Claim processor jobs in Appleton, WI

Responsible for adjudicating PL, CL, Shipping, and CarePlan claims as assigned. The claims specialist also assists with administrative duties for the department, helping the team effectively negotiate and resolve claims in a timely manner and in accordance with established good faith handling procedures. A secondary responsibility within this role is to provide support to the Jewelry Recovery Specialist with salvage-related documentation including salvage-related invoices, payments, and recoveries. Why Jewelers Mutual: Since 1913 we've been committed to supporting the Jewelry industry and putting customers at the center of everything we do. With over a century of trusted expertise, we're financially strong, forward-thinking, and driven by curiosity. Guided by our core values of Agility, Accountability, and Relevancy, we lead through innovation. As a technology focused organization, we embrace cutting-edge tools and data-driven insights to continuously improve our products, services, and customer experience. Our mission is to be the industry's most trusted advisor by investing in our people, adopting new technologies, and striving for excellence. We're dedicated to fostering growth through collaboration, powered by bold thinking, teamwork, and the passion of our people. Here, you'll: Move fast and embrace change Always look for better ways Grow, thrive, and help shape what's next Join us and be part of a culture where you can make an impact while building your future. What You'll Do: Investigates, evaluates, and resolves multi-line claims in accordance with established procedures, good faith practices, and in accordance with the policy. Examines claim adjustors' reports or similar claims/precedents to determine extent of coverage and liability. Pays claimant/insured amount due according to our contractual obligation and in alignment with our company procedures. Identifies and refers questionable claims to the special investigation unit in accordance with established fraud reporting procedures. Maintains excellent written and verbal correspondence with all parties involved on the claim. Evaluates and obtains damage documentation to accurately set reserves and effectively resolve claims. Maintains current status on claims and reviews claims on diary system. May be required to provide testimony under oath on claims in litigation. Provides quality customer service along with accurate and timely claim investigations and payments. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. What You'll Bring: Property/casualty insurance adjusting experience is desired. Jewelry expertise, including experience working in the jewelry trade, is desired. Proficient in Microsoft suite applications including Word, Excel, Outlook, and PowerPoint. Proficiency in Guidewire software desired. CERTIFICATES, LICENSES, REGISTRATIONS None PHYSICAL REQUIREMENTS Prolonged periods sitting at a desk and working on a computer. Occasionally required to stand; walk; use hands to finger, handle, or touch objects or controls; and talk or hear. What We Offer You: Competitive Compensation & Benefits: Includes performance bonuses, generous paid time off, and a top-tier retirement program with 401(k) matching and additional company contributions. Collaborative Culture: Work alongside talented, passionate peers who value ownership and continuous learning. Community & Giving: Benefit from 50% charitable gift matching and paid volunteer time to support nonprofit causes Great Place to Work Certified: Join a team recognized for an environment of innovation and growth. Accessibility and Accommodations We are committed to providing an inclusive and accessible recruitment process. If you require accommodation at any stage of the application or interview process, please let us know by contacting *************************.

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: * Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim * The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions * Maintain claim block and meet departmental production and quality metrics * An awareness of industry claim practices * Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records * Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. * Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process * Establish cooperative and productive relationships with professional resources What you will bring with you: * Bachelor's degree preferred * A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing * Demonstrated ability to work as part of a cohesive team * Strong written and verbal communication skills * Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in negotiation, persuasion, and solutions-based underwriting * Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism * Overall knowledge of health care industry * Proficiency using the Microsoft Office suite of products * Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026

What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. Job Responsibilities * Confirms coverage of claims by reviewing policies and documents submitted in support of claims. * Conducts, coordinates and directs investigation into loss facts and extent of damages. * Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure. * Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents. * Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting. Required Qualifications * This role will is responsible for Equine claims; equine knowledge or hands-on experience working with horses is strongly preferred. * Must have or be eligible to receive claims adjuster license. * Successful completion of basic insurance courses or achievement of industry designations. * Ability to be trained in insurance adjusting up to two years of claims experience. * 2-4 years of experience in general liability, construction defect, or related liability lines preferred. * Bachelor's degree preferred * Excellent written and oral communication skills. * Strong organizational and time management skills. #LI-Hybrid US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. * We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. * All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. * We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose 'Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: * All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. * All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.

Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers exciting openings for Workers Compensation Claims Specialists within the Central Region! As a Workers Compensation Claims Specialist, the successful candidate will join a dedicated Claims Team, utilizing the latest technology to manage a caseload of routine to moderately complex claims. Responsibilities include investigating claims, assessing liability and compensability, evaluating losses, and negotiating settlements. The role involves interactions with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claims management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers. Training is a critical component of your success, and that success starts with reliable attendance. Attendance and active engagement during training are mandatory. Training will require 1 week in our Plano, TX office onsite in February 2026. This position may be filled as a Workers Compensation Associate Claims Specialist, Workers Compensation Claims Specialist I, or a Workers Compensation Claims Specialist II. The salary range posted reflects the range for the varying pay scale across various locations. To be considered for this position, candidates must reside within 50 miles of Hoffman Estates, IL, or Indianapolis, IN, and will be required to work in the office twice a month. Candidates located in Ohio, Montana, and Virginia are eligible for 100% remote work, as we do not have claims offices in these states. Please note that this policy is subject to change. Responsibilities * Manages an inventory of claims to evaluate compensability/liability. * Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources. * Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages. * Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. * Evaluates actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. * Performs other duties as assigned. Qualifications * Effective interpersonal, analytical and negotiation abilities required * Ability to provide information in a clear, concise manner with an appropriate level of detail * Demonstrated ability to build and maintain effective relationships * Demonstrated success in a professional environment; success in a customer service/retail environment preferred * Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent * Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory * Licensing may be required in some states About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

Job DescriptionWe are looking to add someone to our team who can work in a fast-paced environment with great customer service, has great attention to detail, and can quickly adapt to change throughout the day. If you have medical insurance and prior authorization experience who promotes positivity, this position is for you. ABOUT BONE & JOINTBone and Joint has one of the most comprehensive teams of orthopedic, pain management, podiatric, physical and occupational therapy experts in Northcentral Wisconsin. We aren't a division of another corporate healthcare organization; Bone & Joint belongs to us and we have numerous locations throughout Central Wisconsin. Our mission is to be the Best place for patients to receive care, the Best place for employees to work, and the Best place for physicians to practice medicine.A DAY IN THE LIFE OF A PRE-CERTIFICATION SPECIALIST Being a part of the Pre-Certification/Verification of Benefits Team you will complete a variety of tasks each day in a very fast-paced environment. Our Pre-Certification Specialists work with several different departments throughout Bone & Joint. You will work and communicate daily with our Providers, their clinical teams, Ambulatory Surgery Center teams, Registration, coding & billing team, Therapy teams along with outside companies such as Insurance carriers, and other outside hospital systems. Primarily you will be completing insurance prior authorizations via online or over the phone for procedures, surgery, High end imaging, DME, etc. that our ordered by our providers. We also complete verification of benefits for all patients to ensure they have active coverage and a plan that Bone & Joint accepts at our clinics and Walk-in locations. QUALIFICATIONS FOR A PRE-CERTIFICATION SPECIALIST High school diploma or equivalent Patience and ability to work with people at all levels, internal and external, required. Must have great attention to detail. 1 plus years' experience with online and telephone prior authorizations for services. Experience and knowledge of all types of insurances (government, commercial, programs, private). WORK SCHEDULEWorkdays of a Pre-Certification Specialist are Monday through Friday 8:30AM to 5:00PM with a 30-minute lunch. Additional flexibility may be offered after the training period and based on business needs.READY TO JOIN OUR TEAM?If you think you have what it takes to do this job, then the next step is to fill out our online application. Don't worry, the application is pretty simple as it asks for your resume and to answer some questions to help us get to know you better. We should warn you though, if you are selected to move forward in the hiring process, we will require that you provide us with further details to help us further understand your interest. Job Posted by ApplicantPro

Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities. Job Summary When employees are injured on the job, they need someone who can guide them through the process with care and expertise. As a Workers' Compensation Claims Representative at West Bend, you'll guide injured employees through the recovery process, ensure fair and timely claim resolution, and help businesses stay compliant. If you thrive on problem-solving, negotiation, and making a real impact, this is your opportunity to lead with confidence. Work Location This position offers a hybrid schedule with three in-office collaboration days for team meetings and other events. In certain cases, highly qualified candidates with strong jurisdictional experience may be considered for a remote arrangement. The internal deadline to apply is 1/9/2026. External applications will be accepted on a rolling basis while the position remains open. Responsibilities & Qualifications As a Claims Representative, you will manage claims of varying complexity using current claim technology and best practices. You will conduct thorough investigations to determine coverage, evaluate damages/benefits, and assess liability/compensability. You will negotiate settlements with insureds, claimants, and attorneys while maintaining proactive file management, accurate reserving, and adherence to audit and regulatory standards. This role collaborates closely with internal partners and external stakeholders, with the scope of responsibility (including field work and regional liaison duties) increasing with experience level. Key Responsibilities Investigate and resolve claims within assigned authority Determine coverage, damages, and liability Negotiate settlements with insureds, claimants, and attorneys Maintain accurate documentation and reserving Communicate promptly and professionally with all stakeholders Collaborate with internal teams and external partners Adhere to audit and compliance standards Participate in training and team initiatives Preferred Experience and Skills Prior experience managing claims at the appropriate level of complexity (from low/moderate to high-exposure/complex) Proficiency with computers and current claim technology Interpersonal, oral, and written communication skills with customer-focused professionalism Negotiation, problem-solving, and conflict resolution skills Time management and organizational discipline with proactive file handling Independent decision-making ability (higher levels) and results orientation Technical expertise in coverage analysis, compensability, and damages evaluation (higher levels) Prior experience managing claims across multiple jurisdictions (higher levels) with preferred jurisdictions of Illinois, Wisconsin, and North Carolina Preferred Education and Training Bachelor's degree in Business, Insurance or related field Associate in General Insurance (AINS) designation Associate in Claims (AIC) designation CPCU coursework or other continuing education Licensure in jurisdictions where required #LI-LW1 Salary Statement The salary range for this position is $67,000 - $100,000. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate. Benefits West Bend offers a comprehensive benefit plan including but not limited to: Medical & Prescription Insurance Health Savings Account Dental Insurance Vision Insurance Short and Long Term Disability Flexible Spending Accounts Life and Accidental Death & Disability Accident and Critical Illness Insurance Employee Assistance Program 401(k) Plan with Company Match Pet Insurance Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates Bonus eligible based on performance West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies. EEO West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.

Join the company defining what it means to be an Impact Lender! Mortgages are what we do, but that doesn't define who we are. In 2008, Movement disrupted the industry with the innovative 6-7-1 mortgage process. In 2023, we pioneered again, helping launch Impact Lending - a new category of lending. Any mortgage lender that commits at least 10% of its profits to helping the neighborhoods it serves is an Impact Lender. At Movement, we are Impact Lenders. We give 40%-50% of our profits to making an impact in our communities. For us, purpose and people have always come before profit. ROLES AND RESPONSIBILITIES (Duties and responsibilities may include, but are not limited to the following): Processing Support Completes order outs to third party vendors Title/CPL/tax cert/wire instructions/preliminary HUD Flood cert Condo questionnaire and supporting documentation FHA case number/CAIVRS Orders payoff (refinance only) Orders any and all necessary verifications (written VOE, VOD, VOR) for borrowers Sends condo questionnaire to homeowners' association and obtain condo docs as necessary (if property is a condo or attached PUD) Completes LDP/GSA checks only on loans that do not require Fraudguard Requests hazard insurance with correct mortgagee clause (binder & paid receipt if purchase) Communicates with title company, appraiser, and other vendors as required to obtains documentation needed to clear conditions REQUIRED SKILLS AND QUALIFICATIONS (To perform the job successfully, the candidate should demonstrate the following competencies to perform the essential functions of this job.) Solid knowledge and understanding of customer service and intrapersonal best practices. Extensive knowledge and understanding of HECM loan program. Solid knowledge and understanding of mortgage lending processes, procedures, and regulations. PREFERRED QUALIFICATIONS Demonstrated experience analyzing and interpreting data. Demonstrated experience researching information, problem solving and making solid business decisions. Demonstrated experience working in a fast paced and changing environment. Demonstrated experience with MS Office products. Hybrid role in Marshfield, WI PREFERRED EDUCATION High School or GED PHYSICAL REQUIREMENTS This position is primarily an in-office position. Normal office environment. The expected salary range for this position is between: $44,500.00 - $59,500.00 The range for the position in other geographies may vary based on market differences. The actual compensation will be determined based on experience and other factors permitted by law. We also offer a benefits package that includes: Competitive pay Benefits Offered: Medical, Dental, Vision, Life, Disability, Critical Care, Hospitalization, HSA, FSA, DCFSA and QTE Retirement plan: 401(k) and Roth Paid Time Off: 16 days front loaded. Prorated based on the start date month 11.5 paid holidays per year Employee assistance program Excellent career growth opportunity Fun, team-focused working environment Employee driven community outreach program Relocation packages available The application window is anticipated to close on: January 5, 2026 We're definitely not your average mortgage company. When you're ready to grow your career AND your impact, we're ready for you. We're also one of the nation's top lenders and are redefining corporate culture. We work hard, we have fun, we invest in our people and we make a difference. Sound like a plan? Good. Learn more at *****************

