Claim processor jobs in Knightdale, NC

Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claim Examiner - Workers Comp (Southeast Experience Required) Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. + Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. + Enjoy flexibility and autonomy in your daily work, your location, and your career path. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. **ARE YOU AN IDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. **PRIMARY PURPOSE** **:** To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Negotiates settlement of claims within designated authority. + Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. + Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. + Prepares necessary state fillings within statutory limits. + Manages the litigation process; ensures timely and cost effective claims resolution. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. **Experience** : Five (5) years of claims management experience or equivalent combination of education and experience required **TAKING CARE OF YOU** + Flexible work schedule. + Referral incentive program. + Career development and promotional growth opportunities. + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

MBP is looking for Claims Analyst/Lead Claims Analyst/Senior Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Highly proficient in Oracle P6 and experienced with one or more of the following: Microsoft Project, Phoenix Project Manager, or similar. Responsibilities Main Duties: Performs review and analysis of construction claims. Assists with development of contractor claims. Develops and/or review time extension requests. Assist with development of expert reports and exhibits. Qualifications Education B.S. in Civil Engineering, Construction Management, or relevant experience which equates to this degree. P.E. license, Certified Construction Manager, Planning and Scheduling Profession, or similar, certification preferred. Skills and Abilities Experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Experience drafting expert reports and deliverables. Proficient in Oracle P6 required and experienced with Microsoft Project desired. Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration. Ability to relate technical knowledge to a non-technical audience. Proficiency in reading/understanding construction plans and specifications. Proficiency with Microsoft Office software programs including Word, Excel, and PowerPoint. Experience providing training, supervision, proposal development, and business development desired. Occasional overnight travel may be required. STATUS: Full-time BENEFITS: Competitive compensation with opportunities for semi-annual bonuses Generous Paid Time Off and holiday schedules 100% Employer paid medical, dental, vision, life, AD&D, and disability benefits (for individual) Health Savings Account with company contribution 401(k)/Roth 401(k) plan with company match Tuition Assistance and Student Loan Reimbursement Numerous Training and Professional Development opportunities Wellness Program & Fitness Program Reimbursement Applicants must be authorized to work in the U.S. without sponsorship. MBP is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Protected veterans and individuals with disabilities are encouraged to apply.

What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. Job Responsibilities Confirms coverage of claims by reviewing policies and documents submitted in support of claims. Conducts, coordinates and directs investigation into loss facts and extent of damages. Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure. Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents. Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting. Required Qualifications This role will is responsible for Equine claims; equine knowledge or hands-on experience working with horses is strongly preferred. Must have or be eligible to receive claims adjuster license. Successful completion of basic insurance courses or achievement of industry designations. Ability to be trained in insurance adjusting up to two years of claims experience. 2-4 years of experience in general liability, construction defect, or related liability lines preferred. Bachelor's degree preferred Excellent written and oral communication skills. Strong organizational and time management skills. # LI-Hybrid US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose ‘Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.

MBP is looking for Claims Analyst/Lead Claims Analyst/Senior Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Highly proficient in Oracle P6 and experienced with one or more of the following: Microsoft Project, Phoenix Project Manager, or similar. Responsibilities Main Duties: Performs review and analysis of construction claims. Assists with development of contractor claims. Develops and/or review time extension requests. Assist with development of expert reports and exhibits. Qualifications Education B.S. in Civil Engineering, Construction Management, or relevant experience which equates to this degree. P.E. license, Certified Construction Manager, Planning and Scheduling Profession, or similar, certification preferred. Skills and Abilities Experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Experience drafting expert reports and deliverables. Proficient in Oracle P6 required and experienced with Microsoft Project desired. Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration. Ability to relate technical knowledge to a non-technical audience. Proficiency in reading/understanding construction plans and specifications. Proficiency with Microsoft Office software programs including Word, Excel, and PowerPoint. Experience providing training, supervision, proposal development, and business development desired. Occasional overnight travel may be required. STATUS: Full-time BENEFITS: Competitive compensation with opportunities for semi-annual bonuses Generous Paid Time Off and holiday schedules 100% Employer paid medical, dental, vision, life, AD&D, and disability benefits (for individual) Health Savings Account with company contribution 401(k)/Roth 401(k) plan with company match Tuition Assistance and Student Loan Reimbursement Numerous Training and Professional Development opportunities Wellness Program & Fitness Program Reimbursement Applicants must be authorized to work in the U.S. without sponsorship. MBP is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Protected veterans and individuals with disabilities are encouraged to apply.

