515 Claims Administration jobs in the United States
Associate I, Legal Claims Administration
92713 Irvine, California
Stretto
Posted 23 days ago
Job Viewed
Job Description
Associate I
Job Description
Stretto is hiring Associates in our Legal Claims Administration department. In this exciting role, you will learn in this fast-paced and dynamic part of our business, and successful employees will have the opportunity to pursue a career progression plan and transition into senior roles based on developed skills and competencies. A typical career path from the Associate position would be a promotion to Senior Associate, then Director.the sky is the limit.
Position Summary: The Associate will support case teams and will work alongside counsel, financial advisors, and tax professionals to help administer large and complex Federal Equity and State-Court Receiverships, among other types of claim administration projects cases. We are hiring for this position to work in our Irvine, California or New York City office, on a hybrid schedule (2-3 days per week in the office).*
The Associate will take direction from their manager and will assist with data processing and various projects to support the case teams. More specifically, this individual will be responsible for assisting in managing and maintaining public websites in order to provide case information to creditors, processing of incoming documents including filed claims and ballots, and any other tasks or duties that may be required to help administer cases.
A Day in the Life of an Associate I:
* Please note that this is an in-office position for the first two months of employment and then you will convert to a hybrid role 2-3 days per week in the office . We want you to train with and learn from your colleagues: the rest of the time you can work from home or continue to work in the office - your choice.
The hourly pay range for this role is currently $22.50 - $24.50. The Company's salary ranges are determined by role, level, location and alignment with market data. Individual pay is determined through interviews and an assessment of various factors, including job-related skills, relevant education and experience, abilities of the applicant and equity with other team members. The hourly base salary range listed here is subject to change at any time, at the Company's discretion, and does not alter in any way the at-will nature of the employment relationship.
Stretto offers a competitive and comprehensive benefits package, along with opportunities for growth. We are an equal opportunity employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, national origin, gender, age, religion, disability, sexual orientation, veteran status, marital status or any other characteristics protected by law.
Job Description
Stretto is hiring Associates in our Legal Claims Administration department. In this exciting role, you will learn in this fast-paced and dynamic part of our business, and successful employees will have the opportunity to pursue a career progression plan and transition into senior roles based on developed skills and competencies. A typical career path from the Associate position would be a promotion to Senior Associate, then Director.the sky is the limit.
Position Summary: The Associate will support case teams and will work alongside counsel, financial advisors, and tax professionals to help administer large and complex Federal Equity and State-Court Receiverships, among other types of claim administration projects cases. We are hiring for this position to work in our Irvine, California or New York City office, on a hybrid schedule (2-3 days per week in the office).*
The Associate will take direction from their manager and will assist with data processing and various projects to support the case teams. More specifically, this individual will be responsible for assisting in managing and maintaining public websites in order to provide case information to creditors, processing of incoming documents including filed claims and ballots, and any other tasks or duties that may be required to help administer cases.
A Day in the Life of an Associate I:
- Interact with case teams, and various investors and creditors
- Collect, manage, and maintain large volumes of records in a database
- Assist in coordinating service of documents including large-scale mailings
- Maintain websites, case calendars, and general case information
- Review contracts and other documents to extract relevant data
- Examine and reconcile claim and address data
- Assist in data management and improvement projects, including name and address research, de-duplication, name change / validation, among other types of projects
- Provide support to investors and creditors by accurately responding to inquiries received via phone, email, chat, or mail, related to basic case information/status, claims, solicitation, and/or distributions
- Other projects or tasks as required by Case Teams
- Bachelor's Degree (preferred)
- Two years of paralegal or similar experience in bankruptcy, receivership or claims-related industry (preferred)
- Excellent attention to detail
- Good problem solving skills
- Excellent communicator and ability to work with people at all levels within and outside the company
- A professional, trustworthy individual with a high level of integrity
- Competitive pay
- Annual discretionary bonus plan for top performers
- 401K with generous matching
- Excellent and comprehensive health benefits
- Generous time off plan, including Sick and Parental Leave
- Department lunches provided a few times per month
- Ability to learn from the best in our industry, with opportunities to advance
* Please note that this is an in-office position for the first two months of employment and then you will convert to a hybrid role 2-3 days per week in the office . We want you to train with and learn from your colleagues: the rest of the time you can work from home or continue to work in the office - your choice.
The hourly pay range for this role is currently $22.50 - $24.50. The Company's salary ranges are determined by role, level, location and alignment with market data. Individual pay is determined through interviews and an assessment of various factors, including job-related skills, relevant education and experience, abilities of the applicant and equity with other team members. The hourly base salary range listed here is subject to change at any time, at the Company's discretion, and does not alter in any way the at-will nature of the employment relationship.
Stretto offers a competitive and comprehensive benefits package, along with opportunities for growth. We are an equal opportunity employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, national origin, gender, age, religion, disability, sexual orientation, veteran status, marital status or any other characteristics protected by law.
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0
Associate II, Legal Claims Administration
92713 Irvine, California
Stretto
Posted 23 days ago
Job Viewed
Job Description
Associate II
Job Description
Stretto is looking to hire an Associate II in our Legal Claims Administration department. In this exciting role, you will learn in this fast-paced and dynamic part of our business, and successful employees will have the opportunity to pursue a career progression plan and transition into senior roles based on developed skills and competencies. A typical career path from the Associate II position would be a promotion to Senior Associate, then Director.the sky is the limit.
