Claim Specialist jobs at Aon

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Peer Specialist
VNS Health 4.1
New York, NY jobs
VNS Health Peer Specialists/ Advocates are living examples of the transformative power of behavioral health intervention programs and who can uniquely relate to those that would benefit from VNS Health Behavioral Health services. Peer Specialists/Advocates embody our core values of Empathy, Integrity, and Agility to engage and connect community members suffering from chronic mental illness, psychological trauma, or substance abuse with meaningful resources. By sharing personal, practical experience, knowledge, and firsthand insights, Peer Specialists/ Advocates directly help VNS Health clients live and heal at home surrounded by their family and community. VNS Health provides vital client-centered behavioral health care to New Yorkers most in need, across all stages of life and mental well-being. We deliver care wherever our clients are, including outpatient clinics, clients' homes, and the community. Our short- and long-term service models include acute, transitional, and intensive care management programs that impact the most vulnerable populations, from children, to adolescents, to aging adults. As part of our fast-growing Behavioral Health team, you'll have an opportunity to develop and advance your skills, whether you're early in your career or an experienced professional. Sharing your experience with others who are navigating behavioral health and substance use challenges is life changing which is why we welcome you to apply even if you don't meet all criteria . What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability Employer-matched retirement saving funds Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement Internal mobility, CEU credits, and advancement opportunities Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals What You Will Do Conducts phone and field outreach to locate and enroll clients/consumers/members into programs services Builds relationship and trust with clients and their family/caregiver and assists with their interactions with professionals on the team Works collaboratively on an interdisciplinary team to discuss care needs and identify solutions to support clients/consumers/members Applies mutually shared and lived experiences to build relationships and trust with the client/consumers/members Educates clients/consumers/members about program services, benefits, and self-help techniques. Serves as a role model, advocate and mentor. Escorts clients/consumers/members to appointments as needed Advocates effective recovery-based services on behalf of clients/consumers/members. Assists in clarifying rehabilitation and recovery goals Teaches and models symptom management and coping skills for resilience. Empowers clients to take a proactive role in their recovery process Reviews service plans with clients/consumers/members and their families or caregivers. Provides ongoing education, guidance, support and encouragement Develops inventory of resources that will meet the client's needs as identified in the assessment and or-treatment process Provides navigation services to help clients/consumers/members connect with community-based services and supports Documents in EMR in accordance with program policies/procedures, VNS Health standards, and city, state and federal regulatory requirements Assists clients/consumers/members with transition to alternate housing, when appropriate Participates in case conferences, staff meetings, supervision and training programs Develops a mutual self-disclosure between themselves and clients/consumers/members. Serves as a bridge between team members and participant For Certified Community Behavioral Health Clinical (CCBHC): Educates clients about the different types of treatment available, including medications for addiction treatment Helps clients identify their strengths as well as obstacles to their recovery Assists clients with applying for benefits Provides resources for external and post-discharge services Participates as part of interdisciplinary team in discussion of, planning for and actively participating in treatment goals for clients/consumers/members For IMT, ACT, MC, OMH Suicide Prevention: Practice regularly in the community, including traveling to patients' homes, or schools, to engage frequently with clients. Navigate emergency situations Qualifications High school diploma or equivalent required FOR CCBHC ONLY: New York Certified Recovery Peer Advocate (CRPA) required Minimum of one year experience in a mental health, substance use treatment program, health care or human services setting, preferred Experience working with a severely mentally ill, psychological trauma, and/or substance using population, preferred Effective oral/written/interpersonal communication and relationship building skills required Ability to work independently and collaboratively on an interdisciplinary team Computer literacy (electronic health records, word processing, e-mail, internet research, data entry), required Valid New York State driver's license, as determined by operational/regional needs Bilingual skills in English and Spanish, preferred Pay Range USD $20.98 - USD $26.23 /Hr. About Us VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us - we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.
$21-26.2 hourly 3d ago
Garage Door Specialist - Experience Required
ABC Home & Commercial Services 4.1
Austin, TX jobs
Be the driving force behind our new Garage Door service - launch, lead, and help grow the team! A minimum of 3 years of garage door repair and installation experience is required. Please do not apply if you do not meet this requirement. Salary 50k+ depending on experience. No actual area/region is designated, so please note that you as a Technician will cover the entire Austin Metro area as required. Schedule: Monday - Friday Hours: Start to Finish (8:00 AM - 6:00 PM) May have to work a Saturday* once or twice a month, as well as on-call services. At ABC Home & Commercial Services, we're more than just a company; we're a family committed to excellence. With 75 years of history and a team of over 1,000+ employees serving a growing network of cities in Central and South Texas, we take pride in being a family-owned business dedicated to fulfilling commitments, serving others, and supporting families. How You'll Make an Impact: As ABC's Residential and Commercial Garage Door Specialist, you will deliver excellent customer service while efficiently performing high-quality Garage Door Repair and/or Installation. Requirements What You'll Bring: Minimum 3 years of garage door repair and installation experience is required. Must hold a valid driver's license with an issue date of at least five years prior to the date of this application. Fluent in English (reading, writing, and speaking). Excellent communication & customer service skills. High proficiency with emailing, instant messaging and use of various electronic devices and applications for effective communication/information sharing. Demonstrates patience and understanding in resolving customer concerns, even in challenging situations. Dependable and self-motivated with desire to work year-round. No actual area/region is designated, so please note that you as a Technician will cover the entire Austin Metro area as required. Ability to walk for long periods of time in extreme temperatures including outdoors. Able to lift 50 lbs. or more. Repetitive lifting, twisting, bending, pulling, pushing and climbing may be required. What We Offer: Comprehensive benefits package including health, dental, vision, and life insurance. 