Claim processor jobs in Evansville, IN

Diversified Services Network, Inc. (DSN) is seeking a full-time Case File Processor to join our team in Springfield, IL! We offer full benefits, PTO, 401k, and more! This position prepares foster care applications for a title IV-E eligibility determination by collecting the required documentation to satisfy the eligibility requirements. This is accomplished by utilizing multiple systems including but not limited to: Department of Children and Family Services' Child Welfare systems (CYCIS & SACWIS), Department of Human Services/Healthcare and Family Services' systems (PACIS, IES, KIDS), Social Security Administration system (SOLQ), and Department of Labor systems (DOL/AWVS). In addition, Case Managers and Supervisors are contacted to resolve discrepancies or request additional information. This position requires the ability to multi-task and to adapt to changes daily. Candidates for this position must be very detail-oriented and possess the ability to process, discern, and retain information across multiple sources. Reading comprehension is a must. The ability to assess a process or situation and recommend an enhancement or change is a plus. Preparing Case Files for Submission to the DCFS Eligibility Determination Unit Job Duties: Check out cases ready for determination (court documentation present in the file). Review and interpret all gathered information. Follow up with the Case Manager and Supervisor if there are any discrepancies or further information is required. Routinely follow up on any outstanding requests for information or documentation. Complete all fields of information on the Cover Sheet for each case. Document any additional information relevant to the determination of eligibility. Ensure all documents are in the case file and are in the correct order. Submit the file to the supervisor for a quality control check. Correct any issues found during the quality control check, if applicable. Assist with all filing duties. Other duties as assigned. The expectation for a fully trained Case File Processor is to complete an average of at least 7 cases a day and with a less than 5% error rate. Required Skills Excellent verbal and written communication skills. Attention to detail. Organizational skills. Ability to take direction and follow instructions. Critical thinking skills. BENEFITS: • 401(k) • Dental insurance • Vision Insurance • Disability insurance • Employee assistance program • Health insurance • Health savings account • Life insurance • Paid time off • Paid Holidays

Do you have experience handling Lawyers Professional Liability or other Professional Liability claims? Are you motivated by working in a collaborative environment? If so, this role may be for you! We are looking for a strategic thinker with leadership skills to join our U.S. Lawyers Claims team. About the Role This role has responsibility for handling Lawyers Professional Liability claims while also supporting internal and external customers. You will manage a caseload of claims from receipt to final resolution. Our team works closely with the U.S. Agents Claims team, and you may have the opportunity to handle Agents Claims, as well. Additional key responsibilities include: * Maintain strong client focus by aggressively and proactively analyzing issues, providing support, and assuring client satisfaction in a timely fashion. * Complying with legal and regulatory requirements, investigate, evaluate, and settle claims, applying technical knowledge and people skills to reach fair and prompt claim resolution. * Complete detailed reviews of claim related issues, including coverage, liability, and damage assessments, and document the claim file appropriately. * Set and maintain appropriate and timely indemnity and expense reserves. * Formulate and execute negotiation and resolution strategies. * Evaluate claims data to assist with identifying claim trends. * Support Underwriting in connection with Claims information and consultation on coverages. * In this role, you will be working with other Claims Handlers dedicated to working on Lawyers Professional Liability Claims. Our team also handles other types of claims, including U.S. Agents claims, and has a strong emphasis on quality and customer service. About the Team We are a highly skilled, professional, and experienced claims team. Our department works closely with colleagues in Client Markets, Underwriting, Products, Actuary, and HR and we collaborate with various offices throughout the US and other places in the world. We are proud to deliver unparalleled customer service to our business partners and clients. We are looking for a new colleague to help us continue to raise the bar! About You Focused, self-motivated, and a confident professional with a hardworking sales mindset to develop insights, propose solutions, and build growth opportunities for clients and Swiss Re. You are a proactive and well-organized decision maker who works well both independently and as part of a team. You also have the following: Additional requirements include: * Bachelor's degree or equivalent industry experience. * 3+ years' Claims handling experience or equivalent industry experience. * Possess solid coverage, liability, damage investigation, evaluation, and claims resolution skills. * Excellent negotiation skills. * Excellent customer service skills and experience collaborating with underwriters, clients, brokers, and internal and external business partners. * Strong data analytic skills. * Experience with handling claims in a paperless environment. * Interest in developing leadership and management skills. * Possess, or willing to obtain, adjuster licenses as needed for various jurisdictions. * Ability to successfully deliver the Swiss Re Claims Commitment. Our company uses a hybrid work model requiring a minimum of three days in the office each week, with the option of working onsite full-time if preferred. The estimated base salary range for this position is $84,000 to $140,000. The specific salary offered for this or any given role will take into account a number of factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget. At Swiss Re, we take a "total compensation approach" when making compensation decisions. This means that we consider all components of compensation in their totality (such as base pay, short-and long-term incentives, and benefits offered), in setting individual compensation. About Swiss Re Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world. Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability. If you are an experienced professional returning to the workforce after a career break, we encourage you to apply for open positions that match your skills and experience. Keywords: Reference Code: 136177 Nearest Major Market: Chicago Job Segment: Liability, Claims, Underwriter, Accounting, Actuarial, Insurance, Finance

