Post job

Claim processor jobs in Carrollton, TX

- 136 jobs
All
Claim Processor
Claim Specialist
Claims Supervisor
Medical Claims Analyst
Claims Analyst
  • Claims Specialist

    Us Tech Solutions 4.4company rating

    Claim processor job in Plano, TX

    Duration:6 Months+ Roles & Responsibilities Maximize customer satisfaction by providing prompt actions to customer's need and obtain quality photos/data to determine root cause of claim to defend or accommodate customer's claim Provide efficient solutions to customer-facing agents by developing and operating guide and contents Use various tools/dashboard/systems to quantify the agent's performance of customer care and develop appropriate actions to improve performance and quality Spanish speaking agent recommended but not a requirement. [Customer Experience Management] Analyze end-to-end processes that customers experience and participate in providing suitable resolutions accordingly and in controlled & monitored turnaround time for each action of customer claim process [Quality Management] Monitor and review customer calls/tickets for customer care quality control, carry out activities to secure quality competitiveness of our company and customers Maintains and improves operational quality by monitoring system performance; identifying and resolving problems; preparing and completing action plans. Qualifications & Experience College Graduate 3~5 Years in customer experience Case management for MX/CE claims CE Tender management Pending Management (KPI, LTP) Case Tracker Management for special issue CPSC claim management (Customer care/tracker) (CE) Monitoring FCCM report quality (ACQ/OS Reports) Special Projects Customer Care Resolution EnR Submission/Management Work to de-escalate customer situations while finding an appropriate solution; involve upper management as needed Skills Customer Care Experience (Call Center) Claims Management Experience Insurance Claims or Adjuster background beneficial About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name: P Praveen Chary Email: **************************** Internal Id: 25-54476
    $27k-40k yearly est. 4d ago
  • Legal Claims Analyst

    Erisa Recovery

    Claim processor job in Plano, TX

    ERISA Recovery are experts in collecting complex and aged claims through the Federal ERISA appeals process. We are a fast-growing organization located in Plano, TX. If you would like to join a friendly, passionate team with limitless potential, we'd love to meet you. This extraordinary opportunity to advance your career and make a difference is now. We are searching for a Legal Hospital Claims Analyst - someone who works well in a fast-paced setting. In this position, you'll provide support in analyzing comprehensive claims and identifying key metrics. You will be a subject matter expert in legal claims. You must be able to work both independently and as part of a team. Key attributes for the ideal candidate include working with intensity, focus, and being detail oriented. Essential responsibilities and duties Conducts legal research and investigation of claims Drafting legal documents Keeping track of changes in legal framework and providing timely updates on these changes Utilizes ERISA law enforcement Utilizes knowledge of health care standards appropriate to specific claim Ability to understand and apply medical reimbursement policies, procedures, and standards Ensures eligibility for claims is reasonable and correct by analyzing claims and providing supporting documentation Utilize a variety of EHR systems Thrives in a fast-paced environment Collaborates effectively with other team members Ability to adapt to changing needs Consistently applies knowledge relevant to claims Work intensely at a fast-paced rate Ability to communicate effectively with third party administrators Determine the status of medical claims through research Meet the standards of the department and quality standards Strong organizational skills Desired skills and Qualifications Bachelor's degree 3+ years working in the legal field 2+ years working with healthcare insurance claims (preferred) Strong Communication skills Working knowledge utilizing Microsoft software (Word, Excel, Outlook) Ability to work in a fast-paced environment Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance Paid lunches Bonus ERISA Recovery is an Equal Opportunity Employer
    $34k-55k yearly est. 3d ago
  • Litigation Claims Supervisor

    Harrison Gray Search

    Claim processor job in Dallas, TX

    Litigation Claims Supervisor - Commercial Auto & Bodily Injury Join a dynamic and growing organization as a Litigation Claims Supervisor, where you will provide daily leadership and direction to a dedicated team of 6-9 Litigation and Bodily Injury claims adjusters. This highly visible, on-site role is based in Westlake, Texas. In this role, you will be crucial in ensuring the consistent delivery of high-quality claim handling and customer service within the Commercial Auto division. You will utilize strong critical thinking and judgment to guide your team in the proper resolution of claims, fostering an environment of accountability, teamwork, and professional development. As a leader, you will coach and guide your team through organizational and industry changes, promoting an entrepreneurial spirit and driving outstanding achievement of unit and company goals. Key Responsibilities Team Leadership & Performance Management Lead and manage a team of 6-9 commercial lines claims adjusters to meet or exceed key performance indicators (KPIs), metrics, and best practices on a monthly and quarterly basis. Provide clear daily goals and solutions to address challenges in work completion and customer service. Offer direction, leadership, and training on coverage, investigations, and claim evaluations, ensuring adherence to company policy and regulations. Conduct management oversight and quality assurance reviews on all open claim inventory (both non-litigated and litigated files). Authorize reserve and settlement decisions according to established company guidelines. Champion a diverse, inclusive, and trusting work environment, encouraging staff to professionally challenge the status quo and identify improvements. Technical & Compliance Oversight Ensure 100% compliance with all claim adjuster licensing requirements. Act as a professional representative of the organization to both internal and external customers. Communicate information to Senior Management and the claims or legal management team regarding claim files with unusual circumstances or excess exposure potential. Maintain strict confidentiality concerning sensitive information and employee matters. Required Qualifications Experience: A minimum of 7+ years of Auto Bodily Injury and litigated claims experience is required. Supervisory Background: Prior experience of 3-5 years in a claims supervisory role is mandatory. Technical Skills: Must possess a strong technical and administrative background in auto claims handling. Licensing: A Texas Adjuster license is required. Education: A High School Diploma or equivalent is required; a Bachelor's degree is preferred. Workplace & Environment This is an On-Site position based in Westlake, Texas. The ideal candidate must be able to work independently on technical and administrative matters in accordance with company policy and procedures.
    $43k-79k yearly est. 2d ago
  • Claims Supervisor (Bodily Injury)

