Claims Specialist
$15 - $16 per hourDirect Staffing Inc
At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100™ companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly. Job Description Kelly Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location. In addition to working with the world’s most recognized and trusted name in staffing, Kelly employees can expect: Competitive pay Paid holidays Year‑end bonus program Recognition and incentive programs Access to continuing education via the Kelly Learning Center Pay $15 - $16 per hour Schedule: Monday through Friday – 9:00 am to 6:00 pm Duration: 4 months, possible extension (possible temp‑to‑perm) Anticipated start date: 10/31/2016 to 03/31/2017 SUMMARY Responsibility for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds until accounts receivable issues are properly resolved. MAJOR JOB DUTIES AND RESPONSIBILITIES Verify member submitted claim forms, member’s eligibility and pharmacy information is complete and accurate, updating system information as needed. Provide superior data entry proficiency to ensure accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Maintain moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Communicate orally or in writing with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations, especially when communicating to others outside. Prioritize and coordinate influx of daily workload for claims processing, returned mail and outgoing correspondence and e‑mails to meet required turnaround time. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for the claims team. EDUCATION/EXPERIENCE High School Diploma or GED required. 1–3 years of Call Center and Reimbursement experience required. Knowledge of completed benefits verifications, submitted test claims, and completed or reviewed prior authorizations required. Strong data entry and 10‑key skills. Proficient in MS Word and Excel. Additional Information Why Kelly? As a Kelly Services candidate you will have access to numerous perks, including: Exposure to a variety of career opportunities as a result of our expansive network of client companies. Career guides, information and tools to help you successfully position yourself throughout every stage of your career. Access to more than 3,000 online training courses through our Kelly Learning Center. Group‑rate insurance options available immediately upon hire* #J-18808-Ljbffr
$55k - $60k
...Aon is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your experience with a globally respected firm, this may be the next step in your career! As part of an industry-leading...SuggestedTemporary workWork experience placementLocal areaRemote work$95k - $105k
...operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist – Professional Liability to join our team! JOB SUMMARY Investigate, evaluate and settle more complex first and third-party...SuggestedWork at officeRemote work$59.9k - $98.2k
...Claims Specialist II, Workers Compensation Zurich North America is seeking a skilled and experienced Claims Specialist II to join our dynamic Workers Compensation team. This is an exciting opportunity to make a meaningful impact by delivering exceptional claims service...SuggestedFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workVisa sponsorship- ...Molina Healthcare seeks a Claims Processing Associate to support adjustment activities, administer payments, and maintain claim records. You will counsel claimants on coverage amounts and benefit interpretation while helping control backlog and ensure timely settlements...Suggested
$54k - $103k
...potential. This individual contributor role operates under moderate direction and within defined authority limits to manage commercial claims of moderate to high complexity and exposure within the General Liability line of business. The position is responsible for...SuggestedWork experience placementWork at officeLocal areaFlexible hours- .... At LA, we are Client-Minded and Community-Centered! About the Role We are seeking a dedicated and detail-oriented Insurance Claims Specialist to join our dynamic law practice. In this vital role, you will be responsible for managing and processing insurance claims efficiently...Temporary workWork at officeMonday to FridayNight shiftWeekend work
- My name is Pondsy Anthony , and I am Recruiting Specialist with Mindlance Inc . I have reviewed your resume and at a first glance find it... ...primary function/purpose of this job: Verify member submitted claims forms, member’s eligibility and pharmacy information is complete...Contract workFor contractorsShift work
$75.8k - $124.1k
...Sr. Claims Specialist, Workers Compensation Zurich North America is looking for an exceptional Senior Workers' Compensation Claims Specialist to join our dynamic and dedicated claims team. This is an exciting opportunity to manage complex, multi-party commercial Workers...Full timeTemporary workApprenticeshipWork at officeLocal areaRemote workVisa sponsorship- ...Holmes Murphy, through its Creative Risk Solutions team, seeks a Liability Claims Specialist to handle commercial auto and general liability claims with licensed authority and strong client service. The role emphasizes adjudication, negotiation, and collaboration within...
- ## Workers’ Compensation Claims Specialist (FL, KY) REMOTE**Job Description:**Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At...Full timeRemote work
- Molina Healthcare in New York seeks a Claims Specialist to support CMS-compliant appeals, disputes, grievances and member/provider inquiries, ensuring timely and accurate resolutions. You will research claims, review medical records and bills, prepare summaries, apply contracts...
