Claim processor jobs in Anchorage, AK - 17 jobs

The Stocking Associate performs various merchandise stocking duties both in Receiving & on the Sales Floor. ESSENTIAL FUNCTIONS: Supports a strong commitment to world class customer service and ensures a pleasant and productive shopping experience for all customers. Organizes and manages back stock daily. Replenishes product on shelves and in back stock as required per Merchandising guidelines. Unloads trucks as needed. Remains Product “expert” through ongoing product knowledge training. Remains knowledgeable of advertised sales and plan-o-grams. Assists with pricing maintenance and signing. Keeps work area clean, neat and well stocked with supplies. Follows all Company Policies and Procedures. ALL OTHER DUTIES AS ASSIGNED. EXPERIENCE/QUALIFICATIONS: Minimum Degree Required: High school diploma or equivalent experience. KNOWLEDGE, SKILLS, AND ABILITY: Ability to calculate figures such as discounts and make change to customers Ability to communicate in a friendly and professional manner to our customers and other associates Ability to establish and maintain effective working relationships with Management, co-workers and customers Ability to operate computerized Point of Sale register system Ability to read label descriptions and stock merchandise by UPC codes TRAVEL REQUIREMENTS: N/A PHYSICAL REQUIREMENTS: Constantly move, lift and carry objects up to 50 pounds Constantly stand and/or walk for prolonged periods Constantly repeat motions that may include the wrists, hands and/or fingers Occasionally ascend or descend ladders, stairs, ramps, etc. Occasionally operate machinery and/or power tools Occasionally communicate with others to exchange information Occasionally move objects up to 100 pounds or more Occasionally work in tight and confined spaces Occasionally work in low or high temperatures Occasionally work in outdoor elements such as precipitation and wind Occasionally work in noisy environments Occasionally work in hazardous conditions Occasionally work in small and/or enclosed spaces INDEPENDENT JUDGEMENT : Performs tasks and duties under general supervision, using established procedures and innovation. Chooses from limited alternatives to resolve problems. Occasional independent judgment is required to complete work assignments. Often makes recommendations to work procedures, policies, and practices. Part Time Benefits Summary: Enjoy discounts on retail merchandise, our restaurants, world-class resorts and conservation attractions! Dental Vision Voluntary benefits 401k Retirement Savings Paid holidays Paid vacation Bass Pro Cares Fund And more! Bass Pro Shops is an equal opportunity employer. Hiring decisions are administered without regard to race, color, creed, religion, sex, pregnancy, sexual orientation, gender identity, age, national origin, ancestry, citizenship status, disability, veteran status, genetic information, or any other basis protected by applicable federal, state or local law. Reasonable Accommodations Qualified individuals with known disabilities may be entitled to reasonable accommodation under the Americans with Disabilities Act and certain state or local laws. If you need a reasonable accommodation for any part of the application process, please visit your nearest location or contact us at ************************. Bass Pro Shops

Company:Description: CERTIFICATE SPECIALIST DEPARTMENT: BUSINESS INSURANCE STATUS: NON-EXEMPT As a Certificate Specialist on the Leadbetter team, the primary focus is to issue certificates of insurance for the Business Insurance department in accordance with the objectives and procedures outlined by the director of client services and the business insurance trainer. ESSENTIAL DUTIES AND RESPONSIBILITIES: " Administer all aspects of certificates: o Process and issue certificates of insurance daily which accurately reflect coverages and policy terms based upon written requests o Review client policies to determine proper limits, coverages, and deductibles o Copy and distribute/mail documents when requested o Maintain client files in document management system o Maintain client portal records as it pertains to certificates o Assist in the processing of final audits " Produce word and excel documents and spreadsheets to maintain records " Provide excellent customer service " All other duties as assigned EDUCATION AND/OR EXPERIENCE: A successful candidate will be a service oriented individual with high personal standards and a hands-on work style. This position requires an individual who is comfortable working at a varying pace, managing multiple tasks and deadlines simultaneously, adjusting priorities often, and managing frequent interruptions. " A high school diploma and 1 year experience in a professional office setting performing duties which required a high level of attention to detail. " Obtain and maintain a valid Alaska Business Insurance License. " Proficient in Microsoft Office software (Word, Excel, and Outlook) with the ability to operate standard office equipment is required. " Skill in organizing resources and establishing priorities. " Ability to work in a supporting role with a variety of associates. " Demonstrate the ability to resolve problems and present results neatly, with clarity and precision in oral and written form. VALUABLE BENEFITS: We value and respect the impact our colleagues make every day both inside and outside our organization. We've built a culture that promotes colleague well-being through robust benefit programs and resources, encourages professional and personal development, and celebrates opportunities to pursue the projects and causes that give colleagues fulfilment outside of work. Some benefits included in this role are: " Generous time off, including personal and volunteering " Tuition reimbursement and professional development opportunities " Charitable contribution match programs " Stock purchase opportunities To learn more about a career at MMA, check us out online: *************************** or flip through our recruiting brochure: ********************** Follow us on social media to meet our colleagues and see what makes us tick: " ************************************ " ********************************** " ***************************** " ******************************************************* Who you are is who we are. We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. We are always seeking those with ethics, talent, and ambition who are interested in joining our client-focused teams. Marsh McLennan and its affiliates are EOE Minority/Female/Disability/Vet/Sexual Orientation/Gender Identity employers.