Multi-Line Claim Specialist (Auto and GL) Schedule: Monday-Friday, 8:00 AM-4:30 PM CT Compensation: $75,000-$85,000 annually At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. Reasons you should consider a career with CCMSI: Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10+ years liability claim experience is required. Bachelor's Degree is preferred. Experience with handling injury claims. Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Object Handling Categories Work requires the ability to sit or stand up to 7.5 or more hours at a time. Work requires sufficient auditory and visual acuity to interact with others. CORE VALUES & PRINCIPLES Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #ClaimsJobs #LiabilityAdjuster #RemoteJobs #InsuranceCareers #ChicagoJobs #LI-Remote We can recommend jobs specifically for you! Click here to get started.

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 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!

Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

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

Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into action, we're looking for extraordinary people to join our talented team. Our service-oriented, ethical, knowledgeable, caring associates are the heart of our vision to be the best company serving independent agents. We help protect families and businesses as they work to prevent or recover from a loss. Share your talents to help us reach for continued success as we bring value to the communities we serve and demonstrate that Actions Speak Louder in Person. If you're ready to build productive relationships, collaborate within a diverse team, embrace challenges and develop your skills, then Cincinnati may be the place for you. We offer career opportunities where you can contribute and grow. Build your future with us The Field Claims department is currently seeking Field Claims Representatives to service the territory surrounding: Evansville, IN. The candidate is required to reside within the territory. This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure accurate settlements. Be Ready to: * complete thorough claim investigations * interview insureds, claimants, and witnesses * consult police and hospital records * evaluate claim facts and policy coverage * inspect property and auto damages and write repair estimates * prepare reports of findings and secure settlements with insureds and claimants * use claims-handling software, company car and mobile applications to adjust loss in a paperless environment * provide superior and professional customer service * once eligible, become a certified and active Arbitration Panelist To be an Entry Level Claims Representative: Salary: The pay range for this position is $55,000 - $76,000 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance. Be equipped with: * be available and communicative during your regular business hours * a desire to learn about the insurance industry and provide a great customer experience * the ability to work unsupervised * excellent verbal and written communication skills * strong interpersonal skills * excellent problem-solving, negotiation, organizational and prioritization skills * preparedness to follow-up with others in a timely manner * a valid driver's license Bring education or experience from: * a bachelor's degree * AINS, AIC, or CPCU designations preferred Benefits in addition to compensation include: * company car * company stock options, including Restricted Share Units and Incentive based stock options * paid time off (PTO) * 401K with 6% company match To be an Experienced Claims Representative: Salary: The pay range for this position is $62,000- $90,000 annually. The pay determination is based on the applicant's education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance. Be equipped with: * be available and communicative during your regular business hours * multi-line claims experience preferred * ability to completely assess auto, property, and bodily injury type damages * capacity to work unsupervised * excellent verbal and written communication skills * strong interpersonal skills * excellent problem-solving, negotiation, organizational, and prioritization skills * preparedness to follow-up with others in a timely manner * a valid driver's license Bring education or experience from: * one or more years of claims handling experience * AINS, AIC, or CPCU designations preferred * bachelor's degree or equivalent experience required Benefits in addition to compensation include: * company car * company stock options, including Restricted Share Units and Incentive based stock options * paid time off (PTO) * 401K with 6% company match Enhance your talents Providing outstanding service and developing strong relationships with our independent agents are hallmarks of our company. Whether you have experience from another carrier or you're new to the insurance industry, we promote a lifelong learning approach. Cincinnati provides you with the tools and training to be successful and to become a trusted, respected insurance professional - all while enjoying a meaningful career. Enjoy benefits and amenities Your commitment to providing strong service, sharing best practices and creating solutions that impact lives is appreciated. To increase the well-being and satisfaction of our associates, we offer a variety of benefits and amenities. Embrace a diverse team As a relationship-based organization, we welcome and value a diverse workforce. We grant equal employment opportunity to all qualified persons without regard to race; creed; color; sex, including sexual orientation, gender identity and transgender status; religion; national origin; age; disability; military service; veteran status; pregnancy; AIDS/HIV or genetic information; or any other basis prohibited by law. All job applicants have rights under Federal Employment Laws. Please review this information to learn more about those rights.

