Claim processor jobs in Baton Rouge, LA

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** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit claims and adjustments as required. Track and trend performance of root cause analysis and provide additional training as needed. Resolve claims edits and suspended claims. **Responsibilities** + Adjudicate or submit claims and adjustments as required. + Implementation and maintenance of claims processing programs and procedures + Verify that claims are being adjudicated or submitted according to contracts in a consistent and accurate manner. + Manage projects and administrative duties as required by business need. + Lead and implement positive changes with a high level of quality and professionalism. + Provide backup support to other team/group members in the performance of job + Other duties as assigned **Education & Experience** + Education Level + A Combination of Education and Work Experience May Be Considered. + Bachelors + Required + Yes + Yes + Fields of Study + Experience Level + 5+ years + Required + Yes + Details + Claims Must be eligible to work in the United States without the need for work visa or residency sponsorship. **Additional Qualifications** + Ability to quickly use a 10-key machine **Preferred Qualifications** **Physical Demands** + Must be able to remain in a stationary position 50% of the time. Must be able to "move or traverse" + Must be able to constantly operate a computer and/or other office productivity equipment + Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information + Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures. Potential pay for this position ranges from $21.15 - $31.73 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, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local 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. At Prime Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference. We know that people make all the difference. If you're ready for a purpose-driven career and are passionate about simplifying health care, let's build the future of pharmacy together. 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, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local 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 *****************************.

**Become a part of our caring community and help us put health first** The Supervisor, Claims Review makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Supervisor, Claims Review works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach. The Supervisor, Claims Review partners with professional staff on pre-screening review by applying guidance, and making an appropriate decision which may include interpretation of provider information or data. Decisions are typically are related to schedule, plans and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies. **Use your skills to make an impact** **Education & Experience:** + Bachelor's degree in business, healthcare administration, or related field, or equivalent experience required. + Minimum of 3 years' experience in claims review, healthcare operations, or insurance industry, with at least 1 year in a supervisory or team lead role. **Knowledge & Skills:** + Solid understanding of claims processing, insurance guidelines, and provider data interpretation. + Familiarity with relevant federal and state regulations, including HIPAA and other applicable compliance standards. + Proficiency in analyzing complex information and applying established guidance to make sound decisions. + Strong interpersonal, communication, and organizational skills. + Ability to work collaboratively with professional staff and cross-functional teams. + Strong Inventory management skills **Leadership & Management:** + Demonstrated ability to supervise, motivate, and provide day-to-day oversight to support and technical associates. + Skilled in coordinating schedules, managing workloads, and ensuring consistency in team execution. + Proven track record of holding team members accountable to established policies and procedures. + Experience handling escalated or complex issues in claims review or related functions. **Technical Competencies:** + Experience with claims management systems, electronic health records, or similar platforms. + Proficiency in Microsoft Office Suite or comparable software. **Other Requirements:** + Commitment to upholding company policies and compliance standards, including information protection and privacy procedures in alignment with enterprise guidelines (see Humana Procedure - EIP - Reporting a Suspected Privacy or Security Policy Violation, Policy Tracking ID: 5073524, Last Reviewed: December 19, 2024). + Ability to maintain confidentiality and ensure secure handling of sensitive information. + Strong problem-solving skills and attention to detail. + Excellent time management and prioritization abilities. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $65,000 - $88,600 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 11-17-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: * Award-winning culture * Inclusion and diversity as a priority * Performance Based Incentive Plans * Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability * Generous PTO (including paid time to volunteer!) * Up to 9.5% 401(k) employer contribution * Mental health support * Career advancement opportunities * Student loan repayment options * Tuition reimbursement * Flexible work environments * All the benefits listed above are subject to the terms of their individual Plans. And that's just the beginning… With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! General Summary: Minimum starting hourly rate is $22.60 This is an entry level position within the Voluntary Benefits Claims Organization. This position is responsible for the thorough, fair, objective, and timely adjudication of voluntary benefits claims in conjunction with providing technical expertise regarding applicable regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, health care providers and other specialized internal resources. Incumbents in this role are considered trainees and are assigned a formal mentor for 6-12 months until they are assessed as capable of independent work. Incumbents are primarily responsible for learning and developing the skills, knowledge, and behaviors necessary to successfully adjudicate assigned claims, in accordance with our claims philosophy and policies and procedures. Incumbent must demonstrate the ability to effectively manage an assigned caseload, exercise discretion and independent judgment, and appropriately render timely claim decisions while demonstrating strong customer service prior to movement to the exempt level claims specialist role. Principal Duties and Responsibilities: * Maintain organizational service standards on all assigned claims demonstrating success in developing and implementing effective strategies to manage a caseload of varying size and complexity. * Develop an understanding and working knowledge of Voluntary Benefits for Unum and Colonial Life, including products, policies, procedures, and contracts. * Develop an understanding of the applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders, and waivers, as well as regulatory and statutory requirements for claim products administered. * Develop skill set to determine appropriate risk management strategies through analyzing and applying technical and complex contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions, and benefits payee. * Develop problem solving skills by demonstrating analytical and logical thinking resulting in the timely and accurate adjudication of a variety of simple to complex voluntary benefits claims. * Develop a working knowledge of systems needed for claims adjudication. * Provide excellent customer service and independently respond to all inquiries within service guidelines. * Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and referrals/notifications to other areas (i.e., medical assessments, billing, etc.) as appropriate. * Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively communicate determinations while ensuring compliance with Voluntary Benefits procedures and all legal requirements including state regulations. * Partner and coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation, when appropriate. * Ensure a timely and well communicated transfer process when transitioning integrated claims across lines of business, ensuring a coordinated and continuous claims experience for customers. * Be familiar with specialized workflow requirements and performance standards for any assigned customers. * May perform other duties as assigned. Job Specifications: * 4-year degree preferred or equivalent work experience * Ability to develop Voluntary Benefits product knowledge and apply a best-in-class service experience * Medical background, voluntary benefits claims and/or disability management experience preferred * Possess strong analytical, critical thinking, and problem-solving skills * Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions, including initial decision and ongoing medical management. * Able to effectively utilize a broad spectrum of resources, materials, and tools needed to assist with the decision-making process * Strong service and quality orientation. * Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc. * Demonstrated ability to operate with a sense of urgency and make balanced decisions with the highest degree of integrity and fairness. * Excellent communication skills, written and verbal * Meets the standards for this position, as defined in the Talent Management framework ~IN3 #LI-LM2022 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $40,000.00-$75,600.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

