Claim processor jobs in Ohio - 324 jobs

Established in 1991, Collabera has been a leader in IT staffing for over 22 years and is one of the largest diversity IT staffing firms in the industry. As a half a billion dollar IT company, with more than 9,000 professionals across 30+ offices, Collabera offers comprehensive, cost-effective IT staffing & IT Services. We provide services to Fortune 500 and mid-size companies to meet their talent needs with high quality IT resources through Staff Augmentation, Global Talent Management, Value Added Services through CLASS (Competency Leveraged Advanced Staffing & Solutions) Permanent Placement Services and Vendor Management Programs. Collabera recognizes true potential of human capital and provides people the right opportunities for growth and professional excellence. Collabera offers a full range of benefits to its employees including paid vacations, holidays, personal days, Medical, Dental and Vision insurance, 401K retirement savings plan, Life Insurance, Disability Insurance. Job Description Position Details : Industry: (Eye Wear Company) Location: Mason - OH Job Title: Claim Processor Duration: 3 Months (possible extension) Roles and Responsibilities: • Accurately and efficiently processes manual claims and other simple processes such as matrix and bypass. • Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication. Major duties and responsibilities: • Processing - Efficiently and accurately processes standard claims or adjustments • Consistently achieves key internals with respect to production, cycle time, and quality • May participate on non-complex special claims projects initiatives, including network efforts • Understands and quickly operationalizes processing changes resulting from new plans, benefit designs. • Drive client satisfaction - Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include EyeMed Account Managers, Operations, Information Systems, Client Representatives and EyeMed leadership team. • Drives Key Performance Indications - Consistently meets or exceeds agreed upon performance standards in both productivity and accuracy. • Proactively works with supervisor to develop self-remediation plan when standards are not being met. Knowledge and skills: • Data entry and claims processing knowledge. Has a working knowledge of interface systems that include the EyeMed claims system, Metastorm Exclaim and EyeNet. Some basic working knowledge of software programs, specifically Excel and Access. • Understands third party benefits and administration. • Strong customer service focus. • Ability to work well under pressure and multi-task. Experience: • Claims processing/data entry experience. • Knowledge of PCs and spreadsheet applications. Education: • High school mandatory Qualifications Claims Processor Additional Information To know more about the position, please contact: Abhinav singh ************

Country USA State Ohio City Cincinnati Descriptions & requirements About the role: When you join TQL as a Claims Representative you will play a key role in protecting our business and customers. In this position, you will own an evolving portfolio of cargo claims from start to finish, resolving them through investigating issues and working with carriers, customers and insurance partners to resolve claims quickly and accurately. The Claims team is a critical part of TQL's commitment to reliability, service excellence, and trust in the fast-paced logistics industry. When unexpected disruptions occur, this group ensures swift resolution, minimizing financial impact, and preserving long-standing customer relationships through efficient, transparent claims management. Who we're looking for: * You're highly detail-oriented with a strong focus on accuracy * You communicate clearly and professionally * You have solid problem-solving and investigation skills * You make sound decisions independently while collaborating closely with your team * You bring a customer-first mindset and build strong relationships * You're comfortable working in a fast-paced environment with changing priorities * You have some professional experience in an office environment, customer service, claims, or insurance What you'll do: * Investigate reported cargo claims and determine validity * Manage documentation, submission, and communication for each claim in your portfolio * Follow up with carriers, insurance partners, and internal and external customers to drive timely resolutions * Gather all required documents and information to file, review, and resolve claims * Serve as the point of contact for internal teams and external partners regarding claim status * Contact carriers, insurance companies, salvage companies and internal/external customers regarding claims made by customers, receivers or shippers * Work with Accounting and Collections teams to resolve carrier and customer accounting issues related to claims What's in it for you: * Compensation starting at $17.50 - $22 per hour, depending on experience * Outstanding career growth potential with structured paths for advancement * Comprehensive benefits package * Health, dental and vision coverage * 401(k) with company match * Perks including employee discounts, financial wellness planning, tuition reimbursement and more * Certified Great Place to Work with 800+ lifetime workplace award wins Where you'll be: 4289 Ivy Pointe Boulevard, Cincinnati, Ohio 45245 Employment visa sponsorship is unavailable for this position. Applicants requiring employment visa sponsorship now or in the future (e.g., F-1 STEM OPT, H-1B, TN, J1 etc.) will not be considered. About Us Total Quality Logistics (TQL) is one of the largest freight brokerage firms in the nation. TQL connects customers with truckload freight that needs to be moved with quality carriers who have the capacity to move it. As a company that operates 24/7/365, TQL manages work-life balance with sales support teams that assist with accounting, and after hours calls and specific needs. At TQL, the opportunities are endless which means that there is room for career advancement and the ability to write your own paycheck. What's your worth? Our open and transparent communication from management creates a successful work environment and custom career path for our employees. TQL is an industry-leader in the logistics industry with unlimited potential. Be a part of something big. Total Quality Logistics is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, genetic information, disability or protected veteran status. If you are unable to apply online due to a disability, contact recruiting at ****************** *