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.

Apply now Work Type: Hybrid Working Employment Type: Permanent Job Description: Key Responsibilities Product / Domain Knowledge * Possesses interpretive knowledge on the domain and works from the operations and technology perspective. * To have e2e knowledge on the functionality of TP & workflow system relevant to the process handled. * Complete understanding of risk points in the product. * Should have the skill set to identify the potential risk areas and put controls in the process handled. * Provides guidance and clarification to others on principles & products * Socialization to the team on the changes in process on account of new product roll out / change in policy...etc * Explains how principles apply to work activity * Should ensure the process note and policy documents are in sync with the practice followed by team. * Obtains feedback, develops or recommends changes to policies and procedures * Analyze / Get feedback from the team on the existing policies and any changes to the current practice should be highlighted to country / PDU team. * Handles exceptions which are complex, is able to judge to a fair degree the consequences of the exceptions. * An awareness of linkages with other products/ process, linkages with various systems, hub resources and country resources. * Should possess the skill set to do a comparitive study on the process / approach handled at different countries and adapt best practice * Able to relate how each one of it impacts and correlate to each other. * Department Operating Instructions / Process note review and signoff * Vendor visits and reviews of their processes as required. Process Management * Identify and eliminate process waste (excessive movement & transportation, wait time, defects, underutilized people/resources & non value-added processing steps). * To conduct process reviews to eliminate the non-value-added processing steps. * Review the process e2e and update in the share point for any further opportunity / defects in the process * Assess process health through key metrics * To perform periodical KCSA checks to check on process adherence * Analyses and remedies inefficiencies in processes * Ensure updated DOI's and end to end system / process manual on a regular basis. * Advises on multiple processes and trains staff. * Instil in team the sense of urgency for change * Makes decisions on area of control and can identify issues that need to be escalated * Expertise in KYC/CDD processes. Capacity Planning * Ability to categorize and to quantify the work plans to suit the SLA requirements * Review cycle times for correctness of input * Develop capacity model for projection of FTE requirements. * Comprehensively describes approach to capacity management and reasons behind it, and applies this approach across a broad range of platforms while taking ownership for their capacity management * Defines and mitigates capacity risks * Displays flexibility in altering plans to achieve objectives or adapt to situations. Operational risk Management * Analyses, interprets and monitors operations risk and suggests mitigation techniques to reduce such risk * Check inherent risk of product and process in the operating environment and demonstrate support for the internal program through behaviour, presentations, and discussions * Able to identify early warning signals and to initiate remedial action. * Able to anticipate and detect fraud and take preventive measures keeping the global fraud environment in mind. * Establish prevention and detection internal controls with an end-to-end perspective (from transaction to customer), which address potential risks of inefficiency, ineffectiveness, fraud, abuse or mismanagement * Use of internal/external audit findings to further improve service excellence * Promote & enable a culture of audit readiness at all times in order to ensure no failed audits * Instructs others in the area of operations risk assessment and monitoring Behavioural Capabilities Precision Accuracy * Executes tasks and assignments accurately within team and self * Possesses ability to differentiate between quality and excellence in the real time BAU activities * Able to provide solutions and ideas to bring down errors. * Create an error free culture by leveraging behavioural recognition, system requirements and other pressure points * Create a collaborative mindset towards driving quality work Client Centric * Takes ownership of team goals and organizational goals in addition to their own * Good understanding of customer's requirements and