Claim processor jobs in Palm Bay, FL

Business Claim Examiner Visa GC/Citizen Division Pharmaceutical Pay Negotiable Contract 6 Month Timings Mon - Fri between 8.00AM - 5.00PM Qualifications · Verify member submitted claims forms, member's eligibility & pharmacy information is complete & accurate, updating system information as needed. · A high data entry proficiency is expected in order to provide accurate & timely processing of claims submitted by member, pharmacy or agencies. · Moderate knowledge of drugs & drug terms used daily. · Process claims according to client specific guidelines while identifying claims requiring exception. · Navigate daily through several platforms to research & finalize claim submissions. · Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. · Adhere to strict HIPPA regulations especially when communicating to others outside of ESI. · Prioritize & coordinate influx of daily workload for claims processing, returned mail & outgoing correspondence & e-mails to assure required turnaround time is met. · Assess accuracy of system adjudication & alert management of potential problems affecting the integrity of claim processing. · Analyze claims for potential fraud by member or pharmacy. · May be required to work on special projects for claims team. If you are available and interested then please reply me with your “ Chronological Resume” and call me on ************** . Additional Information Thanks & Regards, Ranadheer Murari | Team Recruitment | Mindlance, Inc. | W : ************ *************************

At Percepta, we bring first-class service across each market we support. As a Automotive Claims Representative in Melbourne Florida, you'll be a part of creating and delivering amazing customer experiences, while also enjoying the satisfaction of being part of a unique culture. What You'll Be Doing * Ability to analyze repair shop claim information to determine contract coverage * Ability to speak confidently about extended service business products and prior approval process * Ability to utilize web based technical service information to complete the claim adjudication process * Excellent negotiation skills and consultative approach * Establish rapport and portray a knowledgeable and courteous impression to the caller * Excellent interpersonal skills in a team environment * Communicate and articulate in an effective manner both verbally and written * Strong working knowledge of the Internet, computers, and software (MS Office products, Internet Explorer, etc.) * Flexibility and adaptability in a fast-paced environment * Ability to exercise independent judgment and decision making * Reasoning ability and logical thinking What You Bring to the Role * High School Diploma or equivalent * Minimum 2-3 year of customer service experience * Minimum 1-year recent experience as an automotive technician in a powertrain or body/chassis/electrical diagnostic and repair role or equivalent training - preferred What You Can Expect * Hourly rate of 16.50 * Health/Dental/Vision/Life Insurance * Flexible Spending Account (FSA) and Health Savings Account (HSA) * 401(k) with company match * Vacation/Sick Time and Paid Holidays * Tuition Reimbursement * Employee Assistance Program * Employee Discount Program * Training and Development Programs (Percepta College) * Employee Rewards Program (Perci Perks) A Bit More About Your Role * Receive inbound contacts (calls and web) from F/L dealerships, Competitive Make dealerships and independent repair facilities regarding extended service contract coverage and provides claims adjudication per contract terms and contact handling processes * Through use of technology and scripts listens to the callers' requests, and provides appropriate levels of authorization in an efficient professional manner * Receive inbound calls from contract holders to verify contract coverage or review claim participation issues * Process prior approval request for repairs performed on company lease vehicles according to program guidelines * Verify cause of failure is covered under the service contract through the use of probing questions * Identify when a requested repair is covered under another warranty, service contract, improper previous repair or pre-existing condition * Ask probing questions to obtain all pertinent claim information * Utilize web based automotive technical information to very repair procedures, labor time allowances and part pricing is consistent with recommended repairs and contract coverage * Request additional information from the repair facility (digital photos, technical escalation or physical inspection) when automotive knowledge indicates the recommended repair may not be covered by the contract * Effectively negotiate part pricing and labor allowances when required * Communicate professional, grammatically correct verbal responses to customer concerns and inquiries * Properly log all customer contacts into appropriate contact system, to allow for an accurate historical view of a customer's contacts with the CRC * Identify and relay areas for improvement within the program and the CRC to the team leader * Escalate, as appropriate, identified customer inquiries and concerns * Meet or exceed all program specific performance metrics * Continuously improve call handling skills, systems knowledge, and communications skills, thus, enhancing customer satisfaction and service level results * Support and sustain a positive work environment that fosters team performance through own work and behavior * Be receptive to performance feedback and work on improving own skills * Help identify and resolve conflicts with sensitivity and tact. * Work on activities and/or projects as requested by Team Leader/Management. About Percepta Established in 2000, Percepta has contact centers across the globe that proudly deliver a frictionless customer experience to our clients. Our values are the heartbeat of our organization, and we live, breath and play by them every day. As a Percepta team member, you can expect: Culture of Service - to be treated like you are the customer from day one Teamwork - belonging to a supportive family team environment that encourages growth, fosters trust and open communication, and acknowledges value in your contributions Respect - a team that is accountable, dependable and gives you their full attention Proactive - to surround yourself with solution-oriented people who strive to improve themselves, others, and the organization Career Growth - lots of learning opportunities for aspiring minds Diversity - be a part of our growing diverse and community-minded organization that is all about having fun! Competitive Compensation - we take care of family, which is why we offer more than just competitive wages and great benefits. Our programs offer incentives and promote physical, mental, and financial wellness. Percepta requires all employees hired in the United States to successfully pass a background check and depending on location and client program a drug test, as a condition of employment. Percepta is an Equal Opportunity Employer.