401(k) with company matching. Paid vacation, sick leave, and participation in our Profit-Sharing Plan. Additional compensation opportunities through our Lead Now Program. Company clubs, outings, and paid training and development opportunities. Tuition reimbursement and educational scholarships for employees and family members. Volunteer Engagement Program with approved Volunteer Time Off (VTO). Wellness program including a gym membership and a company vehicle with gas card. What You'll Do: Accurately diagnose cause of garage door issues, recommend options for solutions, price repairs (when applicable) in accordance with company policy, complete repairs and/or installs after authorization is received, collect and timely deliver payment from customer to office (daily preferred, but always within two business days), complete and submit all required paperwork in a timely and accurate manner. Upon completion of service, review invoice and explain work completed (in person, by phone or by email) with customer to confirm satisfaction. Communicate any issues, concerns or outstanding items to office for scheduled follow-up. Always maintain positive attitude with customers, fellow employees, and supervisors. Communicate effectively with supervisors, dispatchers, CSRs, and customers to always ensure complete alignment during the service repair or replacement process. Work with and train any helpers which may be assigned to work with you. Maintain company-specified tools, equipment and inventory in your truck for most cost-effective delivery of quality service. Attend department meetings and company or vendor training as required. Maintain necessary licenses or certifications and complete required continuing education. Always exhibit professional conduct, whether at the job site or driving company vehicles. Identify and immediately (first opportunity, but always within one hour) report any damage to customer's property. Clean and clear the work area after job has been completed. Maintain and use required personal protective equipment at all times. Follow all safety protocols, regulations and company policies while driving. Always wear company uniform and maintain well-groomed appearance in accordance with company policies. Be available to serve periodic on-call rotation assignments (per schedule approved by service manager) necessary to ensure quality coverage for customers. May have to work a Saturday once or twice a month. Other duties as assigned. To apply for this position, you must have a minimum of 3 years of garage door repair and installation experience. Join Our Team Today: At ABC Home & Commercial Services, we're excited to welcome you aboard and support your growth as we work together to keep our community rolling smoothly . What are you waiting for? In just two weeks, you could be behind the wheel of our very spiffy white vans - you know, the ones with the Anteater on them - helping our customers when things just aren't opening up for them! ABC is an Equal Opportunity Employer. Please note that if an offer is extended that we do conduct the following pre-employment screenings: Drug Screen, Physical & Physical Performance Evaluation (PPE). ABC participates in the E-Verify (I-9) program and conducts comprehensive criminal background checks, along with a 7-year Motor Vehicle Report (MVR) review. Must hold a valid driver's license with an issue date of at least five years prior to the date of this application. *As an equal opportunity employer, we are committed to respecting the religious beliefs and practices of all individuals. We will consider reasonable accommodation requests from applicants and employees who require adjustments to their work schedules or practices due to sincerely held religious beliefs, provided such accommodations do not create an undue hardship on the company's operations. PM21 #INDP1
$39k-52k yearly est. 2d ago
Garage Door Specialist - Experience Required
ABC Home & Commercial Services 4.1
Texas jobs
Be the driving force behind our new Garage Door service - launch, lead, and help grow the team! A minimum of 3 years of garage door repair and installation experience is required. Please do not apply if you do not meet this requirement. Salary 50k+ depending on experience. No actual area/region is designated, so please note that you as a Technician will cover the entire Austin Metro area as required. Schedule: Monday - Friday Hours: Start to Finish (8:00 AM - 6:00 PM) May have to work a Saturday* once or twice a month, as well as on-call services. At ABC Home & Commercial Services, we're more than just a company; we're a family committed to excellence. With 75 years of history and a team of over 1,000+ employees serving a growing network of cities in Central and South Texas, we take pride in being a family-owned business dedicated to fulfilling commitments, serving others, and supporting families. How You'll Make an Impact: As ABC's Residential and Commercial Garage Door Specialist, you will deliver excellent customer service while efficiently performing high-quality Garage Door Repair and/or Installation. Requirements What You'll Bring: Minimum 3 years of garage door repair and installation experience is required. Must hold a valid driver's license with an issue date of at least five years prior to the date of this application. Fluent in English (reading, writing, and speaking). Excellent communication & customer service skills. High proficiency with emailing, instant messaging and use of various electronic devices and applications for effective communication/information sharing. Demonstrates patience and understanding in resolving customer concerns, even in challenging situations. Dependable and self-motivated with desire to work year-round. No actual area/region is designated, so please note that you as a Technician will cover the entire Austin Metro area as required. Ability to walk for long periods of time in extreme temperatures including outdoors. Able to lift 50 lbs. or more. Repetitive lifting, twisting, bending, pulling, pushing and climbing may be required. What We Offer: Comprehensive benefits package including health, dental, vision, and life insurance. 