Stop Loss Claims Clerk
Claim processor job in Oakbrook Terrace, IL
Claims Clerk
Full TimeSME/Specialist
Oakbrook Terrace, IL, US
Salary Range:$50,500.00 To $57,500.00 Annually
The Claims Clerk will be responsible for accurate, timely screening and distribution of incoming electronic claims correspondence. This role will aid the Analysts in timely processing of the claims and help secure a manageable turnaround time for the entire Claims Department. This position will report to the Claims Manager.
Essential Elements
Manage the Secure File Transfer Portal (SFTP) site ensure all reporting received is processed in a timely manner
Download and pivot reports from Power BI, to locate all possible medical and prescription claims.
Identify and review claims data ensuring data integrity
Distributing claim requests for processing
Convert the PDF claims received into an Excel Template for the Claims Analyst to upload and process
Additional duties as assigned
Requirements
Education and Certifications
Associates degree or commensurate experience required
Experience
Excel, Microsoft Office Suite, Power BI, Clerical functions
Travel Required
May need to travel to the home office quarterly
Hybrid workplace
Case File Processor
Claim processor job in Springfield, IL
Diversified Services Network, Inc. (DSN) is seeking a full-time Case File Processor to join our team in Springfield, IL! We offer full benefits, PTO, 401k, and more!
This position prepares foster care applications for a title IV-E eligibility determination by collecting the required documentation to satisfy the eligibility requirements. This is accomplished by utilizing multiple systems including but not limited to: Department of Children and Family Services' Child Welfare systems (CYCIS & SACWIS), Department of Human Services/Healthcare and Family Services' systems (PACIS, IES, KIDS), Social Security Administration system (SOLQ), and Department of Labor systems (DOL/AWVS). In addition, Case Managers and Supervisors are contacted to resolve discrepancies or request additional information.
This position requires the ability to multi-task and to adapt to changes daily. Candidates for this position must be very detail-oriented and possess the ability to process, discern, and retain information across multiple sources. Reading comprehension is a must. The ability to assess a process or situation and recommend an enhancement or change is a plus.
Preparing Case Files for Submission to the DCFS Eligibility Determination Unit Job Duties:
Check out cases ready for determination (court documentation present in the file).
Review and interpret all gathered information.
Follow up with the Case Manager and Supervisor if there are any discrepancies or further information is required.
Routinely follow up on any outstanding requests for information or documentation.
Complete all fields of information on the Cover Sheet for each case.
Document any additional information relevant to the determination of eligibility.
Ensure all documents are in the case file and are in the correct order.
Submit the file to the supervisor for a quality control check.
Correct any issues found during the quality control check, if applicable.
Assist with all filing duties.
Other duties as assigned.
The expectation for a fully trained Case File Processor is to complete an average of at least 7 cases a day and with a less than 5% error rate.
Required Skills
Excellent verbal and written communication skills.
Attention to detail.
Organizational skills.
Ability to take direction and follow instructions.
Critical thinking skills.
BENEFITS:
• 401(k)
• Dental insurance
• Vision Insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Paid Holidays
Claims Specialist, Lawyers Professional Liability
Claim processor job in Chicago, IL
Do you have experience handling Lawyers Professional Liability or other Professional Liability claims? Are you motivated by working in a collaborative environment? If so, this role may be for you! We are looking for a strategic thinker with leadership skills to join our U.S. Lawyers Claims team.
About the Role
This role has responsibility for handling Lawyers Professional Liability claims while also supporting internal and external customers. You will manage a caseload of claims from receipt to final resolution. Our team works closely with the U.S. Agents Claims team, and you may have the opportunity to handle Agents Claims, as well.
Additional key responsibilities include:
* Maintain strong client focus by aggressively and proactively analyzing issues, providing support, and assuring client satisfaction in a timely fashion.
* Complying with legal and regulatory requirements, investigate, evaluate, and settle claims, applying technical knowledge and people skills to reach fair and prompt claim resolution.
* Complete detailed reviews of claim related issues, including coverage, liability, and damage assessments, and document the claim file appropriately.
* Set and maintain appropriate and timely indemnity and expense reserves.
* Formulate and execute negotiation and resolution strategies.
* Evaluate claims data to assist with identifying claim trends.
* Support Underwriting in connection with Claims information and consultation on coverages.
* In this role, you will be working with other Claims Handlers dedicated to working on Lawyers Professional Liability Claims. Our team also handles other types of claims, including U.S. Agents claims, and has a strong emphasis on quality and customer service.
About the Team
We are a highly skilled, professional, and experienced claims team. Our department works closely with colleagues in Client Markets, Underwriting, Products, Actuary, and HR and we collaborate with various offices throughout the US and other places in the world. We are proud to deliver unparalleled customer service to our business partners and clients. We are looking for a new colleague to help us continue to raise the bar!
About You
Focused, self-motivated, and a confident professional with a hardworking sales mindset to develop insights, propose solutions, and build growth opportunities for clients and Swiss Re. You are a proactive and well-organized decision maker who works well both independently and as part of a team. You also have the following:
Additional requirements include:
* Bachelor's degree or equivalent industry experience.
* 3+ years' Claims handling experience or equivalent industry experience.
* Possess solid coverage, liability, damage investigation, evaluation, and claims resolution skills.
* Excellent negotiation skills.
* Excellent customer service skills and experience collaborating with underwriters, clients, brokers, and internal and external business partners.
* Strong data analytic skills.
* Experience with handling claims in a paperless environment.
* Interest in developing leadership and management skills.
* Possess, or willing to obtain, adjuster licenses as needed for various jurisdictions.
* Ability to successfully deliver the Swiss Re Claims Commitment.
Our company uses a hybrid work model requiring a minimum of three days in the office each week, with the option of working onsite full-time if preferred.
The estimated base salary range for this position is $84,000 to $140,000. The specific salary offered for this or any given role will take into account a number of factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget. At Swiss Re, we take a "total compensation approach" when making compensation decisions. This means that we consider all components of compensation in their totality (such as base pay, short-and long-term incentives, and benefits offered), in setting individual compensation.
About Swiss Re
Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world.
Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability.
