Claim processor jobs in Lower Merion, PA - 54 jobs

At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include: Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support. Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team. What You Bring Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You'll Thrive Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions. Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment. Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.

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 Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing medium-high severity commercial liability claims in jurisdictions throughout the United States. Responsibilities * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures * Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary * Investigate claims and review the insureds' materials, pleadings, and other relevant documents * Identify and review each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Demonstrated ability to take part in active strategic discussions * Demonstrated ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 10% * Hybrid schedule, 3 days a week in office Education * Bachelor's degree required. * Minimum of 3 years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims * Proper & active adjuster licensing in all applicable states #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. $95,000 - $150,000/year based on experience level * 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.

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.

Join Our Team as a Senior Claims Resolution Specialist - MidAtlantic Region Are you ready to take your claims expertise to the next level? Personal Lines Casualty Complex is seeking a dedicated and experienced Senior Claims Resolution Specialist to lead the handling of challenging auto and homeowner's casualty claims across our MidAtlantic Region. In this pivotal role, you'll take ownership of complex, high-exposure cases, diving deep into investigations, evaluations, and strategic resolutions. This is your opportunity to make a real impact, handling severe and catastrophic injury claims that demand both skill and compassion. If you thrive in a fast-paced environment where your expertise drives meaningful outcomes, we want to hear from you! Preference for candidates who reside within Eastern or Central Time Zones. There is an in-office requirement twice a month if you live within 50 miles of one of our Hub locations. 10% travel may be required for mediations, arbitrations, trials and in-person events. Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. Responsibilities: Manages, investigates, and resolves auto and homeowner's casualty claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed procedures and authority. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management and Home Office. Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status. Confers with trial counsel and prepares trial reports. Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports. Ensures adequacy of reserves. Recommends reserve increases on cases in excess of authority. Accountable for security of financial processing of claims, as well as security information contained in claims files. Responsible for managing the practices and billing activities of outside and in-house counsel. May assist in the absence of the Claims Team Manager, representing the company on matters involving state or federal regulatory agencies. May be involved in special projects and/or mentoring at the direction of local management. Ideal experience includes: 5+ years of casualty and litigation experience Expert knowledge of handling personal lines complex claims with severe to catastrophic injuries and fatalities Qualifications Must have an advanced knowledge of coverage, liability, and complex claims handling procedures. Must be knowledgeable of state and federal laws in the adjuster's jurisdiction. A full working knowledge of claims operations and procedures is required. Strong written and oral communication skills required as well as strong interpersonal, analytical, investigative, and negotiation skills. The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and at least 5-7 years of directly related experience. Ability to obtain proper licensing as required. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

Daily Advise sales, parts, and service managers on warranty-related matters to ensure our customers receive fair value while recovering maximum dollars. Assure that our Service Departments follow procedures and complete warranty requirements on warranty service calls and other service documents. Assure all Caterpillar and other product lines' warranty requirements are met daily, and warranty issues are resolved immediately. Communicate with Factory Warranty Analysts and Service Operations Rep. when necessary to ensure fair claims settlement. Advises Corporate Warranty Manager without delay any discrepancies and problems associated with claim recovery, maintenance, processing, and procedures. (i.e., Excessive Labor, partial settlements, zero settlements) Assist the Service Departments in all divisions with warranty service calls and claims processing when necessary. Analyze and process on a timely basis suspected warranty failures to determine responsibility and fair settlement of claims to all parties concerned. Weekly Analyze settlement maintenance (i.e., Status: pending, held) and process to maintain the accuracy of accounting reports. Assure, when presented, that warranty service calls are finished and invoiced without delay. Respond to inquiries and provide warranty-related data on all product lines when requested by customers, co-workers, TEPS dealers, and the credit department promptly. RECOMMENDED QUALIFICATIONS: High School Diploma or equivalent required; Associate degree preferred. Minimum 5 years experience in the heavy equipment or automotive industries and equivalent combination of training and experience, which provides the required knowledge, skills, and abilities. Excellent communication and interpersonal skills, both verbal and written. Experience with Microsoft Office, Excel, and Word. Equal Opportunity Employer Foley, Incorporated does not discriminate against any person applying for employment based on race, color, sex, age, religion, national origin or citizenship status, physical or mental disability, marital status, sexual orientation, gender identity, status as a covered Veteran, or any other legally protected status. This contractor and subcontractor shall abide by the requirements of 41 CFR 60.300.5(a) and 41 CFR 60.741.5(a). These regulations prohibit discrimination against qualified individuals on the basis of disability and protected veteran status, and require affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities and protected veterans.