401(k) with company matching. Paid vacation, sick leave, and participation in our Profit-Sharing Plan. Additional compensation opportunities through our Lead Now Program. Company clubs, outings, and paid training and development opportunities. Tuition reimbursement and educational scholarships for employees and family members. Volunteer Engagement Program with approved Volunteer Time Off (VTO). Wellness program including a gym membership and a company vehicle with gas card. What You'll Do: Accurately diagnose cause of garage door issues, recommend options for solutions, price repairs (when applicable) in accordance with company policy, complete repairs and/or installs after authorization is received, collect and timely deliver payment from customer to office (daily preferred, but always within two business days), complete and submit all required paperwork in a timely and accurate manner. Upon completion of service, review invoice and explain work completed (in person, by phone or by email) with customer to confirm satisfaction. Communicate any issues, concerns or outstanding items to office for scheduled follow-up. Always maintain positive attitude with customers, fellow employees, and supervisors. Communicate effectively with supervisors, dispatchers, CSRs, and customers to always ensure complete alignment during the service repair or replacement process. Work with and train any helpers which may be assigned to work with you. Maintain company-specified tools, equipment and inventory in your truck for most cost-effective delivery of quality service. Attend department meetings and company or vendor training as required. Maintain necessary licenses or certifications and complete required continuing education. Always exhibit professional conduct, whether at the job site or driving company vehicles. Identify and immediately (first opportunity, but always within one hour) report any damage to customer's property. Clean and clear the work area after job has been completed. Maintain and use required personal protective equipment at all times. Follow all safety protocols, regulations and company policies while driving. Always wear company uniform and maintain well-groomed appearance in accordance with company policies. Be available to serve periodic on-call rotation assignments (per schedule approved by service manager) necessary to ensure quality coverage for customers. May have to work a Saturday once or twice a month. Other duties as assigned. To apply for this position, you must have a minimum of 3 years of garage door repair and installation experience. Join Our Team Today: At ABC Home & Commercial Services, we're excited to welcome you aboard and support your growth as we work together to keep our community rolling smoothly . What are you waiting for? In just two weeks, you could be behind the wheel of our very spiffy white vans - you know, the ones with the Anteater on them - helping our customers when things just aren't opening up for them! ABC is an Equal Opportunity Employer. Please note that if an offer is extended that we do conduct the following pre-employment screenings: Drug Screen, Physical & Physical Performance Evaluation (PPE). ABC participates in the E-Verify (I-9) program and conducts comprehensive criminal background checks, along with a 7-year Motor Vehicle Report (MVR) review. Must hold a valid driver's license with an issue date of at least five years prior to the date of this application. *As an equal opportunity employer, we are committed to respecting the religious beliefs and practices of all individuals. We will consider reasonable accommodation requests from applicants and employees who require adjustments to their work schedules or practices due to sincerely held religious beliefs, provided such accommodations do not create an undue hardship on the company's operations. PM21 #INDP1
$39k-51k yearly est. 2d ago
Claims Examiner-Lost Time
Comptech Associates 4.2
New Haven, CT jobs
Job Title: Claims Examiner-Lost Time Duration: 3+ Months (CTH) 3+ years of Workers' Compensation Lost Time Claim Examiner or Commensurate Experience (Having experience in workers' compensation is not a requirement, but a nice thing to have, as long as the skills they do have are transferable.) Technical Skills & Competencies: Lost Time Claim Examiner position with prior experience in workers' compensation as a medical only examiner, or commensurate examiner experience in paralegal, short-term / long-term disability, auto personal injury protection / medical injury, general liability or as a claim technical assistant for lost time claims. Requires knowledge of workers' compensation statutes, regulations and compliance. Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues. Exceptional customer service and focus. Ability to openly collaborate with leadership and peers to accomplish goals. Demonstrates a commitment to a career in claims. Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadlines. Use analytical skills to find mutually beneficial solutions to claim and customer issues. Ability to prepare and make exceptional presentations to internal and external customers. Conscientious about the quality and professionalism of work product and relationships with co-workers and clients. Willing to take ownership and tackle obstacles to meet Client's quality standards for service, investigation, reserving, inventory management, teamwork, and diversity appreciation. Superior verbal and written communication skills. Experience, Education & Requirements: Experience working in a customer-focused, fast-paced, fluid environment Experience utilizing strong communication and telephonic skills Prior experience requiring a high level of organization, follow-up, and accountability Prior workers' compensation claim handling experience is a plus, but not required Familiarity with claim handling (healthcare, short-term/long-term disability, auto personal injury protection / medical injury, or general liability) is a plus but not required Prior insurance, legal or corporate business experience is a plus but not required AIC, RMA, or CPCU completed coursework or designation(s) is a plus but not required Proficiency with Microsoft Office Products Knowledge of medical terminology is a plus but not required Knowledge of bill processing is a plus but not required Claim Adjuster licenses in Connecticut, New Hampshire, Rhode Island and Vermont, are necessary; however, they are not required at the time of posting for the position. - If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure
$37k-64k yearly est. 2d ago
Claims Representative
LHH 4.3
Bellevue, WA jobs