If you are an experienced professional returning to the workforce after a career break, we encourage you to apply for open positions that match your skills and experience.
Keywords:
Reference Code: 136177
Nearest Major Market: Chicago
Job Segment: Liability, Claims, Underwriter, Accounting, Actuarial, Insurance, Finance
Claims Examiner I
Claim processor job in Kansas City, MO
We are currently looking for a Claims Examiner to join our team! The Claims Examiner processes the notification of death claims, ensures state regulations are being maintained in the follow up process, reviews and adjudicates claims, and provides assistance to the beneficiaries through calls and written correspondence.
Job Responsibilities
Review and process death claims
Create payments and letters to settle claims
Correspond with claimants via phone, letter, and email
Follow all state regulations, being mindful of Unfair Claim Practice regulations
Provide excellent, prompt customer service to beneficiaries and other callers
Reconcile suspense items, returned mail, and other items in workflow according to service level agreements
Job Qualifications
Good understanding or ability to learn in house systems (Workflow/Imaging System, Life Insurance Policy Administration systems, Microsoft Office applications)
Knowledge of life and disability insurance
Well organized, detail oriented, uses time efficiently
Able to work independently and think critically
Excellent written and verbal communication
Able to operate effectively in a fast-paced environment while maintaining a professional image and positive attitude
Previous life insurance claims experience
Education Qualifications
Four year degree from an accredited college or university, or relevant industry experience
About Us
Americo: We're in this for life!
The roots of the Americo family of companies date back more than 100 years. Americo is a life insurance and annuity company providing innovative products to our customers. At Americo, it's the people who make things work, so we hope you join us!
What you'll love about working at Americo:
Compensation:
Our competitive pay and robust bonus program, offered to all associates, will make you feel valued.
Learning and development:
We prepare you for success with a comprehensive, paid training program. Additionally, our Talent Development team creates various development opportunities for associates at every stage of their careers.
Work-life balance:
We value work-life balance with our generous paid time off; you begin accruing hours every month, and they increase with tenure. All new hires earn over three weeks of paid time off annually, plus 11 paid company holidays! We also support new mothers with a maternity leave program, along with paid STD and LTD.
Health and well-being:
We commit to your health and well-being and are proud to offer comprehensive health and life insurance options, including FSA or HSA accounts and subsidies to support your health and fitness goals through vendor partnerships at The Y, Orange Theory, WW, and more.
Future planning:
Americo offers a 401(k) with a company match. We also have tuition reimbursement programs to further your education.
Giving back:
We support several local organizations, such as Ronald McDonald House, Hope Lodge, the American Red Cross, Harvesters, and many more. Our associates volunteer their time and donate money alongside the company to make a difference in our community.
The fun stuff:
Americo participates in the Kansas City Corporate Challenge, a great way to connect with coworkers. Additionally, we host events like a Royals Party at the K, a legendary Holiday Party, and in-office events with local vendors to allow associates to step away from work and enjoy each other's company.
Bustling environment:
Our newly renovated offices are conveniently located in downtown Kansas City, within walking distance of your favorite restaurants and attractions. Plus, you'll receive complimentary paid parking near our Americo offices - downtown parking is a premium, but we've got you covered.
#AMERICO
Claims Processor
Claim processor job in Maryland Heights, MO
Responsible and accountable for the accurate and timely claims processing of all claim types. Claims must be processed with a high level of detailed quality and in accordance with claims payment policy and by the terms of our customer/provider contractual agreements.
Essential Functions:
- Adjudicate claims and adjustments as required.
- Resolve claims edits and suspended claims.
- Maintain and update required reference materials to adjudicate claims.
- Provide backup support to other team/group members in the performance of job duties as assigned.
· Requirements/Certifications:
- Ability to quickly use a 10-key machine- Experience with list of ICD-9 codes and Current Procedural Terminology (CPT) Claims
High School (Required) GED (Required)
Additional Information
All your information will be kept confidential according to EEO guidelines.
Auto and GL Claim Specialist
Claim processor job in Chicago, IL
Multi-Line Claim Specialist (Auto and GL)
Schedule: Monday-Friday, 8:00 AM-4:30 PM CT Compensation: $75,000-$85,000 annually
At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile.
Reasons you should consider a career with CCMSI:
Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm.
Career development: CCMSI offers robust internships and internal training programs for advancement within our organization.
Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP.
Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads.
The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards.
Responsibilities
Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws.
Establish reserves and/or provide reserve recommendations within established reserve authority levels.
Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution.
Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
Review and maintain personal diary on claim system.
Assess and monitor subrogation claims for resolution.
Compute disability rates in accordance with state laws.
Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process.
Provide notices of qualifying claims to excess/reinsurance carriers.
Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Excellent oral and written communication skills.
Initiative to set and achieve performance goals.
Good analytic and negotiation skills.
Ability to cope with job pressures in a constantly changing environment.
Knowledge of all lower level claim position responsibilities.
Must be detail oriented and a self-starter with strong organizational abilities.
Ability to coordinate and prioritize required.
Flexibility, accuracy, initiative and the ability to work with minimum supervision.
Discretion and confidentiality required.
Reliable, predictable attendance within client service hours for the performance of this position.
Responsive to internal and external client needs.
Ability to clearly communicate verbally and/or in writing both internally and externally.
Education and/or Experience
10+ years liability claim experience is required.
Bachelor's Degree is preferred.
Experience with handling injury claims.
Computer Skills
Proficient with Microsoft Office programs.
Certificates, Licenses, Registrations
Adjusters license may be required based upon jursidiction.
AIC, ARM or CPCU Designation preferred.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Object Handling Categories
Work requires the ability to sit or stand up to 7.5 or more hours at a time.
Work requires sufficient auditory and visual acuity to interact with others.
CORE VALUES & PRINCIPLES
Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.
Visa Sponsorship:
CCMSI does not provide visa sponsorship for this position.
ADA Accommodations:
CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team.
Equal Opportunity Employer:
CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.
#EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #ClaimsJobs #LiabilityAdjuster #RemoteJobs #InsuranceCareers #ChicagoJobs #LI-Remote
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Auto-ApplyClaims Analyst
Claim processor job in Chesterfield, MO
Company Details
Midwest Employers Casualty (MEC) is a member of the W. R. Berkley Corporation, a fortune 500 company, rated A+ (Superior) by A.M. Best Company, based in Chesterfield, MO. We improve the quality of life for employees severely injured on the job and help companies understand and mitigate their risk for workers' compensation injuries. MEC has a friendly, results-focused work environment. We seek employees who take initiative, are quick to adapt, are dependable, and like working as part of a team.
Company URL: ***************************
The company is an equal opportunity employer.
Responsibilities
The Claims Analyst is responsible for managing high exposure Workers Compensation claims. The primary job objectives are to proactively mitigate loss costs and settle claims by developing relationships and influencing MEC's customers and claim administrators. The role also leverages Advanced Analytics and Assisted Intelligence (A.I.) tools to enhance claim evaluation, reserve accuracy, and settlement strategies, supporting data-driven decision-making and continuous improvement.
Key functions include but are not limited to:
Accurately evaluate WC claims for potential exposure and establish appropriate reserves
Utilize predictive analytics and A.I. driven tools to provide insight into complex medical issues, evaluate trends and explore potential exposures
Lead evaluation, mitigation and resolution of WC claims by collaboration with MEC Medical Management Consultants, Client Consult Managers and Claims Attorneys
Achieve settlement and vendor goals and objectives
Adhere to departmental Best Practices by:
Establishing, reviewing and adjusting case reserves in a timely manner within proper authority levels supported by data driven insights and A.I. assisted tools.
Identifying and influencing appropriate MEC vendors
Identifying and achieving claim settlement agreements and obtaining necessary authority to finalize resolution
Maintaining well documented claim files supported by an effective and current diary system on all assigned claims
Influence TPA adjusters to adopt MEC recommended claim handling strategies
Plan and conduct on-sight Third Party Administrators (TPAs) visits to promote loss mitigation, vendor utilization and timely settlement across assigned portfolio of claims
Collaborate with Regional Team colleagues to support business growth and client retention through consultative engagement
Review and authorize reimbursements
Qualifications
Bachelor's in general studies, liberal arts or business.
Frequent usage and general knowledge of WC industry accepted claim handling practices and standards with a minimum of 5 years of primary claim handling experience
High level of influence management skills
Ability to prioritize, organize and meet deadlines
Ability to analyze issues and barriers, find solutions and effectively implement solutions
Ability to work effectively in a team environment under general supervision
Ability to communicate frequently and effectively to internal and external contacts using both verbal and written communication skills
Ability to learn and maintain skill levels in an electronic environment.
Working toward CPCU or AIC credentials preferred
Ability to travel 5-10% of the time.
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
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. Sponsorship Details Sponsorship not Offered for this Role
Auto-ApplyMedical Device Cybersecurity Analyst
Claim processor job in New Lenox, IL
Job Description
Medical Device Cybersecurity Analyst- New Lenox, IL
Salary: $70,000 to $90,000/yr
Other Forms of Compensation:
Join Intelas, a Compass One Healthcare company.
Intelas, a Compass One Healthcare company, delivers smarter asset management by blending expert service teams with intelligent, data-driven strategies that help hospitals improve uptime, simplify oversight, and make more informed capital decisions. Our programs support 100% regulatory compliance and drives 98% equipment uptime-so clinicians can focus on care, not equipment issues.
We support nearly 4,500 healthcare sites nationwide-from large, campus-based acute care hospitals to system-integrated outpatient clinics. With more than 1.15 million medical devices managed, we provide the clarity and consistency needed in today's rapidly evolving healthcare environment.
Join Intelas-where your career thrives, your potential is unleashed, and your work directly supports patient care. Whether you're just starting out or are a seasoned professional, our people-first approach ensures opportunities for continuous growth, development, and fulfillment.
Explore more at intelashealth.com.
Job Summary
Please note:This is an on site position
SUMMARY The Medical Device Cybersecurity Analyst will be involved in response to cybersecurity alerts, ensuring Client KPI's are met, perform audits and risk assessments of medical devices, and provide subject matter expertise with Intelas's resources for medical device cybersecurity.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Monitors and responds to Intelas's comprehensive medical device asset and cybersecurity management platform findings and mitigating steps.
•Strong knowledge of computers, operating systems, security, and networking
•Ability to interpret technical documentation and manuals
•Generate and build bi-weekly, monthly, and quarterly client reports
•Correlate and perform GAP analysis on discovered medical devices with Intelas's CMMS
•Create security work orders in Intelas's CMMS and assign to the field as applicable
•Triage, respond and assign work orders generated from Intelas's CMMS cybersecurity module as appropriate
•Ensure work orders are completed within defined KPI's and assist on site Crothall resources if needed for successful completion
•Research and engage OEM's for available approved patches and firmware upgrades
•Proactively collect most current MDS2 forms
•Maintain database of approved patches, firmware upgrades and MDS2 forms
•Collaborate and work with Clients to respond and coordinate mitigating steps and compensating controls on contracted medical devices that may arise from Clients passive asset discovery and risk assessment technology
•Participate and contribute to Intelas's CEIT Council
•Maintains operational security metrics to measure the effectiveness of security controls and identify opportunities for improvement
•Assist in threat intelligence gathering, monitoring of zero-day and correlate to clients CMMS inventory
•Assist in development and implementation of continued best practices and risk management of inventoried connected medical devices
•Assures compliance with all regulatory standards including patient safety and all relative criteria governing the safe and appropriate use, testing and management of medical devices.
MINIMUM QUALIFICATIONS:
•Knowledge of the operation and prior hands-on experience in the maintenance and repair of wide variety of medical equipment and systems
•High attention to detail and exceptional work quality
•Experience with process improvement
•Proven ability to work effectively in an unstructured, fast-paced environment
•Excellent written and verbal communication skills
•Overnight travel may be required for Client visits or industry conferences or workshop.
PREFERRED QUALIFICATIONS:
• Healthcare experience; General knowledge of Biomedical and Diagnostic Imaging
• Knowledge of healthcare cybersecurity is considered a plus
• Experience with Computerized Maintenance Management Systems (CMMS)
• Knowledge of connected medical device asset discovery and risk analysist platforms
EDUCATION:
• Associates degree in Information Technology or Biomedical Engineering required
• Security+ within 3 years of employment
• BMET preferred
Apply to Intelas today!
