Claim Processor Jobs in Baltimore, MD

General Job Information This position is located in the Department of Employment Services, Office of Unemployment Compensation, Benefits Division. The Benefits Division is responsible for filing initial, re-opened, and additional unemployment compensation claims and the adjudication of all issues associated with these claims. It is also responsible for processing all requests for combined wages, all UCFE and UCX claims, and all requests for monetary reconsideration. This position functions as Supervisory Unemployment Compensation Claims Examiner within the Benefits Division. Incumbents in this position are responsible for planning, directing, coordinating, and monitoring the activities of staff involved in providing services to unemployment compensation customers. The incumbent, also, serves as an advisor to the Chief of Benefits on matters relative to the filing and adjudication of claims. Duties and Responsibilities Initiates, formulates, plans, executes, and controls activities in the Central Claims Division. Achieves and maintains compliance with Federal criteria for promptness in disposing of payments. Reviews and analyzes promptness on monthly and quarterly basis; identifies problem areas and develops measures to resolve problems and increase the effectiveness of the Program. Directs the implementation and coordination of operational functions relative to the processing of unemployment claims filed in other states against D.C. Plans and provides leadership and direction to the Central Claims staff in area of adjudication of claims, processing appeals and eligibility review. Furnishes technical assistance to claim examiners. Reviews decisions rendered by first level Appeals Division and the General Counsel's Office. Provides accurate and timely payment to both intrastate and interstate claimants in accordance with agency policy, procedures, guidelines, and applicable law. Provides technical and administrative supervision to subordinate staff consisting of Supervisory Unemployment Compensation Claims Examiners, Unemployment Compensation Claims Examiners, and support staff. Plans and directs the work in the Central Claims Unit in the accomplishment of functional responsibilities. Establishes priorities in workload and makes divisions regarding the initiating, curtailing, or dropping of projects. Ensures that workload is accomplished in timely, efficient, and satisfactory manner. Interview candidates for positions to fill vacancies in the Unit. Evaluates the performance of staff. Plans workflow, establish priorities, set deadlines, and insures proper utilization of assigned personnel. Reviews activities and completed assignments to ensure accuracy and compliance with agency policies, procedures, guidelines and applicable laws. Counsels staff on matters relative to productivity and other work-related issues. Makes personal work contact regarding claims activities with all states, the government of the District, the Federal government, claimants, and employers. Participates in the overall program planning and in the formulation of policies and procedures to facilitate the effective operation of the OUC and an efficient different service. Keeps subordinate staff apprised of changes in policies, procedures, district, and guidelines affecting the unemployment Compensation Program for the D.C., through individual conferences, staff meetings and procedural manuals. Qualifications and Education Specialized Experience: Experience that equipped the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled. To be creditable, one (1) year of specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression. A bachelor's degree from an accredited four-year university in Business Administration, Economics, Finance, Policy, and Knowledge of tax, benefits, or financial laws and regulations that pertain to the collection of taxes and payment of benefits are highly preferred. Licensure and Certifications None Work Conditions/Environment The work is typically performed in a normal office setting. Other Significant Facts Tour of Duty: Monday - Friday, 8:30 am - 5:00 pm Duration of Appointment: Management Supervisory Service "At-Will" All positions and appointments in the Management Supervisory Service serve at the pleasure of the appointing authority and may be terminated at any time with or without cause. Pay Plan, Series, and Grade: MS-991-13 Promotion Potential: No known promotion potential Collective Bargaining Unit: This position is not covered under a collective bargaining agreement. Position Designation: This position has been designated as security sensitive therefore the incumbent of this position will be subject to enhanced suitability screening pursuant to Chapter 4 of DC Personnel Regulations, Suitability and as such, incumbents of this position shall be subject to criminal background checks, background investigations, and mandatory drug and alcohol testing, as applicable. EEO Statement: The District of Columbia Government is an Equal Opportunity Employer. All qualified candidates will receive consideration without regard to race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, physical handicap, or political affiliation.

Claims Processor - Entry Level Duration : 5 Months Total Hours/week : 40.00 1 st Shift Client: Medical Device Company Job Category: Customer Service Level of Experience: Entry Level Employment Type: Contract on W2 (Need US Citizens or GC Holders Only) Work days/hours: M - F 8am - 5pm Job Description: The primary responsibility of this position is the investigation, analysis, resolution, trending and corrective action of all claims/complaints. Specific responsibilities include maintaining claim/complaint files and supporting the resolution of claim/complaint CAPAs to closure and verification of CAPA effectiveness. Bachelor's degree required. Minimum of 2 years of experience in complaint investigation. Strong communications and problem solving skills. Ability to work independently. Competent using office software including Database management, MS Word, Excel, Internet Explorer, PowerPoint, and Outlook. Experience with SAP is required.

