Claims Specialist Salary in USA

Innova Solutions is immediately hiring for a Claims Specialist Position type: Contract Duration: 6 months Location: Must be located in Denver metro area*The first day of orientation is onsite and there may be some aspects of training that may need to be done in person until candidate gets up to speed. As a(n) Claim Specialistyou will: Under the direction of the Compliance and Contracts Manager, the Claims Specialist is responsible for working with insurance companies to perform denial resolution on outstanding claims and supports the internal Credentialing process of the center. A successful candidate for the Claims Specialist position can utilize their previous medical billing experience to collaborate and communicate effectively with stakeholders while demonstrating problem-solving skills, bringing denied claims to resolution and working to submit necessary credentialing applications to enroll providers in Medicare, Medicaid and Commercial payer insurance. Essential Functions Billing: Work closely with billing staff to review denied claims related to provider credentialing. Interacts with payers to determine true reason for denial and inquire on what corrections need to be made. Collaborates with internal and external stakeholders to ensure necessary corrections are submitted timely and accurately. Ability to work and update multiple issues within a ticketing queue, providing regular status updates. Sees through the claims reprocessing to achieve the desired results. Credentialing: Completes credentialing and re-credentialing applications to add providers to Medicare, Medicaid and Commercial Payers. Completes revalidation requests issued by government payers. Maintains accurate and up to date provider profiles on CAQH, PECOS, NPPES, and CMS databases. Maintains internal documentation to ensure all information is accurate. Support Credentialing staff in completing quarterly attestations for payers. Qualifications: High School or GED required, Associates or Bachelor's preferred. 2+ years health care and medical billing/Revenue Cycle experience required. General knowledge of finance and accounting functions, policies, practices and terminology. Ability to research and problem solve, using analytical and critical thinking skills. Ability to handle multiple tasks simultaneously and work autonomously. Demonstrated history of resolving challenging issues. Strong interpersonal skills, including excellent written and verbal communication skills. Familiarity with Microsoft Office suite (Excel, Outlook, Word) and strong computer skills. Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible. We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW. Thank you! Anil Sharma Sr. Associates 585-351-2268 [email protected] PAY RANGE AND BENEFITS: Pay Range*: $25 - $28/hr *Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc. Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP). ABOUT INNOVA SOLUTIONS:Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields. Recent Recognitions: One of Largest IT Consulting Staffing firms in the USA - Recognized as #4 by Staffing Industry Analysts (SIA 2022) ClearlyRated® Client Diamond Award Winner (2020) One of the Largest Certified MBE Companies in the NMSDC Network (2022) Advanced Tier Services partner with AWS and Gold with MS Website: https://www.innovasolutions.com/ Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at [email protected] or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b. The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

JOB DESCRIPTION The Claim Specialist, under an appropriate level of direction from the manager, investigates, evaluates, and resolves Professional Liability claims while ensuring the highest level of customer service. Provide outstanding customer service and work with the insured, broker, and counsel in the adjustment of Professional Liability Claims. Identify and evaluate coverage issues, prepare comprehensive coverage letters and analysis. Conduct, coordinate, and direct investigation into loss facts and extent of third-party damages. Direct and closely monitor assignments to experts and defense counsel. Evaluate information on coverage, liability, and damages to determine the extent of exposure to the insured and the company. Set reserves within authority or make claim recommendations concerning reserve changes to supervisor. Participate in virtual settlement conferences and mediations, with occasional travel as necessary. ABOUT US Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.

