Claim processor jobs in Cumberland, MD

Job Responsibilities and Requirements Obtains and analyzes information to make claim decisions and payments on LTD, Voluntary disability and Waiver of Premium claims. The goal of the position/role is to consistently render appropriate claim determinations based on a review of all available information and the terms and provisions of the applicable policy. * Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim. * Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards based on product line. * Utilizes appropriate medical and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner. * Conducts in-depth pre-existing condition or contestable investigations if applicable. * Calculates benefit payments, which may include partial disability benefits, integration with other income sources, survivor benefits, residual disability benefits, etc. * Develops and maintains on-line claim data (and paper file if applicable). * Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands. Analysis and Adjudication * Fully investigates and adjudicates a large volume simple to complex claims. * Identifies and investigates change in Total Disability definition (any occ). * Independently reviews and manage claims with high degree of complexity within the $1,500 per month approval authority limit. * Independently makes the determination if a policyholder with life policy up to $125,000 is eligible for a waiver of premium. * Majority of work is not subject to supervisor review and approval. Case Management * Consistently manage assigned case load of 60-80 simple to complex cases independently. * Collaborates with team members and management in identifying and implementing improvement opportunities. REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR RELATED EXPERIENCE * or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience* Required Knowledge, Skills, Abilities and/or Related Experience * High School Diploma or GED. Associates degree in Business, Finance, Social Work, or Human Resources preferred. Level I LOMA designation preferred. * 2 years experience processing long term disability claims. * Demonstrated understanding of claim management techniques and critical thinking in activities requiring analysis and/or investigation. * Experience working in confidential/protected identification environments. * Knowledge of medical terminology. * Good math and calculation skills. * Proven ability to work well in a high-visibility, public-oriented environment. Ability to Travel: None PHYSICAL REQUIREMENTS When used in the description below, the following terms are defined as: "Occasional": done only from time to time, but necessary when it is performed "Frequent": regularly performed; generally an act that is required on a daily basis "Continuous": typically performed for the majority of an employee's shift Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objecting and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones. Reliance Matrix will provide qualified employees with a reasonable accommodation in accordance with applicable law. CORE VALUES * Collaboration * Compassion * Empowerment * Integrity * Fun The above description reflects the general details considered necessary to describe the principle responsibilities and functions of the job identified and shall not be construed as a detailed description of all the work requirements that may be inherent to this job. The expected hiring range for this position is $50,920.00 - $68,750.00 annually. This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future. Work location may be flexible if approved by the Company. What We Offer At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you. That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing. Our Benefits: * An annual performance bonus for all team members * Generous 401(k) company match that is immediately vested * A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account * Multiple options for dental and vision coverage * Company provided Life & Disability Insurance to ensure financial protection when you need it most * Family friendly benefits including Paid Parental Leave & Adoption Assistance * Hybrid work arrangements for eligible roles * Tuition Reimbursement and Continuing Professional Education * Paid Time Off - new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service. * Volunteer days, community partnerships, and Employee Assistance Program * Ability to connect with colleagues around the country through our Employee Resource Group program Our Values: * Integrity * Empowerment * Compassion * Collaboration * Fun EEO Statement Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications. #LI-Remote #LI-MR1

Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connectingpeople to the work that matters since 1988. We provide meaningful opportunitiesto our extensive network of healthcare and school-based professionals, ready towork in any hospital, government facility, or school. Through partnership andinnovation, Amergis creates unmatched staffing experiences to deliver the bestworkforce solutions. The Claims Examiner Workers' Comp understands and participates in every aspect of the WC claim process. Working in a team approach, the Claims Examiner WC will make decisions concerning reserve adjustments, develop a plan of action, and determine claim resolution. The Claims Examiner WC also works with the Adjusters, WC Manager, and fellow Amergis team members. Essential Duties and Responsibilities: + Manages full cycle claim management for assigned states to resolution + Participates in conference calls with local offices, third-party administrators (TPAs), medical providers, and other Amergis employees in order to communicate status plans + Ensures legal deadlines are met + Monitors TPA's file resolution plans + Represents Amergis in depositions, mediation, and conference calls regarding assigned claim files + Provides analysis on the financial aspects of assigned claims files + Provides excellent customer service to injured workers + Prepares WC claim reports for department management team + Reviews, identifies and makes recommendations for maintaining control and/or reducing the claims experience (loss history) of the company + Authorizes or revise reserve requests + Coordinates with Benefits team during employee's absence + Coordinates with state programs and internal departments for transitional duty + Educates branch offices about all aspects of Workers' Compensation + Assists Manager in achieving overall department goals + Performs other duties as assigned/necessary Minimum Requirements: + College degree preferred; or equivalent work experience + 5 to 10 years of Workers' Compensation experience preferred + Some legal experience strongly preferred + Good organizational skills and attention to detail + Ability to work independently and cooperatively in a team environment + Ability to communicate effectively and provide excellent customer service with individuals at all levels of the organization + Computer proficiency, including Microsoft Office applications, required + Prior experience performing internet research + Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language is required At Amergis Healthcare Staffing, wefirmly believe that our employees are the heartbeat of our organization and weare happy to offer the following benefits: Medical/Prescription,Dental, Vision, Health Advocacy (company paid if enrolled Medical), HealthAdvocate Employee Assistance Program, Health Savings Account , 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability,Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death and Dismemberment Insurance, Voluntary Life and Accidental Death and DismembermentInsurance, Hospital Expense Protection Plan, Critical Illness Insurance,Accident Insurance, Dependent Care Flexible Spending Account, Home and AutoInsurance, Pet Insurance, MilkStork, Transportation Benefit, EducationalAssistance Program, College Partnership Program, Paid Time Off/Company Holidays *Benefit eligibility is dependent onemployment status. AmergisHealthcare Staffing is an equal opportunity/affirmative action employer. Allqualified applicants will receive consideration for employment without regardto sex, gender identity, sexual orientation, race, color, religion, nationalorigin, disability, protected Veteran status, age, or any other characteristicprotected by law. This posting willremain active on job boards for 5 days from date of posting unless there is agood faith basis to extend the posting date. Please note thatthis pay range represents a good faith estimate of the compensation that willbe offered for this position based on the circumstances. The actual pay offeredto a successful candidate will take into account a wide range of factors,including but not limited to location, experience, and other variable factors. "Pursuant tothe San Francisco Fair Chance Initiative, Amergis will consider for employmentqualified applicants with arrest and conviction records"

Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.

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

The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim's management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers. Responsibilities: * Manages an inventory of claims to evaluate compensability/liability. * Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources. * Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages. * Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. * Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. * Performs other duties as assigned. Qualifications * BS/BA degree or equivalent work experience. * Minimum of 2 years experience in claims adjustment, general insurance or formal claims training. * Required to obtain and maintain all applicable licenses. * Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU). * Knowledge of claims investigation techniques, medical terminology and legal aspects of claims. 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

