Claim Processor Jobs in Monroe, LA

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today! This job performs various laboratory functions to support the department in patient care. Conducts phlebotomy procedures; processes and receives specimens; accessions specimens; distributes specimens; and performs and results specific test procedures.Shift Hours 9am -530pm Education Required - High School diploma or equivalent Preferred - Completion of phlebotomy course Work Experience Required - None Certifications Preferred - Current license or trainee license in the state of practice Knowledge Skills and Abilities (KSAs) Must have computer skills and dexterity required for data entry and retrieval of patient information. Must be proficient with Windows-style applications and keyboard. Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. Knowledge of venipuncture procedures Strong interpersonal skills Job Duties Performs clinical assignments. Supports departmental goals and objectives. Processes specimens. Resolves problems. Exhibits versatility and cooperation. Adapts behavior to the specific patient population, including but not limited to: respect for privacy, method of introduction to the patient, adapting explanation of service or procedures to be performed, requesting permissions and communication style. Other related duties as required. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Physical and Environmental Demands The physical essential functions of this job include (but are not limited to) the following: Frequently exerting 10 to 20 pounds of force to move objects; occasionally exerting up to 100 pounds of force. Physical demand requirements are in excess of those for sedentary work. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Mechanical lifting devices (carts, dollies, etc.) or team lifts should be utilized. Must be able to sit for prolonged periods of time. Must be able to travel throughout and between facilities. Must be able to work a flexible work schedule. Duties performed routinely require exposure to blood, body fluid and tissue. There may be an occupational risk for exposure to communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role. Are you ready to make a difference? Apply Today! Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Maryland, New York, Washington,and Washington D.C. Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at ************ (select option 1) or *******************. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. We are proud to be an Equal Employment Opportunity and Affirmative Action employer. We are committed to the principles of equal employment opportunity and providing a workplace that is free from discrimination based on race, color, creed, religion, pregnancy status, pregnancy-related conditions, national origin, ancestry, mental or physical disability, medical condition, age, veteran status, military status, citizenship status, marital status, familial status, sexual orientation, gender, gender identity or expression, genetic information, political affiliation, unemployment status, or any other characteristic protected under applicable federal, state or local law. These protections extend to applicants and all employment related decisions. View the EEO is the Law poster and its supplement, as well as the pay transparency policy for more information. Affirmative Action Policy Statement