The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems. **Knowledge/Skills/Abilities** + Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. + This role is involved in member enrollment, provider information management, benefits configuration and/or claims processing. + Responds to incoming calls from providers regarding claims inquiries and provides excellent customer service; documents calls and interactions. + Assists in the reviews of state or federal complaints related to claims. + Supports the other team members with several internal departments to determine appropriate resolution of issues. + Researches tracers, adjustments, and re-submissions of claims. + Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards. + Manages defect reduction by supporting the identifying and communicating error issues and potential solutions to management. + Handles special projects as assigned. + Other duties as assigned. Knowledgeable in systems utilized: + QNXT + Pega + Verint + Kronos + Microsoft Teams + Video Conferencing + Others as required by line of business or state **Job Function** Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating Molina values in their actions. Responsible for effectively managing and documenting calls and responding to providers regarding issues with claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience; **REQUIRED EXPERIENCE:** 2-3 years customer service, claims, provider and investigation/research experience. Outcome focused and knowledge of multiple systems. 1+ years of claims research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 4 years **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

The Claims Specialist will be responsible for assisting with the management of the Fleet Vehicle Safety & Operations Policy for DPR (and DPR related entities) across the US, as well as first and third-party auto physical damage and low severity property damage claims as requested by, and under the supervision of, DPR's Insured Claims Manager. Specific Duties include: Claims & Incident Management: * Initial processing of first and third-party auto and low severity property damage incidents involving DPR (and DPR related entities), including but not limited to: * Input and/or review all incidents reported in DPR's RMIS system. * Maintain incident records in Insurance Team's document management system. * Ensure all necessary information is compiled to properly manage the claims, including working with the internal teams to identify culpable parties, potential risk transfer to the culpable trade partner, if applicable, collecting documents such as incident reports, root cause analyses, if any, and vehicle lease or rental agreements. * Report, with all appropriate documents and information, all claims for DPR (and DPR related entities) to all potentially triggered insurance policies for various types of programs (traditional, CCIP, OCIP), including analyzing contractual risk transfer opportunities. * Assess potential risk transfer opportunities and ensure additional insured tenders or deductible responsibility letters are sent, where applicable. * Liaison with the carriers in evaluating whether claims reported directly to the carriers are appropriate. * Manage all auto and low severity property damage claims, as assigned, in the DPR RMIS system for DPR (and DPR related entities), including ensuring that all information is kept up to date. * Provide in-network aluminum certified repair shop information to drivers following an incident. * Act as a liaison between our carriers, auto repair shops, Operations, Fleet and EHS teams related to claim progress, strategy, expenses and settlement. * When required, notify the applicable State's Department of Motor Vehicles office of motor vehicle accidents by preparing and mailing the specific State form. * Work with Insurance Controller on auto program claim reports * Liaison with Operations, Fleet and EHS teams on new incident reporting processes, as needed. Fleet Vehicle Safety & Operations Policy Management: * Manage the Fleet Risk Index scores for authorized drivers, ensuring its accurate and up to date based on incidents and MVRs * Assign training to authorized drivers based on MVA incidents, MVRs and citations, as well as managing completion of the training * Ensure authorized driver list is kept current * Liaison with internal HR, Fleet, EHS and Business Unit Leaders, where appropriate, on suspending vehicle usage permissions * Responsible for working with internal teams on implementing appropriate updates to the Fleet Vehicle Safety & Operations Policy Key Skills: * Strategic thinking * Ability to mentor and inspire others * Integrity * Team player * Strong writing and communication skills * Self-Starter * Highly organized and responsive - ability to meet deadlines * Detail Oriented * Basic working knowledge in all of the following coverages/programs: auto insurance, commercial general liability, property insurance, and controlled insurance programs. * Risk and dispute management - insured claims Qualifications: * A minimum of five years relevant insurance industry experience * Previous experience in auto claims management highly desired DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************