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

Confident Staff Solutions is a leading staffing agency in the healthcare industry, specializing in providing top talent to healthcare organizations across the country. Our team is dedicated to helping healthcare facilities improve patient outcomes and achieve their goals by connecting them with highly skilled and qualified professionals. Overview: We are offering a HEDIS course to individuals looking to start working as a HEDIS Abstractor. Once the course is completed, we will connect you with hiring recruiters looking to hire for the upcoming HEDIS season. HEDIS Course: Includes - Medical Terminology - Introduction to HEDIS - HEDIS Measures (CBP, LSC, CDC, BPM, CIS, IMA, CCS, PPC, etc) - Interview Tips Self-Paced Course https://courses.medicalabstractortemps.com/courses/navigating-hedis-2026

How You Will Contribute Investigate, evaluate, and resolve casualty claims in accordance with company policies and applicable laws. Determine coverage, liability, and damages through thorough analysis and documentation. Communicate effectively with policyholders, claimants, attorneys, and other stakeholders. Maintain accurate and timely claim files and documentation. Collaborate with internal teams to ensure efficient claim resolution. Negotiate Auto Material Damage and other Property Damage claims as a result of liability related to the Casualty Claim file. What You Bring to the Table Strong working knowledge of policy language and interpretation. Expertise in claims settlement principles and practices. Familiarity with medical technology, law, repair techniques, and auto estimating. Clear and concise communication skills, both written and oral. Planning and organizational skills. Ability to analyze situations, solve problems, and make decisions. Proficiency with computers and current technology. Excellent communication skills, capable of testifying by deposition and trial if required. Strong negotiation skills. Eagerness to adapt and learn new technology. Your Background Bachelor's degree or equivalent experience. Minimum of 3 years of experience in handling casualty claims. Successful completion of IIA and/or AIC program studies. Working towards, or completion of, CPCU designation. About Celina Insurance Group Celina Insurance Group is a regional Property & Casualty insurer specializing in Commercial, Farm, and Personal Lines insurance. We have over 400 independent agents in Ohio, Indiana, Tennessee, Kentucky, and West Virginia. Since 1914, Celina has been committed to investing in local communities. We are looking for individuals with positive attitudes to join our team and contribute to our ongoing success.

Cash Claims Processor needs 1+ years experience Cash Claims Processor requires: experience applying cash against medical claims 8a-430p Working knowledge of mainframe computers and systems in general, ie: AS400. Understands third party benefits and administration. Minimum keystrokes per hour requirement of 10,000 with less than 2% error rate. High level of detail orientation. Flexibility working in both a team and individual environments. Proficient in Microsoft Excel applications. Understand and honor high level of confidentiality. Promote integrity. Strong work ethic. High school degree required, Cash Claims Processor duties: Research and apply insurance payments from clients to the appropriate system invoice. Research insurance claim payments in the AS/400 to identify correct claim based on customer information, date of service and service/material procedure codes and related charges. Continuously improve methods for research and in order to effectively and efficiently process transactions. Process transactions - apply cash, member bills, resubmit invoices, write-offs, etc. Follow data processing guidelines to meet established departmental standards. Communicate with supervisor regarding transactions processed in a timely manner.

Job Summary: The RTW Examiner will be the key contact between our clients and non-profit partners. They will need to be motivated, results-oriented and responsible for identifying light duty opportunities with nonprofit organizations. Principal Duties & Responsibilities: Effectively communicate the details of our services with nonprofit organizations to help build our national network. Review work restrictions provided by our clients and coordinate job offers with our network of nonprofit organizations. Follow client service instructions for identifying light duty opportunities. Effectively communicate the details of the program with case managers, employers, attorneys and injured workers. Maintain detailed and accurate records. Prepare documentation outlining job offer details. Understanding of employment labor issues as they relate to state jurisdiction, laws and regulations. Ability to problem solve and communicate effectively related to client issues. Provide outstanding customer service to our clients, injured workers' and non-profit organizations. Prepare client and company reports. Sell and market our business to prospects and nonprofit organizations. Qualifications: Associates Degree or bachelor's degree in Business, Human Resources, Communications or other related field preferred Requirements Bilingual and able to communicate (verbal and written) in English and Spanish. 1-year prior customer support experience Workers' compensation experience preferred but not required Strong communication skills Goal oriented Problem solver Skills, Specialized Knowledge and Abilities Excellent customer service and telephone skills. Ability to handle sensitive information and maintain a high level of confidentiality. Ability to type 40 WPM with accuracy: data entry skills, both accurate and efficient. Able to perform at high levels of efficiency in a fast-paced production environment. Proficient with Microsoft Office products - Outlook, Word, Excel, PowerPoint. Organization, attention to detail, flexibility, and strong ability to multi-task. Ability to work in a fast-paced environment without direct supervision. Effectively work with others to build consensus and rapport. This job description is not intended to be all inclusive and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required.