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. At CNA, we provide insurance solutions to a wide range of businesses. Our Marine Claims Team handles all lines of ocean and some inland marine claims. We are seeking a motivated claim professional to join us primarily handling Hull, P&I, and Marine Liability claims. There will also be the opportunity to handle Ocean Cargo and Motor Truck Cargo claims. Under general management direction, the individual contributor will analyze, coordinate and resolve litigated and non-litigated claims within an established authority level. JOB DESCRIPTION: Essential Duties & Responsibilities * Interprets policy coverages, and determines if coverages apply to claims submitted, escalating issues as needed. * Sets activities, reserves and authorizes payments within scope of authority. Ensures issuance of disbursements while managing loss costs and expenses. * Coordinates and performs investigations and evaluates claims and lawsuits through contact with insureds, claimants, business partners, witnesses and experts. Seeks early resolution opportunities. Identifies files that have potential fraud and refers to SIU. * Utilizes negotiation skills to develop settlement packages. * Identifies claims with third party recovery potential and coordinates with subrogation/salvage unit. * Partners with attorneys, account representatives, agents, underwriters, and insureds to develop a focused strategy for timely and cost effective resolution of more complex claims. * Analyzes claims activities. Prepares and presents reports for management. May be responsible for special projects and presentations. * Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes. * May provide guidance and assistance to other claims staff and functional areas. * Keeps current on state/territory regulations and issues as well as industry activity and trends. * Some travel may be required as needed for mediations, settlement conferences, team activities and/or trials. * May perform additional duties as assigned. Reporting Relationship * Manager. Skills, Knowledge & Abilities * Solid knowledge of marine or commercial liability claims, and insurance industry theory and practices. * Demonstrated technical expertise and product specific knowledge. * Strong interpersonal, communication and negotiation skills. Ability to effectively interact with all levels of CNA's internal and external business partners. * Ability to work independently, managing time and resources to accomplish multiple tasks and meet deadlines. * Strong analytical and problem solving skills enabling viable alternative solutions. * Ability to exercise independent judgement, and make critical business decisions effectively assessing the merits of claims as well as evaluating claims based on a cost benefit analysis. * Solid knowledge of Microsoft Office Suite, as well as other business-related software. * Ability to adapt to change and value diverse opinions and ideas. * Ability to fully comprehend claim information; and to further articulate analyses of claims in internal reports. * Ability to handle claims with a proactive long-term view of business goals and objectives. Education & Experience * Bachelor's degree or equivalent experience. Professional designations preferred. * Typically a minimum three to five years claims experience. 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, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 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 ***************************.