Shift: Monday-Friday, 8:00a-4:30p EST

Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Essential Functions: Reviews providers' disputes and appeals for professional and hospital claims to determine resolution according to policies and procedures. Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and resolution timeliness Perform any projects delegated by claims supervisor Qualifications Minimum Education/ Licensures/Qualifications High School Diploma or GED 1+ year experience handling provider disputes / appeals, preferably in PPO, Self-Funded and/or HMO setting Healthcare Background Understanding of Medical Terminology Additional Information Shift: M-F 8am-5pm RTH or Temp-To-Perm (Any transition heavily depends on performance) Pay Rate: Up to 20/hour

Headquarters - Baltimore, MD High School **Job Details** Experienced Hybrid Full Time None Day Admin - Clerical **Description** **Description and Requirements** Maryland Auto Insurance is seeking a Claims Representative to join our Claims Department. The successful candidate will be primarily responsible for the management and maintenance of our Total Loss desk. This includes moving vehicles to and from savage yards within 24-48 hours of assignment, negotiating costs associated with this process and executing payments appropriately. This individual will also respond to phone calls, mail from insureds, claimants and others concerning claims, performs various administrative duties in support of the claims process and may make decisions affecting the disposition of first and third party automobile physical damage claims. This position performs a wide range of duties under minimal supervision with a large degree of independence and discretion in decision making. Responsibilities include: * Communicates, answers questions, and resolves problems with insureds, claimants, producers, and others by telephone, by mail, and in person * Obtains required documentation and information from appropriate sources * Documents all claims work in the appropriate systems * Negotiates tow and storage charges * Receives and moves vehicles within 24-48 hours * Process salvage * Generate field assignments on vehicles within 24 hours of being moved * Follows up daily on problem vehicles not picked up * Monitors the potential total loss tracking screes * Assigns total loss files * Acts as a back-up to the salvage technician * Process and send salvage certificates * Questions the moving of vehicles with higher than normal charges * Complies with the provisions of the Unfair Claims Practices Act * Pay invoices * Assist in the training and development of junior members of the department * Other duties may be assigned as necessary **Qualifications** **Education and Experience Required****:** Education - High school diploma or high school equivalency certificate. Experience - Three years of clerical work experience. Education at an accredited college or university may substitute for the required experience at a rate of thirty credits to one year of experience. Representative position - $46,736 - $70,045 **Maryland Auto Insurance****,** a Property & Casualty insurance carrier and independent agency of the State of Maryland, is located in the charming Locust Point neighborhood of Baltimore. We offer an excellent benefit package including comprehensive health and dental coverage, pension plan, 401(k) plan, and incentive program tied to strategic corporate and departmental goals. **Maryland Auto Insurance is a drug-free workplace and an equal opportunity employer, committed to diversity in the workplace. We do not discriminate on the basis of race, color, religion, age, sex, marital status, national origin, physical or mental disability, familial status, genetic information, gender identity or expression, sexual orientation, or any other characteristic protected by State or federal law. Applicants who need an ADA Accommodation for an interview should request the accommodation when notified of a request to be interviewed. Applicants must be United States citizens or eligible to work in the United States.**

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. **Job Posting Title** Claims Processor II **Job Description** + Adjudicates claims and adjustments as required. + Resolves claims edits and suspended claims. + Maintains and updates required reference materials to adjudicate claims. + Provides backup support to other team/group members in the performance of job duties as assigned. Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (******************************************* and click on the "Benefits at a glance" button for more detail. _Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law._ _We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._ _Prime Therapeutics LLC is a Tobacco-Free Workplace employer._ Positions will be posted for a minimum of five consecutive workdays. Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives. Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at ************** or email *****************************.

**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 160 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** $48,700.00 - $80,400.00 **Target Openings** 1 **What Is the Opportunity?** This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. This role will cover one or several of the Maryland territories listed, therefore you must reside in that general area. **What Will You Do?** + Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel. + The on the job training includes practice and execution of the following core assignments: + Handles 1st party property claims of moderate severity and complexity as assigned. + Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates. + Broad scale use of innovative technologies. + Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate. + Establishes timely and accurate claim and expense reserves. + Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. + Negotiates and conveys claim settlements within authority limits. + Writes denial letters, Reservation of Rights and other complex correspondence. + Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. + Meets all quality standards and expectations in accordance with the Knowledge Guides. + Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. + Manages file inventory to ensure timely resolution of cases. + Handles files in compliance with state regulations, where applicable. + Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. + Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as required. + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. + May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. + Must secure and maintain company credit card required. + 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. + In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards. + This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience preferred. + Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic + Verbal and written communication skills -Intermediate + Attention to detail ensuring accuracy - Basic + Ability to work in a high volume, fast paced environment managing multiple priorities - Basic + Analytical Thinking - Basic + Judgment/ Decision Making - Basic + Valid passport preferred. **What is a Must Have?** + High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required. + Valid driver's license - required. **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 believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. We are committed to recruiting, retaining and developing the diverse talent of all of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results. 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 ******************************************************** .

