Claims Examiner
Claim processor job in Philadelphia, PA
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibilityâ„ .
Position Summary
The Claims Division is seeking a team member to join the Shared Services Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of commercial first and third party low complexity claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence.
Responsibilities:
Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level
Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution
Review and analyze supporting damage documentation
Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions
Establish appropriate loss and expense reserves with documented rationale
Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines
Experience & Qualifications
Hands-on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint, and Word
Knowledge of ImageRight preferred
Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions
Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines
Ability to work well independently and in a team environment
Texas Claim Adjuster license preferred, but not required for posting. Upon employment candidate would be required to obtain Texas Claim Adjuster license within six months of hire date.
Education
Bachelor's degree preferred
3-5 years' experience handling the process of commercial insurance claims
#LI-SW1
#LI-HYBRID
For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.
$71,900 - $97,110/year
Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.
Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
14400 Arch Insurance Group Inc.
Auto-ApplyLTD Claims Examiner II
Claim processor job in Unity, PA
Job Responsibilities and Requirements Obtains and analyzes information to make claim decisions and payments on LTD, Voluntary disability and Waiver of Premium claims. The goal of the position/role is to consistently render appropriate claim determinations based on a review of all available information and the terms and provisions of the applicable policy.
* Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim.
* Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards based on product line.
* Utilizes appropriate medical and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner.
* Conducts in-depth pre-existing condition or contestable investigations if applicable.
* Calculates benefit payments, which may include partial disability benefits, integration with other income sources, survivor benefits, residual disability benefits, etc.
* Develops and maintains on-line claim data (and paper file if applicable).
* Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands.
Analysis and Adjudication
* Fully investigates and adjudicates a large volume simple to complex claims.
* Identifies and investigates change in Total Disability definition (any occ).
* Independently reviews and manage claims with high degree of complexity within the $1,500 per month approval authority limit.
* Independently makes the determination if a policyholder with life policy up to $125,000 is eligible for a waiver of premium.
* Majority of work is not subject to supervisor review and approval.
Case Management
* Consistently manage assigned case load of 60-80 simple to complex cases independently.
* Collaborates with team members and management in identifying and implementing improvement opportunities.
REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR RELATED EXPERIENCE
* or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience*
Required Knowledge, Skills, Abilities and/or Related Experience
* High School Diploma or GED. Associates degree in Business, Finance, Social Work, or Human Resources preferred. Level I LOMA designation preferred.
* 2 years experience processing long term disability claims.
* Demonstrated understanding of claim management techniques and critical thinking in activities requiring analysis and/or investigation.
* Experience working in confidential/protected identification environments.
* Knowledge of medical terminology.
* Good math and calculation skills.
* Proven ability to work well in a high-visibility, public-oriented environment.
Ability to Travel: None
PHYSICAL REQUIREMENTS
When used in the description below, the following terms are defined as:
"Occasional": done only from time to time, but necessary when it is performed
"Frequent": regularly performed; generally an act that is required on a daily basis
"Continuous": typically performed for the majority of an employee's shift
Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objecting and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones. Reliance Matrix will provide qualified employees with a reasonable accommodation in accordance with applicable law.
CORE VALUES
* Collaboration
* Compassion
* Empowerment
* Integrity
* Fun
The above description reflects the general details considered necessary to describe the principle responsibilities and functions of the job identified and shall not be construed as a detailed description of all the work requirements that may be inherent to this job.
The expected hiring range for this position is $50,920.00 - $68,750.00 annually. This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future.
Work location may be flexible if approved by the Company.
What We Offer
At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you.
That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.
Our Benefits:
* An annual performance bonus for all team members
* Generous 401(k) company match that is immediately vested
* A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
* Multiple options for dental and vision coverage
* Company provided Life & Disability Insurance to ensure financial protection when you need it most
* Family friendly benefits including Paid Parental Leave & Adoption Assistance
* Hybrid work arrangements for eligible roles
* Tuition Reimbursement and Continuing Professional Education
* Paid Time Off - new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service.
* Volunteer days, community partnerships, and Employee Assistance Program
* Ability to connect with colleagues around the country through our Employee Resource Group program
Our Values:
* Integrity
* Empowerment
* Compassion
* Collaboration
* Fun
EEO Statement
Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.
#LI-Remote #LI-MR1
Auto-ApplyClaim Representative - Bodily Injury
Claim processor job in Marietta, PA
Donegal Insurance Group is an insurance holding company whose insurance subsidiaries offer personal and commercial property & casualty lines of insurance. Headquartered in Lancaster County, Pennsylvania, along with four (4) regional offices located in: Athens, GA, Grand Rapids, MI, Albuquerque, NM, and Glen Allen, VA, our steady growth and successes have allowed us to establish a culture of which we're proud. Check out our Glassdoor profile where our rating speaks for itself.
At Donegal, our values are founded on supporting the independent agency system, providing best-in-class service, and building relationships customers can trust. By joining the Donegal family, you would be joining a team of dedicated, hard-working employees, all with a common goal of providing peace of mind to our policyholders and being there when it matters most.
Job Summary
Donegal Insurance Group has an opening for a Claim Representative on our Casualty Claims team handling Bodily Injury Claims. As a member of our Claims team, this position is responsible for the handling casualty claims in compliance with established company standards and guidelines. Ideal candidate will possess strong interpersonal and analytical skills with a strong technical knowledge of claim handling procedures.