Position Summary: The Associate II will support case teams while also helping to manage projects and junior team members. The Associate II will work alongside counsel, financial advisors, and tax professionals to help administer large and complex Federal Equity and State-Court Receiverships, among other types of claim administration projects cases. We are hiring for this position to work in our Irvine, California or New York City office, on a hybrid schedule (2-3 days per week in the office).*
The Associate II will take direction from their manager and will assist with various projects to support the case teams. More specifically, this individual will be responsible for assisting in managing and maintaining public websites, online claim portals, processing of incoming documents, such as filed claims and W-9 forms, assisting in executing noticing projects, address research, and other data management tasks, responding to client and investor / creditor inquiries, assisting in connection with distribution projects and any other tasks or duties that may be required to help administer receivership or other LCA matters / cases / projects.
A Day in the Life of an Associate II:
(*Please note that this is an in-office position for the first two months of employment and then you will convert to a hybrid role 2-3 days per week in the office . We want you to train with and learn from your colleagues: the rest of the time you can work from home or continue to work in the office - your choice.)
The hourly pay range for this role is currently $28.50 - 32.50. The Company's salary ranges are determined by role, level, location and alignment with market data. Individual pay is determined through interviews and an assessment of various factors, including job-related skills, relevant education and experience, abilities of the applicant and equity with other team members. The hourly base salary range listed here is subject to change at any time, at the Company's discretion, and does not alter in any way the at-will nature of the employment relationship.
Stretto offers a competitive and comprehensive benefits package, along with opportunities for growth. We are an equal opportunity employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, national origin, gender, age, religion, disability, sexual orientation, veteran status, marital status or any other characteristics protected by law.
Job Description
Stretto is looking to hire an Associate II in our Legal Claims Administration department. In this exciting role, you will learn in this fast-paced and dynamic part of our business, and successful employees will have the opportunity to pursue a career progression plan and transition into senior roles based on developed skills and competencies. A typical career path from the Associate II position would be a promotion to Senior Associate, then Director.the sky is the limit.
Position Summary: The Associate II will support case teams while also helping to manage projects and junior team members. The Associate II will work alongside counsel, financial advisors, and tax professionals to help administer large and complex Federal Equity and State-Court Receiverships, among other types of claim administration projects cases. We are hiring for this position to work in our Irvine, California or New York City office, on a hybrid schedule (2-3 days per week in the office).*
The Associate II will take direction from their manager and will assist with various projects to support the case teams. More specifically, this individual will be responsible for assisting in managing and maintaining public websites, online claim portals, processing of incoming documents, such as filed claims and W-9 forms, assisting in executing noticing projects, address research, and other data management tasks, responding to client and investor / creditor inquiries, assisting in connection with distribution projects and any other tasks or duties that may be required to help administer receivership or other LCA matters / cases / projects.
A Day in the Life of an Associate II:
- Interact with Case Teams, and various investors and creditors
- Collect, manage, and maintain large volumes of records in a database
- Assist in coordinating service of documents including large-scale mailings
- Maintain websites, calendars, and general case information
- Review contracts and other documents to extract relevant data
- Examine and assist in reconciling claim information
- Assist in managing address files, including address research
- Assist in developing and managing on-line claim portals
- Participate and support Case Team and client meetings
- Manage and provide support to investors and creditors by accurately responding to inquiries received via phone, email, chat, or mail, related to basic case information/status, claims, solicitation, and/or distributions
- Other projects or tasks as required by Case Teams
- Bachelor's Degree (preferred)
- Three years paralegal or similar experience in bankruptcy, receivership or other claims-related industry (preferred)
- Excellent attention to detail
- Good problem solving skills
- Excellent communicator and ability to work with people at all levels within and outside the company
- A professional, trustworthy individual with a high level of integrity
- Competitive pay
- Annual discretionary bonus plan for top performers
- 401K with generous matching
- Excellent and comprehensive health benefits
- Generous time off plan, including Sick and Parental Leave
- Department lunches provided a few times per month
- Ability to learn from the best in our industry, with opportunities to advance
(*Please note that this is an in-office position for the first two months of employment and then you will convert to a hybrid role 2-3 days per week in the office . We want you to train with and learn from your colleagues: the rest of the time you can work from home or continue to work in the office - your choice.)
The hourly pay range for this role is currently $28.50 - 32.50. The Company's salary ranges are determined by role, level, location and alignment with market data. Individual pay is determined through interviews and an assessment of various factors, including job-related skills, relevant education and experience, abilities of the applicant and equity with other team members. The hourly base salary range listed here is subject to change at any time, at the Company's discretion, and does not alter in any way the at-will nature of the employment relationship.
Stretto offers a competitive and comprehensive benefits package, along with opportunities for growth. We are an equal opportunity employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, national origin, gender, age, religion, disability, sexual orientation, veteran status, marital status or any other characteristics protected by law.
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1
Claims & Legal Administration Manager - Universal Horror Unleashed
89105 North Las Vegas, Nevada
Universal Orlando Resort
Posted 2 days ago
Job Viewed
Job Description
Universal Horror Unleashed is a terrifyingly unique experience that will bring haunts to Las Vegas year-round. Located at Area 15 is the heart of horror we would love to have you haunting alongside us! With the nature of this experience comes a unique working environment. You will find yourself working in dark environments around special effects including strobe lights, fog, artificial smells, and more. The working hours will be unique, typically spanning over late evenings/nights and weekends (holidays included). This position is eligible for company sponsored benefits, including medical, dental and vision insurance, 401(k), paid leave, and a variety of other discounts and perks.