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. **You will:** + Receive and process requests for patient health information in accordance with Company and Facility policies and procedures. + Maintain confidentiality and security with all privileged information. + Maintain working knowledge of Company and facility software. + Adhere to the Company's and Customer facilities Code of Conduct and policies. + Inform manager of work, site difficulties, and/or fluctuating volumes. + Assist with additional work duties or responsibilities as evident or required. + Consistent application of medical privacy regulations to guard against unauthorized disclosure. + Responsible for managing patient health records. + Responsible for safeguarding patient records and ensuring compliance with HIPAA standards. + Prepares new patient charts, gathering documents and information from paper sources and/or electronic health record. + Ensures medical records are assembled in standard order and are accurate and complete. + Creates digital images of paperwork to be stored in the electronic medical record. + Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately. + Answering of inbound/outbound calls. + May assist with patient walk-ins. + May assist with administrative duties such as handling faxes, opening mail, and data entry. + Must meet productivity expectations as outlined at specific site. + May schedules pick-ups. + Other duties as assigned. **What you will bring to the table:** + High School Diploma or GED. + Ability to commute between locations as needed. + Able to work overtime during peak seasons when required. + Basic computer proficiency. + Comfortable utilizing phones, fax machine, printers, and other general office equipment on a regular basis. + Professional verbal and written communication skills in the English language. + Detail and quality oriented as it relates to accurate and compliant information for medical records. + Strong data entry skills. + Must be able to work with minimum supervision responding to changing priorities and role needs. + Ability to organize and manage multiple tasks. + Able to respond to requests in a fast-paced environment. **Bonus points if:** + Experience in a healthcare environment. + Previous production/metric-based work experience. + In-person customer service experience. + Ability to build relationships with on-site clients and customers. + Comfortable bringing new ideas, process improvement suggestions, and feedback to internal stakeholders. We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks and industry best practices. We're building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job. The estimated _salary range_ for this role is $15.00 - $18.32. _Comp target_ is between $16.00 - $17.00 for this role _At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your responses will be_ _anonymous and_ _used to help us identify areas of improvement in our recruitment process._ _(_ _We can only see aggregate responses, not individual responses. In fact, we aren't even able to see if you've responded or not_ _.)_ _Responding is your choice and it will not be used in any way in our hiring process_ _._ Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $15-$18.32 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (************************************************** . Know Your Rights (*********************************************************************** , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (************************************************************** Id=**********48790029&layout Id=**********48795462) by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (******************************************************************************************************* . Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy (**************************************** .

Department Guest Services Employment Type Seasonal - Full Time Location Anchorage Transportation and Guest Services Workplace type Onsite Responsibilities Requirements Benefits About Holland America/Princess Alaska-Yukon Land Operations We're a collaboration of Princess Cruises and Holland America Line, innovators in Alaska tourism and advocates for the environment. We offer guests adventure, comfort, and a variety of lifetime memories-whether sailing past glaciers, cozying up in a wilderness lodge, or spotting a bear from a dome-window rail car. Our teams participate in HAP's sustainability program, aka “Sustain Alaska & the Yukon”, and efforts by actively recycling (where available), reducing waste, and educating guests about our commitment to the environment. We are dedicated to delivering excellent customer service to all guests, coworkers, and vendors and provide a safe workplace for all team members and a safe vacation experience for all guests. HAP is committed to a diverse, equitable, and inclusive work environment. The best way to learn more about all of our roles and opportunities is to connect with us on Facebook and Instagram.