- ...Great American Insurance Group is seeking a Crop Adjuster in the Town of Florida, NY, to handle insurance claims for various crops. This role involves conducting field inspections, documenting claims, and ensuring compliance with insurance policies and regulations. The...Part timeSeasonal work
- ...Title: Combined Cycle Specialist (I/C) (Polk) Company: Tampa Electric Company Location: Florida - Mulberry Shift: 12 Hr. X 7 Days Position Concept The Combined Cycle Specialist (CCS) reports to the Superintendent of Generation for the performance of all assigned operating...For contractorsWork experience placementShift work
$48k - $55k
...Job Description To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments. Responsibilities...Temporary work- ...Bristol West Claims Liability Claims Representative-Hybrid We are Farmers – where ambition meets opportunity. Job Summary Participates... ...and fire departments, state and country fraud and arson specialists, special investigators, attorneys, medical professionals and other...For contractorsTraineeshipWork at officeFlexible hoursShift work
$16 - $17 per hour
GoldenTrust Insurance is one of South Florida’s fastest-growing agencies, known for delivering trusted insurance solutions with professionalism, transparency, and care. We are expanding our team and seeking a detail-oriented and analytical Insurance Underwriter Agent to...Hourly payFlexible hours- ...Casualty Claims Examiner at AssuranceAmerica Job Summary This position is responsible for the oversight of complex and large exposure losses and will report to the National Casualty Claims Manager. The Casualty Claims Examiner works alongside claims management, providing...Full timeContract workWork experience placementLocal areaHome office
- ...of education and experience, which would provide an equivalent background. Minimum of two (2) years of experience working within a Claims Operations environment highly preferred. Prior experience supporting Medicare Fee-for-Service (FFS) claims processing strongly preferred...
- At Frontline Insurance, we are on a mission to Make Things Better, and our Territory Personal Lines Underwriter plays a pivotal role in achieving this vision. We strive to provide high quality service and proactive solutions to all our customers to ensure that we are making...Temporary workLocal area
- The underwriter is responsible for assessing and managing risk associated with surety bond applications. They evaluate the financial strength and credibility of applicants, analyze terms, and make informed decisions to protect the interests of the surety company while ...Temporary workWork visaFlexible hours
$40k - $45k
Triton Recovery LLC is a fully insured and bonded commercial collection firm, licensed in the State of Florida. We specialize in the Merchant Cash Advance (MCA) industry and provide comprehensive commercial debt collection services nationwide. Our team is committed to ...Full timeMonday to Friday$49.92k - $83.16k
A leading insurance firm is seeking an Underwriter II for the Group Benefits Priority Account team. This role involves managing New Business and Renewals, negotiating rates, and building relationships with business partners. Candidates should have a bachelor's degree, ...- The Underwriter is responsible for validating income, asset, and collateral documents including self-employed tax returns. The Underwriter may be involved in one or several types of mortgage lending including, but not limited to, conventional, FHA, government, USDA, etc...Self employmentWork at officeRemote work
- Regular or Temporary: Regular Language Fluency: English (Required) Work Shift: 1st Shift (United States of America) Responsibilities Meet or exceed production goals as assigned by manager. Underwrite new and renewal business. Supervise a multi‑person team ensuring all ...Full timeTemporary workShift workDay shift
- A financial services company in New York seeks an experienced Senior Underwriter to make final credit decisions, manage risk, and mentor junior staff. The ideal candidate will have at least 2 years of MCA underwriting experience and strong analytical skills. Responsibilities...
$115k - $145k
Role Summary Stand is seeking a Wind States Underwriter to own risk selection, pricing, and portfolio management for a high-net-worth personal lines book of business with a strong emphasis on wind-exposed risks. This individual will combine underwriting expertise, creativity...Full timeTemporary workH1bVisa sponsorshipWork visaFlexible hours- Since ourinception, Apex MCA Holdings has made it our mission to provide a better funding experience for small to mid-market businesses. We understand that traditional capital sources have made it unreasonably difficult for businesses to get the capital needed to remain...Bank staffWork at office
$55k - $65k
Job Location: First Light (Remote) - Dania, FL 33312 Position Type: Full Time Education Level: 2 Year Degree Salary Range: $55,000.00 - $65,000.00 Travel Percentage: None Job Shift: Day Job Category: Underwriting SUMMARY The Underwriter I position is responsible for profitability...Full timeWork experience placementWork at officeRemote workShift workNight shift- General Placement Service is recruiting on behalf of a respected national insurance carrier. they seek to hire a P&C Underwriter to underwrite new business for their clients. In this role you will work fully remote for a growing insurance provider with national reach. ...Remote work
- Team Focus Insurance Group seeks a Call Center-Underwriter II - Commercial Lines to deliver high-level service and underwriting support for small to mid-size commercial accounts. You will process policy transactions, endorsements, and certificates within your authority...
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