Share If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. **Claims Litigation Specialist** Full-Time Professional 4 days ago Requisition ID: 1589 Salary Range: $76,000.00 To $85,000.00 Annually **At Davies, we get it... you are not just looking for a job, you are looking to build a life and a career. We believe in our people and realize that our success is a direct result of creating a learning atmosphere, leadership opportunities, and promoting from within. We believe that engaging in corporate social activities and working together as a team is a vital part of the Davies culture.** With a multinational global team, Davies Group is a specialist professional services and technology firm working in partnership with leading insurance, highly regulated, and global businesses. At Davies Group, we help clients to manage risk, operate core business processes, and to transform and grow. We deliver operations, consulting and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation, customer experience, human capital, transformation, and change management. ****Job Overview**** Davies Claims North America is looking for an experienced **Claims Litigation Specialist** who will oversee and monitor all claims that are in the litigation status while providing directions to the TPA claim staff and MTA Defense Counsel based on prudent claim and legal principles. Reporting to the Liability Claims Supervisor, you will review and monitor open litigation cases for the purposes of diary, reserves, subrogation, Pre-Trial, and Trial dates. To be successful in this role, you need to have high level attention to detail and problem-solving skills, superior time management skills with capability of working with and meeting deadlines, and superb communication skills, both verbal and written, conducted in a timely manner. You must have a bachelor's degree and at least four (4) years of legal claims adjusting experience. Additionally, you will need to possess a high level of technical expertise and knowledge of Maryland tort law, Maryland Pattern Jury Instructions, and claims practices and principles. This role is a full-time, hybrid position based out of Baltimore, MD. **Responsibilities and Duties** * Assess insurance claims to determine their validity and potential legal implications * Analyze claim files and make sound legal judgments regarding the investigation, denial, or settlement of litigated claims * Provide litigation directions at the approval of the MTA Claims Management * Ensure the claim files are thoroughly investigated and settled cost-effectively on complex cases * Possess strong negotiation skills to assure the optimum outcome for the claims settlement process, especially with respect to serious financial exposure * Exhibit proven ability to establish and maintain effective working relationships with all legal counsel and claims personnel * Establish goals to reduce litigation expenses while decreasing the interlude between receipt and settlement of claims related to suit papers * Forward documentation to MTA Defense Counsel * Effectively conduct monthly reporting of suit assignments * Efficiently conduct an audit of a minimum of four files in litigation assigned during the previous month to confirm directives and suit papers were completed in a timely manner, recorded statements were transcribed and forwarded to Defense Counsel, additional official reports obtained were forwarded to Defense Counsel, Pre-Trial and Trial dates were added to the claim system, and confirm the directives provided by the MTA were completed * Exhibit company values of We are Dynamic, We are Innovative, We are Connected, and We Succeed Together * Perform other duties as assigned **Experience and Qualifications** Required * Four (4) years of legal and claims experience * Bachelor's degree from an accredited college or university * One (1) year of supervisory experience * Extensive knowledge of Maryland statutory and case law with respect to tort, property and casualty, general liability, and subrogation claims * Experience with an emphasis on general liability, auto liability, and bodily injury claims * Proficiency with Microsoft Office Suite Preferred * Four (4) year Paralegal degree * CPCU, AIC, CLA designation(s) * Four (4) years of legal and claims experience with an emphasis on mass transit liability **Knowledge, Skills, and Abilities** * Proactive, independent, and takes initiative with consistent follow through * Superb communication skills, verbal and written, conducted in a timely manner * Superior time management skills with capability of working with and meeting deadlines * Exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment * Excellent team player with interpersonal skills * High level attention to detail and problem-solving skills * Capable of working collaboratively and independently with minimal supervision * Exhibit discretion with sensitive and confidential information * Display a comfort level working with key people at all levels within an organization **Essential Requirements** * Must have US work rights * Must speak English * Four (4) years of legal and claims experience * Bachelor's degree from an accredited college or university * One (1) year of supervisory experience * Extensive knowledge of Maryland statutory and case law with respect to tort, property and casualty, general liability, and subrogation claims * Experience with an emphasis on general liability, auto liability, and bodily injury claims * Proficiency with Microsoft Office Suite **Other Duties** This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the individual for this job and is subject to change with or without notice. **Diversity and Inclusion** Davies is committed to being a diverse and inclusive workplace. We welcome candidates of all genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof). **Rewards and Recognition** We embrace innovation and run an annual competition available for all colleagues to submit their ideas. The top finalists travel to the current year's competition site where they pitch their ideas to our investors. The winner receives funding to bring their idea to life and the runners up receive a reward for their involvement. Some of our teammates have moved across into brand new positions to further develop their ideas/projects! **Benefits** * Medical, dental, and vision plans * 401k plan with employer matching * Paid Time Off, Sick Leave, and Paid Holidays * Life insurance, short term, and long-term disability plans * Amazing Executive and Senior leadership as well as fabulous teammates **Position Type, Work Environment and Physical Demands** This is a hybrid, full time, salaried, exempt position that predominantly operates from a professional office and home-based environment routinely using standard office equipment such as computers, phones, printers, photocopiers, and scanners and requires prolonged periods of sitting at a desk while working on a computer. While performing the duties of this job, the individual will be required to regularly hear and talk. This is a largely sedentary role requiring the ability to sit at a desk, reach outward, use a phone, have use of fingers to operate office equipment such as a keyboard, mouse, phone, printer, copier, and to reach above the head, bend, or stand as necessary. **Location** Davies Claims North America is currently able to support employees residing in the fo

