Location: King Of Prussia, PA
Company: Sedgwick Claims Management Services
support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve.
If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work Most Loved Workplace Forbes Best-in-State Employer Claims Representative- Workers Compensation PRIMARY
PURPOSE : To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency. Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments. Approves and processes assigned claims,
determines benefits due, and administers action plan pursuant to the claim or client contract.
Administers subrogation of claims and negotiates settlements. Communicates claim action with claimant and client. Ensures claim files are properly documented and claims coding is correct. May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. Maintains professional client relationships. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). Travels as required.
QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Experience Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required. Skills & Knowledge Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Ability to work in a team environment Ability to meet or exceed Service Expectations WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway!
Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Requisition #: R44483tcv57hlu2
products for medium-sized businesses. This exciting and fast-paced opportunity will allow the individual to improve their underwriting skills, expand their industry knowledge and further develop their marketing abilities while working on a diverse risk portfolio with key wholesale customers.
KEY OBJECTIVES: Include understanding and managing risks, contributing proportionately to production goals, meeting or exceeding business unit service standards, building or improving trading partner relationships, demonstrating sound underwriting discipline and displaying a " can do" attitude. MAJOR DUTIES & RESPONSIBILITIES (include but are not limited to): Ownership and management of
production within assigned underwriting territory(ies) Solicit new business opportunities from assigned customers Understand and achieve retention and rate goals for renewal business Execute on key individual and business unit performance and SLA goals Create, maintain and improve broker relationships through excellent customer service Utilize " Underwriter Best Practices" as a guide to prioritize business unit objectives and execute on underwriting fundamental Promote visibility of Westchester Middle Market through marketing efforts, industry events and networking opportunities Travel Percentage: 10% - 15% MINIMUM REQUIREMENTS: 3 - 5 years underwriting experience, preferably with
a focus on commercial package property and casualty Bachelor's degree, preferably in Risk Management DESIRED QUALIFICATIONS: Insurance industry designation, such as CPCU or ARM Comprehensive understanding of insurance industry including in-depth knowledge of underwriting concepts, practices, and procedures Strong negotiation, marketing and problem-solving skills Highly capable of prioritizing and multi-tasking Outstanding oral, presentation, and written communication skills Proficient in Microsoft Word, Excel, Power Point and Outlook Chubb strives to offer a diverse and inclusive and rewarding work environment.
Teamwork and mutual respect are central to how Chubb operates, and we believe the best solutions draw upon diverse perspectives, experiences and skills.
We operate in such a way where everyone, regardless of their singular background has the opportunity to contribute to our collective success Requisition #: 3549106ahf9io63
Disney & more, employee appreciation events, Daily Pay, EAP, medical, dental, vision, 401K, company paid life insurance, paid time off, paid parental leave, pet insurance and more! Skills: Must be able to read, write, and speak the English language in an understandable manner Prior housekeeping experience preferred Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, interaction/gender (including pregnancy), interactionual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally
protected category.
In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with Pro Medica, please contact more details: jobs-search.
org/insurance_king-of-prussia-c445955/housekeeping-team-member-full-time-king-of-prussia_i1972317086
guidelines. The Associate Underwriter - Individual may assist in protocol development, train and direct assistant underwriting staff in performance of related duties. The Associate Underwriter - Individual must report detailed activity to manager and may be responsible for developing reports for management.
Responsibilities: Analyze health information from applicants using commercial underwriting guidelines. Manage communication of underwriting requirements and decisions with appropriate sales personnel. Identify and document best practices and operational efficiencies. Create and document standardized processes for the individual underwriting processes. Train and direct assistant personnel
in department process and practice relative to Individual Underwriting. Organize and manage individual underwriting workflow to time delivery of accurate quotes.
Summarize and report activities to manager. Direct compilation of all data necessary for audit of department activities. Ensure compliance with domestic and international insurance laws and regulations. Document department activities and develop with manager input UW guidelines for department control processes. Monthly and quarterly reporting to maintain data sets. Represent underwriting as a subject matter expert. Maintain department file systems. Other duties as assigned. Requirements: Bachelor's degree required. One-year experience
with health insurance underwriting procedures. Desire to work in the international health insurance industry.
Strong analytic skills and detail oriented. Strong oral and written communication skills. Ability to meet strict deadlines. Employee is required to have at minimum an internet speed of 75 Mbps (standard high-speed Internet access). Working Conditions: Flexibility to work in an office and/or at-home, remote office environment. Overtime and/or schedule flexibility are occasionally necessary in this position. Individual may be required to attend key business/departmental meetings and/or perform certain business critical job functions outside of normal working hours.
Physical Demands: Must be able to communicate internally and externally through receiving and responding to auditory and visual methods. This Job is a Pay Grade 7 which will be a salary of 45,465$ to 56,832$ per year depending on experience. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. Associated topics: underwriter
commercial medical underwriting guidelines. The Underwriter will assist in protocol development, train associate or assistant staff in performance of related duties. At the discretion of management, the Underwriter may represent the Underwriting department at corporate sponsored projects.
Responsibilities: Analyze health information from group applicants using commercially consistent underwriting guidelines. Manage communication of underwriting requirements and decisions with appropriate sales personnel. Be proficient in the use of all department underwriting software. Analyze rating software methods and make recommendations for expansions or other improvements to department underwriting
software. Understands the competitive position of quotes and will develop mechanisms for financial comparisons. Train assistant personnel in department process and practice relative to group underwriting.
Track and manage exception provision with financial implications to the company. Mentor junior level personnel. Direct compilation of all data necessary for audit of department activities. Ensure compliance with domestic and international insurance laws and regulations. Document department activities and develop with supervisor input UW guidelines for department control processes. Coordinate salesforce changes/fixes/enhancements under the direction of the Director - Underwriting Operations.