Intelas is a member of Compass Group USA
Click here to Learn More about the Compass Story
Associates at Intelas are offered many fantastic benefits.
• Medical
• Dental
• Vision
• Life Insurance/ AD
• Disability Insurance
• Retirement Plan
• Flexible Time Off
• Holiday Time Off (varies by site/state)
• Associate Shopping Program
• Health and Wellness Programs
• Discount Marketplace
• Identity Theft Protection
• Pet Insurance
• Commuter Benefits
• Employee Assistance Program
• Flexible Spending Accounts (FSAs)
• Paid Parental Leave
• Personal Leave
Associates may also be eligible for paid and/or unpaid time off benefits in accordance with applicable federal, state, and local laws. For positions in Washington State, Maryland, or to be performed Remotely, click here for paid time off benefits information.
Compass Group is an equal opportunity employer. At Compass, we are committed to treating all Applicants and Associates fairly based on their abilities, achievements, and experience without regard to race, national origin, sex, age, disability, veteran status, sexual orientation, gender identity, or any other classification protected by law.
Qualified candidates must be able to perform the essential functions of this position satisfactorily with or without a reasonable accommodation. Disclaimer: this job post is not necessarily an exhaustive list of all essential responsibilities, skills, tasks, or requirements associated with this position. While this is intended to be an accurate reflection of the position posted, the Company reserves the right to modify or change the essential functions of the job based on business necessity. We will consider for employment all qualified applicants, including those with a criminal history (including relevant driving history), in a manner consistent with all applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and the New York Fair Chance Act. We encourage applicants with a criminal history (and driving history) to apply.
Applications are accepted on an ongoing basis.
Intelas maintains a drug-free workplace.
Req ID: 1467914
Intelas
ASHLEY VAVROCK
[[req_classification]]
Senior Liability Reinsurance Claims Manager
Claim processor job in Saint Louis, MO
At Safety National, we don't just offer jobs - we build careers with purpose! Since 1942, we've been an industry leader, valuing integrity, teamwork, and stability while providing competitive rewards, top-tier benefits, career growth opportunities, and flexible work options that promote balance. With tuition reimbursement, wellness perks, and a strong community impact, we invest in your success-both personally and professionally. Ready to grow with us? Apply today!
Follow this link to view all of our available careers and apply: ********************************************
This opportunity is in the Claims department.
Our Claims Department oversees both high-exposure workers' compensation and liability claims. As an unbundled carrier, we work actively with third-party administrators (TPAs) and self-administered accounts to assist in guiding claims to a successful resolution. As an excess carrier, the catastrophic claims we handle keep our group challenged, but the uniqueness provides plenty of growth opportunities.
Role Description:
Are you an expert in complex liability claims, particularly those involving facultative reinsurance or runoff operations? In this role, you'll take ownership of high-exposure litigation cases, guide TPAs and self-administered programs, and play a crucial role in managing our umbrella runoff program. You'll conduct detailed coverage reviews, set and monitor reserves, and participate in litigation management, settlement, and reporting. This role calls for strategic oversight and collaboration across multiple business units, ensuring timely reporting, reinsurance recovery efforts, and client engagement. With opportunities to travel for mediations, audits, and trials, your impact will be both national and deeply strategic. If you're looking for a challenging claims role where your litigation knowledge, analytical abilities, and project experience can shine-this is your opportunity to lead and make a difference.
Qualifications:
Education:
Bachelor's Degree from an accredited college or university required. JD preferred.
Required Qualifications:
Must be presently authorized to work in the U.S. without a requirement for work authorization sponsorship by our company for this position now or in the future.
10 or more years of litigation or claims experience handling complex, high-exposure liability claims, including facultative reinsurance, umbrella run-off, and construction liability claims.
5 or more years handling environmental and latent disease claims.
Strong knowledge of coverage issues, with the ability to draft reservation of rights and coverage letters.
Preferred Qualifications:
Experience across multiple jurisdictions with an insurance carrier or Third-Party Administrator.
Proficiency with all phases of claims litigation, including mediations, settlement conferences, and trials.
Demonstrated project leadership and cross-functional influence.
Exceptional organizational, analytical, and communication skills.
Self-starter with the ability to independently prioritize a high-volume workload.
Proficiency with Microsoft Excel, Word, and Outlook.
AIC, SCLA, or CLCS designation preferred.
Ability to travel as business needs require.
Protect the confidentiality, integrity and availability of information and technology assets against unauthorized disclosure, destruction and/or alteration, in accordance with Safety National policies, standards, and procedures.
Safety National is a leading specialty insurance and reinsurance provider. Our culture is built upon relationships, which allow us to demonstrate our expertise gained through our rich 80-year history. As a wholly-owned subsidiary of Tokio Marine, Inc., we appreciate the benefits and support provided by our affiliation with one of the top 10 insurance companies in the world.
Total Rewards That Put Employees First
In our vision to be First with Co-Workers, compensation that includes base salary, holiday bonus, and incentive awards is only a small portion of the comprehensive total rewards package we offer. Our total rewards approach recognizes and rewards the time, talents, efforts, and results of our valued employees. Highlights of our exceptional benefits include generous health, dental, and vision coverage, health savings accounts, a 401(k)-retirement savings match and an annual profit sharing contribution. We proudly offer family forming benefits for adoption, fertility, and surrogacy, generous paid time off and paid holidays, paid parental and caregiver leave, a hybrid work environment, and company-paid life insurance and disability. To support employees in their career journeys, we provide professional growth and development opportunities in addition to employee recognition and well-being programs. Apply today to learn more.
Safety National is committed to fair, transparent pay and we strive to provide competitive, market-based compensation. In our vision to be First with Co-Workers, compensation is only one piece of the comprehensive total rewards package we offer. The target base salary range for this position is $99,000 to $128,500. Compensation for the successful candidate will consider the candidate's particular combination of knowledge, skills, competencies, experience and geographic location.
#LI-Hybrid
#LI-Remote
Claims Auditor I, II & Senior
Claim processor job in Saint Louis, MO
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.
