The Medical Only Claims Specialist manages non-complex, medical-only workers’ compensation claims under close supervision, supporting departmental goals. Essential functions include receiving claims, confirming coverage, determining compensability, establishing reserves, and communicating claim status to relevant parties.
Remote Jobs & Work From Home Positions in United States (122,590)
Remote in = United States
The Telehealth Billing agent is responsible for processing medical bills for various ancillary healthcare services by reviewing notes, claim forms, and authorizations to ensure alignment with diagnosis and provider recommendations. This involves applying strong data-entry skills to guarantee accurate and timely submission for provider payments and client invoicing.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, aiming to support quality treatment and timely return to work. This involves assessing treatment plan appropriateness using clinical expertise and communicating directly with treating physicians to evaluate and recommend alternative care options.
The Intake Specialist provides administrative customer service by receiving and entering new ancillary healthcare referrals via telephonic and written communication. They must maintain a high focus on accuracy and urgency to quickly process service orders aligned with customer needs.
The Intake Specialist provides administrative customer service by receiving and entering new ancillary healthcare referrals via telephonic and written communication. They must maintain a high focus on accuracy and urgency to quickly process service orders aligned with customer needs.
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Management Analyst 4
Arizona Department of Administration
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Full Time
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11 Weeks Ago
Arizona Department of Administration
The analyst supports the development and implementation of Value Based Purchasing (VBP) strategies and Differential Adjusted Payment initiatives by collaborating with cross-functional teams to advance payment initiatives aimed at improving health outcomes and containing costs. Major duties include supporting existing VBP initiatives, preparing necessary financial summaries and policy documentation, and engaging stakeholders to inform VBP strategies.
The Account Executive will manage the entire sales cycle for smaller accounts, from initial prospecting through closing, onboarding, and driving renewals for SaaS and mobile solutions. This role involves building strong customer relationships and ensuring clients gain maximum value before transitioning larger accounts to an Area Sales Manager.
This position supports the sales team through strategic pre-sales, functional assessment, and technical scoping activities to meet department sales targets. The role involves understanding client business challenges and technology to guide the provision of optimal solutions to both business and technical stakeholders.
WC Disability Claims Specialist II - NY Pension/ PPD
CorVel Corporation
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Full Time
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11 Weeks Ago
CorVel Corporation
The Claims Specialist manages workers’ compensation disability claims toward the best possible outcome, focusing on closure and identifying settlement opportunities through regular reviews. Essential functions include receiving claims, confirming coverage, reviewing validity, authorizing payments within limits, and ensuring timely benefit payments.
SENIOR PROPERTY AND LIABILITY CLAIMS ADJUSTER
Arizona Department of Administration
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Full Time
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11 Weeks Ago
Arizona Department of Administration
This senior role involves managing high-exposure claims and complex civil lawsuits against the State of Arizona, requiring independent investigation, accurate reserve establishment, and comprehensive settlement authority requests. The adjuster will act as a primary negotiator, represent the State in mediations, and liaise with the Attorney General’s Office to protect state interests.
The Market Physician Executive leads the in-home multi-specialty care model, overseeing clinical strategies, policies, and daily operations, including direct patient care and supervision of clinical and operations teams. A primary focus is delivering exceptional outcomes through disease detection, evidence-based clinical pathways, and managing total cost of care and quality improvement metrics.
The Billing Specialist is responsible for completing invoicing processes for all Ancillary Healthcare services, which includes administrative review of vendor and provider bills, determining appointment types, and generating vendor payments and customer invoices with a high focus on accuracy and urgency. This role also involves providing quality and friendly inbound and outbound telephonic customer service to assist customers and vendors with billing questions.
The Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority, ensuring adherence to company best practices and supporting departmental goals. Key duties include confirming coverage, determining compensability, establishing reserves, authorizing payments, and communicating claim status to all relevant parties.
CA Senior Liability Claims Specialist
CorVel Corporation
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Full Time
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11 Weeks Ago
CorVel Corporation
The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, focusing on achieving optimal outcomes for the company and clients. Responsibilities include receiving claims, confirming coverage, investigating, determining compensability, establishing reserves, and authorizing payments within limits.
