Claim processor jobs in Evansville, IN

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 Description Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Bodily Injury Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to Warrior Insurance Network! We offer: Competitive Salaries Excellent benefits Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! If you are an experienced Auto CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! The Auto Bodily Injury Claims Specialist will be responsible for investigating and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. DUTIES & RESPONSIBILITIES: Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability status, and damages that are applicable for each claim Process Bodily Injury, and coverage claims in accordance with established office procedures Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation Research case and statutory law in order to conduct proper claim investigation Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims Prepare and present claim evaluations for the appropriate settlement authority Maintain reasonable expense factors Handle other duties as assigned QUALIFICATIONS REQUIRED: 3-5 Years in Auto Bodily Injury/Casualty claims experience a MUST! Non-Standard Auto Claims experience a plus, not required Knowledge of legal and medical terminology Excellent negotiation, communication, written, organizational and interpersonal skills Ability to pass written examinations where required by state statutes to become a licensed claims adjuster Proficiency in Microsoft Office products Warrior Insurance Network (WIN) provides a competitive benefits package to all full- time employees. Following are some of the perks Warrior Insurance Network (WIN) employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental and Vision Reimbursement Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $54,750/year-$97,500/year* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location. Job Posted by ApplicantPro

Job Description Medical Device Cybersecurity Analyst- New Lenox, IL Salary: $70,000 to $90,000/yr Other Forms of Compensation: Join Intelas, a Compass One Healthcare company. Intelas, a Compass One Healthcare company, delivers smarter asset management by blending expert service teams with intelligent, data-driven strategies that help hospitals improve uptime, simplify oversight, and make more informed capital decisions. Our programs support 100% regulatory compliance and drives 98% equipment uptime-so clinicians can focus on care, not equipment issues. We support nearly 4,500 healthcare sites nationwide-from large, campus-based acute care hospitals to system-integrated outpatient clinics. With more than 1.15 million medical devices managed, we provide the clarity and consistency needed in today's rapidly evolving healthcare environment. Join Intelas-where your career thrives, your potential is unleashed, and your work directly supports patient care. Whether you're just starting out or are a seasoned professional, our people-first approach ensures opportunities for continuous growth, development, and fulfillment. Explore more at intelashealth.com. Job Summary Please note:This is an on site position SUMMARY The Medical Device Cybersecurity Analyst will be involved in response to cybersecurity alerts, ensuring Client KPI's are met, perform audits and risk assessments of medical devices, and provide subject matter expertise with Intelas's resources for medical device cybersecurity. ESSENTIAL DUTIES AND RESPONSIBILITIES: • Monitors and responds to Intelas's comprehensive medical device asset and cybersecurity management platform findings and mitigating steps. •Strong knowledge of computers, operating systems, security, and networking •Ability to interpret technical documentation and manuals •Generate and build bi-weekly, monthly, and quarterly client reports •Correlate and perform GAP analysis on discovered medical devices with Intelas's CMMS •Create security work orders in Intelas's CMMS and assign to the field as applicable •Triage, respond and assign work orders generated from Intelas's CMMS cybersecurity module as appropriate •Ensure work orders are completed within defined KPI's and assist on site Crothall resources if needed for successful completion •Research and engage OEM's for available approved patches and firmware upgrades •Proactively collect most current MDS2 forms •Maintain database of approved patches, firmware upgrades and MDS2 forms •Collaborate and work with Clients to respond and coordinate mitigating steps and compensating controls on contracted medical devices that may arise from Clients passive asset discovery and risk assessment technology •Participate and contribute to Intelas's CEIT Council •Maintains operational security metrics to measure the effectiveness of security controls and identify opportunities for improvement •Assist in threat intelligence gathering, monitoring of zero-day and correlate to clients CMMS inventory •Assist in development and implementation of continued best practices and risk management of inventoried connected medical devices •Assures compliance with all regulatory standards including patient safety and all relative criteria governing the safe and appropriate use, testing and management of medical devices. MINIMUM QUALIFICATIONS: •Knowledge of the operation and prior hands-on experience in the maintenance and repair of wide variety of medical equipment and systems •High attention to detail and exceptional work quality •Experience with process improvement •Proven ability to work effectively in an unstructured, fast-paced environment •Excellent written and verbal communication skills •Overnight travel may be required for Client visits or industry conferences or workshop. PREFERRED QUALIFICATIONS: • Healthcare experience; General knowledge of Biomedical and Diagnostic Imaging • Knowledge of healthcare cybersecurity is considered a plus • Experience with Computerized Maintenance Management Systems (CMMS) • Knowledge of connected medical device asset discovery and risk analysist platforms EDUCATION: • Associates degree in Information Technology or Biomedical Engineering required • Security+ within 3 years of employment • BMET preferred Apply to Intelas today! Intelas is a member of Compass Group USA Click here to Learn More about the Compass Story Associates at Intelas are offered many fantastic benefits. • Medical • Dental • Vision • Life Insurance/ AD • Disability Insurance • Retirement Plan • Flexible Time Off • Holiday Time Off (varies by site/state) • Associate Shopping Program • Health and Wellness Programs • Discount Marketplace • Identity Theft Protection • Pet Insurance • Commuter Benefits • Employee Assistance Program • Flexible Spending Accounts (FSAs) • Paid Parental Leave • Personal Leave Associates may also be eligible for paid and/or unpaid time off benefits in accordance with applicable federal, state, and local laws. For positions in Washington State, Maryland, or to be performed Remotely, click here for paid time off benefits information. Compass Group is an equal opportunity employer. At Compass, we are committed to treating all Applicants and Associates fairly based on their abilities, achievements, and experience without regard to race, national origin, sex, age, disability, veteran status, sexual orientation, gender identity, or any other classification protected by law. Qualified candidates must be able to perform the essential functions of this position satisfactorily with or without a reasonable accommodation. Disclaimer: this job post is not necessarily an exhaustive list of all essential responsibilities, skills, tasks, or requirements associated with this position. While this is intended to be an accurate reflection of the position posted, the Company reserves the right to modify or change the essential functions of the job based on business necessity. We will consider for employment all qualified applicants, including those with a criminal history (including relevant driving history), in a manner consistent with all applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and the New York Fair Chance Act. We encourage applicants with a criminal history (and driving history) to apply. Applications are accepted on an ongoing basis. Intelas maintains a drug-free workplace. Req ID: 1467914 Intelas ASHLEY VAVROCK [[req_classification]]