We are united in our mission to make a positive impact on healthcare. Join Us! South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2024 2024 Black Book Awards, ranked #1 EHR in 11 Specialties 2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold) 2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara) Who we are: We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany. ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine! Your Role: Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates Input and update patient account information and document calls into the Practice Management system Special Projects: Other duties as required to support and enhance our customer/patient-facing activities Skills & Requirements: High School Diploma or GED required Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST Minimum of 1-2 years of previous healthcare administration or related experience required Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs) Manage/ field 60+ inbound calls per day Bilingual required (Spanish & English) Proficient knowledge of business software applications such as Excel, Word, and PowerPoint Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone Ability and openness to learn new things Ability to work effectively within a team in order to create a positive environment Ability to remain calm in a demanding call center environment Professional demeanor required Ability to effectively manage time and competing priorities #LI-SM2 ModMed Benefits Highlight: At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits: India Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk, Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees, Allowances: Annual wellness allowance to support your well-being and productivity, Earned, casual, and sick leaves to maintain a healthy work-life balance, Bereavement leave for difficult times and extended medical leave options, Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave, Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind. United States Comprehensive medical, dental, and vision benefits 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep. Generous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.

US-FL-MelbourneDescription Automotive Claims Representative At Percepta, we bring first-class service across each market we support. As a Automotive Claims Representative in Melbourne Florida, you'll be a part of creating and delivering amazing customer experiences, while also enjoying the satisfaction of being part of a unique culture. What You'll Be Doing · Ability to analyze repair shop claim information to determine contract coverage · Ability to speak confidently about extended service business products and prior approval process · Ability to utilize web based technical service information to complete the claim adjudication process · Excellent negotiation skills and consultative approach Establish rapport and portray a knowledgeable and courteous impression to the caller Excellent interpersonal skills in a team environment Communicate and articulate in an effective manner both verbally and written Strong working knowledge of the Internet, computers, and software (MS Office products, Internet Explorer, etc.) Flexibility and adaptability in a fast-paced environment Ability to exercise independent judgment and decision making Reasoning ability and logical thinking What You Bring to the Role · High School Diploma or equivalent · Minimum 2-3 year of customer service experience · Minimum 1-year recent experience as an automotive technician in a powertrain or body/chassis/electrical diagnostic and repair role or equivalent training - preferred What You Can Expect · Hourly rate of 16.50 · Health/Dental/Vision/Life Insurance · Flexible Spending Account (FSA) and Health Savings Account (HSA) · 401(k) with company match · Vacation/Sick Time and Paid Holidays · Tuition Reimbursement · Employee Assistance Program · Employee Discount Program · Training and Development Programs (Percepta College) · Employee Rewards Program (Perci Perks) A Bit More About Your Role · Receive inbound contacts (calls and web) from F/L dealerships, Competitive Make dealerships and independent repair facilities regarding extended service contract coverage and provides claims adjudication per contract terms and contact handling processes · Through use of technology and scripts listens to the callers' requests, and provides appropriate levels of authorization in an efficient professional manner · Receive inbound calls from contract holders to verify contract coverage or review claim participation issues · Process prior approval request for repairs performed on company lease vehicles according to program guidelines · Verify cause of failure is covered under the service contract through the use of probing questions · Identify when a requested repair is covered under another warranty, service contract, improper previous repair or pre-existing condition · Ask probing questions to obtain all pertinent claim information · Utilize web based automotive technical information to very repair procedures, labor time allowances and part pricing is consistent with recommended repairs and contract coverage · Request additional information from the repair facility (digital photos, technical escalation or physical inspection) when automotive knowledge indicates the recommended repair may not be covered by the contract · Effectively negotiate part pricing and labor allowances when required · Communicate professional, grammatically correct verbal responses to customer concerns and inquiries · Properly log all customer contacts into appropriate contact system, to allow for an accurate historical view of a customer's contacts with the CRC · Identify and relay areas for improvement within the program and the CRC to the team leader · Escalate, as appropriate, identified customer inquiries and concerns · Meet or exceed all program specific performance metrics · Continuously improve call handling skills, systems knowledge, and communications skills, thus, enhancing customer satisfaction and service level results · Support and sustain a positive work environment that fosters team performance through own work and behavior · Be receptive to performance feedback and work on improving own skills · Help identify and resolve conflicts with sensitivity and tact. · Work on activities and/or projects as requested by Team Leader/Management. About Percepta Established in 2000, Percepta has contact centers across the globe that proudly deliver a frictionless customer experience to our clients. Our values are the heartbeat of our organization, and we live, breath and play by them every day. As a Percepta team member, you can expect: Culture of Service - to be treated like you are the customer from day one Teamwork- belonging to a supportive family team environment that encourages growth, fosters trust and open communication, and acknowledges value in your contributions Respect- a team that is accountable, dependable and gives you their full attention Proactive- to surround yourself with solution-oriented people who strive to improve themselves, others, and the organization Career Growth - lots of learning opportunities for aspiring minds Diversity - be a part of our growing diverse and community-minded organization that is all about having fun! Competitive Compensation - we take care of family, which is why we offer more than just competitive wages and great benefits. Our programs offer incentives and promote physical, mental, and financial wellness. Percepta requires all employees hired in the United States to successfully pass a background check and depending on location and client program a drug test, as a condition of employment. Percepta is an Equal Opportunity Employer.

