Job Closed

This listing is no longer active.

Davies logo
Davies

At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

Claim Recovery Specialist

Claims SpecialistClaims SpecialistOtherRemoteMid LevelTeam 201-500

Location

United States

Posted

101 days ago

Salary

$50K - $65K / year

Seniority

Mid Level

Job Description

Claim Recovery Specialist

Davies

Claim Recovery Specialist Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To: Marie Noble Compensation: $50,000 - $65,000 / year Description Our Story Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. We are on the lookout for an experienced and professional Claim Recovery Specialist – Property & Casualty to join our team. The ideal candidate must possess a solid background in insurance claims handling, along with the appropriate demeanor to work effectively both under direction and independently. This position involves performing detailed reviews of potential auto and liability claims.The successful candidate will be an integral part of our subrogation unit, tasked with the review and analysis of potential subrogation claims. They will be responsible for pursuing and recovering claim funds in accordance with applicable laws and insurance policies. This role involves evaluating incoming claim information to identify recovery opportunities, primarily within the Property & Casualty sector. It requires extensive experience and understanding of governmental entity risk pools. Key Responsibilities - Work within the subrogation unit to meticulously review potential subrogation claims - Conduct thorough investigations to pursue and recover claim funds in accordance with applicable laws and insurance policies - Analyze incoming claim information from various clients - Employ expertise in file investigations by obtaining and reviewing all necessary file documentation, i.e., police reports, video evidence, interviews, estimates, photographs and all other related information - Utilize extensive negotiation skills to effectively resolve claims and recover funds on behalf of clients - Responds promptly to communications from clients, customers and other insurance companies and/or attorneys - Perform other duties as assigned Skills, knowledge & expertise - Possess a college degree and/or possess a combination of education and experience - 5 years insurance industry claims handling experience, with at least 3 years in handling property & casualty claims - Analytical Proficiency: Strong analytical skills to assess claim details and determine the potential for recovery - Attention to Detail: Exceptional attention to detail to ensure accurate review and processing of claims - Organizational Skills: Strong organizational skills to manage multiple claims efficiently and effectively - Communication Skills: Excellent verbal and written communication skills to interact with clients and team members professionally - Technological Proficiency: Proficiency in Microsoft Word and Excel for documentation and data analysis - Independent and Collaborative Work: Ability to work independently as well as collaboratively within a collegial group setting, depending on the project requirements - Interpersonal Skills: Appropriate interpersonal skills to maintain a professional and consultative demeanor in all interactions Benefits Benefits At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes: - Medical, dental, and vision plans to ensure your health and that of your family. - A 401k plan with employer matching to help you build a secure financial future. - Our time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment. - Paid holidays. - Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones. Massachusetts Notice It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Diversity and Inclusion Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard. Compensation Transparency: The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices. We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at recruitment@davies-group.com

Related Categories

Related Job Pages

More Claims Specialist Jobs

Med-Metrix logo

Insurance Information Coordinator

Med-Metrix

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Claims Specialist101 days ago
OtherRemoteTeam 1,001-5,000

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Insurance Information Coordinator supports the Collections and/or Denial Management department by gathering and disseminating information from hospitals and insurance companies pertaining to referred claims. - Verify member benefits, effective dates, claims and appeal information with insurance companies - Research claims and insurance information through hospital/state databases - Organize time frames in which claims must be appealed - Use Microsoft Outlook to set follow-up reminders - Provide daily/weekly updates to management - Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Qualifications - High School diploma or equivalent required - Experience with insurance claims, review of EOBs or denials - Experience with EAGLE, NAVI-Net, Epic, and I-SUITE a plus - Proficiency in Microsoft Office applications (Word, Excel, and Outlook) - Must be comfortable speaking with external contacts, including insurance company representatives - Solid data entry skills and the ability to learn proprietary databases - Strong verbal and written communication skills - Strong organization and time-management skills and the ability to work in a fast-paced environment - Excellent customer service skills - Solid investigative skills and a persistent demeanor - Reliable, detail-oriented, resourceful, and analytical Requirements - Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes. - Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. - Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress. - Work Environment: The noise level in the work environment is usually minimal. Company Description Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

United States
$21 - $23 / hour
Job Closed
NTT DATA logo

Medical Claims Processor, Remote Temporary

NTT DATA

NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. Our consulting and industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D.

Claims Specialist101 days ago
OtherRemoteTeam 10,001+H1B Sponsor

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim forms files by provider • Reviewing the policies and benefits • Comply with company regulations regarding HIPAA, confidentiality, and PHI • Abide with the timelines to complete compliance training of NTT Data/Client • Work independently to research, review and act on the claims • Prioritize work and adjudicate claims as per turnaround time/SLAs • Ensure claims are adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client productivity/quality targets to avoid penalties • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. • Timely response and resolution of claims received via emails as priority work • Correctly calculate claims payable amount using applicable methodology/ fee schedule Requirements: • 3 year(s) hands-on experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools • High school diploma or GED. • Previously performing – in P&Q work environment; work from queue; remotely • Key board skills and computer familiarity – o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products – Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: • Amisys • Ability to communicate (oral/written) effectively in a professional office setting • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities • Time management with the ability to cope in a complex, changing environment

United States
NTT DATA logo

Medical Claims Processor, Remote Temporary

NTT DATA

NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. Our consulting and industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D.

Claims Specialist101 days ago
OtherRemoteTeam 10,001+H1B Sponsor

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim forms files by provider • Reviewing the policies and benefits • Comply with company regulations regarding HIPAA, confidentiality, and PHI • Abide with the timelines to complete compliance training of NTT Data/Client • Work independently to research, review and act on the claims • Prioritize work and adjudicate claims as per turnaround time/SLAs • Ensure claims are adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client productivity/quality targets to avoid penalties • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. • Timely response and resolution of claims received via emails as priority work • Correctly calculate claims payable amount using applicable methodology/ fee schedule Requirements: • 3 year(s) hands-on experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools • High school diploma or GED. • Previously performing – in P&Q work environment; work from queue; remotely • Key board skills and computer familiarity – o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products – Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: • Amisys • Ability to communicate (oral/written) effectively in a professional office setting • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities • Time management with the ability to cope in a complex, changing environment"

United States
Job Closed
NTT DATA logo

HC & Insurance Operations Processing Sr Rep

NTT DATA

NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. Our consulting and industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D.

Claims Specialist101 days ago
OtherRemoteTeam 10,001+H1B Sponsor

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim forms files by provider • Reviewing the policies and benefits • Comply with company regulations regarding HIPAA, confidentiality, and PHI • Abide with the timelines to complete compliance training of NTT Data/Client • Work independently to research, review and act on the claims • Prioritize work and adjudicate claims as per turnaround time/SLAs • Ensure claims are adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client productivity/quality targets to avoid penalties • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. • Timely response and resolution of claims received via emails as priority work • Correctly calculate claims payable amount using applicable methodology/ fee schedule Requirements: • 3 year(s) hands-on experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools • High school diploma or GED. • Previously performing – in P&Q work environment; work from queue; remotely • Key board skills and computer familiarity – o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products – Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: • Amisys • Ability to communicate (oral/written) effectively in a professional office setting • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities • Time management with the ability to cope in a complex, changing environment"

United States
Job Closed