    Geico 4.1company rating

    Claim processor job in Dallas, TX

    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. Join a team where your expertise truly matters!Our Casualty Claims department is seeking a highly motivated and experienced Claims Supervisor (Bodily Injury). As a key leader within our Casualty organization, you will be responsible for empowering a team that handles attorney-represented automotive liability claims. Your team will manage: complex investigations coverage determinations liability assessments bodily injury claim resolutions-through both settlement and litigation. This role requires advanced knowledge of litigation processes and the ability to strategically support litigated and attorney-represented claims. If you're passionate about developing talent, driving results, and making an impact in the automotive liability space, we'd love to hear from you.Success in this role is built on the foundation of GEICO's core leadership behaviors: Ownership: You take responsibility for outcomes in all scenarios. Adaptability: You navigate dynamic environments with creativity and resilience. Leading People: You empower individuals and teams to achieve their best. Collaboration: You build and strengthen partnerships across organizational lines. Driving Value: You use data-driven insights to align actions with strategic goals. What You'll Do: Lead, mentor, and inspire a team of associates to deliver exceptional customer service while building trust. Leverage your property and casualty insurance expertise to guide team members in resolving complex customer inquiries and claims. Provide authority on evaluations that exceed your adjusters personal, assigned authority and work with others on claims that exceed your authority Personalize your leadership approach to develop team members' skills, fostering their growth and ensuring they consistently exceed customer expectations. Monitor and evaluate team performance using key performance indicators (KPIs) to enhance efficiency, customer satisfaction, and retention. Hold your team accountable for achieving results, maintaining compliance with insurance regulations, and delivering outstanding service. Address escalated customer concerns with professionalism and empathy, modeling GEICO's dedication to service excellence. Collaborate with leadership and cross-functional teams to identify and implement process improvements. Serve as a resource for team members on insurance-related questions providing mentorship and training to build their industry knowledge. What We're Looking For: Minimum of 2 years of leadership experience in Bodily Injury claims, including direct oversight of litigated cases. Active Adjuster license (required) Expertise in Casualty claims, including knowledge of industry regulations and best practices Strong ability to assess needs and guide associates in negotiating claim settlements as needed Experienced in the use of various claims tools with ability to assist associates Strong adherence to compliance and regulatory requirements Proven ability to motivate, inspire, and develop high-performing teams in a customer-centric environment Strong results orientation, with a history of meeting or exceeding performance goals Excellent interpersonal and communication skills, with the ability to adapt leadership styles to diverse individuals and situations Ability to analyze data and metrics to inform decision-making and improve customer outcomes Collaborative mindset with a commitment to fostering a culture of inclusivity and excellence Why Join GEICO? Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Inclusive Culture: Join a company that values diversity, collaboration, and innovation. Workplace Flexibility: This is a M-F, 8:00am - 4:30pm position offering a Hybrid work model based in Richardson, TX. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Licensing and continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Increased Earnings Potential: Pay Transparency: The starting salary for this position is between $97,735 annually and $151,700 annually. Incentives and Recognition: Corporate wide bonus programs are in place to reward top performers. Beware of scams! As a recruiter, I will only contact you through ************ email address and will never ask you for financial information during the hiring process. If you think you are being scammed or suspect suspicious activity during the hiring process, please contact us at ...@geico.com. keywords: litigation, auto liability, liability claims#geico300#LI-AL2 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.
    $49k-73k yearly est. 13d ago
  • Claims Processor II

    Pennymac 4.7company rating

    Claim processor job in Fort Worth, TX

    PENNYMAC Pennymac (NYSE: PFSI) is a specialty financial services firm with a comprehensive mortgage platform and integrated business focused on the production and servicing of U. S. mortgage loans and the management of investments related to the U. S. mortgage market. At Pennymac, our people are the foundation of our success and at the heart of our dynamic work culture. Together, we work towards a unified goal of helping millions of Americans achieve aspirations of homeownership through the complete mortgage journey. Job Overview The Claims Processor is a specialized role within the mortgage industry, primarily focused on the financial aspects and reimbursement of fees, costs and advances that incurred during the foreclosure process. A Typical Day The Claims Processor is mainly responsible for filing MI, investor, and/or insurer claims timely and accurately, providing all back-up as requested, and the reconciliation and posting of claim proceeds. As the Claims Processor, you will demonstrate proficiency in all aspects of the role (including the ability to meet and exceed personal goals) and is ready to assume additional responsibility including but not limited to; OJT training, writing policies and procedures, management of multiple claim types, reporting, and other related duties as required and assigned. The Claims Processor will perform post-foreclosure servicing functions as required by MI, investor, insurer, and internal guidelines including: Eviction management, property inspection and maintenance Filing reimbursement claims, Conveyance of Title and Title Delivery Maintenance of HOA, Taxes, and/or property insurance during the GSE REO process Assist in development and maintenance of Claims related policies and procedures Maintain workflow in a current status through demonstrated proficiency in dashboard and exception reporting tools Performs other related duties and assist with projects as required Demonstrate behaviors which are aligned with the organization's culture and values What You'll Bring High School Diploma or equivalent work experience 3+ years' Default-related experience is required An aptitude for data, reporting, and working with numbers, is desired Proficiency in Microsoft Office Knowledgeable with GSE, insurer servicing guidelines and requirements Why You Should Join As one of the top mortgage lenders in the country, Pennymac has helped over 4 million lifetime homeowners achieve and sustain their aspirations of home. Our vision is to be the most trusted partner for home. Together, 4,000 Pennymac team members across the country are guided by our core values: to be Accountable, Reliable and Ethical in all that we do. Pennymac is committed to conducting a business that makes positive contributions and promotes long-term sustainable growth and to fostering an equitable and inclusive environment, where all employees and customers feel valued, respected and supported. Benefits That Bring It Home: Whether you're looking for flexible benefits for today, setting up short-term goals for tomorrow, or planning for long-term success and retirement, Pennymac's benefits have you covered. Some key benefits include: Comprehensive Medical, Dental, and Vision Paid Time Off Programs including vacation, holidays, illness, and parental leave Wellness Programs, Employee Recognition Programs, and onsite gyms and cafe style dining (select locations) Retirement benefits, life insurance, 401k match, and tuition reimbursement Philanthropy Programs including matching gifts, volunteer grants, charitable grants and corporate sponsorships To learn more about our benefits visit: ********************* page. link/benefits For residents with state required benefit information, additional information can be found at: ************ pennymac. com/additional-benefits-information Compensation: Individual salary may vary based on multiple factors including specific role, geographic location / market data, and skills and experience as defined below: Lower in range - Building skills and experience in the role Mid-range - Experience and skills align with proficiency in the role Higher in range - Experience and skills add value above typical requirements of the role Some roles may be eligible for performance-based compensation and/or stock-based incentives awarded to employees based on company and individual performance. Salary $40,000 - $60,000 Work Model OFFICE
    $40k-60k yearly Auto-Apply 9d ago
  • Risk Claims Specialist

