Verification specialist work from home jobs - 247 jobs

Responsive recruiter Benefits: Flex- Time Opportunity for advancement Training & development KENTECH Consulting Inc. is an award-winning background technology screening company. We are the creators of innovative projects such as eKnowID.com, the first consumer background checking system of its kind, and ClarityIQ, a high-tech and high-touch investigative case management system. MISSION We are on a mission to help the world make clear and informed hiring decisions. VALUE To achieve our mission, our team embodies the core values aligned with it: Customer Focused: We are customer-focused and results-driven. Growth Minded: We believe in collaborative learning and industry best practices to deliver excellence. Fact Finders: We are passionate investigators for discovery and truth. Community and Employee Partnerships: We believe there is no greater power for transformation than delivering on what communities and employees care about. IMPACT As a small, agile company, we seek high performers who appreciate that their efforts will directly impact our customers and help shape the next evolution of background investigations. KENTECH Consulting Inc. is seeking a detail-oriented, hardworking, and team-focused Verification Specialist / Call Center Representative to support accurate and timely background verifications. This role requires strong communication skills, professionalism, and the ability to manage a high volume of outreach efficiently. Key Responsibilities • Verification and Outreach, contact employers, educational institutions, and references to verify candidate information. • High-Volume Calls, conduct 70 or more clear and professional phone calls each day to collect required verification details. • Multi-Channel Communication, gather and confirm information by phone, fax, and email while ensuring accuracy. • Data Research and Accuracy, retrieve and verify data from various websites and databases to support background checks. • Client Updates and Reporting, provide timely updates on verification progress and maintain detailed records. • Team Collaboration, support team goals by assisting with additional tasks as assigned. Qualifications and Experience • Two or more years of experience in call center or customer service roles and one or more years in an office environment. • College Degree (preferred), Criminal Justice, Pre-Law, Paralegal, Journalism, or Political Science, or three or more years of relevant work experience. • Fast and Accurate Typing, minimum 50 words per minute with strong accuracy. • Security Clearance Requirement, must be able to pass background checks to obtain a Permanent Employee Registration Card (PERC). Soft Skills • Strong Communication, professional, clear, and client-focused verbal and written communication. • Organized and Detail-Oriented, able to manage multiple verifications and meet deadlines. • Quick Problem Solver, adaptable and resourceful when resolving verification challenges. • Team Player, comfortable working in a fast-paced, team-oriented environment with a customer-first approach. Why Join KENTECH? • Remote and Flexible, work from anywhere while supporting a global team. • Professional Growth, gain valuable experience in background verification and compliance. • Impactful Work, play a key role in helping organizations make informed hiring decisions. Apply Now If you are a detail-driven professional with strong communication and research skills, we would love to hear from you. KENTECH Consulting Inc. is an equal opportunity employer. We celebrate diversity and remain committed to fostering an inclusive workplace. This is a remote position. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. 🌐 WHO WE ARE KENTECH Consulting, Inc. is a premier U.S.-based background investigation solutions firm and licensed Private Detective Agency. Our team of investigative experts blends cutting-edge technology with industry insight to deliver fast, accurate, and comprehensive reports. With deep cross-industry experience, we provide fully compliant investigative services that meet the high demands of today's business environment. 🔎 WHAT WE DO We offer customized background screening solutions tailored to meet the needs of diverse industries. Our advanced tools and digital platforms allow us to conduct background and security checks up to 75% faster than traditional methods. With real-time access to over 500 million records, KENTECH is a trusted authority in background checking technology across the U.S. 🌟 OUR VISION To help the world make clear and informed decisions. 🎯 OUR MISSION To deliver fast, accurate, and secure background investigations on a global scale-supporting safer hiring decisions and stronger communities. 🚀 CAREERS AT KENTECH We're building a team of remarkable individuals who are: ✅ Critical thinkers and problem solvers who see challenges as opportunities ✅ Driven professionals who create meaningful impact through their ideas and results ✅ Mission-driven collaborators who believe in the power of digital identity to create safer environments ✅ Naturally curious and eager to innovate in an ever-changing landscape ✅ Team players who believe in the value of camaraderie, laughter, and high standards 💼 WHO THRIVES HERE? People who never back down from a tough challenge Professionals who bring their best every day-and uplift others around them Individuals who value purpose, performance, and a good laugh Teammates who want to shape the future of digital security and identification You, if you're reading this and thinking: “This sounds like my kind of place.” 🎉 YOUR NEXT CHAPTER STARTS HERE Ready to do work that matters with people who care? Explore our current openings-your future team is waiting.