Requirements This individual performs the following responsibilities independently with minimal supervision: Reviews information collected and research/investigations performed by fellow teammates, preparing detailed summaries of accounts and associated medical documentation. Monitors accounts; communicates with teammates, other departments, clients, attorneys, employers, and patients; and takes necessary action to support the desired and timely resolution of litigation efforts. Specifically assists with small claims litigation and garnishment questions or concerns. Gathers and makes appropriate documentation in internal technology platforms. Proactively informs leadership of account statuses through the resolution of litigation efforts. Executes workload by following company and department standards, processes, and procedures with an emphasis on compliance. Supporting Teammates Contributes to the optimization and creation of department processes, developing reference materials as requested. Participates in the cross-training or sharing of knowledge, skills, and abilities throughout the team, supporting, guiding, and training teammates as appropriate. Supports the continual growth and development of teammates by observing phone calls, reviewing referrals, and providing constructive feedback. Serves as a resource to the Collections Contact Center by supplying information about the litigation process to call-takers addressing the questions or concerns of patients. Eligibility Requirements Required Education: High School Diploma / GED Experience & Knowledge 6+ months of experience in a professional small claims capacity (ideally at Americollect) preferred 1+ year(s) of experience in a customer service capacity preferred 1+ year(s) of experience multi-tasking, specifically in performing data entry and web-based research simultaneously preferred 1+ year(s) of experience contributing to a team culture of learning and growth preferred Knowledge of department processes and procedures or equivalent, specifically for outside counsel and the state of Wisconsin required Knowledge of collections industry, healthcare revenue cycle, and litigation proceedings (specifically small claims actions) preferred Completion of procedural training facilitated by the Small Claims department or equivalent required Proficient in typing 45 words per minute required Proficient in leveraging technology platforms or equivalent required Proficient in managing a multi-line phone system required Proficient in Microsoft Office Suite preferred Disclaimer: This may not be inclusive of all assigned duties, responsibilities, or aspects of the job described. The full job description is available to applicants through the hiring process and upon request. Americollect - Believe in More. Believe in Teamwork and Collaboration. Believe in growth and developing the future you. Believe in friendships and family. Believe in celebrating and having fun. Believe in Community involvement and helping others. At Americollect, it's more than just a job- it's doing something you believe in . Americollect provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, transfer, leaves of absence, compensation and training.

Job Title:Billing and Claims Specialist Reports to:Director of Operations Description:The Billing and Claims Specialist will work with clinicians, administrative staff, patients, and insurance companies to submit and process insurance claims for mental health services at Behavioral Health Clinic (BHC). Duties and Responsibilities: Oversee coding of services using ICD-10 and DSM-5 Coding Submit claims using the Electronic Health Record and claims processing software Enter Payments (ERA, EFT, & Other Payments) Prepare Billing Statements Research and Resolve billing issues by working with insurance companies Run Billing Cycle Reports Research Coding Rules and Regulations with Contracted Payers to help guide best business practice Patient Collection Duties (collecting copays and patient allowed amounts, creating refunds, managing collections process etc.) Other duties as assigned Qualifications: Compassionate and Confidential Efficient with computer software systems (with training) Working knowledge of Microsoft Office and Google products (Documents, Sheets, etc.) Ability to work effectively both independently and as part of a team Willingness to learn and adapt Strong organization and time management skills Skilled in verbal and written communication including good phone skills Experience in medical coding and billing preferred but not required; 3-5 years of work experience (preferred) Willingness to work occasional overtime Benefits: Starting pay $22.00 - $26.00 per hour Healthcare Benefit Package - Including Dental, Vision, STD, LTD, and Retirement Plan Options Supportive and collaborate team environment & Opportunities for advancement and leadership Paid Time Off (PTO) and Holidays *In accordance with legal requirements and company policies, successful candidates for this position will be required to complete the form I-9, Employment Eligibility Verification and Background Check, as part of the onboarding process*