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. )

Under minimal supervision, the Claims Specialist/Executive Claims Specialist manages a caseload of high complexity commercial insurance claims focused on Allied Health (assisted living and skilled nursing facilities). The Claims Specialist will review claims to analyze land determine applicable coverage, facts, liability, damages, plan and strategy for resolution in accordance with state and company guidelines. The Claims Specialist will function independently and act as a key resource on issues within area of specialty. Duties and Responsibilities Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service Perform coverage, liability, and damage analysis on all claims assignments Investigate allegations, determine facts based on evidence and interviews Draft disclaimers and reservation of rights letters when coverage issues arise Assign limited investigations and appraisals to independent licensed professionals Manage a caseload of high complexity claims with delegated authority Manage litigated files Negotiate settlements, mitigate losses, and control expenses Participate in and attend mediations to facilitate settlements Maintain accurate documentation in claim files Maintain a high level of communication internally with Claims management team and externally with insureds, claimants, attorneys and brokers Act as a consultant providing technical expertise within specialty area to internal stakeholders Provide technical guidance, assistance and training as needed for less experienced Claims professionals Maintain a passing quality assurance score on all audits and QAs Provide exceptional customer service to insureds, claimants, and attorneys, addressing inquiries, concerns, and providing regular updates on claim status Ensure compliance with state regulations, industry standards, and best practices in claims handling, maintaining a high level of professionalism and integrity Handle claims in accordance with established James River Claims Best Practices Other duties as required by management Knowledge, Skills and Abilities Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL) Expert level of expertise in claim handling and suit management Expert knowledge of P&C insurance industry Expert ability to effectively assess risk Proficiency in MS Office (Word, Excel, Outlook) Excellent written and verbal communication skills Advanced analytical and organizational skills Advanced negotiation skills Ability to work independently and take initiative Ability to exercise sound judgement in making critical decisions Research, analysis and problem-solving skills Ability to work in a team environment and accept feedback from Claims management Ability to build effective relationships with business partners Ability to organize complex information and pay close attention to detail Ability to anticipate customer needs and take initiative to meet those needs Ability to train and provide technical guidance to less experienced Claims professionals Ability to successfully obtain the required state adjusters' licenses within six (6) months following the completion of Company-provided licensure training courses and maintain appropriate licensure thereafter Experience and Education Claims Specialist High school diploma required Bachelor's Degree preferred Advanced Degree or Juris Doctorate Degree preferred Minimum of seven years of experience handling primary and excess claims-made and occurrence liability policies and claims. Experienced in coverage, liability, and litigated claims related to health services claims, assisted living and skilled care facilities claims, life sciences (medical devices and products) claims, and professional liability claims. Successful candidate will have strong written, verbal, injury evaluation, and negotiation skills Adjuster license and/or certifications desired preferred Executive Claims Specialist High school diploma required Bachelor's Degree preferred Advanced Degree or Juris Doctorate Degree preferred Minimum of ten years of experience handling primary and excess claims-made and occurrence liability policies and claims. Experienced in coverage, liability, and litigated claims related to health services claims, assisted living and skilled care facilities claims, life sciences (medical devices and products) claims, and professional liability claims. Successful candidate will have strong written, verbal, injury evaluation, and negotiation skills Extensive expertise in specific specialty area of claims (i.e. PL, M&C, GL) Project management and process implementation experience preferred #LI-KS1 #LI-Remote

Job Description METIS | Location: Roanoke, VA | Full-Time Are you seeking a professional career in Roanoke? Do you like solving problems, analyzing details, and helping people? At Metis, we take a unique approach to commercial insurance through administering self-insurance Risk Pools. If you are looking for a change and a challenge, we're looking for a dedicated Property and Casualty Claims Specialist to join our growing team. What You'll Do: Manage and resolve property and casualty and/or general liability claims Assess and evaluate claims, conduct investigations, and ensure documentation is collected Build relationships with members and help claimants navigate the claims process What You Bring: Bachelor's Degree or higher - required 7+ years of experience in property and casualty claims handling Strong knowledge of policy analysis and associated legal issues A team player with excellent communication and a customer focused mindset *Please be sure to fully complete and upload the attached “Application for Employment” form along with your electronic application. Incomplete submissions may not be considered. What We Offer: Competitive compensation and performance bonuses Individual dental, life, short-term & long-term disability insurance at no cost Medical insurance with wellness incentives Health Savings Account with annual company contribution 401(k) with 200% company match up to 6% of salary Generous paid time off, including vacation, sick leave, and 11 paid holidays Support for continuing education and professional growth A beautiful campus with a collaborative, supportive, wellness-focused culture including onsite gym and café

