Health claims examiner jobs near me

Create Music Group is currently looking for self-described viral internet culture enthusiasts to join our Viral Department. Viral Content Claiming Specialist perform administrative tasks such as YouTube copyright claiming and asset onboarding, as well as scope out trending memes and social media videos on a daily basis. This position requires a regular workload of data entry/administration in order to carry out the most basic functions of our department but there are plenty of opportunities for more creative and ambitious pursuits if you are so inclined. This is a full time position which may be done remotely, however our office is located in Hollywood, California, and we are currently only looking for job candidates who are located in California. In the future, you may be encouraged to come into our office for meetings or company functions, so it is best if you are located in the Los Angeles/Southern California area. Through our Viral team, we collaborate with some of the most prominent viral talent from the TikTok and meme world including Supa Hot Fire (Deshawn Raw), Welven Da Great (Deez Nuts), Verbalase, KWEY B, Hoodnews, presidentofugly1, 10k Caash, dimetrees, Zackass, Supreme Patty, The Man with the Hardest Name in Africa, ViralSnare, Adin Ross, and more. YouTube monetization provides an alternative consulting and revenue-generating resource for our clients to grow their audience and earnings. We have helped our clients monetize and collected millions in previously unclaimed revenue for content creators, artists and labels. REQUIREMENTS: 1-3 years work experience Excellent communication skills, both written and verbal Internet culture and social media platforms, especially YouTube Conducting basic level research Organizing large amounts of data efficiently Proficiency with Mac OSX, Microsoft Office, and Google Apps PLUSES: Strong understanding of the online video market (YouTube, Instagram, TikTok) Bilingual - any language, although Spanish, Mandarin, and Russian is preferred RESPONSIBILITIES: We work directly with our clients and their team to help them break down the data and find potential opportunities to build their career. Daily responsibilities include but are not limited to the following. Watching YouTube videos for several hours daily Content claiming Uploading and defining intellectual assets Administrative metadata tasks Researching potential clients Staying on top of accounts for current client roster As this is a remote position, you are required to have your own computer and reliable internet connection. This position may require you to download a great deal of video files (files which may be deleted once onboarding tasks are completed) so please make sure that you have a computer that is up to the task. Laptops are preferable if you would like to come into our office to work (snacks, soft drinks, and Starbucks coffee are provided at our physical office). BENEFITS: Paid company holidays, paid time off, and health benefits (medical, dental, vision, and supplementary policies) are included. TO APPLY: Send us your resume and cover letter (in one file). After you apply, you will be redirected to take our Culture Index survey here. Otherwise, copy and paste the link to your web browser: ********************************************************* Info.php?cfilter=1&COMPANY_CODE=cYEX5Omste Applications without a cover letter and Culture Index survey will not be considered. OPTIONAL: Link relevant social media campaigns and/or writing samples from your portfolio.

DETAILS Complex Claims Specialist - Property & Casualty Department: Property and Casualty Claims Reports To: Claims Supervisor FLSA Status: Exempt Job Grade: 14 Career Ladder: Next step in progression could include Claims Supervisor ATHENS ADMINISTRATORS Since our founding in 1976, Athens Administrators has been a recognized leader in third-party claims administration services. However, more important than what we do is how we do it. Athens employees provide service that translates into real and lasting benefits-every single day! With offices throughout the United States, Athens Administrators offers Workers' Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a third-generation family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. We are so proud that our employees have consistently voted Athens as a Best Place to Work! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Complex Claims Specialist to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA, and WV). This position does allow for work from home if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week. The Complex Claim Specialist is responsible for the review, investigation, analysis, and processing of complex claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure and often entail litigation and complex coverage. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Advanced knowledge in the following areas: 1) Complex Auto or General Liability claims handling concepts, practices and techniques, to include but not limited to complex coverage issues, and product line knowledge, 2) advanced, functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills. Analyze, investigate, and evaluate losses to determine appropriate layers of coverage, settlement value and disposition strategy, including claim merits or denial of liability Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to clients and senior level management Manage the litigation process through the retention of selected counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment Document and manage claims (i.e.: statements, diaries, write reports) from inception to closure Ensure appropriateness of all coverage memorandums and payments Coordinate and work with dedicated vendor services such as law professionals, industry experts, county officials and client executives to manage professional claims and communications Facilitate interactions between insured entities, claimants, client contacts, and attorneys in resolution of severe and complex claims Lead and conduct comprehensive claim reviews and case analysis discussions with various committees or district level authorities Provide superior customer service to all layers of authorities within the county Meet with clients, attend hearings, and assist senior management with planning, forecasting and new business opportunities that may arise in the servicing of the account. May assist management in hiring other account dedicated examiners Provide guidance and serve as a technical expert to less experienced examiners May conduct meetings or training sessions to help develop less experienced examiners Attend all required meetings and educational seminars for professional development Conduct on-sight or frequent claim reviews in Ventura County with the client representatives, as required. Maintain required licenses ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Possesses a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL preferred Additional State Adjuster License(s), may be required within 180 days Maintain licenses and continuing education requirements in all states Relies on extensive experience and judgement to plan and accomplish goals with a minimum of 8-10 years complex/major claims experience, including proficiency in investigation and resolution of severe to major casualty and general liability claims Experience with relevant insurance laws, codes, and procedures Experience with property and casualty insurance policies, insurance tort laws, codes, and procedures Understanding Auto and General Liability exposure and unique coverage endorsements Understanding of medical, legal terminology and liability concepts Proficiency in investigation and resolution of severe to major level casualty claims Time Management and project management skills Strong negotiation and litigation management skills Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at *************************************************

Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry. Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2024 Great Place to Work Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion. C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: ************** Job Description Crum & Forster is looking for an Executive Claim Specialist who enjoys being a key part of a dynamic team. As an Executive Specialist, you will manage an assigned pending of liability claims arising primarily from the Construction sector. You will also be expected to operate under appropriate levels of supervision and within established authority. The position will report to assigned Manager, Director or Vice President, as determined by business needs. This position can be located in Morristown, NJ; Jersey City, NJ; or remote. What you will do for C&F: Receives claims assignments. Verifies and determines applicability of coverage. Ability to not only interpret complex coverage issues, but possess the ability to write appropriate reservation of rights and declination of coverage letters. Reviews and manages outstanding files, as assigned, for adequacy and timeliness of investigation, evaluation and reserve, and maintains a timely diary for each case. Evaluates and adjusts claims within the adjuster's authority level. Sound understanding of additional insured status, contractual indemnification, and primacy of coverage among defendants. Ability to assess risk transfer potential and responsible for the development of information required to successfully address tender issues. Reports directly on technical matters to supervisor or management. Evaluates and manages litigated claims. Determines future course of handling and proper method of disposition. Consults with the claim manager on those claims in which assistance and consultation is needed, as well as on those claims which exceed assigned authority. Assesses recovery potential and is responsible for the development of information required to successfully pursue recovery. Meets with current and prospective customers to discuss C&F claims capabilities and address specific claim needs. Accountable for the equitable and prompt adjustment and management of assigned claims to disposition in accordance with company Best Practices. Responsible for providing superior customer service to all agents, insureds, and others encountered during the claims handling process. Possesses and demonstrates good interpersonal skills, both verbal and written, on a consistent basis. What you will bring to C&F: College degree is required or equivalent work experience. Insurance industry designation and/or insurance related courses are a plus. 5+ years of experience handling Construction and General Liability claims. Experience handling New York Labor Law claims is preferred. Experience with Employer Liability claims a plus. Obtain and maintain required state licenses. Excellent verbal and written communication skills are essential and the ability to communicate with all levels within the organization. Computer skills with a working knowledge of the Microsoft Office suite of programs a must. Travel occasionally required. Will abide by departmental policies and procedures, including authority levels, to comply with C&F's risk management controls. What C&F will bring to you Competitive compensation package Generous 401K employer match Employee Stock Purchase plan with employer matching Generous Paid Time Off Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path A dynamic, ambitious, fun and exciting work environment We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community At C&F you will BELONG If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information. Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $82,900.00 to a maximum of $121,600.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs. #LI-AV1 #LI-Remote

We are united in our mission to make a positive impact on healthcare. Join Us! South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2024 2024 Black Book Awards, ranked #1 EHR in 11 Specialties 2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold) 2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara) Who we are: We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany. ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine! Your Role: Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates Input and update patient account information and document calls into the Practice Management system Special Projects: Other duties as required to support and enhance our customer/patient-facing activities Skills & Requirements: High School Diploma or GED required Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST Minimum of 1-2 years of previous healthcare administration or related experience required Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs) Manage/ field 60+ inbound calls per day Bilingual a plus (Spanish & English) Proficient knowledge of business software applications such as Excel, Word, and PowerPoint Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone Ability and openness to learn new things Ability to work effectively within a team in order to create a positive environment Ability to remain calm in a demanding call center environment Professional demeanor required Ability to effectively manage time and competing priorities #LI-SM2 ModMed Benefits Highlight: At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits: India Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk, Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees, Allowances: Annual wellness allowance to support your well-being and productivity, Earned, casual, and sick leaves to maintain a healthy work-life balance, Bereavement leave for difficult times and extended medical leave options, Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave, Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind. United States Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution, 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep. Generous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.

Illinois Casualty Company is seeking an experienced Property Claims Specialist to join our team! As a small but growing insurance carrier, ICC provides unlimited opportunity for employees who demonstrate the interest and ability to contribute to their team and grow professionally. Work Location: Field, about 25% travel required with ability to work from home the remainder of the time. Company vehicle provided. Salary Range: $83,850 to $95,000 annually Essential Functions * Handling large property claims from start to finish, typically ranging from $75,000 to upwards of $1,000,000 in loss * Building accurate, reliable claim files through prompt and thorough investigation and documentation * Inspecting damaged property, writing repair estimates, and obtaining repair price agreement with contractors and policyholders * Determining coverage, damages, and recovery potential based on facts developed in the investigation of assigned claims * Establishing appropriate and timely reserves, updating as needed until conclusion of each claim * Provide exemplary customer service and build positive relationships with independent agents Qualifications * Minimum of five years' field commercial property claims experience including complex and severe claims * Strong working knowledge of construction practices * Computer and data entry skills with intermediate level proficiency in word processing, spreadsheets, presentations, and automated claims systems; experience with Xactimate or Symbility desired * Sound knowledge of insurance policies, coverage, theories, and practices as well as court decisions or case law impacting property claims * Must be a licensed driver and maintain a valid driver's license in the state of residence with the ability to travel extensively when required Best In Class Benefits * Comprehensive health and pharmaceutical plan with company-funded HRA and telemedicine * A la carte Dental, Vision, Critical Illness, and Accident insurance coverages * Lifestyle Account * Traditional and Roth 401k plans with company match * Modified workweek and generous PTO policy * Paid parental leave

SOLV Energy is an engineering, procurement, construction (EPC) and solar services provider for utility solar, high voltage substation and energy storage markets across North America. The Property & Casualty Claim Specialist is responsible for managing and processing insurance claims related to property and casualty losses. This role involves investigating claims, assessing damages, claim reporting, and ensuring timely and accurate claim resolution. The ideal candidate will have a strong understanding of insurance policies, excellent analytical skills, and a commitment to providing outstanding service. : *This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned Position Responsibilities and Duties: Investigate and evaluate property and casualty claims to determine coverage, liability, and damages. Communicate with carriers, adjusters, claimants, and other stakeholders to gather necessary information and documentation. Analyze policy terms and conditions to determine claim eligibility. Coordinate with adjusters, contractors, and other professionals to assess and estimate damages. Work with carrier(s) in settlement negotiations with claimants and ensure fair and equitable claim resolution. Maintain accurate and detailed claim files and documentation. Provide regular internal updates on the status of claims. Ensure compliance with company policies, procedures, and regulatory requirements. Identify and report potential fraud or suspicious activities. Participate in training and development programs to stay current with industry trends and best practices. Minimum Skills or Experience Requirements: Bachelor's degree in a related field or equivalent work experience. Recommended heavy knowledge in Commercial Auto and Builders Risk coverages. Minimum of 5-10 years of experience in property and casualty claims handling - whether at a carrier, broker or with a construction client. Strong knowledge of insurance policies, coverage, and claim processes. Excellent analytical and problem-solving skills. Effective communication and negotiation abilities. Ability to work independently and as part of a team. Strong attention to detail and organizational skills. Customer-focused with a commitment to delivering high-quality service. SOLV Energy Is an Equal Opportunity Employer At SOLV Energy we celebrate the power of our differences. We are committed to building diverse, equitable, and inclusive workplaces that improve our communities. SOLV Energy prohibits discrimination and harassment of any kind against an employee or applicant based on race, color, age, religion, sex, sexual orientation, gender identity or expression, marital status, national origin, or ethnicity, mental or physical disability, veteran status, parental status, or any other characteristic protected by law. Benefits: Employees (and their families) are eligible for medical, dental, vision, basic life and disability insurance. Employees can enroll in our company's 401(k) plan and are provided vacation, sick and holiday pay. Compensation Range: $65,133.00 - $81,416.00 Pay Rate Type: Salary SOLV Energy does not accept unsolicited candidate introductions, referrals or resumes from third-party recruiters or staffing agencies. We require all third-party recruiters to communicate exclusively with our internal talent acquisition team. SOLV Energy will not pay a placement fee to any third-party recruiter or agency that has not coordinated their recruiting activity with the appropriate member of our internal talent acquisition team. In addition, candidate introductions or resumes can only be submitted to our internal talent acquisition recruiting team if a signed vendor agreement is already on file and the third-party recruiter or agency has received formal instructions from our internal talent acquisition team to submit candidates for a particular job posting. Any unsolicited candidate introductions, referrals or resumes sent by third-party recruiters to SOLV Energy or directly to any of our employees, or received through our website or career portal, will be considered property of SOLV Energy and will not be eligible for a placement fee. In the event a third-party recruiter submits a resume or refers a candidate without a previously signed vendor agreement, SOLV Energy explicitly reserves the right to pursue and hire the candidate(s) without financial liability to such third-party recruiter. Job Number: J11771 If you're interested in a meaningful career with a brighter future, join the SOLV Energy Team.

