Claim processor jobs in Maple Grove, MN

**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $55,200.00 - $91,100.00 **Target Openings** 3 **What Is the Opportunity?** Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process. This role is eligible for a sign on bonus. **What Will You Do?** + Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. + Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. + Determine claim eligibility, coverage, liability, and settlement amounts. + Ensure accurate and complete documentation of claim files and transactions. + Identify and escalate potential fraud or complex claims for further investigation. + Coordinate with internal teams such as investigators, legal, and customer service, as needed. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + Three years of experience in insurance claims, preferably Auto claims. + Experience with claims management and software systems. + Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. + Strong analytical and problem-solving skills. + Proven ability to handle complex claims and negotiate settlements. + Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. **What is a Must Have?** + High School Diploma or GED required. + A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required. **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 ******************************************************** .

At Trane TechnologiesTM and through our businesses including Trane and Thermo King, we create innovative climate solutions for buildings, homes, and transportation that challenge what's possible for a sustainable world. We're a team that dares to look at the world's challenges and see impactful possibilities. We believe in a better future when we uplift others and enable our people to thrive at work and at home. We boldly go. What's in it for you: Be a part of our mission! As a world leader in creating comfortable, sustainable, and efficient environments, it's our responsibility to put the planet first. For us at Trane Technologies, sustainability is not just how we do business-it is our business. Do you dare to look at the world's challenges and see impactful possibilities? Do you want to contribute to making a better future? If the answer is yes, we invite you to consider joining us in boldly challenging what's possible for a sustainable world. Thrive at work and at home: * Benefits kick in on DAY ONE for you and your family, including health insurance and holistic wellness programs that include generous incentives - WE DARE TO CARE! * Family building benefits include fertility coverage and adoption/surrogacy assistance. * 401K match up to 6%, plus an additional 2% core contribution = up to 8% company contribution. * Paid time off, including in support of volunteer and parental leave needs. * Educational and training opportunities through company programs along with tuition assistance and student debt support. * Learn more about our benefits here! Where is the work: On-site (5 days) What you will do: * Provide a best in class customer experience in the warranty and service environment * Work with channel and field functions to understand channel and customer concerns and create solutions for warranty and service issues through strong customer service * Analyzes and monitors a warranty and service claim information process to uphold policy guidelines and create process improvements * Use claim analytics process to data mine, research and analyze dealer warranty and service performance to suggest and execute on improvements in process and systems * Provide communication on warranty and service policy to channel and customers to ensure claims are filed within guidelines * Support team efforts to manage and reduce warranty spend, accruals, and reserves What you will bring: * 3+ years of experience in customer service, claims analysis, warranty support, service or related field * Customer focus and continuous improvement mentality * Ability to collaborate, partner with both internal and external Customers * Strong written and verbal communication skills * Ability to learn and work in multiple systems Compensation: Base Pay Range: $ 45,000 - $70,000 Disclaimer: This base pay range is based on US national averages. Actual base pay could be a result of seniority, merit, geographic location where the work is performed. Equal Employment Opportunity: We offer competitive compensation and comprehensive benefits and programs. We are an equal opportunity employer; all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, pregnancy, age, marital status, disability, status as a protected veteran, or any legally protected status.

