Average Salary for Jobs with Claim Reviews Skills

Conducts the medical review activities needed to resolve and process clinical appeals and claims. Reviews applicable medical records and assesses clinical data to investigate and resolve disputes over the medical necessity for services, approvals, pre-certifications, or other cases. Understands and interprets applicable medical terminology, clinical procedures, regulations and policies. Documents ... View job details

Denies, settles, or authorizes payments to routine property/casualty claims based on coverage, appraisal, and verifiable damage. Corresponds with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested insurance claims. Makes recommendations for settlement of routine property/casualty claims based on coverage, appraisal, and verifiable damage. Prep... View job details

Denies, settles, or authorizes payments to routine property/casualty claims based on coverage, appraisal, and verifiable damage. Responsible for corresponding with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested claims. Prepares reports of investigation findings. May conduct field evaluations to inspect and document damage or loss. May requ... View job details

Denies, settles, or authorizes payments to more complex property/casualty claims based on coverage, appraisal, and verifiable damage. Examines claim forms and other records to determine coverage. Responsible for corresponding with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested. Conducts field investigations to inspect and document damage o... View job details

Reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Verifies coverage eligibility. Calculates settlement amounts according to guidelines. Processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. Works under the... View job details