claims coordinator

1330 Dental Associates

Job Description:1330 Dental Associates is seeking an Insurance Coordinator to join our team in Portland, ME. This position will be responsible for the coordination of insurance claims, processing, and verification. We are looking for an ambitious and detail-oriented person who wants to grow and learn as an individual, as well as, in their career with us. This position requires an independent thinker who can hold significant responsibility. Multi-tasking along with attention to detail are a daily responsibility. Teamwork and a team atmosphere are paramount at our front desk. We typically enjoy much camaraderie with each other while maintaining a focused, task oriented, front desk environment.As an insurance coordinator you will be focused on various tasks involving insurance. A brief description of tasks is seen below:&middot; Phone calls (in-bound and out-bound)o Notify patients of insurance denials or issues involving the patient&rsquo;s insuranceo To verify eligibility when online portals are not availableo To gather additional information regarding claims/following up on outstanding claimso Answering calls when needed (ex: the other front desk associates are already busy with patients or other phone calls)&middot; Posting insurance payments correctly to patient accounts, noting important information as needed.&middot; Resubmitting claims as neededo This may include attaching additional info/ writing letters to insurance&middot; Managing outstanding claims that are over 30 days old&middot; Verifying eligibility and entering insurance plans into our software (We use Curve Hero- it is very user friendly)&middot; Monitoring and handling a separate email only regarding insurance&middot; Answering insurance questions as needed for patientsJob Type: Full-Time/ Part-TimeAs a full-time employee, benefits include: has 8 scheduled paid holidays, and offers accrued vacation and sick hours, 401K profit sharing, health insurance and employee discounts are availablePay: $25+ per hour (pay is negotiable depending on experience)COVID-19 considerations: We follow all American Dental Association, CDC, and State guidelines to best protect our staff and patientsPay: From $25.00 per hourBenefits:<ul><li>401(k)</li><li>Employee discount</li><li>Health insurance</li><li>Paid time off</li></ul>Experience:<ul><li>Dental Insurance: 1 year (Preferred)</li><li>Dental Office: 1 year (Preferred)</li></ul>Work Location: In person

Dental Insurance Coordinator (FT/PT)

AV Sierra Dental Center

Dental Insurance/Financial Coordinator Front Office Position Job PostingIf you currently enjoy where you are working, congratulations! If you are interested in looking for an office that will compliment your talents, we may be a match! We are interested in developing a long-term relationship with that special person to join our team.Here at AV Sierra Dental, we work hard with a progressive management style. Our phenomenal team members are all partners in the practice with policy and direction decided by vote as a group. We understand and appreciate the knowledge and abilities of a talented Insurance/Financial Coordinator. We offer many incentives as a team.We are a high-production dental office seeking an experienced Insurance Coordinator who can take full ownership of our insurance systems, claims, and collections performance.This is NOT an entry-level role. We are looking for someone who understands how insurance impacts production, collections, and profitability.Insurance/Financial Coordinator Office Duties are not limited to but include the following:Responsibilities:<ul><li>Insurance verification with accurate breakdowns (PPOs, frequencies, downgrades)</li><li>Claims submission, tracking, and follow-up</li><li>AR management and reducing aging (goal: &lt;45 days)</li><li>Handling denials, appeals, and resubmissions</li><li>Coordination of benefits and complex cases</li><li>Working closely with front office to maximize case acceptance and collections</li><li>Answer Incoming calls, handle customer inquiries, schedule appointments</li><li>Follow up with Patients with any pre-authorizations.</li><li>Ensure every patient has a great experience</li></ul>Qualifications:<ul><li>3+ years dental insurance experience (required)</li><li>Strong knowledge of PPO plans and fee schedules</li><li>Proven experience managing AR and insurance follow-up</li><li>Experience with Open Dental (preferred)</li><li>Detail-oriented and proactive (not just task-based)</li></ul>Our practice philosophy is: We are here to provide the highest quality health care in the most comfortable environment possible. We believe our patients are our friends and deserve only the best. We will provide an atmosphere of enthusiasm that is contagious.If you are looking for fulfillment and believe you control your own success, we would love to meet you and discuss an exciting career with our vibrant team.Please send us your cover letter and resume here to start the interviewing process.We look forward to meeting you!Job Type: Full-timePay: $24.00 - $30.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee discount</li><li>Health insurance</li><li>Paid time off</li><li>Retirement plan</li></ul>Application Question(s):<ul><li>What was the approximate monthly collections of your previous office?</li></ul>Education:<ul><li>High school or equivalent (Required)</li></ul>Experience:<ul><li>Dental Front Office/Insurance: 3 years (Required)</li></ul>Language:<ul><li>Spanish (Preferred)</li></ul>Work Location: In person

