Up Representative I- Remote

Customer Service Representative - State Farm Agent Team Member

Insurance Verifier Representative I

Customer Service Representative - State Farm Agent Team Member

Customer Service Representative - State Farm Agent Team Member

Customer Service Representative - State Farm Agent Team Member

Customer Service Representative - State Farm Agent Team Member

Registration Representative I- Emergency Department/Brent Lane

Customer Service Representative - State Farm Agent Team Member

Commercial Lines Account Manager

Life Insurance Position - State Farm Agent Team Member

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