Company:Description: CERTIFICATE SPECIALIST DEPARTMENT: BUSINESS INSURANCE STATUS: NON-EXEMPT As a Certificate Specialist on the Leadbetter team, the primary focus is to issue certificates of insurance for the Business Insurance department in accordance with the objectives and procedures outlined by the director of client services and the business insurance trainer. ESSENTIAL DUTIES AND RESPONSIBILITIES: " Administer all aspects of certificates: o Process and issue certificates of insurance daily which accurately reflect coverages and policy terms based upon written requests o Review client policies to determine proper limits, coverages, and deductibles o Copy and distribute/mail documents when requested o Maintain client files in document management system o Maintain client portal records as it pertains to certificates o Assist in the processing of final audits " Produce word and excel documents and spreadsheets to maintain records " Provide excellent customer service " All other duties as assigned EDUCATION AND/OR EXPERIENCE: A successful candidate will be a service oriented individual with high personal standards and a hands-on work style. This position requires an individual who is comfortable working at a varying pace, managing multiple tasks and deadlines simultaneously, adjusting priorities often, and managing frequent interruptions. " A high school diploma and 1 year experience in a professional office setting performing duties which required a high level of attention to detail. " Obtain and maintain a valid Alaska Business Insurance License. " Proficient in Microsoft Office software (Word, Excel, and Outlook) with the ability to operate standard office equipment is required. " Skill in organizing resources and establishing priorities. " Ability to work in a supporting role with a variety of associates. " Demonstrate the ability to resolve problems and present results neatly, with clarity and precision in oral and written form. VALUABLE BENEFITS: We value and respect the impact our colleagues make every day both inside and outside our organization. We've built a culture that promotes colleague well-being through robust benefit programs and resources, encourages professional and personal development, and celebrates opportunities to pursue the projects and causes that give colleagues fulfilment outside of work. Some benefits included in this role are: " Generous time off, including personal and volunteering " Tuition reimbursement and professional development opportunities " Charitable contribution match programs " Stock purchase opportunities To learn more about a career at MMA, check us out online: *************************** or flip through our recruiting brochure: ********************** Follow us on social media to meet our colleagues and see what makes us tick: " ************************************ " ********************************** " ***************************** " ******************************************************* Who you are is who we are. We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. We are always seeking those with ethics, talent, and ambition who are interested in joining our client-focused teams. Marsh McLennan and its affiliates are EOE Minority/Female/Disability/Vet/Sexual Orientation/Gender Identity employers.

This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for building positive client relationships, providing education, and analyzing client claim losses as well as current issues regarding client activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. **ESSENTIAL RESPONSIBILITIES** + Processes daily incoming Stop Loss claims including initial entry claims or subsequent claims as needed; provides counseling to clients and assists with client service programs. + Evaluates various claims submitted by Third Party Administrators (TPAs) and Pharmacy Benefit Managers (PBMs) on behalf of self-funded clients for compliance with the following: underlying policy provisions, federal and state regulatory guidelines, and industry standards. + Monitors, reviews and analyzes various complex potential claims with emphasis on controlling losses through effective managed care. This includes following a departmental claim checklist to ensure eligibility is met, the payment reimbursement request is accurate by auditing the claim for duplicate line-item charges and determining if all information is available to finalize the payment request. Refers the claim to the cost containment and RxOps departments for review of high dollar charges if applicable. + Determines whether to pend or adjudicate claims following organizational policies and procedures; finalizes and adjudicates claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim information to TPAs, brokers, or customers utilizing the appropriate application and/or template. + Identifies potential discrepancies in claim submissions and involves the Special Investigation Unit as necessary. Identifies issues which can be used to educate/train internal staff, streamline, and improve processes and update documentation. + Assists leadership with performing client performance evaluations to assess the accuracy of client reports submitted to the organization, efficiency of claim operations, and adequacy of systems and procedures. + Approves claim payments on behalf of multiple clients and provides client counseling and support services. Assists in the client service programs including revising and establishing procedures, protocols and ensuring client satisfaction with the organization. + Maintains accurate claim records. + Other duties as assigned or requested. **EDUCATION** **Required** + High School Diploma/GED **Substitutions** + None **Preferred** + Bachelor's degree **EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience processing 1st dollar health insurance claims + 3 years of experience with medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information effectively. + Organizational skills + Ability to manage time effectively. + Ability to work independently. + Problem Solving and analytical skills. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $22.71 **Pay Range Maximum:** $35.18 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273755

