Claim processor jobs in Fishers, IN - 30 jobs

The Claims Coding Analyst's primary responsibilities require independent judgement in making coding-based decisions on claims and appeals to maintain and enhance Healthfirst's claims editing systems in ensuring proper claims payments, reviewing, researching, and responding to written and emailed correspondence from providers regarding claim denials, and acting as a subject matter expert handling more complex provider issues. They are involved in setting Healthfirst claims policy and ensure that Healthfirst payment policy is aligned with CMS (Centers for Medicare and Medicaid Services), New York State Department of Health (NYSDOH), and all CPT, HCPCS, and ICD-10 coding guidelines, among others. Work Schedule This position requires three days per week in office (Tues/Wed/Thurs) at either: 1101 Greenwood Blvd. Lake Mary, FL. or 100 Church St. New York, NY. Duties & Responsibilities: * Conducts independent assessments of current claims edits to ensure comprehensive and defensible claims editing is in place across all Healthfirst product lines. * Proactively identifies areas of opportunity with respect to new edits, modifications to existing edits, and recommended claims policy changes. * Leads implementation efforts with respect to new or modified edits and works with other departments to ensure proper integration with existing systems and edits. * Monitors and reports on performance of current claims editing packages to substantiate savings to Healthfirst. * Serves as a subject matter expert to defend claims payment policy disputes and appeals. * Reviews claims editing escalated provider disputes/appeals and provides guidance on coding rules and industry standards across all areas of the company with regards to claims editing and proper coding, billing, and payment. * Researches and provides feedback on claims editing performance issues, both internally and externally with providers, vendors, etc. * Collaborates with claims editing vendors to maintain and update edits as changes in the regulatory, legislative, or industry accepted payment policy requires. * Collaborates with other departments to improve compliance with coding conventions and clinical practice guidelines. * Leads continuous improvement and quality initiatives to improve processes across departments. * Reviews and responds to written provider disputes, clearly and articulately outlining the payment discrepancy to the provider. * Thoroughly researches post payment claims and takes appropriate action to resolve identified issues within turnaround time requirements and quality standards. * Navigates CMS and State specific websites, as well as AMA guidelines, and compares to current payment policy configuration to resolve the provider payment discrepancies. * Reviews medical records to ensure coding is consistent with the services billed and compares against the clinical coding guidelines to determine if a claim adjustment is necessary. * Processes claim adjustment requests following all established adjustment and claim processing guidelines. * Identifies and escalates root cause issues to supervisor for escalated review. * Reviews and responds independently to internally escalated provider disputes transferred by management and other associates. * Additional duties as assigned Minimum Qualifications: * Coding certification from either American Academy of Professional Coders (AAPC), Certified Professional Coders (CPC) or American Health Information Management Association (AHIMA). * High school diploma or GED from an accredited institution. Preferred Qualifications: * Previous relevant experience * Bachelor's degree in related field * Time management, critical/creative thinking, communication, and problem-solving skills * Demonstrated professional writing, electronic documentation, and assessment skills. * Intermediate Outlook, Basic Word, Excel, PowerPoint, Adobe Acrobat skills. * Knowledge of anatomy and pathophysiology medical terminologies. Compliance & Regulatory Responsibilities: See Above License/Certification: See Above WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to *********************** or calling ************ . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC. Know Your Rights All hiring and recruitment at Healthfirst is transacted with a valid "@healthfirst.org" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process. Hiring Range*: * Greater New York City Area (NY, NJ, CT residents): $68,900 - $99,620 * All Other Locations (within approved locations): $61,300 - $91,120 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. * The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.

Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers exciting openings for Workers Compensation Claims Specialists within the Central Region! As a Workers Compensation Claims Specialist, the successful candidate will join a dedicated Claims Team, utilizing the latest technology to manage a caseload of routine to moderately complex claims. Responsibilities include investigating claims, assessing liability and compensability, evaluating losses, and negotiating settlements. The role involves interactions with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claims management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers. Training is a critical component of your success, and that success starts with reliable attendance. Attendance and active engagement during training are mandatory. Training will require 1 week in our Plano, TX office onsite in February 2026. This position may be filled as a Workers Compensation Associate Claims Specialist, Workers Compensation Claims Specialist I, or a Workers Compensation Claims Specialist II. The salary range posted reflects the range for the varying pay scale across various locations. To be considered for this position, candidates must reside within 50 miles of Hoffman Estates, IL, or Indianapolis, IN, and will be required to work in the office twice a month. Candidates located in Ohio, Montana, and Virginia are eligible for 100% remote work, as we do not have claims offices in these states. Please note that this policy is subject to change. Responsibilities * Manages an inventory of claims to evaluate compensability/liability. * Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources. * Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages. * Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. * Evaluates actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. * Performs other duties as assigned. Qualifications * Effective interpersonal, analytical and negotiation abilities required * Ability to provide information in a clear, concise manner with an appropriate level of detail * Demonstrated ability to build and maintain effective relationships * Demonstrated success in a professional environment; success in a customer service/retail environment preferred * Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent * Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory * Licensing may be required in some states About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

Company Details Carolina Casualty is a member company of W. R. Berkley Corporation, an insurance holding company that is among the largest commercial lines insurance writers in the United States. We specialize in liability, physical damage, cargo and other insurance solutions for the commercial auto markets including trucking, public transportation and others. The company is an equal employment opportunity employer. Responsibilities The primary role of a Complex Claims Specialist is to promptly and professionally ensure high quality claim handling by analyzing liability of claim submissions while making coverage determinations, investigating losses, conducting independent assessment as to the insured's exposure and moving cases towards timely resolution. You will be an effective source for help and support because of your deep knowledge and liability claim expertise. Key Functions will include but not be limited to: The Complex Claims Specialist is a high-level adjuster role that adjudicates assigned claims within given authority and provides operational support to the claims team. This person also: Adjusts and resolves complex to severe commercial claims that may also include all phases of litigation for our Bodily Injury team. Plans and conducts investigations of high severity claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Refers to claim to subrogation group or Special Investigations Unit as appropriate. Assesses policy coverage for submitted claims and notifies the insured of any issues. With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters. Determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim. Reviews and analyses claim documentation and legal filings. Assesses actual damages associated with claims and confidently conducts negotiation within assigned authority limits, to settle claims. Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company. Acts as senior technical professional on team, assisting team members with escalated issues. Develops and maintains excellent rapport with our agency force, insureds, claimants, experts, attorneys, and internal customers Attend mediations, trials, and overnight travel as needed. Qualifications Bachelor's Degree Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally acquired through a bachelor`s degree (or equivalent training) plus 3 to 5 years directly related work experience. Ability to investigate and evaluate complex liability claims. Ability to analyze available information and make effective decisions. Ability to evaluate damages and negotiate fair settlements. Advanced analytical skills. Advanced knowledge of coverage within the team's specialty or focus. Litigation and mediation management experience required. Excellent verbal and written communication skills. Strong background in auto and general liability coverage analysis particularly involving commercial claims with complex issues. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role

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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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.

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!