**We Put the World on Vacation** Travel + Leisure Co. is the world's leading vacation ownership and travel membership company, with a dynamic and growing portfolio of resort, travel club, and lifestyle travel brands. Our dedicated associates help the company achieve its mission to put the world on vacation. Innovation and growth keep our work interesting and fun. Every day is a chance to learn something new and turn vacation inspiration into exceptional experiences for millions of travelers worldwide. The **Workers Compensation** **Claims Analyst** is responsible for supporting workers' compensation claims function for the organization. This cost management role would consist of proactive claim administration for workers' compensation claims by providing analysis on each open claim, as well as devising and implementing resolution strategies that have a positive impact on the file. Additionally, this position will provide transparent and reliable claim reports on a monthly, quarterly, and annual basis to corporate management and our business unit leaders. On a secondary level, this role will also aid other departmental risk management objectives including the use of our Risk Management Information System (RMIS) to conduct analysis of claims data, insurance policy and claim document management and retention, general insurance program administration, and special projects. This role is hybrid in office Monday, Tuesday and Wednesday, and remote Thursday and Friday. **How You'll Shine:** + Manage and support workers' compensation claims from investigation through resolution. + Compile, analyze, and maintain accurate claims and loss data within the RMIS. + Ensure data integrity throughout the claims process. + Collaborate with HR, Operations, Loss Prevention, adjusters, brokers, and legal teams to proactively resolve claims. + Lead and participate in claim reviews, including quarterly reviews and telephonic claim discussions. + Partner with third-party adjusters (TPAs) on standard and litigated files and provide technical support on complex claims. + Handle monopolistic state filings and monitor related claims. + Prepare reserve adjustment and settlement requests with summaries and rationale for senior management approval. + Ensure all reserve and settlement documentation complies with SOX requirements. + Develop and distribute periodic claims reports with analysis of trends, risks, and opportunities. + Support annual workers' compensation insurance renewals through data collection and analysis. + Audit TPA performance, contribute to process improvements, and manage Certificates of Insurance requests. **Travel Requirements** + Less than 20% **What You'll Bring:** + Bachelor's Degree or equivalent work experience + AIC (Associate in Claims) or ARM (Associate in Risk Management) or equivalent education preferred + Previous workers' compensation claims experience and process knowledge preferred + Ability to work under pressure; must possess good written and oral communication skills; ability to manage multiple projects simultaneously. + Ability to assess priorities. + Self-motivated team player with excellent interpersonal skills. + Must have excellent organizational skills. + Familiarity with Microsoft Office applications (Outlook, Teams, Word, Excel, PowerPoint, etc.) + 2 years' related work experience preferred _Experience equivalent to the education requirement may be accepted in lieu of the education requirement._ **How You'll Be Rewarded:** We offer a diverse range of comprehensive health and welfare benefits to associates who work 30 or more hours per week to meet your needs and support you throughout your career with us. Travel + Leisure Co. benefits include: **_Note: Temporary and/or seasonal associates are ineligible for Paid Time Off._** + Medical + Dental + Vision + Flexible spending accounts + Life and accident coverage + Disability + Depending on position, paid time off, parental leave and holidays (speak to your recruiter for additional information) + Wish day paid time to volunteer at an approved organization of your choice + 401k with employer match (subject to eligibility requirements, including tenure - speak to your recruiter for additional information) + Legal and identify theft plan + Voluntary income protection benefits + Wellness program (subject to provider availability) + Employee Assistance Program **Where Memories Start with You** Hospitality is at the heart of all we do at Travel + Leisure Co. Here, you'll find an inclusive environment where we deliver excellence and take time to have fun, celebrate together, and support one another. We're always looking ahead to what's next and how we can strengthen our business, its neighboring communities, and the customer experience. Join our global team and build a career where memories start with you. We are an equal opportunity employer, and all applications will be considered for employment without attention to their membership in any protected class. If you require any reasonable accommodation to complete your application or any part of the recruiting process, please email your request to ***************************** , including the title and location of the position for which you are applying.