This position is eligible for Mid Atlantic Retina's $1,000 Hiring Incentive! The hired candidate will receive $500 after successful completion of 90 days of employment and $500 after successful completion of 1 year of employment! Available to new hires only- not available to agency hires, internal transfers, or re-hires. Sign On Bonus Eligible: Yes Job Type: Full Time Qualifications * 3-5 years medical billing experience in a physician practice or third-party billing company preferred * Previous experience with claims processing and working with a clearinghouse. * Experience with CPT, ICD10 and Microsoft Office Suite required. Job Description The Claims Representative is responsible for submitting both electronic and paper claims to insurance companies. This position ensures that all accounts are billed appropriately and meet all regulatory and compliance requirements. The Claims Representative is also responsible for reviewing daily claim edit reports and working with other departments to resolve the claim edits. Essential Functions 1. Pulls daily Claim Edit report from Nextgen to review red edits for errors. 2. Collaborates with Front Desk and Clinic to correct errors. 3. Submits corrected report through clearinghouse via EDI file or uploading. 4. Complete paper claims by reviewing account, attaching needed information, and mailing out to responsible payer. 5. Ensures correct processing of all accounts. 6. Acts as customer service representative in person and by telephone. Promptly responds to patient and corresponding payor questions regarding accounts. 7. Maintains up to date billing knowledge of insurance carriers to act as a resource for other departments within MAR. 8. Attends regular staff meetings. 9. Works overtime as needed. 10. Travels to other MAR locations as needed. 11. Performs other duties as assigned. Benefits * Health Insurance * Dental Insurance * Vision Insurance * Paid Sick Time * Paid Vacation Time * Company Bonuses twice a year (after 1 year of employment) * 7 Paid Company Holidays * 401K * Profit Sharing * Company Paid Life Insurance Physical and Cognitive Demands The physical and cognitive demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. * This is largely a sedentary role; however, some filing may be required. This would require the ability to occasionally lift files, bend, stoop, crouch, reach, and stand on a stool as necessary. * Ability to lift or move up to 15 pounds at times. * Work with data by calculating and manipulating numbers, processing data on a computer, classify, record, store and retrieve information. * Use words to communicate ideas, read with comprehension and explain abstract or complex ideas in more basic terms. * The employee will use hands to operate equipment such as a computer mouse, show manual or finger dexterity, handle things with precision or speed, use muscular coordination and physical stamina. * While performing the duties of this job, the employee is regularly required to talk, communicate verbally one to one, in front of groups, over the telephone or with a headset and in email. * This position requires listening to verbal communication using a telephone or with a headset and processing the information while entering the data into a computer system, processing auditory information, and responding verbally back in an appropriate manner. * Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus with or without corrective lenses. * Ability to follow through on plans or instructions.

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 claims 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.

Insight Global is looking for a Senior Indemnity Adjuster to join our client's team. Responsibilities will include managing complex workers' compensation claims, ensuring fair and efficient resolution while maintaining compliance with state regulations. The ideal candidate will have extensive experience handling indemnity claims, negotiating settlements, and collaborating with medical and legal professionals. This candidate will handle a desk with at least 50-70% litigation and would only have a small amount of med only files. Claims total would be around 135. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements Indemnity Claims Experience; specifically litigation claims Minimum 3 years of Complex Claims Experience Experience with NJ, PA and DE Claims

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.

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 XgP5WY2DnT

The Billing and Claims Specialist will be responsible for managing all aspects of customer billing, including preparing invoices, reconciling accounts, claims and resolving billing discrepancies. The ideal candidate will have a minimum of 3 years of experience in billing or accounts receivable within a fast-paced environment. Key Responsibilities: Prepare, review, and process accurate customer invoices in a timely manner. Reconcile billing statements and resolve discrepancies with internal teams and customers. Maintain accurate and organized billing and claims records. Collaborate with operations and sales teams to ensure proper billing for services rendered. Respond to customer inquiries regarding billing issues professionally and promptly Continuously identify and implement process improvements in billing operations. Identify process improvements to streamline billing and claims management. Qualifications: Minimum of three (3) years billing or accounts receivable experience, preferably in logistics or warehousing. Strong attention to detail and accuracy. Proficiency in Microsoft Office, especially Excel. Experience with billing software is a plus. Excellent communication and customer service skills. Ability to work independently and as part of a team. Strong organizational and time-management skills. Schedule: Full-time, Monday - Friday (with flexibility).