Responsibilities and Duties
* Investigate, evaluate, and settle claims as assigned by the Supervisor
* Monitor and direct file handling being performed by Independent Adjusters, Appraisers, and Defense Counsel
* Report all pertinent information to the Underwriting Department
* Experience handling claims in litigation required
* Experience handling claims in Ohio, Indiana, and Michigan preferred
Qualifications and Skills
* Minimum of 3 - 5 years of claims handling experience
* Bachelor's Degree preferred
* Ability to learn industry specific software applications applicable to performance of position responsibilities
* Attention to detail
* Strong organizational skills
* Ability to communicate effectively in written correspondence and strong verbal skills
* Strong problem solving and decision-making skills
* Ability to meet deadlines
* Ability to manage time effectively and work independently
* Ability to relay coverage denials and liability denials
Starting Pay: The pay range for this position is $75,000 to $95,000 annually. The specific offer will vary based on an applicant's education, qualifications, professional experience, skills, abilities, and any applicable designations/certifications. The posted pay range reflects our ability to hire at different position titles and levels depending on background and experience. The pay range may also be adjusted based on an applicant's geographic location.
The base pay is just one component of Donegal's total compensation package for employees. This role may also be eligible to participate in a discretionary annual incentive program. The amount of any bonus varies and is subject to the terms and conditions of the applicable incentive plan.
Ongoing applications are being accepted.
To apply, please submit your resume and online application
Competitive Benefits Package
Donegal Insurance Group offers a comprehensive benefits package for all full-time, permanent positions including:
* Medical, Dental, and Vision Coverage: Available to you and your dependents. Coverage begins the first of the month after start date.
* 401(k) with the first 3% matched at 100%: the next 6% is matched at 50%
* Paid Time Off: Paid vacation, sick days, paid holidays, & bereavement days
* Career Development: Including college partnership discounts and industry designation(s) reimbursements
Additional benefits include company-paid basic life insurance; short & long-term disability insurance; employee stock purchase plan; and employee assistance program (EAP). Learn more about our full benefit offerings by visiting our Benefits page.
Who We Are
Donegal Insurance Group provides commercial and personal insurance products through a network of independent agents in 21 states and across several regions of the U.S. In Texas, Colorado, Utah, New Mexico and Arizona, business is conducted under the Mountain States Insurance Group name; and in Michigan, business is conducted under the Michigan Insurance name.
Headquartered in Lancaster County, Pennsylvania, along with four (4) regional offices located in: Athens, GA, Grand Rapids, MI, Albuquerque, NM, and Glen Allen, VA, our steady growth and successes have allowed us to establish a culture of which we're proud. Check out our Glassdoor profile where our rating speaks for itself:
By joining the Donegal family, you would be joining a team of dedicated, hard-working employees, all with a common goal of providing peace of mind to our policyholders and being There when it matters most..
Work Arrangement
With each department and position being different, the work arrangement for a specific position will be reviewed with candidates during a initial phone screening. For a position not requiring an onsite expectation at one of our offices, the ideal candidate must live within our Donegal footprint. Current approved states are: AL, AZ, CT, DE, FL, GA, IA, IL, IN, MD, MI, MN, MO, NC, ND, NE, NH, NJ, NM, NY, OH, PA, SC, SD, TN, TX, UT, VA, WI, and, WV. (Please note, this list is subject to change without notice.)
E-Verify
Donegal Insurance Group participates in E-Verify in the following states: Alabama, Arizona, Florida, Georgia, Louisiana, Mississippi, Nebraska, North Carolina, South Carolina, Tennessee, and Utah. If you reside in one of the listed states, please review the "Notice of E-Verify Participation" and the "Right to Work Poster" on the links below:
* Notice of E-Verify Participation Poster (English and Spanish)
* Right to Work Poster (English and Spanish)
Multiline Auto Claims Examiner
Claim processor job in Ephrata, PA
Job DescriptionOur client is seeking a skilled Multiline Auto Claims Examiner to join their team. This key role focuses on investigating and resolving moderate to complex auto liability and bodily injury claims, ensuring fair and efficient outcomes while maintaining compliance with all regulatory standards. The ideal candidate will have a strong background in casualty claims, particularly auto liability, and will demonstrate excellent judgment in evaluating exposures and negotiating settlements.Key Responsibilities:
Investigate and evaluate Auto Liability and Bodily Injury claims to determine coverage, liability, and damages.
Manage claims through all stages, including litigation, negotiation, and settlement.
Review and analyze medical records, accident reports, and legal documentation to accurately assess claims.
Collaborate with defense counsel and other experts to ensure cost-effective and timely resolutions.
Provide clear communication and updates to policyholders, claimants, and brokers.
Maintain accurate claim documentation in the claims management system.
Ensure all claim handling complies with regulatory requirements and internal company guidelines.
Requirements:
3 - 8+ years of experience handling Commercial or Personal Auto Liability and Bodily Injury claims, preferably with an insurance carrier.
Active adjuster license strongly preferred.
Strong negotiation and litigation management skills with a proven ability to drive equitable settlements.
Solid analytical, organizational, and problem-solving skills.
Proficiency with claims management software and Microsoft Office Suite.
Bachelor's degree preferred.
Salary & Benefits:
$70,000 to $90,000+ annual base salary (depending on experience) plus bonus potential
Generous PTO and paid holidays
Competitive 401k with employer matching contributions
Comprehensive health, dental, and vision coverage
Professional growth opportunities within a supportive team environment
Catastrophe Data & Claims Analyst
Claim processor job in York, PA
Who We Are
For over 70 years, Glatfelter Insurance Group has believed in doing the right thing for our clients, agents, communities and associates. This founding principle has enabled Glatfelter to grow from the kitchen-table, one-man-operation as it began, to one of the largest managing general agencies in the U.S. with nearly 500 associates across the country, a distribution network of over 4,500 independent brokers and more than 30,000 clients. It is what drives us to innovate-the desire to deliver the best for our clients. Founded as The Glatfelter Agency, which is still in operation, the program basis of Glatfelter Insurance Group, Volunteer Firemen's Insurance Services (VFIS), was founded in 1969. Throughout the years, Glatfelter has expanded to include specialized program business inclusive of public entities, educational institutions, healthcare facilities, and religious organizations. Glatfelter provides their insureds with comprehensive insurance solutions including property, casualty, life insurance, and more. In 2018, Glatfelter joined American International Group (AIG) and is now part of the AIG family.