General Electric Credit Union is a not-for-profit, member-owned full service financial institution headquartered in Cincinnati with branches in Ohio and Kentucky. At GECU, we pride ourselves on maintaining quality service, being an employee-friendly workplace, and developing our team members while teaching you the skills to lead you to career advancement opportunities. Overview: The Claims Specialist processes insurance, warranty, and gap claims, acting as the primary point of contact for GECU members experiencing a claim or total loss of a vehicle. The Claims Specialist investigates and reviews claims, ensuring they are handled efficiently, and plays an important role in educating and updating members on their claim status. Essential Responsibilities: Determine covered insurance losses by studying provisions of a policy or certificate Analyze insurance claims to determine legitimacy of claim Establish proof of loss by reviewing documentation (such as police reports, mechanic reports, and auction house reports) and assembling additional information from outside sources Document claims by completing and recording forms, reports, logs, and records Collaborate with members to collect appropriate reports and documentation needed for the claims process Evaluate member and claim documentation and reports to help reduce loss for member and credit union Ensure legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations Maintain quality member service by ensuring claims process is completed within a 90-day time frame Protect operations by keeping claims information confidential Process and submit cancellation requests for extended warranties to the dealerships, coordinating follow-up actions as needed Systematically gather, categorize and file all necessary documentation for total loss GAP claims, ensuring completeness and adherence to regulator and company requirements Perform other duties to support the department as needed Education and Experience: High school diploma or GED required; bachelor's degree preferred Minimum two years of experience in claims processing, insurance administration, dealer services or related role required Knowledge, Skills, and Abilities: Excellent communication and interpersonal skills Strong conflict resolution skills Ability to work under pressure and meet deadlines Strong analytical and problem-solving skills with proficiency in analytical math Attention to detail and accuracy Proficiency in Microsoft Office Suite Good organizational and time management skills Member service-oriented mindset Ability to work independently and as part of a team At GECU, we want to support your wellbeing by offering a wide range of benefits: Health, Dental and Vision insurance Life and Disability insurance options Paid Time Off starts accruing once hired and take your birthday off - paid 401k Retirement plan with up to a 10% match of your base gross compensation Tuition reimbursement opportunities & professional development Volunteer opportunities -and earn additional PTO hours! On-site clinics for Vaccines and Mammograms And many more! Come join GECU as we are a curated culture of respect, understanding, and mutual recognition. We believe forming bonds and connecting with each other only stands to strengthen the service we provide to our members in our mission of improving the Quality of Financial lives! General Electric Credit Union is an Equal Opportunity Employer