As the world's largest car sharing marketplace, Turo is growing fast and hiring talent in the US, Canada, the UK, France, and Australia! Our driven, down-to-earth team empowers you to push yourself, make a huge impact, and accelerate your career growth. About the team Turo is looking for an enthusiastic and pragmatic Claims Processor to join us as we expand our operations team in Phoenix! You will bridge the gap between Turo Support and Claims while supporting Claims Associates. This position requires someone comfortable with change, driven, and wants to learn every day. You will be reporting to our Claims Processor Supervisor. What you'll do * Provide exceptional customer service and support for Turo hosts, guests, external vendors, and internal teams via Slack, email, voice, and/or chat. * Support collections efforts, review eligibility for accounts and vehicles relative to claims, review for liability, and own our resolving indirectly space. * Assist Turo members in the incident process. * Assist with non-complex claim resolutions. * Contribute to internal process documents and help streamline workflows. Your profile * Can multitask while ensuring all proper and accurate notations on an account are completed within a timely manner. * You are the go-to person to answer questions at your current job and are looking for a challenge and a change of pace. * Attention to detail is crucial, we work in a marketplace supporting hosts and guests across multiple geographies. * You can work in an ever-evolving environment while maintaining quality standards, meeting KPIs, and requiring minimal supervision. * You bring a positive attitude, high energy, strong work ethic, and commitment to the Turo values * You can work in a hybrid environment. This is not a fully remote position, and it will require on-site attendance (Hybrid Model) Bonus if you have * Previous startup experience * Strong proficiency with technology such as Slack and other CRM systems * Someone who thrives in a space that is not always black and white. The Phoenix base pay for this full-time position is $20.00 per hour + equity + benefits. Our base pay is determined by role, level, and location. Your recruiter can share more about the specific compensation offered for this role during the hiring process. Please note that the base pay listed in this posting reflects the base pay only, and does not include bonus (if applicable), equity, or benefits. Benefits * Competitive salary, equity, benefits, and perks for all full-time employees * Employer-paid medical, dental, and vision insurance (Country specific) * Retirement employer match * Learning & Development stipend to invest in your professional development * Turo host matching program * Turo travel credit * Cell phone and internet stipend * Paid time off to relax and recharge * Paid holidays, volunteer time off, and parental leave * For those who are in the office full-time or hybrid we have in-office lunch, office snacks, and fun activities We are committed to building a diverse team. If you are from a background that's underrepresented in tech, we'd love to meet you. Aside from an award winning work environment and the opportunity to be part of the world's largest car sharing marketplace, we are also growing the team quickly - join us! Even if you don't meet every qualification, we are looking for people with enthusiasm for what we do and we will consider you for this and other possibilities. About Turo Turo is the world's largest car sharing marketplace where you can book the perfect car for wherever you're going from a vibrant community of trusted hosts across the US, UK, Canada, Australia, and France. Whether you're flying in from afar or looking for a car down the street, searching for a rugged truck or something smooth and swanky, Turo puts you in the driver's seat of an extraordinary selection of cars shared by local hosts. Discover Turo at ***************** the App Store, and Google Play, and check out our blog, Field Notes. Read more about the Turo culture according to Turo CEO, Andre Haddad. Turo is an Equal Opportunity Employer and a participant in the U.S. Federal E-Verify program. Women, minorities, individuals with disabilities and protected veterans are encouraged to apply. We welcome people of different backgrounds, experiences, abilities and perspectives. Turo will consider qualified applicants with criminal histories in a manner consistent with the San Francisco Fair Chance Ordinance, as applicable. We welcome candidates with physical, mental, and/or neurological disabilities. If you require assistance applying for an open position, or need accommodation during the recruiting process due to a disability, please submit a request to People Operations by emailing ******************.

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. **Job Posting Title** Claims Processor II **Job Description** + Adjudicates claims and adjustments as required. + Resolves claims edits and suspended claims. + Maintains and updates required reference materials to adjudicate claims. + Provides backup support to other team/group members in the performance of job duties as assigned. Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (******************************************* and click on the "Benefits at a glance" button for more detail. _Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law._ _We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._ _Prime Therapeutics LLC is a Tobacco-Free Workplace employer._ Positions will be posted for a minimum of five consecutive workdays. Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives. Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at ************** or email *****************************.

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work Most Loved Workplace Forbes Best-in-State Employer Claims Examiner, Bodily Injury **PRIMARY PURPOSE** : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly. + Responsible for litigation process on litigated claims. + Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims. + Reports large claims to excess carrier(s). + Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution. + Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage. + Communicates claim action/processing with insured, client, and agent or broker when appropriate. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position. **Experience** Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws. **Skills & Knowledge** + In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills + Ability to work in a team environment + Ability to meet or exceed Service Expectations **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical:** Computer keyboarding, travel as required **Auditory/Visual:** Hearing, vision and talking _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is_ **_$65,000- $77,000_** _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ **_Always accepting applications._** The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Taking care of people is at the heart of everything we do. Caring counts** Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (************************************** BGSfA)

Job Description | Job Attributes Apply Now External Applicant Current Associate

We are looking to add an experienced claims processor to our team! This position offers room for growth with great benefits! Apply today! Duties Include: Provide timely processing of medical claims. This includes approving, pending and denying claims according to the accepted coverage guidelines. Request and review correspondence such as medical records in order to make a claim payment determination. Correspond with medical providers, plan members, and clients. Maintain working relationship with nurse case managers. Maintain patient confidentiality in accordance with HIPAA and company policies. Coordinate benefits with other medical insurance plans, Medicaid and Medicare. Benefits Offered: • Health insurance • Dental and Vision insurance • Disability insurance • Supplemental benefits • Simple IRA • In-house workout area