    Maya Management Group LLC 4.1company rating

    Claim processor job in Dallas, TX

    Job Description Key Responsibilities: Customer Claims: • Manage Customer Injury and Liability Claims: Oversee the investigation, documentation, and resolution of customer claims related to personal injury, property damage, or any other incidents occurring on organization premises. • Coordinate with Insurance Providers: Liaise with insurance companies to ensure proper claims filing and coordinate the resolution of claims involving external parties. • Customer Support: Handle escalated customer claims and provide appropriate resolutions while ensuring the store's best interests are maintained. • Documentation & Compliance: Ensure that all claims are properly documented in compliance with company policies and legal requirements. Keep detailed records of each customer-related claim. • Risk Prevention: Identify trends or recurring incidents that may contribute to customer claims and work with store management to implement safety measures or preventive actions. Employee Claims: • Workers' Compensation Claims: Oversee and manage all workers' compensation claims, ensuring compliance with state and federal regulations, and ensuring employees receive appropriate benefits. • Workplace Injury Claims: Manage the investigation of employee injury claims, including gathering evidence, interviewing witnesses, and ensuring all necessary forms are completed and submitted on time. • Fleet Claims Management: Manage the investigation of employee fleet claims, support employee's injuries if any, gather witness statements • Support and Guidance: Provide support to injured employees, ensuring they are informed throughout the claims process and are aware of their rights and available benefits. • Collaboration with HR and Legal: Work with HR and legal teams to ensure employee-related claims are handled correctly and in compliance with labor laws, insurance regulations, and company policies. • Collaboration with Safety Team: Work with the Safety Team to consistently do store visits, conduct safety audits, checklists and investigations as needed. Development: • Process Improvement: Identify opportunities to improve the claims process, whether through more efficient systems, better documentation, or enhanced communication strategies. Risk Management and Reporting: • Claims Analysis and Reporting: Review and analyze the data on claims to identify trends, recurring issues, or areas for improvement. Prepare detailed reports for management regarding claim frequency, costs, and risk mitigation efforts. • Collaboration with Risk and Safety Teams: Work closely with the Risk Management and Safety teams to address underlying causes of incidents that may lead to claims and develop preventive strategies. • Compliance: Ensure that all claims are processed in line with company policies, industry standards, and legal requirements, including managing documentation for audits or regulatory reviews. • Invoices: Reconcile and verify all invoices generated from claims. • Safety Monitor Report: Complete Safety Monitor report and communicate all parties involved to resolve an issue related to an investigation. Qualifications: • Bachelor's degree in Business, Risk Management, Insurance, or a related field (or equivalent experience). • 3-5 years of experience in claims management, risk management, or a specialist role, preferably in a retail or supermarket environment. • Strong understanding of risk management principles, insurance claims processes, and workers' compensation regulations. • Strong problem-solving and analytical abilities to investigate and resolve complex claims efficiently. • Excellent communication skills, both written and verbal, with the ability to manage sensitive issues with customers and employees. • Attention to detail and ability to maintain accurate records and reports. • Proficient in Microsoft Office and experience with claims management software or risk management tools. Physical Requirements: • Ability to stand for extended periods • Ability to lift up to 50 lbs as needed Work Environment: • Fast-paced, high-volume environment • Occasional evening, weekend, or holiday work may be required • Occasional travel to different company locations Physical Demands: Some lifting, carrying, pushing, and/or pulling; some stooping, kneeling, crouching, and/or crawling; and significant fine finger dexterity. Generally, the job requires 70% sitting, 20% walking, and 10% standing. This job is performed in a generally clean and healthy office environment.
    $37k-65k yearly est. 26d ago
  • US Retail Markets Claims Specialist Development Program-(January, June 2026)

    Liberty Mutual 4.5company rating

    Claim processor job in Plano, TX

    Advance your career at Liberty Mutual - A Fortune 100 Company! Manages, investigates and resolves claims assigned and assists in providing service to policyholders. Responsibilities: * Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. * Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. * Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports. * Ensures adequacy of reserves. * Accountable for security of financial processing of claims, as well as security information contained in claims files. * Makes effective use of loss management techniques. Negotiates settlements with attorneys, claimants, and/or co-defendants. Arranges for expert inspections involving third party or potential fraud actions as needed. * Updates files and provides comprehensive reports as required Qualifications Qualifications: * Strong written and oral communications skills required. * Good interpersonal, analytical, investigative, and negotiation skills required. * Customer service experience preferred. * Basic knowledge of legal liability, general insurance policy coverage and State Tort Law. * Bachelor's degree is required. * Ability to obtain proper licensing as required. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco
    $53k-77k yearly est. Auto-Apply 60d+ ago
  • Insurance Claims Specialist