At Delta Faucet, we are committed to transforming everyday experiences with water through innovative products and exceptional service. As a leader in the plumbing industry, we take pride in our dedication to quality, sustainability, and customer satisfaction. We believe that diverse perspectives strengthen our mission to create solutions that inspire and elevate the lives of all our customers. We welcome individuals from all backgrounds to join us on this journey toward inclusivity and excellence. Your Role at Delta Faucet Delta Faucet Company has an opportunity for someone who enjoys resolving consumer and customer issues to ensure satisfaction with our products. When an experience with a Delta Faucet product does not meet expectations, this employee works in a team environment to resolve the issue. The Product Claims Specialist will research and address inquiries from customers and/or agencies that distribute Delta Faucet products. This team member should be prepared to connect with consumers and customers with efficiency and excellence by phone, e-mail, in person, or through other channels. The successful candidate will be able to work with a team as well as independently and have excellent follow-up and accountability for tasks. This will be a hybrid role in our Indianapolis headquarters. Responsibilities * Review returned products and call data to take next steps to resolve a customer's issue * Monitor e-mail and mail for receipt of subrogation or litigation paperwork and request / file needed information; communicate with Delta and Masco personnel as needed to resolve * Review Product Return data in Smartsheet and update the submitted data as needed * Evaluate Level 1 Product Returns and determine if the claim should be dispositioned or submitted to Delta's test lab for further evaluation * Submit returned product to Delta's test lab for evaluation when needed to evaluate product performance * Leverage internal information to answer questions from customers and internal personnel; questions can be both general and technical in nature * Communicate directly with customers, consumers, Contact Center employees, and sales personnel * Work with Delta Faucet's engineers and other technical resources to understand potential product issues and resolution * Request inspection of in-house stock when there is a potential non-conformance * Monitor and respond to on-line portal concerns professionally and efficiently * Work with product development teams on coordination of product field trials * Stay up to date on product changes and new products that are introduced * Address consumer or customer dissatisfaction with care, patience, and concern * Respond positively when faced with fast-paced decision making * Elevate issues within Delta Faucet Company when necessary * Additional responsibilities or projects may be assigned Qualifications * The ideal candidate will possess a degree from a 4-year college or university and customer service experience * Working knowledge of Delta's products or plumbing products is desired * Proficient use of software, including the use of Microsoft products and Smartsheet, is required; SAP and Salesforce experience are a plus * The demonstrated ability to handle multiple tasks concurrently with attention to detail is required * The employee will need to make business decisions with little supervision * The candidate must possess strong written and verbal communication skills and must exhibit a high degree of professional excellence characterized by good judgment, initiative, and a high standard of ethics * A consistent track record of successfully completing assigned responsibilities without direct supervision required Why Join Us? At Delta Faucet Company, our people are our greatest assets. We value different perspectives and fostering an inclusive environment. You'll have the opportunity to shape the future of our brand, working alongside passionate professionals committed to excellence and innovation. Join us to lead progressive growth and make a significant impact within a leading organization. Here are some of the benefits we offer for your personal and professional growth: * Culture: Recognized and award-winning reputation for equality, diversity and inclusion, flexibility, work-life balance, and more. * Wellbeing: Comprehensive benefit plans; retirement, savings, tuition reimbursement, and employee incentive programs; resources for mental, physical, and financial wellbeing. * Learning & Development: LinkedIn Learning access; internal opportunities to work on projects cross-company. * Social Impact: Four employee-led and self-directed Business Resource Groups; Paid volunteer day annually; Employees share their time, skills and talent with charities and nonprofit organizations across the U.S. and around the globe. Company: Delta Faucet Company Full time Hiring Range: $20.70 - $32.45 Actual compensation may vary based on various factors including experience, education, geographic location, and/or skills. Delta Faucet Company (the "Company") is an equal opportunity employer and we strive to employ the most qualified individuals for every position. The Company makes employment decisions only based on merit. It is the Company's policy to prohibit discrimination in any employment opportunity (including but not limited to recruitment, employment, promotion, salary increases, benefits, termination and all other terms and conditions of employment) based on race, color, sex, sexual orientation, gender, gender identity, gender expression, genetic information, pregnancy, religious creed, national origin, ancestry, age, physical/mental disability, medical condition, marital/domestic partner status, military and veteran status, height, weight or any other such characteristic protected by federal, state or local law. The Company is committed to complying with all applicable laws providing equal employment opportunities. This commitment applies to all people involved in the operations of the Company regardless of where the employee is located and prohibits unlawful discrimination by any employee of the Company. Delta Faucet Company is an E-Verify employer. E-Verify is an Internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States. Please click on the following links for more information. E-Verify Participation Poster: English & Spanish E-verify Right to Work Poster: English, Spanish