Peach Tree Dental - Monroe, LA Monroe, LA 71270 Job details Salary: Starting from $16.00-$20.00/hourly Pay is based on experience and qualifications. **incentives after training vary and are based on performance Job Type: Full-time Full Job Description With our hearts, minds, and hands, we build better smiles, better relationships, and better lives. Living this purpose over the last 25 years has allowed us to create a world-class dental organization that continues to grow. At every turn, you will see our continued investment in leadership, the community, and advanced technologies. Do you want to be a part of developing one of the leading models of dental care in Louisiana? Do you thrive in a fast-paced, progressive environment? The role of the Insurance Claims Specialist could be for you! Please go to WWW.PEACHTREEDENTAL.COM to complete your online application and assessments or use the following URL: ********************************************** Qualifications High school or equivalent (Required) Takes initiative. Has excellent verbal and written skills. Ability to manage all public dealings in a professional manner. Ability to recognize problems and problem solve. Ability to accept feedback and willingness to improve. Ability to set goals, create plans, and convert plans into action. Is a Brand ambassador, both in and outside of the facility. Benefits offered for Full-time Insurance Claims Specialists: Medical, Dental, Vision Benefits Dependent Care & Healthcare Flexible Spending Account Simple IRA With Employer Match Basic Life, AD&D & Supplemental Life Insurance Short-term & Long-term Disability Perks & Rewards for Full-time Insurance Claims Specialists: Competitive pay + bonus Paid Time Off & Sick time 6 paid Holidays a year

) Salary: $65,000-$75,000 annually Schedule: Monday-Friday, 8:00 AM-4:30 PM Disclaimer: T he posted salary range for this position reflects the anticipated base pay for this role. Actual pay is determined based on factors such as qualifications, skills, relevant experience, internal equity, and location. Additional compensation may include discretionary bonuses, benefits, or other forms of compensation, depending on the role. The salary range provided is in compliance with state and local requirements and is intended to offer transparency to applicants. We encourage open discussions with our hiring team regarding any questions you may have about compensation and benefits for this position. CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefits package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP, and 401K. CCMSI conducts background checks in accordance with applicable federal, state, and local laws. At CCMSI, we are driven by our commitment to delivering exceptional service to our clients. As a leading Employee-Owned Third Party Administrator in self-insurance services, we invest in our people with structured career development programs, robust benefits, and a collaborative culture. We are proud to be certified as a Great Place to Work, with employee satisfaction and retention in the 95th percentile. Why Join CCMSI? Culture: Experience a workplace that values integrity, passion, and enthusiasm. Career Growth: Advance your career with internal training and promotion opportunities. Benefits: Enjoy 4 weeks of PTO in your first year, 10 paid holidays, Medical, Dental, Vision, Life Insurance, 401K, ESOP, and more. Work-Life Balance: Be part of a supportive environment with manageable caseloads and a focus on team success. About the Role As a Multi-Line Claim Specialist, you will manage complex litigated claims from start to finish across multiple accounts. Performance will be measured by your ability to meet deadlines, resolve claims efficiently, and maintain exceptional service standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications Experience: 10+ years of multi-line claims experience, with expertise in complex litigated claims. License: Louisiana Adjuster's License is required. Skills: Excellent communication, negotiation, and analytical abilities. Proficiency in Microsoft Office. Education: AIC, ARM, or CPCU designations are a plus. What Success Looks Like: Completing claims efficiently from start to finish. Maintaining a high level of accuracy and organization. Delivering outstanding service to multiple accounts. Consistently achieving performance goals and deadlines. Physical Requirements: Ability to sit or stand for extended periods. Core Values & Principles: Employees are expected to uphold CCMSI's Core Values and Principles, which include performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example. At CCMSI, we believe in creating an environment of integrity, enthusiasm, and opportunity. Apply today and join a team that is committed to excellence and continuous improvement! #CCMSI #InsuranceCareers #RemoteJobs #ClaimsSpecialist #LitigatedClaims #AdjusterJobs #CareerGrowth #WorkLifeBalance #HiringNow #JoinOurTeam #CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #MLClaims #LiabilityClaims #IND123 We can recommend jobs specifically for you! Click here to get started.