State of Location: At Ivy Rehab, we're "All About the People"! As a Workers Compensation (WC) Authorization and Verification Specialist, you will play a crucial role in our mission to help enable people to live their lives to the fullest. Join Ivy Rehab's dedicated team where you're not just an employee, but a valued teammate! Together, we provide world-class care in physical therapy, occupational therapy, speech therapy, and applied behavior analysis (ABA) services. Our culture promotes authenticity, inclusion, growth, community, and a passion for exceptional care for every patient. Job Description: The Workers Compensation (WC) Authorization and Verification Specialist will report to the WC Authorization and Verification Team Lead and will work in combination with front office teammates and any external authorization and verification vendors to ensure Ivy's authorization and verification processes and workflows are executed successfully, set goals and best practices are achieved, and the risk of lost revenue is minimized. In this role, you will be driving both internal and external customer satisfaction through a focus on faster and more efficient reimbursement. The ideal candidate will not only ensure a positive experience for patients, providers, and fellow teammates but will also be a key contributor in optimizing and standardizing authorization and verification workflows within Ivy. Please note: This position falls under the Workers' Compensation Department and is dedicated to supporting functions related to work-related injury claims, compliance, and case management. Your responsibilities will include: Submit authorization requests timely within EMR, following payer and state specific guidelines Specialize in Workers Compensation Financial Class and fluidity within different state and payer specifics Partner with Front Desk teammates and/or Workers Compensation Centralized Scheduling (WCCS) teammates within clinics to ensure appropriate and accurate documentation for authorization submission is completed and uploaded for submission Provide regular feedback to front desk and/or WCCS regarding areas of opportunity in authorization or verification timeline or process Address and respond to authorization or verification related queries from Ivy teammates and WC Payers Ensure all authorization and verification related denials are addressed timely and accurately, providing denial prevention feedback to WC Team Lead Accurately complete verifications for same day or walk-in patients by contacting the provided insurance via phone, fax, or online portal to obtain outpatient therapy benefits, eligibility, and authorization information Request, follow-up, and secure authorizations prior to and during treatment episode for Workers Compensation patients Assist with training and education for new A&V teammates as well as ongoing training and education for established team members Maintain a professional and collaborative relationship with all teammates and vendors to resolve issues, increase knowledge of insurance requirements, and create standardized workflows Run EMR or BI reports as needed to monitor maximum benefits, missing authorization, or other areas of focus as determined by the A&V Team Lead Attend and participate in Department and Organizational meetings to discuss departmental goals and progress Perform other duties as assigned by leadership staff To excel in this role, you should possess: 1 year+ of experience with Workers Compensation insurance in a healthcare environment required; experience with outpatient therapy preferred Demonstrates flexibility in responding to priorities and organizational change Demonstrates ability to work under pressure and follow through on assignments 2-3 years previous experience in pre-auth verification; experience with obtaining authorizations, referral coordination and patient services preferred Ability to multi-task, prioritize needs to meet required timelines. Customer service experience Effective written and verbal communication skills. Solution oriented mindset and ability to use critical thinking and analytical skills Ability to use standard office equipment to include copiers, fax machines, and other methods of electronic communications. Open availability Monday through Friday from 8am-5pm EST Ability to self-motivate and focus in a remote position Proficient in Microsoft applications Why choose Ivy? Best Employer: A prestigious honor to be recognized by Modern Healthcare, signifying excellence in our industry and providing an outstanding workplace culture. Exceeding Expectations: Deliver best-in-class care and witness exceptional patient outcomes. Incentives Galore: Eligibility for full benefits package beginning within your first month of employment. Generous PTO (Paid Time Off) plans and paid holidays. Empowering Values: Live by values that prioritize teamwork, growth, and serving others. Compensation ranges up to an hourly rate of $23.00 based on experience. #LI-remote #LI-ST1 We are an equal opportunity employer, committed to diversity and inclusion in all aspects of the recruiting and employment process. Actual salaries depend on a variety of factors, including experience, specialty, education, and organizational need. Any listed salary range or contractual rate does not include bonuses/incentive, differential pay, or other forms of compensation or benefits. ivyrehab.com

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.

