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| Employer Name: InsurCrossing |
SpiderID: 2286443 |
| Location: Dubuque, Iowa |
Date Posted: 6/16/2008 |
| Wage: |
Category: Insurance |
| Job Code: |
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Job Description:
Supervises claims examiners processing claims for a single product line. Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office. Provides technical/jurisdictional direction to examiner reports on claims adjudication. Compiles, reviews and analyzes management reports and takes appropriate action. Performs quality review on disability claims in compliance with audit requirements, service contract requirements, and quality standards. Acts as second level of appeal for client and employees issues regarding claim specific, procedural or special requests; implements final disposition of the appeal. Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner. Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client. Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client. Ensures claims files are coded correctly and adequate documentation is made by claims examiners.
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Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:
Contact Information:
| Contact Name: - |
Company Type: Employer |
| Company: InsurCrossing |
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| City: Pasadena |
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| State: California |
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| Zip: |
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Web Site: http://www.insurcrossing.com
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