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

Job Description Details Job Title: Claims Specialist Department: Commercial Lines Division: Risk Control/Claims Reports To: Claims Supervisor Contract: No FLSA status: Exempt Position Description The Claims Specialist will provide heroic claims service by assisting with the management of all claims from the initial report of the claim to the closing to ensure the best outcome for all our customers. Primary Responsibilities & Duties Support and manage claim process for clients who are/and are not on a Client Service Plan. This includes initial claim reporting, carrier correspondence, data collection, and internal documentation. Manage daily client correspondences in regard to claims and claim updates. Manage data entry in agency management system. Aid clients through property damage restoration process. All other duties as assigned. Position-specific Competencies Effective Communication: Can clearly articulate oneself in a professional manner with the ability to read the audience and adapt. Possesses the intuition on what information to communicate, feedback to provide, and the right manner of delivery. Practices active listening with patience and can restate opinions accurately, as needed. Attention to Detail: Ability to achieve thoroughness and accuracy when accomplishing a task. Strong ability to focus and provide thorough attention. Relationship Management: Possesses the ability to create and maintain strong relationship with business owners and contacts. Decision Quality: Consistently makes good decisions. Through analysis, wisdom, experience, and judgement can accurately act in the best interest of colleagues and clients. HBI Competencies Integrity: Conducts business with the utmost moral decency. A trusted advisor who displays the highest standard of ethics. Heroic Service: White glove approach to client service and satisfaction. Can anticipate needs, and consistently exceeds expectations. Teamwork: Works well with others towards a shared goal. Actively participates, shares responsibilities and rewards, and contributes to the effectiveness of the group. Kindness: Shows concern and consideration for others. Is generous with time, talent, and overall possess a willingness to help. Qualifications Bachelor's degree or insurance designation preferred 1-3 years of claims experience required CIA, ARM, CLA, etc. preferred but not required *if you are not licensed, you will be required to obtain licensure within first 90 days of hire* An insurance background or understanding of different types of insurance coverage is beneficial, but not required Strong verbal communication and listening skills Proficient in Microsoft Office products such as Word, PowerPoint, and Excel Proficient virtual communication skills-preferably Zoom Work Environment This position requires travel capabilities. A valid driver's license is necessary to provide self-transportation to client meetings, events, and seminars. Local travel up to 50%. While performing the responsibilities of the job, these work environment characteristics are representative of the environment the job holder will encounter. Reasonable accommodations may be made to enable people with disabilities to perform the essential functions of the job. EEO Statement Henderson Brothers supports workplace diversity and does not discriminate on the basis of race, color, religion, gender identity or expression, national origin, age, military service eligibility, veteran status, sexual orientation, marital status, physical or mental disability, or any other protected class. Powered by JazzHR ao IpIQUs2U

Job Description METIS | Location: Roanoke, VA | Full-Time Are you seeking a professional career in Roanoke? Do you like solving problems, analyzing details, and helping people? At Metis, we take a unique approach to commercial insurance through administering self-insurance Risk Pools. If you are looking for a change and a challenge, we're looking for a dedicated Property and Casualty Claims Specialist to join our growing team. What You'll Do: Manage and resolve property and casualty and/or general liability claims Assess and evaluate claims, conduct investigations, and ensure documentation is collected Build relationships with members and help claimants navigate the claims process What You Bring: Bachelor's Degree or higher - required 7+ years of experience in property and casualty claims handling Strong knowledge of policy analysis and associated legal issues A team player with excellent communication and a customer focused mindset *Please be sure to fully complete and upload the attached “Application for Employment” form along with your electronic application. Incomplete submissions may not be considered. What We Offer: Competitive compensation and performance bonuses Individual dental, life, short-term & long-term disability insurance at no cost Medical insurance with wellness incentives Health Savings Account with annual company contribution 401(k) with 200% company match up to 6% of salary Generous paid time off, including vacation, sick leave, and 11 paid holidays Support for continuing education and professional growth A beautiful campus with a collaborative, supportive, wellness-focused culture including onsite gym and café

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 to join our team! Summary: Investigate, evaluate and settle more complex first and third party commercial auto insurance claims. A typical day will include the following: Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Communicates with all relevant parties and documents communication as well as results of investigation. 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. 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 *****************************************