what's generally offered by other similar set-ups. * Able to generate improvement ideas from indicators and drive the team to achieve same. * Is able to network with customers and able to manage expectations * Is able to serve customer with high quality service within boundaries of policies and procedures without compromising on mandated procedures and able to convince customers on exceptions * Is courageous to communicate to the customer on negative trends of service and actual root causes Communication * Shares critical information in a timely and effective manner * Possess ability to understand differences in the target audience and accordingly modifies the communication style across differing cultures. * Possess negotiation skills to achieve common goals. * Be spontaneous in communication and handle criticisms effectively * Displays ability to train on communication skills Problem Resolution * Able to identify and highlight both obvious and underlying problems and identify/implement actions to resolve same. * Able to guide team members in managing problems and apply controls to minimize recurrence * Able to handle conflicts through negotiation, collaboration and accommodation * Uses tools such as flow charts, Fish Diagram, etc to disclose meaningful patterns in data * Be sensitive to cultural differences so that there are no conflicts based on diversity * Drives an environment for finding solutions * Take courageous decision * Mentors others to be solution oriented * Involve stakeholders in managing issues * Risk Takers and push back, when warranted Managerial Capabilities Stakeholder Management * Know your stakeholders and their goals * Instil in your team a customer centric approach and develop a no-tolerance approach toward sloppy customer interactions * Constantly engage stakeholders in any changes envisaged and Manage expectations and concerns * Able to deliver meaningful MIS on areas of vital interest to stakeholders * Be a central bridge between stakeholders and the team * Serving on committees with members from across different functions * Attending professional / trade association meetings People Management * Sponsors and develops (e.g. coaches, mentors) key employees to build bench strength and ensure adequate succession planning * Ability to ensure people engagement as evidenced by My Voice. Ability to negotiate performance ratings and have courageous conversations. * Ability to work with matrix reporting relationship * Develops short and long-term career development plans with employees * Builds teams using appropriate structures e.g. cross-functional, project team Change Management * Able to contribute to the design of business process change and facilitate the changes required * Creates clear accountability for change in measurable terms and integrates it into performance management * Clearly communicates and develops shared reasons for change initiatives, mobilizes commitment, introduces changes to systems and structures and actively monitors progress * Analyses and evaluates the success, failure and risk in the change process at a business or country level * Analyses and evaluates the success, failure and risk in the change process at a business or country level * Able to convince others of the need to change and instil in team the sense of urgency for change Project Management * Understands the basic project management concepts, able to lead a medium-sized project team and able to interact with parties outside the team to pursue actions * Able to liaise with all stakeholders and teams working on the project in terms of following up actions and contribute when issues / concerns arise * Takes independent action to change the direction of events. * Ensures there are regular reviews, there is accountability, and that management of projects, stakeholders and suppliers are in place. * Verifies and validates the project ensuring adherence to standards and alignment with the vision. Financial and Budgetary Management * Applies internal financial processes/systems effectively (e.g. planning expenses and allocating funds appropriately, processing invoices, control) * Takes a stand on control reports and justifies deviations from budget * Ability to contribute ideas to influence trends which create sustainable cost advantages and * scale efficiencies Data Analytics * Ability to analyse the complex information in hand and identify risks involved which could have been overlooked / camouflaged. * Able to analyse the trends and patterns in the unit (Volume, capacity, performances & errors) * Able to interpret the ratio analysis