(2) Columbus- Claims Specialist - PN: 20069************5 (2600002Z) Organization: Workers' CompensationAgency Contact Name and Information: Ohio Bureau of Workers' Compensation Human Resources, ******************* Unposting Date: Jan 14, 2026, 4:59:00 AMWork Location: William Green Building 30 West Spring Street Columbus 43215-2256Primary Location: United States of America-OHIO-Franklin County Compensation: $25.77 - $33.52Schedule: Full-time Work Hours: 40Classified Indicator: ClassifiedUnion: OCSEA Primary Job Skill: Claims ExaminationTechnical Skills: Claims Examination, Customer ServiceProfessional Skills: Attention to Detail, Critical Thinking, Teamwork, Time Management, Written Communication Agency OverviewA Little About Us:With roughly 1,500 employees in seven offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers. For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries. Our Culture:BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC strives to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee work groups, participate in on-line forums and learn about how different perspectives can improve leadership skills.Our Vision:To transform BWC into an agile organization driven by customer success.Our Mission:To deliver consistently excellent experiences for each BWC customer every day.Our Core Values:One Agency, Personal Connection, Innovative Leadership, Relentless Excellence.Job DutiesBWC's core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC's seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.What our employees have to say:BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.I have worked at several state agencies and BWC is the best place to work.Best place to work in the state and with a sense of family and support.I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.If you are interested in helping BWC grow, please click this link to read more, and then come back to this job posting to submit your application!What You'll Be Doing: Manages a caseload of Workers' Compensation claims: Communicates, coordinates & collaborates with internal & external stakeholders (e.g. Disability Management Coordinator [DMC], Medical Service Specialist [MSS], Managed Care Organization [MCO], Employer Management [EM] team, Safety & Hygiene, injured workers, employers, Third Party Administrators [TPA] & rehabilitation personnel) in order to set return to work expectations.Performs initial/subsequent claims investigation & determination within prescribed timeframes: Contacts parties involved in claim process; completes investigation during initial claim development to determine information pertinent to management of claim (e.g., jurisdiction, coverage, causality, compensability, claim data accuracy, current work status of claimant, job description, salary continuation, physical demands of job, & work history of claimant).Process various types of compensation ranging from Temporary Total (TT) Compensation, Wage Loss, Permanent Partial and Percentage of Permanent Partial, Living Maintenance, to Lump Sum Advancement requests; addresses subsequent requests by parties to claim via due process notification, investigation, BWC orders & referrals to the Industrial Commission (IC) of Ohio.Evaluates information & issues orders, makes claim allowance decisions in regard to Workers' Compensation law &/or policy develops, implements, customer care plan on all eligible claims through collaboration with MCOs (e.g. Return to Work), processes various types of compensation. Responds to customer inquiries Follows Ohio Revised Code and BWC policies and procedures Communicates with legal representatives, employers, claimants, etc.Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsTo Qualify, You Must Clearly Demonstrate:Required Experience and/or Education36 mos. exp. working in private insurance organization as claims representative or equivalent position; successful completion of one typing course or demonstrate ability to type 35 words per minute. Or Completion of undergraduate core coursework in business, humanities, social & behavioral science, education or related field; successful completion of one typing course or demonstrate ability to type 35 words per minute. Or 24 mos. exp. as Workers' Compensation Claims Assistant, 16720 (i.e., providing assistance to claims field operations team or medical claims team by ensuring all documents are complete, accurate & in compliance with bureau of workers' compensation procedures, determining allowances using code manual ICD/CPT & taking appropriate action on self- insured claims or referring documents for further action by claims team member, reconstructing lost claim files or assigning claim numbers & updating claim information, & managing caseload of self-insured medical & disability claims to ensure compliance with Ohio Workers' Compensation Law). Or 24 mos. exp. as BWC Customer Service Representative, 64451, (i.e., providing information/assistance to &/or answering complaints, questions &/or telephone inquiries &/or written correspondence from customers pertaining to claims status or procedures, reviewing & analyzing claims, referring customers to available community services, & conducting telephone interviews with citizens reporting fraud allegations) &/or as BWC Employer Service Representative, 63521, (i.e., providing information & assistance &/or responding to complaints, questions & inquiries from customers regarding workers' compensation coverage, established binder/applications maintenance, demographics, supplemental & legal entities, manual classifications, debits/credits & payroll reports &/or various BWC programs & research & explain employer refunds, attorney general balances, payments made to policies &/or divided credits). Or 12 mos. exp. as Workers' Compensation Medical Claims Specialist, 16721 (i.e., managing caseload of medical-only claims & paying medical claims for Ohio Bureau Of Workers' Compensation). Or any combination of at least 36 mos. exp. working in private insurance organization as claims representative or equivalent position &/or as Workers' Compensation Claims Assistant, 16720 &/or as Workers' Customer Service Representative, 64451 &/or as Workers' Compensation Employer Service Representative, 63521. Or equivalent of Minimum Class Qualifications For Employment noted above. Note: Classification may require use of proficiency demonstration to determine minimum class qualifications for employment. Job Skills: Claims Examination Major Worker Characteristics:Knowledge of workers' compensation laws, policies & procedures*; eligibility criteria & procedures used for processing workers' compensation claims*; English grammar & spelling; oral & written business communication; public relations*; addition, subtraction, multiplication, division, fractions, decimals & percentages; interviewing techniques; internet search engines & navigation; medical terminology; medical diagnosis coding*; Industrial Commission processes*; claims reserving*Skill in operation of a personal computer; typing; use of Microsoft Office software (e.g., Outlook, Word, Excel, Access, PowerPoint); use of BWC-specific software (e.g., Workers' Compensation Claims Management System, Intrafin, FMS fraud system)*; operation of office machinery (e.g. calculator, printer, copier, fax, phone); communication skills (e.g., listening, writing, reading, phone etiquette); use of internet Ability to define problems, collect data, establish facts, & draw valid conclusions; read & understand medical reference manuals & reports, gather, collate, & classify information about data, people, or things; respond to sensitive inquiries from & contacts with injured workers, employers, providers or their representatives, & the public; answer routine & technical inquiries from injured workers, employers, medical providers & public*; make proper referrals (within agency & external sources)*; diffuse potentially volatile situations; present information to others; work with a team; use International Classification of Diseases (ICD) coding manuals/system*; generate properly formatted business correspondence; read and understand compensation payment plan screens*, interpret Cognos reports*.(*) Developed after employment Supplemental InformationEEO & ADA Statement:The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order.The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request a reasonable accommodation due to disability, please contact the ADA mailbox: *********************** OCSEA Selection Rights:This position shall be filled in accordance with the provisions of the OCSEA Collective Bargaining Agreement. BWC bargaining unit members have selection rights before non-bargaining unit members. All other applications will only be considered if an internal bargaining unit applicant is not selected for this position.Salary Information:Hourly wage is expected to be paid at step 1 of the pay range associated with the position for candidates who are new employees of the state. Current employees of the state will be placed in the appropriate step based on any applicable union contract and/or requirements of the Ohio Revised Code. Movement to the next step of the pay range (a roughly 4% increase) will occur after six months, assuming job performance is acceptable. Thereafter, an employee will advance one step in the pay range every year until the highest step of the pay range is reached. There may also be possible cost of living adjustments (COLA) and longevity supplements begin after five (5) years of state service.Educational Transcripts:For any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed.All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted.Background Check:Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************