Claims SpecialistSUMMARY: As a Claims Specialist for the Marsh McLennan Agency, you will be a claims consultant providing oversight and advocacy on behalf of our clients throughout the process of a loss event and the life of a claim.Duties include:You will submit claims or provide guidance on claim submission;Review coverages and resolve claims issues;Ensure carrier commitments are honored;Coordinate and participate in scheduled claims reviews;Serve as your client's advocate with adjusters and their coverage counsel;Resolve coverage disputes whenever possible;Assess and strategize to produce best possible claim outcomes;Duties may also include:Review of client's overall claims program and individual complex claims situations;Develop strategic action plans to reach desired outcomes;Provide guidance regarding potential large settlements;Recommend suitable vendor partners, including claims TPAs, nurse triage, and others;Review adjuster's claim action plans; facilitate claims resolutions;Evaluate insurance company claim reserves and push for reductions where appropriate;REQUIREMENTS: High School Diploma, Bachelor's degree preferred;Adjusters license;Knowledge of accepted industry standards and practices;Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges;Analytical skill necessary to make decisions and resolve issues inherent in handling of claims;We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. Marsh & McLennan Agency offers competitive salaries and comprehensive benefits and programs including: health and welfare, tuition assistance, 401K, employee assistance program, career mobility, employee network groups, volunteer opportunities, and other programs. For more information about our company, please visit us at: http://marshmma.com/careers.

JOB DESCRIPTION This is not your average Claims role. When you think of a job handling insurance claims, you may think about storm damage or auto accidents. Or maybe a large stack of paper? A career in Employment Practices Liability exposes you to emerging issues in the workplace that have been and remain at the center of national and global media. Issues such as the Me Too movement, Racial Injustice and Covid. In this paperless environment, you will use your analytical skills to resolve workplace claims. We will teach you about Employment Law, contracts and claims. You will use your influence skills and knowledge to partner with defense counsel and our insureds in resolving discrimination, harassment and other workplace related claims. The work is interesting. The environment is collaborative. Our Claims Professionals in Employment Practices Liability enjoy the work they do and working with their peers that come from a variety of backgrounds (including Law Enforcement, Human Resources, other disciplines in Claims and Legal, to name a few) and bring different perspectives into the team. Responsibilities after training include:Contribute to a collaborative environment by raising new ideas and demonstrating teamwork, high motivation, positive behavior and effort to achieve goals and objectives. Complete accurate and timely coverage, liability and damage investigations and evaluations on complex Employment Practices Liability insurance policies. Establish, document and execute appropriate strategies to bring early and cost-effective resolution to assigned claims. Represent the company at meetings with management and business partners, as well as virtually at mediations. Effectively utilize technology systems and tools to track and manage caseload in most efficient and effective manner. Build and maintain productive relationships with internal and external customers, including clients, underwriters and agents. Consistently demonstrate sound claim handling practices by achieving compliance in areas including investigation, coverage, loss assessment, and case management. Assume part of training responsibilities for new claim examiners. Provide coaching and guidance to new claim examiners. ABOUT US Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.

Job Summary: The Claims Specialist is expected to work independently and will be responsible for effectively researching, validating, and resolving customer claims from inception to completion. Primary Duties and Responsibilities: Transactional (35%) Analytical (25%) Support (40%) Required Skills: * Highly motivated, driven individual * Ability to effectively multitask and excel in a fast-paced, dynamic work environment * Strong negotiation skills required to influence customers to issue payments for invalid claims. * Accomplished user of Microsoft Suite (Excel, PowerPoint, Word, Outlook) * SAP system experience highly desired Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: https://jobs.beaconhillstaffing.com/eeoc/Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records.Company Profile: Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.Learn more about Beacon Hill Staffing Group and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.beaconhillstaffing.com . We look forward to working with you.Beacon Hill. Employing the Future (TM)