At TruStage, we're on a mission to make a brighter financial future accessible to everyone. We put people first, and work hand in hand with employees and customers to create a diverse and inclusive environment. Passionate about building insurance and financial services solutions, we push the boundaries of what's possible. We need you to help us shape what's next. You'll be encouraged to share your experiences, ideas and skills to help others take control of their financial future. Join a team that has received numerous awards for being a top place to work: TruStage awards and recognition This position is responsible for oversight of assigned Program Third Party Administrators (TPA's) and handling new and existing litigation claims. Ensure timely and effective application of policies and processes. Accountable for team goals related to customer service and compliance with best practices. Provide claim file direction and assistance with complex claim issue resolution. Maintain effective communication with internal and external business partners. Participate in quality assurance reviews and work on special projects to best meet the needs of the department. Contribute to the development of functional/team strategy. The position will also oversee complex professional and general liability litigated claims. Job Responsibilities: Serve as the primary point of contact and relationship manager for program claims. Oversee proactive litigation management on assigned claims including investigating, evaluating, and negotiating to resolution. Coordinate operational and leadership responsibilities to ensure consistent claim results, quality, and customer service. Develop protocols to aid in the establishment and maintenance of claim strategies and appropriate claim handling authority providing education and training as required. Collaborate with business partners vetting and onboarding new Programs and TPA's. Develop/maintain tools to monitor and improve the communication of essential claim information to ensure that monthly data collection and information sharing practices support TruStage Corporate standards. Work in close collaboration with cross-functional teams including Underwriting, Actuarial, Product, Finance, and Treasury to analyze and structure existing and new Program Business. Conduct in-person or remote claim file reviews and audits on multiple TPA claim systems. Identifies emerging claim trends as warranted. Monitor and document claim processes/guidelines for effectiveness and efficiency, identifying and implementing process improvements. Participate in Claim organization strategy initiatives and projects in collaboration with the Claim Operations team. Collaborate with Claim Operations leaders regarding the selection and ongoing management of TPA's and other outside vendors. The above statement of duties is not intended to be all inclusive and other duties will be assigned from time to time. Job Requirements: Bachelor's Degree in Business Administration, Insurance, Finance, Economics, or related field of study is strongly preferred. 7+ years of P&C Insurance claims experience. CPCU, AIC, ASLI, or other industry designations or certifications are highly desirable. Adjuster license and continuing education as needed. Proven ability to clearly and effectively communicate information to internal/external clients remotely or in person. Strong critical thinking and analytical skills. Demonstrated experience in progressively senior claim roles with strong technical skills. Experience in a range of Property and Casualty lines of business and products including Property, General Liability, Automobile Liability and Physical Damage Liability, and Professional Liability. Strong interpersonal and consultative skills. Creativity, flexibility, emotional intelligence, adaptability, and problem-solving skills. Ability to manage and develop existing and new industry relationships with Program Managers, Brokers, and Reinsurance partners. Ability to travel ~10%. If you're ready to help make a difference, apply today. A resume is required to apply. TruStage may process applicant information using an Artificial Intelligence (AI) tool. This tool automatically generates a screening score based on how well applicant information matches the requirements and qualifications for the position. TruStage recruiters use the screening score as a guide to further evaluate candidates; the score is one component of an application review and does not automatically determine whether a candidate moves forward. Candidates may choose to opt out of this process. Compensation may vary based on the job level, your geographic work location, position incentive plan and exemption status. Base Salary Range: $91,300.00 - $136,900.00 At TruStage, we believe a sound, inclusive benefits program is of vital importance, along with a flexible workplace that allows for work-life balance, career growth and retirement assistance. In addition to your base pay, your position may be eligible for an annual incentive (bonus) plan. Additional benefits available to eligible employees include medical, dental, vision, employee assistance program, life insurance, disability plans, parental leave, paid time off, 401k, and tuition reimbursement, just to name a few. Beyond pay and benefits, we also recognize that flexibility, including working in a place you prefer, is essential to caring for our employees. We will continue to strive to offer flexibility and invest in technology and other tools that will make hybrid working normal rather than an exception, so that when “life happens,” you can focus on what's most important. Accommodation request TruStage is a place where everyone can bring their best self and thrive. If you need application or interview process accommodations, please contact the accessibility department.

**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $67,000.00 - $110,600.00 **Target Openings** 1 **What Is the Opportunity?** Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery The injured worker is working modified duty and receiving ongoing medical treatment. The injured worker as returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and there has been a change in the current position. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered. **What Will You Do?** + Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability + Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions. + Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment.in collaboration with internal nurse resources where appropriate. + Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome. + Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits. + Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment. + Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations. + Negotiate settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction. + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + 2 years Workers Compensation claim handling experience. + Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. + Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. + Ability to effectively present file resolution to internal and/or external stakeholders. + Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. + General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract. + Principles of Investigation: Intermediate investigative skills including the ability to take statements. + Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss. + Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. + Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package. + Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. + Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed. + WC Technical: + Intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. + Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. + Intermediate knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. + Customer Service: + Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. + Teamwork: + Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. + Planning & Organizing: + Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. + Maintain Continuing Education requirements as required or as mandated by state regulations. **What is a Must Have?** + High School Diploma or GED. + 1 year Workers Compensation claim handling experience or successful completion of the WC trainee program. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .

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HomeGoods At TJX Companies, every day brings new opportunities for growth, exploration, and achievement. You'll be part of our vibrant team that embraces diversity, fosters collaboration, and prioritizes your development. Whether you're working in our four global Home Offices, Distribution Centers or Retail Stores-TJ Maxx, Marshalls, Homegoods, Homesense, Sierra, Winners, and TK Maxx, you'll find abundant opportunities to learn, thrive, and make an impact. Come join our TJX family-a Fortune 100 company and the world's leading off-price retailer. Job Description: Opportunity: Grow Your Career Responsible for delivering a highly satisfied customer experience proven by engaging and interacting with all customers, embodying customer experience principles and philosophy, and maintaining a clean and organized store environment. Adheres to all operational, merchandise, and loss prevention standards. May be cross-trained to work in multiple areas of the store in order to support the needs of the business. Role models established customer experience practices with internal and external customers Supports and embodies a positive store culture through honesty, integrity, and respect Accurately rings customer purchases/returns and counts change back to customer according to established operating procedures Promotes credit and loyalty programs Maintains and upholds merchandising philosophy and follows established merchandising procedures and standards Accurately processes and prepares merchandise for the sales floor following company procedures and standards Initiates and participates in store recovery as needed throughout the day Maintains all organizational, cleanliness, and recovery standards for the sales floor and participates in the maintenance/cleanliness of the entire store Provides and accepts recognition and constructive feedback Adheres to all labor laws, policies, and procedures Supports and participates in store shrink reduction goals and programs Participates in safety awareness and maintains a safe environment Other duties as assigned Who We're Looking For: You. Possesses excellent customer service skills Able to work a flexible schedule to support business needs Possesses strong communication and organizational skills with attention to detail Capable of multi-tasking Able to respond appropriately to changes in direction or unexpected situations Capable of lifting heavy objects with or without reasonable accommodation Works effectively with peers and supervisors Retail customer experience preferred Benefits include: Associate discount; EAP; smoking cessation; bereavement; 401(k) Associate contributions; child care & cell phone discounts; pet & legal insurance; credit union; referral bonuses. Those who meet service or hours requirements are also eligible for: 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long term disability; paid parental leave; paid holidays/vacation/sick; auto/home insurance discounts; scholarship program; adoption assistance. All benefits are provided in accordance with and subject to the terms of the applicable plan or program and may change from time to time. Contact your TJX representative for more information. In addition to our open door policy and supportive work environment, we also strive to provide a competitive salary and benefits package. TJX considers all applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, marital or military status, or based on any individual's status in any group or class protected by applicable federal, state, or local law. TJX also provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. Applicants with arrest or conviction records will be considered for employment. Address: 9366 State Road 16 Ste 200 Location: USA HomeGoods Store 0265 Onalaska WIThis position has a starting pay range of $14.00 to $14.50 per hour. Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.

Join a FAST-paced, high-ENERGY team BUILD & ASSESS amazing, high-quality team uniforms Assure QUALITY of each uniform we build construction PREPARE uniforms for delivery Have FUN while making money Stefans Soccer is looking for a enthusiastic Team Uniform Processor to join our fast-paced and high-energy team. In this position you will be responsible for building and assessing amazing, high-quality team uniforms. You may be responsible for printing uniforms, assuring the quality of each uniform, and/or preparing uniforms for delivery. We are looking for someone who takes pride in their work and wants to have fun while making money. No experience necessary, paid training. We will figure out what best suits you! Extraordinary Attention to detail - must have the patience, acumen and determination to work with many details at the same time Requirements Able to work under pressure in a fast-paced environment Team player - works well in a group environment Able to lift boxes up to 30 pounds Able to stand for long periods of time Responsibilities Accountability - Ability to accept responsibility and account for his/her actions Communication, Oral-Ability to communicate effectively with others using the spoken word Honesty/Integrity - Ability to be truthful, maintain high level of confidentiality and be seen as credible in the workplace Time Management - Ability to utilize the available time to organize and complete work within given deadlines Compensation & Benefits Wage ranges: Full-time: Part-time: Full-time employees will receive: Company-contributed health insurance, dental and vision 401K program with generous company match Paid Personal Time Off and Holidays All employees will receive Great work environment with a high energy team in a family business and exciting industry No experience necessary, paid training Quick opportunities for raises as experience, reliability and job performance dictates Employee discount at our retail stores