Claims Auditor I, II and Senior Location : 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. 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. The Claims Auditor I is responsible for pre and post payment and adjudication audits of high dollar claims for limited lines of business, claim types and products including specialized claims with appropriate guidance from management and peers. The Claims Auditor II is responsible for audits of high dollar claims across the stop loss business, including specialized claims, working independently and without significant guidance. The Claims Auditor Senior is responsible for auditing of high dollar claims across the stop loss business, including complex specialized claims within Service Experience. Serves as the subject matter expert for the unit. How you will make an impact : * Performs audits of high dollar claims. * Ensures claim payment accuracy by verifying various aspects of the claim including eligibility, pre-authorization, and medical necessity. * Contacts others to obtain any necessary information. * Completes and maintains detailed documentation of audit which includes decision methodology, system or processing errors, and monetary discrepancies which are used for financial reporting and trending analysis. * Provides feedback on processing errors; identifies quality improvement opportunities and initiates basic requests related to coding or system issues, where applicable. * Refers overpayment opportunities to Recovery Team. * Claims Auditor II - all the above, plus: Independently interprets Medical Policy and Clinical Guidelines. * Claims Auditor Senior - all the above, plus : Service as a subject matter expert for Policy and Clinical Guidelines. Associates at this level serve as a mentor and resource to other audit staff. Must possess strong research and problem solving skills. Minimum Requirements : * Claims Auditor I : Requires a HS diploma or GED and a minimum of 3 years of claims processing experience; or any combination of education and experience which would provide an equivalent background. * Claims Auditor II : Requires a HS diploma or GED and a minimum of 5 years of claims processing experience including a minimum of 1 year related experience in a quality audit capacity (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background. * Claims Auditor Senior : Requires a HS diploma or GED and a minimum of 4 years related experience in a quality audit capacity (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities & Experiences: * Stop loss claims experience highly preferred. * Working knowledge of insurance industry and medical terminology; working knowledge of relevant systems and proven understanding of processing principles, techniques and guidelines strongly preferred. * Ability to acquire and perform progressively more complex skills and tasks in a production environment strongly preferred. * Strong research and problem solving skills preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is : Claims Auditor I $21.41 to $38.88/hr Claims Auditor II $22.54 to $40.94/hr Claims Auditor Senior $25.69 to $46.64/hr Locations: Illinois, Massachusetts, Minnesota, Washington State In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Non-Exempt Workshift: 1st Shift (United States of America) Job Family: CLM > Claims Support 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.

Are you looking for a great team environment? Southern Farm Bureau Casualty Insurance Company is currently seeking a Office Claims Representative. Southern Farm Bureau is a great company and an excellent place to work. The Company offers a family-oriented work environment and a rich benefit package including paid time off, company matched 401(k), pension/retirement, medical, dental, vision, group life, accidental death and dismemberment, employee assistance program, a continued education program, and a hybrid home/office work schedule. This position is located in Little Rock , Arkansas. The Office Claims Representative will resolve property damage and injury claims caused by or incurred by insureds. This includes verifying coverage, determining liability, evaluating damages and affecting a settlement with the parties involved. Essential Functions • Analyze policy contracts to determine coverage. • Negotiate fair settlement with insured, third party claimants and/or legal representatives and issue payment. • Collect settlement documents and prepare status reports for file documentation. • Investigate the facts surrounding the claim by using various types of communication such as telephone, mail, email, and other means available to determine liability. • Prepare status reports to the District Claims Manager and/or Office Claims Supervisor in a timeline designated by those individuals. • Assist in catastrophe claims operations as needed. • Attend training sessions to gain the skills and ability to perform the functions of a Claims Representative. Additional Responsibilities • Other duties and responsibilities as assigned. • Regular and predictable attendance is required. Education Education Level Education Details Req Pref H.S. Diploma or equivalent required. X Bachelor's Degree X Or Other Previous insurance or customer service experience (minimum 2 years) may be substituted for degree. X And Other Must be able to obtain required adjuster licenses in applicable states within one year of hire. X Other Must be able to obtain appraiser license for FL & SC within one year of hire. X