Hello,I hope all is well! I am not sure if you are still in the market looking for work as I received a couple of 12+ months (Temp-to-hire/ Perm) as a Medical Claims Retrieval Specialist with one of our top National Clients.Mode of work: 100% RemoteFacility Zip code: 60607 (Chicago, IL)Profession: Medical Claims Retrieval SpecialistWork Authorization/ Taxation: Citizen of the US/ Green card Holder on W2Experience (Min.):High school diploma, GED or equivalentDuration: Monday - Friday 08.00 AM - 05.00 PMField of expertiseDemonstrated understanding of HIPAA regulationsPrevious collections experienceRequired SkillPrior experience in healthcare, insurance, or collections industries.Demonstrated ability to work in fast-paced, remote environments with minimal supervision.Strong communication skills, including the ability to communicate professionally and effectively with medical providers and insurance representatives.Knowledge of medical terminology and the insurance industry.Proven track record of meeting or exceeding call targets and deadlines.Familiarity with Microsoft Office.Candidates with additional relevant certifications or training in medical billing, coding, or insurance will be given preference.Ability to maintain a HIPAA-compliant work environment, ensuring privacy and security.Metrics-focused mindset, with a commitment to continuous improvement and growth.ResponsibilitiesMake outbound calls to medical providers and insurance companies to retrieve medical records and facilitate the claims retrieval process.Utilize available resources to solve issues on the phone and reach out for help resolving claims when needed.Request medical records on behalf of insurance companies for review and overcharge collection afterward.Update the database with claim information and ensure the accuracy of data.Meet daily/weekly/monthly call targets as set by management.Actively seek feedback and apply it to improve performance and achieve objectives.Continuously strive for self-improvement and professional growth.Requirements for Client SubmittalUpdated resumeComputer Navigation Quiz (Results are documented automatically) - Needs at least a 9/12 to be considered.Test Link: https://docs.google.com/forms/d/e/1FAIpQLScSSm_WdtWnGC-NZj3dZ3Z6jdF5oAGo_6GQGsEHf4VYqC9gbg/viewform?usp=pp_url

A health services network in New York is currently seeking a new Claims Specialist for a promising opportunity with their growing team in Flushing.Responsibilities:The Claims Specialist will:Be responsible for reviewing claims processed by the outside vendor, including resolving provider appeals/disputes. Performs root cause analysis for all provider projects to identify areas for provider education and/or system (re)configuration. Initiates and follows through with resolution of all pended claims.Reviews and investigates claims to be adjudicated by the TPA, including the application of contractual provisions in accordance with provider contracts and authorizationsCompiles claim reports for adjustments resulting from external providers, vendors, and internal inquiries in a timely mannerInvestigates suspense conditions to determine if the system or procedural changes would enhance claim workflowCommunicates and follows up with a variety of internal and external sources, including but not limited to providers, members, attorneys, regulatory agencies, and other carriers on any claim related mattersAnalyzes patient and medical information to identify COB, Worker's Compensation, No-Fault, and Subrogation conditionsValidates DRG grouping and (re)pricing outcomes presented by the claims processing vendorAttends JOC meetings with providers as appropriate to assist in communicating proper billing procedures and to explain company coverage guidelinesAssists TPA with provider compensation configuration by creating and testing compensation grids used for reimbursement and claims processingEnsures that refund checks are logged and processed, enabling expedited credit of monies returnedAnalyzes check return/refunds volumes and trends to determine root causes. Proposes workflow changes to correct and enhance claim processes to prevent returned checks/refundsGenerates routine daily, monthly and quarterly reports used for managing process timeframes and vendor productivity, ensuring compliance with all regulatory requirements and contractual vendor SLAsParticipates in special projects and performs other duties as assigned Qualifications:Bachelor's degreeCertified Professional Coder (a plus)Desired Skills:3-5 years of insurance experience within a healthcare or managed care setting (preferred)Claims adjudication experience Knowledge of MLTC/ Medicaid/Medicaid benefit Knowledge of Member (Subscriber) enrollment & billing Knowledge of Utilization Authorizations Knowledge of Provider ContractingKnowledge of CPTs, ICD 9/ICD 10, HCPC, DRG, Revenue, RBRVSProficiency in MS Excel, Word, PowerPoint, and experience using a claims processing system or comparable database software

