Claims Specialist with FineOS Remote Fulltime Responsibilities: To provide Absence case management ... Approval or denial on FMLA claims as per Insurance carrier, and employer's guidelines Analyzes ...
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Claims Specialist with FineOS Remote Fulltime Responsibilities: To provide Absence case management ... Approval or denial on FMLA claims as per Insurance carrier, and employer's guidelines Analyzes ...
Quick apply
Claims Specialist with FineOS Remote Fulltime Responsibilities: To provide Absence case management ... Approval or denial on FMLA claims as per Insurance carrier, and employer's guidelines Analyzes ...
CA ยท Remote
$99K - $110K/yr
We are actively hiring for a Commercial Claims Insurance Analyst - Remote Your Role: Seasoned professional with a strong understanding of the functional area who supports overall business strategy ...
CA ยท Remote
$99K - $110K/yr
We are actively hiring for a Commercial Claims Insurance Analyst - Remote Your Role: Seasoned professional with a strong understanding of the functional area who supports overall business strategy ...
Charlotte, NC ยท Remote
$52K - $85K/yr
This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
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Charlotte, NC ยท Remote
$52K - $85K/yr
This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
Charlotte, NC ยท Remote
$52K - $85K/yr
This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
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Charlotte, NC ยท Remote
$52K - $85K/yr
This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
$40 - $45/hr
Our client, a major Life Insurance carrier is seeking an Annuity Claims Specialist for a long term ... Advisor (CAA) certifications, courses or designations are a big plus. - A bachelor's degree or ...
$40 - $45/hr
Our client, a major Life Insurance carrier is seeking an Annuity Claims Specialist for a long term ... Advisor (CAA) certifications, courses or designations are a big plus. - A bachelor's degree or ...
Oakland, CA ยท On-site +1
$73K - $156K/yr
This position is remote, with a preference for candidates located in Southern California or ... Health Insurance * Vision and Dental Insurance * Generous Paid Time Off Plans WHAT YOU'LL DO:
Oakland, CA ยท On-site +1
$73K - $156K/yr
This position is remote, with a preference for candidates located in Southern California or ... Health Insurance * Vision and Dental Insurance * Generous Paid Time Off Plans WHAT YOU'LL DO:
Austin, TX ยท Remote
$48K - $60K/yr
Claims Specialist We support clients by keeping their insurance claims processing organized ... Fully remote position * Competitive health, dental, and vision insurance * 401(k) with up to 6% ...
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Austin, TX ยท Remote
$48K - $60K/yr
Claims Specialist We support clients by keeping their insurance claims processing organized ... Fully remote position * Competitive health, dental, and vision insurance * 401(k) with up to 6% ...
Highly qualified candidates outside the Austin area for a remote work arrangement. Position Summary ... Serve as a technical resource and trusted advisor for leadership and team members.
Highly qualified candidates outside the Austin area for a remote work arrangement. Position Summary ... Serve as a technical resource and trusted advisor for leadership and team members.
Austin, TX ยท On-site +1
Highly qualified candidates outside the Austin area for a remote work arrangement. Position Summary ... Serve as a technical resource and trusted advisor for leadership and team members.
Austin, TX ยท On-site +1
Highly qualified candidates outside the Austin area for a remote work arrangement. Position Summary ... Serve as a technical resource and trusted advisor for leadership and team members.
Rancho Cucamonga, CA ยท Remote
$61K - $98K/yr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
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Rancho Cucamonga, CA ยท Remote
$61K - $98K/yr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
San Diego, CA ยท Remote
$61K - $98K/yr
This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms policy ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
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San Diego, CA ยท Remote
$61K - $98K/yr
This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms policy ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
Charlotte, NC ยท Remote
$61K - $98K/yr
This is a remote role. Candidates must physically reside in the Eastern or Central Time zone ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
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Charlotte, NC ยท Remote
$61K - $98K/yr
This is a remote role. Candidates must physically reside in the Eastern or Central Time zone ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
Mitcheldean, Gloucestershire Remote work options are available - After successfully passing the ... Claims Advisors take details of the failure, using the information provided, alongside the terms ...