The Medical Case Manager will provide in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The Scheduling Coordinator is responsible for participating in the daily operations and maintenance of the Medical Scheduling Departments, primarily by facilitating and scheduling medical services for claimants. Essential functions include proactively monitoring and managing files, identifying potential problems, proposing solutions to ensure no delay in care, and providing telephonic and written customer support.
The Scheduling Coordinator is responsible for participating in the daily operations and maintenance of the Medical Scheduling Departments, primarily by facilitating and scheduling medical services for claimants. Essential functions include proactively monitoring and managing files using proprietary web-based applications and providing telephonic and written customer support services.
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The Product Support Specialist II will troubleshoot and resolve complex application issues submitted via ServiceNow, acting as a subject-matter expert for proprietary applications and ITSM processes. This involves analyzing issues for root causes, participating in post-release testing, and maintaining technical documentation.
The Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority, confirming coverage, determining validity, establishing reserves, and authorizing payments. They communicate claim status to customers, claimants, and clients while adhering to guidelines and assisting with more complex claims as needed.
Senior WC Claims Specialist FLOAT (Part-time)
CorVel Corporation
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Full Time
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11 Weeks Ago
CorVel Corporation
The Senior Claims Specialist manages complex Workers' Compensation claims by confirming coverage, determining compensability through investigation, and establishing reserves and authorizing payments. This role involves developing action plans with case managers to reduce claim costs, coordinating return-to-work efforts, and managing subrogation and potential recoveries.
The Medical Case Manager will provide in-person and telephonic case management, working closely with injured workers, physicians, and providers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress, ensuring treatment plans are appropriate, medically necessary, and cost-effective.
Administrative Assistant / Data Entry Clerk (Remote Work From Home Online Telecommute) 20 APPLICANTS
Jobconversion, LLC
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Full Time
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11 Weeks Ago
Jobconversion, LLC
The primary responsibility involves performing data entry tasks accurately and efficiently from a remote location. Candidates must also be prepared to handle emailing clients as needed.
Centralized Leasing and Admin Specialist
Continental Properties
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Full Time
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11 Weeks Ago
Continental Properties
This role involves proactively managing communication with applicants to gather required documentation, thoroughly reviewing and verifying credit reports, income documents, and identification materials for accuracy and compliance. The specialist will also monitor documentation trends and partner with Community Managers to ensure 100% document completion prior to application approval.
The Clinical Adherence Nurse will conduct patient outreach and engagement primarily through video messaging and consultations to enroll patients in a medication adherence program. Key duties involve providing personalized clinical support, motivational coaching, medication reconciliation, and monitoring adherence through video-based interactions.
The Medical Case Manager will provide in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and medical necessity, attending provider visits, and coordinating necessary care like durable medical equipment.
The Sales Representative is responsible for positioning Sika Sarnafil as a quality provider, achieving sales objectives for Roofing and Waterproofing systems, and coordinating with local manufacturer’s representatives. Key duties include overseeing specification activity through consultants, managing roofing contractor accounts, establishing owner relationships, and providing sales activity reports.
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The IT Compliance Analyst is primarily responsible for collaborating with external and internal auditors to finalize all IT department audits, which includes maintaining and providing necessary compliance evidence. Essential functions also involve conducting regular audits on IT systems, procedures, and user accounts to ensure adherence to regulatory compliance.
Team members will assist healthcare providers and patients by phone, addressing questions and requests, and coordinating medication refill deliveries. They will also serve as the primary contact for calls and work with insurance companies regarding claim rejections and prior authorizations.
Patient Assistance Program / Financial Advocacy Coordinator
Onco360
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Full Time
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11 Weeks Ago
Onco360
The Patient Advocacy Coordinator assists patients and/or families in accessing financial resources for pharmacy co-pays by navigating systems to find suitable assistance through Not for Profit Organizations and Manufacturer Programs. This involves explaining processes, aiding in application completion, and reviewing required documentation.
The specialist will manage prior authorization requests and appeals with insurance carriers to ensure patients receive necessary medications. This involves receiving prescriptions, rectifying rejected claims, and conducting third-party authorization requests.
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