of the key elements in the units * Ability to read and interpret the system reports to identify any out of pattern trends in the units / system * Ability to provide information / suggest based on the trends & pattern analysis for system / process enhancements. * Ability to evaluate data using analytical and logical reasoning to examine each component of the data provided for the purpose of drawing conclusions to help decision making. Strategy Formulation & Implementation * Has a good understanding of what the strategies and tactical goals of the organization are * Able to execute given actions that will contribute towards achieving business strategies * Provides ground level inputs to fit for purpose plans and upward feedback as a reality check for implementation * Able to drive business goals among team members as per action plan and timelines percolated down * Builds informal relationships across units to ensure best implementation processes are used and to reduce duplication Regulatory & Business Conduct * Display exemplary conduct and live by the Group's Values and Code of Conduct. * Take personal responsibility for embedding the highest standards of ethics, including regulatory and business conduct, across Standard Chartered Bank. This includes understanding and ensuring compliance with, in letter and spirit, all applicable laws, regulations, guidelines and the Group Code of Conduct. * Effectively and collaboratively identify, escalate, mitigate and resolve risk, conduct and compliance matters. Key stakeholders * Country and internal and external stake holders Qualifications * Greater Than 10 Years Of Work Experience With Below Skills Sets * People Management Skills * Stake Holder Management * Communication Skills * Decision Making Skills and Experience * MS Excel / Power point * Analytical Skill Competencies Action Oriented Collaborates Customer Focus Manages Ambiguity Nimble Learning Technical Competencies: This is a generic competency to evaluate candidate on role-specific technical skills and requirements About Standard Chartered We're an international bank, nimble enough to act, big enough for impact. For more than 170 years, we've worked to make a positive difference for our clients, communities, and each other. We question the status quo, love a challenge and enjoy finding new opportunities to grow and do better than before. If you're looking for a career with purpose and you want to work for a bank making a difference, we want to hear from you. You can count on us to celebrate your unique talents and we can't wait to see the talents you can bring us. Our purpose, to drive commerce and prosperity through our unique diversity, together with our brand promise, to be here for good are achieved by how we each live our valued behaviours. When you work with us, you'll see how we value difference and advocate inclusion. Together we: * Do the right thing and are assertive, challenge one another, and live with integrity, while putting the client at the heart of what we do * Never settle, continuously striving to improve and innovate, keeping things simple and learning from doing well, and not so well * Are better together, we can be ourselves, be inclusive, see more good in others, and work collectively to build for the long term What we offer In line with our Fair Pay Charter, we offer a competitive salary and benefits to support your mental, physical, financial and social wellbeing. * Core bank funding for retirement savings, medical and life insurance, with flexible and voluntary benefits available in some locations. * Time-off including annual leave, parental/maternity (20 weeks), sabbatical (12 months maximum) and volunteering leave (3 days), along with minimum global standards for annual and public holiday, which is combined to 30 days minimum. * Flexible working options based around home and office locations, with flexible working patterns. * Proactive wellbeing support through Unmind, a market-leading digital wellbeing platform, development courses for resilience and other human skills, global Employee Assistance Programme, sick leave, mental health first-aiders and all sorts of self-help toolkits * A continuous learning culture to support your growth, with opportunities to reskill and upskill and access to physical, virtual and digital learning. * Being part of an inclusive and values driven organisation, one that embraces and celebrates our unique diversity, across our teams, business functions and geographies - everyone feels respected and can realise their full potential. Apply now Information at a Glance * * * * *