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage primarily motor truck cargo claims with moderate to high complexity and exposure. There may also be opportunity to handle ocean marine claims. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: * Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. * Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. * Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols. * Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. * Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. * Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. * Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. * Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. * Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. * Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. * May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities * Solid working knowledge of motor truck cargo claims handling, liability analysis, policy coverage and claim practices. * Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. * Demonstrated ability to develop collaborative business relationships with internal and external work partners. * Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. * Demonstrated investigative experience with an analytical mindset and critical thinking skills. * Strong work ethic, with demonstrated time management and organizational skills. * Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. * Developing ability to negotiate low to moderately complex settlements. * Adaptable to a changing environment. * Knowledge of Microsoft Office Suite and ability to learn business-related software. * Demonstrated ability to value diverse opinions and ideas Education & Experience: * Bachelor's Degree or equivalent experience. * Typically a minimum four years of relevant experience, preferably in claim handling. * Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. * Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. * Professional designations are a plus (e.g. CPCU) #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Maryland, New York and Washington, the national base pay range for this job level is $49,000 to $98,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

The position is located in the CIS Business Office and reports directly to the Insurance Claims Team Leader and Director of Business Services for all matters, including job duties, performance evaluations, approval of leave, and other assignments as deemed necessary by CIS management. NATURE OF DUTIES: Works in the billing office as an Insurance Claims Specialist. SPECIFIC DUTIES: 1. Work Insurance collections accounts as received, correcting and refilling claims as needed, or posting the necessary adjustments daily. 2. Work mail including refund requests, extensions, and requests for additional information daily. 3. Keep current on Insurance, Managed Care, and other changes including CPT and ICD coding, global, and CCI guidelines by reading provider newsletters, talking to provider representatives, etc. 4. Answer patient questions concerning insurance or billing issues. 5. Work follow-ups on a regular basis. 6. Prepare and work outstanding reports. 7. Prepare and work credit balance report. 8. Maintain log of audits, including pre-payment audits. 9. Performs other related duties as assigned and serves in whatever other capacity deemed necessary for successful completion of the mission and goals of CIS and in concordance with its patient philosophy. STANDARDS OF PERFORMANCE: 1. Maintain acceptable A/R levels for Private Insurance (Under 75 days in A/R). 2. Maintain proper documentation (as outlined in the denial tracking handout) and keep follow-ups current. 3. Keeps work area neat and organized. 4. Helping fellow employees when all duties are complete 5. Communicate any problems or difficulties concerning job duties as they arise to supervisor. 6. Meets all deadlines and timeframes for completion of assignments. 7. Performs all duties without significant error occurring with any regularity. 8. Represents CIS in a professional manner at all times. 9. Exhibits at all times good communication skills with physicians, patients, supervisors, and co-workers. 10. Exhibits whenever possible a harmonious relationship with other CIS employees in order to accomplish the duties and responsibilities of the position. While perfect harmonious relationships with all employees is sometimes not achievable, not more than an occasional complaint should be received by the supervisor about the incumbent of this position. 11. Adheres to the CIS Compliance Plan as it pertains to the above specific job duties. Uses best efforts to maintain compliance by following the CIS Corporate Compliance Plan, attending CIS compliance education, following medical documentation guidelines, and communicating concerns regarding compliance issues. QUALIFICATIONS FOR THE POSITION: 1. High School graduate preferred 2. Demonstrated ability to organize 3. Possess time management skills 4. Ability to understand and use a computer system 5. Experience with telephone collections preferred, but not required.