Dental Insurance/Financial Coordinator

NJM Insurance Group

<div>General Summary: A brief description of the main purpose for this position.
The Appraisal Vendor Coordinator oversees and works with NJM shops to ensure processes are followed and customer issues are resolved.
Hours:<ul><li>
Monday to Friday- 8AM - 4:15PM</li><li>
Hybrid opportunity once training is complete</li><li>
Position can be filled within the West Trenton, Parsippany, or Hammonton NJM office.</li></ul>
Essential Duties and Responsibilities: Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and predictable onsite attendance is an essential function of the job.<ul><li>
Serve as a liaison between various General Claims departments on repair processes</li><li>
Ensure NJM shops complete required processes to keep customers and NJM informed of repair status</li><li>
Provide updates to customers and Claims staff of status of repair escalations</li><li>
Document all issues into NJM&rsquo;s Vendor Tracker</li><li>
Serve as a point of contact for Enterprise Rent-a-Car to monitor rental average for NJM shops</li><li>
Recover reimbursements from NJM shops due to excess rental or corrective repairs needed</li><li>
Address all Customer Surveys needing attention involving negative shop performance and/or customer dissatisfaction</li><li>
Review estimates from NJM Staff and Independent Companies as part of a bi-monthly Audit</li><li>
Perform Paint &amp; Material calculations to resolve cost issues with shops</li><li>
Provide monthly report on shops not following required update process</li><li>
Complete arbitration responses on a monthly basis</li></ul>
Required Qualifications: Knowledge, skills &amp; abilities, experience, minimum &amp; desired education, certification and/or license requirements.<ul><li>
Familiar with CCC One Estimating platform</li><li>
Minimum 3 years repair shop or Auto Appraiser experience</li><li>
Strong communication skills</li><li>
Ability to prioritize workload</li><li>
High School Diploma or GED</li></ul>
Preferred Qualifications:<ul><li>
Experience with NJM&rsquo;s Vendor Portal</li></ul>
Compensation: Salary is commensurate with experience and credentials.
Pay Range: $77,698-$90,252<div><div><div><div><div><div><div>
Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses.</div></div></div></div></div></div></div><div><div><div><div><div><div><div>
Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.</div></div></div></div></div></div></div></div>

Appraisal Vendor Coordinator

Colorado Access

The vision of Colorado Access is to have healthy communities transformed by the care that people want at a cost we can all afford. Our mission is to partner with communities and empower people through access to quality, affordable care.
 
Why should you consider a career with Colorado Access?
 We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision, supported by our values and pillared by diversity, equity and inclusion.
 1. Find work/life balance: We offer PTO, floating holidays, nine company paid holidays, a hybrid work environment, an Employee Assistance Program and a 401K.
 2. Be a part of something bigger and make an impact: We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference.
 3. Sharpen your skills, learn, and grow: We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend.
 
What you will do: 
We are looking for a CLAIMS & ADJUSTMENT SPECIALIST who can help shape our vision and support our mission. Here is what the position will look like.
 <ul>
<li>Researches, analyzes, and determines appropriate outcome for provider carrier disputes based on company policies and procedures and regulations, while meeting quality and production standards as established by department director.</li>
<li>Documents and maintains claim appeal status in the claim appeal tracking tool. Sends out applicable provider carrier dispute outcome letters, and other correspondence.</li>
<li>Performs research and analysis on a variety of claim adjustments. Applies claims knowledge, company policies and procedures, and regulations to appropriately adjust claims.</li>
<li>Manages and works daily claim pend reports. Finalizes claims as needed and communicates with Cognizant on the status of daily pend reports.</li>
<li>Submits, manages and follows up on Snow tickets associated with claims and appeals to Cognizant.</li>
<li>Assists with auditing of special projects, as needed.</li>
<li>Assists with department training of new employees.</li>
<li>Serves as a back up to the Claims Coordinator and will log in claim appeals into the claim appeals tracking tool, when needed.</li>
</ul>
What you will bring: 
Education: High School Diploma or equivalent required. Associates degree in health, social services or additional college courses preferred. Equivalent combination of experience and/or education may substitute with a preference for four years progressive relevant work experience.
 
Experience: Minimum of four years’ healthcare experience. Three years of claims or appeals processing experience preferred.
 
Knowledge, Skills, and Abilities: Solid knowledge of claims payment and record keeping required. Must possess basic understanding of health care, medical terminology, medical procedures and managed care principles. Requires familiarity with all claim forms and coding types including CPT/HCPCS, ICD-10, HCFA 1500 and UB-92. Demonstrates support for the company’s mission, vision and values. Excellent organization skills and decision-making skills required. Excellent written and verbal communications skills required. Must be able to interpret data and effectively summarize information. Knowledge of Microsoft Excel, Access & Word strongly preferred. May be required to manage multiple priorities and projects with tight deadlines.
 
Licenses/Certifications: A valid driver's license and proof of current auto insurance will be required for any position requiring driving.
 
Together we will be: an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization.
 
Pay, Perks and Benefits at Colorado Access: 
The compensation for this position is $65,900.00 - $77,700.00 annually and is a non-exempt (hourly) position. . Colorado Access has provided a compensation range that represents its good faith estimate of what Colorado Access may pay for the position at the time of posting. Colorado Access may ultimately pay more or less than the posted compensation range. The salary offered to the selected candidate will be determined based on factors such as the qualifications of the selected candidate, departmental budget availability, internal salary equity considerations, and available market information, but not based on a candidate’s sex or any other protected status.
 
In addition to being part of a mission driven organization serving our community, as an eligible Colorado Access employee, you’ll receive a generous benefits package, that includes:
 <ul>
<li>Medical, dental, vision insurance that starts the first day of the month following start date.</li>
<li>Supplemental insurance such as critical illness and accidental injury.</li>
<li>Health care and dependent care flexible spending account options.</li>
<li>Employer-paid basic life insurance and AD&D (employee, spouse and dependent).</li>
<li>Short-term and long-term disability coverage.</li>
<li>Voluntary life insurance (employee, spouse, dependent).</li>
<li>Paid time off</li>
<li>Retirement plan</li>
<li>Tuition reimbursement (based on eligibility).</li>
<li>Annual bonus program (based on eligibility, requirements and performance).</li>
</ul>
Where you will work: 
This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’
 
We are not able to support out of state employees at this time as we continue to serve our members and community in the metro Denver area and across the beautiful state of Colorado.
 
Colorado Access is committed to providing equal opportunities to all people regardless of race, color, national origin, age, sex, genetic information, religion, pregnancy, disability, sexual orientation, veteran status or any other status protected by applicable law. We strive to maintain a work environment that is free from unlawful harassment and discrimination.

Claims & Adjustment Specialist

Sedgwick

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Leave of Absence Coordinator
Leave of Absence Coordinator
Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you&rsquo;ll need to live near one of our dynamic Centers of Excellence Southfield, MI. 3 00 Galleria Officentre Southfield MI 48034.
✨ What we offer:
<ul><li>A stable, consistent work environment &mdash;both in-office and virtual
</li><li>A comprehensive training program to help you support employees and customers from some of the world&rsquo;s most respected brands
</li><li>A dedicated mentor and manager to guide you every step of your career journey
</li><li>Career development and promotional opportunities as you take on new responsibilities
</li><li>A diverse, all-inclusive benefits package designed to support your mental, physical, financial, and professional well-being
</li></ul>Your next big opportunity starts here&mdash;are you ready to join us?
PRIMARY PURPOSE OF THE ROLE :
To analyze reported leave requests and determine paid leave benefits due based on client paid leave plans, policies, state and federal regulations and to make timely calculations, payments and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices.
ARE YOU AN IDEAL CANDIDATE?
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused. 
 
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Establishes FMLA claims; tracks and codes documentation in accordance with internal workflow processes.
</li><li>Analyzes FMLA and other paid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with client paid leave plans, policies, and state and federal regulations.
</li><li>Identifies action plan, determines benefits due, and makes timely case decisions based on service expectations as established by the client.
</li><li>Communicates decisions and on-going expectations with claimants and clients.
</li><li>Maintains professional client relationships.
</li><li>Attendance during scheduled work hours is required.
</li></ul>QUALIFICATIONS
<ul><li>Education &amp; Licensing: High school diploma or GED required.
</li><li>Skills: Strong oral and written communication, computer literate &ndash; including Microsoft Office, organizational skills required
</li><li>PC literate, including Microsoft Office products, Windows environment.
</li><li>Must meet minimum typing requirements.
</li><li>Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
</li></ul>TAKING CARE OF YOU
<ul><li>Entry-level colleagues are offered a world class training program with a comprehensive curriculum
</li><li>An assigned mentor and manager that will support and guide you on your career journey
</li><li>Career development and promotional growth opportunities
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more
</li></ul>WORK ENVIRONMENT
 
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental : Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical : Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required.
Auditory/Visual : Hearing, vision and talking
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. 
 
