claims administrator

Fluence Energy

<div><p>Fluence (Nasdaq: FLNC) is a global market leader delivering intelligent energy storage and optimization software for renewables and storage. Our solutions and operational services are helping to create a more resilient grid and unlock the full potential of renewable portfolios. With gigawatts of successful implementations across nearly 50 markets, we are transforming the way we power our world for a more sustainable future. For more information, please visit fluenceenergy.com .
</p><p></p><p><b>Job Description:
</b></p>Skills Required: - Contracts and Claims Manager APAC for upstream and downstream. - - Bachelor's degree in engineering (preferably Electrical)/ Contracts Management from a well-recognized university. An advance degree is preferred. - Strong knowledge of EPC construction contracts having dealt with FIDIC, NEC and other standard form of Contract. - Minimum of 8 years of experience in Contract Administration and Claims Management. - Sound experience of Change Orders (variations, Change of Scope), Delay Analysis, Extension of time, Change in Law and Cost Claims etc.
<p></p><p><b>Our Culture
</b></p><p>At Fluence, our culture is the foundation that drives our ambitious growth strategy and fuels our mission to transform the future of energy. Our core cultural pillars empower us to innovate, collaborate, and lead with purpose, ensuring we continue to deliver unparalleled value to our customers and the world.
</p><p></p><p><b>Unleash Voices
</b></p><p>We believe every voice matters. We encourage openness, active listening, and decisive action to create a culture where everyone has the opportunity to contribute to our success. We foster an environment where diverse perspectives are heard and valued, driving innovation and progress.
</p><p></p><p><b>Customer Fluent
</b></p><p>Our customers are at the heart of everything we do. We&rsquo;re committed to delivering exceptional value that exceeds expectations by understanding our customers' needs and adapting swiftly to meet them. Our deep focus on customer satisfaction drives us to continuously improve and innovate.
</p><p></p><p><b>Infinite Impact
</b></p><p>We are committed to creating the impossible. We push boundaries to deliver sustainable, game-changing solutions that shape a brighter, more energy-efficient future for all. Our team is passionate about making a lasting impact that will resonate for generations to come.
</p><p></p><p><b>All In
</b></p><p>We are all in for growth. Our teams are relentlessly focused on identifying and seizing opportunities that propel us forward. We embrace an ownership mindset, pushing ourselves and each other to accelerate progress and create lasting success.</p></div>

Contracts and Claims Manager

MetLife

<div>
 <strong>
  Requirements
  <br/>
  <br/>
 </strong>
 <strong>
  Description and Requirements
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Provide general administrative support including handling emails, filing, and organizing claim-related materials.
  </li>
  <li>
   Maintain accurate and up-to-date information in the claims database.
  </li>
  <li>
   Assist with bill processing, documentation production, and data entry.
  </li>
  <li>
   Use the Claims System for inquiries and to generate correspondence.
  </li>
  <li>
   Resolve routine administrative inquiries and ensure timely responses.
  </li>
  <li>
   Proofread and edit materials to uphold accuracy, thoroughness, and professionalism.
  </li>
  <li>
   Maintain confidentiality and comply with HIPAA regulations in managing sensitive information.
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 Support the team in delivering exceptional service to our customers, reflecting MetLife&rsquo;s value of putting customers first
 <br/>
 <br/>
 <strong>
  About MetLife
  <br/>
  <br/>
 </strong>
 Recognized on Fortune magazine's list of the "World's Most Admired Companies" and Fortune World&rsquo;s 25 Best Workplaces&trade;, MetLife, through its subsidiaries and affiliates, is one of the world&rsquo;s leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
 <br/>
 <br/>
 Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we&rsquo;re inspired to transform the next century in financial services. At MetLife, it&rsquo;s #AllTogetherPossible . Join us!
</div>