Job Description Job Title: Claims Specialist Reporting to: Director of Project Management Company: Tate About Us At Tate, we are passionate about everything we do. As an independent brand operating within Kingspan Group, a global plc group of companies, Tate has been recognized worldwide as an industry leader in the development and manufacture of data center infrastructure solutions and commercial office raised access floors, for over 60 years. With revenues of over $420m and growing, Tate plays a pivotal role in offering expertise in cutting edge design engineering to craft solutions, by working collaboratively with clients as a trusted partner. Tate continues to grow and expand, operating multiple manufacturing and commercial sites across the US, Europe, the Middle East, Asia, and Australia. We are excited about our fresh, dynamic, and inclusive team of experts working on new innovations and forward-thinking designs, as we remain a market leading player within our industry. We continue to invest heavily in the best available manufacturing tools and equipment needed to adhere to Tate's world class standards and in keeping with our Planet Passionate sustainability strategy, our focus is on having minimal climate impact. We are excited to potentially welcome you as part of our team as we continue to grow on a worldwide scale. About the Role We are seeking a highly organized and customer-focused Claims Specialist to manage and resolve customer claims with precision and empathy. In this role, you will serve as the primary point of contact for customers, ensuring claims are logged, tracked, and resolved efficiently while collaborating across Manufacturing, Finance, and Customer Service teams. The ideal candidate will use strong analytical, project management, and communication skills to drive root cause analysis, implement corrective actions, and enhance the overall customer experience. What You'll Do Log, track, and manage customer claims in Salesforce from initiation to resolution. Communicate empathetically with customers, providing timely updates throughout the claims process. Collaborate with Manufacturing, Finance, and other internal teams to investigate claims and implement resolutions. Facilitate cross-functional meetings and follow up on corrective actions to ensure accountability. Identify trends in claims, perform root cause analysis, and recommend process improvements. Provide regular reports on claim volume, resolution times, root causes, and customer impact. Additional Expectations Maintain accurate and thorough documentation of all claims, communications, and outcomes. Escalate complex issues appropriately and ensure follow-through on resolutions. Uphold a high standard of service excellence in every customer interaction. Support continuous improvement initiatives by analyzing data and providing actionable insights. Manage multiple priorities effectively while maintaining attention to detail and quality. What You'll Bring Bachelor's degree in business, Project Management, or a related field. 3+ years of experience in customer service, claims resolution, or project coordination. Proficiency in Salesforce, Excel, and data analysis tools. Excellent communication, problem-solving, and organizational skills. Ability to drive cross-functional collaboration and manage multiple priorities. Preferred: experience in manufacturing or B2B environments, familiarity with root cause analysis frameworks (e.g., 5 Whys, Fishbone), exposure to corrective action planning, and project management certification (CAPM or PMP). Employee Benefits Career Scope and Advancement: As we grow, new positions and career opportunities arise, offering accelerated paths for the right candidates, locally and globally. World of Wellness Philosophy: We empower you to take charge of your health and well-being. You'll have access to a wide range of medical, dental, and vision benefits, along with personalized guidance from a “Health Advocate.” We also offer other supplemental options, including 401k, legal, disability, and theft insurance, to ensure your financial wellness. Corporate Social Responsibility: Through Planet Passionate we are determined to reduce our manufacturing carbon (CO2e) emissions to as close to zero as technically possible, together with halving carbon intensity in our primary supply chain. We are very involved in our community, and you will have ample opportunities to support us in creating a better world. Skills Development: Given the dynamic pace of our business and a strong collaborative environment, your new role will be diverse and multifaceted - allowing you to be more versatile and develop a broader skill set. Mentorship and development: At Tate, we don't believe in hierarchy; we work together as one team for one common goal. You will have access and exposure to our senior leaders and experts for learning in your role, and additional mentorship for the future. Culture: We have a great team of culture, highly collaborative, supportive, and social skills. Together we innovate, collaborate, take ownership, and strive for excellence. Stay connected with us on LinkedIn for insights into life at Tate. Join us in our mission to make a difference through exceptional solutions. Tate Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to legally protected characteristics. We are committed to providing reasonable accommodations to qualified individuals with disabilities. Employment may be contingent upon completion of post-offer requirements in accordance with applicable law.

Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries. Job Qualifications: Bachelor's Degree (preferred); High School Diploma or equivalent (required) Minimum of three (3) years experience in claims handling Proficiency in Microsoft Office Suite, especially Word and Excel Strong verbal and written communication skills Excellent problem-solving and conflict-resolution abilities High attention to detail and ability to work independently Pay: Based on experience This is a full-time, temporary role expected to last at least 6 months. If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************

Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries. Job Qualifications: Bachelor's Degree (preferred); High School Diploma or equivalent (required) Minimum of three (3) years experience in claims handling Proficiency in Microsoft Office Suite, especially Word and Excel Strong verbal and written communication skills Excellent problem-solving and conflict-resolution abilities High attention to detail and ability to work independently Pay: Based on experience This is a full-time, temporary role expected to last at least 6 months. If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! * Competitive compensation * Healthcare benefits package that begins on first day of employment * 401K retirement plan with company match * Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays * Up to 6 weeks of parental and bonding leave * Hybrid work schedule (3 days in the office, 2 days from home) * Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) * Tuition reimbursement after 6 months of employment * Numerous opportunities for continued training and career advancement * And much more! Responsibilities Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service. Key Responsibilities * Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures. * Review and interpret policy language to determine coverage and consult with coverage counsel when needed. * Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies. * Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information. * Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts. * Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards. * Participate in file reviews, team meetings, and ongoing training to support continuous learning. Qualifications * Minimum of 3 years of trucking industry experience. * Experience with bodily injury and/or cargo exposures. * Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices. * Strong analytical and negotiation skills, with the ability to manage multiple priorities. * Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism. * Possession of applicable state adjuster licenses. * Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.

UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The selected candidate for this role will need to have their West Virginia workers comp adjuster license. The UPMC WorkPartners Workers Compensation Lost Time Claims Specialist II reports to the Workers Compensation Claims Supervisor. The Lost Time Claims Specialist II is responsible for coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims for the WorkPartners Workers Compensation business unit. The Lost Time Claims Specialist II will apply litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The Lost Time Claims Specialist II will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority within established best practices and performance standards. The Lost Time Claims Specialist II should possess strategic thought process skills to effectively and efficiently manage loss exposures. Responsibilities: * Assign medical or other experts to case and arrange for medical examinations when necessary. * Develop lost time claim disposition skills under limited direction of supervisor. * Pro-actively manages the case resolution process. May participate in mediations within limit of settlement authority. * Ensure proper referrals and timely updates to appropriate Reinsurer(s). * Actively participate in claim reviews with clients. * Timely analyze information in order to evaluate assigned claims to determine the extent of loss. * Manage the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment under limited direction of supervisor. * Communicate claim status with the injured worker, clients, and broker as needed. * Effectively evaluate, negotiate and resolve claims within delegated authority utilizing the appropriate denials or releases. * Establish appropriate reserves and review on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level. * Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, clients, witnesses and others having pertinent information. * Provide required reports to AVP, Claims, Underwriting, Reinsurance and Actuarial on significant exposure cases. * Appropriate state licensing to be obtained for assigned jurisdictions. * Effectively evaluate and resolve coverage issues for all Workers' Compensation claim types. * Effectively and efficiently manage vendors and expenses. * Participate in monthly account renewal meetings as needed. * Mentoring and training new employees as appropriately assigned by management. * Bachelors and/or advanced degree or a minimum of 3 years of Workers Compensation claims handling experience. * Minimum of 2 years of Workers Compensation lost time claims handling experience. * West Virginia insurance adjuster license is highly preferred. * Experience with PA workers compensation is a bonus. * Intermediate knowledge of law and insurance regulations in various jurisdictions. * Demonstrated strong verbal and written communications skills. * Demonstrated strong analytical and decision making skills. * Intermediate knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, litigation management, and product line knowledge. * Previous experience with the reserving and adjudication of the following: Workers' compensation lost time claims, Workers' compensation claim investigations (including subrogation) and compensability decisions. Licensure, Certifications, and Clearances: * Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

Job Details The Ambulatory Care Capacity Analyst provides strategic support for provider access initiatives across the Jefferson Medical Group (JMG). This role provides internal schedulers and patients a standard, comprehensive approach to appointment availability across the enterprise. Job Description Essential Functions: Responsible for building, maintaining, and modifying centralized scheduling templates for all scheduling providers, including resource providers · Ensure all approved template changes follow change management procedures and protocols and align with Jefferson's template strategy guidelines Provide impact analysis for master template changes Report, review, and reschedule patient appointments as indicated by the Reschedule List Collaborate with Ambulatory practice administrative and clinical leadership on template optimization through the use of Epic Cadence functionality and advise on best practices Participate in department meetings that address patient access-related metrics Identify potential access limiting factors and develop possible solutions for department collaboration Monitor the effectiveness of access-related initiatives using data analysis via Qlik Reporting, Epic Reporting Workbench, and excel Strategize operational and technical methodologies to enhance patient self-scheduling for both patients and the ambulatory practices Present, demonstrate, and train internal staff on access and capacity strategies and initiatives On-board providers on scheduling decision tree and open scheduling platforms Rotate with peers for on-call schedule Education and Experience: High School Diploma Required; Bachelor's Degree preferred. Epic Cadence or other Epic application certification - plus. Minimum 2-3 years experience in an ambulatory care or IT setting preferred. Prior scheduling template management experience preferred. Work Shift Workday Day (United States of America) Worker Sub Type Regular Employee Entity Jefferson University Physicians Primary Location Address 1101 Market, Philadelphia, Pennsylvania, United States of America Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years. Jefferson is committed to providing equal educa tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. Benefits Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance. For more benefits information, please click here

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.