About the Role PuroClean of Shreveport is seeking a high-character individual to join our team as a Loss Claims Specialist. This is more than a job-it's a leadership role designed for someone who can take full ownership of a project from start to finish and align with our mission of providing empathetic, efficient, and professional restoration services to our community. As a Loss Claims Specialist, you will serve in a project manager capacity, overseeing the execution of all services related to water damage, mold, biohazard, contents handling, and reconstruction. This role demands strong organizational skills, technical knowledge, and a commitment to both customer care and team collaboration. Why Join Us * Profit Sharing Position - your success is our success * Annual Draw of $50,000 + laptop + software subscriptions * Be part of a purpose-driven company that values integrity, excellence, and service * Opportunities for growth and advancement in a fast-paced industry What You'll Need * A personal vehicle and reliable transportation * A working phone * A desire to learn and align with our SOPs and company goals * Willingness to take ownership and be accountable for job outcomes * Ability to manage multiple claims and ensure timely completion of each project What You'll Do * Manage restoration projects from intake through completion * Coordinate and execute all mitigation and reconstruction services: * Water Damage * Mold Remediation * Biohazard Cleanup * Contents Pack-Out and Cleaning * Reconstruction/Build-Back * Estimate, invoice, and track jobs using software including: * Xactimate * Estimate * Time and Materials platforms * Learn and apply our internal SOPs with consistency and accuracy * Meet or exceed quarterly performance goals Preferred (but not required): * Prior construction or restoration experience * Familiarity with insurance claims processes or property loss mitigation Who We're Looking For We're looking for someone with more than just technical skills. We value character, accountability, and alignment with our company vision. If you take pride in your work, can lead by example, and are looking to grow in an environment that rewards dedication and results-you may be exactly who we're looking for.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Workers Compensation (MUST RESIDE IN LOUISIANA) Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. PRIMARY PURPOSE: To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency. Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments. Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract. Administers subrogation of claims and negotiates settlements. Communicates claim action with claimant and client. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). Travels as required. QUALIFICATIONS Education & Licensing High school diploma or GED; Licenses as required LA Adjuster License required Bachelor's degree from an accredited college or university preferred. Experience: Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required. TAKING CARE OF YOU Flexible work schedule. Referral incentive program. Career development and promotional growth opportunities. A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. 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.

EMBRACING OUR DIVERSITY MAKES US STRONGER We believe that our individual differences are our strength, and it forms the foundation that allows our agency to empower individuals to experience a greater quality of life. Our agency's vision is that all people will be empowered to lead meaningful and productive lives among friends, relatives, and neighbors regardless of behavioral health needs or developmental disabilities. We have been lighting the path forward into recovery by providing person-centered services to adults and children who meet the treatment criteria for substance use disorders, developmental disabilities, and/or mental health. This is a part-time, advanced specialized position within the Florida Parishes Human Services Authority/Waiver Supports and Services office specifically assigned to conduct Act 421 Nursing Assessments and Reassessments. Due to Act 421 requirements, the incumbent must be a licensed RN. This position will manage the assessments for children who don't have Medicaid but may qualify for Medicaid due to a serious health condition. If you have experience working with children that have serious health conditions or working with developmentally disabled clients, we strongly encourage you to apply to join our team! A current Louisiana license in a health services field, health regulation field, or social services field plus three years of experience in hospital or nursing home administration, health services, health regulation, or social services; OR A bachelor's degree plus three years of experience in hospital or nursing home administration, health services, health regulation, or social services; OR A master's degree in a health services field, health regulation field, or a social services field plus two years of experience in hospital or nursing home administration, health services, health regulation, or social services. The official job specifications for this role, as defined by the State Civil Service, can be found here. Job Duties: * Conducts an Act 421, Children Medicaid Options (CMO), assessment in accordance with Act 421 CMO assessment tool to determine if the child meets nursing home/hospital level of care criteria; * Communicates and notifies the family of the outcome of the assessment via written notification; * Conducts an annual level of care re-assessment for all individuals in the Act 421 CMO program; * Responsible for fair hearing requests related to a determination that the applicant doesn't require the level of care provided in a hospital or nursing facility, and completes all necessary appeals activity resulting from the request; * Completes notes in the OCDD Participant Data system Position-Specific Details: Appointment Type: This position is for a part-time WAE (When Actually Employed) position only and is not to exceed 1245 hours in a 12-month period. DUE TO ACT 421 REQUIREMENTS, THE INCUMBENT MUST BE A LICENSED REGISTERED NURSE. Compensation: Salary may be negotiable depending on the chosen applicant's level of experience. Below is a list of the pay range for the position: * Medical Certification Specialist 2: $31.60/hour minimum - $56.86/hour maximum. Location: This position is domiciled in Hammond, Louisiana. How To Apply: No Civil Service test score is required in order to be considered for this vacancy. To apply for this vacancy, click on the "Apply" link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page. * Information to support your eligibility for this job title must be included in the application (i.e., relevant, detailed experience/education). Resumes will not be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete. Contact Information: For further information on this vacancy, please contact: Emily Barthelemy HR Analyst C Florida Parishes Human Services Authority 835 Pride Drive, Suite B Hammond, LA 70401 ************************** Louisiana is a State As a Model Employer (SAME) that supports the recruitment, hiring, and retention of individuals with disabilities. FPHSA is an Equal Opportunity Employer.