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Medica's Claim Analyst III (Stop Loss) serves as a subject matter expert responsible for reviewing, analyzing, and processing stop-loss claims to ensure accuracy and compliance with contractual guidelines. This senior-level professional builds and maintains operational relationships with internal and external stakeholders, supports process improvements, and provides expertise in claims adjudication and reconciliation. Performs other duties as assigned. Key Accountabilities Review and Analyze Claims: Examine stop-loss claims to confirm eligibility, contract terms, and policy limits. Ensure claims are processed accurately and meet production standards Claims Verification: Verify that all underlying claims are paid appropriately according to standard operating procedures Claims Tracking and Reconciliation: Track claim submissions, monitor status, and reconcile medical records and correspondence. Collaborate with internal teams (Claims, Utilization Management, Client Services) to resolve eligibility and coordination-of-benefits issues Process Improvement: Identify opportunities to enhance accuracy and turnaround time (TAT) for stop-loss claims. Support management with ad hoc analysis and reporting related to claims adjudication and stop-loss Stakeholder Engagement: Build and strengthen relationships with stakeholders through effective problem resolution and communication Required Qualifications Bachelor's degree or equivalent experience in related field 5 years of work experience beyond degree Preferred Qualifications Strong analytical, organizational, and communication skills High attention to detail; ability to manage multiple priorities under tight deadlines Proficiency in Microsoft applications and claims systems Knowledge of ICD-10, CPT/HCPCS coding, and coordination-of-benefits principles This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN office, on average, 3 days per week. The full salary grade for this position is $44,900 - $77,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $44,900 - $67,410. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Requires regular and consistent attendance Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”) Additional projects and duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to learn rapidly to develop knowledge and understanding of claims practice Ability to identify, analyze and solve problems Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to meet or exceed performance competencies Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Minimum of 1 year of industry experience and claims management preferred State Certification as an Experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 - $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Who is Federated Insurance? At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own. Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values. What Will You Do? Customer-focused, source of knowledge and comfort, desire to help, professional - Does that sound like you? We are seeking someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss. No previous insurance or claims experience needed! Federated provides an exceptional training program to teach you the fundamentals of claims and will prepare you to assist clients. This is an in-office position that will work out of our Edina, MN office, located at 7700 France Avenue South. A work from home option is not available. Responsibilities Work with policyholders, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair and courteous way. Explain policy coverage to policyholders and third parties. Complete thorough investigations and document facts relating to claims. Determine the value of damaged items or accurately pay medical and wage loss benefits. Negotiate settlements with policyholders and third parties. Resolve claims, which may include paying, settling, or denying claims, defending policyholders in court, compromising or recovering outstanding dollars. Minimum Qualifications Current pursuing, or have obtained a four-year degree Experience in a customer service role in industries such as retail, hospitality, logistics, banking, automotive dealerships, vehicle rental, sales or similar fields Ability to make confident decisions based on available information Strong analytical, computer, and time management skills Excellent written and verbal communication skills Leadership experience is a plus Salary Range: $61,700 - $75,400 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information can be discussed with a with a member of the Recruiting team. What We Offer We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You. Employment Practices All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization. If California Resident, please review Federated's enhanced Privacy Policy. We can recommend jobs specifically for you! Click here to get started.

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 CategoryClaimCompensation 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$47,700.00 - $78,600.00Target Openings1What Is the Opportunity?Under moderate supervision, manage Workers' Compensation Claims with: Stable Lifetime Indemnity and/or Medical Benefits where the medical expenditures are not expected to exceed $6,000 annually and there are settlement opportunities. Death Benefits, payment of award only, minimal active/pending litigation, including mediation. 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.What Will You Do? Manage and resolve stable lifetime claims. May use structured settlement/annuity as appropriate for the jurisdiction. Manage existing offsets, including apportionment, contribution and subrogation. Facilitate timely claim resolution by leveraging any mitigation opportunities. Establish and update reserves to reflect claim exposure and document rationale. Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e., structured settlement, discontinuation of benefits through litigation). Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. Apply knowledge to determine causal relatedness of medical conditions. Negotiate settlement of claims within designated authority. Proactively manage inventory with documented plans of action to ensure timely and appropriate file closure or reassignment. Manage cases telephonically with an emphasis on maximizing quality and controlling costs through aggressive case resolution. Review, approve and issue accurate and timely indemnity, medical and expense payments for lifetime/long-term claims. Determine Value of Claim. Complete required letters and state forms and any other documents as required. Establish and maintain incurreds which reflect the exposure of the claim, and document a clear reserve rationale. Apply coverage (limits, endorsements). Determine and apply offset/contribution from 3rd party, second injury fund, liens, etc. Develop and Execute Resolution Strategy. Determine and actively develop ongoing strategic plans for resolution as required and when a significant event impacts the claim. Utilize and manage resources as necessary to resolve outstanding issues. Communicate and complete denials on medical and indemnity issues. Manage inventory to ensure timely file closing or timely reassignment if necessary. Settlement Evaluation and Negotiation. Evaluate and document a detailed settlement analysis, value and range within settlement authority. Execute negotiation strategy and communicate status. Identify and evaluate the need for Allocation or Medicare Set Aside and make appropriate referral. Customer Engagement. Participate in Telephonic and/or onsite File Reviews. Respond to inquiries - verbal and written. Keeping injured worker apprised of claim status. Engage specialty resources as needed. 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. Maintain Continuing Education requirements as required. Perform other duties as assigned. What Will Our Ideal Candidate Have? College degree. Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. Ability to effectively present file resolution to internal and/or external stakeholders. Negotiation: Basic ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. Working Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract. Principles of Investigation: Introductory investigative skills including the ability to take statements. Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss. Value Determination: Basic ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. Settlement Techniques: Basic ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package. Legal Knowledge: Working knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. Medical knowledge: Working knowledge of the nature and extent of injuries, periods of disability, and treatment needed. Understanding of when to utilize a medical resource is needed. WC Technical: Basic ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. Customer Service: Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. Teamwork: Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. Planning & Organizing: Intermediate ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. What is a Must Have? High School Diploma or GED and one year of customer service experience OR Bachelor's Degree. 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 *********************************************************