The Brink's Company (NYSE:BCO) is a leading global provider of cash and valuables management, digital retail solutions, and ATM managed services. Our customers include financial institutions, retailers, government agencies, mints, jewelers, and other commercial operations. Our network of operations in 52 countries serves customers in more than 100 countries. We believe in building partnerships that secure commerce and doing that requires fostering an engaged culture that values people with diverse backgrounds, ideas, and perspectives. We build a sense of belonging, so all employees feel respected, safe, and valued, and we provide equal opportunity to participate and grow. Job Description Who We Are: Brink's U.S., a division of Brink's Incorporated, is the trusted leader in armored transportation, currency processing, ATM services, and secure logistics for banks, retailers, and government clients. We take pride in offering our employees meaningful career growth and advancement opportunities. As a Vault Processor, you'll handle, secure, and process large volumes of cash and valuables within Brink's vaults. This position plays a key role in maintaining the flow of currency between financial institutions and commercial clients, with a strong emphasis on accuracy, security, and team collaboration. Key Responsibilities: Securely manage vault operations and protect assets Prepare, verify, and process cash shipments and deposits Record and report all transactions with accuracy Enter liability and inventory data into tracking systems Monitor machinery and workflows Follow all safety and security procedures Minimum Qualifications: At least 21 years old Able to lift up to 50 lbs Proficient in data entry Able to obtain a firearms permit and guard card Preferred Qualifications: Experience with vault operations or cash handling Military background Familiarity with ATM servicing, deposit processing, or account reconciliation Benefits & Perks: Access to benefits after 30 days of employment! Medical, Dental, Vision, 401K, Paid Holidays & Vacation Hours (For Full Time positions). Link to our benefits: brinksbenefits.com Uniforms and protective gear provided Opportunities for internal growth in a team-first culture Brink's is an equal opportunity employer and is committed to providing a workplace free of discrimination and harassment. We consider all qualified applicants for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected characteristic under applicable law. We believe in fostering an inclusive environment where everyone feels respected, valued, and empowered to succeed. What's Next? Thank you for considering applying for a job at Brink's. To be considered for this position, you must complete the entire application process, which includes answering all prescreening questions and providing your eSignature. Upon completion of the application process, you will receive an email confirming that we have received your application. We will review all candidates and notify you of your status should we deem you fit for a job. Thank you again for your interest in a career at Brink's. For more information about future career opportunities, join our talent network, like our Facebook page or Follow us on X. Brink's is an equal opportunity/affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, marital status, protected veteran status, sexual orientation, gender identity, genetic information, or history or any other characteristic protected by law. Brink's is also committed to providing a drug-free workplace. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state, or local protected class.

**Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. **Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.** **Schedule:** Monday - Friday; 8:30am-5:00pm Eastern Time The **Subrogation Examiner** is responsible for researching and examining routine health claims that may be related to Third Party Liability, Workers' Compensation and other subrogation/reimbursement recovery cases. **How you will make an impact:** + Initiates calls to groups, insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party. + Responds to inquiries regarding information on injury claims. + Utilizes various research methods and vendor systems to gather information. + Works with subrogation staff, other departments and outside clients to assist with the recovery process. + Prepares written communications. + Reviews diagnostic and procedure codes to determine claims relevant to each case. + Reviews internal systems/applications for various information needs. + Assists with small scale special projects. **Minimum Requirements:** + Requires a minimum of 1 year of inbound or outbound call experience; or any combination of education and experience, which would provide an equivalent background. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Job Information Job Title Claims Representative II-General Liability (Bodily Injury focused) Home Department: Claims Employment Status: Exempt; Full-time Schedule: 40 hours/week with Flexible Scheduling Opportunities Home Office, Telecommuting, and Remote Opportunities in CO, GA, IL, IN, IA, MN, TN, TX, & WI Overview Protecting our policyholders' dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society. Society Insurance is seeking a Claims Representative II to join our Claims team. This position has a general liability focus. This position will resolve mildly complex general liability claims by investigating losses and negotiating out-of-court settlements. About the Role * Settles mildly complex claims by determining insurance carrier's liability and reaches agreement with claimant according to policy provisions and authority level. * Handles mediations, arbitrations, subrogation, and recorded settlement agreements. * Determines coverage through investigations by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; consulting police and hospital records; inspecting damages; and consulting with experts when appropriate. * Mentors and trains claims representatives in claims expertise by assisting in identifying training needs and opportunities. * May be involved with litigation by analyzing negotiated settlement options; evaluating evidence, and overseeing attorney in the handling of discovery and settlement. * Resolves questionable claims by investigating the claim and comparing claims information with evidence. * Ensures proper file documentation of assigned files by complying with company and state requirements. * Prepares reports by collecting, analyzing, and summarizing claim information. * Contributes to team effort by participating on catastrophe teams; participating in determining department investigation guidelines; providing feedback to underwriting as needed. About You * You enjoy communicating and building relationships with others. * You are composed, cool under pressure, and can negotiate without damaging relationships. * You hold yourself accountable and act in accordance with rules and regulations. * You enjoy analyzing, investigating, and using the facts to make decisions. * You are naturally curious and have a desire to know more. What it Will Take * Bachelor's Degree and 3+ years of claims handling experience OR 5+ years of claims handling experience. * Proficiency in general liability claims demonstrated through knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology. * Ability to obtain and maintain proper licensing prior to handling a state that requires it. * Professional insurance designations highly desirable. * Experience using Guidewire Claims System preferrable. What Society Can Offer * Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance * Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan * Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options * Education: Career Coaching; company-paid courses; student loan and tuition reimbursement * Community: Charitable Match; paid volunteer time; team sponsorships * Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws. Society Insurance is a drug-free workplace.