JOB SUMMARY:
The Manager, Claims and Legal Administration is responsible for overseeing liability claims and litigation, managing the Workers Compensation program, and implementing risk mitigation strategies. This role collaborates with Comcast Risk Management and NBCU Litigation, internal stakeholders, third-party administrators, outside counsel, and medical providers to conduct investigations and audits of incidents involving guests and Team Members, collect witness statements and respond to discovery requests, ensure effective claims handling, compliance, and communication. The Manager will work with the Comcast Risk Management and Universal Horror Unleashed Management teams to develop and maintain a Transitional Duty program and provide data-driven insights to support risk mitigation efforts. Additionally, they deliver training programs as developed in collaboration with UDX Claims Management Team Members to educate internal partners on Workers Compensation and Risk Management best practices, as well as act as the liaison on contract and other legal issues with the UDX Legal & Business Affairs Department.
JOB RESPONSIBILITIES:
- Manages Liability claims and litigation by working with internal and external partners to request, gather, and evaluate documentation and evidence to include reviewing and responding to discovery requests, pleadings, working with internal partners and outside counsel to schedule and attend site inspections, mediations, and meetings with outside counsel. Responsible for managing the relationship with outside defense counsel.
- Manages the Workers Compensation program by collaborating with business leaders, Comcast Risk Management, the Third-Party Administrator, and medical providers to ensure clear communication with injured Team Members. Oversees claim evaluation, documentation collection, submission, and follow-up to facilitate effective claims management.
- Reviews, investigates, and audits incident reports and data involving guests, third parties, and injured Team Members. Establishes reports to track relevant information on claims and litigation and to track and report on trends to the business to support risk mitigation efforts.
- Assists in developing and maintaining a Transitional Duty program to include job identification and assignment, department and employee liaison, job rotation, meetings, pay/time adjustments, and permanent assignments as necessary.
- Assists in developing and provides training and education opportunities to internal business partners on Risk Management and Workers Compensation. Acts as the liaison between the UHU operational teams and the UDX Legal & Business Affairs team on outstanding contractual matters and tracking of legal and other claims matters.
- Understands and actively participates in Environmental, Health & Safety responsibilities by following established UDX policy, procedures, training, and Team Member involvement activities.
- Perform other duties as assigned.
SUPERVISORY RESPONSIBILITY:
- No supervisory responsibilities
ADDITIONAL INFORMATION:
- ARM, CRM, and/or licensed adjuster preferred.
- Ability to work with clients and business partners at multiple locations.
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities (KSAs) required.
- Knowledge of relevant Workers Compensation laws and claims management principles in Nevada
- Knowledge of relevant Nevada tort and civil procedure laws
- Data Analytics with root cause analysis
- Quantitative reasoning skills
- Strong presentation and writing skills
- Strong communication skills
- Ability to make independent judgments based upon known facts
- Conflict resolution skills
- Case organization skills
- Negotiating skills
- Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- Consistent attendance is a job requirement.
EDUCATION:
- Bachelors degree is required in Business Management, Risk Management, Law, Health Care Admin, HR, or related field. J.D. or advanced degree in related field preferred.
EXPERIENCE:
- 5+ years of Risk Management and claims experience to include liability, Workers Compensation, and managing litigation required; or equivalent combination of education and experience.
- Experience should include managing Workers Compensation and Liability claims and litigation in the State of Nevada; or equivalent combination of education and experience.
Your talent, skills and experience will be rewarded with a competitive compensation package.
#J-18808-Ljbffr
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2
Claims & Legal Administration Manager - Universal Horror Unleashed
32806 Orlando, Florida
NBC Universal
Posted today
Job Viewed
Job Description
Universal Horror Unleashed is a terrifyingly unique experience that will bring haunts to Las Vegas year-round. Located at Area 15 is the heart of horror - we would love to have you haunting alongside us! With the nature of this experience comes a unique working environment. You will find yourself working in dark environments around special effects including strobe lights, fog, artificial smells, and more. The working hours will be unique, typically spanning over late evenings/nights and weekends (holidays included). This position is eligible for company sponsored benefits, including medical, dental and vision insurance, 401(k), paid leave, and a variety of other discounts and perks.
JOB SUMMARY:
The Manager, Claims and Legal Administration is responsible for overseeing liability claims and litigation, managing the Workers' Compensation program, and implementing risk mitigation strategies. This role collaborates with Comcast Risk Management and NBCU Litigation, internal stakeholders, third-party administrators, outside counsel, and medical providers to conduct investigations and audits of incidents involving guests and Team Members, collect witness statements and respond to discovery requests, ensure effective claims handling, compliance, and communication. The Manager will work with the Comcast Risk Management and Universal Horror Unleashed Management teams to develop and maintain a Transitional Duty program and provide data-driven insights to support risk mitigation efforts. Additionally, they deliver training programs as developed in collaboration with UDX Claims Management Team Members to educate internal partners on Workers' Compensation and Risk Management best practices, as well as act as the liaison on contract and other legal issues with the UDX Legal & Business Affairs Department.