Snaggle Dental West Monroe, LA 71291 Job details Salary: Starting from $16.00-$20.00/hourly Pay is based on experience and qualifications. **incentives after training vary and are based on performance Job Type: Full-time Full Job Description With our hearts, minds, and hands, we build better smiles, better relationships, and better lives. Living this purpose over the last 25 years has allowed us to create a world-class dental organization that continues to grow. At every turn, you will see our continued investment in leadership, the community, and advanced technologies. Do you want to be a part of developing one of the leading models of dental care in Louisiana? Do you thrive in a fast-paced, progressive environment? The role of the Insurance Claims Specialist could be for you! Please go to WWW.PEACHTREEDENTAL.COM to complete your online application and assessments or use the following URL: ********************************************** Qualifications High school or equivalent (Required) Takes initiative. Has excellent verbal and written skills. Ability to manage all public dealings in a professional manner. Ability to recognize problems and problem solve. Ability to accept feedback and willingness to improve. Ability to set goals, create plans, and convert plans into action. Is a Brand ambassador, both in and outside of the facility. Benefits offered for Full-time Insurance Claims Specialists: Medical, Dental, Vision Benefits Dependent Care & Healthcare Flexible Spending Account Simple IRA With Employer Match Basic Life, AD&D & Supplemental Life Insurance Short-term & Long-term Disability Perks & Rewards for Full-time Insurance Claims Specialists: Competitive pay + bonus Paid Time Off & Sick time 6 paid Holidays a year

Thank you for your interest in The University of New Orleans. Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting. You must complete all required portions of the application and attach the required documents in order to be considered for employment. Department OPH-Bureau of Emergency Medical ServicesJob SummaryJob Description Serves on a psychomotor exam team as an examiner, professional partner, patient, or other role as needed for the Office of Public Health (OPH) Bureau of Emergency Services (BEMS). Responsible for conducting unbiased examination activities for all candidates. Participates in the examination process by acting in any one of three defined positions as follows: Skill Examiner - provides specific and consistent instructions to each candidate. Records, totals and documents all performances as required on skill evaluation forms and submit to the National Registry Representative and/or Exam Coordinator. EMT Assistant - serves as the trained partner for all candidates testing. Simulated Patient - effectively acts out the role of an actual patient in a similar hospital situation; assists the skill examiner when reviewing a candidate's performance, and verifies completion of a procedure or treatment. Arrives at the examination site at the time indicated on the communication received from the Exam Coordinator to meet with the National Registry Representative and/or Exam Coordinator and receive assignments. Thoroughly reads the specific essay for the assigned skill before the actual evaluation begins, and role-play if necessary. Checks all equipment, props, and moulage before and during the examination. Assures professional conduct of all personnel involved with the particular skill throughout the examination. Maintains the security and integrity of all examination material. Maintains confidentiality of candidates and their performance results. Fairly and accurately completes all skill evaluation forms. Spotlights common areas of weakness to the National Registry Representative and/or Exam Coordinator. Other tasks as assigned. QUALIFICATIONS REQUIRED: Bachelor's degree, or Associate's degree plus 3 years of professional experience, or 6 years of professional work experience. Minimum 2 years professional experience in the Emergency Medical Services (EMS) profession. National certification from the National Registry of EMTs. Licensed Louisiana EMS Clinician. Excellent analytical and critical thinking skills; effective organizational and time management skills. Great attention to detail and follow up. Ability to manage projects, assignments, and competing priorities. Proficient in the use of Zoom, Teams, and Microsoft Office, including but not limited to Outlook, Word, and Excel. DESIRED: Advanced degree. Minimum 6 years professional experience in the Emergency Medical Technician (EMT) profession. Minimum 2 years performing administrative functions within an office environment or health care field. Minimum 1 year professional experience working as an EMS examiner. Additional relevant industry certifications or training. Required Attachments Please upload the following documents in the Resume/Cover Letter section. Detailed resume listing relevant qualifications and experience; Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems; Names and contact information of three references; Applications that do not include the required uploaded documents may not be considered. Posting Close DateThis position will remain open until filled. Note to Applicant: Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials. References will be contacted at the appropriate phase of the recruitment process. This position may require a criminal background check to be conducted on the candidate(s) selected for hire. As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks. The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.