The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims, in a timely and accurate manner. Schedule: Provides superior customer service consistent with company standards and goals, including inbound calls from providers and health plans. Responsible for quality and continuous improvement within the job scope. Also responsible for all actions/responsibilities described in company-controlled documentation for this position. Contributes to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely follow-up on inquiries received and correctly logs all incoming calls and emails. Maintains the minimum accuracy standard and follows up timely to meet compliance standards for claims, pends, and tasks. Reviews claim images and batches to ensure accuracy. Uses proper plan documentation to determine benefits and correctly adjudicate. Meets and maintains the minimum production in addition to completing reports and projects given by the supervisor. Effectively participates in meetings, training, and committees as designated by the supervisor. Reviews feedback from supervisors, trainers, auditors, examiners, and trending spreadsheets. Identifies and implements required steps for improvement. Minimum Qualifications One year of claims processing, claims logging, or customer service experience in a managed care environment. - and - Demonstrated minimum of 100 SPM on ten key and 30 WPM typing. Preferred Qualifications Associates degree or some college level coursework. Degree obtained from accredited institution. Education is verified. - and - Demonstrated excellent verbal, written, and interpersonal skills. - and - Demonstrated consistent accuracy and processing efficiency in work. - and - Demonstrated ability to resolve complex claims problems and be detailed oriented. **Physical Requirements:** Manual dexterity, hearing, seeing, speaking. **Location:** Central Office - Las Vegas **Work City:** Las Vegas **Work State:** Nevada **Scheduled Weekly Hours:** 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $18.38 - $26.65 We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (***************************************************************************************** , and for our Colorado, Montana, and Kansas based caregivers (********************************* ; and our commitment to diversity, equity, and inclusion (********************************************************************************* . Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice.

About Us: Struction Solutions is an innovative Independent Adjusting, Building Consultant, and Disaster Recovery Firm, known for our commitment to delivering innovative and tailored solutions to our clientele. Our team of professionals work tirelessly to ensure accuracy, efficiency, and customer satisfaction. As we continue to grow and expand, we're seeking talented individuals who share our dedication to excellence and are eager to make a meaningful impact in our industry. Position Details: Resolves insurance claims involving marine casualties. Their role includes investigating, evaluating, and negotiating claims to determine the extent of the insurance company's liability. This role requires a thorough understanding of maritime laws, insurance policies, and handling procedures. Investigation: They conduct thorough investigations of marine incidents, such as collisions, groundings, sinkings, fires, or cargo damage. This includes gathering evidence, interviewing witnesses, and inspecting vessels and cargo. Assessment: They assess the extent of the damage and determine the cause of the incident. This may involve working with marine surveyors, engineers, and other experts to evaluate the condition of the vessel and cargo. Documentation: They collect and review relevant documents, such as ship logs, maintenance records, cargo manifests, and insurance policies, to support the claim. Evaluation: They evaluate the claim to determine whether it is covered under the insurance policy and to what extent. This involves interpreting policy terms and conditions, as well as applicable laws and regulations. Negotiation: They negotiate settlements with claimants, which can include shipowners, charterers, cargo owners, and other affected parties. The goal is to reach a fair and equitable resolution while minimizing the financial impact on the insurance company. Reporting: They prepare detailed reports and recommendations for the insurance company, documenting their findings, the extent of the damage, and the proposed settlement. Liaison: They act as a liaison between the insurance company and other parties involved in the claim, such as legal representatives, regulatory authorities, and other stakeholders. Compliance: They ensure that all claims are handled in compliance with relevant laws, regulations, and industry standards. Risk Management: They may also be involved in risk management activities, helping to identify and mitigate potential risks to reduce the likelihood of future claims. Qualifications: Proven experience in insurance claims adjustment, preferably in marine insurance. Strong knowledge of maritime laws and regulations. Excellent analytical, negotiation, and communication skills. Ability to manage multiple claims efficiently under tight deadlines. Proficiency in claim management software and Microsoft Office Suite. Location: New Orleans, LA area Marine casualty claim adjustment specialists need a strong understanding of maritime law, insurance principles, and the technical aspects of marine operations. They also require excellent analytical, communication, and negotiation skills. Join us at Struction Solutions, and let's redefine the future of the Independent Adjusting industry together! View all jobs at this company