Mitcheldean, Gloucestershire Remote work options are available - After successfully passing the ... Claims Advisors take details of the failure, using the information provided, alongside the terms ...
Rancho Cucamonga, CA ยท Remote
$25.48 - $41.09/hr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Manages non-complex and non ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
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Rancho Cucamonga, CA ยท Remote
$25.48 - $41.09/hr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Manages non-complex and non ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...
MA ยท On-site +1
$61K/yr
Remote: Candidates who live more than 50 miles from a Liberty Mutual Claims office are eligible to ... Demonstrated competency of legal liability, general insurance policy coverage and State Tort Law.
MA ยท On-site +1
$61K/yr
Remote: Candidates who live more than 50 miles from a Liberty Mutual Claims office are eligible to ... Demonstrated competency of legal liability, general insurance policy coverage and State Tort Law.
$83K - $108K/yr
Selective's unique position as both a leading insurance group and an employer of choice is ... Overview Selective is seeking a skilled General Liability Claims Specialist for this fully remote ...
$83K - $108K/yr
Selective's unique position as both a leading insurance group and an employer of choice is ... Overview Selective is seeking a skilled General Liability Claims Specialist for this fully remote ...
MA ยท On-site +1
$61K/yr
Remote: Candidates who live more than 50 miles from a Liberty Mutual Claims office are eligible to ... Demonstrated competency of legal liability, general insurance policy coverage and State Tort Law.
MA ยท On-site +1
$61K/yr
Remote: Candidates who live more than 50 miles from a Liberty Mutual Claims office are eligible to ... Demonstrated competency of legal liability, general insurance policy coverage and State Tort Law.
Union, NJ ยท On-site +1
$65K - $90K/yr
Review, investigate, and manage claims within captive insurance programs from intake through ... Hybrid or remote flexibility depending on location and business needs
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Union, NJ ยท On-site +1
$65K - $90K/yr
Review, investigate, and manage claims within captive insurance programs from intake through ... Hybrid or remote flexibility depending on location and business needs
Longterm Contract Onsite or Remote both works here Role Overview The Senior Technical Lead - FINEOS ... This role combines deep technical expertise in FINEOS, strong understanding of insurance claims ...
Longterm Contract Onsite or Remote both works here Role Overview The Senior Technical Lead - FINEOS ... This role combines deep technical expertise in FINEOS, strong understanding of insurance claims ...
Charlotte, NC ยท Remote
$40 - $45/hr
Our client, a major Life Insurance carrier is seeking an Annuity Claims Specialist for a long term ... Advisor (CAA) certifications, courses or designations are a big plus. - A bachelor's degree or ...
Quick apply
Charlotte, NC ยท Remote
$40 - $45/hr
Our client, a major Life Insurance carrier is seeking an Annuity Claims Specialist for a long term ... Advisor (CAA) certifications, courses or designations are a big plus. - A bachelor's degree or ...
$40K - $44.7K
8% of jobs
$44.7K - $49.5K
7% of jobs
$53.2K is the 25th percentile. Wages below this are outliers.
$49.5K - $54.2K
12% of jobs
$54.2K - $58.9K
14% of jobs
The median wage is $60.2K / yr.
$58.9K - $63.6K
33% of jobs
$64.2K is the 75th percentile. Wages above this are outliers.
$63.6K - $68.4K
11% of jobs
$68.4K - $73.1K
7% of jobs
$73.1K - $77.8K
4% of jobs
$77.8K - $82.5K
3% of jobs
$82.5K - $87.3K
1% of jobs
$87.3K - $92K
0% of jobs
$40K
$61.6K
$92K
Cities with the most Remote Insurance Claims Advisor job openings:
For Remote Insurance Claims Advisor jobs, the most frequently searched job titles are:

Cincinnati, OH โข Remote
Full-time
PTO
Re-posted 4 days ago
Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employer’s guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned
Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.