The Verification Specialist II, Criminal Operations supports the day-to-day processing of criminal background screening tasks at Americhek. Responsibilities include assisting with social security traces, criminal record searches, motor vehicle reports, and providing occasional support across other verification channels as needed. This role works under the guidance of the operations team and interacts with vendors to help ensure accurate and timely completion of assigned tasks. Responsibilities Social Security Traces: Process social security traces promptly and assign to vendors as directed. Add counties per client instructions and ensure basic accuracy of submitted data. Criminal Verifications: Input required counties, districts, and jurisdictions from social security traces or client requests into the system. Confirm that all names and regions are included based on provided guidelines. Turnaround Monitoring: Complete assigned verifications with attention to detail and within expected timeframes. Flag any delays to the appropriate team lead. Vendor Follow-Up: Assist with following up on vendor delays, particularly for searches pending beyond 72 hours. Communicate updates to the internal team as needed. Issue Escalation: Report any inconsistencies, incomplete results, or discrepancies to the operations team or supervisor for review and resolution. Cross-Functional Support: Provide occasional support with incoming phone calls or other verification areas during peak volume or team coverage needs. Requirements Associate or bachelor's degree preferred; high school diploma or equivalent required. 1-2 years of experience in criminal background screening including but not limited to: data entry, administrative operations, or customer service (preferably B2B) Experience handling confidential information and following industry regulations such as the FCRA Strong verbal and written communication skills with the ability to handle escalations professionally Proven attention to detail, critical thinking, and problem-solving ability Ability to type at least 45 WPM accurately and use Microsoft Excel, Word, and other office tools Comfortable using standard office equipment (e.g., computer, scanner, multi-line phone). Highly organized, self-motivated, and able to manage time effectively in a fast-paced, remote work environment Collaborate with team members and maintain a positive, solutions-oriented attitude. Benefits Generous Paid Time Off (PTO) Medical Coverage 401(k) Retirement Plan Dental Coverage Vision Coverage Telemedicine / Virtual Visits Basic Life and AD&D Insurance Short-Term Disability Insurance Long-Term Disability Insurance Employee Assistance Program (EAP) UnitedHealthcare Wellness Resources and Rewards

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. There is particular emphasis on runoff program claims for this desk. 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 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 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 *************************************************

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 is a requirement (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 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.

Remote Telecommute Work From Home Job Description: We are looking for remote, telecommuting candidates from all types of work backgrounds and skill levels to join us. This is a flexible, work from home position with highly competitive pay working as a research participant for various companies. Work-info: Due to increased demand we are now accepting a limited number of individuals to take part in our nationwide online or in person market research studies. Work-Pay info: $50 - $350 (Per 30min. to 2hr. Sessions) $150 - $3,000 (Multiple Session Studies) Work-Benefits: **Applicants will have the flexibility to choose particular studies which can be either online, in person or over the telephone. Flexibility to take part in discussions online or in-person.. No minimum hours or commitment. You can do this part-time or full-time You get to review and use new products or services before they are launched to the public. Take part and enjoy free samples from our sponsors and partners in exchange for your honest - feedback of their products. No commute needed if you choose to only work from home Participants are wanted to help with research for a variety of topics including but not limited to: · Food & Beverages · Entertainment · Social Media · Financial · Retirement · Gender · Housing · Health Issues · Consumer Products · Shopping · Internet Usage · Vehicles · Employment * Participants will have the flexibility to choose any studies based on their ability to participate either online, in person or over the telephone. Work Responsibilities: Show up at least 10 minutes prior to discussion start time. Participate by following any and all written and oral instructions. Fully complete written survey provided for each panel or study. MUST actually use products and/or services, if provided. Then be ready to discuss PRIOR to the meeting date. Work Qualifications: Willing and wanting to participate in one or several of the topics listed above Be able to read, understand and follow oral and/or written instructions Have working and reliable internet access Must be self-motivated and 100% willing & able to complete tasks assigned to you. Must have either a phone, computer or tablet with either a working camera or webcam Work Education Requirements: - Will vary by study but all education backgrounds are acceptable This is a perfect position for those looking for either temporary, part-time or full-time remote work at home. Whether your current position or job skill is a data entry clerk, administrative assistant, receptionist, warehouse or factory worker, driver, medical assistant, nurse or health care worker, call center or customer service representative or anyone who is looking for a part-time, remote, work from home job, this is an excellent position to supplement your income with great flexibility and zero prior experience needed.

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ***************** How YOU will make a Difference: As a Claims Specialist, you'll be at the heart of our mission to deliver exceptional service. Working alongside a dedicated team, you'll ensure the accurate and timely processing of medical, dental, vision, and short-term disability claims that HMA administers for our members. Your role goes beyond handling claims, you'll be a key player in shaping a positive healthcare experience for our members. Every claim you interact with helps someone navigate their healthcare journey with confidence, making your work both meaningful and impactful. What YOU will do: Carefully research discrepancies, process returned checks, issue refunds, and manage stop payments with precision. This ensures financial accuracy and builds trust with both clients and members. Manage high-importance claims and vendor billing with urgency and attention to detail. Review and reply to appeals, inquiries, and other communications related to claims. Work with third-party organizations to secure payments on outstanding balances. Process case management and utilization review negotiated claims Spot potential subrogation claims and escalate them appropriately. Actively contribute to team success by assisting colleagues when workloads peak, sharing knowledge, and fostering a collaborative environment. Requirements High school diploma required 3-5+ years of claims processing experience 2+ years of BCBS claims processing experience Strong interpersonal and communication skills Strong attention to detail, with high degree of accuracy and urgency Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving Previous success in a fast-paced environment Benefits Compensation: The base salary range for this position in the greater Seattle area is $28/hr - $32/hr for a level II and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: *****************

We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1

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. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