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation. Become an integral part of a dedicated team supporting the World Trade Center Health Program. In this role, you will leverage your strong attention to detail and commitment to accuracy in processing complex medical claims. If you are eager to make a positive impact in the community through your administrative skills, we encourage you to apply. Work Schedule Remote Monday through Friday, 8:30 AM to 5:00 PM EST Must be able to work 8am - 5pm Eastern Standard Time Responsibilities Claims Review and Processing Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. Critical Analysis Adjudicate claims according to program guidelines, applying critical thinking skills to navigate complex scenarios. Timely Processing Ensure prompt claims processing to meet client standards and regulatory requirements. Identify and resolve any barriers using effective problem-solving strategies. Issue Resolution Collaborate with internal departments to proactively resolve discrepancies and issues. Use analytical skills to identify root causes and implement solutions. Confidentiality Maintenance Uphold confidentiality of patient records and company information in accordance with HIPAA regulations. Detailed Record Keeping Maintain thorough and accurate records of claims processed, denied, or requiring further investigation. Trend Monitoring Analyze and report trends in claim issues or irregularities to management. Assist Team Leads with reporting to contribute to continuous process improvements. Audit Participation Engage in audits and compliance reviews to ensure adherence to internal and external regulations. Critically evaluate and recommend process improvements when necessary. Mentoring Mentor and train new claims processors as needed. Requirements High school diploma or equivalent. Minimum of five years of experience in medical claims processing, including professional and facility claims, as well as complex and high-dollar claims. Billing experience doesn't count towards years of experience qualification Familiarity with ICD-10, CPT, and HCPCS coding systems. Understanding of medical terminology, healthcare services, and insurance procedures (experience with worker's compensation claims is a plus). Strong attention to detail and accuracy. Ability to interpret and apply insurance program policies and government regulations effectively. Excellent written and verbal communication skills. Proficiency in Microsoft Office Suite (Word, Excel, Outlook). Ability to work independently and collaboratively within a team environment. Commitment to ongoing education and staying current with industry standards and technology advancements. Experience with claim denial resolution and the appeals process. Ability to manage a high volume of claims efficiently. Strong problem-solving capabilities and a customer service-oriented mindset. Flexibility to adjust to the evolving needs of the client and program changes. Benefits 401(k) with employer matching Health insurance Dental insurance Vision insurance Life insurance Flexible Paid Time Off (PTO) Paid Holidays What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting. Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client and their team. **NOTE** : This is a US based, W-2 project. All candidates will be paid through NTT DATA only. **In this Role the candidate will be responsible for:** + Processing of Professional claim forms files by provider + Reviewing the policies and benefits + Comply with company regulations regarding HIPAA, confidentiality, and PHI + Abide with the timelines to complete compliance training of NTT Data/Client + Work independently to research, review and act on the claims + Prioritize work and adjudicate claims as per turnaround time/SLAs + Ensure claims are adjudicated as per clients defined workflows, guidelines + Sustaining and meeting the client productivity/quality targets to avoid penalties + Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. + Timely response and resolution of claims received via emails as priority work + Correctly calculate claims payable amount using applicable methodology/ fee schedule **Requirements:** + 1-3 year(s) hands-on experience in **Healthcare Claims Processing** + 2+ year(s) using a computer with Windows applications using a keyboard, **navigating multiple screens and computer systems, and learning new software tools** + High school diploma or GED. + **Previously performing - in P&Q work environment; work from queue; remotely** + Key board skills and computer familiarity - + **Toggling back and forth between screens** /can you navigate multiple systems. + Working knowledge of MS office products - Outlook, MS Word and **MS-Excel** . + Must be able to work **7am - 4 pm CST** online/remote (training is **required on-camera** ). + Effective **troubleshooting where you can leverage your research, analysis and problem-solving abilities** + **Time management with the ability to cope in a complex, changing environment** + **Ability to communicate (oral/written) effectively** in a professional office setting **Preferred Skills & Experiences:** + Amisys &/or Xcelys Preferred **About NTT DATA** NTT DATA is a $30 billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize and transform for long-term success. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure and connectivity. We are one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. Visit us at us.nttdata.com (************************* NTT DATA endeavors to make ********************** (**********************/en) 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 **********************/en/contact-us . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here (**********************/en/compliance#eeos) . If you'd like more information on your EEO rights under the law, please click here (**********************/en/compliance#know-your-rights) . For Pay Transparency information, please click here (**********************/en/compliance#ppnp) .

