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Claims adjuster • brockton ma

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Medical Claims Reviewer

Medical Claims Reviewer

OSI VisionRandolph, MA, United States
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Be among the first 25 applicants.We are seeking Medical Claims Reviewers to assist the Air Force Security Assistance and Training (AFSAT) Squadron in monitoring the welfare of U.Air Force-sponsored...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Claims Intern

Claims Intern

FM GlobalNorwood, MA, US
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FM is a leading property insurer of the world's largest businesses, providing more than one-third of FORTUNE 1000- size companies with engineering-based risk management and property insurance solut...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Homeowner Property Claims Adjuster

Homeowner Property Claims Adjuster

The Jonus GroupBridgewater, MA, United States
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Looking for a dedicated and detail-oriented Homeowner Claims Adjuster to join a team.This role involves the inspection and investigation of property damage losses for active insurance claims.The su...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Independent Insurance Claims Adjuster in Norwood, Massachusetts

Independent Insurance Claims Adjuster in Norwood, Massachusetts

MileHigh Adjusters Houston IncNorwood, MA, US
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IS IT TIME FOR A CAREER CHANGE?.INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!.Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster?.This is you...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Claims Adjusters, Examiners, and Investigators

Claims Adjusters, Examiners, and Investigators

MercorWeymouth Town, Massachusetts, US
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Role Overview • •Mercor is collaborating with a top-tier AI research group to model real-world claims workflows for property and casualty insurance. We are seeking experienced independent contractors—...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
Medical Claims Reviewer

Medical Claims Reviewer

OSI VisionRandolph, MA, United States
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1 day ago Be among the first 25 applicants

We are seeking Medical Claims Reviewers to assist the Air Force Security Assistance and Training (AFSAT) Squadron in monitoring the welfare of U.S. Air Force-sponsored international students. Selected individuals will perform medical claims review activities, receive and process treatment requests, and provide guidance to treatment facilities.

Primary Responsibilities

  • Perform medical claim review activities in support of Security Assistance and Security Cooperation training programs.
  • Receive, track, and verify medical, dental, and pharmacy pre-authorizations and claims for International Military Students (IMS) and their dependents.
  • Verify that the International Classification of Diseases (ICD) codes on the claims comply with treatment diagnosis using most recent ICD guidance, advocate for reduced treatment costs and provide claims to AFSAT / FMF for processing.
  • Provide validation / return of treatment requests to facilities and resolve discrepancies.
  • Provide guidance to treatment facilities, military base referral service (may be the TRICARE Office) on IMS medical insurance process, explain student Invitational Travel Order (ITO) and various ways student medical bills may be reimbursed.

Knowledge and Experience Requirements

  • 2 years of related medical claims work experience with at least 1 year working for the DoD (preferably the Air Force) in a medical claims position.
  • Working knowledge of medical terminology, insurance terminology, agencies policies, practices and regulations, various health care delivery and information systems to accomplish pricing analysis, third party collections, ICD codes, procedure codes and evaluation and measurement codes.
  • Working knowledge with the latest version of Microsoft Windows (e.g., 10), and Microsoft Office applications (e.g. Excel, Word, PowerPoint, Access).
  • Ability to become familiar with the Defense Security Assistance Management System (DSAMS) and proficient with the Security Assistance Network Web (SANWeb) within 90 days after employment.
  • Clearance Level : Tier 1 background investigation (formerly known as a NACI) required prior to issuance of a Common Access Card (CAC).

    • Language Skills

  • Ability to read, analyze, and interpret technical procedures and governmental regulations.
  • Ability to write reports.
  • Ability to effectively present information and respond to questions from managers, clients and customers.

    • Reasoning Ability

  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

    • Seniority Level

  • Entry level

    • Employment Type

  • Full-time

    • Job Function

  • Administrative
  • Industries : IT Services and IT Consulting

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