Job Information Job Title Claims Representative II-General Liability (Bodily Injury focused) Home Department: Claims Employment Status: Exempt; Full-time Schedule: 40 hours/week with Flexible Scheduling Opportunities Position Location: Home Office, Telecommuting, and Remote Opportunities in CO, GA, IL, IN, IA, MN, TN, TX, & WI Overview Protecting our policyholders' dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society. Society Insurance is seeking a Claims Representative II to join our Claims team. This position has a general liability focus. This position will resolve mildly complex general liability claims by investigating losses and negotiating out-of-court settlements. About the Role Settles mildly complex claims by determining insurance carrier's liability and reaches agreement with claimant according to policy provisions and authority level. Handles mediations, arbitrations, subrogation, and recorded settlement agreements. Determines coverage through investigations by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; consulting police and hospital records; inspecting damages; and consulting with experts when appropriate. Mentors and trains claims representatives in claims expertise by assisting in identifying training needs and opportunities. May be involved with litigation by analyzing negotiated settlement options; evaluating evidence, and overseeing attorney in the handling of discovery and settlement. Resolves questionable claims by investigating the claim and comparing claims information with evidence. Ensures proper file documentation of assigned files by complying with company and state requirements. Prepares reports by collecting, analyzing, and summarizing claim information. Contributes to team effort by participating on catastrophe teams; participating in determining department investigation guidelines; providing feedback to underwriting as needed. About Yo u You enjoy communicating and building relationships with others. You are composed, cool under pressure, and can negotiate without damaging relationships. You hold yourself accountable and act in accordance with rules and regulations. You enjoy analyzing, investigating, and using the facts to make decisions. You are naturally curious and have a desire to know more. What it Will Take Bachelor's Degree and 3+ years of claims handling experience OR 5+ years of claims handling experience. Proficiency in general liability claims demonstrated through knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology. Ability to obtain and maintain proper licensing prior to handling a state that requires it. Professional insurance designations highly desirable. Experience using Guidewire Claims System preferrable. What Society Can Offer Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options Education: Career Coaching; company-paid courses; student loan and tuition reimbursement Community: Charitable Match; paid volunteer time; team sponsorships Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws. Society Insurance is a drug-free workplace.

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: Monday - Friday; 8:30am-5:00pm Eastern Time The Subrogation Examiner is responsible for researching and examining routine health claims that may be related to Third Party Liability, Workers' Compensation and other subrogation/reimbursement recovery cases. How you will make an impact: * Initiates calls to groups, insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party. * Responds to inquiries regarding information on injury claims. * Utilizes various research methods and vendor systems to gather information. * Works with subrogation staff, other departments and outside clients to assist with the recovery process. * Prepares written communications. * Reviews diagnostic and procedure codes to determine claims relevant to each case. * Reviews internal systems/applications for various information needs. * Assists with small scale special projects. Minimum Requirements: * Requires a minimum of 1 year of inbound or outbound call experience; or any combination of education and experience, which would provide an equivalent background. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.