JOB RESPONSIBILITIES:
+ Manages Liability claims and litigation by working with internal and external partners to request, gather, and evaluate documentation and evidence to include reviewing and responding to discovery requests, pleadings, working with internal partners and outside counsel to schedule and attend site inspections, mediations, and meetings with outside counsel. Responsible for managing the relationship with outside defense counsel.
+ Manages the Workers' Compensation program by collaborating with business leaders, Comcast Risk Management, the Third-Party Administrator, and medical providers to ensure clear communication with injured Team Members. Oversees claim evaluation, documentation collection, submission, and follow-up to facilitate effective claims management.
+ Reviews, investigates, and audits incident reports and data involving guests, third parties, and injured Team Members. Establishes reports to track relevant information on claims and litigation and to track and report on trends to the business to support risk mitigation efforts.
+ Assists in developing and maintaining a Transitional Duty program to include job identification and assignment, department and employee liaison, job rotation, meetings, pay/time adjustments, and permanent assignments as necessary.
+ Assists in developing and provides training and education opportunities to internal business partners on Risk Management and Workers' Compensation. Acts as the liaison between the UHU operational teams and the UDX Legal & Business Affairs team on outstanding contractual matters and tracking of legal and other claims matters.
+ Understands and actively participates in Environmental, Health & Safety responsibilities by following established UDX policy, procedures, training, and Team Member involvement activities.
+ Perform other duties as assigned.
SUPERVISORY RESPONSIBILITY:
+ No supervisory responsibilities
ADDITIONAL INFORMATION:
+ ARM, CRM, and/or licensed adjuster preferred.
+ Ability to work with clients and business partners at multiple locations.
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities (KSAs) required.
+ Knowledge of relevant Workers Compensation laws and claims management principles in Nevada
+ Knowledge of relevant Nevada tort and civil procedure laws
+ Data Analytics with root cause analysis
+ Quantitative reasoning skills
+ Strong presentation and writing skills
+ Strong communication skills
+ Ability to make independent judgments based upon known facts
+ Conflict resolution skills
+ Case organization skills
+ Negotiating skills
+ Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
+ Consistent attendance is a job requirement.
EDUCATION:
+ Bachelor's degree is required in Business Management, Risk Management, Law, Health Care Admin, HR, or related field. J.D. or advanced degree in related field preferred.
EXPERIENCE:
+ 5+ years of Risk Management and claims experience to include liability, Workers' Compensation, and managing litigation required; or equivalent combination of education and experience.
+ Experience should include managing Workers' Compensation and Liability claims and litigation in the State of Nevada; or equivalent combination of education and experience.
Your talent, skills and experience will be rewarded with a competitive compensation package.
Universal is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Universal Destinations & Experiences via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Universal Destinations & Experiences HR/Recruitment will be deemed the sole property of Universal Destinations & Experiences. No fee will be paid in the event the candidate is hired by Universal Destinations & Experiences as a result of the referral or through other means.
Universal Horror Unleashed. Here you can.
Universal Destinations & Experiences is an equal opportunity employer. Universal elements and all related indicia TM & © 2024 Universal Studios. All rights reserved. EOE
JOB SUMMARY:
The Manager, Claims and Legal Administration is responsible for overseeing liability claims and litigation, managing the Workers' Compensation program, and implementing risk mitigation strategies. This role collaborates with Comcast Risk Management and NBCU Litigation, internal stakeholders, third-party administrators, outside counsel, and medical providers to conduct investigations and audits of incidents involving guests and Team Members, collect witness statements and respond to discovery requests, ensure effective claims handling, compliance, and communication. The Manager will work with the Comcast Risk Management and Universal Horror Unleashed Management teams to develop and maintain a Transitional Duty program and provide data-driven insights to support risk mitigation efforts. Additionally, they deliver training programs as developed in collaboration with UDX Claims Management Team Members to educate internal partners on Workers' Compensation and Risk Management best practices, as well as act as the liaison on contract and other legal issues with the UDX Legal & Business Affairs Department.
JOB RESPONSIBILITIES:
+ Manages Liability claims and litigation by working with internal and external partners to request, gather, and evaluate documentation and evidence to include reviewing and responding to discovery requests, pleadings, working with internal partners and outside counsel to schedule and attend site inspections, mediations, and meetings with outside counsel. Responsible for managing the relationship with outside defense counsel.
+ Manages the Workers' Compensation program by collaborating with business leaders, Comcast Risk Management, the Third-Party Administrator, and medical providers to ensure clear communication with injured Team Members. Oversees claim evaluation, documentation collection, submission, and follow-up to facilitate effective claims management.
+ Reviews, investigates, and audits incident reports and data involving guests, third parties, and injured Team Members. Establishes reports to track relevant information on claims and litigation and to track and report on trends to the business to support risk mitigation efforts.
+ Assists in developing and maintaining a Transitional Duty program to include job identification and assignment, department and employee liaison, job rotation, meetings, pay/time adjustments, and permanent assignments as necessary.
+ Assists in developing and provides training and education opportunities to internal business partners on Risk Management and Workers' Compensation. Acts as the liaison between the UHU operational teams and the UDX Legal & Business Affairs team on outstanding contractual matters and tracking of legal and other claims matters.