Job Details Blackburn's Corporate - Tarentum, PA InsuranceDescription Job Opening: Claims Processing Specialist at Blackburn's Are you a detail-oriented professional with a passion for the healthcare industry? Blackburn's is looking for a Claims Processing Specialist to join our Corporate Claims department and perform third-party medical billing functions. If you thrive in a fast-paced environment and possess excellent organizational and communication skills, this could be the perfect opportunity for you! What You'll Do: Manage and verify third-party medical claims for accuracy and compliance. Collaborate with cross-functional teams to resolve billing discrepancies and insurance denials. Process claims efficiently while adhering to strict filing deadlines. Contribute to the improvement of billing processes to reduce denials and increase efficiency. Utilize your strong communication skills to work with internal teams and external clients. Why Join Us? At Blackburn's, we're committed to creating a positive impact in the healthcare industry by delivering quality products and services. As part of our team, you'll have access to in-house training, opportunities for career growth, and a collaborative work environment. We offer competitive pay, benefits, and the chance to be part of a company that values its employees. Work Hours: 8:00 a.m. - 4:30 p.m. or 8:30 a.m. - 5:00 p.m. If you have a passion for medical billing and enjoy working in a dynamic, fast-paced environment, we'd love to hear from you! Apply today and join us in making a difference at Blackburn's! Qualifications What We're Looking For: Prior experience in healthcare-related industries, preferably with third-party medical billing. Strong attention to detail, time management, and the ability to juggle multiple tasks. Excellent interpersonal skills, with the ability to work both independently and as part of a team. Proficiency in Microsoft Office, with knowledge of Word and Excel. Ability to work independently, prioritize workload, and adapt to changing environments.