*** This is where your organization can create a consistent intro to all of your jobs, creating consistency in voice and messaging across all job posts *** C'est ici que votre organisation peut créer une introduction cohérente à tous vos emplois, en créant une cohérence dans la voix et la messagerie dans tous les postes. Overview The Claims Specialist position is responsible for Point of Sale (POS) data management and processing back-end pricing rebates/credits, including resolution of issues/disputes in a timely and accurate manner. Responsibilities Ingest and cleanse partner Point of Sale (POS) data in Vistex Go-to-Market Suite (GTMS). Upload manual POS files timely and track monthly progress. Review data for deficiencies or errors, correct any inaccuracies in POS daily. Investigate, research, and identify business entities with minimal information provided. Cleanse, enrich, and monitor master data elements (customer, product, and pricing). Collaborate with POS reporters to improve the completeness and accuracy of the data submitted in Electronic Data Interchange (EDI) or manual submissions. Identify issues related to master data that impact POS and/or claims data. Process and issue credits for incoming claims in an accurate and timely manner. Upload claim files timely and track weekly/monthly progress. Resolve and analyze claim errors/rejections; escalate to management and/or Bid Desk for further internal review as needed. Communicate discrepancies/denials to claim partner for review and alignment. Issue credits for approved claims and send claim discrepancy report to claim partner. Work with Accounts Receivable to reconcile discrepancies/denials for collection. Collaborate with claim partners to improve the claim submission data for processing efficiency. Address any internal and/or external issues or questions regarding data or claims in an accurate and timely manner. Validate and create credits honoring price protection in SAP. Qualifications High school diploma or GED required. Associate degree in Business or work-related experience. Minimum one year rebate/claim processing, data management, or equivalent experience. Demonstrated problem solving skills with a proficient understanding of processes. Proven detail-oriented individual who enjoys managing large amounts of data. Established strong process and organizational skills with the ability to process high volumes of transactions, research errors and exceptions, and manage to completion. Ability to interact with a variety of individuals/functions within the organization as well as with external customers. Ability to work independently in a fast-paced, professional team environment with minimal supervision. Demonstrated experience creating and managing reports that identify discrepancies. Proven capacity to identify and maintain consistent accuracy. Strong oral and written communication skills. Intermediate Microsoft application user including Outlook, Word, and especially Excel. Ability to multi-task and prioritize. Experience with Salesforce, Channel Data Management (CDM), SAP ECC6, Vistex is a plus. ABOUT US: Sharp Imaging and Information Company of America (SIICA) Sharp Imaging and Information Company of America (SIICA) is a division of Sharp Electronics Corporation, the U.S. subsidiary of Japan's Sharp Corporation, a global technology company which has been named to Fortune magazine's World's Most Admired Company List. Sharp strives to help businesses achieve Simply Smarter work by helping companies manage workflow efficiently, create immersive and engaging environments, and increase productivity. SIICA offers a full suite of secure printer and copier solutions, professional and commercial visual displays and projectors, software management and productivity software and markets durable Dynabook laptops. As a total solutions provider, Sharp has a reputation for innovation, quality, reliability, and industry-leading customer support expertise. Compensation for this position The compensation range for this role is $53,900 - $67,650. The listed salary range or contractual rate excludes bonuses, incentives, differential pay, and any other forms of compensation or benefits. The starting salary will be determined by several variables, including but not limited to experience, education, training, certification, and location. You may also be eligible to receive an annual discretionary incentive award, commissions, and program-specific awards, which are subject to the rules governing these programs. Employee perks Comprehensive, family-friendly healthcare plans (medical, dental, vision). 401k retirement plan with a competitive match and plenty of financial support tools. Employee Assistance Plan to care for you and your family's mental and behavioral health, balance, and support. Financial protection for you and your family (life insurance and disability insurance) Rewarding and wholistic wellness program. Training, professional development, and mentorship Full suite of voluntary insurance benefits for financial planning (auto, home, ID protection and legal) Dynamic culture eager to innovate, enhance diversity, and work smarter. Sharp Electronics Corporation is an equal opportunity employer - minority - female - disability - veteran. No agency resumes will be accepted or fees paid in the absence of an official written engagement agreement executed in advance by Human Resources for this particular position. All applicants must be authorized to work in the US without sponsorship. All applications must include compensation expectations in order to be considered. Local candidates only, please. #LI-SR1 #SIICA *** Similar to the introduction that can precede all job descriptions, an outro can also be formatted for consistency on all posts *** Semblable à l'introduction qui peut précéder toutes les descriptions de poste, une outro peut également être formatée pour la cohérence sur tous les messages