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI #IN-DNI

At Delta Faucet, we are committed to transforming everyday experiences with water through innovative products and exceptional service. As a leader in the plumbing industry, we take pride in our dedication to quality, sustainability, and customer satisfaction. We believe that diverse perspectives strengthen our mission to create solutions that inspire and elevate the lives of all our customers. We welcome individuals from all backgrounds to join us on this journey toward inclusivity and excellence. Your Role at Delta Faucet Delta Faucet Company has an opportunity for someone who enjoys resolving consumer and customer issues to ensure satisfaction with our products. When an experience with a Delta Faucet product does not meet expectations, this employee works in a team environment to resolve the issue. The Product Claims Specialist will research and address inquiries from customers and/or agencies that distribute Delta Faucet products. This team member should be prepared to connect with consumers and customers with efficiency and excellence by phone, e-mail, in person, or through other channels. The successful candidate will be able to work with a team as well as independently and have excellent follow-up and accountability for tasks. This will be a hybrid role in our Indianapolis headquarters. Responsibilities Review returned products and call data to take next steps to resolve a customer's issue Monitor e-mail and mail for receipt of subrogation or litigation paperwork and request / file needed information; communicate with Delta and Masco personnel as needed to resolve Review Product Return data in Smartsheet and update the submitted data as needed Evaluate Level 1 Product Returns and determine if the claim should be dispositioned or submitted to Delta's test lab for further evaluation Submit returned product to Delta's test lab for evaluation when needed to evaluate product performance Leverage internal information to answer questions from customers and internal personnel; questions can be both general and technical in nature Communicate directly with customers, consumers, Contact Center employees, and sales personnel Work with Delta Faucet's engineers and other technical resources to understand potential product issues and resolution Request inspection of in-house stock when there is a potential non-conformance Monitor and respond to on-line portal concerns professionally and efficiently Work with product development teams on coordination of product field trials Stay up to date on product changes and new products that are introduced Address consumer or customer dissatisfaction with care, patience, and concern Respond positively when faced with fast-paced decision making Elevate issues within Delta Faucet Company when necessary Additional responsibilities or projects may be assigned Qualifications The ideal candidate will possess a degree from a 4-year college or university and customer service experience Working knowledge of Delta's products or plumbing products is desired Proficient use of software, including the use of Microsoft products and Smartsheet, is required; SAP and Salesforce experience are a plus The demonstrated ability to handle multiple tasks concurrently with attention to detail is required The employee will need to make business decisions with little supervision The candidate must possess strong written and verbal communication skills and must exhibit a high degree of professional excellence characterized by good judgment, initiative, and a high standard of ethics A consistent track record of successfully completing assigned responsibilities without direct supervision required Why Join Us? At Delta Faucet Company, our people are our greatest assets. We value different perspectives and fostering an inclusive environment. You'll have the opportunity to shape the future of our brand, working alongside passionate professionals committed to excellence and innovation. Join us to lead progressive growth and make a significant impact within a leading organization. Here are some of the benefits we offer for your personal and professional growth: Culture: Recognized and award-winning reputation for equality, diversity and inclusion, flexibility, work-life balance, and more. Wellbeing: Comprehensive benefit plans; retirement, savings, tuition reimbursement, and employee incentive programs; resources for mental, physical, and financial wellbeing. Learning & Development: LinkedIn Learning access; internal opportunities to work on projects cross-company. Social Impact: Four employee-led and self-directed Business Resource Groups; Paid volunteer day annually; Employees share their time, skills and talent with charities and nonprofit organizations across the U.S. and around the globe. Company: Delta Faucet CompanyFull time Hiring Range: $20.70 - $32.45Actual compensation may vary based on various factors including experience, education, geographic location, and/or skills. Delta Faucet Company (the “Company”) is an equal opportunity employer and we strive to employ the most qualified individuals for every position . The Company makes employment decisions only based on merit. It is the Company's policy to prohibit discrimination in any employment opportunity (including but not limited to recruitment, employment, promotion, salary increases, benefits, termination and all other terms and conditions of employment) based on race, color, sex, sexual orientation, gender, gender identity, gender expression, genetic information, pregnancy, religious creed, national origin, ancestry, age, physical/mental disability, medical condition, marital/domestic partner status, military and veteran status, height, weight or any other such characteristic protected by federal, state or local law. The Company is committed to complying with all applicable laws providing equal employment opportunities. This commitment applies to all people involved in the operations of the Company regardless of where the employee is located and prohibits unlawful discrimination by any employee of the Company. Delta Faucet Company is an E-Verify employer. E-Verify is an Internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States. Please click on the following links for more information. E-Verify Participation Poster: English & Spanish E-verify Right to Work Poster: English, Spanish

Who is Federated Insurance? At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own. Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values. What Will You Do? Customer-focused, source of knowledge and comfort, desire to help, professional - Does that sound like you? We are seeking someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss. No previous insurance or claims experience needed! Federated provides an exceptional training program to teach you the fundamentals of claims and will prepare you to assist clients. This is an in-office position that will work out of our Indianapolis, IN office, located at 9785 Crosspoint Blvd. A work from home option is not available. Responsibilities Work with policyholders, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair and courteous way. Explain policy coverage to policyholders and third parties. Complete thorough investigations and document facts relating to claims. Determine the value of damaged items or accurately pay medical and wage loss benefits. Negotiate settlements with policyholders and third parties. Resolve claims, which may include paying, settling, or denying claims, defending policyholders in court, compromising or recovering outstanding dollars. Minimum Qualifications Current pursuing, or have obtained a four-year degree Experience in a customer service role in industries such as retail, hospitality, logistics, banking, automotive dealerships, vehicle rental, sales or similar fields Ability to make confident decisions based on available information Strong analytical, computer, and time management skills Excellent written and verbal communication skills Leadership experience is a plus Salary Range: $63,800 - $78,000 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information can be discussed with a with a member of the Recruiting team. What We Offer We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You. Employment Practices All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization. If California Resident, please review Federated's enhanced Privacy Policy.

Who are we? A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world. Part of Berkshire Hathaway's insurance operations, we bring our solutions to market with our stellar brand name, top-rated balance sheet, and the expertise of our global team of professionals, who exude excellent capabilities and strong character. We are a values-based organization where respect, integrity, excellence, collaboration, and passion define who we are and how we do business. We value diversity of backgrounds, experience, and perspectives and strive to foster an inclusive environment that enables all our team members to bring their best selves to work. We are one team committed to building a culture where every teammate has the opportunity to contribute and be recognized. Want to be part of the team building the finest property, casualty and specialty lines insurance company in the world? Learn more about our unique culture and history. Job Opportunity: Berkshire Hathaway Specialty Insurance (BHSI) has an exciting opportunity for a Medical Stop Loss Senior Claims Auditor with knowledge of employer group health insurance, managed care, and direct medical claims products. This position will work with our Third-Party Administrator's (TPA's) daily with interaction with several other areas in our Medical Stop-Loss Division. The position is preferably located in our Indianapolis or Plymouth Meeting, PA office. We are open to candidates who could work from out Atlanta or Boston office as well. Duties & Responsibilities: * Audit specific and aggregate claims for assigned complex blocks of business * Audit and process claim reimbursements * Verify claims are paid in accordance with the plan document and reimbursable under the Stop Loss policy * Verify participant and dependent eligibility * Maintain and exceed targeted claims accuracy standards * Maintain accurate and detailed information for each file * Conduct implementation calls for newly sold groups * Review and approve plan documents and plan amendments * Initiate and further cost containment opportunities * Audit program business claims across several lines within our Accident & Health Division * Assist management with implementation calls for new business sold * Set and adjust reserves Qualifications, Skills, and Experience: * Minimum of 5+ years' experience examining and auditing medical stop loss claims * Proficient with Microsoft Office Suite, especially Excel * Knowledge of group insurance, managed care, and direct medical claims products * Demonstrate excellent mathematical, communication and customer service skills * Excellent problem-solving and critical-thinking skills * Detail/results-oriented * Strong analytical skills * Excellent customer service * Knowledge of COB, Medicare, HIPAA, CPT, ICD9/ICD10, and interpretation of employer group health plan benefits * Ability to work independently with minimal supervision while meeting or exceeding established turn-around-time, production, and accuracy standards BHSI Offers: * A competitive package and exciting growth opportunities for career-oriented teammates * A dynamic, action oriented, and thoughtful environment centered on always doing the right thing for our customers, teammates and our other stakeholders * A purposely non-bureaucratic organization that embraces simplicity over complexity and emphasizes individual excellence in a team framework * Benefits that support your life and well-being, which include: * Comprehensive Health, Dental and Vision benefits * Disability Insurance (both short-term and long-term) * Life Insurance (for you and your family) * Accidental Death & Dismemberment Insurance (for you and your family) * Flexible Spending Accounts * Health Reimbursement Account * Employee Assistance Program * Retirement Savings 401(k) Plan with Company Match * Generous holiday and Paid Time Off * Tuition Reimbursement * Paid Parental Leave NOTE: This job description is not intended to be all-inclusive. Team Member may perform other related duties as negotiated to meet the ongoing needs of the organization. The base salary range for this position is from $70,000 - $80,000 along with annual bonus eligibility; a candidate's actual salary is commensurate with experience as determined by their relevant skills, experience, and geographical location. We value our teammates - both their capabilities and character - as demonstrated by our amazing culture.

At Delta Faucet, we are committed to transforming everyday experiences with water through innovative products and exceptional service. As a leader in the plumbing industry, we take pride in our dedication to quality, sustainability, and customer satisfaction. We believe that diverse perspectives strengthen our mission to create solutions that inspire and elevate the lives of all our customers. We welcome individuals from all backgrounds to join us on this journey toward inclusivity and excellence. Your Role at Delta Faucet Delta Faucet Company has an opportunity for someone who enjoys resolving consumer and customer issues to ensure satisfaction with our products. When an experience with a Delta Faucet product does not meet expectations, this employee works in a team environment to resolve the issue. The Product Claims Specialist will research and address inquiries from customers and/or agencies that distribute Delta Faucet products. This team member should be prepared to connect with consumers and customers with efficiency and excellence by phone, e-mail, in person, or through other channels. The successful candidate will be able to work with a team as well as independently and have excellent follow-up and accountability for tasks. This will be a hybrid role in our Indianapolis headquarters. Responsibilities * Review returned products and call data to take next steps to resolve a customer's issue * Monitor e-mail and mail for receipt of subrogation or litigation paperwork and request / file needed information; communicate with Delta and Masco personnel as needed to resolve * Review Product Return data in Smartsheet and update the submitted data as needed * Evaluate Level 1 Product Returns and determine if the claim should be dispositioned or submitted to Delta's test lab for further evaluation * Submit returned product to Delta's test lab for evaluation when needed to evaluate product performance * Leverage internal information to answer questions from customers and internal personnel; questions can be both general and technical in nature * Communicate directly with customers, consumers, Contact Center employees, and sales personnel * Work with Delta Faucet's engineers and other technical resources to understand potential product issues and resolution * Request inspection of in-house stock when there is a potential non-conformance * Monitor and respond to on-line portal concerns professionally and efficiently * Work with product development teams on coordination of product field trials * Stay up to date on product changes and new products that are introduced * Address consumer or customer dissatisfaction with care, patience, and concern * Respond positively when faced with fast-paced decision making * Elevate issues within Delta Faucet Company when necessary * Additional responsibilities or projects may be assigned Qualifications * The ideal candidate will possess a degree from a 4-year college or university and customer service experience * Working knowledge of Delta's products or plumbing products is desired * Proficient use of software, including the use of Microsoft products and Smartsheet, is required; SAP and Salesforce experience are a plus * The demonstrated ability to handle multiple tasks concurrently with attention to detail is required * The employee will need to make business decisions with little supervision * The candidate must possess strong written and verbal communication skills and must exhibit a high degree of professional excellence characterized by good judgment, initiative, and a high standard of ethics * A consistent track record of successfully completing assigned responsibilities without direct supervision required Why Join Us? At Delta Faucet Company, our people are our greatest assets. We value different perspectives and fostering an inclusive environment. You'll have the opportunity to shape the future of our brand, working alongside passionate professionals committed to excellence and innovation. Join us to lead progressive growth and make a significant impact within a leading organization. Here are some of the benefits we offer for your personal and professional growth: * Culture: Recognized and award-winning reputation for equality, diversity and inclusion, flexibility, work-life balance, and more. * Wellbeing: Comprehensive benefit plans; retirement, savings, tuition reimbursement, and employee incentive programs; resources for mental, physical, and financial wellbeing. * Learning & Development: LinkedIn Learning access; internal opportunities to work on projects cross-company. * Social Impact: Four employee-led and self-directed Business Resource Groups; Paid volunteer day annually; Employees share their time, skills and talent with charities and nonprofit organizations across the U.S. and around the globe. Company: Delta Faucet Company Full time Hiring Range: $20.70 - $32.45 Actual compensation may vary based on various factors including experience, education, geographic location, and/or skills. Delta Faucet Company (the "Company") is an equal opportunity employer and we strive to employ the most qualified individuals for every position. The Company makes employment decisions only based on merit. It is the Company's policy to prohibit discrimination in any employment opportunity (including but not limited to recruitment, employment, promotion, salary increases, benefits, termination and all other terms and conditions of employment) based on race, color, sex, sexual orientation, gender, gender identity, gender expression, genetic information, pregnancy, religious creed, national origin, ancestry, age, physical/mental disability, medical condition, marital/domestic partner status, military and veteran status, height, weight or any other such characteristic protected by federal, state or local law. The Company is committed to complying with all applicable laws providing equal employment opportunities. This commitment applies to all people involved in the operations of the Company regardless of where the employee is located and prohibits unlawful discrimination by any employee of the Company. Delta Faucet Company is an E-Verify employer. E-Verify is an Internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States. Please click on the following links for more information. E-Verify Participation Poster: English & Spanish E-verify Right to Work Poster: English, Spanish