Join Our Team as a Claims Negotiation Specialist! Are you a strategic thinker with a passion for driving business growth and innovation? We are looking for a Claims Negotiation Specialist to develop data-driven strategies, identify new opportunities, and optimize business performance for long-term success. Why You'll Love This Role: 📈 High-Impact Role - Shape business strategies that drive sustainable growth. 🚀 Career Advancement - Access professional development and leadership opportunities. 💡 Strategic Influence - Work closely with decision-makers to implement winning strategies. 💰 Competitive Compensation - Earn a stable income with performance-based incentives. Your Responsibilities: Analyze market trends, business performance, and competitive landscapes to identify growth opportunities. Develop and implement data-driven growth strategies that optimize revenue and profitability. Collaborate with cross-functional teams to align business strategies with company objectives. Provide strategic recommendations on market expansion, customer acquisition, and operational efficiencies. Monitor key performance indicators (KPIs) and adjust strategies to maximize success. Identify and mitigate potential risks while exploring new business opportunities. What We're Looking For: Proven experience in business strategy, growth consulting, or a related field. Strong analytical and problem-solving skills with expertise in market analysis. Ability to develop and execute scalable growth strategies. Excellent communication and presentation skills. Experience working with executive leadership to drive business decisions. Perks & Benefits: Professional development and continuous learning opportunities. Health insurance and retirement plans. Performance-based bonuses and recognition programs. Leadership growth and career advancement opportunities. 🚀 Ready to Drive Business Growth? If you're passionate about helping businesses scale and succeed, apply today! Join us and be a key player in shaping innovative growth strategies. Your journey as a Claims Negotiation Specialist starts here-let's unlock new opportunities together!