Auto Property Damage Claims Specialist
Claim processor job in Oak Brook, IL
Job Description
Are you unhappy at your present job?
?
Is it time for a change?
Are you an experienced Auto Liability Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities?
If you answered YES to the above, it's time to talk to Warrior Insurance Network!
We offer:
Competitive Salaries
Excellent benefits
Growth opportunities!
Apply only if you consider yourself a career professional who loves to work, because we work hard here!
We have openings in our Bedford Park, IL and Oak Brook, IL offices!
If you are an experienced Non-Standard Auto CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!!
This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First- and Third-Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims.
DUTIES & RESPONSIBILITIES:
Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss
Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim
Honor/decline/negotiate first and third-party liability claims upon completion of coverage/policy investigation and analysis of damages and liability
Work directly with internal and external customers to develop evidence and establish facts on assigned claims
Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims
Prepare and present claim evaluations for the appropriate settlement authority
Notify the Underwriting Department of any adverse information uncovered in the course of the investigation
Familiarity with unfair claim practices in states where we do business
Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service
Provide customer service both to internal and external customers
Handle other duties as assigned
QUALIFICATIONS REQUIRED:
Minimum 4 years previous auto liability and auto PD claims experience A MUST!
Non-Standard auto claims experience a plus but not required.
Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills
General working knowledge of policies, file procedures, state rules and regulations
Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster
On-Site position.
Preferred:
Prior claims experience
Ability to use on-line claims system
Bi-lingual a plus!
Warrior Insurance Network (WIN) provides a competitive benefits package to all full- time employees. Following are some of the perks Warrior Insurance Network (WIN) employees receive:
Competitive Salaries
Commitment to your Training & Development
Medical and Dental and Vision Reimbursement
Short Term Disability/Long Term Disability
Life Insurance
Flexible Spending Account
Telemedicine Benefit
401k with a generous company match
Paid Time Off and Paid Holidays
Tuition Reimbursement
Wellness Program
Fun company sponsored events
And so much more!
Estimated Compensation Range: $41,600/year-$75,000/year*
*Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.
Job Posted by ApplicantPro
Damage Claims Representative
Claim processor job in Town and Country, MO
This role requires the ability to work lawfully in the U.S. without employment-based immigration sponsorship, now or in the future. The Damage Claims Rep I must have in-depth knowledge of multiple systems and have experience handling escalated situations. Responsible for handling damage claim escalations; becoming the point of contact between field management and the customer and accurately capturing claim details for reporting purposes.
MAJOR DUTIES AND RESPONSIBILITIES
Actively and consistently support all efforts to simplify and enhance the customer experience
Provides customer support for service complaints; answer questions regarding services and products; receive telephone calls from internal and external customers through the resolution of the claim.
Provides support and guidance to Field Operations to ensure timely resolutions to damage claims.
Enters damage tickets into ticketing system and update systems as required.
Creates investigation forms and other official documents; drafts and sends mail correspondence to external customers and field management.
Completes required liability forms for submission to risk management.
Performs basic troubleshooting for all damage claims internal process. Some of these issue may include problems with the ticketing system; email attachments; damage claim reporting or liability form submission.
Interacts with the regional leadership, the field, other departments and customers to ensure timely resolutions to damage claim reports.
Accesses multiple billing systems for account information; conducts research in multiple billing and online systems.
Accurately and thoroughly documents customer interactions and claim detail.
Reports and escalates Field Operations missed SLA's as needed.
Generates reports for management as required.
Performs multiple tasks simultaneously and follows direction with minimal supervision.
Performs other duties as requested by supervisor.
REQUIRED QUALIFICATIONS
Required Skills/Abilities and Knowledge
Ability to read, write, speak and understand English
Ability to prioritize and organize effectively
Ability to multitask at a high level
Ability to use critical thinking in complex situations
Ability to use personal computer & software applications
Ability to work independently in group environment
Ability to effectively address/resolve customer complaints and issues
Ability to work while seated for prolonged periods of time
Ability to communicate orally and in writing in a clear and straightforward and professional manner
Demonstrated knowledge of all three lines of business (Cable, HSI, Telephone)
Knowledge of office procedures and Company policies
Knowledge of KMS and CSG
Knowledge of service troubleshooting
Knowledge of MS Office Suite
Required Education
High School Diploma or equivalent
Required Related Work Experience and Number of Years
Customer service experience - 3
Telephone, Video, High Speed Data experience - 2
Telecommunication experience or equivalent - 2
PREFERRED QUALIFICATIONS
Preferred Skills/Abilities and Knowledge
Preferred Education
Preferred Related Work Experience and Number of Years
WORKING CONDITIONS
Office, team setting environment
Exposure to moderate noise level
CRP145 2025-65275 2025
Here, our employees don't just have jobs, they're building careers. That's why we offer a comprehensive pay and benefits package that rewards employees for their contributions to our success, supporting all aspects of their well-being at every stage of life.
A qualified applicant's criminal history, if any, will be considered in a manner consistent with applicable laws, including local ordinances.
Get to Know Us Charter Communications provides superior communication and entertainment products for residential and business customers through the Spectrum brand. Our offerings include Spectrum Internet, TV, Mobile and Voice. Beyond our connectivity solutions, we also provide local news, programming and regional sports via Spectrum Networks and multiscreen advertising solutions via Spectrum Reach. When you join our team, you'll be keeping our customers connected to what matters most in 41 states across the U.S. Watch this video to learn more.
Grow Your Career Here We're committed to growing a workforce that reflects the customers and communities we serve - providing opportunities for employment and advancement to all team members. Spectrum is an Equal Opportunity Employer, including job seekers with disabilities and veterans. Learn about Life at Spectrum.
Claims Specialist
Claim processor job in Chicago, IL
*** This is where your organization can create a consistent intro to all of your jobs, creating consistency in voice and messaging across all job posts
*** C'est ici que votre organisation peut créer une introduction cohérente à tous vos emplois, en créant une cohérence dans la voix et la messagerie dans tous les postes.
Overview
The Claims Specialist position is responsible for Point of Sale (POS) data management and processing back-end pricing rebates/credits, including resolution of issues/disputes in a timely and accurate manner.