AMI is seeking a Full Time Pre-Certification / Pre-Service Representative to join the team. This remote position will include on-site training in AMI offices. AMI offers a generous compensation and benefits package including medical, prescription, dental, vision, flexible spending accounts, Paid Time Off (PTO), Paid Holidays, 401k and Profit sharing and the opportunity to work in an exciting and progressive outpatient practice. Offered rates increase based on years of work experience. The Pre-Certification / Pre-Service Specialist is responsible for ensuring that all outpatient insurance requirements are completed in advance of patient's scheduled appointment date. The team works directly with AMI's referring provider offices. Evaluates patient's scheduled procedures to determine if prior authorization is required. Reviews and validates patient insurance information to confirm coverage for scheduled procedures, leveraging a strong understanding of insurance plans and their specific provisions. Monitors authorization request, follows up with payers, and records all communications regarding insurance claims. Reviews insurance denials, resubmits claims, and submits appeals as necessary to ensure patients obtain required care. Ensures patient insurance eligibility is verified and authorizations are obtained through insurance portals (e.g., Evicore, etc.) on behalf of physician practices registered with the AMI Pre-Authorization Service, when applicable, prior to the patient's scheduled procedure or testing date. Communicates updates in pre-authorization procedures to management to keep the pre-certification manual accurate and current. Documents denial reasons and contributing factors to ensure team alignment with industry standards. Maintains an up-to-date list of facility insurance pre-certification agreements. Other duties as assigned. This Full time, 40 hour per week position is remote and includes a work schedule of Monday-Friday, 7:30am-4pm. Candidates must be able to travel to AMI offices for initial training, occasional meetings, and ongoing training. Qualifications Candidates must have a high school diploma or equivalent, with at least 2 years' experience with insurance coverage verification in a medical practice or healthcare setting; radiology practice experience is a plus. Intermediate computer skills, with a working knowledge of the Microsoft Office Suite is required. Candidates must have experience with online medical insurance portals. A demonstrated knowledge of insurance plans and the authorization process is required. A knowledge of and familiarity with medical terminology, ICD-10, and CPT coding is strongly preferred. Additionally, candidates must have the ability to remain highly organized with accounts, work independently, and receive & implement direction as provided, with minimal supervision. The ability to remain detail oriented while managing a high volume of requests is required. Exceptional interpersonal skills, verbal & written communication, and customer service skills are required for success in this position. These skills must be maintained in a fast-paced environment, while maintaining a professional demeanor and providing exceptional service to patients and referrers. AMI offers a generous compensation and benefits package including medical, prescription, dental, vision, flexible spending accounts, Paid Time Off (PTO), Paid Holidays, 401k and Profit sharing and the opportunity to work in an exciting and progressive outpatient practice. Offered rates increase based on years of work experience. EOE

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: $22.00-$24.00 per hour What You'll Get To Do: The Compliance Specialist will be responsible for keeping abreast of all HUD, state agency, and tax credit rules and regulations concerning occupancy, recertifications, and tax credit related issues. The Compliance Specialist will deal directly with HUD and state agencies in reference to Section 8 contract renewals. This role will be responsible for but not limited to: Prepare monthly, quarterly, and annually reports for Tax Credit Properties Prepare Company Occupancy Reports weekly and for properties and owners Review and critique recertification move in packages at tax credit properties Prepare handouts for training classes and an assist in allocating the cost to each property that attended training Site visits may be required from time to time to offer assistance to onsite staff pertaining to occupancy, file compliance or other tax credit specific areas Attend educational seminars relating to tax credit compliance & other affordable housing Monitor the timely completion of annual recertifications for all sites. Advise Regional Manager of any potential problems Written correspondence with owners and agencies, relating to affordable housing Requirements: High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position. Valid driver's license and reliable transportation Ability to work with a variety of people and make them feel comfortable quickly Strong customer service skills required Must have strong organizational and time management skills Valid driver's license Proficiency at multi-tasking Organizational skills Working knowledge of Microsoft Office software Experience with verifications and renewals Other administrative duties as assigned Onsite Monday-Friday 8:00am-4:30pm Excellent communication, writing and people skills Must have tax credit experience 3 years of project-based section 8 experience 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 passion for property management and a desire to work for a reputable company, we encourage you to apply for this exciting opportunity. Powered by JazzHR ou WLXs3gKD