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. Researches and resolves co-worker process questions and concerns. 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 Graduate or equivalent. 2. HFMA Certified Revenue Cycle Representative (CRCR) Certification within 90 days of hire. 3. Completes sixteen hours of revenue cycle continuing education required annually. EXPERIENCE: 1. Six (6) years medical billing/medical office experience with Nine (9) months directly working with hospital insurance claims. PREFERRED QUALIFICATIONS: EXPERIENCE: 1. Six (6) years medical billing/medical office experience, preferably related to claims billing and insurance follow-up. 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. Accesses and utilizes all necessary computer software, applications and equipment to perform job role. 11. Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth. 12. Attends department meetings, teleconferences and webcasts as necessary. 13. Researches and processes mail returns and claims rejected by the payer. 14. Reconciles billing account transactions to ensure accurate account information according to established procedures. 15. Processes billing and follow-up transactions in an accurate and timely manner. 16. Develops and maintains working knowledge of all federal, state and local regulations pertaining to hospital billing. 17. Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts. 18. Maintains work queue volumes and productivity within established guidelines. 19. Provides excellent customer service to patients, visitors and employees. 20. Participates in performance improvement initiatives as requested. 21. Works with supervisor and manager to develop and exceed annual goals. 22. Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information. 23. Communicates problems hindering workflow to management in a timely manner. 24. Researches and resolves staff questions and concerns. Summarizes for supervisors/managers and works with leadership to resolve/improve workflows. 25. Works with HB Trainer to identify training opportunities for staff. 26. Works with Revenue Cycle Systems Coordinators to optimize Quadax and other PFS specific applications for end users. 27. Works with managers/supervisors and Contracting to prepare for payer meetings and calls by summarizing issues and collecting staff concerns. 28. Represents end users for vendor demonstrations, training sessions, payer workshops and educational sessions and communications information back to staff. 29. Exceeds productivity measures in like work group as demonstrated by Epic dashboards. 30. Leads special projects and/or other work assignments as assigned by Manager/Supervisor. 31. Assists supervisor with delegate staff work assignments. 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. 4. Visual acuity must be within normal range. 5. Must be able to communicate effectively. 6. 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 third party payers required. 5. Knowledge of business math preferred. 6. Knowledge of ICD-10 and CPT coding processes preferred. 7. Excellent customer service and telephone etiquette. 8. Ability to use tact and diplomacy in dealing with others. 9. Maintains current knowledge of third party payer and managed care billing requirements and contracts. 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

About TMHCC Tokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry, today offering over 100 products to commercial customers in 180 countries around the world. Every policy we write is special, enabling our clients to do amazing things. From insuring the crops that feed us to the rock concerts that entertain us, to rescuing international travelers in trouble. Organic growth and over 60 successful acquisitions have grown our 2023 Gross Written Premium (GWP) to over $7.5 Billion. Our workforce has grown to 4,300 worldwide … big, but not so big that you cannot make a difference. Our Good Company values, including integrity, empowerment, and commitment to customer service, and a culture of innovation, communication, and collaboration make TMHCC a great place to work. What We Offer Competitive salary and employee benefit package Strong learning culture Growth perspectives 6% 401K match 20 days of PTO and 2 Floating Days Paid parental leave An opportunity to love what you do About the job Do you want to be part of an evolving insurance line of business and a growing team? Are you interested to continue working in insurance with one of the top-rated companies in the industry? Tokio Marine HCC - Casualty Group has an exciting opportunity for a Casualty Claims Specialist. This is a great opportunity to support a critical claim unit and add significant value to the organization. The Casualty Group, a member of Tokio Marine HCC, consists of Primary Casualty, Excess Casualty and Artisan Contractors. With more than 250 years of combined underwriting experience, the Casualty Group creates customized casualty products for sophisticated liability buyers. Job Summary Handles claims that involve the investigation of coverage, liability, damages and resolution of both non-litigated and litigated claim files for primary casualty lines, with emphasis on Artisan, small- to mid-level Construction Defect and Owners, Landlords & Tenant (OL&T) claims throughout the United States. Bodily Injury experience as well. Key Responsibilities Proactively handle complex claims from the First Notice of Loss (FNOL) to resolution of the claim while working with and advising business partners. Analyze and draft coverage letters while properly communicating coverage positions to insureds, brokers and agents. Assimilate all transfer cases and have current diary on all files. All files should have been worked on and brought current. Understand and apply best practices to all files. Maintain a 1 to1 open to close ratio while reducing average indemnity and additional living expense (ALE). Conduct and proactively handle investigation of claims whenever possible. If outside vendors or experts are needed, direct and closely monitor their work. Draft high-quality reports, set timely reserves, or report to leadership cases wherein the reserves need to be set over your authority As an experienced adjuster, provide technical advice to claims leadership and underwriting. Mentor and educate less experienced adjusters. Travel to conferences, mediations, and trials as is necessary. Become proficient on all systems Education Minimum 4 Year / Bachelor's Degree in Business Administration, Accounting, Finance, a related field, or the equivalent education and/or experience Preferred Graduate Degree Doctor of Jurisprudence Certifications, Licenses, and Designations Required State Adjusting Licenses as required Preferred Chartered Property Casualty Underwriter (CPCU) Preferred Associate in Claims (AIC) Preferred OCIPs (Owner Controlled Insurance Programs) and CCIPs (Contractor Controlled Insurance Programs) Experience Relevant and progressive experience in handling construction defect and bodily injury cases throughout the United States. Deep knowledge of Construction defect claims Must be highly proficient in coverage and have handled coverage litigation on behalf of a carrier Must posses a high understanding of Risk Transfer and Recovery Proficient in Litigation Management with an emphasis on legal budget creation and review Knows the most effective and efficient methods to get things done, with a focus on continuous improvement and innovation