Specialist

<div><div><div><div><div><div>Country
</div><div>India
</div></div><div><div>Working Schedule
</div><div>Full-Time
</div></div><div><div>Work Arrangement
</div><div>Hybrid
</div></div><div><div>Relocation Assistance Available
</div><div>No
</div></div><div><div>Posted Date
</div><div>22-Oct-2025
</div></div><div><div>Job ID
</div><div>12983
</div></div></div></div></div><div><div><div><h3 class="jobSectionHeader"><b>Description and Requirements
</b></h3></div></div><div><div><div><div><ul><li> Provide general administrative support including handling emails, filing, and organizing claim-related materials.</li><li> Maintain accurate and up-to-date information in the claims database.</li><li> Assist with bill processing, documentation production, and data entry.</li><li> Use the Claims System for inquiries and to generate correspondence.</li><li> Resolve routine administrative inquiries and ensure timely responses.</li><li> Proofread and edit materials to uphold accuracy, thoroughness, and professionalism.</li><li> Maintain confidentiality and comply with HIPAA regulations in managing sensitive information.</li></ul><p>
Support the team in delivering exceptional service to our customers, reflecting MetLife&rsquo;s value of putting customers first</p>
</div></div></div></div></div><div><div><div><div><div><b>About MetLife</b><br>
<div></div>
<p>Recognized on Fortune magazine's list of the &quot;World's Most Admired Companies&quot; and Fortune World&rsquo;s 25 Best Workplaces&trade;, MetLife, through its subsidiaries and affiliates, is one of the world&rsquo;s leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
</p><p></p><p>Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we&rsquo;re inspired to transform the next century in financial services. At MetLife, it&rsquo;s #AllTogetherPossible. Join us!</p></div></div></div></div></div></div>

Guardian Industries

<div>
 <strong>
  Your Job
  <br/>
  <br/>
 </strong>
 Guardian Glass is looking for a dedicated Claims Customer Service Specialist to join our team in 10th of Ramadan City, Sharqia, Egypt.
 <br/>
 <br/>
 <strong>
  Our Team
  <br/>
  <br/>
 </strong>
 You will be an integral part of our Supply Chain Department, working closely with cross-functional teams to ensure exceptional customer service and efficient claims handling.
 <br/>
 <br/>
 <strong>
  What You Will Do
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Follow up on open complaints with internal departments.
  </li>
  <li>
   Ensure decisions align with Service Level Agreements (SLAs).
  </li>
  <li>
   Provide excellent customer service and resolve inquiries or complaints.
  </li>
  <li>
   Escalate when needed.
  </li>
  <li>
   Maintain high customer service standards in a fast-paced environment.
  </li>
  <li>
   Communicate effectively across different levels and work both independently and in teams.
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Who You Are (Basic Qualifications)
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Bachelor&rsquo;s degree in business, Accounting, Finance, or another related field.
  </li>
  <li>
   0-1 years of experience.
  </li>
  <li>
   Fluent spoken and written English.
  </li>
  <li>
   Excellent Communication skills.
  </li>
  <li>
   High customer service orientation.
  </li>
  <li>
   Ability to work in a fast-paced, performance-based environment.
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 <em>
  At Koch companies, we are entrepreneurs. This means we openly challenge the status quo, find new ways to create value and get rewarded for our individual contributions. Any compensation range provided for a role is an estimate determined by available market data. The actual amount may be higher or lower than the range provided considering each candidate's knowledge, skills, abilities, and geographic location. If you have questions, please speak to your recruiter about the flexibility and detail of our compensation philosophy.
  <br/>
  <br/>
 </em>
 <strong>
  Who We Are
  <br/>
  <br/>
 </strong>
 As a Koch company, Guardian Glass is one of the world&rsquo;s largest manufacturers of float, value-added and fabricated glass products and solutions. We produce high-performance glass for architectural, residential, interior, transportation and technical glass applications. You&rsquo;ll find our glass in homes, offices and cars and in some of the world&rsquo;s most iconic projects.
 <br/>
 <br/>
 At Koch, employees are empowered to do what they do best to make life better. Learn how our business philosophy helps employees unleash their potential while creating value for themselves and the company.
 <br/>
 <br/>
 Additionally, everyone has individual work and personal needs. We seek to enable the best work environment that helps you and the business work together to produce superior results.
 <br/>
 <br/>
</div>


Claims Admin

<div><b>Your Job</b><p>
Guardian Glass is looking for a dedicated Claims Customer Service Specialist to join our team in 10th of Ramadan City, Sharqia, Egypt.</p><p><b>
Our Team</b></p><p>
You will be an integral part of our Supply Chain Department, working closely with cross-functional teams to ensure exceptional customer service and efficient claims handling.</p><p><b>
What You Will Do</b>
</p><p></p><ul><li>Follow up on open complaints with internal departments.
</li><li>Ensure decisions align with Service Level Agreements (SLAs).
</li><li>Provide excellent customer service and resolve inquiries or complaints.
</li><li>Escalate when needed.
</li><li>Maintain high customer service standards in a fast-paced environment.
</li><li>Communicate effectively across different levels and work both independently and in teams.
</li></ul><p><b>Who You Are (Basic Qualifications)</b>
</p><p></p><ul><li>Bachelor's degree in business, Accounting, Finance, or another related field.
</li><li>0-1 years of experience.
</li><li>Fluent spoken and written English.
</li><li>Excellent Communication skills.
</li><li>High customer service orientation.
</li><li>Ability to work in a fast-paced, performance-based environment.
</li></ul><p>At Koch companies, we are entrepreneurs. This means we openly challenge the status quo, find new ways to create value and get rewarded for our individual contributions. Any compensation range provided for a role is an estimate determined by available market data. The actual amount may be higher or lower than the range provided considering each candidate's knowledge, skills, abilities, and geographic location. If you have questions, please speak to your recruiter about the flexibility and detail of our compensation philosophy.</p><p><b>
Who We Are</b></p><p>
A s a Koch company, Guardian Glass is one of the world's largest manufacturers of float, value-added and fabricated glass products and solutions. We produce high-performance glass for architectural, residential, interior, transportation and technical glass applications. You'll find our glass in homes, offices and cars and in some of the world's most iconic projects.
</p><p>At Koch, employees are empowered to do what they do best to make life better. Learn how our business philosophy helps employees unleash their potential while creating value for themselves and the company.</p><p>
Additionally, everyone has individual work and personal needs. We seek to enable the best work environment that helps you and the business work together to produce superior results.</p><p>
#LI-AL2</p></div>