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

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

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 $52,600.00 - $86,800.00 Target Openings 1 What Is the Opportunity? LOCATION REQUIREMENT: This position services Insureds/Agents in and around Chantilly, Fairfax, Sterling, Manassas, Springfield, areas. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. What Will You Do? * Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel. * The on the job training includes practice and execution of the following core assignments: * Handles 1st party property claims of moderate severity and complexity as assigned. * Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates. * Broad scale use of innovative technologies. * Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate. * Establishes timely and accurate claim and expense reserves. * Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. * Negotiates and conveys claim settlements within authority limits. * Writes denial letters, Reservation of Rights and other complex correspondence. * Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. * Meets all quality standards and expectations in accordance with the Knowledge Guides. * Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. * Manages file inventory to ensure timely resolution of cases. * Handles files in compliance with state regulations, where applicable. * Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. * Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. * Identifies and refers claims with Major Case Unit exposure to the manager. * Performs administrative functions such as expense accounts, time off reporting, etc. as required. * Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. * May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. * Must secure and maintain company credit card required. * In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. * In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards. * This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience. * Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic. * Verbal and written communication skills -Intermediate. * Attention to detail ensuring accuracy - Basic. * Ability to work in a high volume, fast paced environment managing multiple priorities - Basic. * Analytical Thinking - Basic. * Judgment/ Decision Making - Basic. * Valid passport. What is a Must Have? * High School Diploma or GED and one year of customer service experience OR Bachelor's Degree. * Valid driver's license. 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 *********************************************************

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

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.

* There are multiple positions open across the 26 states in which we operate. The current locations for which we are seeking CAT Claim Reps are located in the job posting.* Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated claims professional to join our team. The position requires the following, but is not limited to: * Frequent travel up to 21 days at a time and is required upon short notice to location of catastrophe, which would most likely be out of state. * Can meet the physical demands required for the position including carrying and climbing a ladder. * Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses. * Familiar with insurance coverage by studying insurance policies, endorsements and forms. * Work towards the resolution of claims, possibly attending arbitrations, mediations, depositions or trials as necessary. * Ensure that claims payments are issued in a timely and accurate manner. Desired Skills & Experience * Bachelor's degree or equivalent experience * Minimum of 2 years claims handling experience or comparable experience * Field claims experience with multi-line property and casualty claims and wind/hail * Proficient with Xactimate software * Above-average communication skills (written and verbal) * Ability to resolve complex issues * Organize and interpret data * Ability to handle multiple assignments * Possess a valid driver's license * Military experience is considered Benefits Competitive salary, matching 401(k) retirement plans, fully funded pension plan, bonus programs, paid holidays, vacation days, personal days, paid sick leave and a comprehensive health care plan. Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-KC1 #LI-Hybrid

Company Details With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results. All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong), by S&P. For further information about Key Risk please visit *************** The company is an equal opportunity employer. Responsibilities Key Risk is looking for a Claims Representative who enjoys analysis and management of workers compensation claims. Key functions include but are not limited to the following: Analyzes and processes workers' compensation claims by investigating and gathering information to determine the exposure on the claim. Negotiate settlement of claims up to designated authority level and makes claims payments. Calculates and assigns timely an appropriate reserve to claims and continues to manage reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level. Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution. Prepares necessary state filings within statutory limits. Actively manages the litigation process; ensures timely and cost-effective claims resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. Frequently communicates with all appropriate parties involved with the claim. Maintains professional client relationships. Actively executes appropriate claims activities to ensure consistent delivery of quality claims services. Qualifications BA/BS Degree 2-3 years of workers compensation claims experience Adjuster license strongly desired or ability to obtain license within six months Knowledge of appropriate insurance principles and laws of workers' compensation, preferably jurisdiction specific. Strong verbal and written communication Strong interpersonal, time management and organizational skills. Strong negotiation skills. Proven critical thinking skills that demonstrates analysis/judgment and sound decision making with focus on attention to detail. Ability to perform with a sense of urgency. Ability to work both independently and within a team environment. Ability to travel for business purposes, approximately less than 10%. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.

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.