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 19.31. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Leave of Absence Coordinator

M & M Fibers

PRIMARY RESPONSIBILITIESThe Claims Manager is responsible for resolving all quality related claims fairly, professionally, providing outstanding service to all customers.ESSENTIAL DUTIES AND RESPONSIBILITIES1. Responsible for investigating and collecting all data related to claims. including invoices, samples, commissioning of independent inspectors, cleaners and lab testing.2. Responsible for negotiating fair, accurate, and timely resolution of claims with lowest possible cost to the company.3. Involve management and seek approval for claims exceeding the company authorized limit.4. Coordinate the sale of goods that have been refused by dealers (reconsignment sales) to avoid return costs.5. Responsible for filing, negotiating and tracking of charge backs to vendors for defective or damaged products.6. Responsible for entering all mail, faxes and other communication daily into the claims system as received.7. Other duties/special projects assigned by the Business Operations Manager.8. Conduct communication with all customers, internal employees, vendors, and financial institutions in a professional manner, with integrity and a positive attitude.9. Follow all published company policies and procedures.Pay: $18.00 - $20.00 per hourBenefits:<ul><li>401(k) 3% Match</li><li>Health insurance</li><li>Health savings account</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Claims Analyst

Proficient Auto Logistics

<div><h1 class="jobSectionHeader">About Proficient Auto Logistics</h1>
<div>Proficient Auto Logistics (PAL) is a leading specialized freight company focused on providing auto transportation and logistics services. Formed via IPO in May 2024, PAL combined five industry-leading operating companies and has since acquired a sixth. As a combined entity, we operate one of the largest auto transportation fleets in North America with over 1200 trucks, 50 terminal locations and 700 employees, a majority of whom are drivers.</div>
<div></div><div>We offer a broad range of auto transportation and logistics services, primarily focused on transporting finished vehicles from automotive production facilities, marine ports of entry, or regional rail yards to auto dealerships around the country. We have developed a differentiated business model due to our scale, breadth of geographic coverage, and embedded customer relationships with leading auto original equipment manufacturing companies (OEMs).
</div><div></div><div>While this is a remote position, the candidate needs to be able to work the hours of 8:00 AM-5:00 PM Eastern time.
</div><h1 class="jobSectionHeader">Job Summary</h1>
<div>Responsible for working with internal and external stakeholders to effectively resolve cargo claims submissions and disputes.</div>
<h1 class="jobSectionHeader">Essential Duties and Responsibilities</h1>
<ul><li>Receives, reviews and acknowledges cargo claims damage notifications and FNOL in a timely manner</li>
<li>Monitors claims management software and activities to identify and implement quality improvement initiatives</li>
<li>Evaluates claims experience based upon driver category to assess damage type, severity, and costs</li>
<li>Investigates, negotiates, and processes cargo claims in accordance with various customer&rsquo;s policies and procedures within industry standards</li>
<li>Follows standard operating procedures to appropriately review, handle, and settle large volumes of claims in a timely manner</li>
<li>Requests claims documentation from dealers, customers, claimants, and insurers</li>
<li>Reviews, updates, and reports cargo claims data to support process improvement and operating performance measures</li>
<li>Works with Claims Management team members to determine cargo claims damage liability</li>
<li>Collaborate with drivers, dealers, customers, and insurers to collect and communicate cargo claim information</li>
<li>Communicates outcomes of cargo claim acceptance or denial decisions to owner-operators and/or customers</li>
<li>Submits approved claims to accounting for payment processing</li>
<li>Additional duties assigned as needed</li>
</ul><h1 class="jobSectionHeader">Requirements</h1>
<ul><li>High school education or GED required.</li>
<li>Two years of prior claims processing experience preferred.</li>
<li>Auto hauling or transportation industry experience preferred.</li>
</ul><h1 class="jobSectionHeader">Skills and Abilities</h1>
<ul><li>Exceptional written and oral communication skills</li>
<li>Exceptional time management and organizational skills</li>
<li>Exceptional analytical and critical thinking skills</li>
<li>Knowledge of DOT/FMCSA regulations</li>
<li>Knowledge of MS Office software, including Word, Excel, and Outlook</li>
<li>Ability to resolve and de-escalate conflict</li>
<li>Ability to drive change and improve processes</li>
<li>Ability to build and nurture relationships</li>
<li>Ability to work in a fast-paced environment and make time-sensitive deadlines</li>
<li>Ability to prioritize and manage multiple tasks</li>
<li>Willingness to travel up to 10%</li>
</ul>
<div></div><div>EEO Statement</div>
<div>All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.</div></div>

Claims Analyst (Auto)

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