About Us: Struction Solutions is an innovative Independent Adjusting, Building Consultant, and Disaster Recovery Firm, known for our commitment to delivering innovative and tailored solutions to our clientele. Our team of professionals work tirelessly to ensure accuracy, efficiency, and customer satisfaction. As we continue to grow and expand, we're seeking talented individuals who share our dedication to excellence and are eager to make a meaningful impact in our industry. Position Details: Resolves insurance claims involving marine casualties. Their role includes investigating, evaluating, and negotiating claims to determine the extent of the insurance company's liability. This role requires a thorough understanding of maritime laws, insurance policies, and handling procedures. Investigation: They conduct thorough investigations of marine incidents, such as collisions, groundings, sinkings, fires, or cargo damage. This includes gathering evidence, interviewing witnesses, and inspecting vessels and cargo. Assessment: They assess the extent of the damage and determine the cause of the incident. This may involve working with marine surveyors, engineers, and other experts to evaluate the condition of the vessel and cargo. Documentation: They collect and review relevant documents, such as ship logs, maintenance records, cargo manifests, and insurance policies, to support the claim. Evaluation: They evaluate the claim to determine whether it is covered under the insurance policy and to what extent. This involves interpreting policy terms and conditions, as well as applicable laws and regulations. Negotiation: They negotiate settlements with claimants, which can include shipowners, charterers, cargo owners, and other affected parties. The goal is to reach a fair and equitable resolution while minimizing the financial impact on the insurance company. Reporting: They prepare detailed reports and recommendations for the insurance company, documenting their findings, the extent of the damage, and the proposed settlement. Liaison: They act as a liaison between the insurance company and other parties involved in the claim, such as legal representatives, regulatory authorities, and other stakeholders. Compliance: They ensure that all claims are handled in compliance with relevant laws, regulations, and industry standards. Risk Management: They may also be involved in risk management activities, helping to identify and mitigate potential risks to reduce the likelihood of future claims. Qualifications: Proven experience in insurance claims adjustment, preferably in marine insurance. Strong knowledge of maritime laws and regulations. Excellent analytical, negotiation, and communication skills. Ability to manage multiple claims efficiently under tight deadlines. Proficiency in claim management software and Microsoft Office Suite. Location: New Orleans, LA area Marine casualty claim adjustment specialists need a strong understanding of maritime law, insurance principles, and the technical aspects of marine operations. They also require excellent analytical, communication, and negotiation skills. Join us at Struction Solutions, and let's redefine the future of the Independent Adjusting industry together! View all jobs at this company

Job Category: Accounting Job Type: Full-Time Facility Type: Corporate Shift Type (Clinical Positions): Day Shift At AMG we offer our employees much more than just a job in the healthcare industry. We offer unique career opportunities for people who are called to make a difference in the lives of others and desire to be part of a team that contributes to making a difference each day for our patients. We invite you to join our team and share your gifts and talents. In addition to market-competitive pay rates and benefits in the Lafayette market, you will have the opportunity to work for an Employee Stock Ownership Plan (ESOP), as AMG is an employee-owned company! AMG, Integrated Healthcare Management (AMG Corporate) is seeking a Hospital Billing & Claims Appeal Specialist in Lafayette, Louisiana. This position is crossed trained and is responsible for patient account billing, including monthly statement mail out, and electronic billing submissions. Also responsible for fiscal year end cost reporting. Also providing support for the Billing Specialists and the corporate office team in relation to managing incorrect contracted payments with managed care payors to seek resolution and file necessary appeals. The position will be responsible for assisting the billing specialist with obtaining necessary documentation, writing appeals and following up with appeals as requested by the billing team. The candidate must possess strong communication skills, excellent customer services skills, and be able to work collaboratively with a team. This position requires a strong Hospital Billing and Claim Appeals background with experience in the Post-Acute setting and interpretation of payor contracts for appropriate appeal rights. This is not a remote position. Join our dynamic team and enjoy a career where you can make a difference with AMG Integrated Healthcare Management! Apply Now Job Requirements * Position located in Lafayette, Louisiana. * Strong knowledge of MS Word and Excel. * Requires a strong Claim Appeals background with experience in the Post-Acute setting. * Requires interpretation of payor contracts for appropriate appeal rights. * Minimum of 2-3 years hospital billing/collections/accounting experience in health care related field. * A strong background in Long Term Acute Care (LTAC). * Must be able to diplomatically articulate communications, interpret and explain complex information, and comprehend written, verbal and electronic communication. * Strong problem-solving skills with effective time management. * Strong organizational skills to maintain awareness of appeal timelines. * Self-starter with strong analytical skills and attention to detai About Us AMG is a hospital system committed to our patients, our people, and to the pursuit of healing. As a Top-5 Post-Acute hospital system, we're known for excellence, integrity, community, and compassion. Our mission is to return patients to their optimal level of well-being in the least restrictive medical environment. We accomplish this through a multi-disciplined approach that includes aggressive clinical and therapeutic interventions, as well as family involvement. Our high staff to patient ratio ensures individualized attention. Our nurses, therapists, and physicians work with each patient to obtain the best possible outcomes. Acadiana Management Group, LLC is an equal opportunity employer.

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 $52,600.00 - $86,800.00 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. 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 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 *********************************************************

**About Us** At ENFRA, we blend a rich history with a forward-looking vision. With over 100 years of experience, we are a pillar of stability in the energy infrastructure industry and a leader in innovative energy solutions. Our commitment to leveraging emerging technologies ensures that we remain at the forefront of the Energy-as-a-Service sector. We believe in growth-not just for our business, but for our people. Our team members have the opportunity to advance their careers in a supportive environment that values continuous learning and development. We embrace innovation and encourage creative problem solving to tackle the energy infrastructure and energy challenges of tomorrow. Inclusion is at the heart of our culture. We strive to create a workplace where every voice is heard and valued, fostering a collaborative environment where diverse perspectives drive our success. Join us to be part of a legacy of excellence and a future of groundbreaking advancements. At ENFRA, stability, innovation, and growth are more than just values-they are the pillars of our continued success. **Overview** The Lead Claims Specialist is responsible for the overall administration of property and casualty claims (General Liability, Auto Liability, and Worker's Compensation). Works closely within the Risk Management team (Claims, Legal, and Operations Senior Leadership) to mitigate losses and communicate claim progress with various levels of management (Business Unit Managers, Project Managers, President) from inception through closure. **Responsibilities** - Handle high risk/high exposure claims. - Review applicable lines of insurance coverage to determine possible coverage, exclusion, and deductibles. - Calculates and reports projections, final cost, and the anticipated impact of the claim to the Team. - Provide outstanding customer service to Operations, while also collaborating successfully with the carriers, brokers, and TPAs in the handling of construction casualty claims. - Review claims for coverage and when applicable, submit claims to the insurance carrier. - Lead in claims cost control and initiates the prevention of similar re-occurring claims. - Contact applicable employees regarding their claims to provide counsel regarding the explanation of benefits. - Handle complex issues and problems. - Provide leadership, coaching, and/or mentoring to a subordinate group. **Qualifications** **Required Education, Experience, and Qualifications** - Bachelor's degree. - 7-10 years of claims experience. - Construction, Risk, and Insurance Specialist (CRIS), Associate in Claims (AIC), or Associate in Risk Management (ARM). - Possesses expert knowledge of the subject matter. - Leadership skills. - Problem-solving skills. - Organizational skills. - Excellent written and verbal communication skills. **Preferred Education, Experience, and Qualifications** - Certified Worker's Compensation Professional (CWCP) - Certified Property & Casualty Underwriter (CPCU) - Previous experience in construction company Risk Management highly desired. **Travel Requirements** - 0-5 % of time will be spent traveling to job site/office location. **Physical Activities** Remaining in a stationary position, often standing or sitting for prolonged periods Climbing stairs. Repeating motions that may include the wrists, hands and/or fingers **Environmental Conditions** Quiet environment **Physical Demands** Light work that includes adjusting and/or moving objects up to 20 pounds ENFRA is proud to be an Equal Opportunity Employer of Minorities, Women, Protected Veterans, and Individuals with Disabilities, and participates in the e-Verify program. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, age, sexual orientation, gender identity, national origin, veteran status, disability, or any other classification protected by law. Submit a Referral (************************************************************************************************************************** **Job Locations** _US-LA-Metairie_ **ID** _2025-8613_ **Category** _HR/Legal/Safety/Risk_ **Position Type** _Full-Time_ **Remote** _No_

Healthy Careers Start Here At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle. The Claims & Adjustments Specialist, BlueCard is responsible for maintain inventories which focus on the accurate and timely processing of member claim as well as member and provider inquiries. The Claims & Adjustments Specialist will process fully insured group, fully insured non-group and self insured in-state and out-of-area claims for Mississippi members. The Claims & Adjustments Specialist is also responsible for handling member and provider inquiries and inter-plan communication with other BlueCross and BlueShield Plans as well as provider and member correspondence. In completing these activities, the Claims & Adjustments Specialist is responsible for ensuring performance levels meet or exceed established timeliness and accuracy benchmarks. Job-Specific Requirements Bachelor's degree required. Must have average PC skills including experience with Microsoft Office suite Logical thought process in order to interpret and apply contract benefits as well as identify issues, recommend solutions, interpret and apply contract benefits and accurately adjust claims. Customer focused and service oriented to ensure timely and accurate performance and benchmark achievement. Ability to work with a high degree of accuracy and attention to detail to ensure work products are of high quality. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.