Job Description Job Type: Contract Workplace Type: Hybrid (50% remote, 50% fieldwork) Compensation: $22/hr plus $.50/mi Phoenix Loss Control (PLC) is a US-based business services provider in the cable, telecom, and utilities sector. PLC's core service is outside plant damage investigation, recovery, and prevention. Across the US and parts of Canada, we help our clients recover the costs of third-party damage to their infrastructure, such as underground fiber optic or gas lines. PLC currently employs over 140 people, servicing some of the largest cable and telecoms operators (e.g., Comcast, Spectrum, AT&T, and Google). PLC is currently aggressively expanding its business and looking for talented and energetic people to bring onboard to help drive growth. POSITION SUMMARY Outside Plant Damage (OPD) costs our clients over 30 million annually. Field investigators are needed to collect, access, and report these damages. This is a part-time, on-call contract job to help support our clients with damage recovery. For our field investigators, each day and every investigation is different. We need inquisitive, self-driven individuals who are comfortable rolling up their sleeves and working in a constantly changing, dynamic environment. Duties Conduct on-site field investigations Write detailed but concise investigation reports using diverse sources of information, types of evidence, witness statements, and costing estimates Develop and maintain comprehensive knowledge of local and state statutes, laws, and regulations for underground and aerial cables and utility service lines Remain prepared and willing to respond to damage calls within a timely manner Complete damage investigations within 7 days and then work with and support our claims managers to complete the investigation and begin the recovery process Respond to damages same day if received during business hours (if not, first response following day) Accurately record all time, mileage, and other associated specific items Requirements Interpersonal skills to gather information and conduct field interviews with involved parties including contractors and technicians, witnesses, law enforcement, and possible damagers Smartphone to gather photos, videos, and other information while conducting investigations Computer, with high-speed internet access, to upload and download reports, research cases, and to interact with our claims system and other databases and portals Exceptional attention to detail and strong written and verbal communication skills Proven ability to operate independently and prioritize while adhering to timelines Strong and objective analytical skills Valid driver's license, current insurance, and reliable vehicle with ability to respond to damages at any time Safety vest, work boots, and hard-hat Preferred Qualifications and Skills Current or previous telecommunication or utility experience Knowledge of underground utility locating procedures and systems Investigation, inspection, or claims/field adjusting Criminal justice, legal, or military training or work experience Engineering, infrastructure construction, or maintenance background Remote location determined at discretion of investigations manager This is a contract position. There are no benefits offered with this position.