Overview Advanced Hearing Providers (“AHP”) coordinates hearing healthcare services for employees with workers' compensation claims. We connect patients with our nationwide network of qualified hearing healthcare providers on behalf of our clients; the payers and third-party administrators of workers' compensation claims. We are seeking hard-working, self-motivated candidates with a positive attitude who like the idea of being involved in the process of helping people hear better. The position of Claims Specialist (“CS”) I plays a critical role in the operation of the organization. The main function of an AHP CS I is coordinating authorized hearing healthcare for covered employees. AHP staff work as a TEAM - this is crucial! We expect team members to build trust and respect for each other by producing consistent results and going above and beyond, especially to help each other. Even though each CS will be working on their own assigned cases, interaction with other team members, clients, providers, and patients will occur often. Responsibilities - Obtain a complete, thorough understanding of the workers' compensation claims administration process, fees and participants. - Adhere to customer Service Level Agreements (SLAs) by maintaining contact with clients, providers, and claimants/patients as prescribed to ensure all parties are kept informed of the process status. - Successfully prioritize the workday utilizing our task-based systems, resulting in achieving daily completion of all required tasks (ensuring SLA compliance). - Ensure orders are properly documented in a timely manner. - Demonstrate an understanding of the workers' compensation referral and RFA process - Demonstrate an understanding of navigating client/claimant requirements to ensure billable item eligibility is reviewed prior to submitting requests to client - Perform verification of all HCPC/CPT codes that will be requested. This includes not only verifying eligibility but confirming whether NCCI edits and/or a state fee schedule (SFS), is applicable. - Coordinate the completion of necessary documentation to be filed with state agencies when applicable. - Maintain a high degree of detail and accuracy throughout the claim administration process. - Cross utilize phone, email, and fax for communication to ensure efficient processing time. - Assist with phone answering and intake related duties. - Demonstrate basic to intermediate level process understanding and ability to critically think and solution for complex situations that arise. - Other duties as assigned by the manager Qualifications - Advanced knowledge and experience with computer systems and business software programs, in particular Salesforce, Word, Excel, Outlook, Office 365 Apps and Adobe Acrobat - Previous workers' compensation, insurance claims management, and/or hearing healthcare industry experience is preferred - Bilingual skills will be extremely helpful with some patients - Excellent grammar and written skills - Ability to type at a minimum of 40 WPM - Ability to travel for training and occasional on-site meetings Other Personal Characteristics and Experience - Communicate clearly, professionally and in a timely manner. - Manage multiple tasks simultaneously in a proficient manner. - Ability to maintain professional client and provider relationships. - Work collaboratively with colleagues, including regularly providing direct support by completing team members' tasks for them as needed. - Understand when situational discretion must be employed in the handling and sharing of client, provider, and/or claimant information. - Self-motivated; ability to work independently - Must have a high attention to detail - Must be coachable and receptive to feedback - Must be dependable and consistent - Ability to take a proactive approach to all situations - Driven by a focus on reaching a specific objective or accomplishing a given task - Eagerness to adapt to new methods - Obtain satisfaction from delivering great customer service - Willing to try new things/operate outside of your comfort zone EDUCATION - HS Diploma or equivalent Company Values We Create Trust- We value the opinions of our customers and colleagues. We promote a work environment based on inclusion, honesty, integrity and respect. We always keep our promises. We are Team Players- We collaborate and network effectively across Demant. We take initiative and help each other to achieve our ambitious goals. We Create Innovative Solutions- We challenge ourselves to improve and find new, value-adding solutions. We are curious to share ideas and insights to increase our collective innovativeness. We Apply a Can-do attitude- We always look for opportunities to win the business and do our best to add value to our customers. We find solutions and act. What we have to offer: Medical, dental, prescription, and vision benefits 24/7 virtual medical care Employee Assistance Program for you and your family 401(k) with company match Company-paid life insurance Supplemental insurance for yourself, your spouse/partner, and your children Short-term and long-term disability insurance Pre-tax Health Savings Account and Flexible Spending Accounts for Health Care or Dependent Care Pet Insurance Commuter accounts The Company is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status. The pay range for this position is expected to be between $18.90-22.05 hourly; however, while the salary range is effective as of the date of this posting, fluctuations in the job market may necessitate adjustments to pay ranges. Further, final pay determinations will depend on various factors, including but not limited to experience level, knowledge, skills, and abilities. The total compensation package for this position may also include other elements, such as bonus, commissions, or discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. #Birdsong #LI-JB1 #LI-REMOTE