    DPR Construction 4.8company rating

    Claim processor job in Dallas, TX

    The Claims Specialist will be responsible for assisting with the management of the Fleet Vehicle Safety & Operations Policy for DPR (and DPR related entities) across the US, as well as first and third-party auto physical damage and low severity property damage claims as requested by, and under the supervision of, DPR's Insured Claims Manager. Specific Duties include: Claims & Incident Management: Initial processing of first and third-party auto and low severity property damage incidents involving DPR (and DPR related entities), including but not limited to: Input and/or review all incidents reported in DPR's RMIS system. Maintain incident records in Insurance Team's document management system. Ensure all necessary information is compiled to properly manage the claims, including working with the internal teams to identify culpable parties, potential risk transfer to the culpable trade partner, if applicable, collecting documents such as incident reports, root cause analyses, if any, and vehicle lease or rental agreements. Report, with all appropriate documents and information, all claims for DPR (and DPR related entities) to all potentially triggered insurance policies for various types of programs (traditional, CCIP, OCIP), including analyzing contractual risk transfer opportunities. Assess potential risk transfer opportunities and ensure additional insured tenders or deductible responsibility letters are sent, where applicable. Liaison with the carriers in evaluating whether claims reported directly to the carriers are appropriate. Manage all auto and low severity property damage claims, as assigned, in the DPR RMIS system for DPR (and DPR related entities), including ensuring that all information is kept up to date. Provide in-network aluminum certified repair shop information to drivers following an incident. Act as a liaison between our carriers, auto repair shops, Operations, Fleet and EHS teams related to claim progress, strategy, expenses and settlement. When required, notify the applicable State's Department of Motor Vehicles office of motor vehicle accidents by preparing and mailing the specific State form. Work with Insurance Controller on auto program claim reports Liaison with Operations, Fleet and EHS teams on new incident reporting processes, as needed. Fleet Vehicle Safety & Operations Policy Management: Manage the Fleet Risk Index scores for authorized drivers, ensuring its accurate and up to date based on incidents and MVRs Assign training to authorized drivers based on MVA incidents, MVRs and citations, as well as managing completion of the training Ensure authorized driver list is kept current Liaison with internal HR, Fleet, EHS and Business Unit Leaders, where appropriate, on suspending vehicle usage permissions Responsible for working with internal teams on implementing appropriate updates to the Fleet Vehicle Safety & Operations Policy Key Skills: Strategic thinking Ability to mentor and inspire others Integrity Team player Strong writing and communication skills Self-Starter Highly organized and responsive - ability to meet deadlines Detail Oriented Basic working knowledge in all of the following coverages/programs: auto insurance, commercial general liability, property insurance, and controlled insurance programs. Risk and dispute management - insured claims Qualifications: A minimum of five years relevant insurance industry experience Previous experience in auto claims management highly desired DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************
    $57k-73k yearly est. Auto-Apply 60d+ ago
  • Claims Specialist - Auto

    Philadelphia Insurance Companies 4.8company rating

    Claim processor job in Plano, TX

    Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
    $82.8k-97.3k yearly Auto-Apply 60d+ ago
  • Paralegal/Claims Specialist

    Sundt Construction 4.8company rating

    Claim processor job in Irving, TX

    As a 100% employee-owned contractor, when you work at Sundt, you're not just hiring on at a company, you're joining a culture. Because everyone at Sundt is part owner, you'll join a team of people who are deeply invested in their work. From apprentices to managers, we're passionate about the details and deliberate in everything we do. At Sundt we focus on building long-term prosperity for our clients, communities, and employee-owners. We offer competitive pay, industry-leading benefits including a 401k and employee stock ownership plan, incentive programs for craft and administrative employees as well as training that focuses on your personal and professional growth. We're driven by skill, grit and purpose. Join us as we strive to be the most skilled builder in America. Job Summary The Paralegal / Claims Specialist supports the company's Legal and Risk Management functions by assisting attorneys and insurance professionals in the investigation, evaluation, and resolution of claims and lawsuits. The role involves direct collaboration with outside counsel, insurance adjusters, and internal Safety and Operations teams. The Paralegal/Claims Specialist will independently manage the day-to-day handling of routine litigation and claims matters, including discovery, documentation, and coordination with defense counsel. Key Responsibilities 1. Assists attorneys with trial preparation, exhibits, witness coordination, and logistics. 2. Assists company attorneys with responding to non-party subpoenas and regulatory inquiries. 3. Attends mediations, depositions, and hearings as appropriate to support counsel, our internal personnel and maintain awareness of case progress. 4. Communicates directly with claimants, witnesses, experts, and internal personnel to obtain and analyze relevant information, including managing internal electronic data preservation in coordination with IT team, and oversee transfer of preserved data for discovery. 5. Coordinates with Safety personnel regarding incident intake, documentation, and potential claims escalation. 6. Drafts and edits legal documents including correspondence, discovery requests and responses, routine pleadings, affidavits, and case summaries. 7. In conjunction with attorneys, manages litigation, including coordinating discovery and e-discovery, tracking deadlines, managing document production, approving and processing legal invoices and maintaining organized case files. 8. Maintains accurate and up-to-date records in Risk Information Management Systems {RIMS) or other claims databases. 9. Reviews and analyzes claims in coordination with legal and risk management professionals determine liability, damages, and insurance coverage. 10. Works closely with company attorneys, outside counsel, and insurance adjusters to investigate, evaluate, and resolve claims and lawsuits. Minimum Job Requirements 1. 5-10 Years of Experience 2. Bachelor's degree 3. Knowledge working for a law firm or an insurance company representing clients in responding to claims and lawsuit preferred. 4. Paralegal certification Note: is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 50Ibs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Note: Job Description is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 501bs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Equal Opportunity Employer Statement: Sundt is committed to the equal treatment of all employees, and/or applicants for employment, and prohibits discrimination based on race, religion, sex (including pregnancy), sexual orientation, gender identity, color, age, disability, national origin, covered veteran status, genetic information; or any other classification protected by applicable Federal, state, or local laws. Benefit list: Market Competitive Salary (paid weekly) Bonus Eligibility based on company, group, and individual performance Employee Stock Ownership Plan & 401K Industry Leading Health Coverage Starting Your First Day Flexible Time Off (FTO) Medical, Health Savings, and Wellness credits Flexible Spending Accounts Employee Assistance Program Workplace Wellness Programs Mental Health Program Life and Disability Insurance Employee-Owner Perks Educational Assistance Sundt Foundation - Charitable Employee-Owner's program #LI-KA1
    $45k-61k yearly est. Auto-Apply 9d ago
  • Claims Specialist