**Introduction** **This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).** **Do you want to join an organization that invests in you as a Worker's Compensation Follow-up Rep? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.** **Benefits** **Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:** + **Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.** + **Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.** + **Free counseling services and resources for emotional, physical and financial wellbeing** + **401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)** + **Employee Stock Purchase Plan with 10% off HCA Healthcare stock** + **Family support through fertility and family building benefits with Progyny and adoption assistance.** + **Referral services for child, elder and pet care, home and auto repair, event planning and more** + **Consumer discounts through Abenity and Consumer Discounts** + **Retirement readiness, rollover assistance services and preferred banking partnerships** + **Education assistance (tuition, student loan, certification support, dependent scholarships)** + **Colleague recognition program** + **Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)** + **Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.** **Learn more about Employee Benefits (************************************************************************ **_Note: Eligibility for benefits may vary by location._** **You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Worker's Compensation Claims Follow-up Rep like you to be a part of our team.** **Job Summary and Qualifications** **As** **a** **n** **Worker's Compensation Claims Follow-up Rep** **you will** **be responsible** **for** **p** **rocess** **ing** **insurance accounts to address claim issues and thereby affect payment and/or bringing them** **to resolution.** **What you will do in this role:** + **Status account and document all work performed in the company and client computer systems.** + **Assess accounts to** **determine** **the next** **appropriate course** **of action in line with company policies and procedures.** + **Place outbound calls to insurance companies, guarantors, patients, doctors'** **offices** **and/or facilities and handle incoming calls as necessary utilizing proper customer service protocol.** + **Process related correspondence from insurance companies and perform pertinent follow-up.** + **Reconcile balances and payments between insurance companies and** **client's** **computer systems.** + **Medical and insurance terminology (such as procedure codes, diagnoses, and patient liability), and full understanding of hospital/physician billing.** + **Demonstrated communication and** **problem-solving** **skills and the ability to act/decide accordingly.** + **Ability to collect, create and research complex or diverse information.** + **Exceptional customer service and the ability to** **plan,** **organize and exercise sound judgment.** **Qualifications you will need:** + **Minimum 3-5** **years' experience** **in Medical** **Insurance Claims** **Follow-up/Billing for a facility, medical clinic, or doctor's office and experience with Microsoft Office suite and standard office equipment (efax application) preferred.** + **Physician and Hospital Claim Denial experience required** + **Experience with Adobe documents** + **Work from home roles require employees must have wired high speed internet** **25** **MB download and** **15** **MB upload.** + **Remote employees are required to live within a 60 mile radius of an HCA Hospital** **Parallon (************************ **provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients,providers and their communities.** **HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.** "Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Medical Insurance Claims Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock the possibilities and apply today!** We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Job Description Customer Claims Representative- Orlando Join the Service Pros Auto Glass team inside our partnered dealerships! You'll engage customers, spot glass-replacement opportunities, and coordinate quick, professional service - all while building strong relationships and developing a personal team. This role is perfect for a teachable person who loves being part of a supportive, winning team. What You'll Do: Engage customers in the service drive and identify windshield replacement needs. Educate and guide customers through their options and next steps. Build strong relationships with service advisors, managers, and technicians. Encourage dealership referrals and hit daily/weekly sales goals. Schedule and coordinate on-site glass services. Keep accurate records of leads, interactions, and completed jobs. Represent the company with a professional, positive attitude. What Makes You a Great Fit: Experience in customer service or sales is a plus, but not required. Strong communication and people skills. A self-motivated, proactive approach - you enjoy taking the lead. Team-oriented mindset with a friendly, professional appearance. Valid driver's license and reliable transportation. What We Offer: A fun, energetic, team-first culture Ability to earn $1000 - $2500 per week You are paid on a weekly basis Promotion from within and clear growth paths Ongoing training and development Team events, company outings, and a culture that celebrates wins

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

Overview Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference. Job Description Allied Universal is hiring a Claims Investigator. Claim Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation. Florida applicants must either hold a C Private Investigators' License OR Independently complete the 40-hour course necessary to successfully apply for a CC Private Investigator's license (apprenticeship) before applying. Must possess a valid driver's license with at least one year of driving experience RESPONSIBILITIES: Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters Run appropriate database indices if necessary and verify the accuracy of results found QUALIFICATIONS (MUST HAVE): Must possess one or more of the following: Bachelor's degree in Criminal Justice Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims Ability to be properly licensed as a Private Investigator as required by the states in which you work Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country Special Investigative Unit (SIU) Compliance knowledge Ability to type 40+ words per minute with minimum error Flexibility to work varied and irregular hours and days including weekends and holidays Proficient in utilizing laptop computers and cell phones PREFERRED QUALIFICATIONS (NICE TO HAVE): Military experience Law enforcement Insurance administration experience One or more of the following professional industry certifications Certified Fraud Investigator (CFE) Certified Insurance Fraud Investigator (CIFI) Fraud Claim Law Associate (FCLA) Fraud Claim Law Specialist (FCLS) Certified Protection Professional (CPP) Associate in Claims (AIC) Chartered Property Casualty Underwriter (CPCU) BENEFITS: Medical, dental, vision, basic life, AD&D, and disability insurance Enrollment in our company's 401(k)plan, subject to eligibility requirements Seven paid holidays annually, sick days available where required by law Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law. Closing Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: *********** If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices. Requisition ID 2025-1488499

Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference. Job Description Allied Universal is hiring a Claims Investigator. Claim Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation. Florida applicants must either hold a C Private Investigators' License OR Independently complete the 40-hour course necessary to successfully apply for a CC Private Investigator's license (apprenticeship) before applying. Must possess a valid driver's license with at least one year of driving experience RESPONSIBILITIES: Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters Run appropriate database indices if necessary and verify the accuracy of results found QUALIFICATIONS (MUST HAVE): Must possess one or more of the following: Bachelor's degree in Criminal Justice Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims Ability to be properly licensed as a Private Investigator as required by the states in which you work Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country Special Investigative Unit (SIU) Compliance knowledge Ability to type 40+ words per minute with minimum error Flexibility to work varied and irregular hours and days including weekends and holidays Proficient in utilizing laptop computers and cell phones PREFERRED QUALIFICATIONS (NICE TO HAVE): Military experience Law enforcement Insurance administration experience One or more of the following professional industry certifications Certified Fraud Investigator (CFE) Certified Insurance Fraud Investigator (CIFI) Fraud Claim Law Associate (FCLA) Fraud Claim Law Specialist (FCLS) Certified Protection Professional (CPP) Associate in Claims (AIC) Chartered Property Casualty Underwriter (CPCU) BENEFITS: Medical, dental, vision, basic life, AD&D, and disability insurance Enrollment in our company's 401(k)plan, subject to eligibility requirements Seven paid holidays annually, sick days available where required by law Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law. Closing Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: *********** If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices. Requisition ID 2025-1488499

General Description: Investigates, evaluates, negotiates, and resolves assigned property claims having low to moderate complexity and value, working within delegated reserve and settlement authority. Works closely with the Unit Manager, occasionally handling claims with additional complexities related to unique coverage and/or exposure issues. Essential Duties and Responsibilities: Investigates, evaluates, negotiates, and resolves assigned property claims of low to moderate complexity. Determines the facts of the loss, coverage compensability, and the degree of exposure by unit of coverage. Reviews, analyzes, and applies policy conditions, provisions, exclusions and endorsements pertinent to a variety of losses. Establishes timely and accurate property claim and expense reserves. Communicates clearly and professionally with the customer, or their representative, by telephone and/or written correspondence regarding all aspects of the claims process. Determines settlement amounts based on independent judgment, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits, and deductibles. Negotiates and conveys property claim settlements within authority limits to insureds. Controls damage exposures through proper usage of cost containment tools. Maintains an effective diary system to ensure timely resolution and documents property claim file activities in accordance with established procedures and state regulations. Provides excellent customer service to meet the needs of the insured, agent, and all other internal and external customers. Handles files in compliance with state regulations, where applicable. Writes denial letters, Reservation of Rights, and other complex correspondence to insureds. Identifies property claims that may have value added by an outside field inspection. Determines cases that may have fraud potential and refers claims to Special Investigations Unit. Identifies potential for subrogation and refers appropriate claims to the Subrogation Unit. Partners with counsel to develop litigation plan and adhere to applicable guidelines. Performs other duties as required. Supplementary Information: This job description has been prepared to indicate the general nature and level of the work that the employees perform within their classification. This description is not to be interpreted as an inventory of all the duties, tasks, responsibilities and qualifications required for the employees assigned to this job. Education and / or Experience: Bachelor's Degree preferred but not required. Minimum of three (3) years of progressive experience in the adjusting of residential and commercial claims or a combination of education and experience. Strong verbal and written communications skills. Must be able to work in a collaborative atmosphere. Must be proficient with Microsoft Office, including Word, Excel, PowerPoint. Customer service orientation; empathy. Demonstrates ownership attitude and customer centric response to all assigned tasks. Solid analytical and decision making skills. Spanish speaking is a plus. Licenses and / or Certifications: Adjuster's license(s) (where applicable) required or successfully acquired within 60 days of hiring. AIC a plus. Professional designation specific to claims a plus.

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. - Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. - Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. - Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. - Assists in reviews of state and federal complaints related to claims. - Collaborates with other internal departments to determine appropriate resolution of claims issues. - Researches claims tracers, adjustments, and resubmissions of claims. - Adjudicates or readjudicates high volumes of claims in a timely manner. - Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. - Meets claims department quality and production standards. - Supports claims department initiatives to improve overall claims function efficiency. - Completes basic claims projects as assigned. **Required Qualifications** - At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. - Research and data analysis skills. - Organizational skills and attention to detail. -Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine! Your Role: * Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections * Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates * Input and update patient account information and document calls into the Practice Management system * Special Projects: Other duties as required to support and enhance our customer/patient-facing activities Skills & Requirements: * High School Diploma or GED required * Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST * Minimum of 1-2 years of previous healthcare administration or related experience required * Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs) * Manage/ field 60+ inbound calls per day * Bilingual required (Spanish & English) * Proficient knowledge of business software applications such as Excel, Word, and PowerPoint * Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone * Ability and openness to learn new things * Ability to work effectively within a team in order to create a positive environment * Ability to remain calm in a demanding call center environment * Professional demeanor required * Ability to effectively manage time and competing priorities #LI-SM2