+ Understands and actively participates in Environmental, Health & Safety responsibilities by following established UDX policy, procedures, training, and Team Member involvement activities.
+ Perform other duties as assigned.
SUPERVISORY RESPONSIBILITY:
+ No supervisory responsibilities
ADDITIONAL INFORMATION:
+ ARM, CRM, and/or licensed adjuster preferred.
+ Ability to work with clients and business partners at multiple locations.
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities (KSAs) required.
+ Knowledge of relevant Workers Compensation laws and claims management principles in Nevada
+ Knowledge of relevant Nevada tort and civil procedure laws
+ Data Analytics with root cause analysis
+ Quantitative reasoning skills
+ Strong presentation and writing skills
+ Strong communication skills
+ Ability to make independent judgments based upon known facts
+ Conflict resolution skills
+ Case organization skills
+ Negotiating skills
+ Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
+ Consistent attendance is a job requirement.
EDUCATION:
+ Bachelor's degree is required in Business Management, Risk Management, Law, Health Care Admin, HR, or related field. J.D. or advanced degree in related field preferred.
EXPERIENCE:
+ 5+ years of Risk Management and claims experience to include liability, Workers' Compensation, and managing litigation required; or equivalent combination of education and experience.
+ Experience should include managing Workers' Compensation and Liability claims and litigation in the State of Nevada; or equivalent combination of education and experience.
Your talent, skills and experience will be rewarded with a competitive compensation package.
Universal is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Universal Destinations & Experiences via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Universal Destinations & Experiences HR/Recruitment will be deemed the sole property of Universal Destinations & Experiences. No fee will be paid in the event the candidate is hired by Universal Destinations & Experiences as a result of the referral or through other means.
Universal Horror Unleashed. Here you can.
Universal Destinations & Experiences is an equal opportunity employer. Universal elements and all related indicia TM & © 2024 Universal Studios. All rights reserved. EOE
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3
Senior Analyst - Operations Administration (Claims)
65018 Brentwood, Missouri
GLOVIS America, Inc.
Posted 8 days ago
Job Viewed
Job Description
Senior Analyst - Operations Administration (Claims) Join to apply for the Senior Analyst - Operations Administration (Claims) role at GLOVIS America, Inc. Senior Analyst - Operations Administration (Claims) 1 week ago Be among the first 25 applicants Join to apply for the Senior Analyst - Operations Administration (Claims) role at GLOVIS America, Inc. About Hyundai GLOVIS America Inc. GLOVIS America, Inc. is a third-party logistics provider headquartered in Irvine, CA. Since our inception in 2002, we are committed to delivering our customers' products via truck, rail, or ocean vessel throughout the U.S., Canada, and Mexico. Glovis America makes every effort to exceed standards by providing quality service to our customers and vendors of the automotive, freight forwarding, parts distribution, used car, and fuel industries. We cater logistics strategies and processes to our customers' needs by utilizing the latest information systems and advanced technologies. About Hyundai GLOVIS America Inc. GLOVIS America, Inc. is a third-party logistics provider headquartered in Irvine, CA. Since our inception in 2002, we are committed to delivering our customers' products via truck, rail, or ocean vessel throughout the U.S., Canada, and Mexico. Glovis America makes every effort to exceed standards by providing quality service to our customers and vendors of the automotive, freight forwarding, parts distribution, used car, and fuel industries. We cater logistics strategies and processes to our customers' needs by utilizing the latest information systems and advanced technologies. Summary The Senior Analyst - Operations Administration (Claims) will be responsible for reviewing, evaluating and processing damage claims for transportation and force majeure incidents. To handle and resolve claims issues and disputes. Responsibilities Handle and process transportation damage claims Review and investigate damage liability Provide recommendation if damaged vehicle will require 3rd party inspection Catastrophic/force majeure events claims handling and processing (hail storm, flood, tornado) Review and investigate if damaged to the vehicle is covered under customers policy Coordinate and monitor/report progress of damage repairs Prepare and submit claims invoice to liable party Monthly distribution and reconciliation of open claims Follow up on claims payment status Assist with claims data analysis Other duties as assigned Compensation Range $58,000-$3,000 Per Year (Subject to Compensation Study Upon Candidate Selection) Benefits Of Working At Hyundai GLOVIS America Inc. Medical Insurance Vision Insurance Dental Insurance Health Care & Dependent Care Flexible Spending Accounts (FSA) Basic Life and AD&D as well as Short-Term & Long-Term Disability Paid Vacation, Holidays, and Sick leave Pet Insurance Hospital and Critical Illness Insurance Wellness Program and Gym Reimbursement* 401(k) with Generous Matching Referral Bonuses* Auto Allowance* Quarterly Employee Lunches, Summer Refreshments, and Monthly Team Building Activities* Discretionary Bonuses* Tuition Reimbursement* Benefits may vary by location. All benefits pursuant to Company policy Skills Excellent written and verbal communication skills Required Strong communication, critical thinking, planning and organizational skills Required Experience with computer database management systems Required Broad knowledge of general business application programs, including Excel, Access, Word, PowerPoint, Outlook, Windows OS environment Required Education & Experience H.S Diploma/G.E.D Required Bachelor's Degree Preferred 3 - 5 years of experience in Accounting, Billings, Claims, Financial Analysis, or Vehicle Logistics Required 4 - 7 years of experience in Accounting, Billings, Claims, Financial Analysis, Vehicle Logistics Preferred Physical Requirements Ability to sit in front of a desk and/or in front of the computer for long periods Repetitive use of hand/grasping product, writing, and