    MSIG Holdings 4.1company rating

    Claim processor job in Addison, TX

    MSIG USA continues to grow! MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world's top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business's unique risks. Summary/Job Purpose: This position is responsible to conduct thorough investigations and evaluate and negotiate complex claims including litigation and coverage issues. Accountable to ensure compliance with MSMM Claim Handling Guidelines, including reserving and payment practices, regulatory requirements and Fair Claims Practices Acts. Essential Functions: Investigates, researches and analyzes highly complex or severe claims, including coverage issues and legal issues affecting liability and damages. Establishes appropriate case reserves, completes settlements and case resolutions within established reserve and settlement authorities. Recommends reserve and settlement values on assigned cases in excess of established reserve and settlement authority. Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claim practices and company policy and procedures. Attends pre-trials, trials, settlement conferences and mediations on assigned cases as required Assigns the defense of lawsuits to approved defense counsel; directs and monitors quality and performance of defense counsel. Maintains compliance with all requirements of the company's Litigation Management Program. Reviews and adjusts, where appropriate, fee bills and legal expenses for accuracy and reasonableness. Services the claim needs of our customers including insureds, claimants, brokers, etc., in accordance with company policy and procedures, and attends client visitations with underwriters and other parties to conduct presentations and reviews. Maintains ongoing communication with all customers throughout the claims process in an effort to provide timely and appropriate claim status as appropriate and/or required by statutory regulations. Completes timely and accurate data reports to state reporting agencies to ensured full compliance with MSMM and regulatory requirement. Maintains full compliance with all regulatory Fair Claim Practices Acts and state and federal regulations. Maintains full compliance with all state licensing and continuing education requirements to ensure current and appropriate filing/standing of all adjuster licenses. Maintains regular reporting of case status, developments and direction to Home Office staff and other appropriate parties as necessary. Ensures timely and appropriate file reports and system documentation as required by company claim manuals and procedures. Participates and/or manages special projects and assignments as needed. 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, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and Experience Required: High School Degree or G.E.D. is required. Bachelor's degree preferred 7+ years related experience handling complex Liability or Workers' Compensation Claims It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group! It is the policy of MSIG USA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG USA will provide reasonable accommodations for qualified individuals with disabilities.
    $37k-65k yearly est. 60d+ ago
  • Medical Coding Appeals Analyst

    Carebridge 3.8company rating

    Claim processor job in Grand Prairie, TX

    Sign On Bonus: $1,000 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 This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. 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.
    $44k-65k yearly est. Auto-Apply 60d+ ago
  • Medical Coding Appeals Analyst

    Elevance Health

    Claim processor job in Grand Prairie, TX

    Sign On Bonus: $1,000 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 This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed/Certified - Other 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.
    $40k-62k yearly est. 60d+ ago
  • Complex Claims Specialist

    Lockton 4.5company rating

    Claim processor job in Dallas, TX

    Lockton is currently seeking a Clinical Claims Specialist within our Specialty Practice unit. The objective of this role is to improve and reduce the severity of complex and catastrophic claims, reduce the cost of risk while improving the health of our employer client's employee health plan. * Provide explanation of disease states and associated costs to internal and external stakeholders. * Provide cost-of-care estimates used in the risk assessment of stop loss underwriting. * Consult with and advise underwriting on medical/clinical care approaches, standards of care and research of data for new business and renewals. * Serve as a resource regarding medical necessity issues, standards of care and analysis for the reimbursement of submitted stop loss claims. * Review claims and clinical documents to identify and monitor opportunities to increase member quality of care and overall cost reduction. * Collaborate with various key stake holders to strategize clinical and cost savings strategies and assist on execution of plan. * Coordinate implementation of claims savings solutions with Lockton Client Service Teams, TPAs, and stop loss carriers including regular tracking to measure savings and plan performance. * Manage and organize task lists and open items and cases. * Attend team clinical rounds to discuss cases and strategy solutions.
    $36k-49k yearly est. 60d+ ago
  • Claims Specialist III