Liberty Mutual has an immediate opening for a Complex Claims Specialist with Managed Care, Errors & Omissions (E&O) and Directors & Officers (D&O) Professional Liability claims experience. The Complex Claims Specialist, with minimal supervision, handles a book of specialty lines claims under E&O and D&O policies issued to health plans and other Managed Care Organizations throughout the entire claim's life cycle. In this role, you will be responsible for conducting investigations, evaluating coverage, setting adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed authority limits for the line of business. *This position may have an in-office requirement and other travel needs depending on candidate location. If you reside within 50 miles of one of the following offices, you will be required to go to the office twice a month: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; Westborough, MA; or Weatogue, CT. Please note this policy is subject to change. Responsibilities Analyzes, investigates and evaluates the loss to determine coverage and claim disposition. Utilizes proprietary claims management system to document claims and to diary future events or follow up. Issue detailed coverage position letters for all new claims within prescribed time frames. Within prescribed settlement authority, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level. Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting. Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment. Pro-actively manages the case resolution process. Actively participates in mediations and arbitrations, as well as negotiation discussions within limit of settlement authority. Participates in the claims audit process. Provides claims marketing services by meeting with brokers and insureds. As required, maintains insurance adjuster licenses Qualifications Bachelors' and/or advanced degree 7 + years claims/legal experience, with at least 2 years within a technical specialty preferred (Managed Care, Errors & Omissions and Directors & Officers) Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge Functional knowledge of law and insurance regulations in various jurisdictions Demonstrated advanced verbal and written communications skills Demonstrated advanced analytical, decision making and negotiation skills 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. As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally. At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow. We are dedicated to fostering an inclusive environment where employees from all backgrounds can build long and meaningful careers. By actively seeking employee feedback and amplifying the voices of our seven Employee Resource Groups (ERGs), which are open to all, we create an environment where every individual can make a meaningful impact so we continue to meet the evolving needs of our customers. 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.

We're delighted you're considering joining us! At Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members. Join Our Team! Hill Physicians has much to offer prospective employees. We're regularly recognized as one of the “Best Places to Work in the Bay Area” and have been recognized as one of the “Healthiest Places to Work in the Bay Area.” When you join our team, you're making a great choice for your professional career and your personal satisfaction. DE&I Statement: At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are. We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right! Job Description: Hill Physicians Care Solutions (HPCS) is a wholly owned subsidiary of Hill Physicians and operates under a Restricted Knox-Keene license issued by the California Department of Managed Care (DMHC). HPCS handles the highly visible and fast-growing Medicare Advantage claims for the full risk line of business. Under the leadership of the HPCS Supervisor, the Full Risk Claims Analyst is responsible for ensuring Full Risk claims and disputes are processed accurately and timely pursuant to health plan coverage and Hill Physicians' reimbursement policies as well as within CMS and AB1455 regulations. The analyst will be Responsible for resolving/responding to complex issues for members, health plans and physicians by conducting detailed research and by interfacing with appropriate departments and management to ensure that the standards for claims resolution processes are met. Analyst must have experience processing full risk claims, including but not limited to MS DRG Inpatient Hospital, Ambulatory Surgery Centers, Home Health Care, Skilled Nursing Facility, DME, Emergency Room Facility, Ambulance, etc. Essential Responsibilities Adjudicating and/or adjusting claims, specifically for the full risk line of business, including but not limited to MS DRG Inpatient Hospital, Ambulatory Surgery Centers, Home Health Care, Skilled Nursing Facility, DME, Emergency Room Facility, Ambulance, etc. Ensure these full risk claims are handled accurately, timely and appropriately. Claim contains pertinent and correct information for processing. Services have the required authorization. Accurate final claims adjudication/adjustment by using pricing system and provider contracts. Identify billing patterns, processing errors and/or system issues that inhibit the final adjudication of claims. Adjudicate claims on Epic Tapestry according to HPCS and HPMG guidelines. Navigate and decipher pricing rules using Optum Prospective Pricing System. Review, interpret and process MS DRG rules, Home Health and ASC groupings, DME and ambulance claims. Ensure all claim lines post to the appropriate fund. Maintain departmental productivity goal. Maintain a 97% payment accuracy rate and 98% non-payment accuracy rate in Claims Services Determine benefits using automated-system controls, policy guidelines, and HMO Fact Sheets. Coordinate and resolve claims issues related to claims processing with the appropriate departments as required. Review and process out of network claims according to the guideline/out of network claims research protocol in order to contain out-of-network cost Conduct second-level review of all Medicare denials for Not Authorized and/or Not A Covered Benefit. Research, resolve, and respond to claim resubmission disputes and inquires Coordinate and resolve claims issues related to claims processing with the appropriate departments as required. Provide claims contact resolution to the call center. Complete special projects as assigned to meet department and company goals. Document follow-up information on the system and generate appropriate letters to member and providers. Skills and Experience Required Minimum years of experience required - 3 Minimum level of education required - High School/GED Licenses and certifications required - None. Must have experience processing full risk claims, including but not limited to MS DRG Inpatient Hospital, Ambulatory Surgery Centers, Home Health Care, Skilled Nursing Facility, DME, Emergency Room Facility, Ambulance, etc. Working knowledge of CPT, Revenue codes, PDGM Home Health, ICD-10 codes, Red Book, MS DRGs, HCPC codes and ASC groupings. Three years' experience in claims-payment adjudication at a Health Maintenance Organization (HMO) Health Plan or IPA. (Internal applicants are expected to have one year of experience in claims-payment adjudication). Ability to process all claim types on UB-04 and CMS 1500 claim form, including but not limited to Surgery, Medicine, Lab and Radiology. Ability to understand member benefits and patient cost-shares. Ability to calculate and convert standard drug measurements. Knowledge of CMS and the DMHC rules and regulations. Excellent problem solving, organizational, research and analytical skills. Strong written- and verbal-communication skills. Strong Microsoft application skills. Strong interpersonal skills and the ability to interact with employees and others in a professional manner. Strong judgment, decision-making and detailed oriented skills. Ability to work independently or as a team. Ability to work in a fast- paced environment. Additional Information Remote - Multiple Positions Available Salary: $28 - $32 hourly Hill Physicians is an Equal Opportunity Employer