Job Details Corinth, MS Optional Work from Home Full Time None DayDescription Workers' Compensation Claims Representative - This position will assist healthcare providers in identification, verification, billing and follow-up on workers' compensation claims. The claims representative will help identify the appropriate workers' compensation carrier and provide the documentation necessary for payment. The claims representative will work directly with adjusters to obtain claim updates and resolve outstanding claims. Representatives will need excellent communication and organizational skills to gather information and achieve resolution on assigned claims. Prior medical billing experience is preferred. Essential Duties Answering inbound calls and making outbound calls, while demonstrating proper phone etiquette and HIPAA compliance Identification and verification of workers' compensation insurance Properly noting the account and setting appropriate follow-up Proficient communication related to standard billing forms (UB04 and 1500) Qualifications High School Diploma and GED Strong Knowledge of computer skills and typing Intermediate knowledge of Outlook, Excel Dependable and Detailed individuals with organizational skills Great Communication skills Recommended- 1- or 2-years' medical billing experience

Job DescriptionAbout the Role PuroClean of Shreveport is seeking a high-character individual to join our team as a Loss Claims Specialist. This is more than a jobits a leadership role designed for someone who can take full ownership of a project from start to finish and align with our mission of providing empathetic, efficient, and professional restoration services to our community. As a Loss Claims Specialist, you will serve in a project manager capacity, overseeing the execution of all services related to water damage, mold, biohazard, contents handling, and reconstruction. This role demands strong organizational skills, technical knowledge, and a commitment to both customer care and team collaboration. Why Join Us Profit Sharing Position your success is our success Annual Draw of $50,000 + laptop + software subscriptions Be part of a purpose-driven company that values integrity, excellence, and service Opportunities for growth and advancement in a fast-paced industry What Youll Need A personal vehicle and reliable transportation A working phone A desire to learn and align with our SOPs and company goals Willingness to take ownership and be accountable for job outcomes Ability to manage multiple claims and ensure timely completion of each project What Youll Do Manage restoration projects from intake through completion Coordinate and execute all mitigation and reconstruction services: Water Damage Mold Remediation Biohazard Cleanup Contents Pack-Out and Cleaning Reconstruction/Build-Back Estimate, invoice, and track jobs using software including: Xactimate Estimate Time and Materials platforms Learn and apply our internal SOPs with consistency and accuracy Meet or exceed quarterly performance goals Preferred (but not required): Prior construction or restoration experience Familiarity with insurance claims processes or property loss mitigation Who Were Looking For Were looking for someone with more than just technical skills. We value character, accountability, and alignment with our company vision. If you take pride in your work, can lead by example, and are looking to grow in an environment that rewards dedication and resultsyou may be exactly who were looking for.

Peach Tree Dental - Monroe, LA Monroe, LA 71270 Job details Salary: Starting from $16.00-$20.00/hourly Pay is based on experience and qualifications. **incentives after training vary and are based on performance Job Type: Full-time Full Job Description With our hearts, minds, and hands, we build better smiles, better relationships, and better lives. Living this purpose over the last 25 years has allowed us to create a world-class dental organization that continues to grow. At every turn, you will see our continued investment in leadership, the community, and advanced technologies. Do you want to be a part of developing one of the leading models of dental care in Louisiana? Do you thrive in a fast-paced, progressive environment? The role of the Insurance Claims Specialist could be for you! Please go to WWW.PEACHTREEDENTAL.COM to complete your online application and assessments or use the following URL: ********************************************** Qualifications High school or equivalent (Required) Takes initiative. Has excellent verbal and written skills. Ability to manage all public dealings in a professional manner. Ability to recognize problems and problem solve. Ability to accept feedback and willingness to improve. Ability to set goals, create plans, and convert plans into action. Is a Brand ambassador, both in and outside of the facility. Benefits offered for Full-time Insurance Claims Specialists: Medical, Dental, Vision Benefits Dependent Care & Healthcare Flexible Spending Account Simple IRA With Employer Match Basic Life, AD&D & Supplemental Life Insurance Short-term & Long-term Disability Perks & Rewards for Full-time Insurance Claims Specialists: Competitive pay + bonus Paid Time Off & Sick time 6 paid Holidays a year