Shape Your Future With UsGeneral Re Corporation, a subsidiary of Berkshire Hathaway Inc., is a holding company for global reinsurance and related operations, with more than 2,000 employees worldwide. It owns General Reinsurance Corporation and General Reinsurance AG, which conducts business as Gen Re. Gen Re delivers reinsurance solutions to the Life/Health and Property/Casualty insurance industries. Represented in all major reinsurance markets through a network of 38 offices, we have earned superior financial strength ratings from each of the major rating agencies. Gen Re currently offers an excellent opportunity for a Claims Specialist in our Life Health Global Claims unit to work remotely based out of our Stamford, CT office. Role Description The Claim Specialist is responsible for the delivery of the reinsurance claim risk management on multiple lines of business to both internal and external Gen Re clients. This includes, but is not limited to, the risk assessment of reinsurance liability and may include client training development and delivery, audit activities as well as representing the company and/or speaking at various industry conferences, as requested. Responsibilities: Responsible timely decision making and accuracy of reinsurance determinations on multiple lines of claim submissions. Incumbent contributes to the accurate and efficient adjudication of claims by supporting the department and client's investigation or coaching/mentoring on claims in all ranges of complexity to ensure compliance with policy provisions, state/federal regulations and reinsurance treaties in effect. Maintains a working knowledge of state and federal regulatory issues and keeps on the cutting edge of changes within the incumbent's area of expertise. Deliver high levels of customer service to internal and external customers in a professional, reliable and responsive manner. The incumbent works with claims management to develop, prioritize and execute a claim management strategy for each assigned client. Responsible for influencing a variety of constituents at various levels and not within one's direct employ. Thus, being accountable for the effective development, ongoing maintenance and consistent application of client communications and relationships. As an expert claim resource within a specific line of business, the Claim Specialist monitors national verdict/settlement trends and legal developments pertaining to their particular line of business. The incumbent researches, drafts and publishes articles and training oriented to educating clients on best practices gleaned. Responds to ad hoc reporting /projects from manager. Timely and accurate reporting of statistical information to management. Provides a broad range of regular (monthly/quarterly) management information in support of the Claims Department. Responsible for synthesizing a large amount of information from a variety of sources. May participate in client / TPA due diligence activities such as supporting audit activity, identifying emerging trends and themes not only in the client's inventory but within the industry; supporting manager with industry gleaned best practices via building and delivering customer specific training programs and seminars; emphasizing and implementing technical solutions to business needs to achieve desired improvements when asked. May participate in client meetings or with prospective accounts. Role Qualifications and Experience Prior claims experience in insurance and/or reinsurance operations. Prior experience managing claims (preferably LTC or Income Protection) thereby equipping the incumbent with the ability to assess reinsurer responsibility in its broadest sense (e.g. reviewing and offering risk management insights and recommendations on facultative and consultative claim submissions). Experience auditing claim files. Audit work of reinsured claims remotely or in client locations is an expectation. The audit process requires the ability to quickly adapt to the multitude of imaged systems in use by clients. The audit process may involve analyzing and verifying coverage and/or corresponding payments issued. The audit process may consist of managing internal and external communication with client executives in various areas such as claims, financial and legal resources, actuarial resources, etc. Thus, demonstrating an ability to emphasize and implement solutions to help clients manage risk and developing an in-depth knowledge of the management and organization of each assigned account. Holds insurance adjuster's license or a willingness to secure same within 1 year of hire Strong working knowledge of key coverage lines especially health (Long Term Care, Individual Disability) type claims Strong written and verbal communication skills Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously or as an effective member of a team Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to detail Flexibility to travel for business purposes, approximately less than 10 trips per year Strong client relationship, influencing and interpersonal skills Proven initiative, prioritization, presentation, and training abilities. Experience with and proficiency in Microsoft Suite of Products (WORD, EXCEL, PowerPoint), Visio, Power BI, developing and running queries etc. Salary Range 91,000.00 - 152,000.00 USD The annual base salary range posted represents a broad range of salaries around the US and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. Our Corporate Headquarters Address General Reinsurance Corporation 400 Atlantic Street, 9th Floor Stamford, CT 06901 (US) At General Re Corporation, we celebrate diversity and are committed to creating an inclusive environment for all employees. It is the General Re Corporation's continuing policy to afford equal employment opportunity to all employees and applicants for employment without regard to race, color, sex (including childbirth or related medical conditions), religion, national origin or ancestry, age, past or present disability , marital status, liability for service in the armed forces, veterans' status, citizenship, sexual orientation, gender identity, or any other characteristic protected by applicable law. In addition, Gen Re provides reasonable accommodation for qualified individuals with disabilities in accordance with the Americans with Disabilities Act.