- The Claims Specialist will be responsible for reviewing claims processed by the outside vendor, including resolving provider appeals/disputes. Performs root cause analysis for all provider projects to identify areas for provider education and/or system (re)configuration. Initiates and follows through with resolution of all pended claims, (re)pricing, returned or refund checks and the development of provider and facility compensation grids. Provides feedback or suggestions to enhance current processes or systems.- Reviews and investigates claims to be adjudicated by the TPA, including the application of contractual provisions in accordance with provider contracts and authorizations- Compiles claim reports for adjustments resulting from external providers, vendors, and internal inquiries in a timely manner- Investigates suspense conditions to determine if the system or procedural changes would enhance claim workflow- Communicates and follows up with a variety of internal and external sources, including but not limited to providers, members, attorneys, regulatory agencies, and other carriers on any claim related matters- Analyzes patient and medical information to identify COB, Worker's Compensation, No-Fault, and Subrogation conditionsExperience:Eight or more years of insurance experience within a healthcare or managed care setting (preferred)Claims adjudication experienceKnowledge of MLTC/ Medicaid/Medicaid benefitKnowledge of Member (Subscriber) enrollment & billing

LHH Recruitment Solutions is seeking a Claims Specialist for a plaintiff law firm. This opportunity is full time and hybrid out of New York, NY. Hours: 9:30am - 5:30pm, overtime when necessary Responsibilities Format documents and communications for clients; review documents (release/document verification) for production to defense counsel for quality controlCalendar and entry of case info into database; run and analyze client data reportsPerform intake and initial filtering of client inquiries; analyze and summarize client inquiries to identify trends and patterns requiring further actionPreparation of submissions involving large volumes of individual claimsEnsure that case documents accurately reflect a client's information; keep track of communications or developments relating to client cases and deadlines Prepare and send client communicationsWork with attorneys to plan data gathering and settlement update workflowsAssist with the development of processes and technological systems for addressing large volumes of client interactionsQualifications1-2 years of claims experience required Must be willing and available to work overtime, both evening and weekends Familiarity with Filesite and client management systems or databases preferredStrong written and oral communication skills and strong interpersonal skillsMust possess great attention to detail and analytical and critical thinking skillsStrong organizational and time-managementProficient with Microsoft Word and Excel; Strong technical skills and ability to quickly learn new litigation support softwareBenefits This is a posting on the behalf of LHH's client. Benefits may include PTO and health insurance. The salary range is $50K-$55K.

Subrogation Specialist Direct Hire/Full-time Hudson, OH - Onsite$52K+Our client is seeking qualified Subrogation Specialists to join their team in Hudson, Ohio! The Subrogation Specialist is responsible for the subrogation investigation, negotiation, and recovery of claims while adhering to the statute of limitation and client parameters. As one of the top workplaces and fastest growing companies, our client is known for an outstanding company culture, workplace flexibility, and career growth. Requirements • Subrogation/liability experience preferred. • Strong interpersonal skills to ensure excellent internal and external customer service. • Strong investigative and organizational skills. • Excellent written and verbal skills. • Strong ability to multi-task and manage time effectively. • Ability to negotiate repair disputes and liability challenges • Highly motivated, strong initiative, self-starter with team focus. • Demonstrates dependability, punctuality and excellent attendance. Main Job Duties • Investigates claim details to maximize recovery opportunity and identify sources for recovery. • Initiates request for reimbursement and negotiates settlements. • Provides detailed recommendations for next steps on complex claims. • Complies with departmental policies on recovery process and follows client directives in accordance with state laws. • Meets or exceeds both individual and team recovery performance metrics. Work Schedule This position is being offered with several possible work schedules, including; Traditional schedule with all hours being worked out of corporate office in Hudson Flexible work schedule that includes a portion of hours worked at home and a portion of hours worked out of our corporate office in Hudson (dependent on approval). Monday through Friday, 8:00 am until 5:00 pm. Other schedule options available Additional Info: offers a competitive salary, casual work environment, major medical health plan, dental, long term disability, group life, 401(k) plan, AFLAC and paid vacation. Eight Eleven Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, national origin, age, sex, citizenship, disability, genetic information, gender, sexual orientation, gender identity, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws.