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Claim processor jobs in Forest Acres, SC

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  • Claims Specialist

    Mecklenburg County, Nc 4.2company rating

    Claim processor job in North Carolina

    Annual Salary Range: $47,393 - $59,241 This is a non-exempt (hourly) position. Pay rates are based on education, skill, experience level and internal equity Performs thorough review, and transmission of healthcare claims, conducts financial analysis to ensure compliance with established local, state, and governmental billing and coding guidelines, thorough understanding of third-party financial reimbursement, payment posting, and reconciliation policies. This position, under general supervision, is to apply laws, rules, regulations, and policies to complex paraprofessional work. ESSENTIAL FUNCTIONS * Analyze claim data to ensure proper reimbursement * Prepare, review, and submit claim payments to financial management system (live check within 24 hours, Online Credit Card payments by next business day, EFT (Electronic Funds Transfer) deposits within 72 hours * Monitor and analyze all referred accounts to determine categorization, level of the appeal process, and personally handle complex appeal responses for private health care and government-specific denials * Record financial and statistical data within payment receipt database and accurately balance financial transaction reports * Performs accurate financial clearance review along with a comprehensive analysis of client/patient and payer specific benefit and liability * Develop training materials and implement quality assurance processes to serve as a resource to and from internal departments, financial institutions, and external agencies * Monitor and analyze collection of past due accounts, follow-up on payment arrangements, assign delinquent account as outlined in FIS-02_Uncollectible Account Policy * Serve as a liaison to public health and clinical administration for financial and statistical claim data * Participate in special projects related to financial activities * May assist in monitoring of budgets for fiscal compliance * Given the wide range of staff involved in the revenue cycle process, the incumbent must be able to work collegially and respond efficiently and effectively MINIMUM QUALIFICATIONS Experience: Minimum of three years of directly related experience. Education: High School Diploma or equivalent and two years of basic accounting coursework. Combination of relevant education and relevant experience accepted: Yes Licenses and Certifications May require a valid North Carolina or South Carolina Driver's License PREFERRED QUALIFICATIONS Associate degree in accounting or a related field KNOWLEDGE, SKILLS, AND ABILITIES Knowledge of * Revenue Cycle principles * Federal, State, and local Healthcare Coding and Billing rules and regulations * Accounting principles * Medical terminology, ICD-10, CPT, and HCPCS codes * Budgetary principles * Arithmetic, algebra, geometry, calculus, statistics, and their applications * The structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar * Principles and processes for providing customer service, including customer needs assessment, meeting quality standards for services, and evaluating customer satisfaction Skills * Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times * Understanding written sentences and paragraphs in work related documents * Talking to others to convey information effectively * Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems * Using mathematics to solve problems Abilities * Applied Learning - Assimilating and applying new job-related information in a timely manner. * Communication - Clearly conveying information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain information required * Decision Making - Identifying and understanding issues, problems and opportunities; comparing data from different sources to draw conclusions; using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts, constraints and probably consequences Computer Skills Proficient in various computer applications including Microsoft Office Suite REASONABLE ACCOMMODATIONS STATEMENT To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions. DISCLAIMER STATEMENT This is not intended to be an all-inclusive list of job-related responsibilities, duties, skills, requirements or working conditions. Other duties may be assigned based on business need and the supervisor's request. Mecklenburg County reserves the right to revise the job description at any time. Designated positions may be required to assist in emergency and/or disaster situations.
    $47.4k-59.2k yearly 6d ago
  • Claims Processor I

    PGBA 4.2company rating

    Claim processor job in Columbia, SC

    Responsible for the accurate and timely processing of claims. Logistics: PGBA - one of BlueCross BlueShield's South Carolina subsidiary companies Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is located on-site at 17 Technology Cir., Columbia, SC, 29203. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. What You'll Do: Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes. Resolves system edits, audits and claims errors through research and use of approved references and investigative sources. Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary. To Qualify for This Position, You'll Need the Following: Required Education: High School Diploma or equivalent Required Skills and Abilities: Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills. Required Software and Tools: Basic office equipment. We Prefer That You Have the Following: Preferred Work Experience: 1 year-of experience in a healthcare or insurance environment. Preferred Skills and Abilities: Ability to use complex mathematical calculations. Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. Proficient in database software. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.
    $27k-41k yearly est. Auto-Apply 3d ago
  • Ancillary Claims Examiner

    Bankers Fidelity Life Insurance Company 4.1company rating

    Claim processor job in Atlanta, GA

    Job Summary:The Claims Examiner I is responsible for adjudicating individual and group voluntary benefits claims, including Critical Illness, Accident, Hospital Indemnity, Short Term Disability, Short Term Care, and Life products. This role ensures the accurate entry of claims data while conducting thorough reviews and analyses to determine eligibility. As an entry-level position, the Claims Examiner I works closely with more senior examiners to ensure the accurate and timely processing of claims. This role supports the company's mission by maintaining high standards of accuracy and efficiency in claims adjudication.Key Responsibilities: Deliver exceptional service to claimants, internal teams, and external customers, aligning with company values. Process and adjudicate routine claims for Critical Illness, Accident, Hospital Indemnity, Short Term Disability, Short Term Care, and Life products under direct supervision. Investigate, resolve, and make decisions on less complex claims, ensuring full compliance with company policies and industry regulations. Ensure claims are processed in compliance with company policies and industry regulations. Meet or exceed minimum production averages and accuracy targets for payment, procedure, and financial goals. Participate in the development and implementation of policies and procedures to improve claim handling processes. Assist in enhancing claims processes to boost operational efficiency while maintaining compliance. Consistently meet production and accuracy targets, including payment, procedure, and financial goals. Collaborate with team members and other departments to ensure seamless claims handling and customer service. Day-to-Day Activities: Review and enter claims data accurately. Conduct thorough reviews and analyses to determine eligibility. Communicate with claimants and other stakeholders to gather necessary information and provide updates. Research and resolve discrepancies in claims data. Participate in team meetings and training sessions to stay updated on policies and procedures. Contribute to various claims-related projects and process improvement initiatives. Qualifications: High school diploma or equivalent required; Bachelor's degree preferred. Minimum of 1 year of claims experience preferred, with exposure to group and/or individual products. Basic understanding of claims processing and settlement practices. Strong communication and interpersonal skills. Ability to manage multiple priorities and meet deadlines. Basic knowledge of regulatory standards and compliance requirements. Skills: Analytical Skills: Ability to review claim details, medical records, and policy provisions to make informed decisions. Claims examiners must analyze information to determine coverage and benefits accurately. Attention to Detail: Precision in reviewing documentation, identifying discrepancies, and ensuring all required information is present before making a decision. This skill is crucial for accurate claim adjudication. Communication Skills: Strong written and verbal communication abilities to clearly explain claim decisions to stakeholders. Claims examiners must also effectively communicate with internal teams. Time Management: Efficient handling of multiple claims and tasks, ensuring timely adjudication within set deadlines. Time management is vital for managing high workloads and meeting service-level agreements. Problem-Solving: Capacity to address complex claims scenarios, interpret policy language, and find solutions to claims issues. Claims examiners need to resolve questions or disputes related to coverage. Knowledge of Policy Provisions: Deep understanding of policy terms, conditions, and exclusions for accident indemnity, hospital indemnity, short-term care, critical illness, and disability coverage. This is necessary for accurate application of benefits. Regulatory Compliance Awareness: Knowledge of relevant insurance laws and regulations to ensure all claims are handled in compliance with legal and regulatory requirements. Work Environment / Physical Requirements:The work environment is a standard office setting with typical office equipment. This role involves professional collaboration with colleagues and clients. Responsibilities may involve extended periods of sitting, occasional walking between departments or meeting rooms, and periodic standing, reaching, stooping, and lifting office items weighing up to 25 pounds.
    $36k-46k yearly est. Auto-Apply 60d+ ago
  • Claims Processor I

    Palmetto GBA 4.5company rating

    Claim processor job in Columbia, SC

    Responsible for the accurate and timely processing of claims. Logistics: PGBA - one of BlueCross BlueShield's South Carolina subsidiary companies Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is located on-site at 17 Technology Cir., Columbia, SC, 29203. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. What You'll Do: Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes. Resolves system edits, audits and claims errors through research and use of approved references and investigative sources. Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary. To Qualify for This Position, You'll Need the Following: Required Education: High School Diploma or equivalent Required Skills and Abilities: Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills. Required Software and Tools: Basic office equipment. We Prefer That You Have the Following: Preferred Work Experience: 1 year-of experience in a healthcare or insurance environment. Preferred Skills and Abilities: Ability to use complex mathematical calculations. Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. Proficient in database software. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.
    $23k-34k yearly est. Auto-Apply 5d ago
  • Claims Processor I

    Us Tech Solutions 4.4company rating

    Claim processor job in Myrtle Beach, SC

    + Responsible for the accurate and timely processing of claims. + Research and processes claims according to business regulation, internal standards and processing guidelines. **Responsibilities:** + Verifies the coding of procedure and diagnosis codes. Resolves system edits, audits and claims errors through research and use of approved references and investigative sources. + Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary. **Skills:** + **Required Skills and Abilities:** Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math. + **Required Software and Tools:** Proficient in word processing and spreadsheet applications. Proficient in database software. **Education:** + **Required Education Level and Degree Type** : High School Diploma or equivalent + Required Work Experience: Experience processing, researching and adjudicating claims **Experience:** + Experience processing, researching and adjudicating claims **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (********************************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
    $20k-30k yearly est. 60d+ ago
  • Global Risk Solutions Claims Specialist Development Program (January, June 2026)

    Liberty Mutual 4.5company rating

    Claim processor job in Suwanee, GA

    Claims Specialist Program Are you looking to help people and make a difference in the world? Have you considered a position in the fast-paced, rewarding world of insurance? Yes, insurance! Insurance brings peace of mind to almost everything we do in our lives-from family trips to your first car to weddings and college graduations. As a valued member of our claims team, you'll help our customers get back on their feet and restore their lives when catastrophe strikes. The details When you're part of the Claims Specialist Program, you'll acquire various investigative techniques and work with experts to determine what caused an accident and who is at fault. You'll independently manage an inventory of claims, which may include conducting investigations, reviewing medical records, and evaluating damages to determine the severity of each case. You'll resolve cases by working with individuals or attorneys to settle on the value of each case. You will have required comprehensive training, one-on-one mentoring, and a strong pay-for-performance compensation structure at a global Fortune 100 company. Make a difference in the world with Liberty Mutual. Qualifications What you've got * You have 0-2 years of professional experience. * A strong academic record with a cumulative 3.0 GPA preferred * You have an aptitude for providing information in a clear, concise manner with an appropriate level of detail, empathy, and professionalism. * You possess strong negotiation and analytical skills. * You are detail-oriented and thrive in a fast-paced work environment. * You must have permanent work authorization in the United States. What we offer * Competitive compensation package * Pension and 401(k) savings plans * Comprehensive health and wellness plans * Dental, Vision, and Disability insurance * Flexible work arrangements * Individualized career mobility and development plans * Tuition reimbursement * Employee Resource Groups * Paid leave; maternity and paternity leaves * Commuter benefits, employee discounts, and more Learn more about benefits at ************************** A little about us As one of the leading property and casualty insurers in the country, Liberty Mutual is helping people embrace today and confidently pursue tomorrow. We were recognized as a '2018 Great Place to Work' by Great Place to Work US, and were named by Forbes as one of the best employers in the country for new graduates and women-as well as for diversity. Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information, or on any basis prohibited by federal, state, or local law. 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
    $62k-86k yearly est. Auto-Apply 60d+ ago
  • Claims Specialist

    Parker's Kitchen 4.2company rating

    Claim processor job in Savannah, GA

    The Claims Specialist position is an on-site role based at our corporate headquarters in Savannah, Georgia. This role will play a key part in supporting and managing the claims process, working closely with cross-functional teams across the organization to help reduce and prevent accidents, injuries, and property damage involving both employees and customers, while promoting a proactive, safety-focused culture company-wide. ESSENTIAL DUTIES AND RESPONSIBILITIES Responsibilities: Will assist with the management process of claims for all lines of insurance to include property, general liability, auto, unemployment, and workers' compensation. Utilizes skills and trend-tracking to assist in reducing accidents, and occupational injuries. Coordinates claim notification with the insurance carriers and serves as a point of contact for all assigned claims with the insurance carriers. Contacts employees and customers with potential claims to assist in mitigating potential loss and further injuries. Assist with all Parker's Workers' Compensation (WC) Claims, Unemployment Claims, General Liability Claims, and all other from initial notification through to claim closure, including reviewing, analyzing, and approving authority amounts. Case management can include scheduling of appointments, obtaining current medical information, assisting managers with the transition of injured employees back to work, and assisting the injured employee. Ensure continued communication with injured parties to include customers, workers and leaders of the injured worker. May act as Parker's representative for depositions, informal conferences, mediations, and/or hearings pertaining to claims, working with assigned attorneys as necessary. Prepares Parker's written responses to unemployment claims based upon a summary of facts compiled from files, personnel records and interviews. May prepare cases for and represents Parker's at unemployment claim appeal hearings. Provides personnel employment information and verification, questions witnesses and claimant to ascertain facts of separation and presents a closing summary statement of the employer's position to the hearing officer. Prepares client witnesses for hearing appearances. Case preparation for hearings involves document gathering and organization, unemployment law research, and defense strategies. Maintains frequent telephone contact with management and leaders, gathering facts necessary to determine if unemployment claims are disputable and explaining unemployment rules, regulations, decisions and options. Refers information ascertained during investigations to the Claims team, Operations, and/or Human Resources, as necessary, when possible EEOC charges, wrongful discharge, or threatened litigation facts may have been uncovered. Other similar duties as required. Knowledge, Skills, and Abilities: Strong attention to detail Advanced skills in the use of Windows-based office software: Microsoft Office, Word, Excel, and PowerPoint and G-Suite products Must possess strong analytical and problem-solving skills Able to manage multiple priorities Able to research, collect, and analyze data and prepare written and oral reports Knowledge of claims processing techniques Able to analyze, classify, and rate risks, exposure, and loss expectancies Knowledge of workers' compensation laws and requirements, safety, loss control, and risk management principles Principles, practices, and procedures of general business including knowledge of the unemployment compensation system, filing appropriate unemployment responses, and personnel administration including legal aspects of hiring and firing; and the relationship of the Federal Unemployment Tax Act and the various state acts; knowledge of state and federal unemployment laws, rules and regulations. Highly organized and able to track a project from initial contact through the end of the project Ability to effectively communicate information and ideas in written and verbal format EDUCATION AND REQUIREMENTS Required: Associate or Bachelor's degree or equivalent experience 1-2 years' experience processing workers' compensation, general liability, and/or unemployment claims Experience in creating reports Preferred: ARM, CRM or similar designation 4+ years' experience processing workers' compensation, general liability, and/or unemployment claims TRAVEL As required PHYSICAL REQUIREMENTS Prolonged periods sitting/standing at a desk and working on a computer
    $38k-72k yearly est. 60d+ ago
  • Management Liability Claims Specialist

    IAT Insurance Group

    Claim processor job in Raleigh, NC

    IAT Insurance Group has an immediate opening for a Management Liability Claims Specialist that can be located in any of our IAT locations. This role works a hybrid schedule from an IAT Office. The hybrid schedule reflects our values (thinking and acting like an owner, collaboration, and teamwork) as it requires working from the office with colleagues and other disciplines Monday through Wednesday, with the option of working Thursday and Friday remotely. Responsibilities: Responsible for handling Management Liability Claims (EPL, D&O, Fiduciary and Crime) for Private and Non-Profit businesses based on Claim Guidelines Within authority limit, thoroughly analyze, investigate, negotiate and resolve all levels of severity claims Selects, directs and manages defense counsel including approval of budgets Develops litigation/file disposition strategy. Attends mediations, settlement conferences and trials Verifies/analyzes applicable coverage for the reported claims Follow operational policies and procedures, including compliance, regulatory and performance and customer service standards Prepare reports, including Large Loss Reports, to management which accurately reflects loss development, potential/actual financial exposure, coverage issues, claim and recovery strategies Establishes 24-hour contact and maintain appropriate contact with all involved stakeholders throughout the life of the claim file Identifies and addresses recovery/contribution/SIU opportunities Sets accurate/timely loss/expense reserves in compliance with Claim Guidelines. Drafts correspondence, including but not limited to, coverage letters to stakeholders as required Support business partners on an as needed basis on various claim and underwriting related issues and marketing meetings Maintains resident/nonresident adjuster licenses as required Performs other duties as assigned Qualifications: Must Have: Bachelor's Degree with 5+ years of management liability claims experience (including handling employment liability practices, directors & officers' liability and fiduciary liability coverages) or equivalent Equivalent experience is defined as 9+ years of relevant claims experience, specifically claims involving litigation. Excellent coverage analysis skills with experience in drafting coverage position correspondence Experience handling litigated files and direction of defense counsel Excellent negotiation skills Must be willing to travel, average 1 day a month Claims Licensure as required by respective state(s) Excellent oral and written communication skills Ability to organize, multi-task and prioritize work Excellent customer service and interpersonal skills Ability to analyze data, utilize sound judgment to draw conclusion and make supported decisions To qualify, applicants must be authorized to work in the United States and must not require, now or in the future, VISA sponsorship for employment purposes Preferred to Have: CPCU and other insurance related studies Our Culture IAT is the largest private, family-owned property and casualty insurer in the U.S. I nsurance A nswers T ogether is how we define IAT, in letter and in spirit. We work together to provide solutions for people and businesses. We collaborate internally and with our partners to provide the best possible insurance and surety options for our customers. At IAT, we're committed to driving and building an open and supportive culture for all. Our employees propel IAT forward - driving innovation, stable partnerships and growth. That's why we continue to build an engaging workplace culture to attract and retain the best talent. We offer comprehensive benefits like: 26 PTO Days (Entry Level) + 12 Company Holidays = 38 Paid Days Off 7% 401(k) Company Match and additional Profit Sharing Hybrid work environment Numerous training and development opportunities to assist you in furthering your career Healthcare and Wellness Programs Opportunity to earn performance-based bonuses College Loan Assistance Support Plan Educational Assistance Program Mentorship Program Dress for Your Day Policy All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We maintain a drug-free workplace and participate in E-Verify. Compensation: Please note, that the annual gross salary range associated with this posting is $60,600 - $95,700. This range represents the anticipated low and high end of the base salary for this position. Actual salaries will vary based on factors such as a candidate's qualifications, skills, competencies, and geographical location related to this specific role. The total compensation will include a base salary, performance-based bonus opportunities, 401(K) match, profit-sharing opportunities, and more. To view details of our full benefits, please visit **************************************************
    $60.6k-95.7k yearly 60d+ ago
  • General Liability Claims Specialist

    Builders Insurance Group 4.0company rating

    Claim processor job in Atlanta, GA

    Job Details Corporate Headquarters - Atlanta, GA HybridDescription Integrity. Care. Trust. Compassion. Expertise. Do these words resonate with you? These values of Builders culture create success in all we do. We strive to provide deeply supportive partnerships to our customers, agents, and each other. Builders is proud to be named among the Great Places to Work. Our award-winning culture has earned top marks in Company Direction, Employee Appreciation, Work-Life Balance, Leadership, and Compensation and Benefits. Our strong culture keeps us Built Strong in a forever-changing world, and our AM Best A Rating is evidence of our financial strength. Position Summary The General Liability Claims Specialist is responsible for the thorough investigation, evaluation and resolution of general liability/construction defect claims. The Specialist delivers quality technical outcomes while ensuring exceptional customer service throughout the claims process. Responsibilities Manage a diverse caseload of property and casualty claims, including general liability, construction defect, and automobile losses across multiple jurisdictions, utilizing best-in-class claims handling practices. Conduct thorough investigations and in-depth coverage analyses to make informed coverage determinations; draft clear, professional coverage correspondence and communicate decisions to policyholders and key stakeholders with minimal supervision. Oversee all aspects of the claims process, ensuring comprehensive and timely investigations. Establish timely and appropriate reserves within designated authority, continuously evaluating and adjusting as necessary throughout the life of the claim. Assess liability, analyze exposure, and strategically negotiate claims to fair and efficient resolution. Identify and pursue risk transfer opportunities and enforce additional insured provisions to mitigate exposure. Maintain detailed, accurate, and organized documentation in all claim files, supporting transparency and compliance. Manage litigation toward prompt and cost-effective resolution. Prepare high-quality, timely reporting, including large loss summaries and reinsurance updates. Optimize claim outcomes through careful vendor management and cost control. Negotiate and resolve claims within established authority, balancing efficiency with fairness. Foster productive communication and collaboration with internal partners-such as Underwriting, Auditing, and Compliance-and external stakeholders, including agents, insureds, and claimants. Meet or exceed quality performance benchmarks and service expectations. Participate in hearings, pre-trial conferences, settlement discussions, trials, and related proceedings, as required. Perform other duties as assigned. Qualifications Bachelor's degree or an equivalent combination of education and experience in the insurance field Ten or more years of experience processing auto and/or general liability claims with five or more years of experience processing construction defect claims Senior Claim Law Associate (SCLA) or Chartered Property Casualty Underwriter (CPCU) designation Georgia Adjuster License along with additional state licenses, as applicable Knowledge of construction defect and auto liability laws, rules and regulations Skill in analysis, time management, prioritization, negotiation and project management; ability to multi-task effectively while paying attention to detail Self -motivated, flexible with the capacity to work autonomously while ensuring transparent communication with internal leadership Skill in interpersonal interactions, with the ability to collaborate effectively with individuals at all organizational levels and with external stakeholders; skill in customer service and problem-solving Proficient in both verbal and written communication with the ability and commitment to maintain confidentiality Proficient with Microsoft Office Suite and function specific software applications Let's talk benefits! Competitive Salary Bonus Structure Profit Sharing Medical, Dental, Vision Insurance Employer Paid Short Term Disability Employer Paid Long Term Disability Employer Paid Life Insurance Voluntary Life Insurance 401K with Company Match PTO About Builders Builders is a mid-sized mutual with remarkable strengths. Rated A by AM Best, Builders has forged rock-solid financial strength and a reputation for reliability and fairness in fulfilling our promises to customers. Kind, collaborative, and customer-centric, our experienced and passionate teams foster a rewarding atmosphere of excellence, trust, and mutual respect, meriting the “Culture Excellence” honors from Top Workplaces. Flexible and highly personal, our experts leverage deeply supportive partnerships with knowledgeable independent agencies to drive better services and protection for policyholders. Our financial excellence, amazing people, and powerful partnerships build outstanding outcomes and peace of mind for our agents and their clients. This is what we mean by Insurance Built Strong . Builders Insurance Group is an Equal Opportunity Employer. We welcome applicants from all walks of life and don't discriminate based on any protected status. Join us in creating a diverse and inclusive workplace! If, during the application process you need assistance, or an accommodation due to a disability, please contact *******************.
    $52k-75k yearly est. 60d+ ago
  • Complex Liability Claims Specialist - Primarily NY / New York Labor Law

    Utica National Insurance Group 4.8company rating

    Claim processor job in North Carolina

    The Company At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an "A" rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier. Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago. What you will do The Specialist will be responsible for the management and effective resolution of high exposure, complex liability claims in primarily New York venues, inclusive of New York Labor Law claims. The ideal candidate will have considerable experience in effectively negotiating settlements via mediation and direct negotiations, managing and directing litigation, conducting coverage and additional insured evaluations, and drafting coverage position letters. Experience handling complex commercial general liability is required. Key responsibilities * Responsible for thorough evaluation of coverage and proactive investigation, reserving, negotiating and managing the defense of complex liability claims in primarily New York jurisdictions. * Manage all claims in accordance with Utica National's established claim procedures. * Draft and present claim reviews to supervisor and upper management that provide full evaluation of coverage, liability and damages associated with claim, proposed plan to resolve claim and sufficient basis and support for authority requests above the Complex Liability Claims Specialist's individual monetary authority level. * Maintain timely and accurate claim reserves in accordance Utica National's reserving philosophy. * Effectively manage litigation process including appropriate assignment of defense panel counsel, monitoring of defense counsel's work product and working with defense counsel to efficiently and fairly resolve claims. * Participate as appropriate in litigation activities including settlement negotiations, depositions, conferences, hearings, alternative dispute resolution sessions and trials. * Maintain effective communications with insureds, claimants, agents, and other representatives involved in the claims cycle. * Achieve the service standard of "excellent" during all phases of claims handling. * Stay abreast of legal trends, case law, and jurisdictional environment and its impact on handling claims within the jurisdiction. * Responsible for analyzing and communicating changes in law, regulation, and custom to ensure consistent quality claim handling. What you need * Four year degree or equivalent experience preferred. * Minimum of 5 years of commercial casualty claims handling experience working with high complexity litigated casualty claims. * Proven experience negotiating claims and active participation in alternative dispute resolution practices. * Experience with general liability, additional insured considerations and complex coverage determinations. * Experience with New York Labor Law Claims strongly preferred. Licensing Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment. Salary range: $103,300 - $136,400 The final salary to be paid and position within the internal salary range is reflective of the employee's work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications. Benefits: We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following: * Medical and Prescription Drug Benefit * Dental Benefit * Vision Benefit * Life Insurance and Disability Benefits * 401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results) * Health Savings Account (HSA) * Flexible Spending Accounts * Tuition Assistance, Training, and Professional Designations * Company-Paid Family Leave * Adoption/Surrogacy Assistance Benefit * Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance * Student Loan Refinancing Services * Care.com Membership with Back-up Care, Senior Solutions * Business Travel Accident Insurance * Matching Gifts program * Paid Volunteer Day * Employee Referral Award Program * Wellness programs Additional Information: This position is a full time salaried, exempt (non-overtime eligible) position. Utica National is an Equal Opportunity Employer. Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy. #LI-HL1
    $42k-64k yearly est. 8d ago
  • Medical Coding Appeals Analyst

    Elevance Health

    Claim processor job in Atlanta, GA

    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.
    $38k-57k yearly est. 60d+ ago
  • Claims Mitigation & Management Specialist

    The Nuclear Company

    Claim processor job in Columbia, SC

    The Nuclear Company is the fastest growing startup in the nuclear and energy space creating a never before seen fleet-scale approach to building nuclear reactors. Through its design-once, build-many approach and coalition building across communities, regulators, and financial stakeholders, The Nuclear Company is committed to delivering safe and reliable electricity at the lowest cost, while catalyzing the nuclear industry toward rapid development in America and globally. About the role The Nuclear Company is looking for an experienced Claims Mitigation & Management Specialist to support the deployment of major nuclear reactor projects. This role will focus on contract formation, administration, and proactive claims prevention. You will work closely with project teams, contract managers, and leadership to identify and address potential risks, respond to claims, and ensure contractual compliance across complex, utility-scale nuclear energy projects. Responsibilities Proactively identify potential claims and disputes on projects. Develop and implement strategies for early claims identification and mitigation. Provide guidance to project teams on contract administration and documentation. Conduct detailed forensic analysis of project documentation for claims assessment. Quantify cost and schedule impacts of potential claims, including delay and disruption. Prepare comprehensive claims position papers and reports. Support the negotiation process for claims and disputes. Assist in preparing for and participating in dispute resolution forums (e.g., mediation, arbitration). Develop and maintain a robust claims log, tracking all active and potential claims. Ensure all claims-related documentation is meticulously organized. Prepare regular reports on claims status, liabilities, and resolution progress. Work closely with Project Controls, Contracts, and Legal teams on claims management. Participate in project reviews to provide insights on claims trends. Experience Bachelor's degree in Engineering, Construction Management, Quantity Surveying, Law, or a related field. 8+ years of progressive experience in claims management, dispute resolution, or contract administration. 3+ years of focused claims management experience. Experience on energy mega-projects (utility-scale, high capital, high complexity). Experience on nuclear energy projects is highly valued. Demonstrated expertise in contract formation, negotiation, and administration. Exceptional analytical, critical thinking, and problem-solving skills. Excellent written and verbal communication and negotiation skills. Proficiency in project management software, scheduling tools, and advanced Excel. Ability to work effectively under pressure and manage multiple priorities. Knowledge of construction law and dispute resolution processes. Benefits Competitive compensation packages 401k with company match Medical, dental, vision plans Generous vacation policy, plus holidays Estimated Starting Salary Range The estimated starting salary range for this role is $121,000 - $143,000 annually less applicable withholdings and deductions, paid on a bi-weekly basis. The actual salary offered may vary based on relevant factors as determined in the Company's discretion, which may include experience, qualifications, tenure, skill set, availability of qualified candidates, geographic location, certifications held, and other criteria deemed pertinent to the particular role. EEO Statement The Nuclear Company is an equal opportunity employer committed to fostering an environment of inclusion in the workplace. We provide equal employment opportunities to all qualified applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic. We prohibit discrimination in all aspects of employment, including hiring, promotion, demotion, transfer, compensation, and termination. Export Control Certain positions at The Nuclear Company may involve access to information and technology subject to export controls under U.S. law. Compliance with these export controls may result in The Nuclear Company limiting its consideration of certain applicants.
    $25k-45k yearly est. Auto-Apply 60d+ ago
  • Claims Specialist

    Parker's Convenience Stores

    Claim processor job in Savannah, GA

    Under the supervision of the Risk Manager, the Claims Specialist will assist in managing the claims process, including collaborating with all departments to help mitigate accidents, injuries, and property damage involving both employees and customers. ESSENTIAL DUTIES AND RESPONSIBILITIES Responsibilities: * Will assist with the management process of claims for all lines of insurance to include property, general liability, auto, unemployment, and workers' compensation. * Utilizes skills and trend-tracking to assist in reducing accidents, and occupational injuries. * Coordinates claim notification with the insurance carriers and serves as a point of contact for all assigned claims with the insurance carriers. * Contacts employees and customers with potential claims to assist in mitigating potential loss and further injuries. * Assist with all Parker's Workers' Compensation (WC) Claims, Unemployment Claims, General Liability Claims, and all other from initial notification through to claim closure, including reviewing, analyzing, and approving authority amounts. * Case management can include scheduling of appointments, obtaining current medical information, assisting managers with the transition of injured employees back to work, and assisting the injured employee. * Ensure continued communication with injured parties to include customers, workers and leaders of the injured worker. * May act as Parker's representative for depositions, informal conferences, mediations, and/or hearings pertaining to claims, working with assigned attorneys as necessary. * Prepares Parker's written responses to unemployment claims based upon a summary of facts compiled from files, personnel records and interviews. * May prepare cases for and represents Parker's at unemployment claim appeal hearings. Provides personnel employment information and verification, questions witnesses and claimant to ascertain facts of separation and presents a closing summary statement of the employer's position to the hearing officer. Prepares client witnesses for hearing appearances. Case preparation for hearings involves document gathering and organization, unemployment law research, and defense strategies. * Maintains frequent telephone contact with management and leaders, gathering facts necessary to determine if unemployment claims are disputable and explaining unemployment rules, regulations, decisions and options. * Refers information ascertained during investigations to the Claims team, Operations, and/or Human Resources, as necessary, when possible EEOC charges, wrongful discharge, or threatened litigation facts may have been uncovered. * Other similar duties as required. Knowledge, Skills, and Abilities: * Strong attention to detail * Advanced skills in the use of Windows-based office software: Microsoft Office, Word, Excel, and PowerPoint and G-Suite products * Must possess strong analytical and problem-solving skills * Able to manage multiple priorities * Able to research, collect, and analyze data and prepare written and oral reports * Knowledge of claims processing techniques * Able to analyze, classify, and rate risks, exposure, and loss expectancies * Knowledge of workers' compensation laws and requirements, safety, loss control, and risk management principles * Principles, practices, and procedures of general business including knowledge of the unemployment compensation system, filing appropriate unemployment responses, and personnel administration including legal aspects of hiring and firing; and the relationship of the Federal Unemployment Tax Act and the various state acts; knowledge of state and federal unemployment laws, rules and regulations. * Highly organized and able to track a project from initial contact through the end of the project * Ability to effectively communicate information and ideas in written and verbal format EDUCATION AND REQUIREMENTS Required: * Associate or Bachelor's degree or equivalent experience * 1-2 years' experience processing workers' compensation, general liability, and/or unemployment claims * Experience in creating reports Preferred: * ARM, CRM or similar designation * 4+ years' experience processing workers' compensation, general liability, and/or unemployment claims TRAVEL * As required PHYSICAL REQUIREMENTS * Prolonged periods sitting/standing at a desk and working on a computer
    $32k-56k yearly est. 56d ago
  • Inventory Claim Specialist

    Kioti Tractor

    Claim processor job in Wendell, NC

    Inventory Claims Coordinator Department: Warehouse Operations - 171032 Reports to: Inventory Supervisor Location: Wendell, NC Position Status: Full-time Status: Hourly, Non-Exempt Management Level: Non-Management JOB SUMMARY The Inventory Claims Coordinator serves as a support element and liaison for all distribution centers and the dealer network. This person will be cross trained and gain exposure to many functions including claims processing, inventory investigations, dealer network relationship building and recording claim data. KEY RESPONSIBILITIES OF JOB The Inventory Claims Coordinator key responsibilities are outlined below: Claims: Resolve and process claim disputes Technical drawing look-up Inventory background investigations Credit and Debit process on claim investigations Issuing and monitoring call tags Resolve and process freight claim disputes and tracking reimbursement if applicable Inventory Management Provide inventory control reporting and vendor reports Track claim data and communicate common themes for mitigation Directly or indirectly locate misplaced parts to help satisfy sale to customer/dealer Help maintain or relay proper product identification and location accuracy and ability to transfer product to correct location if needed Other Responsibilities Determine and record data for KPI's Promote dealer satisfaction utilizing customer service skills EDUCATIONAL AND PHYSICAL REQUIREMENTS High school diploma or GED equivalent required with minimum of 3 years' related experience Associate or Bachelor degree with a minimum of 1 year experience 1-5 Years of related customer service or inventory experience. Must be a team player with strong interpersonal communication skills Good time-management skills and attention to detail Outstanding written and oral communication skills with the ability to effectively present information Proficiency in Microsoft programs, including Excel, a plus SAP experience preferred SalesForce experience preferred
    $31k-55k yearly est. Auto-Apply 60d+ ago
  • Complex Claims Specialist - Cyber, Technology, Media & Crime

    Hiscox

    Claim processor job in Atlanta, GA

    Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: West Hartford, CT (preferred) Atlanta, GA Boston, MA Chicago, IL Los Angeles, CA Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for tech E&O, first and third party cyber claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our must-haves: 5+ years of professional lines claims handling experience A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional PTO days Paid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary range $140,000 - $155,000 (Boston, Manhattan, West Hartford) Salary range $125,000-$135,000 (Chicago, Atlanta) The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-AJ1 Work with amazing people and be part of a unique culture
    $31k-54k yearly est. Auto-Apply 20d ago
  • Global Risk Solutions Claims Specialist Development Program (January, June 2026)

    Law Clerk In Cincinnati, Ohio

    Claim processor job in Suwanee, GA

    Claims Specialist Program Are you looking to help people and make a difference in the world? Have you considered a position in the fast-paced, rewarding world of insurance? Yes, insurance! Insurance brings peace of mind to almost everything we do in our lives-from family trips to your first car to weddings and college graduations. As a valued member of our claims team, you'll help our customers get back on their feet and restore their lives when catastrophe strikes. The details When you're part of the Claims Specialist Program, you'll acquire various investigative techniques and work with experts to determine what caused an accident and who is at fault. You'll independently manage an inventory of claims, which may include conducting investigations, reviewing medical records, and evaluating damages to determine the severity of each case. You'll resolve cases by working with individuals or attorneys to settle on the value of each case. You will have required comprehensive training, one-on-one mentoring, and a strong pay-for-performance compensation structure at a global Fortune 100 company. Make a difference in the world with Liberty Mutual. Qualifications What you've got You have 0-2 years of professional experience. A strong academic record with a cumulative 3.0 GPA preferred You have an aptitude for providing information in a clear, concise manner with an appropriate level of detail, empathy, and professionalism. You possess strong negotiation and analytical skills. You are detail-oriented and thrive in a fast-paced work environment. You must have permanent work authorization in the United States. What we offer Competitive compensation package Pension and 401(k) savings plans Comprehensive health and wellness plans Dental, Vision, and Disability insurance Flexible work arrangements Individualized career mobility and development plans Tuition reimbursement Employee Resource Groups Paid leave; maternity and paternity leaves Commuter benefits, employee discounts, and more Learn more about benefits at ************************** A little about us As one of the leading property and casualty insurers in the country, Liberty Mutual is helping people embrace today and confidently pursue tomorrow. We were recognized as a ‘2018 Great Place to Work' by Great Place to Work US, and were named by Forbes as one of the best employers in the country for new graduates and women-as well as for diversity. Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information, or on any basis prohibited by federal, state, or local law. We can recommend jobs specifically for you! Click here to get started.
    $31k-54k yearly est. Auto-Apply 1d ago
  • Claims Specialist

    Capsigna

    Claim processor job in Charlotte, NC

    Responsibilities: Processing fast paced inbound customer service calls. Taking inbound calls from clients Providers, Consumers and Insurance companies regarding medical billing. Resubmitting claims, and answering questions regarding benefits Demonstrates excellent customer service skills with the ability to take ownership in assisting, researching and resolving customer issues. Performs other duties as assigned. Requirements Previous Call Center or Customer Service experience preferred. Ability to develop rapport and demonstrate a caring attitude. Clear, distinct oral and written communication skills. Must be detail oriented.
    $30k-54k yearly est. 60d+ ago
  • Claims Specialist