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

Temp Medical Intake Processor- is responsible for gathering and processing patient information. This role focuses on initiating the patient's care journey by collecting essential data, verifying insurance, and scheduling appointments. Responsibilities: Gathering Patient Information: This includes collecting demographics, medical history, insurance details, and the reason for the patient's visit. Data Entry and Record Management: Accurately entering patient information into electronic health records systems and ensuring data integrity. Insurance Verification: Confirming patient insurance coverage and benefits to ensure proper billing and payment processes. Appointment Scheduling: Scheduling appointments for consultations, procedures, and follow-up visits based on patient needs and facility availability. Patient Communication: Answering patient inquiries, addressing concerns, and providing information about services and procedures. Paperwork and Documentation: Preparing and managing patient paperwork, including admissions forms, consent forms, and other relevant documents. HIPAA Compliance: Ensuring the confidentiality and privacy of patient information in accordance with HIPAA regulations. Referrals and Coordination: Directing patients to appropriate departments or specialists and coordinating care transitions. Clerical Duties: Performing general office tasks such as filing, copying, and faxing as needed.

Leverage your strong analytical, decision-making, and problem-solving skills to manage complexity and severity, ensuring a fair resolution of all claims, including those in litigation. This position will be located in our Stevens Point - Division Street office, Davenport, IA office, Goldsboro, NC office, Nashville, TN office, Madison, WI office, El Paso, TX office, or Richmond, VA office location. What You'll Do: As a Claims Representative Specialist on our PL - Litigation team, you'll provide prompt claim investigation, evaluation, and settlement or denial of claims of high complexity. In addition, you'll: * Handle complex claims involving litigation, and possibly high severity non-litigated exposures. * Verify coverages through investigation and reviewing policy terms, conditions, and language. This may require working with coverage counsel in filing declaratory/summary judgements. * Evaluate liability by taking recorded statements from involved parties and witnesses and reviewing police reports accident scene photos and other pertinent evidence. * Negotiate claims settlements with claimants and their legal representation within assigned authority limits * Comply with industry regulations, legal requirements, and internal policies through thorough documentation of all decisions correspondence and discussions that occur throughout the life cycle of the claim. * Work with and mentor other associates to share your knowledge, expertise, insights and perspectives to assist others in achieving their goals and enhancing their skills. What it Takes: * Bachelor's degree or equivalent work experience * 5+ years of related work experience * Extensive claims knowledge with the ability to understand and manage litigated claims * Ability to review and analyze complex documents, insurance policies, coverages, medical reports, and insurance regulations. * Ability to make appropriate claims decisions, prioritize, and manage workload * Advanced writing, communication, and presentation skills * Advanced conflict resolution and negotiation skills * Technology aptitude What You'll Receive: At Sentry, your total rewards go beyond competitive compensation. Below are some benefits and perks that you'll receive. * Sentry is happy to offer flexibility through a scheduled Hybrid work model. Monday and Friday work from home if you choose to, Tuesday through Thursday you'll work in office. * As a Sentry associate, you will have an in-office workspace and materials for your home office. In addition to the laptop, you will receive prior to your start, Sentry will provide equipment for your home office. * Meal Subsidy available for associates who report to an office. * 401(K) plan with a dollar for dollar match on your first eight percent, plus immediate vesting to help strengthen your financial future. * Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program * Generous Paid-Time Off plan for you to enjoy time out of the office as well as Volunteer-Time off * Group Medical, Dental, Vision, Life insurance, Parental leave, and our Health and Wellness benefits to encourage a healthy lifestyle. * Well-being and Employee Assistance programs * Sentry Foundation gift matching program to encourage charitable giving. About Sentry: We take great pride in making Forbes' list of America's Best Midsize Employers. A lot of different factors go into that honor, many of which contribute to your job satisfaction. Our bright future is built on a long track record of success. We got our start in 1904 and have been helping businesses succeed and protect their futures ever since. Because of the trust placed in us, we're one of the largest and financially strongest mutual insurance companies in the United States. We're rated A+ by A.M. Best, the industry's leading rating authority. Our headquarters is in Stevens Point, Wisconsin, with offices located throughout the United States. From sales to claims, and information technology to marketing, we enjoy a rewarding and challenging work environment with opportunities for ongoing professional development and growth. Get ready to own your future at Sentry. Opportunities await! Joe Larsen Talent Acquisition Specialist ********************* Equal Employment Opportunity Sentry is an Equal Opportunity Employer. It is our policy that there be no discrimination in employment based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.