Converses with insured to obtain information to assure completeness of information and to prepare claim form. Prepares reports and insurance claim forms for damage or loss against insurance companies. Helps Claims Department by performing clerical duties.

Records routine claims. Forwards report... [+] More

Converses with insured to obtain information to assure completeness of information and to prepare claim form. Prepares reports and insurance claim forms for damage or loss against insurance companies. Helps Claims Department by performing clerical duties.

Records routine claims. Forwards report of claim or claim form to insurance company. Acts as intermediary between company and insured. May handle Medicare claims. May assist in settling claims. [-] Less

Supplies telephone inquirers with information concerning activities and programs of automobile club. Gives information on matters, such as traffic engineering and motor-vehicle safety, applicable motor vehicle laws, licensing regulations, automobile insurance and financing, and legal actions. Receives and records complaints on road conditions. Participates in traffic surveys. May specialize in assisting members file insurance claims for motor vehicle property damage.

Converses with insured to obtain information to assure completeness of information and to prepare claim form. Prepares reports and insurance claim forms for damage or loss against insurance companies. Helps Claims Department by performing clerical duties.

Records routine claims. Forwards report... [+] More

Converses with insured to obtain information to assure completeness of information and to prepare claim form. Prepares reports and insurance claim forms for damage or loss against insurance companies. Helps Claims Department by performing clerical duties.

Records routine claims. Forwards report of claim or claim form to insurance company. Acts as intermediary between company and insured. May handle Medicare claims. May assist in settling claims. [-] Less

Converses with insured to obtain information to assure completeness of information and to prepare claim form. Prepares reports and insurance claim forms for damage or loss against insurance companies. Helps Claims Department by performing clerical duties.

Records routine claims. Forwards report... [+] More

Converses with insured to obtain information to assure completeness of information and to prepare claim form. Prepares reports and insurance claim forms for damage or loss against insurance companies. Helps Claims Department by performing clerical duties.

Records routine claims. Forwards report of claim or claim form to insurance company. Acts as intermediary between company and insured. May handle Medicare claims. May assist in settling claims. [-] Less

Converses with insured to obtain information to assure completeness of information and to prepare claim form. Prepares reports and insurance claim forms for damage or loss against insurance companies. Helps Claims Department by performing clerical duties.

Records routine claims. Forwards report... [+] More

Converses with insured to obtain information to assure completeness of information and to prepare claim form. Prepares reports and insurance claim forms for damage or loss against insurance companies. Helps Claims Department by performing clerical duties.

Records routine claims. Forwards report of claim or claim form to insurance company. Acts as intermediary between company and insured. May handle Medicare claims. May assist in settling claims. [-] Less

Oversees and directs the management of... [+] More

Oversees and directs the management of the claims function to include review and approval of claims. Directs the implementation and ongoing maintenance of claims handling systems, policies, and procedures. Typically requires a college degree and five or more years of claims management experience.

Monitors departmental operations to ensure compliance with regulatory agencies as well as contractual obligations. Performs regular data analysis of claims payment reports to identify variances so that areas of focus may be identified and resources may be appropriately deployed. Provides support on complex claims issues. Prepares and manages the departmental budget and manages expenses. Hires, develops, and motivates a qualified claims processing staff. [-] Less

Directs the Claims Quality Audit Department and provides managerial oversight to employees engaged in claims auditing and training. Approves department policies, practices, and procedures to ensure identification of claims processing errors. Provides planning, organizing, and budgeting for the department. Typically... [+] More

Directs the Claims Quality Audit Department and provides managerial oversight to employees engaged in claims auditing and training. Approves department policies, practices, and procedures to ensure identification of claims processing errors. Provides planning, organizing, and budgeting for the department. Typically requires a college degree in a related field and an in-depth understanding of claims auditing.

Provides oversight of departmental training and auditing activities. Monitors departmental operations to ensure compliance with regulatory agencies and contractual obligations. Develops strategic initiatives and transforms initiatives into action plans. Hires, trains, and motivates a qualified management staff. Oversees the development of training programs that are targeted toward error reduction and decision quality in claims processing. Analyzes audit and training reports to determine department effectiveness. [-] Less

Supervises and facilitates the coordination and scheduling of all external claims audits conducted by customers, audit firms, external vendors, and regulators. Assists in the preparation of audits and management of the audit process.

Notifies appropriate parties of the audit and schedules... [+] More

Supervises and facilitates the coordination and scheduling of all external claims audits conducted by customers, audit firms, external vendors, and regulators. Assists in the preparation of audits and management of the audit process.

Notifies appropriate parties of the audit and schedules entrance and exit conferences. Develops tools to assist staff in effectively coordinating audits and holds staff meetings as needed. Reviews customer contracts for audit rights, and prepares necessary audit confidentiality agreements and Par Plan addendum agreements. Supervises the obtaining and reviewing of claim samples and documentation. Ensure all HIPAA requirements applicable to the job are met. Directs and oversees analysis of requested data in order to minimize organization's risks. Ensures data integrity. Assures that auditors have a positive experience. Reviews findings and responses for adequacy and appropriateness. Reviews draft and final audit reports from auditors. Prepares responses to report findings. May travel to other claims audit locations as needed. [-] Less

Oversees claims management to ensure timely, accurate handling of claims, quality claims services, and appropriate resolution of claim discrepancies. Supervises claims staff.

Manages, reviews, and resolves claims, including determining course of action, developing arguments and addressing claimants' rebuttals, conducting preliminary negotiations,... [+] More

Oversees claims management to ensure timely, accurate handling of claims, quality claims services, and appropriate resolution of claim discrepancies. Supervises claims staff.

Manages, reviews, and resolves claims, including determining course of action, developing arguments and addressing claimants' rebuttals, conducting preliminary negotiations, and preparing and issuing notices to claimants and other third-parties. Manages administrative, financial, accounting, and reporting functions for claims. Assists in overall case resolution strategies, settlements, and litigation support. Authorizes appropriate payment or refers claims to investigators for further review. Analyzes and identifies trends and provides reports as necessary. Provides input for forecasting and planning activities. Generates risk analysis reports for management. Monitors and participates in quality control and reviews. Manages and monitors all high-exposure and complex files. Oversees operational management of the Claims Department, including overall productivity, efficiency, and accuracy. Provides expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing, and adjusting claims. Directs claims staff hiring, oversight, coaching, and training. [-] Less

Supervises employees engaged in claims auditing and training. Implements claim auditing department policies, practices, and procedures to ensure identification of claims processing errors. Typically requires prior experience as a Claims Processor or Adjudicator and an in-depth understanding of claims auditing.

Supervises... [+] More

Supervises employees engaged in claims auditing and training. Implements claim auditing department policies, practices, and procedures to ensure identification of claims processing errors. Typically requires prior experience as a Claims Processor or Adjudicator and an in-depth understanding of claims auditing.

Supervises auditing activities by monitoring weekly backlogs, distributing audit assignments based on work loads, and reviewing and responding to audit inquiries. Responds to error rebuttals from Claims Processors or Adjudicators. Assists in hiring, training, coaching, and evaluating performance of assigned staff. Contributes to the development of training programs that are targeted toward error reduction and decision quality in claims processing. Monitors training programs to evaluate effectiveness. [-] Less