Looking for a career with purpose and reward? At LoanCare we help customers every day with what is for many their largest and most personal financial transaction: the purchase of their home. With the mission to simplify the complex with empathy and insight, we are constantly innovating and are a top provider in the mortgage services industry as a result. We are actively seeking to fill the role of Claims Specialist II. Our ideal candidate enjoys working with clients, both internal and external, eager to learn and maximize results, is detail oriented and driven to meet tight deadlines in a fast-paced environment. Background in the mortgage or real estate industry is a plus. If this sounds like you, and you are ready for a career and not just your next job, apply today! Responsibilities • Prepare mortgage insurance claims for two or more agencies- or investor-acquired properties. • Complete reconciliation of all advances to be included in the claim. • Assist in conducting internal department quality control audits of post claim activity. • Validate all the necessary supporting documents needed for the claim. • Maintain clear records and reports for management regarding daily production. • Assist with updating appropriate workstations for claim payments. • Follow up and track payment of filed claims. • Conduct miscellaneous research to complete daily tasks. • Conduct research for post-claim activities such as “missing documents and/or agency inquiries”. • Complete tasks queue and notate internal system accordingly. • All other duties as assigned. Qualifications 2-4 years of experience in default mortgage servicing and/or mortgage insurance claim and/or the legal field. Knowledge of accepted business practices in the mortgage industry and understanding of claims process. Proficient knowledge of foreclosure process and appropriate guidelines (FHD). LPS-MSP (Mortgage Servicing Platform) experience. Ability to manage time and priorities wisely. Ability to make sound decisions and resolve issues. Ability to work independently and effectively meet deadlines. Ability to communicate effectively in writing, in person, and by telephone. Ability to use Microsoft Office applications, specifically, Excel and Word. Ability to maintain strict confidentiality. Total Rewards LoanCare's Total Rewards Package offers a comprehensive blend of health and welfare, financial, lifestyle and learning benefits to support employee well-being and engagement. Highlights include: Health & Welfare Coverage: Optional medical, dental, vision, life, and disability insurance Time Off: Paid holidays, vacation, and sick leave Retirement & Investment: Matching 401(k) plan and employee stock purchase plan Wellness Programs: Access to mental health resources, including free Calm memberships, and initiatives that promote physical and emotional well-being Employee Recognition: Programs that celebrate achievements and milestones Lifestyle & Learning Perks: Enjoy discounts on gym memberships, pet insurance, and employee purchasing programs, plus access to a tuition reimbursement program that supports your continued education and professional growth. Compensation Range: $17.88 - $26.73 hourly. Actual compensation may vary within the range provided, depending on a number of factors, including qualifications, skills and experience. Build Your Future with LoanCare At LoanCare, we don't just service mortgage loans-we serve people. As a leading full-service mortgage loan subservicer, we deliver excellence to banks, credit unions, independent mortgage companies, investors, and the homeowners they support. Backed by the strength and stability of Fidelity National Financial (NYSE: FNF), a Fortune 500 company, we offer a career foundation built on integrity, innovation, and collaboration. Here, you'll find: A culture that helps you thrive, with resources and support to fuel your growth Flexibility to work remotely, while staying connected through virtual engagement Opportunities to make a real impact in an industry that touches millions of lives If you're ready to grow your career in a place that values your contributions and empowers your success, we invite you to join our team. About Remote Employment We provide the necessary equipment; all you need is a quiet, private place in your home and a high-speed internet connection with a minimum network download speed of 25 megabits per second (MBPS) and a minimum network upload speed of 10 MBPS. Work Conditions Able to attend work and be productive during normal business hours and to work early, late or weekend hours as needed for successful job performance. Overtime required as necessary. Physical Demands Sitting up to 90% of the time Walking and standing up to 10% of the time Occasional lifting, stooping, kneeling, crouching, and reaching Equal Employment Opportunity LoanCare, its affiliates and subsidiaries, is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, protected veteran status, national origin, sexual orientation, gender identity or expression (including transgender status), genetic information or any other characteristic protected by applicable law.

Job DescriptionDescription: We are hiring in the following states: AR, AZ, CA, CO, CT, FL, GA, IA, IL, MN, MO, NC, NJ, NE, NV, OK, PA, SD, TN, TX, VA, WA, WI This is a remote position. Candidates who meet the minimum qualifications will be required to complete a video prescreen to move forward in the hiring process. Hourly Rate: Up to $23.00/hour based on experience At Currance, we believe in recognizing the unique skills and experiences that each candidate brings to our team. Our overall compensation package is competitive and is determined by a combination of your experience in the industry and your knowledge of revenue cycle operations. We are committed to offering a rewarding environment that aligns with both individual contributions and our company goals. Benefits include paid time off, 401(k) plan, health insurance (medical, dental, and vision), life insurance, paid holidays, training and development opportunities, a focus on wellness and support for work-life balance, and more. Please note that we are looking for people who have hospital billing experience in collections and have some HB billing experience, in high dollar collections, adjustments and denials management. Job Overview As a healthcare revenue cycle business, we manage insurance claims and oversee timely claim resolution and payment processing for our clients. This role involves reviewing, correcting, and resolving claim edits, errors, and denials to maintain revenue flow. Acting as a subject matter expert, you will handle denials, appeals, and account follow-up across various payer types, collaborating with client teams to ensure the financial success of the healthcare organizations we support. Job Duties and Responsibilities Submit accurate medical claims following federal, state, and payer-specific guidelines. Investigate, follow up with payers, and collect on insurance accounts receivables. Execute and manage EPIC system workflows, including reroutes, denial closures, and adjustments to maintain accurate account records. Review Explanation of Benefits (EOBs) to identify and address payment discrepancies, claim denials, and contractual underpayments. Initiate and track appeals, rebills, and corrections, providing comprehensive documentation to ensure maximum reimbursement. Analyze payment discrepancies and implement corrective actions. Meet productivity benchmarks while ensuring high-quality performance standards. Research, analyze, and correct claim errors and rejections, document root causes, and implement preventative solutions. Verify and adjust claims, ensuring accurate client liability and account balances. Stay updated on payer guidelines and process modifications for accurate claim submissions. Participate and contribute to daily shift briefings. Requirements: Qualifications Experience with EPIC system preferred. High school diploma or equivalent required Associate's degree preferred Minimum 2 years of experience securing medical claim payments from health insurance companies. Minimum 2 years of experience managing claim follow-up and appeals with healthcare vendors, hospitals, Proficiency in Microsoft Office Suite, Teams, and virtual meeting platforms (GoToMeeting, Zoom). Proficiency with computers including Microsoft Office Suite/Teams, GoToMeeting/Zoom, etc. Knowledge, Skills, and Abilities Knowledge of ICD-10 Diagnosis and procedure codes and CPT/HCPCS codes. Knowledge of rules and regulations relative to Healthcare Revenue Cycle administration. Skills in investigating medical accounts and resolving claims. Ability to validate payments. Ability to make decisions and act. Ability to learn and use collaboration tools and messaging systems. Ability to maintain a positive outlook, a pleasant demeanor, and act in the best interest of the organization and the client. Ability to research healthcare revenue cycle rules and regulations Ability to take professional responsibility for quality and timeliness of work product. Ability to achieve results with little oversight.

