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Direct Claims Jobs in Delaware (NOW HIRING)

Brinks

Area Director

Wilmington, DE

... claims, prevent security losses, and protect employees, customers, and company assets. * Lead ... and direct leadership engagement. Minimum Qualifications: * Minimum of 7 years operations ...

Specialty1 Partners

Insurance Coordinator

Newark, DE · On-site

$19 - $21/hr

Submit accurate and timely insurance claims electronically and via mail. * Follow up on outstanding ... Position Base Pay Range $19-$21 USD Specialty1 Partners is the direct employer of non-clinical ...

Specialty1 Partners

Insurance Coordinator

Newark, DE · On-site

$19 - $21/hr

Submit accurate and timely insurance claims electronically and via mail. * Follow up on outstanding ... Position Base Pay Range $19-$21 USD Specialty1 Partners is the direct employer of non-clinical ...

Walgreens

Pharmacy Customer Service Associate

Delmar, DE · On-site

In accordance with state and federal regulations, assists the pharmacist, under direct supervision ... Processes (corrects and resubmits) manual claims for third party program prescription services in a ...

Walgreens

Pharmacy Customer Service Associate

Delmar, DE · On-site

In accordance with state and federal regulations, assists the pharmacist, under direct supervision ... Processes (corrects and resubmits) manual claims for third party program prescription services in a ...

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Showing results 21-40

All JobsDirect Claims JobsDirect Claims Jobs in Delaware

Direct Claims information

What is a direct claim?

Direct claims refer to insurance claims that are filed directly by the policyholder with their own insurance company, rather than going through a third party or the at-fault party's insurer. This process is common in situations like auto accidents, where the policyholder seeks compensation for damages or losses under their own policy. Direct claims help streamline the process, reduce delays, and ensure the policyholder receives prompt assistance and settlements. They are often associated with 'first-party' insurance coverage, such as collision, comprehensive, or health insurance claims.

Can you work remotely in direct claims jobs?

Many direct claims jobs offer remote work options, especially for roles involving claims processing, customer service, or administrative tasks. Employers may require familiarity with claims management software and good communication skills, and remote positions often involve standard office hours and secure internet connections.

Do I need a degree to be a direct claims specialist?

A degree is not typically required to become a direct claims specialist, but relevant experience, knowledge of insurance policies, and strong communication skills are important. Many employers provide on-the-job training and may prefer candidates with a high school diploma or equivalent. Certifications in insurance or claims processing can enhance job prospects.

What are some common challenges faced by professionals in direct claims roles, and how can they effectively manage these challenges?

Professionals in Direct Claims often face the challenge of balancing a high volume of claims with the need for thorough investigation and timely resolution. Managing customer expectations and handling sensitive situations, such as denied claims or complex cases, can also be demanding. Effective communication, strong organizational skills, and staying updated on policy guidelines are crucial for success. Building collaborative relationships with adjusters, underwriters, and other departments helps ensure accurate and efficient claims processing.

What are the key skills and qualifications needed to thrive as a direct claims specialist?

To thrive as a Direct Claims Specialist, you need a solid understanding of insurance policies, claims processes, and relevant legal regulations, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, customer relationship management (CRM) systems, and sometimes industry certifications like AIC or CPCU is typical. Exceptional attention to detail, problem-solving abilities, and strong communication skills set top performers apart in this role. These skills and qualifications ensure claims are processed accurately and efficiently, leading to customer satisfaction and minimized risk for the insurer.

What is the difference between Direct Claims vs Claims Adjuster?

AspectDirect ClaimsClaims Adjuster
CredentialsInsurance license, knowledge of policiesInsurance license, sometimes certifications like AIC or CPCU
Work EnvironmentCustomer service, office or remoteFieldwork, office, or remote
Employer & IndustryInsurance companies, agenciesInsurance companies, third-party administrators
Search & Comparison IntentUnderstanding direct claims handlingEvaluating claims adjustment roles

Direct Claims professionals primarily handle claims directly from policyholders, focusing on processing and resolving claims within the insurance company. Claims Adjusters evaluate, investigate, and settle claims, often working in the field or remotely. Both roles require insurance licensing, but Claims Adjusters may have additional certifications. While their work overlaps in claims processing, Direct Claims roles are more customer-facing, whereas Claims Adjusters focus on assessment and negotiation.