Responsibilities
Ingest and cleanse partner Point of Sale (POS) data in Vistex Go-to-Market Suite (GTMS).
Upload manual POS files timely and track monthly progress.
Review data for deficiencies or errors, correct any inaccuracies in POS daily.
Investigate, research, and identify business entities with minimal information provided.
Cleanse, enrich, and monitor master data elements (customer, product, and pricing).
Collaborate with POS reporters to improve the completeness and accuracy of the data submitted in Electronic Data Interchange (EDI) or manual submissions.
Identify issues related to master data that impact POS and/or claims data.
Process and issue credits for incoming claims in an accurate and timely manner.
Upload claim files timely and track weekly/monthly progress.
Resolve and analyze claim errors/rejections; escalate to management and/or Bid Desk for further internal review as needed.
Communicate discrepancies/denials to claim partner for review and alignment.
Issue credits for approved claims and send claim discrepancy report to claim partner.
Work with Accounts Receivable to reconcile discrepancies/denials for collection.
Collaborate with claim partners to improve the claim submission data for processing efficiency.
Address any internal and/or external issues or questions regarding data or claims in an accurate and timely manner.
Validate and create credits honoring price protection in SAP.
Qualifications
High school diploma or GED required. Associate degree in Business or work-related experience.
Minimum one year rebate/claim processing, data management, or equivalent experience.
Demonstrated problem solving skills with a proficient understanding of processes.
Proven detail-oriented individual who enjoys managing large amounts of data.
Established strong process and organizational skills with the ability to process high volumes of transactions, research errors and exceptions, and manage to completion.
Ability to interact with a variety of individuals/functions within the organization as well as with external customers.
Ability to work independently in a fast-paced, professional team environment with minimal supervision.
Demonstrated experience creating and managing reports that identify discrepancies.
Proven capacity to identify and maintain consistent accuracy.
Strong oral and written communication skills.
Intermediate Microsoft application user including Outlook, Word, and especially Excel.
Ability to multi-task and prioritize.
Experience with Salesforce, Channel Data Management (CDM), SAP ECC6, Vistex is a plus.
ABOUT US: Sharp Imaging and Information Company of America (SIICA)
Sharp Imaging and Information Company of America (SIICA) is a division of Sharp Electronics Corporation, the U.S. subsidiary of Japan's Sharp Corporation, a global technology company which has been named to Fortune magazine's World's Most Admired Company List. Sharp strives to help businesses achieve Simply Smarter work by helping companies manage workflow efficiently, create immersive and engaging environments, and increase productivity. SIICA offers a full suite of secure printer and copier solutions, professional and commercial visual displays and projectors, software management and productivity software and markets durable Dynabook laptops. As a total solutions provider, Sharp has a reputation for innovation, quality, reliability, and industry-leading customer support expertise.
Compensation for this position
The compensation range for this role is $53,900 - $67,650. The listed salary range or contractual rate excludes bonuses, incentives, differential pay, and any other forms of compensation or benefits. The starting salary will be determined by several variables, including but not limited to experience, education, training, certification, and location. You may also be eligible to receive an annual discretionary incentive award, commissions, and program-specific awards, which are subject to the rules governing these programs.
Employee perks
Comprehensive, family-friendly healthcare plans (medical, dental, vision).
401k retirement plan with a competitive match and plenty of financial support tools.
Employee Assistance Plan to care for you and your family's mental and behavioral health, balance, and support. Financial protection for you and your family (life insurance and disability insurance)
Rewarding and wholistic wellness program.
Training, professional development, and mentorship
Full suite of voluntary insurance benefits for financial planning (auto, home, ID protection and legal)
Dynamic culture eager to innovate, enhance diversity, and work smarter.
Sharp Electronics Corporation is an equal opportunity employer - minority - female - disability - veteran.
No agency resumes will be accepted or fees paid in the absence of an official written engagement agreement executed in advance by Human Resources for this particular position.
All applicants must be authorized to work in the US without sponsorship. All applications must include compensation expectations in order to be considered. Local candidates only, please.
#LI-SR1 #SIICA
*** Similar to the introduction that can precede all job descriptions, an outro can also be formatted for consistency on all posts
*** Semblable à l'introduction qui peut précéder toutes les descriptions de poste, une outro peut également être formatée pour la cohérence sur tous les messages
Auto-ApplyGlobal Risk Solutions Claims Specialist Development Program (January, June 2026)
Claim processor job in Hoffman Estates, IL
Claims Specialist Program
Are you looking to help people and make a difference in the world? Have you considered a position in the fast-paced, rewarding world of insurance? Yes, insurance!
Insurance brings peace of mind to almost everything we do in our lives-from family trips to your first car to weddings and college graduations. As a valued member of our claims team, you'll help our customers get back on their feet and restore their lives when catastrophe strikes.
The details
When you're part of the Claims Specialist Program, you'll acquire various investigative techniques and work with experts to determine what caused an accident and who is at fault.
You'll independently manage an inventory of claims, which may include conducting investigations, reviewing medical records, and evaluating damages to determine the severity of each case. You'll resolve cases by working with individuals or attorneys to settle on the value of each case.
You will have required comprehensive training, one-on-one mentoring, and a strong pay-for-performance compensation structure at a global Fortune 100 company. Make a difference in the world with Liberty Mutual.
Qualifications
What you've got
You have 0-2 years of professional experience.
A strong academic record with a cumulative 3.0 GPA preferred
You have an aptitude for providing information in a clear, concise manner with an appropriate level of detail, empathy, and professionalism.
You possess strong negotiation and analytical skills.
You are detail-oriented and thrive in a fast-paced work environment.
You must have permanent work authorization in the United States.
What we offer
Competitive compensation package
Pension and 401(k) savings plans
Comprehensive health and wellness plans
Dental, Vision, and Disability insurance
Flexible work arrangements
Individualized career mobility and development plans
Tuition reimbursement
Employee Resource Groups
Paid leave; maternity and paternity leaves
Commuter benefits, employee discounts, and more
Learn more about benefits at **************************
A little about us
As one of the leading property and casualty insurers in the country, Liberty Mutual is helping people embrace today and confidently pursue tomorrow.