About the Position
This new role is central to Glatfelter's expansion of analytics capabilities, primarily in support of catastrophe management and claims predictions. The Analyst will work closely with Executive Leadership, Actuarial, Claims, and Underwriting in developing new tools to monitor and, ultimately, optimize the property portfolio's footprint relative to key catastrophe metrics (e.g. AAL, PML). In addition, they will create new claims reporting capabilities that will lead to better predictability of claims outcomes through incorporation of data mining/scraping and modeling. This position is required to be onsite at our York, PA or Berwyn, PA office.
Key Responsibilities
Monitoring and steering of CAT exposure through creation of accumulation tools, including mapping/visualizations.
Support individual deal evaluations through modeling and validation of US natural catastrophe (CAT) exposures/AAL
Training and support of the local AIG Programs & Glatfelter underwriting and actuarial teams on the fundamentals of CAT modeling, exposure monitoring, and CAT management
Contribute to portfolio management for AIG Programs & Glatfelter by devising a cost framework for optimizing AAL allocations
Validate analysis and resulting reinsurance cost allocations to AIG Programs & Glatfelter
Support post-CAT event impact analysis and provide timely exposure assessments Claims Analytics
Creation and refinement of key claims indicators that bring greater transparency and predictability to loss frequency and severity forecasts. Using various techniques (e.g. text mining, data scraping), build models that predict complex claims and large loss propensity.
Monitoring of critical coverage and high profile risks, such as abuse, PFAS, and excess liability
Investigate claims patterns and work with Actuarial to update loss development factors for use in pricing and reserving work
Work with IT to capture new metrics that contribute to claims predictability
Optimize claims resources through predictive measures by lines of business
What We're Looking For
Bachelor's degree in Mathematics, Economics, Business Administration, Computer Science, or related field.
Minimum of five (5) years of property and casualty commercial lines' experience in Analytics, Actuarial, Claims, and/or IT.
Excellent analytical skills and work with P&C insurance reporting and monitoring tools. Experience in building tools that support insurance functions (e.g. UW, Claims) is required.
Working knowledge of core P&C lines of business, as well as A&H
Working knowledge of Catastrophe modeling concepts (e.g. AAL, PML, accumulation) and industry models (e.g. RMS, AIR)
Strong organizational and communication skills.
Ability to make decisions within scope of authority.
Demonstrated advanced proficiency with Microsoft Excel & Power BI (or equivalent) products. Programming knowledge, such as SQL or Python, is preferred.
Why Choose Glatfelter?
Glatfelter is honored to have been named a Best Place to Work in PA since 2005. We are proud to offer a range of employee benefits and resources that help you protect what matters most - your health care, savings, financial protection and wellbeing. In addition to 17 paid holidays, (which includes a personal holiday and mental health and wellness day) we provide a variety of leaves for personal, health, family, and volunteer needs.
We believe in fostering our associates' development and offer a range of learning opportunities for associates to hone their professional skills to position themselves for the next steps of their careers. We have a tuition reimbursement program for eligible associates to enhance their education, skills, and knowledge in areas that relate to their current position or future positions to which they may transfer or progress.
Equal Opportunity Employer
It has been and will continue to be the policy of Glatfelter Insurance Group to be an Equal Opportunity Employer. We provide equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories. At Glatfelter, we believe that diversity and inclusion are critical to our future and our mission - creating a foundation for a creative workplace that leads to innovation, growth, and profitability. Glatfelter is committed to working with and providing reasonable accommodations to job applicants and employees with physical or mental disabilities. If you believe you need a reasonable accommodation in order to search for a job opening or to complete any part of the application or hiring process, please contact Human Resources. Reasonable accommodations will be determined on a case-by-case basis.
Job Grade: 9
Auto-ApplyClaims Specialist - Auto
Claim processor job in Harrisburg, PA
Marketing Statement:
Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.
We are looking for a Claims Specialist - Auto to join our team.
JOB SUMMARY
Investigate, evaluate and settle more complex first and third party commercial insurance auto claims.
JOB RESPONSIBILITIES
Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner.
Communicates with all relevant parties and documents communication as well as results of investigation.
Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts.
Travel is required to attend customer service calls, mediations, and other legal proceedings.
JOB REQUIREMENTS
High School Diploma; Bachelor's degree from a four-year college or university preferred.
10 plus years related experience and/or training; or equivalent combination of education and experience.
• National Range : $82,800.00 - $97,300.00
• Ultimate salary offered will be based on factors such as applicant experience and geographic location.
EEO Statement:
Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.
Benefits:
We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.
Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
Auto-ApplyClaims Representative II - Trainee
Claim processor job in Harrisburg, PA
The Claims Representative II Trainee is a closely supervised, entry-level position in which the incumbent obtains knowledge and an understanding of claims handling through both a formal and on-the-job training program. Upon the successful completion of the program, the Claims Representative II Trainee is a candidate for promotion to the Claims Representative II position.
The ideal candidate will reside in the Harrisburg, PA region.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Team Building
Demonstrates honesty; keeps commitments made to others; behaves in a consistent manner; keeps sensitive information confidential; adheres to moral, ethical, and professional standards, regulations, and organizational policies.
Listens to others and objectively considers their ideas and opinions, even when they conflict with own.