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Responsible for managing patient account balances including accurate claim submission, compliance will all federal/state and third party billing regulations, timely follow-up, and assistance with denial management to ensure the financial viability of the WVU Medicine hospitals. Employs excellent customer service, oral and written communication skills to provide customer support and resolve issues that arise from customer inquiries. Supports the work of the department by completing reports and clerical duties as needed. Works with leadership and other team members to achieve best in class revenue cycle operations. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High School diploma or equivalent. PREFERRED QUALIFICATIONS: EXPERIENCE: 1. One (1) year medical billing/medical office experience. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Submits accurate and timely claims to third party payers. 2. Resolves claim edits and account errors prior to claim submission. 3. Adheres to appropriate procedures and timelines for follow-up with third party payers to ensure collections and to exceed department goals. 4. Gathers statistics, completes reports and performs other duties as scheduled or requested. 5. Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability and efficiency. 6. Complies with Notices of Privacy Practices and follows all HIPAA regulations pertaining to PHI and claim submission/follow-up. 7. Contacts third party payers to resolve unpaid claims. 8. Utilizes payer portals and payer websites to verify claim status and conduct account follow-up. 9. Assists Patient Access and Care Management with denials investigation and resolution. 10. Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth. 11. Attends department meetings, teleconferences and webcasts as necessary. 12. Researches and processes mail returns and claims rejected by the payer. 13. Reconciles billing account transactions to ensure accurate account information according to established procedures. 14. Processes billing and follow-up transactions in an accurate and timely manner. 15. Develops and maintains working knowledge of all federal, state and local regulations pertaining to hospital billing. 16. Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts. 17. Maintains work queue volumes and productivity within established guidelines. 18. Provides excellent customer service to patients, visitors and employees. 19. Participates in performance improvement initiatives as requested. 20. Works with supervisor and manager to develop and exceed annual goals. 21. Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information. 22. Communicates problems hindering workflow to management in a timely manner. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Must be able to sit for extended periods of time. 2. Must have reading and comprehension ability. 3. Visual acuity must be within normal range. 4. Must be able to communicate effectively. 5. Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Office type environment. SKILLS AND ABILITIES: 1. Excellent oral and written communication skills. 2. Working knowledge of computers. 3. Knowledge of medical terminology preferred. 4. Knowledge of business math preferred. 5. Knowledge of ICD-10 and CPT coding processes preferred. 6. Excellent customer service and telephone etiquette. 7. Ability to use tact and diplomacy in dealing with others. 8. Maintains knowledge of revenue cycle operations, third party reimbursement and medical terminology including all aspects of payer relations, claims adjudication, contractual claims processing, credit balance resolution and general reimbursement procedures. 9. Ability to understand written and oral communication. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 544 SYSTEM Patient Financial Services

HAAWK is looking for a Claiming Specialist to join our team. In this role you will be responsible for accuracy and integrity of music assets within YouTube's Content Management System (CMS), and play a critical part in ensuring proper monetization, rights enforcement, and conflict resolution across digital content platforms. The ideal candidate is highly detail-oriented, technically proficient, and possesses a strong understanding of YouTube's platforms and policies. What You Will Be Doing: * Monitoring and troubleshooting issues related to claims, monetization, and policy enforcement within YouTube CMS. * Investigating and resolving disputed claims, reference overlaps, and ownership conflicts to ensure proper asset management. * Maintaining accurate metadata, confirming correct ownership, and applying appropriate policies across music assets. * Serving as a point of contact for clients and partners, providing timely assistance with content-related issues and conflict resolution. * Stay up-to-date and informed on YouTube platform developments, Content ID tools, and industry best practices. What Makes You Qualified: * Proficiency in organizing and analyzing data using tools such as Microsoft Excel or Google Sheets. * Strong attention to detail, with excellent organizational and analytical problem-solving abilities. * Comfortable working with and learning new technologies. * Proven ability to work collaboratively in a team environment with a positive, solutions-oriented attitude and a willingness to support others to achieve shared goals. * Hands-on experience with YouTube CMS or similar content management systems. * Background in music, digital rights management, or copyright is a plus. * Solid understanding of popular music and awareness of current and emerging trends in the music industry. * Exceptional communication skills with the ability to interact professionally in client-facing situations.

Summary of Essential Functions: Files insurance claims on the UB-04 and CMS 1500 form for hospital and physician services. Computes insurance benefits, allowances, adjustments, and patient balances. Processes, traces, and verifies reimbursement from payers, and other payers as assigned. Displays positive customer relations with other departments within the hospital, patients, and insurance companies. Work from home available after 60-90 days of on-the-job training. Educational Requirements: High school graduate or equivalent. 1 to 2 years billing and/or claims follow-up obtained through related work experience or vocational school preferred. Insurance and medical terminology are helpful. Must be able to communicate effectively in English, both verbally and in writing. Qualifications/Knowledge/Skills/Abilities: Knowledge in all areas of insurance, including but not limited, the ability to analyze and compile insurance billing data on the UB-04 and CMS 1500 forms. Knowledge of the filing practices for all third-party payers. Ability to compute insurance benefits, allowances, adjustments, and patient balances. Knowledge of the appeal process to government payers, and other payers as assigned. Ability to analyze payment practices of governmental payers, and other payers as assigned. Demonstrate diligence, patience, and persistence to obtain required information on outstanding accounts. Ability to read, comprehend and apply governmental rules and regulations. Ability to utilize tools available (i.e. payer websites). Knowledge of patient accounts and the ability to discuss account information with patients and insurance companies. Basic mathematical knowledge including understanding of debits and credits for correct account transactions. Type 45 w.p.m. ensuring correct spelling and grammar when documenting account actions or written communications. Must have internet access and a secure office space to work from home. Requires the use of office equipment such as computer terminals, telephones and telephone headsets, copiers, 10-key adding machine, and fax machine. Duties and Responsibilities: Compiles data and prepares insurance claims for billing utilizing patient, hospital and insurance data, and reviews LMRP queries to ensure proper processing. Reviews and corrects/posts appropriate adjustments to patient accounts. Investigates and corrects questionable charges to patient accounts. Processes and traces for hospital and physician claims ensuring timely filing to avoid missing deadlines. Utilize billing process to ensure claims are filed accurately daily. Properly applies the 24/72-hour regulations to ensure compliance. Verifies and calculates hospital and physician payments, follows up on incorrect payments or denials in a timely manner and ensures proper status of accounts. Generate appropriate secondary billing if applicable. Determine whether to re-file a claim, refund, or process an adjustment. Submit written and verbal inquiries to payers in an efficient and professional manner to determine status of claims. Ensure accurate information is included for the payer to identify the claim. Supply payers with requested information for the claim to be processed in a timely manner. Document all information pending from other providers. Follow through on all resources by contacting other providers and inform them of pended claim due to their outstanding claim information. Contacts patients as needed for required information. Demonstrate diligence and persistence with payers while maintaining tact and diplomacy. Notifies management of any consistent discrepancies or potential reimbursement problems. Processes daily reports, mail, e-mails, and phone calls. All mail received is worked within 2 days of receipt and all information is documented in the patients account note file. Identifies Medicare and Medicaid combine messages daily. Responsible for obtaining proper assistance combining accounts. Non-billable report is worked daily ensuring adjustments are posted accurately and timely. Ensure all pertinent information is documented in the patient account note file. Ensure names and phone numbers are documented when applicable. Ensures correct insurance information is maintained and makes changes when necessary. Ensures work queues are reviewed and worked according to expectations. Maintains good working relationships with coworkers and revenue cycle departments. Maintains productivity set forth by department standards. Performs all other tasks/responsibilities as necessary.