    PRG 4.4company rating

    Claim processor job in Charlotte, NC

    Project Resources Group (PRG) is seeking a Claims Recovery Specialist for our Charlotte, NC office. Be part of our expanding team focused on recovering third-party property and utility damage claims, primarily in a B2B setting. We're looking for motivated, detail-oriented professionals with strong negotiation skills. Experience in collections or insurance adjusting is highly relevant and transferable. We offer a competitive base salary plus commission. Key Responsibilities Resolve and negotiate claims recovery of repair and replacement costs on third-party cable/fiber and utility damages across multiple state lines, via phone, email, and letters. Work directly with liable parties' insurance providers to defend and negotiate claims settlements. Collaborate with claims departments and management of liable parties, from small businesses to large corporations to municipalities. Learn, understand, and be able to utilize state dig laws and statutes, 811 excavator requirements, NESC standards, CGA guidelines, etc. Develop a professional working relationship with damaging parties, on-site field investigators, management, and other personnel. Conduct 40-50 inbound/outbound calls daily, approximately 2-2.5 hours of total talk time throughout the day. Enter notes and documentation throughout the recovery process into the company's proprietary Claims Database Tool. Use a calendar and diary system to coordinate handling claims to be worked twice weekly. Follow advanced claim handling procedures as detailed by the OPD Claims Manager. Use photographs, narratives, job costs, site sketches, locate tickets, and other components on-site field investigators provide to visualize and understand the damage scene to defend liability accurately. Participate in weekly department meetings to discuss individual and team recovery tactics, strategies, and goals. Maintain a working knowledge of the entire PRG claims recovery process. Preferred Qualifications Strong proficiency in Microsoft Word, Outlook, and Excel. Tech-savvy with the ability to quickly adapt to new software and systems. Excellent written and verbal communication skills, with an emphasis on professional phone and email correspondence. Familiarity with the construction, cable, or utility locate industries is advantageous. Understanding of B2B construction, claims management, recovery, or insurance claim negotiation and settlement processes is preferred. Ideally, 3-5 years of experience in claims, recovery, and/or the insurance industry. College education is preferred. Bilingual in Spanish is a plus. Compensation and BenefitsWe offer a competitive hourly pay ($19-$23/hour based on experience), plus the potential to earn substantial commissions up to $4,000-$10,000 monthly based on performance. Along with a comprehensive benefits package, including: Medical, dental, and vision coverage for employees and dependents 401(k) retirement plan, with company match after 1 year Short-term disability coverage after 1 year Paid time off and holidays Additional perks such as company-paid life insurance, and other supplemental insurances available About PRG Since 2001, PRG has been a leader in construction management and outside plant damage recovery for the telecommunications and utility industries. With 20+ offices and 800+ employees nationwide, we deliver industry-leading solutions with speed, accuracy, and expertise. Equal Opportunity EmployerPRG is proud to be an Equal Opportunity Employer. PRG does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, pregnancy-related conditions, and lactation), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, or any other characteristic protected by applicable federal, state, or local law and ordinances.#INDCS
    $19-23 hourly Auto-Apply 60d+ ago
  • Claims Specialist

    Conflux Systems, Inc.

    Claim processor job in Georgia

    Here are the job details for your review: Job Title: Claims Specialist Pay Rate: $22/hr on W2, Duration: 12 Months Job Location: REMOTE Notes: Position is 100% remote, 40 hours/week. Seeking candidates who have proficient SAP and excel knowledge/skills Job Description: • Supervise the transportation claims inbox and work with the vendors, customers and internal partners to ensure that KC is recovering the appropriate funds o Assist with end-to-end task completion • Maintain daily contact with key client contacts and perform data entry / order processing within specified system. • Document and report on status of pending inquiries regarding account problems, plus some outgoing phone calls. • Intermediate position that requires a Bachelors degree or 8+ years of equivalent experience. • Work with freight payment team to ensure any disputes with transportation carriers are solved timely • Communication with carriers to ensure that there are no gaps in information required • End to end management of freight claims inclusive of assisting KC in creating a new procedure in how to file claims • Assistance to returns and refusals inbox which will require associate to coordinate with carriers, distribution facilities and customer service to determine if loads need to be cancelled, re-scheduled or re-worked
    $22 hourly 60d+ ago
  • Claims Processing Expert

    The Strickland Group 3.7company rating

    Claim processor job in Raleigh, NC

    Join Our Dynamic Insurance Team - Unlock Your Potential! Are you ready to take control of your future and build a career in one of the most stable and lucrative industries? We are seeking driven individuals to join our thriving insurance team, where you'll receive top-tier training, support, and unlimited income potential. NOW HIRING: ✅ Licensed Life & Health Agents ✅ Unlicensed Individuals (We'll guide you through the licensing process!) We're looking for our next leaders-those who want to build a career or an impactful part-time income stream. Is This You? ✔ Willing to work hard and commit for long-term success? ✔ Ready to invest in yourself and your business? ✔ Self-motivated and disciplined, even when no one is watching? ✔ Coachable and eager to learn? ✔ Interested in a business that is both recession- and pandemic-proof? If you answered YES to any of these, keep reading! Why Choose Us? 💼 Work from anywhere - full-time or part-time, set your own schedule. 💰 Uncapped earning potential - Part-time: $40,000 - $60,000 /month | Full-time: $70,000 - $150,000+++/month. 📈 No cold calling - You'll only assist individuals who have already requested help. ❌ No sales quotas, no pressure, no pushy tactics. 🧑 🏫 World-class training & mentorship - Learn directly from top agents. 🎯 Daily pay from the insurance carriers you work with. 🎁 Bonuses & incentives - Earn commissions starting at 80% (most carriers) + salary 🏆 Ownership opportunities - Build your own agency (if desired). 🏥 Health insurance available for qualified agents. 🚀 This is your chance to take back control, build a rewarding career, and create real financial freedom. 👉 Apply today and start your journey in financial services! ( Results may vary. Your success depends on effort, skill, and commitment to training and sales systems. )
    $27k-34k yearly est. Auto-Apply 37d ago

Learn more about claim processor jobs

How much does a claim processor earn in Forest Acres, SC?

The average claim processor in Forest Acres, SC earns between $19,000 and $48,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Forest Acres, SC

$31,000

What are the biggest employers of Claim Processors in Forest Acres, SC?

The biggest employers of Claim Processors in Forest Acres, SC are:
  1. Sedgwick LLP
  2. Palmetto GBA
  3. PGBA
  4. Imagenetllc
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