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for claim or reconsideration. **Required Qualifications** - New York Independent Adjuster License - Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience - DG system knowledge **Education** **-** High School Diploma required - Preferred Associates degree or equivalent work experience. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $18.50 - $42.35 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/27/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

DEPARTMENT: BUSINESS INSURANCE STATUS: NON-EXEMPT As a Certificate Specialist on the Leadbetter team, the primary focus is to issue certificates of insurance for the Business Insurance department in accordance with the objectives and procedures outlined by the director of client services and the business insurance trainer. ESSENTIAL DUTIES AND RESPONSIBILITIES: " Administer all aspects of certificates: o Process and issue certificates of insurance daily which accurately reflect coverages and policy terms based upon written requests o Review client policies to determine proper limits, coverages, and deductibles o Copy and distribute/mail documents when requested o Maintain client files in document management system o Maintain client portal records as it pertains to certificates o Assist in the processing of final audits " Produce word and excel documents and spreadsheets to maintain records " Provide excellent customer service " All other duties as assigned EDUCATION AND/OR EXPERIENCE: A successful candidate will be a service oriented individual with high personal standards and a hands-on work style. This position requires an individual who is comfortable working at a varying pace, managing multiple tasks and deadlines simultaneously, adjusting priorities often, and managing frequent interruptions. " A high school diploma and 1 year experience in a professional office setting performing duties which required a high level of attention to detail. " Obtain and maintain a valid Alaska Business Insurance License. " Proficient in Microsoft Office software (Word, Excel, and Outlook) with the ability to operate standard office equipment is required. " Skill in organizing resources and establishing priorities. " Ability to work in a supporting role with a variety of associates. " Demonstrate the ability to resolve problems and present results neatly, with clarity and precision in oral and written form. VALUABLE BENEFITS: We value and respect the impact our colleagues make every day both inside and outside our organization. We've built a culture that promotes colleague well-being through robust benefit programs and resources, encourages professional and personal development, and celebrates opportunities to pursue the projects and causes that give colleagues fulfilment outside of work. Some benefits included in this role are: " Generous time off, including personal and volunteering " Tuition reimbursement and professional development opportunities " Charitable contribution match programs " Stock purchase opportunities To learn more about a career at MMA, check us out online: *************************** or flip through our recruiting brochure: ********************** Follow us on social media to meet our colleagues and see what makes us tick: " ************************************ " ********************************** " ***************************** " ******************************************************* Who you are is who we are. We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. We are always seeking those with ethics, talent, and ambition who are interested in joining our client-focused teams. Marsh McLennan and its affiliates are EOE Minority/Female/Disability/Vet/Sexual Orientation/Gender Identity employers.

This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements. **ESSENTIAL RESPONSIBILITIES** + Coordinate, analyze, and interpret the benefits and claims processes for the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties. + Investigate benefit/claim information and provide technical guidance to clinical and claims staff regarding the final adjudication of complex claims. Research and investigate conflicting benefit structures in multi-payor situations. + Provide prompt, thorough and courteous replies to written, electronic and telephonic inquiries from internal/external customers (e.g., clinical, sales/marketing, providers, vendors, etc.) Follow-up on all inquiries in accordance with corporate and regulatory standards and timeframes. + Must have the ability to apply knowledge about the business operations of the area within the defined scope of the job. Assess benefit limitations in accordance with Medical Policy Guidelines. + Monitor and identify claim processing inaccuracies. Bring trends to the attention of management. + Assist with handling inbound calls and strive to resolve customer concerns received via telephone or written communication. + Work independently of support, frequently utilizing resources to resolve customer inquiries. + Collaborate with Clinical Strategy, Sales/Client Management and other areas across the enterprise to respond to client questions and concerns about care/case management and high-cost claimants. + Gather information and develop presentation/training materials for support and education. + Other duties as assigned or requested. **EDUCATION** **Required** + High School or GED **Substitutions** + None **Preferred** + Associate's degree in or equivalent training in Business or a related field **EXPERIENCE** **Required** + 3 years of customer service, health insurance benefits and claims experience. + Working knowledge of Highmark products, systems (e.g., customer service and clinical platforms, knowledge resources, etc.), operations and medical policies + PC Proficiency including Microsoft Office Products + Ability to communicate effectively in both verbal and written form with all levels of employees **Preferred** + Working knowledge of medical procedures and terminology. + Complex claim workflow analysis and adjudication. + ICD9, CPT, HPCPS coding knowledge/experience. + Knowledge of Medicare and Medicaid policies **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services + Knowledge of administrative and clerical procedures and systems such as managing files and records, designing forms and other office procedures + The ability to take direction, to navigate through multiple systems simultaneously + The ability to interact well with peers, supervisors and customers + Understanding the implications of new information for both current and future problem-solving and decision-making + Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate and not interrupting at inappropriate times + Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems + Ability to solve complex issues on multiple levels. + Ability to solve problems independently and creatively. + Ability to handle many tasks simultaneously and respond to customers and their issues promptly. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $21.53 **Pay Range Maximum:** $32.30 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273827

Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level of knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Candidates should be based in California with California Self-Insured Certification or based in West Region with experience in handling Alaska Workers Compensation claims. The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region. Responsibilities Investigates claims to determine whether coverage is provided, establish compensability and verify exposure. Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure. Establishes and maintains accurate reserves on all assigned files. Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority. Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds. Demonstrates the ability to understand new and unique exposures and coverages. Demonstrates the ability to understand key data elements and claims related data analysis. Confers directly with policyholders on coverage and resolution strategy issues. Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff. Qualifications A bachelor's degree or equivalent business experience is required In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skills required About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at HMS, a Gainwell Company carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. Summary HMS is hiring Claims Specialists to support our Alaska account. These positions processes moderately complex claims for our Alaska Medicaid client. They will make decisions on payment of medical claims using the existing policy and rules to ensure accurate and timely completion. Your role in our mission * Ability to work both independently and as part of a team. * Strong communication skills with the ability to communicate clearly and effectively in writing and verbally. * Ability to access and retrieve information using a PC. * Intermediate understanding of Microsoft Office products. * Organizational skills to balance and prioritize work, and analytical and problem-solving skills. What we're looking for * Review and research suspended medical claims and adjudicate them per DHS policy. * Refer claims to Utilization Review and Provider Services units. * Maintain necessary documentation. * Participate in meetings as necessary. * Participate in process improvement sessions. * Train as a back-up for other areas, such as document control, courier, and customer service desk. * Other duties as assigned What you should expect in this role * Hybrid role with ability to work in the Anchorage, AK office preferred, with the possibility of working remotely from another state for the right candidate. The person will need to work Alaska Time hours. #LI-LS2 #LI-HYBRID The pay range for this position is $37,500.00 - $53,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at HMS, a Gainwell Company. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with HMS, a Gainwell Company, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about HMS, A Gainwell Technologies Company at our company website and visit our Careers site for all available job role openings. HMS, a Gainwell Company, is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

Global Channel Management is a technology company that specializes in various types of recruiting and staff augmentation. Our account managers and recruiters have over a decade of experience in various verticals. GCM understands the challenges companies face when it comes to the skills and experience needed to fill the void of the day to day function. Organizations need to reduce training and labor costs but at same requiring the best "talent " for the job. Job Description May perform one or more of the following duties: Performs data entry of material from source documents to a computer database. Qualifications Hours: Monday - Friday 8 am - 5 pm with occasional overtime. Prior experience with healthcare claims or medical billing and coding is strongly preferred.May perform one or more of the following duties: Performs data entry of material from source documents to a computer database.Ensures accuracy and completeness data. Requirements: Must have a high school diploma or GED. Need skills in Microsoft Word, Outlook, Excel and basic math skills. Additional Information $14/hr 3 MONTHS