Job Description Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Liability Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to First Chicago Insurance Company! We offer: Competitive Salaries Excellent benefits Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! If you are an experienced AUTO CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! We have openings in our Bedford Park, IL and Oak Brook, IL offices! This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First and Third Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims. DUTIES & RESPONSIBILITIES: Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim Honor/decline/negotiate first and third party liability claims upon completion of coverage/policy investigation and analysis of damages and liability Work directly with internal and external customers to develop evidence and establish facts on assigned claims Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims Prepare and present claim evaluations for the appropriate settlement authority Notify the Underwriting Department of any adverse information uncovered in the course of the investigation Familiarity with unfair claim practices in states where doing business Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service Provide customer service both to internal and external customers Handle other duties as assigned QUALIFICATIONS REQUIRED: 4 years previous auto liability and PD claims experience A MUST! Prior Non-Standard Auto Claims experience a plus, not required Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills General working knowledge of policies, file procedures, state rules and regulations Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster On-Site position Preferred: College degree Prior claims experience Ability to use on-line claims system Bi-lingual a plus! First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental and Vision Reimbursement Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $41,600/year-$75,000/year* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location. Job Posted by ApplicantPro

Job Title: Claims Representative The Hoosier Lottery Claims Representative Temp will assist customers with the claims process of Hoosier Lottery prizes, questions related to Hoosier Lottery products and other duties as needed. •Greet customers upon arrival in the Claims Center; •Ensure all proper documentation is presented prior to claim processing; •Assist Hoosier Lottery staff with daily office duties; •Answer claims hotline and assist customers with questions; •Assist with PR photos of winners when needed.. Job Requirements •High School diploma or equivalent ; •Excellent customer service skills; •General knowledge of and ability to operate a telephone and cash register; •Basic knowledge of clerical procedures, methods, and principles; •Proficient in office software, including Microsoft Outlook, Microsoft Excel and Microsoft Word; •Proficient with modern office equipment including computer, fax machine, and scanners Required/Desired Skills: High School Diploma or Equivalent Required: 0 years of experiencex` Excellent Customer Service Skills Required: 0 years of experience General Knowledge of and Ability to Operate a Telephone and Cash Register Required: 0 years of experience Basic Knowledge of Clerical Procedures, Methods, and Principles Required: 0 years of experience Proficiency in Office Software (Microsoft Outlook, Microsoft Excel, Microsoft Word) Required: 0 years of experience Proficiency with Modern Office Equipment (computer, fax machine, scanners) Required: 0 years of experience Compensation: $15.23 - $16.80 per hour About Us We're more than Software Company with a creative side. We're a full-service creative studio with a serious technology background. We take a holistic view of sales and marketing, building digital brands that deliver real value to our client. As a marketing agency, our innovative digital strategies grab and hold people's attention, and produce the communication and organizing tools needed for success. With a mix optimized to the specific goals of each client and the character of their target customer demographics, we provide true integration across media platforms and channels. Our Vision Inteletech Global, Inc provides consulting services to assist clients with their ongoing demand for changing IT environments. The early 2000s were an exciting time for IT. Digital technology was transforming our lives, and with each innovation, it became clear that digital was the future. We use our Global Delivery Model for the success of every engagement. Improve effectiveness and efficiency of IT application environments by adopting re-usable software platforms. Our onsite teams work directly with our clients to understand and analyze the current-state of problems and design specifically tailored conceptual solutions.

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 Daily Responsibilities: • Post cash to patient and insurance accounts for services rendered • Identify, resolve and rebalance keying errors in patient accounts • Update insurance changes, read EOB's, preform insurance verification and file up for patients Qualifications Requirements : • HS diploma or GED • 1+ year experience in billing/claims background • Strong communication and Microsoft Office skills Additional Information Hours for this Position: Full time: M-F 8am-5pm 3+month contract (project based) Interested in being Considered? If you are interested in applying to this position, please click Apply Now or reach Stephanie Z directly at 407-636-7030 ext. 220.

Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Liability Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to First Chicago Insurance Company! We offer: Competitive Salaries Excellent benefits Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! If you are an experienced AUTO CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! We have openings in our Bedford Park, IL and Oak Brook, IL offices! This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First and Third Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims. DUTIES & RESPONSIBILITIES: Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim Honor/decline/negotiate first and third party liability claims upon completion of coverage/policy investigation and analysis of damages and liability Work directly with internal and external customers to develop evidence and establish facts on assigned claims Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims Prepare and present claim evaluations for the appropriate settlement authority Notify the Underwriting Department of any adverse information uncovered in the course of the investigation Familiarity with unfair claim practices in states where doing business Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service Provide customer service both to internal and external customers Handle other duties as assigned QUALIFICATIONS REQUIRED: 4 years previous auto liability and PD claims experience A MUST! Prior Non-Standard Auto Claims experience a plus, not required Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills General working knowledge of policies, file procedures, state rules and regulations Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster On-Site position. Preferred: College degree Prior claims experience Ability to use on-line claims system Bi-lingual a plus! First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental and Vision Reimbursement Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $41,600/year-$75,000/year* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.

The Hoosier Lottery Claims Representative Temp will assist customers with the claims process of Hoosier Lottery prizes, questions related to Hoosier Lottery products and other duties as needed. • Greet customers upon arrival in the Claims Center; • Ensure all proper documentation is presented prior to claim processing; • Assist Hoosier Lottery staff with daily office duties; • Answer claims hotline and assist customers with questions; • Assist with PR photos of winners when needed.. Job Requirements • High School diploma or equivalent ; • Excellent customer service skills; • General knowledge of and ability to operate a telephone and cash register; • Basic knowledge of clerical procedures, methods, and principles; • Proficient in office software, including Microsoft Outlook, Microsoft Excel and Microsoft Word; • Proficient with modern office equipment including computer, fax machine, and scanners Required/Desired Skills Skill Required /Desired Amount of Experience High School diploma or equivalent 0 Excellent customer service skills 1 Years General knowledge of and ability to operate a telephone and cash register 1 Years Basic knowledge of clerical procedures, methods, and principles 1 Years Proficient in office software, including Microsoft Outlook, Microsoft Excel and Microsoft Word 1 Years Proficient with modern office equipment including computer, fax machine, and scanners 1 Years

The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems. Knowledge/Skills/Abilities * Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. * This role is involved in member enrollment, provider information management, benefits configuration and/or claims processing. * Responds to incoming calls from providers regarding claims inquiries and provides excellent customer service; documents calls and interactions. * Assists in the reviews of state or federal complaints related to claims. * Supports the other team members with several internal departments to determine appropriate resolution of issues. * Researches tracers, adjustments, and re-submissions of claims. * Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards. * Manages defect reduction by supporting the identifying and communicating error issues and potential solutions to management. * Handles special projects as assigned. * Other duties as assigned. Knowledgeable in systems utilized: * QNXT * Pega * Verint * Kronos * Microsoft Teams * Video Conferencing * Others as required by line of business or state Job Function Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating Molina values in their actions. Responsible for effectively managing and documenting calls and responding to providers regarding issues with claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience; REQUIRED EXPERIENCE: 2-3 years customer service, claims, provider and investigation/research experience. Outcome focused and knowledge of multiple systems. 1+ years of claims research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 4 years PHYSICAL DEMANDS: Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

We are seeking a detail-oriented and experienced VA Community Care Network (CCN) Claims Specialist to support high-volume claims processing and follow-up within the U.S. market. This role focuses exclusively on tasks performed within the VA CCN portal, including claims submission, status checks, payment resolution, and accounts-receivable follow-up. Key Responsibilities Claims Processing & Management Submit, track, and manage VA CCN medical claims through the VA portal. Review claims for completeness, accuracy, and compliance with VA regulations. Correct and resubmit denied or rejected claims. Maintain detailed claim records, documentation, and follow-up actions. Accounts Receivable (A/R) & Follow-Up Conduct timely A/R follow-up on outstanding VA CCN claims. Investigate delayed payments, claim discrepancies, and processing issues. Communicate with VA representatives to resolve pending items professionally and efficiently. Maintain A/R aging categories and ensure consistent progress on high-volume workloads. Compliance & Documentation Ensure all work aligns with VA CCN rules, federal guidelines, and internal policies. Protect sensitive data according to HIPAA and VA security requirements. Generate reports on claim status, aging, and resolution timelines. Cross-Functional Collaboration Coordinate with billing, credentialing, patient services, and clinical teams to gather required claim details. Escalate systemic claim issues or trends to leadership with clear documentation. Required Qualifications U.S.-based candidate with valid Social Security Number (mandatory for VA portal access). 2+ years of experience in VA CCN billing, medical claims processing, or healthcare RCM. Strong understanding of medical terminology, CPT/HCPCS/ICD-10 coding, and claims workflows. Experience working with high-volume claims environments. Excellent organizational skills and attention to detail. Strong written and verbal communication skills. Ability to work independently, manage deadlines, and prioritize effectively. Preferred Qualifications Prior experience managing large VA claims A/R volumes. Familiarity with EMR, Clearing Houses, TriWest, OptumServe, or other payer-specific Community Care processes. Familiarity with eCW, Meditech, Medent, and Rycan (TruBridge) Experience generating operational or A/R reporting. Work Environment Remote U.S.-based position. Requires secure workspace and adherence to privacy standards. Tools, training, and portal credentials provided. Compensation Competitive and based on experience. Full benefits available depending on employment classification.