LHH Recruitment Solutions is seeking an Claims Representative for our client in Bellevue, WA 98008 Our client is a leading asset manager dedicated to helping individuals, financial professionals and institutions design better portfolios. Title: Claims Representative Location: Bellevue, WA 98008 Pay: $26.00 - $40/hr Hybrid: In-office Tuesday, Wednesday, Thursday Summary The Claims Representative manages and resolves property/casualty insurance claims efficiently and fairly. This role requires prior adjusting experience and focuses on training candidates on company-specific policies and systems-not basic claim handling. Active state adjuster license(s) are a plus. Day-to-Day Responsibilities Investigate and maintain claims: Gather reports, statements, photos, and estimates. Evaluate claims: Assess coverage, damages, and liability. Communicate with stakeholders: Policyholders, agents, legal reps; provide updates and explain processes. Negotiate settlements: Ensure fairness within policy limits. Document and report: Maintain accurate records for compliance. Collaborate with other departments: Legal, underwriting, special investigations. Ensure compliance: Adhere to state regulations and company guidelines. Deliver excellent customer service: Professional and empathetic communication. Qualifications Education: Bachelor's degree not required. Experience: 6 months to 3 years of property/casualty claims adjusting experience. Must have verifiable adjusting experience; ready for advanced training. Position- Claims Representative 📍 Location: Bellevue, WA 98008 💵 Pay: $26.00 - $40/hr Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria. Equal Opportunity Employer/Veterans/Disabled To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to ******************************************* The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: The California Fair Chance Act Los Angeles City Fair Chance Ordinance Los Angeles County Fair Chance Ordinance for Employers San Francisco Fair Chance Ordinance
$26-40 hourly 3d ago
Claims Analyst
Teksystems 4.4
Brookfield, WI jobs
We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role, you will determine whether to return, pend, deny, or pay claims in accordance with established policies and procedures. Key responsibilities of this position include the following: Adjudicate claims by following departmental policies, operating memos, and corporate guidelines. Resolve claims and related issues in compliance with policy provisions. Compare claims applications and provider statements with policy files and other records to ensure completeness and validity. Process payments for claims that are approved. Job Responsibilities: Processes Professional and Facility claims for payment in accordance with members Certificate of Coverage, established medical policies and procedures, and plan benefit interpretation while maintaining a high level of confidentiality. Reviews claims to ensure compliance with proper billing standards and completeness of information. Obtains additional information from appropriate person and/or agency as needed. Maintains department quality standards. Maintains established department turn-around processing time. Maintain and/or improves individual production rate standards and department quality standards. Identifies potential coordination of benefits (COB), Workers Compensation, and Subrogation issues and adjudicates claims accordingly. Investigates and resolves pending claims in accordance with established time frames. Identifies claims needing to be pended or suspended. Reviews pending claims timely and denies claims after established time frame is reached without resolution. Monitors computerized system for claims processing errors and make corrections and/or adjustments as needed. Keeps current on group contracts specifics, provider discounts, percentages and per diems, enrollee certificates and agreements, authorizations and other utilization management policies, etc. Reviews home office claims for payment up to $18,000.00. Reviews claims for re-pricing. Enters eligible claim data into appropriate WRAP network re-pricing website. Overrides claims allowed amounts to apply internal/external discounts. Appropriately documents attributes and memos for pertinent information related to claims payment. Processes specialty claims (transplant, URN, COB) to determine appropriate pricing according to external contract. Performs other duties and responsibilities as assigned. Skills claims processing, claims adjudication, call center, medicaid, Coding Top Skills Details claims processing Additional Skills & Qualifications Job Requirements: High school diploma or equivalent preferred. 2-4 years claims processing experience required Knowledge of current procedural terminology (CPT) and international classification of diseases (ICD-9 and ICD-10). Medical terminology, COB processing, subrogation. Past experience using QNXTTM Claims Workflow a plus Prior experience with ACA, Medicaid, or similar health plans preferred. Coding experience preferred. Experience Level Intermediate Level Job Type & Location This is a Contract to Hire position based out of Brookfield, WI. Pay and Benefits The pay range for this position is $19.25 - $19.25/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Dec 12, 2025. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
$19.3-19.3 hourly 10h ago
Claims Specialist
Us Tech Solutions 4.4
Plano, TX jobs
Duration:6 Months+ Roles & Responsibilities Maximize customer satisfaction by providing prompt actions to customer's need and obtain quality photos/data to determine root cause of claim to defend or accommodate customer's claim Provide efficient solutions to customer-facing agents by developing and operating guide and contents Use various tools/dashboard/systems to quantify the agent's performance of customer care and develop appropriate actions to improve performance and quality Spanish speaking agent recommended but not a requirement. [Customer Experience Management] Analyze end-to-end processes that customers experience and participate in providing suitable resolutions accordingly and in controlled & monitored turnaround time for each action of customer claim process [Quality Management] Monitor and review customer calls/tickets for customer care quality control, carry out activities to secure quality competitiveness of our company and customers Maintains and improves operational quality by monitoring system performance; identifying and resolving problems; preparing and completing action plans. Qualifications & Experience College Graduate 3~5 Years in customer experience Case management for MX/CE claims CE Tender management Pending Management (KPI, LTP) Case Tracker Management for special issue CPSC claim management (Customer care/tracker) (CE) Monitoring FCCM report quality (ACQ/OS Reports) Special Projects Customer Care Resolution EnR Submission/Management Work to de-escalate customer situations while finding an appropriate solution; involve upper management as needed Skills Customer Care Experience (Call Center) Claims Management Experience Insurance Claims or Adjuster background beneficial About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name: P Praveen Chary Email: **************************** Internal Id: 25-54476