The Claims Analyst will perform a variety of "changes and claims" related contract administration tasks. An ideal candidate requires experience in transit projects through design, construction and commissioning phases. The Claims Analyst will be responsible for coordinating and reviewing claims / changes and engaging, strategizing, and working with various Program / Project teams to undertake the merit assessment, mitigation, and resolution of claims. The role requires commercial claim knowledge, and preferably also technical understanding, of multiple subject areas related to implementation of a large transit infrastructure projects. Responsibilities Maintain claims and early warnings' register. Review alleged claims. Carry out initial triage and risk assessment of claims. Review project correspondence, and track and report on project claims. Interface with the contractor and other stakeholders, as required, to gather additional details etc. Attend various technical and commercial project working group meetings. Requirements Required Skills: Critical thinking skills sufficient to apply analytical techniques to assess claims. The ability to liaise effectively and to work closely with various multi-disciplinary technical and project controls teams Proficiency with Microsoft Office Suite, particularly Excel. Strong organization, time management, and prioritization skills with proven ability to balance competing tasks and meet deadlines. Self-directed, detail-oriented, excellent at meeting deadlines with well-developed time management skills. Excellent communication (both written and verbal), teamwork, and interpersonal skills. Required Qualifications: Bachelor's degree in engineering, business or other relevant degree. 1 - 4 years of relevant experience Position Location Field: Hybrid - 2 or 3 days in program office

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage primarily motor truck cargo claims with moderate to high complexity and exposure. There may also be opportunity to handle ocean marine claims. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: * Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. * Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. * Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols. * Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. * Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. * Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. * Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. * Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. * Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. * Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. * May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities * Solid working knowledge of motor truck cargo claims handling, liability analysis, policy coverage and claim practices. * Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. * Demonstrated ability to develop collaborative business relationships with internal and external work partners. * Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. * Demonstrated investigative experience with an analytical mindset and critical thinking skills. * Strong work ethic, with demonstrated time management and organizational skills. * Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. * Developing ability to negotiate low to moderately complex settlements. * Adaptable to a changing environment. * Knowledge of Microsoft Office Suite and ability to learn business-related software. * Demonstrated ability to value diverse opinions and ideas Education & Experience: * Bachelor's Degree or equivalent experience. * Typically a minimum four years of relevant experience, preferably in claim handling. * Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. * Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. * Professional designations are a plus (e.g. CPCU) #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Maryland, New York and Washington, the national base pay range for this job level is $49,000 to $98,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