Exceed the expectations of our residential mortgage borrowers & business partners through superior service, simple processes, and effective communications. We deliver on this mission by empowering our employees by encouraging and recognizing superior performance and innovative solutions, by promoting teamwork and divisional cooperation. Primary Function The Loss Draft Claims Specialist will be responsible for assisting with the day-to-day operations of the loss draft claims functions. They will assist with training team members, monitoring internal and vendor reporting, timely processing of day-to-day processes. The Loan Administration Department is also responsible for ensuring compliance with all applicable regulations and investor guidelines. Principal Duties: Build, review, and post the daily disbursement batch to the vendor. Timely and accurately complete assigned research tasks and exception reports. Complete reports and logs to ensure insurance information is current in the system. Request payoff quotes as needed. Review incoming claim checks as needed. Completing assigned responsibilities timely and with minimal to no errors. Respond to various email requests from the vendor and internal partners. Provide accurate communication with vendors based on research. Performs related duties and special projects as assigned by management. *These essential functions are fundamental to the role, and must be performed on-site, as they cannot physically be performed remotely. In addition, the Company has determined that an in-person presence is important to critical components of our work, including oversight, training, collaboration, and productivity. Items not marked (*) as essential on-site may still require partial on-site work to perform the role satisfactorily. Education and Experience Bachelor's degree, preferred. 2-4 years relevant experience in mortgage banking or real estate financing environment. Knowledge, Skills, and Abilities Proficient with Microsoft Office (Excel, Word, and Outlook). Ability to multi-task and well organized. Possess excellent communication (verbal & written). Ability to make sound decisions based upon department, company policies, procedures, knowledge, and experience. SINDHP2 While this description is intended to be an accurate reflection of the position's requirements, it in no way implies/states that these are the only job responsibilities. Management reserves the right to modify, add or remove duties and request other duties, as necessary. By applying to this position candidate acknowledges that this is not a remote role and is required to be on-site. Additional Information: While this description is intended to be an accurate reflection of the position's requirements, it in no way implies/states that these are the only job responsibilities. Management reserves the right to modify, add or remove duties and request other duties, as necessary. All employees are required to have smart phones that meet Company security standards with the ability to install apps such as Okta Verify and Microsoft Authenticator. Employment will be contingent on this requirement. Company Benefits: Newrez is a great place to work but we are only as strong as our greatest asset, our employees, so we believe in rewarding them! Medical, dental, and vision insurance Health Savings Account with employer contribution 401(k) Retirement plan with employer match Paid Maternity Leave/Parental Bonding Leave Pet insurance Adoption Assistance Tuition reimbursement Employee Loan Program The Newrez Employee Emergency and Disaster Fund is a new program to support our team members Newrez NOW: Our Corporate Social Responsibility program, Newrez NOW, empowers employees to become leaders in their communities through a robust program that includes volunteering, philanthropy, nonprofit grants, and more 1 Volunteer Time Off (VTO) day, company-paid volunteer day where all eligible employees may participate in a volunteer event with a nonprofit of their choice Employee Matching Gifts Program: We will match monetary employee donations to eligible non-profit organizations, dollar-for-dollar, up to $1,000 per employee Newrez Grants Program: Newrez hosts a giving portal where we provide employees an abundance of resources to search for an opportunity to donate their time or monetary contributions Equal Employment Opportunity We're proud to be an equal opportunity employer- and celebrate our employees' differences, including race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, and Veteran status. Different makes us better. CA Privacy Policy CA Notice at Collection

Exceed the expectations of our residential mortgage borrowers & business partners through superior service, simple processes, and effective communications. We deliver on this mission by empowering our employees by encouraging and recognizing superior performance and innovative solutions, by promoting teamwork and divisional cooperation. Primary Function The Loss Draft Claims Specialist will be responsible for assisting with the day-to-day operations of the loss draft claims functions. They will assist with training team members, monitoring internal and vendor reporting, timely processing of day-to-day processes. The Loan Administration Department is also responsible for ensuring compliance with all applicable regulations and investor guidelines. Principal Duties: * Build, review, and post the daily disbursement batch to the vendor. * Timely and accurately complete assigned research tasks and exception reports. * Complete reports and logs to ensure insurance information is current in the system. * Request payoff quotes as needed. * Review incoming claim checks as needed. * Completing assigned responsibilities timely and with minimal to no errors. * Respond to various email requests from the vendor and internal partners. * Provide accurate communication with vendors based on research. * Performs related duties and special projects as assigned by management. * These essential functions are fundamental to the role, and must be performed on-site, as they cannot physically be performed remotely. In addition, the Company has determined that an in-person presence is important to critical components of our work, including oversight, training, collaboration, and productivity. Items not marked (*) as essential on-site may still require partial on-site work to perform the role satisfactorily. Education and Experience * Bachelor's degree, preferred. * 2-4 years relevant experience in mortgage banking or real estate financing environment. Knowledge, Skills, and Abilities * Proficient with Microsoft Office (Excel, Word, and Outlook). * Ability to multi-task and well organized. * Possess excellent communication (verbal & written). * Ability to make sound decisions based upon department, company policies, procedures, knowledge, and experience. SINDHP2 While this description is intended to be an accurate reflection of the position's requirements, it in no way implies/states that these are the only job responsibilities. Management reserves the right to modify, add or remove duties and request other duties, as necessary. By applying to this position candidate acknowledges that this is not a remote role and is required to be on-site. Additional Information: While this description is intended to be an accurate reflection of the position's requirements, it in no way implies/states that these are the only job responsibilities. Management reserves the right to modify, add or remove duties and request other duties, as necessary. All employees are required to have smart phones that meet Company security standards with the ability to install apps such as Okta Verify and Microsoft Authenticator. Employment will be contingent on this requirement. Company Benefits: Newrez is a great place to work but we are only as strong as our greatest asset, our employees, so we believe in rewarding them! * Medical, dental, and vision insurance * Health Savings Account with employer contribution * 401(k) Retirement plan with employer match * Paid Maternity Leave/Parental Bonding Leave * Pet insurance * Adoption Assistance * Tuition reimbursement * Employee Loan Program * The Newrez Employee Emergency and Disaster Fund is a new program to support our team members Newrez NOW: * Our Corporate Social Responsibility program, Newrez NOW, empowers employees to become leaders in their communities through a robust program that includes volunteering, philanthropy, nonprofit grants, and more * 1 Volunteer Time Off (VTO) day, company-paid volunteer day where all eligible employees may participate in a volunteer event with a nonprofit of their choice * Employee Matching Gifts Program: We will match monetary employee donations to eligible non-profit organizations, dollar-for-dollar, up to $1,000 per employee * Newrez Grants Program: Newrez hosts a giving portal where we provide employees an abundance of resources to search for an opportunity to donate their time or monetary contributions Equal Employment Opportunity We're proud to be an equal opportunity employer- and celebrate our employees' differences, including race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, and Veteran status. Different makes us better. CA Privacy Policy CA Notice at Collection