This position is responsible for processing Super Service claims according to company guidelines with settlement authority up to $3,500, as well as providing claims customer service to agents, policyholders, and claimants. Functions: Process first party auto claims according to company guidelines and in compliance with the Unfair Claims Practices Act. Receive incoming loss reports, verify policy coverages, and document for review by CSR and Subro Claims Supervisor. Verify policy coverage of assigned losses. Investigate and evaluate assigned Super Service claims for proper settlement. Assign independent adjusters and appraisers when necessary. Pursue subrogation, salvage, and third-party liability contribution. Notify CSR and Subro Claims Supervisor of all claims that exceed settlement authority of $3,500. Establish proper reserves on assigned claims. Issue payments to vendors with prior management/Claims Representative approval. Assist CSRs with end of day, month-end, and quarterly reports. Report claim complaints, questionable claim submissions and possible fraud to CSR and Subro Claims Supervisor. Perform other duties as assigned by CSR and Subro Claims Supervisor. Requirements High school or equivalent education required. Ability to learn basic knowledge of insurance coverages written by the company required. Effective communication skills required. Ability to understand basic insurance terms and law required. Ability to learn through on-the-job training required. Ability to work effectively with company computer systems required. Willingness to participate in insurance related study courses preferred. Ability to work flexible hours, travel to all organization offices (including in Pennsylvania, Ohio, and South Dakota) and travel to vendor work sites required. Ability to work in an office environment with moderate noise level, remain in a stationary position and operate a computer a majority of the time required. Ability to move throughout the office to access work materials and to move work materials weighing up to ten pounds daily required. Ability to perform the essential functions of the job with or without reasonable accommodation required.

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI

About Us We're not like other insurance companies. From our specialty products to our business model, our culture to our results - we're different. Different is who we are, and how we work, interact, deliver and succeed together. Creating a different and better insurance experience doesn't just happen. It takes focus and a shared passion for going beyond the expected to forge relationships and deliver care that makes a difference. This approach rises from and is supported by our talented, ethical and smart team of employee owners united around a single purpose: to work alongside our customers and partners when they need us, in unexpected ways, with exceptional results. Apply today to make a difference with us. RLI is a Glassdoor Best Places to Work company with a strong, successful background. For decades, our financial track record has been stellar - a testament to our culture and validation of our reputation as an excellent underwriting company. Principal Duties & Responsibilities * Proactively handle Personal Umbrella Liability claims (auto, premises and personal liability) with a detailed focus on claim investigation, evaluation, and monitoring of primary carrier activity to achieve optimum results. * Effectively investigate and analyze complex coverage issues and write coverage letters as appropriate. * Complete timely and thorough investigations into liability and damages for early exposure recognition. * Focus on claims resolution with timely and effective liability investigations and damage evaluations and reserve setting. * Handle claims in accordance with RLI's Best Practices. Education & Experience * Typically requires a bachelor's degree and 6+ years of relevant legal or technical claims experience. * Experience handling large exposure third-party liability claims on a primary/excess basis is preferable. * Significant experience in effective handling of policy limit demands in states such as Florida, Texas and California. * Must be able to excel in a fast-paced environment with little supervision. * Effectively work with primary carriers and defense counsel and understand umbrella/excess handling and management of outside counsel. * Ideal candidate will have superior working knowledge of Florida, California, New York and Texas case law, statutes and procedures impacting the handling and value of liability claims. Knowledge, Skills, & Competencies * Ability to use analytical methods in complex claim processes to find workable solutions. * Ability to generate innovative solutions within the claims department. * Ability to communicate findings and recommendations to internal and external contacts on claim matters. Compensation Overview The base salary range for the position is listed below. Please note that the base salary is only one component of our robust total rewards package at RLI. The salary offered will take into account a number of factors including, but not limited to, geographic location, experience, scope & responsibilities of the role, qualifications/credentials, talent availability & specialization, as well as business needs. The below range may be modified in the future. Base Pay Range $108,348.00 - $157,917.00 Total Rewards At RLI, we're all owners. We hire the best and the brightest employees and allow them to share in the company's success through our Total Rewards. With the Employee Stock Ownership plan at its core, the Total Rewards program includes all compensation, benefits and perks that come with being an RLI employee. Financial Incentives * Annual bonus plans * Employee stock ownership plan (ESOP) * 401(k) - automatic 3% company contribution * Annual 401k and ESOP profit-sharing contributions (Up to 15% of eligible earnings) Work & Life * Paid time off (PTO) and holidays * Paid volunteer time off (VTO) to support our communities * Parental and family care leave * Flexible & hybrid work arrangements * Fitness center discounts and free virtual fitness platform * Employee assistance program Health & Wellness * Comprehensive medical, dental and vision benefits * Flexible spending and health savings accounts * 2x base salary for group life and AD&D insurance * Voluntary life, critical illness, & accident insurance for purchase * Short-term and long-term disability benefits Personal & Professional Growth RLI encourages its employees to pursue professional development work in insurance and job-related areas. We make a commitment to employees to provide educational opportunities that help them enhance their skills and further their career advancement. RLI fosters a true learning culture and encourages professional growth through insurance courses, in-house training and other educational programs. RLI covers the cost for most programs and employees typically earn a bonus upon successful completion of approved courses and certifications. Our personal and professional growth benefits include: * Training & certification opportunities * Tuition reimbursement * Education bonuses Diversity & Inclusion Our goal is to attract, develop and retain the best employee talent from diverse backgrounds while promoting an environment where all viewpoints are valued and individuals feel respected, are treated fairly, and have an opportunity to excel in their chosen careers. We actively support, and participate in, initiatives led by the American Property Casualty Insurance Association that aim to increase diversity in the insurance industry. Cultivating an exceptional and diverse workforce to deliver excellent customer service reinforces our culture and is a key to achieving superior business results. RLI is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, national origin, citizenship, gender, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by federal, state, or local law.