SALARY RANGE: $50,797.00 - $61,402.00 Annually BACKGROUND CHECK Eligible candidates under final consideration for appointment to positions identified as positions of trust will be required to complete authorization for a Criminal Background Check and/or Fingerprint screening and must be successfully completed. PROBATION All persons, including current City employees, selected for this position must complete a mandatory 6-month probation. ELIGIBILITY Qualified candidates will be considered for vacancies as they arise, for a period of at least six months. The decision of the Director of Human Resources with respect to acceptable minimum qualifications is final. EDUCATION ACCREDITATION Applicants' education must be obtained from an accredited institution. Education credentials obtained out of the US must be evaluated for US equivalency. Evaluation agencies information may be obtained at ************** CLASS DESCRIPTION A Medical Claims Processor II reviews and evaluates medical charges related to Workers' Compensation claims or emergency ambulance services. Work of this class involves no supervisory duties or responsibilities. Incumbents receive general supervision from a technical superior. Employees in this class work a conventional workweek. Work is performed in an office where there is no exposure to uncomfortable environmental or hazardous working conditions. Work requires minimal physical exertion. SELECTION PROCESS All candidates indicating the minimum qualifications on their applications will be placed on the eligible list without further examination. The training and experience of each candidate will be evaluated for appropriateness and quantity. It is essential, therefore, that you give complete and accurate information on your application. Vagueness or omission may prevent you from being considered for this position. Qualified candidates will not be listed in rank order. MINIMUM QUALIFICATION On or before the date of filing the application, each candidate must: EDUCATION: Have an associate degree from an accredited college or university. AND EXPERIENCE: Have three years of experience in medical claims or ambulance services billing and collection work in a workers' compensation unit, ambulance services billing unit, hospital, health maintenance organization or insurance firm. OR EQUIVALENCY NOTES: Have Six months of additional experience in medical claims or ambulance services billing and collection work may be substituted for each year of the college education. KNOWLEDGE, SKILLS AND ABILITIES * Knowledge of Workers' Compensation Law. * Knowledge of the principles and practices of medical insurance claims processing or emergency ambulance services billing processing. * Knowledge of medical terminology. * Knowledge of medical billing systems. * Knowledge of basic computer operations. * Mathematical ability. * Ability to interpret, explain and apply Workers' Compensation laws, rules, procedures and practices. * Ability to read and interpret medical reports, charts and treatment plans. * Ability to maintain records and prepare reports. * Ability to establish and maintain effective working relationships with coworkers, vendors and patients. * Ability to communicate effectively, orally and in writing. EXAMINATION PROCESS Applicants must provide sufficient information on their application to show that they meet the minimum qualifications for this recruitment. Successful applicants will be placed on the employment certified eligible list for at least six months. The examination will consist of a rating of your education, training, and experience as presented on your application and as they relate to the requirements of the position. You may be required to complete supplemental questions to further examine specific Knowledge, Skills and Abilities of the position. Therefore, it is important that you provide complete and accurate information on your application. BENEFITS The City of Baltimore offers a generous and competitive benefits package. You can learn about our benefits here: ************************************************************** If you have questions regarding this position, please contact Jewel Glenn, HR Specialist I via email at *****************************. Baltimore City Government is an Equal Employment Opportunity Employer, and we are committed to a workplace that values diversity, equity, and inclusion. The City of Baltimore prohibits discrimination on the basis of race, color, religion, age, sex, ancestry, creed, national origin, disability status, genetics, marital status, military service, sexual orientation, gender identity/expression or any other characteristic protected by federal, state or local laws. Applicants requiring accommodations during the hiring process should contact the Department of Human Resources directly. Do not attach your request for accommodation to the application. BALTIMORE CITY IS AN EQUAL OPPORTUNITY EMPLOYER

Founded in 1972, CCI Health Services (CCI) is one of the largest and longest-serving Federally Qualified Health Centers in Maryland. Our team delivers a quality, patient-centered care experience to over 60,000 people of all ages and genders annually. Through our work, we advance health equity, improve community health outcomes, and empower our patients and participants to realize their unique health goals. We manage seven health centers throughout Montgomery and Prince George's counties, serving neighbors from historically marginalized communities. We provide comprehensive health services, including primary care, dental care, behavioral health care, WIC, infectious disease care and management, on-site pharmaceutical care, and more. We run the largest refugee health program in Maryland and are leading an expansion into gender-affirming care in Montgomery County. Position Summary: CCI is seeking a Claims Specialist to serve as a financial resource in support of the clinical services provided. The Claims Specialist will assure that services are promptly and accurately processed in accordance with all applicable Federal, State, and local regulations and guidelines, that claims are adjudicated in a timely manner, and customer's needs are met in a professional and courteous manner. KEY FUNCTIONS AND RESPONSIBILITIES: Review and analyze encounters to ensure completeness, accuracy, adherence to all system edits (both core system and clearinghouse), and in compliance with all State, Federal, and/or contracted payer rules, terms, regulations, and guidelines. Ensures claims are processed in a timely manner, adhering to a standard of claim submission within five (5) days from the date of service, and follows up with individual and/or providers in those situations exceeding five (5) days from the date of service. Ensures any claims which are rejected by the clearinghouse, or the payer are addressed, resolved, and resubmitted with corrections. Addresses all denials from individual insurers in a timely, efficient, and collaborative manner, communicating with the health centers and support center personnel to effectively challenge denials and reverse the denial decision. Files appeal of denials in a timely and professional manner within the specified timeframes as published by regulations, rules, or guidelines of the payer. Responds in a timely and professional manner to all patient, insurance, or professional inquiries and concerns. Exhibit and apply knowledge of Commercial Indemnity guidelines in the processing, adjudication, and payment of claims. Maintain current understanding and application of all Medicare and state Medicaid compliance requirements regarding avoidance of allegations of fraudulent or false claims. Maintain productive and efficient communication with third-party payers which achieves expeditious claim adjudication and payment. Maintains consistent and timely follow-up with third-party payers and patients (as applicable) in unpaid claims beyond the expected payment date, ensuring each account is clearly and concisely documented with all efforts to expedite payment. Utilize online claim status applications in an effective and efficient manner in managing account follow-up. Make necessary adjustments to account balances with prior authorization from management to ensure the integrity of the account balance. Checks each insurance payment to ensure accuracy and compliance with contract discount terms. Evaluates patient financial status and established budget payment plans or eligibility for Sliding Scale consideration. Must ensure open and constructive coordination with health center personnel in maintaining accuracy in data elements and processing crucial to effective claims processing and account resolution. Must ensure adherence with all HIPAA Regulations and Compliance Regulations ensuring the protection of PHI (Patient Health Information). MINIMUM QUALIFICATIONS: Minimum High School diploma, an AA or BS degree preferred or commensurate experience. Must have at least 2 years of relevant work experience in a Physician Practice/Hospital-based Physician Center/FQHC setting or can have an equivalent combination of training and experience to perform functions outlined for this position. Strong attention to detail. Must be familiar with hospital and or physician coding. Strong customer service skills - bi-lingual (English/Spanish) is a plus. Must be assertive and goal oriented. Familiarity with computerized systems is required. Must be a willing participant in ongoing educational activities and a contributing participant in staff meetings. Working on-site is an essential duty for the job. WORKING CONDITIONS: Proper and professional grooming is always expected. Prolonged periods of standing, bending or working at a desk on a computer. The ability to lift (up to 15lbs) is required. Ability to work in a fast-paced, controlled/enclosed, and complex environment. Potential exposure to materials and situations that require extensive safety precautions and may include the use of protective equipment. BENEFITS & PERKS: Health, Dental, and Vision for you and your family. Paid Time Off (PTO), 9 paid holidays, plus mental health days. 403B retirement plan with an employer match up to 6%, and tuition reimbursement. ** CCI Health Services is an Equal Opportunity Employer **