typing Stand/walk Carry/lift up to 15 pounds Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job. Working and Environmental Conditions The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Typical office environment with low-level noise exposure This position will be located in the Irvine, CA office Communication with employees and field partners will be primarily conducted via phone and email The above statements are intended to describe the general nature of work performed by employees assigned to this position. They are not intended to be a complete list of all job duties performed by persons in the position. Glovis America reserves the right to revise or amend duties at any time as the needs of the company and requirements of the job change. Seniority level Seniority level Mid-Senior level Employment type Employment type Full-time Job function Job function Management and Manufacturing Industries Truck Transportation Referrals increase your chances of interviewing at GLOVIS America, Inc. by 2x Get notified about new Operations Analyst jobs in California, United States . 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Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr
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4
Claims Processing Specialist
77588 Pearland, Texas
Kelsey-Seybold Clinic
Posted 2 days ago
Job Viewed
Job Description
**Responsibilities**
Under the supervision of the Business Services Supervisor, the Claim Edit Follow-Up Representative is responsible for processing the electronic claims edits, "front end "edits, as well as claims edits from secondary claims. In the event a claim edit does not pass, the Follow-Up Representative must determine the required action and steps necessary to resolve the claim issue. The Claim Edit Follow-Up Representative will be expected to review and resolve a No-Activity Workfile/Workqueue, which consist of accounts that have no payment or rejection posted on the account and follow Kelsey-Seybold Clinic Central Business Office policies and procedures to determine the appropriate action. The representative will be expected to follow up with daily workloads and also be able to meet work standards and performance measures for this position
**Job Title: Claims Processing Specialist**
**Location: Pearland Administrative Office**
**Department:** **BOfc-PrAuth&Clm Edit**
**Job Type: Full Time**
**Salary Range: $39,179 - $48,397 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)**
**Qualifications**
**Education**
Required: High School diploma or GED
Preferred: Additional training as a medical office assistant, medical claims processor, or medical claims follow
up specialist.
**Experience**
Required: Minimum of 3 years billing experience, knowledge of healthcare business office functions and their
relationships to each other. (i.e. billing, collections, customer service, payment posting) and insurance
products such as managed care, government and commercial products.
Preferred: Three or more years' experience in a healthcare business office setting, preferably in electronic
claims billing, or insurance follow up.
**License(s)**
Required: N/A
Preferred: N/A
**Special Skills**
Required: Must be familiar with laws and regulations governing Medicare billing practices, medical billing
systems, and claims processing.
Preferred: IDX/EPIC, PC skills, and understanding of billing invoice activity such as credits, debits, adjustments,
contractual agreements, etc.
**Other**
Required: N/A
Preferred: N/A
**Working Environment:** Office
**About Us**
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston's fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.
**Why Kelsey-Seybold Clinic?**
+ Medical, Vision, and Dental
+ Tuition Reimbursement
+ Company Matching 401K
+ Employee Reward and Recognition Program
+ Paid time off for vacation, sick, and holidays
+ Employee Assistance Program
+ Continuing Medical Education allowance
Kelsey-Seybold Clinic strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by organizational policy or by federal, state, or local laws unless such distinction is required by law. Kelsey-Seybold is a VEVRAA Federal Contractor and desires priority referrals of protected veterans.
Under the supervision of the Business Services Supervisor, the Claim Edit Follow-Up Representative is responsible for processing the electronic claims edits, "front end "edits, as well as claims edits from secondary claims. In the event a claim edit does not pass, the Follow-Up Representative must determine the required action and steps necessary to resolve the claim issue. The Claim Edit Follow-Up Representative will be expected to review and resolve a No-Activity Workfile/Workqueue, which consist of accounts that have no payment or rejection posted on the account and follow Kelsey-Seybold Clinic Central Business Office policies and procedures to determine the appropriate action. The representative will be expected to follow up with daily workloads and also be able to meet work standards and performance measures for this position
**Job Title: Claims Processing Specialist**
**Location: Pearland Administrative Office**
**Department:** **BOfc-PrAuth&Clm Edit**
**Job Type: Full Time**
**Salary Range: $39,179 - $48,397 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)**
**Qualifications**
**Education**
Required: High School diploma or GED
Preferred: Additional training as a medical office assistant, medical claims processor, or medical claims follow
up specialist.
**Experience**
Required: Minimum of 3 years billing experience, knowledge of healthcare business office functions and their
relationships to each other. (i.e. billing, collections, customer service, payment posting) and insurance
products such as managed care, government and commercial products.
Preferred: Three or more years' experience in a healthcare business office setting, preferably in electronic
claims billing, or insurance follow up.
**License(s)**
Required: N/A
Preferred: N/A
**Special Skills**
Required: Must be familiar with laws and regulations governing Medicare billing practices, medical billing
systems, and claims processing.
Preferred: IDX/EPIC, PC skills, and understanding of billing invoice activity such as credits, debits, adjustments,
contractual agreements, etc.
**Other**
Required: N/A
Preferred: N/A
**Working Environment:** Office
**About Us**
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston's fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.