Candidates may live in Ohio or Indiana! A Claim Specialist works independently or with minimal direction, managing claims that present high exposure and/or complex coverage or liability issues for all lines of business: Homeowners, Personal Auto, Commercial Auto, GarageKeeper, Commercial Liability and Farm Liability. Salary Grade (13) 76,101 - 97,030 - 117,958 Determines coverage, liability, sets and adjusts reserves, evaluates the claim, manages the litigation and negotiates settlements. Works within prescribed authority limits handling claims. Investigate and determine liability of all parties involved. Ensures delivery of high-quality customer service to protect our insured, and assets of the company. Demonstrates a high level of expertise and sound judgment in complex matters; may serve as a subject matter expert. Required to manage assigned caseload of casualty losses in accordance with Company standards and IC 27-4-1/ORC 3901-1-54. ESSENTIAL DUTIES AND RESPONSIBILITIES The following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. Coverage/Investigation/Liability - Determines whether proper coverage exists for the type of claim assigned. Investigates thoroughly to obtain relevant facts concerning all aspects of the claim, such as coverage, liability, legal climate, potential exposure, and damages, and makes decisions, where appropriate, on claim resolution. Monitors ongoing case development for appropriateness. Damages - Determines the value of the physical damage of property, automobiles, or injuries through physical inspections and use of appropriate tools. Obtains all necessary documentation to support claim evaluation. Recognizes claim file exposures and escalates appropriately. Reserving/Reporting - Establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience. Completes appropriate reports so that the status of the claim is clearly documented at all times. Determines need for, and engages independent adjusters, cause and origin experts. independent medical examiners or other experts (e.g. reconstructionist, engineer). Proficiently and proactively handle the claim file through various phases of litigation. Independently review the applicability of coverage and civil law as well as local statutes. Attend mandatory and court ordered litigation events: mediation, pre-trial, trial. Keeps abreast of existing and proposed legislation, court decisions and trends and experience pertaining to coverage, liability and damages. May analyze the impact upon claims policies and procedures and advises Claims Management. Participates in or leads special projects and mentors others, as needed. Initiate prompt and effective communication with all parties having legal or contractual interest in claim presented Capable of drafting clear and concise letters and other correspondence. Accountable for security of financial processing of claims, as well as security information contained in claims files. Confers directly with policyholders on coverage and resolution issues pursuant to Home Office instructions. Prepare claims for trial, comply with trial alert procedures and notify/update reinsurance when appropriate. Participate in training programs, conferences and departmental and intra-departmental meetings. May be required to be on-call, on a limited basis, for afterhours emergencies Any other duties deemed necessary by supervisor or management. SUPERVISORY RESPONSIBILITIES None QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE College Degree or Equivalent Experience At Least 3 years as a Sr. Claim Representative or equivalent preferred Excellent Written and Verbal Communication Skills Excellent Interpersonal Skills Superior Organizational Skills Efficient Time Management skills Ability to Demonstrate effective negotiation skills LANGUAGE SKILLS Excellent verbal and written communication skills. The individual must be able to effectively and clearly communicate with agents, insureds, departmental and company personnel via telephone, fax, e-mail, one-on-one dialogue and small group presentations in a professional manner. REASONING ABILITY The position requires the individual to apply common sense, understanding, reasoning and sound educated judgement coupled with sound Claims training and experience to properly evaluate and analyze claims for recommended action within assigned authority levels. CERTIFICATES, LICENSES, REGISTRATIONS IIA, AIC, or CPCU are highly preferred PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Employees are required to sit at a workstation to perform various PC functions. Additionally, the employee is required to devote substantial time to telephone communication. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, and reach with hands and arms. Employees may be required to travel from time to time. This may require extended periods of time sitting in a vehicle. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The Claim Specialist is responsible for the proper handling of claims. Each Claim Specialist will be assigned a specific work cubicle station and or other individual work areas. The workstation will be located adjacent to other similar workstations. The workstation has the necessary equipment to perform the position duties including personal computer, telephone, file space, and needed work table space. The environment is reasonably quiet with needed interaction between other team members, immediate supervisor, and other Company staff. Moderate noise level from telephone calls is expected.