Purpose/Job Function: The claims associate will support the filing, tracking, and management of claims for all modes supporting a MTS customer. This role will include working closely with the customer at both corporate offices as well as in the field. There will also be frequent communications with carriers to collect documentation as well as status updates. The data collection and analysis produced in this role will be critical in driving continuous improvements to the customer's service performance. Essential Functions: File and manage LTL and Parcel freight claims including freight, shortages, overages, and damages. Deliver reliable service throughout the entire life cycle of each claim, including but not limited to: prompt contact and timely communication throughout the process until the claim is closed, explaining the process, setting expectations, follow-ups and meeting commitments to achieve optimal outcome on every file. Assist with client and vendor damage claims. Develop and grow effective relationships with clients, vendors, and internal business partners. Update and maintain records Recognize and request appropriate inspection type based on the details of the loss and coordinate the appraisal process. Maintain oversight of the repair process and ensure appropriate expense handling, manage approvals per guidelines. Manage and report weekly review of LTL carrier complaints. Provide reports to support visibility to claims trends and opportunities to reduce issues. Run reports and data analysis as needed. Qualifications/Requirements: Excellent verbal and written communication in order to respond effectively to sensitive inquiries and complaints Strong data entry and record keeping skills (may include maintaining records in database/s) Ability to apply principles of logical thinking to a wide range of practical problems Strong organizational skills with accurate attention to detail Aptitude to spot trends in shipment data and detail Proficient in use of Microsoft Office Suite (use of Excel, Word, Outlook) Education/Experience: Highschool diploma or GED Prior data entry experience preferred #IND

Job Category: Accounting Job Type: Full-Time Facility Type: Corporate Shift Type (Clinical Positions): Day Shift At AMG we offer our employees much more than just a job in the healthcare industry. We offer unique career opportunities for people who are called to make a healing difference in the lives of others and desire to be part of a team that contributes to making a difference each day for our patients. We invite you to join our team and share your gifts and talents. In addition to market competitive pay rates and benefits in the Lafayette market, you will have the opportunity to work for an Employee Stock Ownership Plan (ESOP), as AMG is an employee-owned company! AMG, Integrated Healthcare Management (AMG Corporate) is seeking a Billing Claims Appeal Specialist in Lafayette, Louisiana. The Billing Claims Appeal Specialist provides support for the Billing Specialists and the corporate office team in relation to managing incorrect contracted payments with managed care payors to seek resolution and file necessary appeals. The Claims Appeal Specialist will be responsible for assisting the billing specialist with obtaining necessary documentation, writing appeals and following up on appeals as requested by the billing team. The candidate must possess strong communication skills, excellent customer services skills, and be able to work collaboratively with a team. This position requires a strong Claim Appeals background with experience in the Post-Acute setting and interpretation of payor contracts for appropriate appeal rights. This is not a remote position. Join our dynamic team and enjoy a career where you can make a difference with AMG Integrated Healthcare Management! Apply Now Job Requirements * Position located in Lafayette, Louisiana. * Strong knowledge of MS Word and Excel. * Requires a strong Claim Appeals background with experience in the Post-Acute setting. * Requires interpretation of payor contracts for appropriate appeal rights. * A strong background in Long Term Acute Care (LTAC). * Must be able to diplomatically articulate communications, interpret and explain complex information, and comprehend written, verbal and electronic communication. * Strong problem-solving skills with effective time management. * Strong organizational skills to maintain awareness of appeal timelines. * Self-starter with strong analytical skills and attention to detail. * Strong Knowledge of Managed Care Payors. About Us AMG is a hospital system committed to our patients, our people, and to the pursuit of healing. As a Top-5 Post-Acute hospital system, we're known for excellence, integrity, community, and compassion. Our mission is to return patients to their optimal level of well-being in the least restrictive medical environment. We accomplish this through a multi-disciplined approach that includes aggressive clinical and therapeutic interventions, as well as family involvement. Our high staff to patient ratio ensures individualized attention. Our nurses, therapists, and physicians work with each patient to obtain the best possible outcomes. Acadiana Management Group, LLC is an equal opportunity employer.