Title: Medical Claims Examiner Department: Claims Union: OPEIU 12 Grade: 26 The Medical Claims Examiner provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by /Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned. Minimum Qualifications High school diploma or GED. Six months of experience processing health and welfare claims. Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes. Possesses a strong work ethic and team player mentality. Highly developed sense of integrity and commitment to customer satisfaction. Ability to communicate clearly and professionally, both verbally and in writing. Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations. Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages. Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion Computer proficiency including Microsoft Office tools and applications. Preferred Qualifications Experience working in a third-party administrator. *Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice. Working Conditions/Physical Effort Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. Disability Accommodation Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at ******************************, and we would be happy to assist you. Please note that in compliance with certain state law, we are displaying salary. This rate is intended for hires into this location. Compensation: $23.00/hr Zenith American Solutions Real People. Real Solutions. National Reach. Local Expertise. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before. We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American! We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!

* Top 100 Agency for 2025 * Best Agencies to Work for in 2024 by the Insurance Journal * Big "I" Best Practices Agency in 2023 * Annual bonus eligibility * No weekends required - great work/life balance * 3+ weeks of Paid Time Off * 8 Paid Company Holidays We are looking for someone who will * Manage the claims reporting process for agency clients. * Report claims to the appropriate carrier and maintain records in the agency management system by documenting claim actions in accordance with established procedures. * Follow up on claim to obtain the specific adjuster and claim number relevant to the reported loss. Notify appropriate parties when a claim is processed with carrier, providing accurate and timely claim information. * Continuously monitor claims until claims are closed by the insurance carrier. Report any potential issues with a claim to the client's Account Manager and Producer, escalating to management as needed. * Prepare reports by collecting and summarizing information as requested by management. Why Join AAA Club Alliance and the Energy Insurance team? * A base rate of $20.00 to $25.00/hour, depending on experience and geographic location. * Annual bonus potential Do you have what it takes? * Minimum of 2 years experience handling claims for Commercial Insurance - general liability, workers compensation, commercial auto, etc. * Strong communication skills (both verbal and written) and attention to detail * Strong time management skills * Ability to obtain property and casualty license within 60 days of hire Full time Associates are offered a comprehensive benefits package that includes: * Medical, Dental, and Vision plan options * Up to 2 weeks Paid parental leave * 401k plan with company match up to 7% * 2+ weeks of PTO within your first year * Paid company holidays * Company provided volunteer opportunities + 1 volunteer day per year * Free AAA Membership * Continual learning reimbursement up to $5,250 per year * And MORE! Check out our Benefits Page for more information ACA is an equal opportunity employer and complies with all applicable federal, state, and local employment practices laws. At ACA, we are committed to cultivating a welcoming and inclusive workplace of team members with diverse backgrounds and experiences to enable us to meet our goals and support our values while serving our Members and customers. We strive to attract and retain candidates with a passion for their work and we encourage all qualified individuals to apply. It is ACA's policy to employ the best qualified individuals available for all positions. Hiring decisions are based upon ACA's operating needs, and applicant qualifications including, but not limited to, experience, skills, ability, availability, cooperation, and job performance. Job Category: Insurance

_This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges._ Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** A **Medical Claims Analyst (MCA)** is responsible for the intake processing and triage of all initial claim documents in a high-volume environment. This includes but is not limited to referral processing, obtaining required documents, medical records sorting and processing, preparing payment calculations, preparing the claim for a Nurse review, apply all Nurse findings to the claim, prepare and send reports, prepare and send provider packets. This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm MST. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of on-the-job training. The hours of the training will be aligned with your schedule. **Primary Responsibilities:** + Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims + Analyze and identify trends and provide reports as necessary + Consistently meet established productivity, schedule adherence and quality standards This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will support timely processing of the member's claim. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma / GED OR equivalent work experience + Must be 18 years of age OR older + Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications + Experience with Microsoft Word (create correspondence and work within templates) and Microsoft Outlook (email and calendar management) + Intermediate experience with Microsoft Excel (Sorting and filtering data, using formulas, and working with Tables) + Ability to work Monday - Friday, 08:00AM - 05:00PM MST **Preferred Qualifications:** + 1+ years of experience processing medical, dental, prescription or mental health claims + 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools + 1+ years of experience processing insurance claims or billing/collections in a healthcare or commercial setting + Familiarity with UB04's + Understand and maintain HIPAA confidentiality and privacy standards when completing assigned work **Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Required to have a dedicated work area established that is separated from other living areas and provides information privacy + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Title: Medical Claims Examiner Department: Claims The Medical Claims Examiner provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by /Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned. Minimum Qualifications High school diploma or GED. Six months of experience processing health and welfare claims. Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes. Possesses a strong work ethic and team player mentality. Highly developed sense of integrity and commitment to customer satisfaction. Ability to communicate clearly and professionally, both verbally and in writing. Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations. Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages. Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion Computer proficiency including Microsoft Office tools and applications. Preferred Qualifications Experience working in a third-party administrator. *Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice. Working Conditions/Physical Effort Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. Disability Accommodation Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at ******************************, and we would be happy to assist you. Please note that in compliance with certain state law, we are displaying salary. This rate is intended for hires into this location. Compensation: $23.00/hr Zenith American Solutions Real People. Real Solutions. National Reach. Local Expertise. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before. We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American! We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!

Job Description About the Role: We are seeking a highly motivated and detail-oriented Claims Representative to join our team in Minnesota, MN. As a Remote Claims Representative, you will be responsible for investigating, evaluating, and resolving insurance claims related to property and auto damages. You will work closely with clients, insurance adjusters, and other stakeholders to ensure timely and accurate claims processing. Your goal will be to provide exceptional customer service and achieve positive outcomes for our clients. Minimum Qualifications: 3+ years of experience in insurance claims handling Strong knowledge of property and auto claims processes and regulations Excellent communication and interpersonal skills Ability to work independently and as part of a team Preferred Qualifications: Experience with subrogation and claims resolution Knowledge of personal lines insurance Experience with claims processing software Responsibilities: Investigate and evaluate insurance claims related to property and auto damages Communicate with clients, insurance adjusters, and other stakeholders to gather information and resolve issues Process claims in accordance with company policies and procedures Maintain accurate records of claims and related activities Provide exceptional customer service throughout the claims process Skills: As a Claims Representative, you will use your strong analytical and problem-solving skills to investigate and evaluate insurance claims. You will also need excellent communication and interpersonal skills to effectively communicate with clients, insurance adjusters, and other stakeholders. Your ability to work independently and as part of a team will be crucial in ensuring timely and accurate claims processing. Additionally, your knowledge of property and auto claims processes and regulations, as well as experience with claims processing software, will be essential in performing your daily tasks.

Experienced Claims Representative - Workers' Compensation We are seeking a seasoned workers' compensation professional to work with clients to control costs and exposure and help injured workers get back to work. In this position, you will handle workers' compensation claims involving litigated, loss time and complicated medical claims. This position offers a hybrid/ home-based work opportunity . The successful candidate must reside in the state of SD, KS, NE, MN, or IA to be considered. A minimum of three years of progressive workers' compensation claims handling experience to include handling litigated claims and files with larger losses is required Experience in the Midwest jurisdictions is preferred Proven decision making and problem-solving skills Excellent verbal and written communication skills Must be proficient in Microsoft Word and Excel In our 30+-year history, we've soared to great heights, reimagined ourselves, and gained a profound awareness of the value we bring as experienced workers' compensation insurance providers. Today our reputation has grown as the region's leading workers' compensation insurance writer . While our product is insurance, what we truly sell is safer workplaces, help for companies looking to protect their employees, and support for people at their most vulnerable. We offer a competitive wage and benefits package including medical, dental and vision coverage, paid holidays, paid parental leave PTO, 401K, and much more! At RAS, we believe in an inclusive work environment, where employees are welcomed, valued, respected, and heard to ensure that individuals bring their best selves to work. RAS provides equal opportunities to all qualified candidates without regard to race, color, religion, sexual orientation, gender identity or expression, age, disability status, veteran status, national origin, or any other status protected under federal, state or local law.

Introduction At Gallagher Benefit Services, you're a trusted partner to organizations navigating some of their most important people decisions. We help clients build better workplaces, where people feel supported, empowered, and inspired to thrive. Whether it's shaping benefit strategies, designing wellbeing programs, or advising on workforce challenges, the work you do here creates meaningful change for businesses and the people who power them. We're a community of bold explorers, trusted experts, and compassionate partners; working side by side to solve problems, and shape the future of work. Here, curiosity is encouraged, collaboration is second nature, and your ideas have room to grow. If you're looking for a place where your contribution matters and where you can help build a better world of work; think of Gallagher. Overview Our Consultant (Medical Claim Auditor) is an integral part of the Medical Audit Team and is responsible for performing and supporting audits (medical, dental, vision, operational, Medicare, behavioral health and pre/post-implementation, etc.) to validate that the coverage of a claim and the payment of such claim are in compliance with the contractual, regulatory and custom plan guidelines. Consultants must show exemplary attention to detail, organizational skills and an ability to manage time efficiently and handle changing or conflicting priorities. Consultants' job requirements include but are not limited to: * Performance of audits for any healthcare plan (i.e. medical, dental, vision, behavioral health), pre/post implementation audits and special projects as assigned. * Review and understand all aspects of a client's benefit plan and corresponding documents. * Review and evaluate Administrative Services Agreement between the employer and Administrator. * Evaluate the results of the initial claim data (Electronic Risk Assessment) and determine valid audit samples for review and response by the Administrator. * Work with dedicated data analytics team to define and translate plan provisions for testing purposes ensuring that the scope of the audit is in line with the statement of work and client commitments. * If needed, travel to the Administrator to conduct on-site claim audit (Occasional travel may be required by the Administrators) * Work collaboratively with Administrator and Sr. Consultants to resolve exceptions, review supporting documentation and make final claim error determination. * Ensure audit timeline is adhered to and deliver high level of service to Clients. * Prepare and present detailed audit reports which clearly articulate the audit findings and recommendations to the Administrator and Client. * Work collaboratively within the audit team as well as with internal and external customers. * Participate in team meetings, conference calls, WebEx's etc. * Interact directly with clients and respond to client requests, develop strong relationships with clients. About You Required: Bachelor's degree and 5 or more years client coordination and/or claims management experience, OR High School degree with 3 or more years experience Preferred: * 1-3 years' experience in medical claims consulting, auditing or other applicable medical claims industry experience. * Must demonstrate a high level of medical claims or benefit administration knowledge - Medicare experience a strong plus. * Proficient in the use of Microsoft Office suite of programs (Word, Excel, PowerPoint). * Excellent oral and written communication skills required. * Excellent organizational and time management skills. * Personable communication style, positive outlook and self-confidence. * Ability to multi-task and acclimate to changing priorities without losing focus. * Attention to detail and ability to clearly explain thought process in reaching documented conclusions. * Self-directed individuals who require little supervision and can manage multiple projects effectively to ensure deadlines are met. * Team player with a strong work ethic. Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you'll get, depending on your job level these benefits may improve: * Medical/dental/vision plans, which start from day one! * Life and accident insurance * 401(K) and Roth options * Tax-advantaged accounts (HSA, FSA) * Educational expense reimbursement * Paid parental leave Other benefits include: * Digital mental health services (Talkspace) * Flexible work hours (availability varies by office and job function) * Training programs * Gallagher Thrive program - elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing * Charitable matching gift program * And more... The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it's embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees' diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as "protected characteristics") by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

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 Claims Representative (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ 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**

Position Overview As the hub of all claims, the coordinator is responsible for speaking with the customer, ongoing customer follow-up, handling service complaints, logistics of dispatching field personnel to jobs while ensuring that the required Cycle Time and insurance Service Level Agreement tasks deadlines are met. The Coordinator is responsible to follow up daily with the OPS team to ensure that all required documentation, estimates, and procedures are followed according to required program guidelines.A successful Coordinator will possess tenacity and thrives in a fast-paced environment. The coordinator who is detail-oriented and able to focus on many projects in varying degrees of completion will be most successful in this position. Job Responsibilities Understanding of the claims flow process - Water Mitigation, Reconstruction, Contents, and other Environmental work Manages data entry for each claim from First Notice of Loss through to completion of job in the CRM system Daily review of compliance tasks and all job tasks are completed on time Monitor and update jobs in required operating system making sure the job flows efficiently through the claims process requirements and cycle times Ensure that uploading photos, and other documents are appropriately described, titled and uploaded in real time, as well as follows up to get missing required data from homeowner and insurance/mortgage information not obtained on initial call Creates and or assists with job estimate, reviews final estimate to ensure estimate is complete per company standards Manages Customer Service issues and complaints, documenting actions and resolution Understanding of all company cycle times and SLAs required for each job and phase Client Care Calls - ensure constant, often daily, communication with the customer, may communicate with adjuster Ensure daily notes are entered in all jobs, contacting relevant participants and escalating to the department manager as required May be responsible for creating job estimate and or assisting the Estimator/Project Manager with final estimate Job Requirements High school diploma/GED required IICRC Certifications preferred but not required: WTR, ASD, OCT, STC Exceptional Customer Service skills Experience with Microsoft© Office application (Word, Outlook, PowerPoint, and Excel) required Personal time management and organizational skills Strong verbal and written communication skills Dependable and adaptable to operate within a fast-paced work environment Ability to manage highly confidential information Strong problem-solving skills Proficient at using Microsoft Office, Outlook, CRM software Experience do you have with customer interaction and conflict resolution On-Call Phone services (by rotation) Physical Demands and Working Conditions The physical demands are representative of those that must be met by an employee to perform the essential function to this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Incumbent must be prepared to: Move up to 20 pounds occasionally, by lifting, carrying, pushing, pulling, or otherwise repositioning objects. Sitting for long periods of time while using office equipment such as computers, phones etc. Fingering and Repetitive motions; such as movement of wrists, hands and fingers while picking, pinching and typing during your normal working environment. Express or exchange ideas with others quickly, accurately, and receive and act on detailed information. Close visual acuity to perform detail-oriented activities at distances close to the eyes, such as preparing and analyzing data, viewing computer screen and expansive reading. Be exposed to various inside working conditions: The change of building environment such as with or without air conditioning and heating. May be required to travel for short periods of time. Disclaimer The above statements are intended to describe the general nature and level of work being performed by associates assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed. The Company reserves the right to modify this description in the future, with or without notice to the employee. This Job Description does not create an employment contract, implied or otherwise, and employment with the Company remains at will. These responsibilities are subject to possible modification to reasonably accommodate individuals with disabilities. Built on a foundation of great brands and employees with a passion for service, our vision is to be the leading provider of essential services through empowered people, world-class customer service and convenient access. By joining ServiceMaster, you'll be part of a talented network of employees with a shared vision. Our environment is a diverse community where successful people work together to achieve common goals. This franchise is independently owned and operated by a franchisee. Your application will go directly to the franchisee, and all hiring decisions will be made by the management of this franchisee. All inquiries about employment at this franchisee should be made directly to the franchise location, and not to The ServiceMaster Company, LLC.

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $55,200.00 - $91,100.00 Target Openings 3 What Is the Opportunity? Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process. This role is eligible for a sign on bonus. What Will You Do? * Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. * Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. * Determine claim eligibility, coverage, liability, and settlement amounts. * Ensure accurate and complete documentation of claim files and transactions. * Identify and escalate potential fraud or complex claims for further investigation. * Coordinate with internal teams such as investigators, legal, and customer service, as needed. What Will Our Ideal Candidate Have? * Bachelor's Degree. * Three years of experience in insurance claims, preferably Auto claims. * Experience with claims management and software systems. * Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. * Strong analytical and problem-solving skills. * Proven ability to handle complex claims and negotiate settlements. * Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. What is a Must Have? * High School Diploma or GED required. * A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required. 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 *********************************************************