Alpha Automotive is looking for an Automotive Claims Representative to join our rapidly growing team! Here at Alpha Automotive, we pride ourselves on providing the best service possible for our customers by being an alternative to large, impersonal dealerships and providing them with an elevated level of personalized service each and every time. We are now hiring for ALL of our locations: Stealth Auto Recovery, Excite Towing, Wayne's Auto Powell, Wayne's Auto Schrock, Wayne's Auto Westerville, Mann's Expedite Service, H.I.N.T., Excite Collision Repair, and Ernie's Auto Repair! As an Automotive Claims Representative, a typical day may include the following: Acting as a liaison between insurance companies and customers, to assure claims are being paid in a timely manner so repairs can begin Working in harmony with the service writers in getting repair estimates sent to insurance companies, and following up to confirm they have been received and submitted correctly Keeping customers in the loop with any updates from the insurance company, and communicate when there are changes or any additional information is needed from them This career may be for you if: You enjoy helping people and problem solving You love the automotive industry and are ready to make the transition to an office environment You thrive in a fast paced environment Benefits include: Training & competitive pay Dental, vision, life & disability insurance Paid time off after a year of service View all jobs at this company

- Adjust and manage claims brought against security companies, private investigators and alarm installation and monitoring companies, from receipt of claim or suit through resolution or trial/appeal. Key Accountabilities/Deliverables: Provide early contact with insured to identify witnesses, employees, contracts, other relevant documents and to obtain insured's knowledge of the allegations in the claim/suit. Analyze coverage for application to claim and prepare coverage position letters including reservation of rights, disclaimers, tender to other parties and acceptance of tenders to insured where appropriate. Confer with internal and external coverage counsel where necessary to clarify coverage position and coverage litigation. Communicate with underwriting as to insured's risk potential and for clarification of policy language intent. Maintain diaries for file tasks, settlement conferences, mediations, and trial. Oversee defense counsel from initial assignment of defense and throughout litigation to ensure timely reporting, confirmation of defense strategy and analysis of new developments. Collaborate with defense counsel to develop early litigation or settlement strategy. Ensured that Defense Counsel provides timely pretrial reports. Maintain claim files, notes and documentation which comply with both internal guidelines and external regulations to include analysis of liability, damages, adequacy of reserves and outline of plan or next steps. Prepare internal reports for file documentation and early identification of significant reserve increases for presentation to management and upper management for review. Communicate with manager as to critical new developments and significant reserve increase recommendations, and potential settlement recommendations above handler's settlement authority. Timely communication and reporting of critical or new developments to exterior carriers including coverage, litigation developments, reserves, and potential settlement opportunities. Review and approve litigation budgets submitted by Defense Counsel. Regular review and updating of claim files that remain open but currently inactive and are not generating claim activity. Evaluate inactive claims for closure and removal of reserves. Attend mediation and settlement conferences when required to facilitate and negotiate settlement. Monitor and approve/reject litigation expenses recommended by Defense Counsel. Prepare settlement drafts and review of releases for accuracy. This role may require occasional travel for matters that cannot be handled through video conference. Technical Knowledge and Understanding: Licenses to be obtained where required by a state to adjust claims within that state. Knowledge of third-party liability claims handling and risk transfer analysis / coverage analysis required. Knowledge of first party commercial auto claims and security guard claims handling preferred. Experience: Bachelor's degree required. Minimum 5 plus years of claims experience preferred. Law degree strongly preferred. Previous experience in a similar role. Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa for this position. #LI-Hybrid - At Core Specialty, you will receive a competitive salary and opportunities for professional development and advancement. We offer medical, dental, vision, and life insurances; short and long-term disability; a Company-match of 100% of a 6% contribution 401(k) plan; an Employee Assistance Plan; Health Savings Account, Flexible Spending Account, Health Reimbursement Account, and a wellness program

Come to work with us at Community Health Services! We offer full-time benefits, 10 paid holidays, no weekend hours and so much more! We are looking for a full-time Claims Specialist to work in our Fremont office. CHS employs those who are eager to grow professionally, gain great experience, and work with a terrific team. The Claims Specialist will be responsible for performing general finance functions, entering encounters, processing and recording claims and all other duties as assigned. Hours for this position are: Mondays 7am-7pm, Tuesdays through Thursdays 8am-5pm, Fridays 8am-1pm Qualified candidates must have the following to be considered for employment: * Associate's degree from an accredited college or university * Experience in accounting/bookkeeping * Demonstrates ability to organize and implement general accounting and bookkeeping procedures for a healthcare organization * Ability to work with clinic personnel and patients in a courteous, cooperative manner * Ability to function as part of a team * Must have excellent customer service skills * Must have excellent multi-tasking, problem solving, and decision-making skills * Ability to follow instructions with attention to detail * Demonstrates professional relationship skills, and a strong work ethic * Prioritizes responsibilities, takes initiative, and possesses excellent organizational skills * Demonstrates effective communication skills * Ability to work with a culturally diverse group of people At CHS, we value our team and the critical role they play in patient care. If you're dependable, detail-oriented, and passionate about making a difference in your community, we'd love to hear from you. CHS is a drug-free/nicotine free organization. Candidates must pass a drug and nicotine screening upon employment offer.

