Investigate all non standard claim problems (25%) Investigates for COB and determine the primary payer (25%) Investigate and process adjustment requests (25%) Adjust claim payments resulting from duplicate payments, incorrect payee, etc. Recover expended funds for managed care plans System documentation of investigation results Training of Coordination of Benefits claim p

Maintains, confirms and secures referrals, authorization, or pre certifications required for patients to receive physician or medical services. Verifies the accuracy and completeness of patient account information. Maintains database of payer authorization requirements. Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicai

Supervise direct reports, make recommendations for performance management and disciplinary action. Train subordinates to achieve goals. In addition, contribute to the new employee selection process. Supervise the claims department workflow. Distribute and allocate work to ensure efficient and timely processing of claims. Develop and maintain standard operating procedures

Workers Compensation Senior Claims Representative Job Locations US WI West Bend | US WI Madison | US WI Appleton | US WI Waukesha | US NE Omaha | US NE Lincoln | US MO Kansas City | US MO Saint Louis | US Remote | US IA Des Moines ID 2024 2057 Category Claims Position Type Regular Remote/Hybrid Hybrid Company Overview Recognized as a Milwaukee Journal Sentinel Top Workpla

NO late nights - NO weekends and Air Conditioned Body Shop for your techs!

Investigate and settle miscellaneous claims including license, probate, fidelity, and miscellaneous surety to meet contractual obligations and minimize company exposure. Investigate and determine liability of contract bonds claims for performance and labor and material payment bonds to resolve (and/or minimize) these at the lowest possible out of pocket cost to the compan

Vice President Claims Germantown Mutual Insurance Company is looking to add a Vice President of Claims to its team! WHO WE ARE Germantown Mutual Insurance Company is Wisconsin’s oldest insurance company! Founded in 1854, we are celebrating our 171 st year of providing quality insurance products and great customer service to our policyholders. A rated by AM Best for

Complete field inspections, reviews and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company crop insurance policies Ensure compliant and cost effective application of crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory require

of Responsibilities Manage a team of senior level claim specialists and/or supporting technical staff. Claims processed are primarily third party claims on our personal lines and commercial lines of business but could include all lines of business. Oversee the investigation and settlement of all claims, litigated and non litigated assigned to the team. Provide advice and d

Investigate and maintain commercial property claims, focused on residential structures. Determine liability, secure information, review coverages, arrange appraisals, and settle claims. You will report to a Manager. You will work in the field and handle moderately complex commercial property field claims typically within 1 2 hours of Madison/Milwaukee, WI. You must be loca