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.

Job Details Headquarters - Mokena, IL Full Time High School $44000.00 - $50000.00 Salary/year Full Time: 80 hours per pay period Billing & InsuranceDescription The Outbound Claims Specialist is responsible for coding and scrubbing claims for errors, adding modifiers, and submitting claims to insurance. Work Schedule: This position is on-site with a schedule of Monday - Friday 7:30 am - 4:00 pm Essential Functions: Bill out claims to insurance providers in a timely manner. Review provider coding on notes/appointments to ensure compliance with insurance guidelines and to ensure accurate and timely reimbursement. Ensure client records are up-to-date and accurate. Initiate internal communication with therapists ensuring accuracy and completion of notes. Serve as a liaison between clients and clinics to ensure timely, appropriate transfer of information and response to billing inquiries. Attend relevant seminars to remain abreast of current issues regarding therapy and ABA billing practices, compliance with CMS guidelines and industry best practice. Meet or exceed department goals set by team lead or billing manager on a regular basis. Adhere to all practice policies related to HIPAA. Qualifications Required Education, Experience and Credentials: High school diploma or equivalent One year of billing experience in a medical office or healthcare setting Knowledge, Skills and Abilities: Excellent interpersonal and communication skills Able to work effectively with all levels of the organization and in a diverse work group. Proactive and independent with the ability to take initiative. Excellent time management skills with a proven ability to meet deadlines. Comfortable with technology, with the ability to learn multiple systems and software. Proficient with Google Workspace Must maintain discretion and client confidentiality. Personal Attributes: Interpersonal skills with strong verbal and written communication skills Process oriented with strong attention to detail and accuracy Accountability Integrity Problem Solving Initiative Work Environment & Physical Demands Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. Travel Requirements Not applicable This is a full-time position. Full-time employees are eligible for a comprehensive range of benefits, including Medical, Dental, Vision, and Life Insurance; a 401(k) retirement plan with company match; Paid Time Off; Sick Time; and a robust Employee Assistance Program.

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Woodridge, IL. This will be a Full-Time position. This position must be located within driving distance to our pharmacy, with a hybrid work style. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $23.00 an hour and up Sign-On Bonus: $5,000 for employees starting before January 1, 2026. We offer a variety of benefits including: Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Company paid benefits - life; and short and long-term disability Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360... Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information.. Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information. Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim. Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible) Manages all funding related adjudications and works as a liaison to Onco360 Advocate team. Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment. Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable. Document and submit requests for Patient Refunds when appropriate. Pharmacy Adjudication Specialist Qualifications and Responsibilities... Education/Learning Experience Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience Work Experience Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills Desired: Knowledge of Foundation Funding, Specialty pharmacy experience Licenses/Certifications Required: Registration with Board of Pharmacy as required by state law Desired: Certified Pharmacy Technician (PTCB) Behavior Competencies Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills #Company Values: Teamwork, Respect, Integrity, Passion