$27k-40k yearly est. 3d ago
Claims & Benefits Resolution Specialist
Kavaliro 4.2
West Valley City, UT jobs
Job Title: Claims & Benefits Resolution Specialist Pay Rate: $25.00-$26.00 (Training Onsite; Remote After Training with 1 Required Onsite Day/Month) Department: Revenue Cycle Management - Central Business Office Assignment Length: 3 Months (Potential Extension) Top Things Needed: Minimum 2-3 years of experience in healthcare revenue cycle, claims processing, eligibility/benefits, or authorizations. Strong understanding of payer rules, reimbursement methodologies, and claims adjudication. Familiarity with Epic, payer portals, and other claims/RCM systems. High accuracy in auditing and error resolution work. Experience resolving complex claim issues across multiple systems. Ability to work independently, troubleshoot problems, and drive claims to completion Strong communication skills for interacting with payers, internal teams, and leadership. Comfortable with onsite onboarding and required monthly onsite days. Experience working in a Central Business Office or Shared Services model. Prior experience supporting Utah-based payer populations or multi-state payer networks. JOB DESCRIPTION: Our client is seeking a Claims & Benefits Resolution Specialist for a contract opportunity. This role performs comprehensive audits and resolution activities across the claims lifecycle, ensuring accurate billing, timely reimbursement, and compliance with payer requirements. The specialist will handle complex claim discrepancies, conduct follow-up with payers, and coordinate with clinical and non-clinical teams to finalize claim determinations. The ideal candidate has strong revenue cycle experience, particularly in claims, eligibility, benefits, and authorizations, and can quickly identify root-cause errors in a high-volume environment. This is an operational “fix-it” position - the manager needs someone who doesn't just process claims but can find what's broken and correct it without hand-holding. Key Responsibilities: Claims Audit & Correction Perform comprehensive audits on assigned accounts to identify billing, payment, and adjustment errors. Correct claim discrepancies within established turnaround times. Ensure claim data accuracy, compliant coding, and alignment with the member's plan benefit. Timely & Accurate Claims Processing Process claims quickly and accurately according to organizational benchmarks. Apply reimbursement rules based on the member's benefits and plan specifications. Validate supporting documentation needed for accurate processing (eligibility, benefits, authorizations, etc.). Complex Follow-Up & Dispute Resolution Conduct follow-up on delayed, denied, or pended claims; escalate unresolved items as needed. Investigate processing delays, missing information, or system errors and implement corrective action. Refer cases to clinical management teams when medical review is required to ensure appropriate reimbursement. Eligibility, Benefits & Authorization Coordination Verify and document member eligibility, benefits coverage, and authorization requirements. Identify discrepancies in coverage or authorizations that impact payment determinations. Communicate directly with payers or internal departments to resolve missing or inconsistent benefit information. Cross-Functional Collaboration Work closely with leadership, clinical review staff, and the CBO team to ensure timely resolution of claim issues. Participate in problem-solving discussions related to claim trends or systemic issues. Support training and onboarding efforts as needed during onsite sessions. Required Skills & Experience: Minimum 2-3 years of experience in healthcare revenue cycle, claims processing, eligibility/benefits, or authorizations. Strong understanding of payer rules, reimbursement methodologies, and claims adjudication. Familiarity with Epic, payer portals, and other claims/RCM systems. High accuracy in auditing and error resolution work. Experience resolving complex claim issues across multiple systems. Ability to work independently, troubleshoot problems, and drive claims to completion Strong communication skills for interacting with payers, internal teams, and leadership. Comfortable with onsite onboarding and required monthly onsite days. Experience working in a Central Business Office or Shared Services model. Prior experience supporting Utah-based payer populations or multi-state payer networks.
$25-26 hourly 2d ago
Casualty Claims Adjuster
The Jacobson Group 4.9
Hingham, MA jobs
Responsibilities: Conduct in-depth investigations into complex bodily injury claims, determining coverage, establishing liability, and evaluating damages by analyzing medical records, police reports, and witness statements. Develop and execute effective negotiation strategies to achieve fair and timely settlements with claimants, attorneys, and other parties. Manage litigated files, including developing defense strategies, communicating with legal counsel, and attending mediations, arbitrations, and trials as necessary. Maintain meticulous and accurate claim file documentation in compliance with company standards and regulatory requirements. Provide exceptional customer service, guiding insureds and claimants through complex claim processes with professionalism and empathy. Candidate & SkillsTop 3-5 Skills: 5 + years of direct experience handling casualty claims, with a strong focus on bodily injury (BI) claims across various lines (Auto, Homeowners, Commercial). Proven ability to investigate, analyze, and evaluate complex BI claims, including understanding medical terminology and injury causation. Solid understanding of insurance policies, relevant state laws, and the litigation process. Strong negotiation and conflict resolution skills, with a track record of successful settlements. Takes ownership of files, even when litigation is involved. Soft Skills: Exceptional communication (verbal and written), interpersonal, and customer service skills. Ability to work independently, manage a challenging caseload, and make sound judgments. Strong analytical, problem-solving, and decision-making abilities. Meticulous attention to detail and excellent organizational skills. An eagerness to learn, adapt, and embrace new technologies Ability to work effectively both independently and as part of a supportive team. Certifications/Licenses/Education: Active Adjuster License in CT, MA, RI - willing to get additional licenses as needed (company to assist) A bachelor's degree is preferred, or equivalent work experience.