Accenture

<p><b>Skill required:</b> Claims Appeals - Claims Administration<br>
<b>Designation:</b> Health Admin Services New Associate<br>
<b>Qualifications:</b>Any Graduation
<br>
<b>Years of Experience:</b>0 to 1 years
<br>
<b>About Accenture</b><br>
Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song&mdash; all powered by the world&rsquo;s largest network of Advanced Technology and Intelligent Operations centers. Our 699,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com
<br>
<b>What would you do?</b> To provide support to the clinical team and client team to assist in the promotion of quality member outcomes, to optimize member benefits, and to promote effective use of resources. Supports the procedures that ensure adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective. Utilization Management: Gathers information using the appropriate client-specific telephonic screening tools. Conducts pre-review screening under the guidance and direction of US licensed health professionals. Case Management/Disease Management -Provides support functions for wellness programs, health management programs and preventative care opportunities that the member may have as part of their benefits. Gathers information using the appropriate client-specific telephonic screening tools.<br>
<b>What are we looking for?</b> &bull;Microsoft Excel &bull;Microsoft PowerPoint &bull;Written and verbal communication &bull;Related outsourcing operations experience &bull;Claims reviews/audit experience and data entry experience &bull;Knowledge of utilization management process and ability to interpret and apply member contracts, and member benefits &bull;Knowledge of ICD-9 and ICD-IO and CPT codes, preferred &bull;Experience in medical or insurance field, preferred &bull;Requires solving of routine problems, largely through precedent and referral to general guidelines. &bull;Interaction is within own team and direct supervisor &bull;Requires analysis and solving of increasingly complex problems. &bull;Interaction is with peers within Accenture before updating supervisors. Likely has some interaction with clients and/or Accenture management. With proper guidance and oversight by Team Lead, may be tapped for precepting, training, mentoring and job shadowing duties &bull;Holds current and unrestricted local (PH) Registered Nurse license. &bull;Bachelor of Science Nursing (BSN) degree &bull;Excellent written and verbal communication skills in English &bull;Must pass American English and alternate language fluency test (&quot;Test&quot;) upon hire (non-US resident) by successfully completing internal written test. For voice accounts, you must pass US Berlitz B2 level or Versant score 58 and above upon hire or upon assuming role. &bull;Proficiency in basic computer knowledge with the ability to learn additional computer programs &bull;A minimum of three (3) months of prior working experience as a Registered Nurse in a clinical setting required o Three months is equivalent to 480 hours of working experience as an RN o Work experience as a Registered Nurse means holding an active RN license and providing direct patient care o Clinical setting includes inpatient hospital, outpatient hospital or clinic, or 1-year related Accenture or other outsourcing experience or returning Analyst employee &bull;Strong customer service focus o Ability to empathize o Prioritizing customer needs
<br>
<b>Roles and Responsibilities:</b> &bull;Manages incoming or outgoing telephone calls, e-Reviews, and/or faxes, including triage, opening of cases and data entry into client system. &bull;Determines contract; verifies eligibility and benefits. &bull;Conducts a thorough provider radius search in client system and follows up with provider on referrals given. &bull;Checks benefits for facility-based treatment. &bull;Obtains intake (demographic) information from caller, e-Reviews, and/or from fax. Processes incoming requests, collection of non-clinical information needed for review from providers, utilizing scripts to screen basic and complex requests for pre-certification and/or prior authorization. &bull;Performs data entry of contact into client systems and routes as appropriate Match fax/clinical records with appropriate case. &bull;Consolidate inputs for approval. &bull;Generate the needed letters as directed by client and/or outlined in client s procedure manual &bull;Assign cases/activities and work within client s system to facilitate workflow and productivity goals. &bull;Refers cases requiring clinical review to a nurse reviewer. Performs case checks and reviews to ensure case creation is complete, correct, and &quot;nurse ready&quot;. &bull;Tasks cases accurately to the correct queue. &bull;Conducts outbound scripted calls to providers to request clinical information as directed by clinician. &bull;Conducts outbound scripted calls to providers to complete approval notification process as directed by clinician. &bull;Performs Daily Task list maintenance activities under the direction of the Team Lead/Operations Manager and as per customer workflow. &bull;Provide administrative support to /Nurse Reviewer via case preparation, phone number verification, medical record requests and verbal call out approval notifications. &bull;Provide administrative support of post service claims utilizing the member s benefit contract and health plan guidelines. &bull;Performs administrative tasks and work as directed by clinician or Team Lead/Operations. Consults clinician and Team Lead/Operations Manager timely and appropriately. &bull;Reports inventory numbers and assigns task lists under the direction of the Team Lead/Operations and as requested by the customer. &bull;Prioritize follow-up and actions based on case request receipt dates, customer workflow, service level agreements and regulatory timeframes. &bull;Responsibilities exclude collection of non-scripted information, evaluation, or interpretation of clinical information, and providing medical advice/opinion on treatment or services. &bull; Please note that this role may require you to work in rotational shifts</p>
<br>
Any Graduation