**Why Kelsey-Seybold Clinic?**
+ Medical, Vision, and Dental
+ Tuition Reimbursement
+ Company Matching 401K
+ Employee Reward and Recognition Program
+ Paid time off for vacation, sick, and holidays
+ Employee Assistance Program
+ Continuing Medical Education allowance
Kelsey-Seybold Clinic strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by organizational policy or by federal, state, or local laws unless such distinction is required by law. Kelsey-Seybold is a VEVRAA Federal Contractor and desires priority referrals of protected veterans.
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5
Claims Processing - Representative I
85067 Phoenix, Arizona
CVS Health
Posted today
Job Viewed
Job Description
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**Position Summary**
Our Claims team is looking for experienced Claims Processors to join our fast-paced Claims Department. As a Claims Processor, you will be responsible for accurate and efficient adjudication of paper claims from electronic images in a production environment.
Primary Responsibilities of the Claims Processor include:
+ Outbound calls to Members and/or Providers for verification of information
+ Processing and adjudicating paper claims.
+ Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures.
+ Accurately resolving pending claims using state and federal regulations and specific health plan criteria.
+ Working within turnaround times to meet client performance guarantees for claims processing.
+ Meeting productivity and accuracy standards.
**Required Qualifications**
+ 1 year of work experience with a progressive trend in responsibility and accountability, preferably in a Healthcare setting
+ Excellent verbal and written communication skills
+ In-depth experience working with Microsoft Office Suite products
+ This position is fully remote, but must be able to work the Arizona Time Zone hours.
**Preferred Qualifications**
+ Previous PBM Experience
+ Strong typing skills with speed and accuracy
+ Team-oriented while also able to pursue personal and departmental production goals daily
+ Ability to stay organized in a multi-demand and multi-priority environment
+ Ability to work overtime as necessary
+ Strong time management skills with ability to meet production goals
**Education**
High School Diploma or equivalent GED
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$17.00 - $28.46
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit anticipate the application window for this opening will close on: 07/21/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**Position Summary**
Our Claims team is looking for experienced Claims Processors to join our fast-paced Claims Department. As a Claims Processor, you will be responsible for accurate and efficient adjudication of paper claims from electronic images in a production environment.
Primary Responsibilities of the Claims Processor include:
+ Outbound calls to Members and/or Providers for verification of information
+ Processing and adjudicating paper claims.
+ Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures.
+ Accurately resolving pending claims using state and federal regulations and specific health plan criteria.
+ Working within turnaround times to meet client performance guarantees for claims processing.
+ Meeting productivity and accuracy standards.
**Required Qualifications**
+ 1 year of work experience with a progressive trend in responsibility and accountability, preferably in a Healthcare setting
+ Excellent verbal and written communication skills
+ In-depth experience working with Microsoft Office Suite products
+ This position is fully remote, but must be able to work the Arizona Time Zone hours.
**Preferred Qualifications**
+ Previous PBM Experience
+ Strong typing skills with speed and accuracy
+ Team-oriented while also able to pursue personal and departmental production goals daily
+ Ability to stay organized in a multi-demand and multi-priority environment
+ Ability to work overtime as necessary
+ Strong time management skills with ability to meet production goals
**Education**
High School Diploma or equivalent GED
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$17.00 - $28.46
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit anticipate the application window for this opening will close on: 07/21/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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6
Assistant of Claims Processing
32232 Jacksonville, Florida
Ascension Health
Posted today
Job Viewed
Job Description
**Details**
+ **Department:** Billing/Claims
+ **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM
+ **Hospital:** Ascension St. Vincent's
+ **Location:** 3 Shircliff Way Jacksonville, Florida 32204-4757 United States
**Benefits**
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community
_Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer._
**Responsibilities**
Prepare and issues bills for reimbursement to individual and third party payers in an out-patient or medical office environment.
+ Prepare insurance claims for submission to third party payers and/or responsible parties.
+ Review claims for accuracy, including proper diagnosis and procedure codes.
+ Review claim rejections and communicates with payers to resolve billing issues.
+ Prepare and review routine billing reports.
+ Recommend process improvements based on findings.
+ Respond to complex telephone and written inquiries from patients and/or third party payers and physician practices.
**Requirements**
Education:
+ High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
+ Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
**Additional Preferences**
No additional preferences.
**Why Join Our Team**
Ascension St. Vincent's is expanding in the fastest-growing county in Northeast Florida with the addition of a fourth regional hospital, Ascension St. Vincent's St. Johns County. Serving Northeast Florida and Southeast Georgia, Ascension St. Vincent's has been providing caregivers in every discipline a rewarding career in healthcare since 1873.
Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.
**Equal Employment Opportunity Employer**
Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.
For further information, view the EEO Know Your Rights (English) ( poster or EEO Know Your Rights (Spanish) ( poster.
As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.
Pay Non-Discrimination Notice ( note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
**E-Verify Statement**
This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.
E-Verify (
+ **Department:** Billing/Claims
+ **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM
+ **Hospital:** Ascension St. Vincent's
+ **Location:** 3 Shircliff Way Jacksonville, Florida 32204-4757 United States
**Benefits**
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community
_Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer._
**Responsibilities**
Prepare and issues bills for reimbursement to individual and third party payers in an out-patient or medical office environment.
+ Prepare insurance claims for submission to third party payers and/or responsible parties.
+ Review claims for accuracy, including proper diagnosis and procedure codes.