    Inshur 4.0company rating

    Claim processor job in Dallas, TX

    Are you keen to work somewhere that's stimulating and friendly, with loads of opportunities for growth and plenty of freedom to make a real impact? This could be the place for you! We are looking for a Claims Specialist III (CS3) to join us at INSHUR! We're based in Dallas, TX , with offices in New York City and Westlake, CA ️ and our company embraces a hybrid working model, allowing you to thrive in both collaborative office settings and the comfort of your own home . You'll have the opportunity to work remotely while also connecting with your colleagues at our Dallas office 3 days a week initially and reducing to 1 day a week following your orientation, typically 90 days, fostering a dynamic and supportive environment. Supported by (and reporting to) Claims Manager and Team Leaders, you'll be joining a friendly team of 29 specialists who believe in delivering great customer service at scale. We value high performance and care deeply about making INSHUR a place where everyone is building something special, that we can all be proud of, while enjoying the ride. What you'll do As our Claim Specialist III (CS3) you will be responsible for handling and resolving commercial auto claims across the United States. The claims that are assigned to you will involve coverage investigations, liability negotiations, third-party bodily injury, and depending on your experience litigation. You will be responsible for setting and maintaining reserves, assigning defense counsel, negotiating settlements with attorneys, issuing payments, and interpreting policy contracts. While we prioritise aptitude and passion over a strict checklist of requirements, we've outlined a core set of skills we believe will lead to success in this role. To make things clear, we've categorised them into "essentials to thrive in the role" and "additional skills that could set you apart" We'd love to hear from you if you have …these essentials to thrive in the role; * Experience handling third-party bodily injury claims in a personal auto or commercial auto space at a recognized insurance carrier * Have already secured an insurance license in Texas. * Ability to secure a license in California and New York within 60 days. * Enjoy working in a fast-paced environment. * Understand that customer satisfaction and retention is driven by handling claims well. * Are passionate about building a successful career in Claims. * Helped resolve customer concerns in your most recent role. * Understand the value of contributing to a team's shared success. * Ability to work from our office in Irving, TX 3 days a week during your first 2 weeks and then 2 days a week for 90 days. After successful completion of trial period, this will reduce to 1 day a week. … these additional skills that could set you apart * A bachelor's degree is strongly preferred. You'll love it here if you: Thrive navigating ambiguity and finding clarity in uncertain situations. Take pride in being accountable and owning your responsibilities. Enjoy in a fast-paced environment where change happens quickly. Are solutions-focused and driven to overcome challenges. Embrace resilience and adapt to setbacks with a positive attitude. Are intellectually curious, constantly seeking to learn, explore new ideas, and not afraid to question and improve your understanding. You may not enjoy working here if: Prefer a more structured, slow-moving environment. Feel most comfortable when tasks and processes are clearly defined from the start. Struggle with handling multiple challenges at once or adapting to frequent changes. Tend to stick strictly to your defined role and avoid contributing outside of your responsibilities. What to expect from the process: Screen & Intro: 20-minute call with the Talent Team to discuss the role and your experience. First Interview: 60- 90 minute onsite interview with a Claims Manager or Team Lead and People Partner to delve into the role, including technical questions and an opportunity for you to ask questions, followed by a brief case study to demonstrate your skill set in a practical setting. What we offer We offer all our employees a competitive salary and stock options. We've also built a benefits package that invests in our people's long-term personal and professional growth and wellbeing. Here's a sample of what this includes: 25 days of holiday (+5 days after 5 years), 5 sick days and 8 federal holidays Medical, dental and vision health insurance plans ️ Life insurance, short-term, and long-term disability benefits 13 weeks fully paid parental leave for all new parents, regardless of your gender 401(k) with 4% company match Commuter Benefits Flexible working hours to fit your lifestyle $650 annual training allowance & learning opportunities ️ $50 monthly wellbeing and home setup allowance 24/7 Employee Assistance Program and mental health benefits It goes without saying that we provide everyone with a laptop, monitor, top of the range kit, and any software you need. About Us INSHUR is on a mission to be the leader in insurance solutions for the on-demand economy, making coverage fair and accessible for drivers. Cutting edge technology & deep insurance know-how underpins our revolutionary offering for on-demand drivers, keeping premiums affordable and delivering results for partners. With a focus on embedded insurance solutions, and complementary technology integrations for digital platform providers such as Uber, Amazon, Bolt, FREENOW and OLA, we've been helping drivers stay on the road since 2016 through our data, technology and in-house insurance expertise. Backed by some of the most forward thinking VC's including Viola Growth, JVP, Munich Re, Viola Fintech, MTech Capital, Antler, and MS&AD, we have secured over $113.5 million in funding as well as the acquisition of American Business Insurance in 2023. We have exciting plans to continue growing our portfolio and product lines and expand to new territories in the future. As a global team of around 220 people based across the US, UK, and the Netherlands, we value: Generosity, inclusivity, open-mindedness, and diversity Delivering great results and learning in the open Freedom to make long-term, high-impact decisions The wellbeing of our teammates and the people around us And… Enjoying the ride! Equal opportunities At INSHUR, we believe that having a diverse team where everyone can bring their authentic selves to work is key to our success. We're passionate about creating equal opportunities and making the tech industry a better place for all and we don't discriminate based on race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, marital status, disability, or age. As at Aug 2025, our team consists of 46% women, 31% from BAME or BIPOC backgrounds, and 12% LGBTQ+ . We proudly represent 30+ nationalities and span multiple generations, including Baby Boomers, Gen X, Millennials, and Gen Z. We're proud to have been recognised for Diversity and Inclusion by the British Insurance Awards . We recognise that some companies often hire people similar to the existing team-something we've worked hard to overcome. We follow a structured hiring process and ensure our interview teams are trained to foster inclusivity and equity. While this position is advertised as full-time, we're flexible on specific arrangements and happy to discuss options like part-time, job-sharing, or other flexible work setups for the right candidate. ️ If you need any adjustments during the interview process, please let us know, and we'll do our best to accommodate your needs.
    $37k-65k yearly est. 16d ago
  • Auto Claims Specialist

    Toyota Insurance Management Solutions

    Claim processor job in Plano, TX

    Who are we: Toyota Insurance is a brand name of Toyota Insurance Management Solutions USA, LLC (TIMS). We are an independent agency specializing in property and casualty insurance for Toyota vehicle owners. We offer insurance through our trusted carrier partners to provide coverage for your Toyota vehicle, home and other assets. Our mission is to improve the Toyota ownership experience by improving the insurance experience. Job Overview: We are seeking a detail-oriented and proactive Auto Claims Specialist to join our team and support the auto property damage claims process. This role combines technical expertise in auto damage assessment with advocacy and coordination between internal and external stakeholders to ensure timely, accurate, and fair resolution. The ideal candidate will possess strong analytical skills, attention to detail, and excellent communication abilities with the desire to grow within the claims and insurance operations field. Job Responsibilities: Claims Intake & Documentation: Receive initial auto claim and damage information from internal teams or external parties. Collect, review, and validate all relevant supporting documentation such as police reports, First Notice of Loss (FNOL), recorded statements, and any other applicable claims information for accuracy and completeness. Accurately enter claims and damage data into the claims management system (Nexure). Must have a solid understanding of rideshare insurance policies, including how coverage exclusions apply and impact claims. File Management & Reporting: Organize and maintain secure auto claim files and records in compliance with company and regulatory standards. Submit loss notices and report claims promptly to insurance carriers. Prepare and submit any additional applicable claims or inquiries as required. Damage Review & Estimation: Review and document auto damages thoroughly. Analyze and validate repair estimates for vehicle damages. Coordinate with repair shops to discuss damages and confirm accuracy of estimates. Repair Process Oversight: Examine and evaluate repair processes and timelines. Monitor repairs through completion, ensuring quality and adherence to agreed timelines. Communication & Collaboration: Serve as the primary liaison between internal departments, vendors, external stakeholders, attorneys, and carriers. Provide clear and timely updates to all parties involved in the claim process. Claims Evaluation & Escalation: Review claim settlement recommendations for accuracy and fairness. Collaborate with senior claims analyst on complex or high-risk claims and escalate as necessary. Required Education and Experience: Licensed as an Adjuster in the State of Texas. 3 to 5 years of experience in auto insurance claims, auto claims adjusting, advocacy and/or auto claims estimation. Strong knowledge of insurance policies, auto repair processes and claims regulations. Knowledge of and experience in auto claims involving public or livery passenger conveyance policy exclusions and endorsements. Excellent organizational, time management skills, and communication skills. Strong understanding of the complete auto claims process, from initial intake to final resolution. Ability to work independently with minimal supervision. Preferred Skills: Strong analytical and problem-solving abilities. Excellent written and verbal communication skills. Proficiency in Microsoft Office Suite (Excel, Word, Outlook) and claims management systems. Ability to manage multiple priorities and meet deadlines in a fast-paced environment. Insurance agency, brokerage, or agent knowledge and/or experience is a plus. Strong attention to detail and organizational skills. Core Competencies: Analytical Thinking: Ability to interpret complex data, identify trends, and make informed decisions to resolve claims efficiently. Attention to Detail: Ensures accuracy in documentation, compliance with regulatory requirements, and thorough investigation of claims. Problem-Solving: Skilled in evaluating claim scenarios and developing effective solutions to minimize risk and optimize outcomes. Communication Skills: Strong written and verbal communication for interacting with internal teams, external partners, and clients. Work Environment and Physical Demands: Ability to work within a Team environment under tight schedules. Willingness to work evenings or weekends, as dictated by the needs of the business. Compensation: Base Salary: $46,000-$60,000based on skills and experience Onsite-Plano office What are the Perks? Medical, Dental & Vision Insurance Paid Time Off, Paid Holidays and Sick Days 401(k) Match FSA and HSA Pet Insurance Life Insurance Degree of Travel: None Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Work Authorization: Applicants must be authorized to work for any employer in the U.S. This position does not offer sponsorship or the transfer of sponsorship of employment Visa. Learn More: Visit our website Toyota Insurance:************************************* learn more about our company culture and career opportunities. FLSA Job Status: Exempt Non-Exempt All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. An Equal Opportunity Employer: Female / Minority / Disability / Protected Veteran / Sexual Orientation / Gender Identity EEOC is The Law' Information: ******************************************************************************
    $46k-60k yearly 17d ago
  • Claims Settlement Specialist