The salary range for this job posting is $55,132.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. While we may prefer candidates who can work a hybrid schedule in our Charleston, WV office, we will consider candidates who live in any of our listed payroll approved states. Lost Time Workers' Compensation claims handling experience in Virginia, West Virginia, Kentucky, or Pennsylvania is preferred. The position reports to the Director, Workers' Compensation Claims on the Energy team. We may hire a senior level depending on the candidate's background and experience and the salary range is inclusive of all levels. Are you a Referral? If you know a current Encova Insurance associate and would like to apply as a referral, please encourage them to submit your referral information before you submit your application. You will receive an email with a direct URL link to the Job Posting of interest. Applying through this URL link will create your referral relationship for our Talent Acquisition Team. Unique residence requirements are listed in each job posting, please review closely for details. Encova is only able to employ associates who reside and work within specific U.S. states. Our current policies are based on the laws in states in which we are registered for payroll. Our current footprint includes: Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin. JOB OBJECTIVE: The Lost Time Claims Specialist, Workers' Compensation primarily manages indemnity claims. The Lost Time Claims Specialist is responsible for the investigation, evaluation, and determination of compensability for work-related injury and disease claims following established guidelines to determine benefit eligibility. The Lost Time Claims Specialist also serves as a resource to Medical Only Claims Specialists and Claims Specialist Trainees. The position's objective is to provide superior service in a cost-effective manner to achieve best possible outcomes as well as proactively collaborate across the enterprise to ensure alignment of objectives and foster continuous improvement. ESSENTIAL FUNCTIONS: 1. Evaluates and establishes an action plan to manage medical and indemnity benefits associated with injury and occupational disease claims to their most cost- effective conclusion. 2. Decides the outcome of the claim using sound judgment by applying established policy, procedures, regulations and guidelines. 3. Gathers facts by conducting interviews with all involved parties and considers all the elements of the claim prior to issuing a decision. 4. Take recorded statements when necessary. 5. Determines eligibility of indemnity and medical benefits once salary information and medical treatment plans have been secured and processed within the designated authority levels. 6. Utilize proactive reserving behaviors to ensure adequate case reserves which reflect the probable ultimate outcome based on the current known circumstances throughout the life of the claim. 7. Actively identifies and develops the investigation of and pursuit of subrogation recoveries when possible. 8. Consults with assigned claim director, return to work specialists, nurse case managers, internal/external medical, and legal on current and/or recommended treatment, litigation or rehabilitation plans to ensure claims outcomes are achievable and appropriate. 9. Works collaboratively with the injured worker, employer, outside counsel, and health and rehabilitation professionals to manage the claims costs and promote quality medical care. 10. Works collaboratively with the injured worker, employer, assigned return to work specialist, and medical providers to facilitate the injured worker's safe and timely return to work. 11. Manages claims litigation, including expenses, by collaborating and providing direction to panel counsel throughout the life of the claim. 12. Analyzes reports from external resources such as physicians, attorneys, and/or vocational rehabilitation experts to evaluate and adjust claim strategies as needed. 13. Evaluates and negotiates claim settlements utilizing human relation skills and technical knowledge to achieve the best possible outcome. 14. Presents and summarizes claim details at internal team staffing, participates in discussions, and provides guidance as needed. 15. Consults with assigned claim director if the loss becomes significantly complex or presents significantly increasing financial exposure. 16. Follows established claims best practices related to medical management, litigation, fraud/abuse and recovery. 17. Effectively and independently uses available resources to prioritize, organize, and complete work in a timely manner to meet jurisdictional requirements, timeframes, and internal metrics. 18. Develops presentations for special projects such as internal/external meetings and conferences as needed. 19. Along with the claim director, regional vice president and other claims staff, participates in claim reviews, onboardings, etc. for our policyholders and agents. 20. Proactively collaborate with our policyholders to ensure alignment of objectives and foster continuous improvement. OTHER FUNCTIONS: 1. Nonessential function: other duties as assigned. KNOWLEDGE, SKILLS AND ABILITIES: • Bachelor's Degree from an accredited college or university is preferred. • Three years of experience in the field of workers' compensation insurance required. • Ability to manage claims through the litigation process. • Internal candidates must demonstrate knowledge of Encova Best Practices guidelines and meet quality standards. • One valid workers' compensation adjuster license is strongly preferred. Must be eligible to obtain additional licenses as required. • Must pass the claims adjuster license exam(s) as assigned within 90 days of being hired. • Preference may be shown to candidates with multiple state claims management experience. • Experience in workers' compensation claims practices and laws, court procedures, precedents and state statutes. • Ability to use logic and sound reasoning to identify alternative solutions for problem-solving. • Strong written and verbal communication skills. • Strong analytical skills. • Ability to multitasks and manage time effectively and productively. • Work effectively independently as well as in a team environment. • Develop and maintain strong, effective internal and external relationships. • Work effectively in a paperless environment. • Skilled in the use of laptops, claims management systems, and other typical business-related programs such as Microsoft Office suite. This position has been evaluated in accordance with the Americans with Disabilities Act. Encova Insurance makes every effort to reasonably accommodate disabilities to permit performance of the essential functions and candidates who need such accommodation are encouraged to seek it. This description reflects the nature and level of work performed by associates in this position. It is not an all-inclusive inventory of duties, responsibilities and qualifications required. It provides an accurate overview of the work and skills needed to perform this position. Because job content may change from time to time, Encova Insurance reserves the right to add and/or delete functions from this job as it deems necessary for business reasons. Ready to join our team? At Encova Insurance, we firmly believe that our associates drive our company's success by delivering unrivaled service to our customers. With success in mind, we make an ongoing effort to provide an environment that offers challenging, stimulating and financially rewarding opportunities. Join us to discover a work experience where your diverse ideas will be met with enthusiasm - where you can learn and grow to your fullest potential. What you can expect from us Join our family of industry leaders, and let us reward you with a competitive salary, bonus and benefits package that includes but is not limited to: a 401(k), wellness programs, bonus incentive plans and flexible schedules, with an early close of the office every Friday. Additionally, Encova aspires to be an outstanding corporate citizen in all the markets we serve; we encourage and support associate participation in community initiatives through our foundations. Encova Insurance is an EOE/E-Verify employer. #LI-Hybrid#LI-MF1

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 *****************************************