What are popular job titles related to Direct Claims jobs in Delaware? For Direct Claims jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Direct Claims jobs in Delaware look for? The top searched job categories for Direct Claims jobs in Delaware are:
What cities in Delaware are hiring for Direct Claims jobs? Cities in Delaware with the most Direct Claims job openings:
Direct Claims jobs near you

LEAD OFFICE - BEEBE WALK IN

Beebe Healthcare

Rehoboth, DE

$18 - $27.90/hr

Full-time

Medical, Dental, Vision, Life, PTO

Posted 5 days ago

Beebe Healthcare rating

6.3

Company rating: 6.3 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

671st of 887 rated healthcare providers

Job description

Why Beebe?

Become part of the Beebe team - an inclusive team positioned in a vibrant, coastal community. Enjoy a fulfilling career as you support the health of our patients and a team focused on excellence.

Benefits

In addition to competitive compensation and wellness benefits (medical, dental, vision and prescription) Beebe Healthcare also offers:

  • Sign-on and Referral Bonuses for select positions
  • Tuition Assistance up to $5,000
  • Paid Time Off
  • Long Term Sick accrual
  • Employer Contribution Plan
  • Free Short and Long-Term Disability for Full Time employees
  • Zero copay for drugs on prescription plan for certain conditions
  • College Bound 529 Savings Plan
  • Life Insurance
  • Beebe Perks via Work Advantage
  • Employee Assistance Program
  • Pet Insurance
OverviewSupervises and directs the day-to-day billing functions for hospital bills prepared for Medicare, Blue Cross, Medicaid, Commercial and Self-Pay claims.ResponsibilitiesDemonstrates ability to plan and organize work flow to maximize productivity while maintaining quality, safety and customer satisfaction.. Assists in the development of PDCA systems to implement and monitor process improvements and take action where appropriate. Ensures team members maintain departmental policies/procedures, and adhere to all quality, safety, and regulatory standards/requirements. Supports department by monitoring regulatory/accreditation compliance. Takes actions to address deficiencies as appropriate. Trains new and current team members and students. Ensures that orientation and training checklists are completed. Makes sure that annual mandatory education is completed and competencies are assessed and documented. Provides feedback to leadership about team members' performance, including need for coaching, counseling, disciplinary action. Assists leadership in completing initial and annual performance appraisals. Recommends/Assists with the preparation of departmental training and education, quality and safety programs and performance improvement projects. Acts as resource person for daily operations within the department, section or unit. Very knowledgeable about the specific aspects/technical details of the job, and readily share knowledge with others. Participates in the interview process and provides feedback on candidates. Responsible for the daily operation of the billing office. Assists the Director of Operations in establishing and monitoring quality assurance standards for the department. Monitors performance and communicates results of performance studies to billing staff to promote quality improvements. Reviews problem claims and meets with billing staff on a daily basis to answer questions and seek resolution to billing problems. Responsible for monitoring and documentation on all material accounts receivable reporting results to upper management in a timely manner. Responsible to stay up-to-date in billing changes and regulation dictated by third-party payors. Responsible for the communication of billing changes and requirements to billing staff. Assists the Director of Operations in the development of desk top procedure guidelines. Responsible to keep procedures current and up-to-date. Provides training and orientation for new staff. Utilizes quality assurance reports to educate staff and make on-going quality improvements in job performance. Assists the Director of Operations in the hiring and interviewing of new personnel. Will also assist in monitoring and evaluating employees' performance. Supervises all personnel of the Billing Department in the absence of the Director of Operations. Prepares transaction reports for write-off of accounts. Refers reports to Director of Operations for write-off approval. Establishes and maintains liaison with federal, state and third party insurance payers to ensure accurate and timely medical billing of claims. Develops and maintains a good working rapport with inter-departmental personnel as well as other departments within the hospital.Qualifications

Should possess knowledge of UB92 billing elements, ICD9/ICD10 and CPT Coding. Five years experience in a health care environment in a patient accounting department. Strong written and verbal communication skills necessary. Strong working knowledge of computer billing systems.

Competencies Skills

Essential:* Clear Communication Skills Both Written And Verbal* Able To Keep Confidential Information Regarding Patients, Team Members* Able To Withstand Crisis Situations* Has Skills To Provides Customer Service To Patients, Team Members And Visitors* Knowledge And Experience With Electronic Health Records* Experience With Or Completed Course In Medical Terminology

CredentialsEducationEssential:* High school graduate or equivalentEntryUSD $18.00/Hr.MaxUSD $27.90/Hr.Employment Type: FULL_TIME

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