$53k-66k yearly est. 1d ago
Commercial General Liability (CGL) Claims Examiner
Hobson Associates 4.0
Hartford, CT jobs
Grow Your Career with a Leading Property & Casualty Insurer Join a nationally recognized insurance provider known for its commitment to customers, communities, and employees. With a strong reputation in the market, this company delivers specialized products and fosters a collaborative, mission-driven culture. Why Join? Named a “Top Workplace” with an A+ rating Team-oriented, inclusive environment Competitive compensation and full benefits package What You'll Be Doing: As a General Liability Claims Examiner, you'll be responsible for overseeing a diverse portfolio of liability claims from start to finish. This includes everything from initial review and investigation through final resolution. You'll work closely with third-party vendors and legal teams, apply sound judgment throughout the process, and support organization's best practices while staying aligned with regulatory standards. What We're Looking For: Bachelor's degree or equivalent experience 3+ years of liability claims handling experience (5+ preferred) All-lines property/casualty adjuster license Strong analytical, negotiation, and communication skills AIC designation and experience with Habitational housing or auto claims are a plus What You'll Receive: Competitive salary Annual merit increases and profit sharing Full health benefits (medical, dental, vision, life, AD&D, disability) 401(k) with strong employer match Flexible schedule and wellness programs Tuition reimbursement and student loan repayment assistance On-site wellness center Ready to Make an Impact? We're actively scheduling interviews-Click ‘APPLY NOW'
$45k-71k yearly est. 2d ago
Automotive Claims Adjuster
Ascendo Resources 4.3
Jacksonville, FL jobs
Verify claim information to determine if the customer's concern, diagnosis, and failure justify the repair approval within the terms of the contract. Verify repair costs are performed within industry standards. Verify repair information to determine if coverage was within the limits of the service contract. Interface with customers, agents, dealers to complete all investigations of claims. Complete a fair settlement of the claim. Contribute to team effort by accomplishing related results as needed. Verify claims are processed following the policy and procedure established by Smart Autocare Periodic Job Functions Participate in any projects, reports, documentation, tasks or objectives assigned Skills & Competencies Required Parts and Labor Guide familiarity. Intermediate knowledge of Windows-based computer programs. Exceptional customer service and communication skills. Ability to read, analyze and interpret general business correspondence or technical procedures. Ability to solve practical problems and deal with a variety of concrete variables in situations where limited standardization exists Spanish fluency/Bilingual a plus Adhere closely to a posted schedule
$43k-52k yearly est. 1d ago
Claims Service Representative
Integration International Inc. 4.1
Chino, CA jobs
Job Title: Claims Analyst Duration: 12 + Months Contract Job Location: Chino, CA, 91710 (Onsite) Pay Rate: $23-25/hr on W2 Ensures that complaints are resolved effectively and without delay and that those not resolved at the entity organization level have been escalated and taken into account in the competent entities. Drive Customer Centricity - for the entity. What do you get to do in this position? - Ensure that complaints are resolved effectively and without delay and those not resolved have been escalated to the appropriate entity - Collaborate with other organizations in order to contain, correct, and prevent problems affecting customers - Utilize I2P tools to process claims on a timely basis - Ensure that Complaint process is supported with warm loop - Share critical customer feedback information with management and all employees at all levels of meetings and on information boards - Work in collaboration with continuous improvement engineer - Update Logistics dashboard Key Responsibilities: - Act as the Customer Experience advocate. - Drive Customer Centricity in entities. - Ensure the Customer Experience is measured according to the Business priorities. - Define and follow-up the improvement action plan and priorities with the Business stakeholders. - Ensure that Customer dissatisfactions are solved quickly and effectively through containment, correction and prevention steps. Qualifications: We know skills and competencies show up in many ways and can be based on your life experience. If you do not necessarily meet all the requirements that are listed, we still encourage you to apply for the position. This job might be for you if: - Excellent verbal and written communication skills, listen effectively and solicit input from others. - Excellent organizational skills including the ability to handle multiple demands and assignments, the ability to prioritize tasks effectively and efficiently, and drive issues/ tasks to closure - Candidate must be a self-starter, highly motivated, and results driven. - Strong problem-solving skills and experience with root cause analysis and implementation of corrective action for process related concerns. - Proficiency with MS Office suite of products, especially Power point and Excel. - Ability to work effectively in a group setting as well as independently.
$23-25 hourly 1d ago
OTDR Specialist
GCS 4.2
Chicago, IL jobs
We are looking for a highly skilled Field Engineer to join our team, specializing in OTDR (Optical Time Domain Reflectometer) testing and Fiber Optic Network troubleshooting. The Field Engineer will be responsible for diagnosing, troubleshooting, and repairing Fiber optic links in large-scale data centre environments. The role involves extensive travel to customer sites, including major clients such as Amazon, Comcast, Google, Microsoft, Meta, and others. Key Responsibilities: Conduct OTDR testing to diagnose defects, breaks, and bends in Fiber optic cables on large Data Centre Sites like (Amazon, Comcast, Google, Microsoft, Meta, and others) Identify Fiber count, location, and possible damage using OTDR equipment. Perform troubleshooting and repair of Fiber optic links at customer sites. Operate and configure OTDR machines, including EXFO and JDSU models. Execute Fiber splicing and testing procedures to ensure network integrity. Work with both ISP (Inside Plant) and OSP (Outside Plant) network infrastructures. Interpret and analyse OTDR trace diagrams and return time calculations for troubleshooting. Preferred Qualifications: Previous experience working with major telecom or data centre clients. Certifications related to Fiber optics or OTDR testing (e.g., CFOT, FOA, or equivalent). Knowledge of high-power laser signal testing procedures and network troubleshooting techniques. Why Join Us? Opportunity to work with leading technology companies and data centres. Hands-on experience with cutting-edge Fiber optic network testing equipment. Competitive salary and benefits package. Dynamic and challenging field-based work environment If you are a highly motivated and skilled Field Engineer with expertise in OTDR testing and Fiber optic network troubleshooting, we encourage you to apply and be part of our growing team!