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.

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: West Hartford, CT (preferred) Atlanta, GA Boston, MA Chicago, IL Los Angeles, CA Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for tech E&O, first and third party cyber claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our must-haves: 5+ years of professional lines claims handling experience A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional PTO days Paid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary range $140,000 - $155,000 (Boston, Manhattan, West Hartford) Salary range $125,000-$135,000 (Chicago, Atlanta) The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-AJ1 Work with amazing people and be part of a unique culture

Primary Responsibilities: Handles property claims and interacts with customers that are filing these claims. Researches and applies knowledge of policies, procedures, laws, statutes, and insurance regulations. Completes all aspects from investigation through settlement of property claims. Monitors and adjusts reserves appropriately. Discusses potential serious losses with Claims management. Trains other claims representatives. Requirements: High school diploma or GED equivalent. Bachelor's degree preferred. Ability to acquire HAAG Wind & Hail Residential Roofing, IICRC, and Commercial Drone Pilot license. 3 years of experience in the insurance industry, an equivalent in the contractor sector, or relevant public social work experience. Knowledge of evaluation and negotiation of Property claims with exposure to working with the public, attorneys, and professionals in the Insurance Industry and resolving conflicts and completing assignments under limited direction. Knowledge of the building repair industry and computer estimating systems. Ability to work in a fast-paced environment and to meet established, as well as unexpected deadlines. Must be able to maintain an educational program and stay current with the insurance and repair industries. Attentive and active listening skills. Must have patience to hear people out and accurately restate what was discussed. Ability to monitor, travel, and work after business hours and weekends for severe first notice of loss. Strong attention to detail. Ability to use technology and business tools required for the position. #FO #LI-TH1

Job Description Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Bodily Injury Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to Warrior Insurance Network! We offer: Competitive Salaries Excellent benefits Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! If you are an experienced Auto CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! The Auto Bodily Injury Claims Specialist will be responsible for investigating and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. DUTIES & RESPONSIBILITIES: Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability status, and damages that are applicable for each claim Process Bodily Injury, and coverage claims in accordance with established office procedures Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation Research case and statutory law in order to conduct proper claim investigation Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims Prepare and present claim evaluations for the appropriate settlement authority Maintain reasonable expense factors Handle other duties as assigned QUALIFICATIONS REQUIRED: 3-5 Years in Auto Bodily Injury/Casualty claims experience a MUST! Non-Standard Auto Claims experience a plus, not required Knowledge of legal and medical terminology Excellent negotiation, communication, written, organizational and interpersonal skills Ability to pass written examinations where required by state statutes to become a licensed claims adjuster Proficiency in Microsoft Office products Warrior Insurance Network (WIN) provides a competitive benefits package to all full- time employees. Following are some of the perks Warrior Insurance Network (WIN) employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental and Vision Reimbursement Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $54,750/year-$97,500/year* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location. Job Posted by ApplicantPro

Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Liability Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to First Chicago Insurance Company! We offer: * Competitive Salaries * Excellent benefits * Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! If you are an experienced AUTO CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! We have openings in our Bedford Park, IL and Oak Brook, IL offices! This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First and Third Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims. DUTIES & RESPONSIBILITIES: * Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss * Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim * Honor/decline/negotiate first and third party liability claims upon completion of coverage/policy investigation and analysis of damages and liability * Work directly with internal and external customers to develop evidence and establish facts on assigned claims * Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims * Prepare and present claim evaluations for the appropriate settlement authority * Notify the Underwriting Department of any adverse information uncovered in the course of the investigation * Familiarity with unfair claim practices in states where doing business * Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service * Provide customer service both to internal and external customers * Handle other duties as assigned QUALIFICATIONS REQUIRED: * 4 years previous auto liability and PD claims experience A MUST! * Prior Non-Standard Auto Claims experience a plus, not required * Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills * General working knowledge of policies, file procedures, state rules and regulations * Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster * On-Site position. Preferred: * College degree * Prior claims experience * Ability to use on-line claims system * Bi-lingual a plus! First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: * Competitive Salaries * Commitment to your Training & Development * Medical and Dental and Vision Reimbursement * Short Term Disability/Long Term Disability * Life Insurance * Flexible Spending Account * Telemedicine Benefit * 401k with a generous company match * Paid Time Off and Paid Holidays * Tuition Reimbursement * Wellness Program * Fun company sponsored events * And so much more! Estimated Compensation Range: $41,600/year-$75,000/year* * Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.

The Hoosier Lottery Claims Representative Temp will assist customers with the claims process of Hoosier Lottery prizes, questions related to Hoosier Lottery products and other duties as needed. • Greet customers upon arrival in the Claims Center; • Ensure all proper documentation is presented prior to claim processing; • Assist Hoosier Lottery staff with daily office duties; • Answer claims hotline and assist customers with questions; • Assist with PR photos of winners when needed.. Job Requirements • High School diploma or equivalent ; • Excellent customer service skills; • General knowledge of and ability to operate a telephone and cash register; • Basic knowledge of clerical procedures, methods, and principles; • Proficient in office software, including Microsoft Outlook, Microsoft Excel and Microsoft Word; • Proficient with modern office equipment including computer, fax machine, and scanners

The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems. **Knowledge/Skills/Abilities** + Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. + This role is involved in member enrollment, provider information management, benefits configuration and/or claims processing. + Responds to incoming calls from providers regarding claims inquiries and provides excellent customer service; documents calls and interactions. + Assists in the reviews of state or federal complaints related to claims. + Supports the other team members with several internal departments to determine appropriate resolution of issues. + Researches tracers, adjustments, and re-submissions of claims. + Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards. + Manages defect reduction by supporting the identifying and communicating error issues and potential solutions to management. + Handles special projects as assigned. + Other duties as assigned. Knowledgeable in systems utilized: + QNXT + Pega + Verint + Kronos + Microsoft Teams + Video Conferencing + Others as required by line of business or state **Job Function** Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating Molina values in their actions. Responsible for effectively managing and documenting calls and responding to providers regarding issues with claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience; **REQUIRED EXPERIENCE:** 2-3 years customer service, claims, provider and investigation/research experience. Outcome focused and knowledge of multiple systems. 1+ years of claims research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 4 years **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

We are seeking a Total Theft / Fire Claims Specialist to join our team! The Theft & Fire Claims Specialist will investigate and handle theft and fire-related property damage claims to prompt, courteous and fair closure while maintaining a reasonable expense factors. Bring proper conclusion to claims which require investigation due to potential coverage issues. DUTIES & RESPONSIBILITIES: Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss Work directly with internal and external customers to develop evidence and establish facts on assigned claims. Ensuring damage is consistent with the report of loss and verify timelines Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, status and damages that are applicable for each claim Conduct thorough recorded statements Consult with agents, witnesses, law enforcement, fire department personnel, vehicle service providers, and forensic specialist Organize, plan, and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims Prepare and present claim evaluations for the appropriate settlement authority Notify the Underwriting Department of any adverse information uncovered during the course of the investigation Familiar with unfair claim practices in states where doing business Conduct business with vendors in a manner while maintaining a reasonable expense factor and upholds the company's reputation for quality service Provide customer service both to internal and external customers Handle other duties as assigned QUALIFICATIONS REQUIRED: 2-3 years previous theft & fire auto insurance or other auto related experience A MUST! Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills Comprehensive working knowledge of policy language, file procedures, state rules and regulations Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster Prior theft & fire claims experience Ability to use on-line claims system Bi-lingual a plus! First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental and Vision Reimbursement Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $55,000/year-$70,000/year* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.