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance PL CLAIM SPECIALIST **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to designated authority level. + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent negotiation skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** **:** Computer keyboarding, travel as required **Auditory/Visual** **:** Hearing, vision and talking _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $117,000 - $125,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for claim or reconsideration. **Required Qualifications** - New York Independent Adjuster License - Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience - DG system knowledge **Education** **-** High School Diploma required - Preferred Associates degree or equivalent work experience. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $18.50 - $42.35 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/27/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer.

Work Arrangement: Onsite Engagement Type: Contract NOTE: Applications with resumes in PDF Format will be automatically rejected. Only Word format resumes will be considered. Short Description: 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. Complete Description: 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

Title: Claims Representative I (Health & Dental) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Claims Representative I responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How you will make an impact: * Learning the activities/tasks associated with his/her role. * Works under direct supervision. * Relies on others for instruction, guidance, and direction. * Work is reviewed for technical accuracy and soundness. * Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. * Researches and analyzes claims issues. Minimum Requirements * HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences * Good oral and written communication skills, previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly 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.

At Axia Women's Health, recognized as a Great Place to Work for a 4th year in a row, our vision is to lead the way in improving women's health. At the core of achieving this is a caring, connected, and progressive community of over 400 providers across nearly 200 women's health centers in New Jersey, Pennsylvania, Indiana, Ohio, and Kentucky. The rapidly growing network spans OB/GYN physicians, breast health centers, high-risk pregnancy centers, two laboratories, urogynecology care, and fertility centers. Together, Axia Women's Health puts women first by delivering the personalized care needed for women to lead healthier, happier lives. We are hiring a full time Pre Certification Specialist to join us in our Carmel Indiana Location. The Precertification Specialist will be responsible for a variety of tasks regarding verifying, checking eligibility of benefits, and obtaining authorization for patients, activating patient files, and for providing support to patients and medical staff. Job duties include but are not limited to: Promptly and professionally answers telephone calls. Route calls appropriately, offering voicemail or redirection of calls as needed. Review patient records to determine the necessity of pre-authorization for services. Communicate with healthcare providers to gather required documentation as needed. Follow up on pending requests to ensure timely approvals. Educate patients about their insurance benefits and pre-certification process. Complete obstetrical intake and schedule all new ob appointments Explain financial requirements to patients; collect and record copays as required. Obtaining precertification's from insurance for testing and procedures. Perform registration functions for new and existing patients. Schedule patient appointments per guidelines given Maintain confidentiality regarding all patients. Adhere to infection control/safety guidelines and confidentiality policies through HIPAA compliance. Other duties as assigned. Qualified candidates can: Adapt to changing priorities and business needs Is flexible and not easily flustered Has great customer service skills An ability to work in a fast paced innovative environment An ability to focus on what is best for the team over the individual Can work 40 hours per week. Can work between the hours of 7:45 a.m. and 9 p.m. as needed. We offer an excellent compensation package, which includes full benefits, such as health/dental coverage, holiday/vacation, and 401(k). Equal Opportunity Employer

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. **Alternate locations may be considered if candidates reside within a commuting distance from an office.** 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.

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI #IN-DNI