HAAWK is looking for a Claiming Specialist to join our team. In this role you will be responsible for accuracy and integrity of music assets within YouTube's Content Management System (CMS), and play a critical part in ensuring proper monetization, rights enforcement, and conflict resolution across digital content platforms. The ideal candidate is highly detail-oriented, technically proficient, and possesses a strong understanding of YouTube's platforms and policies. What You Will Be Doing: Monitoring and troubleshooting issues related to claims, monetization, and policy enforcement within YouTube CMS. Investigating and resolving disputed claims, reference overlaps, and ownership conflicts to ensure proper asset management. Maintaining accurate metadata, confirming correct ownership, and applying appropriate policies across music assets. Serving as a point of contact for clients and partners, providing timely assistance with content-related issues and conflict resolution. Stay up-to-date and informed on YouTube platform developments, Content ID tools, and industry best practices. What Makes You Qualified: Proficiency in organizing and analyzing data using tools such as Microsoft Excel or Google Sheets. Strong attention to detail, with excellent organizational and analytical problem-solving abilities. Comfortable working with and learning new technologies. Proven ability to work collaboratively in a team environment with a positive, solutions-oriented attitude and a willingness to support others to achieve shared goals. Hands-on experience with YouTube CMS or similar content management systems. Background in music, digital rights management, or copyright is a plus. Solid understanding of popular music and awareness of current and emerging trends in the music industry. Exceptional communication skills with the ability to interact professionally in client-facing situations.

Job Description Job Type: Exempt Duration of role: Permanent 1 Report to: Senior Director of Customer Experience About Us At Tate we are passionate about everything we do. As an independent brand operating within Kingspan Group, a global plc group of companies, Tate has been recognized worldwide as an industry leader in the development and manufacture of data center infrastructure solutions and commercial office raised access floors, for over 60 years. With revenues of over $600m and growing, Tate plays a pivotal role in offering expertise in cutting edge design engineering to craft solutions, by working collaboratively with clients as a trusted partner. Tate continues to grow and expand, operating multiple manufacturing and commercial sites across the US, Europe, the Middle East, Asia, and Australia. We are excited about our fresh, dynamic, and inclusive team of experts working on new innovations and forward-thinking designs, as we remain a market leading player within our industry. We continue to invest heavily in the best available manufacturing tools and equipment needed to adhere to Tate's world class standards and in keeping with our Planet Passionate sustainability strategy, our focus is on having minimal climate impact. We are excited to potentially welcome you as part of our team as we continue to grow on a worldwide scale. About the Role Tate Inc. is seeking a highly organized and customer-focused Claims Specialist to manage and resolve customer claims with precision and empathy. This role is responsible for logging and tracking claims in Salesforce, coordinating resolution efforts across Manufacturing, Finance, and Customer Service, and ensuring customers are made whole in a timely and professional manner. The ideal candidate will bring strong project management, analytical, and communication skills to drive root cause analysis and corrective actions that improve customer experience. What You'll Do Log, track, and manage customer claims using Salesforce. Coordinate with cross-functional teams including Manufacturing, Finance, and Customer Service to resolve claims efficiently. Communicate professionally and empathetically with customers to ensure satisfaction. Analyze claims data to identify trends and support root cause analysis. Drive corrective and preventive actions to improve product and service quality. Key Responsibilities: Manage end-to-end claims processing ensuring timely resolution. Maintain accurate records and documentation of all claims and communications. Collaborate with internal departments to investigate and resolve claims. Monitor claim metrics and report on trends or recurring issues. Support continuous improvement initiatives by providing insights based on claim data Additional Expectations Ability to manage multiple priorities in a fast-paced environment. Proactive communication with stakeholders and customers. Strong attention to detail and organizational skills. Commitment to customer satisfaction and quality improvement. What You'll Bring Bachelor's degree in business, Project Management, Supply Chain, or related field. 3+ years of experience in customer service, claims resolution, or project coordination. Strong proficiency in Salesforce, Excel, and data analysis tools. Excellent communication, problem-solving, and organizational skills. Experience working cross-functionally to resolve complex issues. Employee Benefits Career Scope and Advancement: As we grow, new positions and career opportunities arise, offering accelerated paths for the right candidates, locally and globally. World of Wellness Philosophy: We empower you to take charge of your health and well-being. You'll have access to a wide range of medical, dental, and vision benefits, along with personalized guidance from a “Health Advocate.” We also offer other supplemental options, including 401k, legal, disability, and theft insurance, to ensure your financial wellness. Corporate Social Responsibility: Through Planet Passionate we are determined to reduce our manufacturing carbon (CO2e) emissions to as close to zero as technically possible, together with halving carbon intensity in our primary supply chain. We are very involved in our community, and you will have ample opportunities to support us in creating a better world. Skills Development: Given the dynamic pace of our business and a strong collaborative environment, your new role will be diverse and multifaceted - allowing you to be more versatile and develop a broader skill set. Mentorship and development: At Tate, we don't believe in hierarchy, we work together as one team for one common goal. You will have access and exposure to our senior leaders and experts for learning in your role, and additionally mentorship for the future. Culture: We have a great team culture, highly collaborative, supportive, and social. Together we innovate, collaborate, take ownership, and strive for excellence. Tate is an equal-opportunity employer. We encourage applications from candidates of all backgrounds and experiences. Stay connected with us on LinkedIn for insights into life at Tate. Join us in our mission to make a difference through exceptional solutions.