We Put the World on Vacation Travel + Leisure Co. is the world's leading vacation ownership and travel membership company, with a dynamic and growing portfolio of resort, travel club, and lifestyle travel brands. Our dedicated associates help the company achieve its mission to put the world on vacation. Innovation and growth keep our work interesting and fun. Every day is a chance to learn something new and turn vacation inspiration into exceptional experiences for millions of travelers worldwide. The Workers Compensation Claims Analyst is responsible for supporting workers' compensation claims function for the organization. This cost management role would consist of proactive claim administration for workers' compensation claims by providing analysis on each open claim, as well as devising and implementing resolution strategies that have a positive impact on the file. Additionally, this position will provide transparent and reliable claim reports on a monthly, quarterly, and annual basis to corporate management and our business unit leaders. On a secondary level, this role will also aid other departmental risk management objectives including the use of our Risk Management Information System (RMIS) to conduct analysis of claims data, insurance policy and claim document management and retention, general insurance program administration, and special projects. This role is hybrid in office Monday, Tuesday and Wednesday, and remote Thursday and Friday. How You'll Shine: * Manage and support workers' compensation claims from investigation through resolution. * Compile, analyze, and maintain accurate claims and loss data within the RMIS. * Ensure data integrity throughout the claims process. * Collaborate with HR, Operations, Loss Prevention, adjusters, brokers, and legal teams to proactively resolve claims. * Lead and participate in claim reviews, including quarterly reviews and telephonic claim discussions. * Partner with third-party adjusters (TPAs) on standard and litigated files and provide technical support on complex claims. * Handle monopolistic state filings and monitor related claims. * Prepare reserve adjustment and settlement requests with summaries and rationale for senior management approval. * Ensure all reserve and settlement documentation complies with SOX requirements. * Develop and distribute periodic claims reports with analysis of trends, risks, and opportunities. * Support annual workers' compensation insurance renewals through data collection and analysis. * Audit TPA performance, contribute to process improvements, and manage Certificates of Insurance requests. Travel Requirements * Less than 20% What You'll Bring: * Bachelor's Degree or equivalent work experience * AIC (Associate in Claims) or ARM (Associate in Risk Management) or equivalent education preferred * Previous workers' compensation claims experience and process knowledge preferred * Ability to work under pressure; must possess good written and oral communication skills; ability to manage multiple projects simultaneously. * Ability to assess priorities. * Self-motivated team player with excellent interpersonal skills. * Must have excellent organizational skills. * Familiarity with Microsoft Office applications (Outlook, Teams, Word, Excel, PowerPoint, etc.) * 2 years' related work experience preferred Experience equivalent to the education requirement may be accepted in lieu of the education requirement. How You'll Be Rewarded: We offer a diverse range of comprehensive health and welfare benefits to associates who work 30 or more hours per week to meet your needs and support you throughout your career with us. Travel + Leisure Co. benefits include: Note: Temporary and/or seasonal associates are ineligible for Paid Time Off. * Medical * Dental * Vision * Flexible spending accounts * Life and accident coverage * Disability * Depending on position, paid time off, parental leave and holidays (speak to your recruiter for additional information) * Wish day paid time to volunteer at an approved organization of your choice * 401k with employer match (subject to eligibility requirements, including tenure - speak to your recruiter for additional information) * Legal and identify theft plan * Voluntary income protection benefits * Wellness program (subject to provider availability) * Employee Assistance Program Where Memories Start with You Hospitality is at the heart of all we do at Travel + Leisure Co. Here, you'll find an inclusive environment where we deliver excellence and take time to have fun, celebrate together, and support one another. We're always looking ahead to what's next and how we can strengthen our business, its neighboring communities, and the customer experience. Join our global team and build a career where memories start with you. We are an equal opportunity employer, and all applications will be considered for employment without attention to their membership in any protected class. If you require any reasonable accommodation to complete your application or any part of the recruiting process, please email your request to *****************************, including the title and location of the position for which you are applying.

Job Description Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer. Powered by JazzHR jOut3ANYSz

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. * Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. * Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. * Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. * Assists in reviews of state and federal complaints related to claims. * Collaborates with other internal departments to determine appropriate resolution of claims issues. * Researches claims tracers, adjustments, and resubmissions of claims. * Adjudicates or readjudicates high volumes of claims in a timely manner. * Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. * Meets claims department quality and production standards. * Supports claims department initiatives to improve overall claims function efficiency. * Completes basic claims projects as assigned. Required Qualifications * At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. * Research and data analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Customer service experience. * Effective verbal and written communication skills. * Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.