Attention to Details
As training progresses, perform basic claims handling duties on non-complex claims, under the supervision of the Team Leader, to include:
accurate preparation of claim file documentation
verification of coverages
setting/adjusting reserves
making appropriate contacts
identifying subrogation and salvage opportunities
achieving best practices type settlements in the disposition of claims
Issue payments within authority to appropriate parties
Quality Orientation
Accurately and carefully follows established procedures for completing work tasks.
Positive Approach
Looks for and communicates the positive qualities and longer-term benefits of challenging situations (while facing the real problems).
Applied Learning
Successfully complete prescribed professional education courses (IIA, AIC, etc.).
Complete and apply knowledge and skills developed during formal classroom and/or on-the-job training sessions, as set forth in defined training schedule.
Performs other duties as may be assigned by the Team Leader.
SPECIAL RELATIONSHIPS
The Claims Representative II Trainee reports to the Claims Manager.
The Claims Representative II Trainee has direct contact and interaction with all levels of personnel within the Claims Service Office.
As training progresses, will have direct contact with policyholders, claimants, medical and legal professionals and vendors.
QUALIFICATIONS
Education/Credentials
0-2 years of experience in a customer service oriented position
Technical/ Professional Knowledge
Effective communication skills, both oral and written
Effective inter-personal skills
Personal Computer skills, with an emphasis on Microsoft products
Ability to work within a team-oriented, fast-paced, customer-focused environment
JOB REQUIREMENTS (as required by ADA - Americans with Disabilities Act)
This position is primarily a sedentary position that requires occasional standing and walking throughout the office environment.
Must be able to see and effectively use a computer monitor.
Must be able to operate a computer, keyboard and applicable printers and other general office equipment.
Must be able to access and enter information accurately using automated systems.
Must be able to hear and communicate via the telephone and/or monitoring devices to both internal and external clients.
Must be able to present information to individuals and groups.
Must be able to interpret and apply concepts that may or may not be based upon established guidelines.
Must be able to maintain acceptable attendance and adhere to scheduled work hours.
Must have a valid driver's license and be able to operate a motor vehicle.
Auto-ApplyAuto Claim Rep 1
Claim processor job in Wyomissing, PA
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$55,200.00 - $91,100.00
**Target Openings**
5
**What Is the Opportunity?**
*There is also a potential for up to a $10,000 sign-on bonus! *
Be the Hero in Someone's Story
When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most.
As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner.
In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process.
Travelers offers a hybrid work location model that is designed to support flexibility.
**What Will You Do?**
Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations.
Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates.
Determine claim eligibility, coverage, liability, and settlement amounts.
Ensure accurate and complete documentation of claim files and transactions.
Identify and escalate potential fraud or complex claims for further investigation.
Coordinate with internal teams such as investigators, legal, and customer service, as needed.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree.
+ Three years of experience in insurance claims, preferably Auto claims.
+ Experience with claims management and software systems.
+ Strong understanding of insurance principles, terminology with the ability to understand and articulate policies.
+ Strong analytical and problem-solving skills.
+ Proven ability to handle complex claims and negotiate settlements.
+ Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants.
**What is a Must Have?**
+ High School Diploma or GED.
+ One year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Claims Specialist
Claim processor job in Pittsburgh, PA
Job Description
Details
Job Title: Claims Specialist
Department: Commercial Lines
Division: Risk Control/Claims
Reports To: Claims Supervisor
Contract: No
FLSA status: Exempt
Position Description
The Claims Specialist will provide heroic claims service by assisting with the management of all claims from the initial report of the claim to the closing to ensure the best outcome for all our customers.
Primary Responsibilities & Duties
Support and manage claim process for clients who are/and are not on a Client Service Plan. This includes initial claim reporting, carrier correspondence, data collection, and internal documentation.
Manage daily client correspondences in regard to claims and claim updates.
Manage data entry in agency management system.
Aid clients through property damage restoration process.
All other duties as assigned.
Position-specific Competencies
Effective Communication: Can clearly articulate oneself in a professional manner with the ability to read the audience and adapt. Possesses the intuition on what information to communicate, feedback to provide, and the right manner of delivery. Practices active listening with patience and can restate opinions accurately, as needed.
Attention to Detail: Ability to achieve thoroughness and accuracy when accomplishing a task. Strong ability to focus and provide thorough attention.
Relationship Management: Possesses the ability to create and maintain strong relationship with business owners and contacts.
Decision Quality: Consistently makes good decisions. Through analysis, wisdom, experience, and judgement can accurately act in the best interest of colleagues and clients.
HBI Competencies
Integrity: Conducts business with the utmost moral decency. A trusted advisor who displays the highest standard of ethics.
Heroic Service: White glove approach to client service and satisfaction. Can anticipate needs, and consistently exceeds expectations.
Teamwork: Works well with others towards a shared goal. Actively participates, shares responsibilities and rewards, and contributes to the effectiveness of the group.
Kindness: Shows concern and consideration for others. Is generous with time, talent, and overall possess a willingness to help.
Qualifications
Bachelor's degree or insurance designation preferred
1-3 years of claims experience required
CIA, ARM, CLA, etc. preferred but not required
*if you are not licensed, you will be required to obtain licensure within first 90 days of hire*
An insurance background or understanding of different types of insurance coverage is beneficial, but not required
Strong verbal communication and listening skills
Proficient in Microsoft Office products such as Word, PowerPoint, and Excel
Proficient virtual communication skills-preferably Zoom
Work Environment
This position requires travel capabilities. A valid driver's license is necessary to provide self-transportation to client meetings, events, and seminars. Local travel up to 50%.
While performing the responsibilities of the job, these work environment characteristics are representative of the environment the job holder will encounter. Reasonable accommodations may be made to enable people with disabilities to perform the essential functions of the job.
EEO Statement
Henderson Brothers supports workplace diversity and does not discriminate on the basis of race, color, religion, gender identity or expression, national origin, age, military service eligibility, veteran status, sexual orientation, marital status, physical or mental disability, or any other protected class.
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Workers' Compensation Claim Representative I - Eastern Alliance
Claim processor job in Lancaster, PA
An exciting opportunity exists to join the ProAssurance family of companies! Our mission is powerful and simple: We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance?At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, leadership, relationships, and enthusiasm-and want to build their career with a great company where they can be their authentic self and feel valued, recognized, and rewarded for their contributions. ProAssurance specializes in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. We are an industry-leading specialty insurer, with job opportunities in much of the contiguous United States.This position supports our workers' compensation line of business, Eastern Alliance, and is based in Lancaster PA. This role is hybrid, reporting to the Lancaster PA office approximately two days per month.
The primary responsibility of this position is to consistently execute the Company's ecovery Return to Wellness philosophy and business model that leads to better outcomes for our injured workers and insureds. Responsibilities of this position include managing all aspects of assigned claims, including verifying coverage, investigating, managing, and resolving non-complex workers' compensation claims (medical only and lost time) for the Company's customers under direct supervision, following established Company requirements and procedures, and promptly establishing and maintaining accurate reserves with an authority limit of up to $25,000 all in support of the Company's revenue and profitability objectives and overall business plan.
What you'll do:
45% - Complete ongoing claim management activities proactively and with a sense of urgency in accordance with the ecovery Return to Wellness philosophy to execute the established plan of action and achieve favorable outcomes for all parties. Maintain, cultivate, and develop high quality, collaborative working relationships with all parties, including injured workers, agents, customers, and co-workers. Maintain regular contact by telephone and correspondence with all parties. Seek complete information necessary to manage claims and achieve favorable outcomes. Respond to inquiries in a timely, courteous, and professional manner.
30% - Promptly investigate all assigned claims to establish trust and rapport with all parties, accurately assess coverage, determine the nature and extent of the injuries sustained, and reinforce Return to Wellness expectations. Make fair and timely determinations of compensability. Demonstrate empathy, professionalism, integrity, and objectivity at all times. Prepare reports and forms as required by jurisdictional regulations and by the Company's established procedures. Promptly establish and maintain case reserves that accurately reflect the anticipated financial exposure on each claim; revise reserves promptly based on changes in facts and circumstances. Identify subrogation potential.
15% - Manage Return to Wellness initiatives by working collaboratively with agents, clients, risk managers and underwriters to ensure proper return to work guidelines and procedures are established, followed and achieved.
5% - Attend business unit, department and company meetings.
5% - Assist with Company projects as assigned and continue professional growth and development through the attendance and participation in insurance related events/functions, seminars, classes and conferences.
What we're looking for:
Bachelor's degree is preferred; a HS Diploma/GED with a minimum eight years of experience working in a medical, legal or insurance environment can replace the bachelor's degree requirement.
Basic knowledge of medical terminology, common medical procedures and treatments is preferred.
Some knowledge of applicable state laws and industry standards is preferred.
Proficiency in Microsoft Office computer applications, including Word and Excel, and ability to learn new computer software applications.
Attention to detail in processing all information, establishing priorities and meeting deadlines.
Ability to handle multiple priorities simultaneously.
Excellent organization and time management skills.
Excellent analytical and problem-solving skills, including analyzing and interpreting large amounts of information and formulating logical, objective conclusions based upon the facts.
Ability to assess the urgency and importance of a situation and take appropriate action.
Empathic listener with the ability to listen and respond to another person in a way that engenders mutual understanding and trust.
Ability to communicate effectively and professionally both verbally and in writing with various constituencies and at all levels, both in and outside of the organization, including agency partners, customers, injured workers and providers.
Ability to maintain confidential information.
Ability to operate standard office equipment including, but not limited to copiers, printers, etc.
Ability to attend insurance and industry/business functions to promote and present a positive image of the Company.
#LI-Hybrid
We are committed to providing a dynamic and inclusive environment where everyone can do their best work and grow personally and professionally.
For that reason, we partner with The Predictive Index (PI) - an organization equally committed to improving the working lives of people, to help us hire the best talent by providing additional insight about one's work style.
The position you applied to requires completion of two assessments prior to being scheduled to interview with a hiring manager.
A Talent Acquisition team member may review your application and contact you before the assessment is complete.
These assessments are Behavioral and Cognitive (internal candidates will only receive the Behavioral assessment), and each assessment takes less than 12 minutes to complete.
After submitting your application, you will receive two emails from The Predictive Index inviting you to complete each of these assessments (please check your SPAM or Junk email folder if you do not see these emails in your inbox).
Position Salary Range
$49,087.00 - $81,002.00
The salary range displayed represents the entirety of the pay grade for this position. Most candidates will start in the bottom half of the range. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have, your location and comparison to other team members already in this role.
Build your career with us and enjoy access to a best-in-class benefits program.
Auto-ApplyTechnical Claim/Litigation Manager-Auto Bodily Injury/Personal Liability Umbrella
Claim processor job in Pennsylvania
About Us We're not like other insurance companies. From our specialty products to our business model, our culture to our results - we're different. Different is who we are, and how we work, interact, deliver and succeed together. Creating a different and better insurance experience doesn't just happen. It takes focus and a shared passion for going beyond the expected to forge relationships and deliver care that makes a difference. This approach rises from and is supported by our talented, ethical and smart team of employee owners united around a single purpose: to work alongside our customers and partners when they need us, in unexpected ways, with exceptional results. Apply today to make a difference with us.
RLI is a Glassdoor Best Places to Work company with a strong, successful background. For decades, our financial track record has been stellar - a testament to our culture and validation of our reputation as an excellent underwriting company.
Principal Duties & Responsibilities
* Proactively handle Personal Umbrella Liability claims (auto, premises and personal liability) with a detailed focus on claim investigation, evaluation, and monitoring of primary carrier activity to achieve optimum results.
* Effectively investigate and analyze complex coverage issues and write coverage letters as appropriate.
* Complete timely and thorough investigations into liability and damages for early exposure recognition.
* Focus on claims resolution with timely and effective liability investigations and damage evaluations and reserve setting.
* Handle claims in accordance with RLI's Best Practices.
Education & Experience
* Typically requires a bachelor's degree and 6+ years of relevant legal or technical claims experience.
* Experience handling large exposure third-party liability claims on a primary/excess basis is preferable.
* Significant experience in effective handling of policy limit demands in states such as Florida, Texas and California.
* Must be able to excel in a fast-paced environment with little supervision.
* Effectively work with primary carriers and defense counsel and understand umbrella/excess handling and management of outside counsel.
* Ideal candidate will have superior working knowledge of Florida, California, New York and Texas case law, statutes and procedures impacting the handling and value of liability claims.
Knowledge, Skills, & Competencies
* Ability to use analytical methods in complex claim processes to find workable solutions.
* Ability to generate innovative solutions within the claims department.
* Ability to communicate findings and recommendations to internal and external contacts on claim matters.
Compensation Overview
The base salary range for the position is listed below. Please note that the base salary is only one component of our robust total rewards package at RLI. The salary offered will take into account a number of factors including, but not limited to, geographic location, experience, scope & responsibilities of the role, qualifications/credentials, talent availability & specialization, as well as business needs. The below range may be modified in the future.
Base Pay Range
$108,348.00 - $157,917.00
Total Rewards
At RLI, we're all owners. We hire the best and the brightest employees and allow them to share in the company's success through our Total Rewards. With the Employee Stock Ownership plan at its core, the Total Rewards program includes all compensation, benefits and perks that come with being an RLI employee.
Financial Incentives
* Annual bonus plans
* Employee stock ownership plan (ESOP)
* 401(k) - automatic 3% company contribution
* Annual 401k and ESOP profit-sharing contributions (Up to 15% of eligible earnings)
Work & Life
* Paid time off (PTO) and holidays
* Paid volunteer time off (VTO) to support our communities
* Parental and family care leave
* Flexible & hybrid work arrangements
* Fitness center discounts and free virtual fitness platform
* Employee assistance program
Health & Wellness
* Comprehensive medical, dental and vision benefits
* Flexible spending and health savings accounts
* 2x base salary for group life and AD&D insurance
* Voluntary life, critical illness, & accident insurance for purchase
* Short-term and long-term disability benefits
Personal & Professional Growth
RLI encourages its employees to pursue professional development work in insurance and job-related areas. We make a commitment to employees to provide educational opportunities that help them enhance their skills and further their career advancement. RLI fosters a true learning culture and encourages professional growth through insurance courses, in-house training and other educational programs. RLI covers the cost for most programs and employees typically earn a bonus upon successful completion of approved courses and certifications. Our personal and professional growth benefits include:
* Training & certification opportunities
* Tuition reimbursement
* Education bonuses
Diversity & Inclusion
Our goal is to attract, develop and retain the best employee talent from diverse backgrounds while promoting an environment where all viewpoints are valued and individuals feel respected, are treated fairly, and have an opportunity to excel in their chosen careers. We actively support, and participate in, initiatives led by the American Property Casualty Insurance Association that aim to increase diversity in the insurance industry. Cultivating an exceptional and diverse workforce to deliver excellent customer service reinforces our culture and is a key to achieving superior business results.
RLI is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, national origin, citizenship, gender, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by federal, state, or local law.
Auto-ApplyDamage Claims Specialist
Claim processor job in Allentown, PA
Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries.
Job Qualifications:
Bachelor's Degree (preferred); High School Diploma or equivalent (required)
Minimum of three (3) years experience in claims handling
Proficiency in Microsoft Office Suite, especially Word and Excel
Strong verbal and written communication skills
Excellent problem-solving and conflict-resolution abilities
High attention to detail and ability to work independently
Pay: Based on experience
This is a full-time, temporary role expected to last at least 6 months.
If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************
Easy ApplyDamage Claims Specialist
Claim processor job in Allentown, PA
Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries.
Job Qualifications:
Bachelor's Degree (preferred); High School Diploma or equivalent (required)
Minimum of three (3) years experience in claims handling
Proficiency in Microsoft Office Suite, especially Word and Excel
Strong verbal and written communication skills
Excellent problem-solving and conflict-resolution abilities
High attention to detail and ability to work independently
Pay: Based on experience
This is a full-time, temporary role expected to last at least 6 months.
If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************
Easy ApplyTrucking Claims Specialist
Claim processor job in Philadelphia, PA
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
* Competitive compensation
* Healthcare benefits package that begins on first day of employment
* 401K retirement plan with company match
* Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
* Up to 6 weeks of parental and bonding leave
* Hybrid work schedule (3 days in the office, 2 days from home)
* Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
* Tuition reimbursement after 6 months of employment
* Numerous opportunities for continued training and career advancement
* And much more!
Responsibilities
Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service.
Key Responsibilities
* Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures.
* Review and interpret policy language to determine coverage and consult with coverage counsel when needed.
* Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies.
* Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information.
* Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts.
* Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards.
* Participate in file reviews, team meetings, and ongoing training to support continuous learning.
Qualifications
* Minimum of 3 years of trucking industry experience.
* Experience with bodily injury and/or cargo exposures.
* Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices.
* Strong analytical and negotiation skills, with the ability to manage multiple priorities.
* Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism.
* Possession of applicable state adjuster licenses.
* Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.
Auto-ApplyLost Time Claims Specialist II
Claim processor job in Pittsburgh, PA
UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work remotely, Monday - Friday daylight hours. The selected candidate for this role will need to have their West Virginia workers comp adjuster license.
The UPMC WorkPartners Workers Compensation Lost Time Claims Specialist II reports to the Workers Compensation Claims Supervisor. The Lost Time Claims Specialist II is responsible for coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims for the WorkPartners Workers Compensation business unit. The Lost Time Claims Specialist II will apply litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The Lost Time Claims Specialist II will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority within established best practices and performance standards. The Lost Time Claims Specialist II should possess strategic thought process skills to effectively and efficiently manage loss exposures.
Responsibilities:
* Assign medical or other experts to case and arrange for medical examinations when necessary.
* Develop lost time claim disposition skills under limited direction of supervisor.
* Pro-actively manages the case resolution process. May participate in mediations within limit of settlement authority.
* Ensure proper referrals and timely updates to appropriate Reinsurer(s).
* Actively participate in claim reviews with clients.
* Timely analyze information in order to evaluate assigned claims to determine the extent of loss.
* Manage the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment under limited direction of supervisor.
* Communicate claim status with the injured worker, clients, and broker as needed.
* Effectively evaluate, negotiate and resolve claims within delegated authority utilizing the appropriate denials or releases.
* Establish appropriate reserves and review on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level.
* Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, clients, witnesses and others having pertinent information.
* Provide required reports to AVP, Claims, Underwriting, Reinsurance and Actuarial on significant exposure cases.
* Appropriate state licensing to be obtained for assigned jurisdictions.
* Effectively evaluate and resolve coverage issues for all Workers' Compensation claim types.
* Effectively and efficiently manage vendors and expenses.
* Participate in monthly account renewal meetings as needed.
* Mentoring and training new employees as appropriately assigned by management.
* Bachelors and/or advanced degree or a minimum of 3 years of Workers Compensation claims handling experience.
* Minimum of 2 years of Workers Compensation lost time claims handling experience.
* West Virginia insurance adjuster license is highly preferred.
* Experience with PA workers compensation is a bonus.
* Intermediate knowledge of law and insurance regulations in various jurisdictions.
* Demonstrated strong verbal and written communications skills.
* Demonstrated strong analytical and decision making skills.
* Intermediate knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, litigation management, and product line knowledge.
* Previous experience with the reserving and adjudication of the following: Workers' compensation lost time claims, Workers' compensation claim investigations (including subrogation) and compensability decisions.
Licensure, Certifications, and Clearances:
* Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
Ambulatory Care Capacity Analyst - Jefferson Medical Group - Center City
Claim processor job in Philadelphia, PA
Job Details
The Ambulatory Care Capacity Analyst provides strategic support for provider access initiatives across the Jefferson Medical Group (JMG). This role provides internal schedulers and patients a standard, comprehensive approach to appointment availability across the enterprise.
Job Description
Essential Functions:
Responsible for building, maintaining, and modifying centralized scheduling templates for all scheduling providers, including resource providers · Ensure all approved template changes follow change management procedures and protocols and align with Jefferson's template strategy guidelines
Provide impact analysis for master template changes
Report, review, and reschedule patient appointments as indicated by the Reschedule List
Collaborate with Ambulatory practice administrative and clinical leadership on template optimization through the use of Epic Cadence functionality and advise on best practices
Participate in department meetings that address patient access-related metrics
Identify potential access limiting factors and develop possible solutions for department collaboration
Monitor the effectiveness of access-related initiatives using data analysis via Qlik Reporting, Epic Reporting Workbench, and excel
Strategize operational and technical methodologies to enhance patient self-scheduling for both patients and the ambulatory practices
Present, demonstrate, and train internal staff on access and capacity strategies and initiatives
On-board providers on scheduling decision tree and open scheduling platforms
Rotate with peers for on-call schedule
Education and Experience:
High School Diploma Required; Bachelor's Degree preferred.
Epic Cadence or other Epic application certification - plus.
Minimum 2-3 years experience in an ambulatory care or IT setting preferred.
Prior scheduling template management experience preferred.
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Jefferson University Physicians
Primary Location Address
1101 Market, Philadelphia, Pennsylvania, United States of America
Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.
Jefferson is committed to providing equal educa tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.
For more benefits information, please click here
Auto-ApplyEmployment Practice Liability Claim Manager
Claim processor job in Philadelphia, PA
Job Description- National Insurance Carrier is looking for an experienced EPL Claims Manager that is currently managing a team. Prior experience in EPLI & professional liability claims is preferred but not mandatory. Will need a minimum of 5 to 7 years experience in EPL and or professional liability claims.
JD preferred with good interpersonal skills.
Call for additional details.
Senior Litigations Claims Examiner
Claim processor job in Philadelphia, PA
Pennsylvania Lumbermens Mutual Insurance Company
Senior Litigations Claims Examiner Department: Claims
Reports To: Litigations Claims Manager
The successful candidate for this position facilitates, coordinates and expedites the handling of all high-severity casualty claims and controls PLM's largest exposure cases in a prompt, fair and equitable manner.
Essential Functions and Responsibilities:
Establishes accurate reserves in timely fashion.
Determines verification and scope of coverage.
Assists other unit members with settlement evaluations.
Handles all complicated litigation and ensures trial preparation with attorneys.
Attends mediation and settlement conferences.
Analyzes insurance contracts.
Communicates with the public.
Maintains an appropriate diary date on files under direct supervision.
Ensures that a file is proceeding towards a prompt, fair and equitable claim settlement.
Directs responsibility for supervision of all subrogation and arbitration handling.
Requirements
Knowledge and Skills:
10 years experience in casualty claims.
Knowledge of MS Office.
Prior supervisory experience helpful.
Basic knowledge of various applicable state law systems.
Strong understanding of the litigation process.
Above average reading comprehension and math skills.
Ability to deal with a variety of personalities.
Ability to handle difficult situations, including upset policyholders in a courteous and professional manner.
Experience controlling expenses.
Proficient negotiation skills.
Strong oral and written communication skills.
Strong analytic skills and ability to pay close attention to detail.
Strong customer service skills.
Ongoing training through the Insurance Institute of America.
College degree preferred.
Physical Requirements:
Ability to hear
Ability to speak clearly
Ability to write
Claims Processing Specialist
Claim processor job in Tarentum, PA
Job Details Blackburn's Corporate - Tarentum, PA InsuranceDescription
Job Opening: Claims Processing Specialist at Blackburn's
Are you a detail-oriented professional with a passion for the healthcare industry? Blackburn's is looking for a Claims Processing Specialist to join our Corporate Claims department and perform third-party medical billing functions. If you thrive in a fast-paced environment and possess excellent organizational and communication skills, this could be the perfect opportunity for you!
What You'll Do:
Manage and verify third-party medical claims for accuracy and compliance.
Collaborate with cross-functional teams to resolve billing discrepancies and insurance denials.
Process claims efficiently while adhering to strict filing deadlines.
Contribute to the improvement of billing processes to reduce denials and increase efficiency.
Utilize your strong communication skills to work with internal teams and external clients.
Why Join Us? At Blackburn's, we're committed to creating a positive impact in the healthcare industry by delivering quality products and services. As part of our team, you'll have access to in-house training, opportunities for career growth, and a collaborative work environment. We offer competitive pay, benefits, and the chance to be part of a company that values its employees.
Work Hours: 8:00 a.m. - 4:30 p.m. or 8:30 a.m. - 5:00 p.m.
If you have a passion for medical billing and enjoy working in a dynamic, fast-paced environment, we'd love to hear from you!
Apply today and join us in making a difference at Blackburn's!
Qualifications
What We're Looking For:
Prior experience in healthcare-related industries, preferably with third-party medical billing.
Strong attention to detail, time management, and the ability to juggle multiple tasks.
Excellent interpersonal skills, with the ability to work both independently and as part of a team.
Proficiency in Microsoft Office, with knowledge of Word and Excel.
Ability to work independently, prioritize workload, and adapt to changing environments.
Certification Specialist - Walnut Park
Claim processor job in Philadelphia, PA
Job Description
CRM Residential has been a trusted name in the property management industry for over 46 years specializing in affordable housing. Our success story is a testament to the dedicated and talented individuals who have chosen to build their careers with us. We take great pride in our values, and we live and breathe them every day.
Working at CRM Residential is so much more than a job, it is a career with purpose. No matter what department or level of the company you join, our mission is to provide a comfortable and reliable home environment for those who need it most and to provide excellent service to our customers. You will make a difference.
Why Join the CRM Residential Team:
Comprehensive Health Coverage
Retirement Savings with employer contribution
Bonus Potential
Paid Time Off (PTO)
Company Paid Holidays
Once eligible for enrollment, the company will contribute a Safe Harbor match of 3% of your compensation to your 401(k) account, regardless of whether you choose to make your own contributions.
Pay Rate: $25.00 per hour
What You'll Get To Do:
The Recertification Specialist will receive general supervision and direction from the Community Manager. The Recertification Specialist will comply with established policies and authorized approval. Recertification Specialist responsibilities include, but are not limited to the following:
Resident selection and orientation in accordance with the Resident Selection Plan
Assist with the leasing of vacant apartments in an expeditious manner per company policy striving for 100% occupancy
Handle the timely recertification and interim recertifications of residents in accordance with HUD regulation and Low-Income Housing Tax Credit Program
Maintain the waiting list book and keeping it up to date in the computer following HUD regulations
Assist with the development of goals and objectives for the property
Maintain resident files according to policy outlined in CRM's Occupancy Manual
Assist Property Manager in preparation of various file reviews such as:
Management Review
Mortgagee Inspection
Accept daily resident requests and write up corrective work orders as directed by the Maintenance Plus program
Daily management of office duties
Maintain an open office at prescribed times
Immediately handle daily work orders that come in
Take applications for prospective residents
Compute applications for eligibility, with supporting documents
Send out billing notices
Greet in-coming guests, respond to mail and handle all incoming telephone calls
Maintain a professional demeanor
Attend required trainings
In absence of the Community Manager, enforcement of the lease and the rules and regulations
Completion of all required reports as directed by various departments of CRM Residential
Required to observe all federal and local Fair Housing Laws
Perform other related duties, as assigned
Requirements:
High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position.
1-2 years of certification experience required
HUD experience required
Must have experience with recertifications, RealPage OneSite, and inspections
The position requires effective oral and written communication skills
Proficiency in Microsoft Office (Excel and PowerPoint in particular)
Ability to work with a variety of people and make them feel comfortable quickly
Must be able to multi-task
Ability to work independently and as part of a team
Passion for building and engaging communities
Valid driver's license and reliable transportation
Ability to work any scheduled hours as well as additional hours needed to complete the job
The position requires effective oral and written communication skills
Strong customer service skills required
Must have strong organizational and time management skills
Full Time Schedule: Monday-Friday 8:30AM-5:00PM
About CRM Residential:
CRM Residential is an award-winning full-service property management company which professionally manages 11,000+ apartments valued in excess of one billion. We are exclusively third-party so there is no conflict of interest between the properties that we manage for our clients and our own properties, because we do not own any properties. Our focus is dedicated to our clients.
We are an equal opportunity employer and welcome applicants from all backgrounds to apply. If you have a desire to work for a reputable company, we encourage you to apply for this exciting opportunity.
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