The Claims Specialist works on highly complex claim assignments requiring specialized knowledge. The role handles activities including, but not limited to, coverage analysis, liability and damage investigation, litigation, and expense management. The role also evaluates claims for reserve and settlement, executes settlement strategy, negotiates settlements proactively, attends arbitrations and ensures appropriate file documentation. Westfield Casualty Claims resolves third party liability claims involving injury, property damage, construction defect, personal & advertising injury, and environmental cleanup - both pre-suit and in litigation. Job Responsibilities Determines whether proper coverage exists for the type of claim assigned, investigates thoroughly to obtain relevant facts concerning coverage, liability, legal climate, potential exposure, and damages, and makes decisions on claim resolution. Determines the value of damage through physical inspections, uses appropriate tools, reviews policy coverages, inspects damages, determines cause and origin, investigates questionable circumstances, and considers subrogation and salvage possibilities. Establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience. Completes appropriate reports so that the current status of the claim is clearly documented at all times. Assists claims professionals in the handling of large or complicated property losses. Participates in the coaching, development, training and education of claims professionals. Collaborates with property leadership team in the identification of property training needs. Assists in the design, development, and delivery of training to claims professionals. Provides outstanding customer service, works well with the insured and broker in the adjustment of mainstream risks, and claims. Collaborates in the defense and resolution of claims, reviews and analyzes contracts for risk transfer potential. Documents relevant events timely as case facts are developed, evaluates liability, damages, and exposure, negotiates timely settlements and refers claims exceeding authority to appropriate leader or complex claims specialist with recommendations. Provides general administrative, clerical and customer service assistance on the routine tasks to the Claims Adjustment team. Collaborates with internal and external business partners, large account customers, peers and other departments to make decisions that are in the best interest of the company. Remains current on industry topics, trends, processes, technology, best practices through research, industry events, networking, etc. Shares knowledge gained with others, drives new and updated policies, processes, and procedures. Supports and reports on the claims process improvement program, including the coordination and participation in best practice creation, monthly metric analysis etc. Supports catastrophe management efforts, organizes, deploys personnel, trains independent contractors, utilizes loss adjusting software and supports business partners by maintaining and enhancing relationships with customers and brokers. Travels as often as needed to cover assigned territory. This may involve traveling on short notice or other daily driving duties as assigned. Job Qualifications 6+ years of Claims Handling experience. Bachelor's Degree in Business or a related field and/or commensurate work experience. For field roles only: Valid driver's license and a driving record that conforms to company standards. Location Remote Licenses and Certifications Certified Professional Claims Management (CPCM) (preferred) Certified Claims Adjuster (CCA) (preferred) Chartered Property Casualty Underwriter (CPCU) (preferred) Behavioral Competencies Collaborates Communicates Effectively Customer Focus Decision Quality Nimble Learning Technical Skills Account Management Claims Investigations Claims Adjustment Claims Resolution Claims Settlement Financial Controls Auditing Claims Case Management Customer Relationship Management Business Process Improvement Auditing Data Analysis and Reporting This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.

The Associate AMD Claims Representative is an entry-level role that is designed for continuous career growth into the role of AMD Claim Representative. This position learns to investigate and evaluate AMD claims as well as resolves claims from a minor to moderate value. Formal training on claims handling, coverage investigations, negotiations, settlements, diary management, and overall claims resolution are part of the overall role. Essential Functions Complies with company procedures and the applicable State Fair Claims Practices Acts. Reviews policies and claim forms, and manages all external communication with insureds, claimants, and other contacts associated with the claim to determine coverage, liability and damages. Maintains accurate claims and investigative reports. Provides optimal customer service during times of high claim volume, which can be frequent; must be able to manage high call, email, and text volume from various customers. Handles administrative responsibilities associated with the processing and payment of claims: records and updates status notes, documents the results of external information gathering, administers correspondence to customers regarding the status of their claims. Issues loss and expense payments within stated authority and comply with check security procedures. Works in a team environment to: promote and support the unit, department and organizational goals, communicate effectively, establish positive relationships with team members, work with colleagues effectively and professionally. Performs other duties as assigned. Working Conditions Normal office working conditions. Sitting for extended periods of time. Eye strain and fatigue. Extended computer usage. Handling numerous phone and points of contact from customers daily Stress associated with high claims volume, upset customers, making difficult decisions and meeting deadlines. QUALIFICATIONS Skills and Abilities Must be proficient with operating a computer. Exceptional customer service skills. Experience working in a customer service environment where conflict resolution, time management, workload prioritization and follow-up are key priorities. Strong organizational and detail-oriented skills. Ability to focus and manage with frequent interruptions while dealing with various tasks. Ability to develop and maintain customer relationships. Strong verbal and written communication skills. Ability to manage conflict resolution. Strong analytical and critical thinking skills. Education Requirements High School Graduate/GED College degree preferred or equivalent work experience. SUPERVISION Supervision Received Periodic supervision since most duties are repetitive and related with standard instruction and procedures as guides. Self-reliant with limited oversight. Unusual problems are referred frequently to the Claims Unit Manager with suggestions for correction. Supervision Exercised None