Claims Representative/Claims Adjuster - Worker's Comp(Hybrid) page is loaded **Claims Representative/Claims Adjuster - Worker's Comp(Hybrid)** **Claims Representative/Claims Adjuster - Worker's Comp(Hybrid)** remote type Hybrid locations Baton Rouge, LA (USA) time type Full time posted on Posted 10 Days Ago job requisition id R6606 Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers' comp, we strive to provide an atmosphere of constant growth and development for our employees. Summit provides workers' compensation programs and services to thousands of employers throughout the Southeast. Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it's underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. **Essential Job Functions and Responsibilities** * Investigates and maintains claims: + Reviews and evaluates coverage and/or liability. + Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, records or other documents) in the investigation of claims. * Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions or trials as necessary. * May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority. * Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. * Ensures that claims payments are issued in a timely and accurate manner. * Ensures that claims handling is conducted in compliance with applicable statues, regulations and other legal requirements, and that all applicable company procedures and policies are followed. * Performs other duties as assigned. **Job Requirements** **Education: Bachelor's Degree or equivalent experience.** **Field of Study: Liberal Arts, Business or a related discipline.** **Experience: Generally, 6 months to 3 years of related experience.** Workers Compensation license required Texas experience preferred but not required This job is non-exempt in California, Colorado, New York, Washington **Company:** SCI Summit Consulting, LLC**Benefits:** Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process. Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers' comp, we strive to provide an atmosphere of constant growth and development for our employees. With more than 40 years of experience, Summit provides workers' compensation programs and services to thousands of employers throughout the Southeast. Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it's underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise.

Req #54 Louisiana Workers' Compensation Corporation, Baton Rouge, Louisiana, United States of America **Job Description** Posted Sunday, October 20, 2024 at 11:00 PM LWCC is a Champion of Louisiana business and proud to be headquartered in the state capital, Baton Rouge. As a model single-state, private mutual workers' comp company, we promote safety, security, and stability in Louisiana. LWCC is dedicated to excellence in execution, from underwriting to life-long care of injured workers. We are proud to partner with our agents, and together deliver outstanding service to policyholders and their workers. Our commitment is to be there for Louisiana. Always. We are Louisiana Loyal, more than a tagline, this is a mantra and a movement that inspires us to be a catalyst elevating Louisiana's position in America. We hope to inspire other Louisiana businesses and citizens to join us in helping Louisiana thrive by bettering our state one business and one worker at a time. In 2023, the company was named as a Best Place to Work by the Greater Baton Rouge Business Report for the fourth time. LWCC has been recognized by industry leading benchmarker AON and named to the Ward's 50 group of top-performing insurance companies for achieving outstanding results in the areas of safety, consistency, and performance over a five-year period, 2015-2019. Our company offers an excellent benefits package including health, dental, vision, life and disability insurance; a 401(k) savings plan; educational assistance; and an on-site fitness center. LWCC is an equal opportunity employer and does not discriminate on the basis of race, creed, color, national origin, religion, sex, age, handicap, Vietnam era or disabled veteran status. For more information on the corporation and its services, please visit . To learn more about Louisiana Loyal, please visit . **Overview** Integral part of helping Louisiana thrive through efficient and consistent handling of injured workers claims. Investigating assigned claims through completion. Provides unparalleled customer experience for all our stakeholders. **Major Areas of Accountability** * **General** + Participates in a formal training program to develop the knowledge and skills to handle insurance claims involving work-related accidents. Is responsible for the well-being of hundreds of Louisiana employees who are injured. + Examine claims forms and other records to determine insurance coverage. + Interview or correspond with our policyholders, claimants, witnesses, physicians, or other relevant parties to complete investigation. + Investigate facts of loss to determine extent of injury. + Review and understand police reports, medical treatment records, medical bills, and other insurance documents during the duration of the claim. + Adjust reserves or provide reserve recommendations to establish the value of the claim consistent with corporate policies. + Negotiate claim settlement opportunities. + Confer with legal counsel on claims involving litigation. + Takes initiative and manages personal claim caseload in accordance with processes and procedures with a focus on individual, team and departmental goals. + Seeks opportunities for improvement and continued learning + Maintains required LA Workers' Compensation Adjuster License. + Performs other job duties as needed by the department **Personality/Working Style** * **Strong character** + Alignment with company values, mission, and vision + Trustworthy and honest + Decisive + Curious and persistent * **Passion for innovation** + Willingness to learn + Adaptive to changing (tolerance for ambiguity) + Desire to collaborate to achieve corporate goals * **Strong communicator** + Effective communication skills + Empathetic listener and open-minded + Commitment to accountability **Education and Experience** * Bachelor's degree and some work experience, preferably in the insurance industry OR * H.S. Diploma/GED with 4 years of experience as an insurance claims adjuster Scan this QR code and apply! Louisiana Workers' Compensation Corporation, Baton Rouge, Louisiana, United States of America For more information, refer to .