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.

We are recruiting 100 entry level Remote Insurance Verification Representatives in FL, NV, SD, TX, and WY. If you are looking for steady work from home with consistent pay then this is the opportunity for you. To make sure this is a fit for you, please understand: You will be on the phone the entire shift. You will need to overcome simple objections and maintain a positive attitude. You will need to purchase a USB Headset (if you don't already have one). True W2 pay check and direct deposit company (not gimmick 1099 pay) No phone line needed No cellphone needed No driving required No people to meet No packaging materials No shipping No ebay accounts No phone experience needed (but a serious advantage) Company Culture This compant prides itself on empowering their team to be responsible, "show up" on time for their shift(s), and stay focused on their task(s) the whole time. Working from home is a blessing, but it can also be the biggest distraction. That's why they their staff with the utmost respect and expect the same from them. This is a serious opportunity from one of the most modern work from home companies on the planet. They are literally a bunch of people spread out around the country with a common goal of helping select customers complete their car insurance quotes. They skype together all day and everyone supports eachother as a team even though 95% all work from REMOTE locations. This company has been in the online and insurance marketing business for over 3 years now, and the founder has been in this industry for over 10 years now. Compensation $8.25/hr starting or 3$ per lead depending on which is more. Focused and aggressive verifiers make $15-$19 an hour. Scheduling The shifts that are available are 9am-1pm / 1pm-5pm / 5pm-9pm M-F. (Eastern Time). Depending on your location and availability you will be assigned (1) of these shifts temporarily until you are well trained and established. You will start as PART TIME. Once you are established Full time is possible and many reps choose full time. Full on-going success training is provided. (You are NOT required to purchase training materials or anything from them or us.) Again all you need is your own computer, high speed internet, 5 MBPS Download Speeds and 1 MBPS Upload Speeds USB headset.

At Globe Life we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to Make Tomorrow Better. Role Overview: Could you be our next Part-Time Insurance Verification Specialist? Globe Life is looking for a Part-Time Insurance Verification Specialist to join the team! In this role, you will verify life and health insurance applications directly with potential customers. This is a vital part of our Company's New Business and Underwriting process. The information you verify and gather directly affects whether the Company will decline or issue a policy. This is a remote / work-from-home position. What You Will Do: Make outbound calls to potential customers to verify and document required information to finalize applications for underwriting assessment. Use the Quality Assurance database and conduct appropriate assessments on what additional customer information or verification is needed. Clearly explain the application process to potential customers. Accurately complete additional paperwork as needed. Maintain appropriate levels of communication with management regarding actions taken within the Quality Assurance database. Transfer calls to the appropriate department as needed. Successfully meet the minimum expectation for departmental key performance indicators (K.P.I's). Be enlisted in special projects that encompass making numerous outbound calls, recording activities requested by/from customers, etc. What You Can Bring: Minimum typing requirement of 35 wpm. Bilingual English and Spanish preferred Superior customer service skills required - friendly, efficient, good listener. Proficient use of the computer, keyboard functions, and Microsoft Office. Ability to multitask and work under pressure. Knowledge of medical terminology and spelling is a plus. Excellent organization and time management skills. Must be detail-oriented. Have a desire to learn and grow within the Company. Applicable To All Employees of Globe Life Family of Companies: Reliable and predictable attendance of your assigned shift. Ability to work full-time and/or part-time based on the position specifications.

About Us: At Snapscale, we partner with growing healthcare providers to deliver scalable back-office support. We're seeking an experienced Insurance Verification Specialist to join our remote team, focusing on Physical Therapy practices. This role is critical to ensuring accurate insurance verification and benefit coordination to keep patient care and billing flowing smoothly. Key Responsibilities:Empty heading Verify insurance benefits, eligibility, and prior authorization requirements for Physical Therapy services. Confirm coverage details by communicating with insurance carriers and documenting outcomes clearly in the EHR. Identify and flag limitations, deductibles, copays, coinsurance, and authorization needs. Collaborate with intake, billing, and clinical teams to ensure a seamless patient onboarding process. Maintain accurate records in compliance with HIPAA and company documentation standards. Stay up-to-date with payer rules, coverage trends, and authorization workflows specific to PT practices. Proactively resolve discrepancies and escalate coverage issues when necessary. Required Qualifications: 4+ years of insurance verification experience, including 2+ years in a Physical Therapy or Rehab setting. Solid grasp of PT-specific billing and authorization workflows. Familiarity with EHRs and verification platforms like Availity, Navinet, or payer portals. Excellent written and verbal communication skills. Strong attention to detail, with the ability to problem-solve and work independently. Comfortable working in a remote, fast-paced environment and meeting daily verification targets. Knowledge of HIPAA regulations and a commitment to compliance. Preferred Qualifications: Experience supporting multiple PT clinics or multi-location practices. Prior work with US-based clients or BPO healthcare firms. Familiarity with Medicare and commercial insurance plans common in PT.