Service Excellence. Performance. Integrity. Teamwork. Consistency. Innovation. We're seeking a reliable and customer-focused team member to manage delayed and damaged luggage claims in Anchorage, AK. This role involves processing claims, providing timely follow-up, coordinating with ship staff, vendors, and internal teams, and preparing luggage for shipment. Strong collaboration across divisions is essential to ensure efficient luggage operations and deliver a positive guest experience. RESPONSIBILITIES * Responsible for processing delayed and damaged luggage/property claims filed in Anchorage, AK. * Provide customer service to follow up on all claims filed and search for lost claims. * Present claim procedures to guests as needed. * Communicate regularly with other divisions regarding delayed and/or missing luggage/personal property. * Creates, maintains and prepares reports for local office as well as for both Holland America Line and Princess Cruises Corporate Departments. * Prepares luggage for shipment. * Responsible for communicating with ship staff and 3rd party vendors regarding the shipping of luggage. * Assist in general luggage operations at various locations within Anchorage. * Assist guests and employees with general questions and inquiries. REQUIREMENTS * Proficiency in the use of computer business applications and internet. * Two years of experience in property claims or customer service positions is preferred. * Current, valid driver's license, with clean driving record. Motor Vehicle Report (MVR) will be requested. * Must meet Company's clean driver eligibility requirements. * Must pass a pre-employment background check. * Minimum age of 18 years required to reside in company housing, where available. * Must be eligible to work in the United States. Holland America-Princess is unable to sponsor or take over sponsorship of employment visas at this time (e.g., H-2B status). Knowledge, Skills, & Abilities: * Ability to organize and prioritize work, maintain attention to time constraints, while working in a team or group environment. * Ability to work in a fast-paced environment with multiple tasks and external influences. * Ability to work independently with minimal supervision while achieving daily goals. * Ability to support and comply with company policies, procedures and guidelines including support and comply with company health and safety standards. * Ability to stand/walk/work on feet for minimum of 8 hours per day. Benefits * Travel - FREE CRUISE AFTER YOUR FIRST SEASON! * Reward for Referral Program * Experience - Of a lifetime! * Rewards & Incentives * Community Service * Employee Activities * Professional Growth HAP Alaska Yukon is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin, disability or protected veteran status.

Department Guest Services Employment Type Seasonal - Full Time Location Anchorage Transportation and Guest Services Workplace type Onsite RESPONSIBILITIES REQUIREMENTS Benefits About Holland America/Princess Alaska-Yukon Land Operations We're a collaboration of Princess Cruises and Holland America Line, innovators in Alaska tourism and advocates for the environment. We offer guests adventure, comfort, and a variety of lifetime memories-whether sailing past glaciers, cozying up in a wilderness lodge, or spotting a bear from a dome-window rail car. Our teams participate in HAP's sustainability program, aka “Sustain Alaska & the Yukon”, and efforts by actively recycling (where available), reducing waste, and educating guests about our commitment to the environment. We are dedicated to delivering excellent customer service to all guests, coworkers, and vendors and provide a safe workplace for all team members and a safe vacation experience for all guests. HAP is committed to a diverse, equitable, and inclusive work environment. The best way to learn more about all of our roles and opportunities is to connect with us on Facebook and Instagram.

Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level of knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Candidates should be based in California with California Self-Insured Certification or based in West Region with experience in handling Alaska Workers Compensation claims. The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region. Responsibilities * Investigates claims to determine whether coverage is provided, establish compensability and verify exposure. * Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. * Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. * Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. * Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. * Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure. * Establishes and maintains accurate reserves on all assigned files. * Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority. * Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds. * Demonstrates the ability to understand new and unique exposures and coverages. * Demonstrates the ability to understand key data elements and claims related data analysis. * Confers directly with policyholders on coverage and resolution strategy issues. * Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff. Qualifications * A bachelor's degree or equivalent business experience is required * In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims * Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skills required About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

Global Channel Management is a technology company that specializes in various types of recruiting and staff augmentation. Our account managers and recruiters have over a decade of experience in various verticals. GCM understands the challenges companies face when it comes to the skills and experience needed to fill the void of the day to day function. Organizations need to reduce training and labor costs but at same requiring the best "talent " for the job. Job Description May perform one or more of the following duties: Performs data entry of material from source documents to a computer database. Qualifications Hours: Monday - Friday 8 am - 5 pm with occasional overtime. Prior experience with healthcare claims or medical billing and coding is strongly preferred.May perform one or more of the following duties: Performs data entry of material from source documents to a computer database.Ensures accuracy and completeness data. Requirements: Must have a high school diploma or GED. Need skills in Microsoft Word, Outlook, Excel and basic math skills. Additional Information $14/hr 3 MONTHS