Join Our Team as a Senior Claims Resolution Specialist - MidAtlantic Region Are you ready to take your claims expertise to the next level? Personal Lines Casualty Complex is seeking a dedicated and experienced Senior Claims Resolution Specialist to lead the handling of challenging auto and homeowner's casualty claims across our MidAtlantic Region. In this pivotal role, you'll take ownership of complex, high-exposure cases, diving deep into investigations, evaluations, and strategic resolutions. This is your opportunity to make a real impact, handling severe and catastrophic injury claims that demand both skill and compassion. If you thrive in a fast-paced environment where your expertise drives meaningful outcomes, we want to hear from you! Preference for candidates who reside within Eastern or Central Time Zones. There is an in-office requirement twice a month if you live within 50 miles of one of our Hub locations. 10% travel may be required for mediations, arbitrations, trials and in-person events. Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. Responsibilities: * Manages, investigates, and resolves auto and homeowner's casualty claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed procedures and authority. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management and Home Office. * Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. * Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status. * Confers with trial counsel and prepares trial reports. * Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. * Responds to various written and telephone inquiries including status reports. * Ensures adequacy of reserves. Recommends reserve increases on cases in excess of authority. * Accountable for security of financial processing of claims, as well as security information contained in claims files. * Responsible for managing the practices and billing activities of outside and in-house counsel. * May assist in the absence of the Claims Team Manager, representing the company on matters involving state or federal regulatory agencies. * May be involved in special projects and/or mentoring at the direction of local management. Ideal experience includes: * 5+ years of casualty and litigation experience * Expert knowledge of handling personal lines complex claims with severe to catastrophic injuries and fatalities Qualifications * Must have an advanced knowledge of coverage, liability, and complex claims handling procedures. * Must be knowledgeable of state and federal laws in the adjuster's jurisdiction. * A full working knowledge of claims operations and procedures is required. * Strong written and oral communication skills required as well as strong interpersonal, analytical, investigative, and negotiation skills. * The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and at least 5-7 years of directly related experience. * Ability to obtain proper licensing as required. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

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.

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.

The Billing and Claims Specialist will be responsible for managing all aspects of customer billing, including preparing invoices, reconciling accounts, claims and resolving billing discrepancies. The ideal candidate will have a minimum of 3 years of experience in billing or accounts receivable within a fast-paced environment. Key Responsibilities: Prepare, review, and process accurate customer invoices in a timely manner. Reconcile billing statements and resolve discrepancies with internal teams and customers. Maintain accurate and organized billing and claims records. Collaborate with operations and sales teams to ensure proper billing for services rendered. Respond to customer inquiries regarding billing issues professionally and promptly Continuously identify and implement process improvements in billing operations. Identify process improvements to streamline billing and claims management. Qualifications: Minimum of three (3) years billing or accounts receivable experience, preferably in logistics or warehousing. Strong attention to detail and accuracy. Proficiency in Microsoft Office, especially Excel. Experience with billing software is a plus. Excellent communication and customer service skills. Ability to work independently and as part of a team. Strong organizational and time-management skills. Schedule: Full-time, Monday - Friday (with flexibility).

Job DescriptionRisk Intermediary located in New Jersey seeks a VP of Claims for a Municipal Insurance fund. Claims handled are Workers Comp, Property and Liability and Professional Liability. Fund has 28 members submitting New Jersey based Public Entity based claims. This position will lead operational and administrative claims functions including reserving. Will also manage TPA relationships and direct TPA's Workers Comp activities. Will also manage staff Liability Litigation Managers and lead claims reporting. Require JD with 20 years experience in an Insurance Claims Department, TPA or Risk Management Department. Knowledge of New Jersey Civil Tort and Workers Comp claims systems. Advanced skills in Coverage Analysis, Litigation Management and Negotiation. Auto Liability, General Liability and Employer Liability claims. Knowledge needed in MS Office Products (Word, Excel and Powerpoint). Will work remote but must be within driving distance of office. Will manage 9-12 people. Minimal travel. Salary $150-200k no bonus opportunity.

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: $22.00 per hour What You'll Get To Do: The Compliance Specialist will be responsible for keeping abreast of all HUD, state agency, and tax credit rules and regulations concerning occupancy, recertifications, and tax credit related issues. The Compliance Specialist will deal directly with HUD and state agencies in reference to Section 8 contract renewals. This role will be responsible for but not limited to: Prepare monthly, quarterly, and annually reports for Tax Credit Properties Prepare Company Occupancy Reports weekly and for properties and owners Review and critique recertification move in packages at tax credit properties Prepare handouts for training classes and an assist in allocating the cost to each property that attended training Site visits may be required from time to time to offer assistance to onsite staff pertaining to occupancy, file compliance or other tax credit specific areas Attend educational seminars relating to tax credit compliance & other affordable housing Monitor the timely completion of annual recertifications for all sites. Advise Regional Manager of any potential problems Written correspondence with owners and agencies, relating to affordable housing Requirements: High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position. Valid driver's license and reliable transportation Ability to work with a variety of people and make them feel comfortable quickly Strong customer service skills required Must have strong organizational and time management skills Valid driver's license Proficiency at multi-tasking Organizational skills Working knowledge of Microsoft Office software Experience with verifications and renewals Other administrative duties as assigned Onsite Monday-Friday 8:00am-4:30pm Excellent communication, writing and people skills Must have tax credit experience Experience with verifications and renewals 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 passion for property management and a desire to work for a reputable company, we encourage you to apply for this exciting opportunity. Powered by JazzHR GYKHoNUwZ1