Health Insurance Verification Specialist | Atos Medical-US | New Berlin, WI This position is remote but requires you to be commutable to New Berlin, WI for orientation and training/employee events as needed. Join a growing company with a strong purpose! Do you want to make a difference for people breathing, speaking and living with a neck stoma? At Atos Medical, our people are the strength and key to our on-going success. We create the best customer experience and thereby successful business through our 1200 skilled and engaged employees worldwide. About Atos Medical Atos Medical is a specialized medical device company and the clear market and technology leader for voice and pulmonary rehabilitation for cancer patients who have lost their voice box. We design, manufacture, and sell our entire core portfolio directly to leading institutions, health care professionals and patients. We believe everyone should have the right to speak, also after their cancer. That's why we are committed to giving a voice to people who breathe through a stoma, with design solutions and technologies built on decades of experience and a deep understanding of our users. Atos Medical has an immediate opening for a Health Insurance Verification Specialist in the Insurance Department. Summary The Health Insurance Verification Specialist will support Atos Medical's mission to provide a better quality of life for laryngectomy customers by assisting with the attainment of our products through the insurance verification process and reimbursement cycle. A successful Health Insurance Verification Specialist in our company uses client information and insurance management knowledge to perform insurance verifications, authorizations, pre-certifications, and negotiations. The Health Insurance Verification Specialist will analyze and offer advice to our customers regarding insurance matters to ensure a smooth order process workflow. They will also interact and advise our internal team members on schedules, decisions, and potential issues from the Insurance payers. Essential Functions Act as an advocate for our customers in relation to insurance benefit verification. Obtain and secure authorization, or pre-certifications required for patients to acquire Atos Medical products. Verifies the accuracy and completeness of patient account information. Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third party payer requirements/on-line eligibility systems. Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for customers. Follows up with physician offices, customers and third-party payers to complete the pre-certification process. Requests medical documentation from providers not limited to nurse case reviewers and clinical staff to build on claims for medical necessity. Collaborates with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations. Answer incoming calls from insurance companies and customers and about the insurance verification process using appropriate customer service skills and in a professional, knowledgeable, and courteous manner. Educates customers, staff and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance related changes or trends. Verifies that all products that require prior authorizations are complete. Updates customers and customer support team on status. Assists in coordinating peer to peer if required by insurance payer. Notifies patient accounts staff/patients of insurance coverage lapses, and self-pay patient status. May notify customer support team if authorization/certification is denied. Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans. Inquire about gap exception waiver from out of network insurance payers. Educate medical case reviewers at Insurance Companies about diagnosis and medical necessity of Atos Medical products. Obtaining single case agreements when requesting an initial authorization with out of network providers. This process may entail the negotiation of pricing and fees and will require knowledge of internal fee schedules, out of network benefits, and claims information. Complete all Insurance Escalation requests as assigned and within department guidelines for turn around time. Maintains reference materials for Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans. Other duties as assigned by the management team. Basic Qualifications High School Diploma or G.E.D Experience in customer service in a health care related industry. Preferred Qualifications 2+ years of experience with medical insurance verification background Licenses/Certifications: Medical coding and billing certifications preferred Experience with following software preferred: Salesforce, SAP, Brightree, Adobe Acrobat Knowledge Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans. Additional Benefits Flexible work schedules with summer hours Market-aligned pay 401k dollar-for-dollar matching up to 6% with immediate vesting Comprehensive benefit plan offers Flexible Spending Account (FSA) Health Savings Account (HSA) with employer contributions Life Insurance, Short-term and Long-term Disability Paid Paternity Leave Volunteer time off Employee Assistance Program Wellness Resources Training and Development Tuition Reimbursement Atos Medical, Inc. is an Equal Opportunity/Affirmative Action Employer. Our Affirmative Action Plan is available upon request at ************. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Equal Opportunity Employer Veterans/Disabled. To request reasonable accommodation to participate in the job application, please contact ************. Founded in 1986, Atos Medical is the global leader in laryngectomy care as well as a leading developer and manufacturer of tracheostomy products. We are passionate about making life easier for people living with a neck stoma, and we achieve this by providing personalized care and innovative solutions through our brands Provox , Provox Life™ and Tracoe. We know that great customer experience involves more than first-rate product development, which is why clinical research and education of both professionals and patients are integral parts of our business. Our roots are Swedish but today we are a global organization made up of about 1400 dedicated employees and our products are distributed to more than 90 countries. As we continue to grow, we remain committed to our purpose of improving the lives of people living with a neck stoma. Since 2021, Atos Medical is the Voice and Respiratory Care division of Coloplast A/S 56326 #LI-AT