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work Most Loved Workplace Forbes Best-in-State Employer Environmental Claims Specialist ** Summary** To analyze complex or technically difficult environmental claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult environmental liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Conducts or assigns full investigation to include complete coverage review and provides report of investigation pertaining to new events, claims and legal actions. + Analyzes applicable complex liability insurance coverage and policies + Negotiates claim settlement up to designated authority level. + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Licenses are required. Professional certification as applicable to line of business preferred. **Experience** Ten (10) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + In-depth knowledge of appropriate environmental liability insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim duration, cost containment principles application procedures as applicable to line-of-business. In the absence of experience with environmental claims, consideration will be given to candidates with equivalent experience with professional liability, complex coverage and litigation/DJ claims, products liability, marine, class action and multi-district litigation (MDL) claims, asbestos and silica, and other high-exposure claims handling of a complex nature. + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent negotiation skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** **:** Computer keyboarding, travel as required **Auditory/Visual** **:** Hearing, vision and talking **NOTE** **:** Credit security clearance, confirmed via a background credit check, is required for this position. _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is_ **_$110,000- $120,000_** _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Taking care of people is at the heart of everything we do. Caring counts** Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (************************************** BGSfA)

Founded in 1972, CCI Health Services (CCI) is one of the largest and longest-serving Federally Qualified Health Centers in Maryland. Our team delivers a quality, patient-centered care experience to over 60,000 people of all ages and genders annually. Through our work, we advance health equity, improve community health outcomes, and empower our patients and participants to realize their unique health goals. We manage seven health centers throughout Montgomery and Prince George's counties, serving neighbors from historically marginalized communities. We provide comprehensive health services, including primary care, dental care, behavioral health care, WIC, infectious disease care and management, on-site pharmaceutical care, and more. We run the largest refugee health program in Maryland and are leading an expansion into gender-affirming care in Montgomery County. Position Summary: CCI is seeking a Claims Specialist to serve as a financial resource in support of the clinical services provided. The Claims Specialist will assure that services are promptly and accurately processed in accordance with all applicable Federal, State, and local regulations and guidelines, that claims are adjudicated in a timely manner, and customer's needs are met in a professional and courteous manner. KEY FUNCTIONS AND RESPONSIBILITIES: Review and analyze encounters to ensure completeness, accuracy, adherence to all system edits (both core system and clearinghouse), and in compliance with all State, Federal, and/or contracted payer rules, terms, regulations, and guidelines. Ensures claims are processed in a timely manner, adhering to a standard of claim submission within five (5) days from the date of service, and follows up with individual and/or providers in those situations exceeding five (5) days from the date of service. Ensures any claims which are rejected by the clearinghouse, or the payer are addressed, resolved, and resubmitted with corrections. Addresses all denials from individual insurers in a timely, efficient, and collaborative manner, communicating with the health centers and support center personnel to effectively challenge denials and reverse the denial decision. Files appeal of denials in a timely and professional manner within the specified timeframes as published by regulations, rules, or guidelines of the payer. Responds in a timely and professional manner to all patient, insurance, or professional inquiries and concerns. Exhibit and apply knowledge of Commercial Indemnity guidelines in the processing, adjudication, and payment of claims. Maintain current understanding and application of all Medicare and state Medicaid compliance requirements regarding avoidance of allegations of fraudulent or false claims. Maintain productive and efficient communication with third-party payers which achieves expeditious claim adjudication and payment. Maintains consistent and timely follow-up with third-party payers and patients (as applicable) in unpaid claims beyond the expected payment date, ensuring each account is clearly and concisely documented with all efforts to expedite payment. Utilize online claim status applications in an effective and efficient manner in managing account follow-up. Make necessary adjustments to account balances with prior authorization from management to ensure the integrity of the account balance. Checks each insurance payment to ensure accuracy and compliance with contract discount terms. Evaluates patient financial status and established budget payment plans or eligibility for Sliding Scale consideration. Must ensure open and constructive coordination with health center personnel in maintaining accuracy in data elements and processing crucial to effective claims processing and account resolution. Must ensure adherence with all HIPAA Regulations and Compliance Regulations ensuring the protection of PHI (Patient Health Information). MINIMUM QUALIFICATIONS: Minimum High School diploma, an AA or BS degree preferred or commensurate experience. Must have at least 2 years of relevant work experience in a Physician Practice/Hospital-based Physician Center/FQHC setting or can have an equivalent combination of training and experience to perform functions outlined for this position. Strong attention to detail. Must be familiar with hospital and or physician coding. Strong customer service skills - bi-lingual (English/Spanish) is a plus. Must be assertive and goal oriented. Familiarity with computerized systems is required. Must be a willing participant in ongoing educational activities and a contributing participant in staff meetings. Working on-site is an essential duty for the job. WORKING CONDITIONS: Proper and professional grooming is always expected. Prolonged periods of standing, bending or working at a desk on a computer. The ability to lift (up to 15lbs) is required. Ability to work in a fast-paced, controlled/enclosed, and complex environment. Potential exposure to materials and situations that require extensive safety precautions and may include the use of protective equipment. BENEFITS & PERKS: Health, Dental, and Vision for you and your family. Paid Time Off (PTO), 9 paid holidays, plus mental health days. 403B retirement plan with an employer match up to 6%, and tuition reimbursement. ** CCI Health Services is an Equal Opportunity Employer **