    Woongjin

    Claim processor job in Plano, TX

    For More Open Positions Visit us at: ********************************** Our Mission WOONGJIN, Inc. is a rapidly growing team who provides a range of unique, exceptional, and enhanced services to our clients. We have a strong moral code that includes the service of goodness without expectations of reward. We are motivated by the sense of responsibility and servant leadership. Benefits Medical Insurance Vision Insurance Dental Insurance 401(k) Paid Sick hours Job Description Process carrier claim payments (AR) accurately on or before deadlines according to company policy. Collaborate with our Recovery Team to report claim approvals and pending payments. Review essential claim documentation to confirm payment accuracy (AP). Communicate with carriers/3PL's to confirm payment details. Audit/Manage contracts and tariffs in regards to process payments in the system. Dispute invalid claim resolutions to overturn declination and negotiate claim settlements Investigate and diagnose potential errors preventing payment processing Facilitate Legal reviews to review and execute settlement agreements from carriers/3PL's. Work within company guidelines to analyze contractual agreements of the customer, shipper, consignee or carrier and then assess the physical damage reports and the cargo claims findings Track and submit approval requests for aging claim offsets against carrier invoices. Perform ad-hoc reporting or other job-related duties, as required Contract period: 3 months + Extend Salary: $24 - $26/hr. Qualifications Required proficiency in Microsoft Excel, including but not limited to, advanced reporting functions and formatting, VLOOKUP, and pivot tables 3-5 years of Accounting/Finance experience preferred 1+ years of freight claims processing Excellent verbal and written communication skills Strong critical thinking and creative problem solving skills Flexibility to work in a fast-paced, team-oriented environment Superior attention to detail, organization, cross-group collaboration, and project management skills Additional Information All your information will be kept confidential according to EEO guidelines. *** NO C2C ***
    $24-26 hourly 56d ago
  • Global Risk Solutions Claims Specialist Development Program (January, June 2026)

    Law Clerk In Cincinnati, Ohio

    Claim processor job in Plano, TX

    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.
    $28k-48k yearly est. Auto-Apply 5d ago
  • Provider Claims Infusion Specialist

    Lantern 3.9company rating

    Claim processor job in Dallas, TX

    Lantern is the specialty care platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation's top specialists for surgery, cancer care, infusions and more, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation's largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com. About You: You use LOGIC in your decision making and understand that progress is critical to making change. You focus on the execution of your content while balancing a fast-paced environment and you take the time to celebrate both the small & big wins. INCLUSION is a core tenant of your personal beliefs. A diverse and inclusive environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with. You have the GRIT, drive and ambition to tackle big problems. Big problems require big ideas and a team that supports new ideas. You care deeply for your customers are driven to keep HUMANITY in all decisions. Your customers aren't just the individuals using your product. They are the driving factor in your motivation to make a change. Integrity guides you in life. Focusing on the TRUTH vs. giving people the answers they want to hear. You thrive in a Team Environment. Collaboration is key in innovation and creating change. These pillars of LIGHT are a reminder to our team that we are making a difference by providing guidance and support in navigating the often complex and confusing landscape of healthcare. We hope that through this LIGHT, individuals can find their way to the best care, resources, and support they need to get back to life. If this sounds like you, we would love to connect to speak further about career opportunities at Lantern. Please apply to our role & someone from our Talent Acquisition Team will reach out to help you navigate our interview process. Job Overview Our Reimbursement Specialists are a central points of contact for our provider network. The primary responsibility of the role is to deliver effective, accurate payment and communication to our providers. The day-to-day responsibilities of our Reimbursement Specialists include payment processing, researching, accurate billing/payment disbursement, and ensuring payment data accuracy and integrity. The desired candidate is articulate, empathetic, pragmatic, self-starting and ambitious. In addition, our Reimbursement Specialists are horizontal thinkers, analytical, organized and detail oriented. Key Responsibilities: Processes provider payments in accordance with company policies and procedures. Serves as primary contact to Finance Department regarding payment, determinations and payment processing activities. Assist in the final determination on claim disposition and payment determination. Serves as liaison to internal departments regarding provider related inquiries on claims related content. Processes adjustments or provider disputes providing timely follow-up. Coordinates research and responds to system inquiries from providers regarding payment, reimbursement determination, provider contact information and claims billing procedures. Communicates with supervisor on a daily and/or weekly basis regarding any outstanding claims issues related to system, authorizations, reimbursement/payment errors or internal approvals. Works with provider contracting staff when new/modified reimbursement contracts are needed Performs pre-adjudication claims reviews to ensure proper terms and schedules were used. Initiate necessary actions regarding pending claims or payment documentation. Follow up on open items reports to timely and accurate resolution. Respond proactively to provider issues and concerns and give feedback to management. Provide feedback to the manager regarding proper claims billing procedures in accordance with company policy and procedures. Assist in training new Payment Specialists. Initiate change requests to resolve system issues impacting claims/payment processing or issue resolution Runs and analyzes daily activity reports. Analyze, develop and deliver claims resolutions quickly and accurately according to company policies and procedures. Requirements: Minimum Bachelor's degree in healthcare, business, marketing or related field; or HS Diploma (or GED) and 4 years' applicable experience Minimum 2 years of experience in previous claims, health insurance or healthcare practice Knowledge of medical coding systems (i.e., CPT, ICD-9/10, revenue codes) preferred Knowledge of commonly used medical data resources preferred Knowledge of payor contracts and interpretation Knowledge of general office operations and/or experience with standard medical insurance claim forms preferred Strong communication (verbal, written and listening), teamwork, negotiation and organizational skills Ability to commit to providing a level of customer service within established standards Ability to provide attention to detail to ensure accuracy including mathematical calculations Ability to organize workload to meet deadlines and participate in department/team meetings Ability to analyze data and arrive at a logical conclusion Ability to identify issues and determine appropriate course of action for resolution Ability to display professionalism by having a positive demeanor, proper telephone etiquette and use of proper language and tone Ability to use software and hardware related to job responsibilities, including MS Office Suite and database software Ability to work with accuracy in a fast-paced environment Ability to work independently and handle PHI and confidential information Ability to process detailed verbal and written instructions Benefits Medical Insurance Dental Insurance Vision Insurance Short & Long Term Disability Life Insurance 401k with company match Paid Time Off Paid Parental Leave Lantern does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.
    $30k-35k yearly est. Auto-Apply 60d+ ago
  • Paralegal/Claims Specialist