Represent underwriting as a subject matter expert for projects.
Maintain department file systems. Other duties as assigned. Requirements: Bachelor's degree required. 2 years' experience with health insurance underwriting procedures. Desire to work in the international health insurance industry. Strong analytic skills and detail oriented. Strong oral and written communication skills. Ability to meet strict deadlines. Expert in Excel. Employee is required to have at minimum an internet speed of 75 Mbps (standard high-speed internet access). Working Conditions: Flexibility to work in an office and/or at-home, remote office environment. Schedule flexibility is occasionally necessary in this position.
Individual may be required to attend key business/departmental meetings and/or perform certain business critical job functions outside of normal working hours. Physical Demands: Must be able to communicate internally and externally through receiving and responding to auditory and visual methods. This Role is a Pay grade 9 where the salary will range between 57,411$ to 73,199$ Per Year depending on experience. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. Associated topics: underwriter
need to be submitted to the provider representative for contracting action. Identifies denial and underpayment trends that require computer system modifications and recommends necessary to implement corrective action. Prepares reports for meetings with provider representative and senior leadership, as required.
Education - Required: High School Diploma/GED Education - Preferred: Associate's Degree in Health Care Science, Business or related field. Experience - Required: 2 years of professional or facility billing and/or collections for all major third party payers or work experience in healthcare related field. Experience - Preferred: 1 year Medical Coding Experience. Knowledge, Skills,
and Abilities - Required: Excellent follow-up and verification skills. Excellent verbal and written communication skills. Knowledge of insurance contracts, and regulations.
Proficient with Microsoft Excel, Word, and Power Point applications. Strong analytical, mathematical and organizational skills. Successful Completion of DOE and Revenue Cycle Education Training within 3 months of hire. Licensure - Preferred: CPAT - Certified Patient Accounting Technician or equivalent
from the American Heart Association Active professional license within the state of practice NIHSS stroke scale certification and other specialty-related certifications are preferred and may be required for specific positions Experience as a Telemetry RN in a hospital setting Minimum of 2 years of experience as an RN Job Details Weekly Pay: $2,334 per week Location: Allentown, PA Shift Schedule: Nights Assignment Duration: 6 Weeks Weekly Hours: 36 Hours Agency Benefits Day 1 Health Insurance (Medical, Dental, Vision), Flexible Housing Options, Guaranteed Stipend: Facility Cancelled Shifts, JACHO Certified, Prestigious Facilities, PTO Program, Weekly Pay, Paid Compliance Cost, Referral Bonuses, Extra Shift Bonuses, 401(k) Plan For more details: jobs-search.
org/insurance_allentown-c445985/job_i1970118473
Communicates new insurance benefits found to Utilization Management as well as other departments and physician offices throughout the network. Job Duties Obtains and verifies demographic, clinical, financial, and insurance information in the process of pre-registering and financially clearing patients for service delivery.
Performs complete and accurate account pre-registration and insurance verification functions. Meets required accuracy rates. Completes registrations in accordance with department productivity and timeliness standards. Works to provide patient information which maximizes reimbursement, achieves collection ratios, and meets accounts receivable (AR) goals. Ensures that
scheduled appointments match the corresponding account status registration so that information flows into the designated work queue workflows. Creates estimates and identifies any non-covered patient responsibilitiy such as coinsurance, deductibles, and copayments prior to service.
Provides general information to hospital departments, physician offices, patients, and families and ensures that patients meet financial requirements. Works with all pre-service departments and any department throughout the revenue cycle to ensure patient expectations are met. Minimum Qualifications High School Diploma/GED 3 years Previous experience in a customer-oriented environment, patient registration,
or insurance-related field. and 1 year Experience in a related healthcare environment with pre-cert, billing, and registration background.
Ability to anticipate and understand customer financial needs, document, and/or relay patients' needs to appropriate personnel. Knowledge of medical terminology. Must be self directed and able to prioritize duties in fast paced environment. Preferred Qualifications Associate's Degree and Specialized training in insurance, coding, billing, or similar healthcare certificate programs. Knowledge of EPIC, Navinet, and Passport. Ability to speak Spanish. Physical Demands Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Commission on Accreditation (ANCC)! BAYADA Offers Nurse Residents: One on one care Weekly pay Flexible scheduling after our 6-week training program Electronic charting using Alaya Care Paid training and shadowing Awarding-winning adult and pediatric Simulation labs Short commute times - we match you with cases near your home Around the clock clinical support by phone$1,200 nursing referral bonuses BAYADA Home Health Care was founded on the principle that health care gets better when clients get better care at home-the place they most want to be.
Delivering care is our highest priority and greatest joy! We care for people of all ages, diagnoses, and acuity levels, giving you the chance
to explore your interests and practice new skills. Apply now to join our team! Requirements Current valid nursing license in U. S. and graduation from a qualified nursing program CPR in good standing Benefits Include: PTOMedical, Dental, and Vision benefits Company-paid life insurance Employee Assistance Program Public Service Loan Forgiveness Partner 401K Preventive Care Coverage for all employees (PRN included) Want to learn more about the program?
Haven't taken your NCLEX yet? Attend a live info Session by clicking here: MAR-EPA As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates. BAYADA Home Health Care, Inc.
and its associated entities and joint venture partners, are Equal Opportunity Employers.
All employment decisions are made on a non-discriminatory basis without regard to interaction, race, color, age, disability, pregnancy or maternity, interactionual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities. For more details: jobs-search. org/insurance_lehighton-c445796/rn-new-grads-lehighton_i1960638470