We are Hiring for a Trainee to learn and handle Auto Bodily Injury Casualty Claims! Are you a high performing Auto Liability PD Claim Professional, seeking advancement within your career? Are you interested in learning how to handle injury claims, up to and included attorney represented complex casualty claims? Are you currently in a Claims role and feel that there is no opportunity to grow your Claims career? If you answered YES , then look no further! First Chicago Insurance is recruiting a training class of ambitious individuals who currently excel within the auto liability PD claims insurance industry. No prior auto bodily injury/casualty claims handling experience required! At the end of the training program, you will be expected to and able to successfully investigate, evaluate, negotiate, and resolve bodily injury, uninsured/underinsured motorist bodily injury, and medical payments claims. The training class will run approximately 4-6 weeks and will be a balanced mix of classroom instruction and on-the-job/side-by-side training. Following is more information about this unique opportunity to elevate your insurance career: The Casualty Specialist Trainee will be responsible for the investigation and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. DUTIES & RESPONSIBILITIES: Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss. Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability, status, and damages that are applicable for each claim. Process Bodily Injury, and coverage claims in accordance with established office procedures. Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation. Research case and statutory law in order to conduct proper claim investigation. Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims. Prepare and present claim evaluations for the appropriate settlement authority. Maintain reasonable expense factors. Handle other duties as assigned. QUALIFICATIONS REQUIRED: 2+ years of auto liability property damage claim adjusting experience is required. JD (Juris Doctorate) a plus! Non-standard Auto Claims handling experience preferred is not required. Excellent negotiation, written and verbal communication, organizational and interpersonal skills. Ability to pass written examinations where required by state statutes to become a licensed claims adjuster. Proficiency in Microsoft Office products. Bilingual in Spanish preferred but not required. On-Site position. First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Training Programs Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $27.88/hr-$31.25/hr* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.

We are Hiring for a Trainee to learn and handle Auto Bodily Injury Casualty Claims! Are you a high performing Auto Liability PD Claim Professional, seeking advancement within your career? Are you interested in learning how to handle injury claims, up to and included attorney represented complex casualty claims? Are you currently in a Claims role and feel that there is no opportunity to grow your Claims career? If you answered YES, then look no further! First Chicago Insurance is recruiting a training class of ambitious individuals who currently excel within the auto liability PD claims insurance industry. No prior auto bodily injury/casualty claims handling experience required! At the end of the training program, you will be expected to and able to successfully investigate, evaluate, negotiate, and resolve bodily injury, uninsured/underinsured motorist bodily injury, and medical payments claims. The training class will run approximately 4-6 weeks and will be a balanced mix of classroom instruction and on-the-job/side-by-side training. Following is more information about this unique opportunity to elevate your insurance career: The Casualty Specialist Trainee will be responsible for the investigation and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. DUTIES & RESPONSIBILITIES: * Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss. * Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability, status, and damages that are applicable for each claim. * Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation. * Research case and statutory law in order to conduct proper claim investigation. * Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims. * Prepare and present claim evaluations for the appropriate settlement authority. * Maintain reasonable expense factors. * Handle other duties as assigned. QUALIFICATIONS REQUIRED: * 2+ years of auto liability property damage claim adjusting experience is required. * JD (Juris Doctorate) a plus! * Non-standard Auto Claims handling experience preferred is not required. * Excellent negotiation, written and verbal communication, organizational and interpersonal skills. * Ability to pass written examinations where required by state statutes to become a licensed claims adjuster. * Proficiency in Microsoft Office products. * Bilingual in Spanish preferred but not required. * On-Site position. First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: * Competitive Salaries * Commitment to your Training & Development * Medical and Dental * Short Term Disability/Long Term Disability * Life Insurance * Flexible Spending Account * Telemedicine Benefit * 401k with a generous company match * Paid Time Off and Paid Holidays * Tuition Reimbursement Training Programs * Wellness Program * Fun company sponsored events * And so much more! Estimated Compensation Range: $27.88/hr-$31.25/hr* * Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.

Job DescriptionPeople Plus is hiring clerical candidates! Are you detail-oriented and people-friendly with a strong work ethic? If you are, then we have the perfect position for you!The candidate will be making calls to hospitals/insurance companies and checking on the status of claims. Also, I will be entering codes and charges and setting up claims to be billed. *1st Shift- Hours may vary depending on the position *$13. 50*Mandatory Overtime one Saturday per quarter from 8 am-12 pm*Clerical Experience would be a plus Please call ************ or show interest in the app.