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Medica's Claim Analyst III (Stop Loss) serves as a subject matter expert responsible for reviewing, analyzing, and processing stop-loss claims to ensure accuracy and compliance with contractual guidelines. This senior-level professional builds and maintains operational relationships with internal and external stakeholders, supports process improvements, and provides expertise in claims adjudication and reconciliation. Performs other duties as assigned. Key Accountabilities * Review and Analyze Claims: Examine stop-loss claims to confirm eligibility, contract terms, and policy limits. Ensure claims are processed accurately and meet production standards * Claims Verification: Verify that all underlying claims are paid appropriately according to standard operating procedures * Claims Tracking and Reconciliation: Track claim submissions, monitor status, and reconcile medical records and correspondence. Collaborate with internal teams (Claims, Utilization Management, Client Services) to resolve eligibility and coordination-of-benefits issues * Process Improvement: Identify opportunities to enhance accuracy and turnaround time (TAT) for stop-loss claims. Support management with ad hoc analysis and reporting related to claims adjudication and stop-loss * Stakeholder Engagement: Build and strengthen relationships with stakeholders through effective problem resolution and communication Required Qualifications * Bachelor's degree or equivalent experience in related field * 5 years of work experience beyond degree Preferred Qualifications * Strong analytical, organizational, and communication skills * High attention to detail; ability to manage multiple priorities under tight deadlines * Proficiency in Microsoft applications and claims systems * Knowledge of ICD-10, CPT/HCPCS coding, and coordination-of-benefits principles This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN office, on average, 3 days per week. The full salary grade for this position is $44,900 - $77,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $44,900 - $67,410. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

At Trane Technologies TM and through our businesses including Trane and Thermo King , we create innovative climate solutions for buildings, homes, and transportation that challenge what's possible for a sustainable world. We're a team that dares to look at the world's challenges and see impactful possibilities. We believe in a better future when we uplift others and enable our people to thrive at work and at home. We boldly go. **What's in it for you:** **Be a part of our mission!** As a world leader in creating comfortable, sustainable, and efficient environments, it's our responsibility to put the planet first. For us at Trane Technologies, sustainability is not just how we do business-it is our business. Do you dare to look at the world's challenges and see impactful possibilities? Do you want to contribute to making a better future? If the answer is yes, we invite you to consider joining us in boldly challenging what's possible for a sustainable world. **Thrive at work and at home:** + **Benefits** kick in on **DAY ONE** for you _and_ your family, including health insurance and holistic wellness programs that include generous incentives - **WE DARE TO CARE** ! + **Family building benefits** include fertility coverage and adoption/surrogacy assistance. + **401K** **match** up to 6%, plus an additional 2% core contribution = up to **8%** company contribution. + **Paid time off,** including in support of **volunteer** and **parental leave** needs. + Educational and training opportunities through company programs along with **tuition assistance** and **student debt support** . + Learn more about our benefits here (********************************************************* ! **Where is the work:** **On-site** (5 days) **What you will do:** + **Provide a best in class customer experience in the warranty and** **service environment** + **Work with channel and field functions to understand channel and** **customer concerns and create solutions for warranty and** **service issues through strong customer service** + **Analyzes and monitors a warranty and service claim information** **process to uphold policy guidelines and create process** **improvements** + **Use claim analytics process to data mine, research and analyze** **dealer warranty and service performance to suggest and** **execute on improvements in process and systems** + **Provide communication on warranty and service policy to** **channel and customers to ensure claims are filed within** **guidelines** + **Support team efforts to manage and reduce warranty spend,** **accruals, and reserves** **What you will bring:** + 3+ years of experience in customer service, claims analysis, warranty support, service or related field + Customer focus and continuous improvement mentality + Ability to collaborate, partner with both internal and external Customers + Strong written and verbal communication skills + Ability to learn and work in multiple systems **Compensation:** **Base Pay Range: $** **45,000 - $** **70,000** _Disclaimer: This base pay range is based on US national averages. Actual base pay could be a result of seniority, merit, geographic location where the work is performed._ **Equal Employment Opportunity:** We offer competitive compensation and comprehensive benefits and programs. We are an equal opportunity employer; all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, pregnancy, age, marital status, disability, status as a protected veteran, or any legally protected status.

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 CategoryClaimCompensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range$55,200.00 - $91,100.00Target Openings3What Is the Opportunity?Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process. This role is eligible for a sign on bonus.What Will You Do? Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. Determine claim eligibility, coverage, liability, and settlement amounts. Ensure accurate and complete documentation of claim files and transactions. Identify and escalate potential fraud or complex claims for further investigation. Coordinate with internal teams such as investigators, legal, and customer service, as needed. What Will Our Ideal Candidate Have? Bachelor's Degree. Three years of experience in insurance claims, preferably Auto claims. Experience with claims management and software systems. Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. Strong analytical and problem-solving skills. Proven ability to handle complex claims and negotiate settlements. Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. What is a Must Have? High School Diploma or GED required. A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required. 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 *********************************************************