**Insurance Claims Specialist** Administrative - Jonesboro, Louisiana Insurance Claims Specialist Peach Tree Dental - Jonesboro Jonesboro, LA 71251 Job details Salary: Starting from $16.00-$20.00/hourly Pay is based on experience and qualifications. **incentives after training vary and are based on performance Job Type: Full-time Full Job Description Please go to to complete your online application and assessments or use the following URL: Qualifications * High school or equivalent (Required) * Takes initiative. * Has excellent verbal and written skills. * Ability to manage all public dealings in a professional manner. * Ability to recognize problems and problem solve. * Ability to accept feedback and willingness to improve. * Ability to set goals, create plans, and convert plans into action. * Is a Brand ambassador, both in and outside of the facility. Benefits offered for Full-time Insurance Claims Specialists: * Medical, Dental, Vision Benefits * Dependent Care & Healthcare Flexible Spending Account * Simple IRA With Employer Match * Basic Life, AD&D & Supplemental Life Insurance * Short-term & Long-term Disability Perks & Rewards for Full-time Insurance Claims Specialists: * Competitive pay + bonus * Paid Time Off & Sick time * 6 paid Holidays a year Location Jonesboro, Louisiana Minimum Experience Mid-level Compensation $16.00 - $20.00

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers' comp, we strive to provide an atmosphere of constant growth and development for our employees. Summit provides workers' compensation programs and services to thousands of employers throughout the Southeast. Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it's underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. Essential Job Functions and Responsibilities Investigates and maintains claims: Reviews and evaluates coverage and/or liability. Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, records or other documents) in the investigation of claims. Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions or trials as necessary. May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority. Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handling is conducted in compliance with applicable statues, regulations and other legal requirements, and that all applicable company procedures and policies are followed. Performs other duties as assigned. Job RequirementsEducation: Bachelor's Degree or equivalent experience.Field of Study: Liberal Arts, Business or a related discipline.Experience: Generally, 6 months to 3 years of related experience. Workers Compensation license required Texas experience preferred but not required This job is non-exempt in California, Colorado, New York, Washington Company: SCI Summit Consulting, LLC Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.

+ **** + **** **Claims Examiner-Other General Services Savoy-PRN in Mamou, LA** ** Job Description | Apply Now** The Claims Examiner is responsible for processing UB and CMS 1500 claims, performing data entry and claim pend issue resolution within the quality and production requirements. **Requirements:** * High School Diploma **Work Schedule:** TBD **Work Type:** Per Diem As Needed **EEO is the law - click below for more information:** 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 us at **************. to apply **Job Attributes** **Job ID** 233900 **Job Title** Claims Examiner-Other General Services Savoy-PRN **Job Type** PRN **Job Category** General Operations **Location** CHRISTUS St. Frances Cabrini Health System 801 Poinciana Avenue Mamou, LA 70554 **Share this job on** **Claims Examiner-Other General Services Savoy-PRN** **This jobs functionality is being updated, please use the page and filter by location.**