The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims, in a timely and accurate manner. Schedule: Provides superior customer service consistent with company standards and goals, including inbound calls from providers and health plans. Responsible for quality and continuous improvement within the job scope. Also responsible for all actions/responsibilities described in company-controlled documentation for this position. Contributes to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely follow-up on inquiries received and correctly logs all incoming calls and emails. Maintains the minimum accuracy standard and follows up timely to meet compliance standards for claims, pends, and tasks. Reviews claim images and batches to ensure accuracy. Uses proper plan documentation to determine benefits and correctly adjudicate. Meets and maintains the minimum production in addition to completing reports and projects given by the supervisor. Effectively participates in meetings, training, and committees as designated by the supervisor. Reviews feedback from supervisors, trainers, auditors, examiners, and trending spreadsheets. Identifies and implements required steps for improvement. Minimum Qualifications One year of claims processing, claims logging, or customer service experience in a managed care environment. - and - Demonstrated minimum of 100 SPM on ten key and 30 WPM typing. Preferred Qualifications Associates degree or some college level coursework. Degree obtained from accredited institution. Education is verified. - and - Demonstrated excellent verbal, written, and interpersonal skills. - and - Demonstrated consistent accuracy and processing efficiency in work. - and - Demonstrated ability to resolve complex claims problems and be detailed oriented. **Physical Requirements:** Manual dexterity, hearing, seeing, speaking. **Location:** Central Office - Las Vegas **Work City:** Las Vegas **Work State:** Nevada **Scheduled Weekly Hours:** 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $18.38 - $26.65 We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (***************************************************************************************** , and for our Colorado, Montana, and Kansas based caregivers (********************************* ; and our commitment to diversity, equity, and inclusion (********************************************************************************* . Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice.

Pride Health is hiring a Specimen Technician to support our client's medical facility based in Gaithersburg MD 20877. This is a 6-month assignment with the possibility of a contract-to-hire opportunity and a great way to start working with a top-tier healthcare organization! Job Title: Specimen Technician - 3rd Shift Location: Gaithersburg MD 20877 Duration: 6 Months+ Schedule: Monday-Friday 11pm-7:30am with Saturday rotation. Pay Range: $23- $24 per hour *Pay rate is based on years of experience and educational qualifications. Summary: The main function of an accessioner is responsible for processing laboratory samples. They work with other laboratory employees to catalog patient specimens, like blood, urine, or tissue, for analysis. They mostly work with blood. Lab professionals carry out diagnosis and treatment based on the samples received. Essential Duties: Receives and triages all specimens for clinical testing. Manages clinical information within LIMS database. Performs internal audits of clinical charts. Collaborates with various departments to ensure testing accuracy. Qualifications: 0-2 years of work experience. AS or BS degree in biological sciences preferred. Proven attention to accuracy and deadlines. Proven ability to work well independently and within a team. #INDPHCAlliedHV Pride Global offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, , legal support, auto ,home insurance, pet insurance, and employee discounts with preferred vendors.