We were recognized as a ‘2018 Great Place to Work' by Great Place to Work US, and were named by
Forbes
as one of the best employers in the country for new graduates and women-as well as for diversity.
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information, or on any basis prohibited by federal, state, or local law.
We can recommend jobs specifically for you! Click here to get started.
Auto-ApplyOutbound Claims Specialist
Claim processor job in Mokena, IL
Job Details Headquarters - Mokena, IL Full Time High School $44000.00 - $50000.00 Salary/year Full Time: 80 hours per pay period Billing & InsuranceDescription
The Outbound Claims Specialist is responsible for coding and scrubbing claims for errors, adding modifiers, and submitting claims to insurance.
Work Schedule: This position is on-site with a schedule of Monday - Friday 7:30 am - 4:00 pm
Essential Functions:
Bill out claims to insurance providers in a timely manner.
Review provider coding on notes/appointments to ensure compliance with insurance guidelines and to ensure accurate and timely reimbursement.
Ensure client records are up-to-date and accurate.
Initiate internal communication with therapists ensuring accuracy and completion of notes.
Serve as a liaison between clients and clinics to ensure timely, appropriate transfer of information and response to billing inquiries.
Attend relevant seminars to remain abreast of current issues regarding therapy and ABA billing practices, compliance with CMS guidelines and industry best practice.
Meet or exceed department goals set by team lead or billing manager on a regular basis.
Adhere to all practice policies related to HIPAA.
Qualifications
Required Education, Experience and Credentials:
High school diploma or equivalent
One year of billing experience in a medical office or healthcare setting
Knowledge, Skills and Abilities:
Excellent interpersonal and communication skills
Able to work effectively with all levels of the organization and in a diverse work group.
Proactive and independent with the ability to take initiative.
Excellent time management skills with a proven ability to meet deadlines.
Comfortable with technology, with the ability to learn multiple systems and software.
Proficient with Google Workspace
Must maintain discretion and client confidentiality.
Personal Attributes:
Interpersonal skills with strong verbal and written communication skills
Process oriented with strong attention to detail and accuracy
Accountability
Integrity
Problem Solving
Initiative
Work Environment & Physical Demands
Prolonged periods of sitting at a desk and working on a computer.
Must be able to lift up to 15 pounds at times.
Travel Requirements
Not applicable
This is a full-time position. Full-time employees are eligible for a comprehensive range of benefits, including Medical, Dental, Vision, and Life Insurance; a 401(k) retirement plan with company match; Paid Time Off; Sick Time; and a robust Employee Assistance Program.
Trainee Casualty Claims Specialist
Claim processor job in Bedford Park, IL
We are Hiring for a Trainee to learn and handle Auto Bodily Injury Casualty Claims!
Are you a high performing Auto Liability PD Claim Professional, seeking advancement within your career?
Are you interested in learning how to handle injury claims, up to and included attorney represented complex casualty claims?
Are you currently in a Claims role and feel that there is no opportunity to grow your Claims career?
If you answered
YES
, then look no further! First Chicago Insurance is recruiting a training class of ambitious individuals who currently excel within the auto liability PD claims insurance industry. No prior auto bodily injury/casualty claims handling experience required!
At the end of the training program, you will be expected to and able to successfully investigate, evaluate, negotiate, and resolve bodily injury, uninsured/underinsured motorist bodily injury, and medical payments claims.
The training class will run approximately 4-6 weeks and will be a balanced mix of classroom instruction and on-the-job/side-by-side training.
Following is more information about this unique opportunity to elevate your insurance career:
The Casualty Specialist Trainee will be responsible for the investigation and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation.
DUTIES & RESPONSIBILITIES:
Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss.
Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability, status, and damages that are applicable for each claim.
Process Bodily Injury, and coverage claims in accordance with established office procedures.
Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation.
Research case and statutory law in order to conduct proper claim investigation.
Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims.
Prepare and present claim evaluations for the appropriate settlement authority.
Maintain reasonable expense factors.
Handle other duties as assigned.
QUALIFICATIONS REQUIRED:
2+ years of auto liability property damage claim adjusting experience is required.
JD (Juris Doctorate) a plus!
Non-standard Auto Claims handling experience preferred is not required.
Excellent negotiation, written and verbal communication, organizational and interpersonal skills.
Ability to pass written examinations where required by state statutes to become a licensed claims adjuster.
Proficiency in Microsoft Office products.
Bilingual in Spanish preferred but not required.
On-Site position.
First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive:
Competitive Salaries
Commitment to your Training & Development
Medical and Dental
Short Term Disability/Long Term Disability
Life Insurance
Flexible Spending Account
Telemedicine Benefit
401k with a generous company match
Paid Time Off and Paid Holidays
Tuition Reimbursement Training Programs
Wellness Program
Fun company sponsored events
And so much more!
Estimated Compensation Range: $27.88/hr-$31.25/hr*
*Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.
Trainee Casualty Claims Specialist
Claim processor job in Bedford Park, IL
We are Hiring for a Trainee to learn and handle Auto Bodily Injury Casualty Claims! Are you a high performing Auto Liability PD Claim Professional, seeking advancement within your career? Are you interested in learning how to handle injury claims, up to and included attorney represented complex casualty claims?
Are you currently in a Claims role and feel that there is no opportunity to grow your Claims career?
If you answered YES, then look no further! First Chicago Insurance is recruiting a training class of ambitious individuals who currently excel within the auto liability PD claims insurance industry. No prior auto bodily injury/casualty claims handling experience required!
At the end of the training program, you will be expected to and able to successfully investigate, evaluate, negotiate, and resolve bodily injury, uninsured/underinsured motorist bodily injury, and medical payments claims.
The training class will run approximately 4-6 weeks and will be a balanced mix of classroom instruction and on-the-job/side-by-side training.
Following is more information about this unique opportunity to elevate your insurance career:
The Casualty Specialist Trainee will be responsible for the investigation and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation.
DUTIES & RESPONSIBILITIES:
* Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss.
* Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability, status, and damages that are applicable for each claim.
* Process Bodily Injury, and coverage claims in accordance with established office procedures.
* Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation.
* Research case and statutory law in order to conduct proper claim investigation.
* Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims.
* Prepare and present claim evaluations for the appropriate settlement authority.
* Maintain reasonable expense factors.
* Handle other duties as assigned.
QUALIFICATIONS REQUIRED:
* 2+ years of auto liability property damage claim adjusting experience is required.
* JD (Juris Doctorate) a plus!
* Non-standard Auto Claims handling experience preferred is not required.
* Excellent negotiation, written and verbal communication, organizational and interpersonal skills.
* Ability to pass written examinations where required by state statutes to become a licensed claims adjuster.
* Proficiency in Microsoft Office products.
* Bilingual in Spanish preferred but not required.
* On-Site position.
First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive:
* Competitive Salaries
* Commitment to your Training & Development
* Medical and Dental
* Short Term Disability/Long Term Disability
* Life Insurance
* Flexible Spending Account
* Telemedicine Benefit
* 401k with a generous company match
* Paid Time Off and Paid Holidays
* Tuition Reimbursement Training Programs
* Wellness Program
* Fun company sponsored events
* And so much more!
Estimated Compensation Range: $27.88/hr-$31.25/hr*
* Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.
Pharmacy Claims Adjudication Specialist
Claim processor job in Woodridge, IL
We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Woodridge, IL. This will be a Full-Time position. This position must be located within driving distance to our pharmacy, with a hybrid work style. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $23.00 an hour and up Sign-On Bonus: $5,000 for employees starting before January 1, 2026. We offer a variety of benefits including:
Medical; Dental; Vision
401k with a match
Paid Time Off and Paid Holidays
Tuition Reimbursement
Company paid benefits - life; and short and long-term disability
Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360...
Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information..
Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim.
Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays
Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible)
Manages all funding related adjudications and works as a liaison to Onco360 Advocate team.
Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment.
Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable.
Document and submit requests for Patient Refunds when appropriate.
Pharmacy Adjudication Specialist Qualifications and Responsibilities...
Education/Learning Experience
Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication
Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience
Work Experience
Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience
Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience
Skills/Knowledge
Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills
Desired: Knowledge of Foundation Funding, Specialty pharmacy experience
Licenses/Certifications
Required: Registration with Board of Pharmacy as required by state law
Desired: Certified Pharmacy Technician (PTCB)
Behavior Competencies
Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills
#Company Values: Teamwork, Respect, Integrity, Passion
Multi-Line Damage Adjuster Trainee
Claim processor job in Saint Louis, MO
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
Multi-Line Adjuster Trainee
Salary: “*Starting pay rate varies based upon position and location. Ask your Recruiter for details!”
We are looking for a highly motivated and service-oriented individual to join our Multi-line Damage team as a Multi-line Property Damage Trainee! As an ambassador for GEICO's renowned customer service, you will work in a dynamic environment that may include repair shops, salvage yards, a customer's home or in a virtual estimating environment. You will be responsible for inspecting damage, estimating cost of repairs, negotiating settlements, issuing payments, and providing excellent customer service. This position primarily will include servicing boat, motorcycle, RV and other specialty claims.
Our industry-leading, paid training, which includes 3-weeks of required hands-on experience at our Ashburn, VA training facility will teach you the ins and outs of physical damage adjusting. We will provide the resources and training so you can directly assist our customers after accidents or major disasters. We're looking for those who are equally as motivated as they are compassionate. Your unique skillset, along with the latest adjusting tools and tech, will help you.Qualifications & Skills:
Valid driver's license (must meet company underwriting guidelines for at least the past 3 consecutive years) and the ability to maintain applicable state and federal certifications and permits
Willingness to be flexible with primary work location - position may require either remote or field work
Solid computer, mechanical aptitude, and multi-tasking skills
Effective attention to detail and decision-making skills
Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities
Minimum of high school diploma or equivalent, college degree or currently pursuing preferred
At this time, GEICO will not sponsor a new applicant for employment authorization for this position.
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs.
We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being.
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
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Claim processor job in Venice, IL
Job Details BISSELL APTS - Venice, IL Full Time DayDescription
Independent Management Services is a full-service property management and marketing firm, specializing in the revitalization of under-managed multifamily housing developments. Since our founding in 1989, we have expanded our nationwide presence to include over 100 sustainable communities in 11 states focusing exclusively in the affordable and workforce housing sectors. However, our total breath of experience also includes market rate and commercial property management.
We offer competitive salaries commensurate with experience and a comprehensive benefit package. We intend to build a team of individuals, who are self-motivated, willing to learn and grow with our firm. We progressively uphold a professional management team to serve our clients, enhancing our management skills and capabilities. Your progress, training, experience, motivation, attitude, and goals may create many possibilities for career opportunities with our company. If you have superior attention to detail with outstanding communications skills and enjoy a challenging fast pace environment, join our team now!
Responsibilities:
Occupancy, marketing, leasing, and resident verification procedures.
Collect information from residents for eligibility screening, rent calculation, and income verification.
Initial and annual recertification of income for residents.
Complete unit inspections prior to move in/out and ensure units are ready for occupancy within deadlines.
Receive and resolve resident requests and concerns.
Foster positive working relationships with residents while always maintaining a professional demeanor.
Administrative support tasks such as filing, typing, answering telephones, and data entry.
Reports directly to the Site Manager.
Job Qualifications:
Sales-minded individual with attention to detail and strong verbal/written communication skills.
Excellent follow-up skills via telephone or email correspondence.
Experience with Tax Credit Compliance, EIV, and HUD Section 8 subsidy programs.
Knowledge of REAC and MOR compliance.
Proficiency with Paycom software and Microsoft Office suite preferred.
Experience with RealPage OneSite preferred.
Demonstrated track record regarding work attendance and reporting to work timely.
Must adhere to Federal Fair Housing Laws.
Qualifications
We offer a competitive salary plus benefits including:
Employer paid health and dental insurance (100% employee only) with affordable dependent and family coverage.
Voluntary insurance options: Vision, Life, Accident Injury, Long-Term Disability, and Identity Theft.
401(k) with above-average employer matching contribution.
Generous paid time off package.
Training and employee development program.
Among many other employee benefits.