$32k-37k yearly est. 1d ago
Warranty Specialist
Integration International Inc. 4.1
Chino, CA jobs
Job Title: Warranty Specialist Duration: 12 months Pay Rate: 25.50 USD per hour Shift Timing: Monday to Friday, First Shift, 06 am to 02:30 pm Ensures that complaints are resolved effectively and without delay and that those not resolved at the entity organization level have been escalated and taken into account in the competent entities. Drive Customer Centricity - for the entity. What do you get to do in this position? - Ensure that complaints are resolved effectively and without delay and those not resolved have been escalated to the appropriate entity - Collaborate with other organizations in order to contain, correct, and prevent problems affecting customers. - Utilize I2P tools to process claims on a timely basis - Ensure that Complaint process is supported with warm loop - Share critical customer feedback information with management and all employees at all levels of meetings and on information boards - Work in collaboration with continuous improvement engineer - Update Logistics dashboard - Assist with customer satisfaction and quality related projects as needed Key Responsibilities: - Act as the Customer Experience advocate. - Drive Customer Centricity in entities. - Ensure the Customer Experience is measured according to the Business priorities. - Define and follow-up the improvement action plan and priorities with the Business stakeholders. - Ensure that Customer dissatisfactions are solved quickly and effectively through containment, correction and prevention steps.
$62k-114k yearly est. 1d ago
IP Specialist
Adams & Martin Group 4.3
Denver, CO jobs
IP Specialist - Patent Prosecution-Top national law firm! Hybrid option! Detail-oriented IP professional with expertise in U.S. and international patent prosecution, including preparation and filing of patent applications, docket management, correspondence with USPTO and foreign associates, and maintaining accurate records throughout the patent lifecycle. Skilled in reviewing Office Actions, preparing formal documents, managing deadlines, and ensuring compliance with statutory rules. Known for strong organizational skills, process accuracy, and ability to support attorneys and inventors in fast-paced legal environments. Prepare, file, and monitor U.S. and PCT patent applications and related formal documents. Manage prosecution deadlines through accurate docketing and workflow tracking. Coordinate with inventors, attorneys, examiners, and foreign associates. Review and process USPTO Office Actions, IDS submissions, and formalities. Maintain patent databases and ensure adherence to U.S. and international filing requirements. Support the drafting of client communications and prosecution strategies. Handle e-filing using USPTO (PAIR, Patent Center) and international portals. Manage annuities, assignments, and recordation processes as needed. All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county, to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.
$37k-60k yearly est. 2d ago
UAS Specialist I
SBS Creatix 3.6
Saint Charles, MO jobs
General Info: US Citizens or GC Holders only Must be on our W2- no C2C Local Candidates Only Primary Location: St. Charles, MO (Local candidates only; daily travel to multiple sites, mileage reimbursed) About the Role: We are seeking a skilled Unmanned Aerial System (UAS) Specialist I to join our innovative UAS operations and robotics team. This role focuses on conducting drone-based inspections of utility infrastructure, processing the resulting data, and ensuring accurate dissemination to relevant teams. The position is hands-on, fast-paced, and requires both technical expertise and operational decision-making in the field. What You'll Do: Conduct UAV-based inspections of distribution networks using small UAS drones and other survey equipment. Capture, process, analyze, and disseminate inspection data while ensuring data security. Operate independently in the field after a 3-month hands-on mentorship period. Participate in storm damage assessments and emergency operations, including extended hours during high-demand periods. Maintain UAVs and other inspection tools, ensuring operational readiness. Travel locally to multiple sites daily; reimbursed for gas. Must-Have Qualifications: Part 107 Commercial Drone License Bachelor's degree in UAS, GIS, Robotics, Engineering, Surveying, or related technical field Hands-on UAV operation experience beyond hobbyist or real estate photography Safe driving record and strong spatial awareness Ability to work independently and make operational decisions in the field Comfortable with early starts, long days, and occasional overtime Strong organizational skills and high attention to detail Preferred Qualifications: Experience processing drone data (imagery, LIDAR, orthophotography, videography) 1+ year professional drone flight experience (recent UAS graduates considered) Cross-training in multiple UAS mission types Previous utility or infrastructure inspection experience Soft Skills: Safety-conscious mindset Self-starter, able to work independently Strong interpersonal and team collaboration skills Adaptable and flexible in daily operations High attention to detail and operational focus Physical Requirements: Ability to lift up to 55 lbs Ability to work outdoors in various weather conditions Travel and driving throughout local areas Training & Growth: 3 months of hands-on mentorship before field operations Long-term growth opportunities, with many team members converting from contractor to full-time
$35k-58k yearly est. 4d ago
DevOps Specialist
Firstpro, Inc. 4.5
Newton, MA jobs
first PRO is now accepting resumes for a Azure Devops Admin in Newton, MA. This is a 3-6month contract to hire role and onsite 3 days per week. This person will be a technical resource administering ADO and project management tools. Responds to support tickets, trains new users, configuration of ADO, metrics, dashboards, etc. Needs Agile experience Also needs someone with strong business analysis skills because they will be customer facing new initiatives (she mentioned possibly implementing Microsoft AI tools) and be working with other managers, VPs, etc. Really wants someone with ADO, is open someone light on ADO if they also have Jira or Atlassian but really strongly prefers ADO. 2-3 years of experience in this type of role, 3 days onsite in Newton.