+ Review claim rejections and communicates with payers to resolve billing issues.
+ Prepare and review routine billing reports.
+ Recommend process improvements based on findings.
+ Respond to complex telephone and written inquiries from patients and/or third party payers and physician practices.
**Requirements**
Education:
+ High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
+ Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
**Additional Preferences**
No additional preferences.
**Why Join Our Team**
Ascension St. Vincent's is expanding in the fastest-growing county in Northeast Florida with the addition of a fourth regional hospital, Ascension St. Vincent's St. Johns County. Serving Northeast Florida and Southeast Georgia, Ascension St. Vincent's has been providing caregivers in every discipline a rewarding career in healthcare since 1873.
Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.
**Equal Employment Opportunity Employer**
Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.
For further information, view the EEO Know Your Rights (English) ( poster or EEO Know Your Rights (Spanish) ( poster.
As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.
Pay Non-Discrimination Notice ( note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
**E-Verify Statement**
This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.
E-Verify (
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7
Commercial Claims Processing Associate, Claims Examiner
14651 Rochester, New York
MVP Health Care
Posted 9 days ago
Job Viewed
Job Description
Commercial Claims Processing Associate, Claims Examiner Headquarters Office, 625 State Street, Schenectady, New York, United States of America ? Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America Req #2572 Friday, June 20, 2025 At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity for you if you have a passion for analyzing information. **What's in it for you:** + Growth opportunities to uplevel your career + A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team + Competitive compensation and comprehensive benefits focused on well-being + An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work** for and one of the **Best Companies to Work For in New York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred + The availability to work Full-Time, Virtual + Previous related health care experience required + Knowledge of CPT, HCPCS, ICD-9-CM coding systems and Medical terminology preferred. + Strong PC skills required, Microsoft Windows experience highly desired. Strong attention to detail. + Curiosity to foster innovation and pave the way for growth + Humility to play as a team + Commitment to being the difference for our customers in every interaction **Your key responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess Systems. + Reviews and ensures the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible. + Knowledge of Facets and Macess systems strongly preferred, but not required. + Reviews and ensures the accuracy of all changes to claim line information based on information received from other departments and in accord with available benefit information. + Is responsible for the timely and accurate adjudication of claims that are suspended to other MVP departments for benefit and/or authorization determination. + Meets or exceeds department quality and work management standards for claims adjudication. + Successfully completes a course of comprehensive formal training in all areas of benefits determination, system navigation, and MVP policy. + Suspends, investigates and resolves claim issues by coordinating with appropriate departments, based on criteria set by those departments. + Handles inquiries regarding suspended claims from other departments and identifies trends in suspensions based on these inquiries and other feedback. + Keeps abreast of all benefit changes. + Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer. **Where you'll be:** Virtual within Rochester, NY or Schenectady, NY **Pay Transparency** MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role. We do not request current or historical salary information from candidates. **MVP's Inclusion Statement** At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration. MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications. To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at (email protected) . **Other details** + Job Family Claims/Operations + Pay Type Hourly + Min Hiring Rate $20.00 + Max Hiring Rate $23.50 + Headquarters Office, 625 State Street, Schenectady, New York, United States of America + Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America <
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8
Commercial Claims Processing Associate, Claims Examiner
12307 Schenectady, New York
MVP Health Care
Posted 9 days ago
Job Viewed
Job Description
Commercial Claims Processing Associate, Claims Examiner Headquarters Office, 625 State Street, Schenectady, New York, United States of America ? Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America Req #2572 Friday, June 20, 2025 At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity for you if you have a passion for analyzing information. **What's in it for you:** + Growth opportunities to uplevel your career + A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team + Competitive compensation and comprehensive benefits focused on well-being + An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work** for and one of the **Best Companies to Work For in New York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred + The availability to work Full-Time, Virtual + Previous related health care experience required + Knowledge of CPT, HCPCS, ICD-9-CM coding systems and Medical terminology preferred. + Strong PC skills required, Microsoft Windows experience highly desired. Strong attention to detail. + Curiosity to foster innovation and pave the way for growth + Humility to play as a team + Commitment to being the difference for our customers in every interaction **Your key responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess Systems. + Reviews and ensures the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible. + Knowledge of Facets and Macess systems strongly preferred, but not required. + Reviews and ensures the accuracy of all changes to claim line information based on information received from other departments and in accord with available benefit information. + Is responsible for the timely and accurate adjudication of claims that are suspended to other MVP departments for benefit and/or authorization determination. + Meets or exceeds department quality and work management standards for claims adjudication. + Successfully completes a course of comprehensive formal training in all areas of benefits determination, system navigation, and MVP policy. + Suspends, investigates and resolves claim issues by coordinating with appropriate departments, based on criteria set by those departments. + Handles inquiries regarding suspended claims from other departments and identifies trends in suspensions based on these inquiries and other feedback. + Keeps abreast of all benefit changes. + Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer. **Where you'll be:** Virtual within Rochester, NY or Schenectady, NY **Pay Transparency** MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role. We do not request current or historical salary information from candidates. **MVP's Inclusion Statement** At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration. MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications. To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at (email protected) . **Other details** + Job Family Claims/Operations + Pay Type Hourly + Min Hiring Rate $20.00 + Max Hiring Rate $23.50 + Headquarters Office, 625 State Street, Schenectady, New York, United States of America + Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America <
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9