    The Sundt Companies 4.8company rating

    Claim processor job in Irving, TX

    JobID: 9100 JobSchedule: Full time JobShift: : As a 100% employee-owned contractor, when you work at Sundt, you're not just hiring on at a company, you're joining a culture. Because everyone at Sundt is part owner, you'll join a team of people who are deeply invested in their work. From apprentices to managers, we're passionate about the details and deliberate in everything we do. At Sundt we focus on building long-term prosperity for our clients, communities, and employee-owners. We offer competitive pay, industry-leading benefits including a 401k and employee stock ownership plan, incentive programs for craft and administrative employees as well as training that focuses on your personal and professional growth. We're driven by skill, grit and purpose. Join us as we strive to be the most skilled builder in America. Job Summary The Paralegal / Claims Specialist supports the company's Legal and Risk Management functions by assisting attorneys and insurance professionals in the investigation, evaluation, and resolution of claims and lawsuits. The role involves direct collaboration with outside counsel, insurance adjusters, and internal Safety and Operations teams. The Paralegal/Claims Specialist will independently manage the day-to-day handling of routine litigation and claims matters, including discovery, documentation, and coordination with defense counsel. Key Responsibilities 1. Assists attorneys with trial preparation, exhibits, witness coordination, and logistics. 2. Assists company attorneys with responding to non-party subpoenas and regulatory inquiries. 3. Attends mediations, depositions, and hearings as appropriate to support counsel, our internal personnel and maintain awareness of case progress. 4. Communicates directly with claimants, witnesses, experts, and internal personnel to obtain and analyze relevant information, including managing internal electronic data preservation in coordination with IT team, and oversee transfer of preserved data for discovery. 5. Coordinates with Safety personnel regarding incident intake, documentation, and potential claims escalation. 6. Drafts and edits legal documents including correspondence, discovery requests and responses, routine pleadings, affidavits, and case summaries. 7. In conjunction with attorneys, manages litigation, including coordinating discovery and e-discovery, tracking deadlines, managing document production, approving and processing legal invoices and maintaining organized case files. 8. Maintains accurate and up-to-date records in Risk Information Management Systems {RIMS) or other claims databases. 9. Reviews and analyzes claims in coordination with legal and risk management professionals determine liability, damages, and insurance coverage. 10. Works closely with company attorneys, outside counsel, and insurance adjusters to investigate, evaluate, and resolve claims and lawsuits. Minimum Job Requirements 1. 5-10 Years of Experience 2. Bachelor's degree 3. Knowledge working for a law firm or an insurance company representing clients in responding to claims and lawsuit preferred. 4. Paralegal certification Note: is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 50Ibs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Note: Job Description is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 501bs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Equal Opportunity Employer Statement: Sundt is committed to the equal treatment of all employees, and/or applicants for employment, and prohibits discrimination based on race, religion, sex (including pregnancy), sexual orientation, gender identity, color, age, disability, national origin, covered veteran status, genetic information; or any other classification protected by applicable Federal, state, or local laws. Benefit list: Market Competitive Salary (paid weekly) Bonus Eligibility based on company, group, and individual performance Employee Stock Ownership Plan & 401K Industry Leading Health Coverage Starting Your First Day Flexible Time Off (FTO) Medical, Health Savings, and Wellness credits Flexible Spending Accounts Employee Assistance Program Workplace Wellness Programs Mental Health Program Life and Disability Insurance Employee-Owner Perks Educational Assistance Sundt Foundation - Charitable Employee-Owner's program #LI-KA1
    $45k-61k yearly est. Auto-Apply 8d ago

Learn more about claim processor jobs

How much does a claim processor earn in Carrollton, TX?

The average claim processor in Carrollton, TX earns between $23,000 and $54,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Carrollton, TX

$36,000

What are the biggest employers of Claim Processors in Carrollton, TX?

The biggest employers of Claim Processors in Carrollton, TX are:
  1. Partnered Staffing
  2. GuideWell
  3. Sedgwick LLP
Job type you want
Full Time
Part Time
Internship
Temporary