Health Admin Services New Associate

Resorts World Las Vegas

<div>Overview:
<div><b>
Summary Statement:</b></div><div></div><div><br>
The Benefits Administrator is responsible for managing and administering employee benefits programs, including health insurance, retirement plans, wellness initiatives, on-site events, and other related offerings. This role ensures compliance with applicable laws and regulations, provides guidance to employees, and supports the overall strategic goals of the Human Resources department.</div>
Job Duties:
<p><b>
Primary Job Duties:</b> &ndash; Includes but is not limited to:
</p><ul><li>Administer employee benefits programs such as medical, dental, vision, life insurance, disability, retirement plans, voluntary benefits, and wellness initiatives.</li><li>
Serve as the primary point of contact for employee benefits inquiries, providing timely and accurate information.</li><li>
Coordinate benefits enrollment, changes, and terminations, including open enrollment and new hire enrollments.</li><li>
Maintain accurate records and documentation for all benefits-related transactions.</li><li>
Collaborate with vendors and brokers to manage benefits plans and resolve issues.</li><li>
Ensure compliance with federal, state, and local regulations and policies (e.g., ERISA, HIPAA, COBRA, ACA).</li><li>
Prepare and distribute employee communications regarding benefits programs and changes.</li><li>
Audit weekly check run for medical</li><li>
Assist in the development and implementation of benefits policies and procedures.</li><li>
Support audits and reporting requirements related to benefits.</li><li>
Monitor trends and best practices in employee benefits to recommend enhancements.</li><li>
Monitor file feeds for all vendors and ensure any issues are resolved in a timely manner</li><li>
Process and audit invoices in a timely manner and liaise with broker in the case of billing issues</li><li>
Present benefits during New Hire Orientation and Leadership Orientation</li><li>
Obtain and maintain position-specific licensing.</li><li>
Use personal device/cellular phone for job related tasks, job duties, review of company documents, etc.</li><li>
Other duties as assigned.</li></ul>
Qualifications:<p></p><div><b><br>
Qualifications: </b>Includes but is not limited to:</div><ul><li>
Extensive knowledge of employee benefits and applicable laws, including COBRA, HIPAA and ERISA requirements.</li><li>
Excellent communication, organizational, and problem-solving skills.</li><li>
Ability to work varied shifts, including nights, weekends and holidays.</li><li>
Ability to handle sensitive and confidential information with discretion.</li></ul><div>
Preferred:</div><ul><li>
Ability to effectively communicate in English.</li><li>
Fluent in more than one language.</li><li>
Previous experience working in a large, luxury resort setting.</li><li>
Experience with benefits platforms and vendor management.</li></ul><div><b>
Minimum Education and Experience:
</b></div><ul><li>Bachelor&rsquo;s degree in Human Resources, Business Administration, or related field preferred.</li><li>
At least three years of previous benefits administration experience in a similar or related field.</li><li>
Proficiency in HRIS systems and Microsoft Office Suite.</li><li>
At least 21 years of age.</li></ul><div>
Certificates, Licenses, Regulations:
</div><ul><li>Proof of eligibility to work in the United States</li></ul></div>

Benefits Administrator

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