$33k-39k yearly est. 2d ago
Growth Specialist
Search Solution Group 4.0
Charlotte, NC jobs
Search Solution Group, Charlotte, NC If you love fast-paced environments, staying organized, and making things happen behind the scenes… welcome. You just found your people. We're looking for a Sales & LinkedIn Outreach Coordinator to support our business development team and help us amplify our presence in the market. This is part sales support, part digital outreach wizard, part behind-the-scenes powerhouse. You'll be the person who keeps the team moving, connects the dots, and helps us show up boldly and professionally everywhere our clients are - especially on LinkedIn. If you like the idea of being the heartbeat of a high-performing sales team, keep reading. 🎯 What You'll Be Doing 🔹 Sales Support & Daily Momentum Keep our sales team focused on what they do best - winning new business. Build clean, polished client documents and outreach messages. Organize calendars, follow-ups, and anything that keeps deals moving forward. Update the CRM/ATS so nothing slips through the cracks. 🔹 LinkedIn & Email Outreach Mastery Run LinkedIn outreach campaigns like a pro (connection requests, InMails, follow-up sequences). Send targeted emails that spark conversations with HR leaders, executives, and hiring managers. Track engagement and help us refine what's working (and what's not). Be the first friendly voice prospects hear before they get to our sales team. 🔹 Marketing & Brand Support Help us show up strong on LinkedIn - posting content, job ads, updates, and client wins. Bring new creative ideas to the table. Keep our tone, brand, and messaging sharp and consistent. 🔹 Research & Organization Build lists of potential customers, companies, and target prospects. Gather intel that helps our sales team walk into calls smarter. Assist with reports, process improvements, and keeping everything organized. 🌟 Who You Are You love people, you love organization, and you love getting things done. You're naturally upbeat and positive - the kind of person people want to work with. You write clean, friendly, professional communication. You're quick with technology and not scared of learning new platforms. You thrive in fast-paced environments and know how to juggle multiple priorities. You enjoy the recruiting and sales world - or you're excited to dive into it. 🏆 What Success Looks Like More meetings. More conversations. More sales momentum. A sales team that says, “I don't know how we ever lived without you.” A LinkedIn presence that stands out and gets noticed. A role where you grow, learn, and become a critical part of our company's success.
$31k-51k yearly est. 3d ago
Onboarding Specialist
Us Tech Solutions 4.4
Lehi, UT jobs
As a member of the Talent and Culture organization at Client, you'll join a team that values collaboration, innovation, and growth. We're building a world-class Employee Solutions function that not only supports the business but also creates meaningful impact for candidates and employees. As an Onboarding Coordinator, you will play a critical role in ensuring a seamless and compliant new-hire experience. You will manage the full onboarding lifecycle for a steady volume of candidate - often across multiple roles, start dates and regions, oversee background checks and drug screens, troubleshoot system issues, and ensure data accuracy across all onboarding processes. You'll partner closely with Talent Acquisition, HR, and business leaders to create a consistent, high-quality onboarding journey and ensure every new hire starts strong. What You'll Do: Guide candidates through the onboarding journey, providing support, answering questions, and helping troubleshoot system issues in SuccessFactors. Monitor background check and drug screen results, follow up with candidates, and manage the adverse action process when required. Review and validate onboarding data to ensure accuracy, compliance, and alignment with hiring requirements. Partner with recruiters, coordinators, HR, and business partners to resolve onboarding issues and keep hiring timelines on track. Ensure all new hires are hired into the system accurately and on time to meet scheduling and start-date requirements. Support ongoing updates to onboarding processes, tools, and documentation; help drive adoption and consistent use of new workflows. Maintain clear communication with candidates and hiring managers to ensure a positive onboarding experience. Assist with special projects and process improvements to strengthen onboarding efficiency, compliance, and data integrity. What We're Looking For Minimum Requirements: High school diploma or GED equivalent. Bachelor's degree preferred. 1-2 years of experience in Talent Acquisition, HR, or related operations support. Experience with Microsoft Office (Excel, Outlook, Teams). Strong attention to detail and ability to manage multiple priorities. Preferred Qualifications: Experience with SAP SuccessFactors or a similar HRIS/ATS. Background in supporting recruiting programs (Onboarding, high-volume recruiting, seasonal hiring). Experience reviewing, auditing, or validating data for accuracy and compliance Strong collaboration and communication skills, with the ability to work across teams and functions. Skills to Help You Thrive in this Role: Analytical and problem-solving skills with a continuous improvement mindset. Strong written and verbal communication skills with high attention to detail. Ability to prioritize tasks and manage competing demands in a fast-paced environment. Ability to work independently and collaboratively, demonstrating strong teamwork and interpersonal skills. Ability to build effective relationships with employees at all levels of the organization, from front-line staff to senior leadership. Working Conditions: Hybrid role based in Lehi, UT, with in-office days Monday - Thursday; Remote on Friday.. Minimal travel required for business or project needs. Flexibility to adjust schedule occasionally to support key initiatives or special projects. Work is primarily sedentary, involving computer-based tasks. Rare lifting requirements beyond routine office activities. About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name: Sharath Sai Email: ****************************** Internal ID: 25-54780
$24k-34k yearly est. 2d ago
Java Specialist
Motion Recruitment 4.5
Charlotte, NC jobs
Hi Folks, We have a need for a long-term consulting assignment (W2- Hybrid) with our direct banking client. Need Local to Charlotte, NC, Des Moines, IA, Jersey City, NJ, Dallas, TX and willing to work 3days/week in office. Full Stack Java Developer Required Skills: 8-10+ years of Java development experience 8+ years of Java SpringBoot microservices experience 5+ years of Angular experience and last 2 years in Angular 13 or above 5+ SQL database experience MongoDB or related NoSQL database experience Kafka or related Data Streaming technology experience Please reach out to me *********************************** OR ************
$32k-48k yearly est. 1d ago