**Claims Analyst - Construction Project - (321)** Share this job as a link in your status update to LinkedIn. **** Job Title Claims Analyst - Construction Project Location Baltimore, MD - Baltimore, MD US (Primary) Category Engineering Job Type Full-time Career Level Experienced (Non-Manager) Education Bachelor's Degree Salary Grade $40.86 - $60.09 ( $85,000 to $125,000 YR ) Travel Security Clearance Required None Job Description **Position Description** The Claims Analyst will perform a variety of "changes and claims" related contract administration tasks. An ideal candidate requires experience in transit projects through design, construction and commissioning phases. The Claims Analyst will be responsible for coordinating and reviewing claims / changes and engaging, strategizing, and working with various Program / Project teams to undertake the merit assessment, mitigation, and resolution of claims. The role requires commercial claim knowledge, and preferably also technical understanding, of multiple subject areas related to implementation of a large transit infrastructure projects. **Responsibilities** * Review alleged claims. * Carry out initial triage and risk assessment of claims. * Review project correspondence, and track and report on project claims. * Interface with the contractor and other stakeholders, as required, to gather additional details etc. * Attend various technical and commercial project working group meetings. Skills and Requirements **Required Skills:** * Critical thinking skills sufficient to apply analytical techniques to assess claims. * The ability to liaise effectively and to work closely with various multi-disciplinary technical and project controls teams * Proficiency with Microsoft Office Suite, particularly Excel. * Strong organization, time management, and prioritization skills with proven ability to balance competing tasks and meet deadlines. * Self-directed, detail-oriented, excellent at meeting deadlines with well-developed time management skills. * Excellent communication (both written and verbal), teamwork, and interpersonal skills. **Required Qualifications:** * Bachelor's degree in engineering, business or other relevant degree. * 1 - 4 years of relevant experience **Position Location** Field: Hybrid - 2 or 3 days in program office Specialized Skills We are equal opportunity/affirmative action employers, committed to diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status, or any other protected characteristic under state or local law.

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage primarily motor truck cargo claims with moderate to high complexity and exposure. There may also be opportunity to handle ocean marine claims. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: * Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. * Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. * Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols. * Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. * Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. * Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. * Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. * Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. * Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. * Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. * May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities * Solid working knowledge of motor truck cargo claims handling, liability analysis, policy coverage and claim practices. * Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. * Demonstrated ability to develop collaborative business relationships with internal and external work partners. * Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. * Demonstrated investigative experience with an analytical mindset and critical thinking skills. * Strong work ethic, with demonstrated time management and organizational skills. * Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. * Developing ability to negotiate low to moderately complex settlements. * Adaptable to a changing environment. * Knowledge of Microsoft Office Suite and ability to learn business-related software. * Demonstrated ability to value diverse opinions and ideas Education & Experience: * Bachelor's Degree or equivalent experience. * Typically a minimum four years of relevant experience, preferably in claim handling. * Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. * Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. * Professional designations are a plus (e.g. CPCU) #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Maryland, New York and Washington, the national base pay range for this job level is $49,000 to $98,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims, in a timely and accurate manner. Schedule: Provides superior customer service consistent with company standards and goals, including inbound calls from providers and health plans. Responsible for quality and continuous improvement within the job scope. Also responsible for all actions/responsibilities described in company-controlled documentation for this position. Contributes to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely follow-up on inquiries received and correctly logs all incoming calls and emails. Maintains the minimum accuracy standard and follows up timely to meet compliance standards for claims, pends, and tasks. Reviews claim images and batches to ensure accuracy. Uses proper plan documentation to determine benefits and correctly adjudicate. Meets and maintains the minimum production in addition to completing reports and projects given by the supervisor. Effectively participates in meetings, training, and committees as designated by the supervisor. Reviews feedback from supervisors, trainers, auditors, examiners, and trending spreadsheets. Identifies and implements required steps for improvement. Minimum Qualifications One year of claims processing, claims logging, or customer service experience in a managed care environment. - and - Demonstrated minimum of 100 SPM on ten key and 30 WPM typing. Preferred Qualifications Associates degree or some college level coursework. Degree obtained from accredited institution. Education is verified. - and - Demonstrated excellent verbal, written, and interpersonal skills. - and - Demonstrated consistent accuracy and processing efficiency in work. - and - Demonstrated ability to resolve complex claims problems and be detailed oriented. **Physical Requirements:** Manual dexterity, hearing, seeing, speaking. **Location:** Central Office - Las Vegas **Work City:** Las Vegas **Work State:** Nevada **Scheduled Weekly Hours:** 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $18.38 - $26.65 We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (***************************************************************************************** , and for our Colorado, Montana, and Kansas based caregivers (********************************* ; and our commitment to diversity, equity, and inclusion (********************************************************************************* . Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice.