This is a full-time, onsite position based in Robinson Township.
Responsibilities:
Process pharmacy claims accurately and timely to meet client expectations
Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage
Maintain compliance with patient assistance program guidelines
Document all information and data discovery according to operating procedures
Research required information using available resources
Maintain confidentiality of patient and proprietary information
Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws
Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering
Requirements:
High school diploma or GED required, Bachelor's degree strongly preferred
One year of Pharmacy Experience, having resolved third party claims
Healthcare industry experience with claims background
Strong verbal and written communication skills
Attention to detail and a strong operational focus
A passion for providing top-notch patient care
Ability to work with peers in a team effort and cross-functionally
Strong technical aptitude and ability to learn complex new software
Location/Hours
Full time position hourly, on-site role in Pittsburgh (Robinson)
Availability for Monday-Friday across various 8 hours shifts : 8am- 4pm EST , 9am- 5pm EST, 1pm- 9pm EST
Availability for rotating Saturday shifts 9am-5pm
Scheduling flexibility, as your schedule may change over time according to business needs
Benefits
Medical, dental, and vision insurance plans that fit your needs
401(k) retirement plan
Daily snack stipend for onsite marketplace
Pre-tax transit benefits and free onsite parking
$38k-66k yearly est. 19h ago
Looking for a job?
Let Zippia find it for you.
Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
Stout 4.2
Claim processor job in Philadelphia, PA
At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.
About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include:
Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations.
Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies.
Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic.
Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning.
Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives.
Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support.
Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations.
Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery.
Continue developing technical, analytical, and consulting skills while building credibility with clients.
Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement.
Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team.
What You Bring
Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred.
Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles.
Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance.
Epic Resolute or other hospital billing system experience preferred; Epic certification a plus.
Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required.
Additional certifications such as CHC, CFE, or AHFI preferred.
Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization.
Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred.
Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act.
Willingness to travel up to 25%, based on client and project needs.
How You'll Thrive
Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions.
Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships.
Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time.
Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment.
Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility.
Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions.
Why Stout?
At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life.
We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve.
We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals.
Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.
Learn more about our benefits and commitment to your success.
en/careers/benefits
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job.
Stout is an Equal Employment Opportunity.
All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law.
Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.
A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
$27k-33k yearly est. 3d ago
Insurance Company Examiner 1
Commonwealth of Pennsylvania 3.9
Claim processor job in Harrisburg, PA
Are you interested in a role that serves to protect insurance consumers? If so, consider advancing your professional career by becoming an Insurance Company Examiner 1 for the Insurance Department. Your professional experience and knowledge of accounting, business law, and finance or economics will be essential for determining if insurance companies in Pennsylvania are operating in compliance with relevant state laws, rules, and regulations. Apply today and start a new chapter in your career with our Financial Examinations team!
DESCRIPTION OF WORK
As an Insurance Company Examiner 1, your primary responsibility is to review and evaluate insurers' business processes and controls, including the quality and reliability of corporate governance; assist in assessing solvency; and monitor current financial condition and prospective risks. Work involves visiting examination sites to assist experienced Examiners in conducting risk-focused examinations of records, documents, financial statements, and other related materials. You will have the opportunity to communicate and collaborate with the examiner in charge, management, and the insurer regarding potential concerns and findings discovered during the examination. Additional responsibilities include:
Reviewing regulatory filings
Conducting interviews with management and discussing operations with company personnel
Preparing examination work papers to provide accurate and complete documentation of observations, work performed, and examination findings in accordance with Department and NAIC standards and guidelines
Assisting in identifying and assessing current and prospective solvency risks facing the company
Assisting in reviewing and assessing the effectiveness of the insurer's audit function as well as the enterprise risk management (ERM) function to leverage existing work and gain efficiency in conducting examinations
Assisting in identifying relevant controls and/or risk mitigation strategies to address identified risks and perform tests of controls to evaluate their effectiveness
Interested in learning more? Additional details regarding this position can be found in the position description.
Work Schedule and Additional Information:
Full-time employment
Work hours are 8:00 AM to 4:30 PM, Monday - Friday, with a 60-minute lunch.
Telework: This position is home headquartered. In order to be home headquartered, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania.
Salary: Selected candidates who are new to employment with the Commonwealth of Pennsylvania will begin employment at the starting annual salary of $59,345 (before taxes).
You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.
REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY
QUALIFICATIONS
Minimum Experience and Training Requirements:
One year of experience as an Insurance Company Examiner Trainee (Commonwealth job title or equivalent Federal Government job title, as determined by the Office of Administration); or
One year of professional experience in the audit or examination of the financial conditions and operations of insurance companies and a bachelor's degree that includes 6 college credits in accounting, 3 college credits in finance or economics, and 3 college credits in business law; or
An equivalent combination of experience and training that includes 6 college credits in accounting, 3 college credits in finance or economics, and 3 college credits in business law.
Other Requirements:
You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency.
You must be able to perform essential job functions.
How to Apply:
Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
Your application must be submitted by the posting closing date
.
Late applications and other required materials will not be accepted.
Failure to comply with the above application requirements may eliminate you from consideration for this position.
Veterans:
Pennsylvania law (51 Pa. C.S. *7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to ************************************************ and click on Veterans.
Telecommunications Relay Service (TRS):
711 (hearing and speech disabilities or other individuals).
If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.
The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.
EXAMINATION INFORMATION
Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
Your score is valid for this specific posting only.
You must provide complete and accurate information or:
your score may be lower than deserved.
you may be disqualified.
You may only apply/test once for this posting.
Your results will be provided via email.
$59.3k yearly 1d ago
Claims Examiner
Harriscomputer
Claim processor job in Pennsylvania
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.
$29k-53k yearly est. Auto-Apply 30d ago
STD Claims Examiner II
Matrix Absence Management 3.5
Claim processor job in Unity, PA
Job Responsibilities and Requirements Obtains and analyzes information to make claim decisions and payments of Short Term Disability (STD) claims. The goal of the position/role is to consistently pay the accurate amount for each claim in accordance with the contract.
Research
* Applies knowledge of disability products, policies and contracts.
* Interprets and applies contract/policy definitions of disability and relevant provisions, clauses, exclusions, riders and waivers as well as statutory requirements.
* Utilizes reference materials and tools regarding medical, vocational and disability issues to identify and evaluate claim information in a fair and objective manner.
* Efficient use of applicable disability claims system(s).
* Applies routine medical and technical claims skills, practices, and procedures.
* Utilizes most efficient means to obtain claim information.
Analysis and Adjudication
* Fully investigates all relevant claim issues.
* Provides payment or denials promptly and in full compliance with department procedures and regulations.
* Involves technical resources (Social Security specialist, medical resources, and vocational resources) at appropriate claim junctures.
* Determine and implement appropriate return to work strategy for assigned cases.
* Applies contract specifics regarding eligibility and pre-existing formulas in reference to specific claim.
* Communicates with claimants, policyholders, and physicians to resolve investigations concerns.
* Comfortably makes balanced decisions in situations where there are potential adverse consequences.
Case Management
* Utilizes appropriate intervention for the characteristics of each claim.
* Manages assigned case load of 100-110 complex and some simple cases independently.
* Collaborates with team members and management in identifying and implementing improvement opportunities.
* Manages appropriate volumes, consistently meeting turnaround times, high activity levels, and quality focus on timely claim activities.
* Consistently remain within workflow guidelines on diaries and casework & adjust desk management if needed.
* Provides clear, concise and accurate information to claimants as well as the claims administrative system.
* Serves as a subject matter expert within team, provides some mentor support for newer examiners to assist in their development.
Customer Service
* Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands.
* Establishes, communicates, and manages claimant and policyholder expectations.
* Documents claim file actions and telephone conversations appropriately.
Required Competencies
* 2 years STD claims examiner experience (Short Term Disability)
* Associates Degree, Bachelors Preferred
* Promptly acknowledges customers' needs, both internal and external. Ensures customers' needs are handled in a timely and appropriate manner. Creates a positive impression.
* Demonstrates effective interpersonal and listening skills: takes direction, practices active listening, accepts feedback. Communicate/respond appropriately to varied audiences/tasks. Exhibits teamwork, honors commitments.
* Anticipates, analyzes and defines problems. Develops and assesses alternative solutions as necessary. Makes appropriate decisions in a timely manner. Analyzes impact of decisions.
* Work is accomplished quickly and accurately. Takes responsibility for actions. Prioritizes work effectively and uses time efficiently. Accomplishes goals and objectives.
* Makes/fulfills commitments. Consistently works independently, meets deadlines, and accepts responsibility for his/her actions. Adheres to all attendance requirements. Prompt, well prepared and ready to contribute.
* Level I LOMA Designation Preferred
Ability to Travel: None
The expected hiring range for this position is $23.24 - $29.04 hourly for work performed in the primary location (South Portland, ME). This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future.
Work location may be flexible if approved by the Company.
What We Offer
At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you.
That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.
Our Benefits:
* An annual performance bonus for all team members
* Generous 401(k) company match that is immediately vested
* A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
* Multiple options for dental and vision coverage
* Company provided Life & Disability Insurance to ensure financial protection when you need it most
* Family friendly benefits including Paid Parental Leave & Adoption Assistance
* Hybrid work arrangements for eligible roles
* Tuition Reimbursement and Continuing Professional Education
* Paid Time Off - new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service.
* Volunteer days, community partnerships, and Employee Assistance Program
* Ability to connect with colleagues around the country through our Employee Resource Group program
Our Values:
* Integrity
* Empowerment
* Compassion
* Collaboration
* Fun
EEO Statement
Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.
#LI-Remote #LI-MR1
Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers' Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred.
Essential Responsibilities:
Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner.
Investigates, evaluates, and resolves Workers' Compensation claims.
Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching coverage issues.
Enters and maintains accurate information on a computer system during the claim process, to include final settlement information.
Generates checks for indemnity and medical payments daily.
Develops and monitors consistency in procedural matters of the claims handling process with CRS.
Compiles and interprets Workers' compensation reports on designated accounts, as requested.
Ability to adjudicate lost time claims.
Participates in claim reviews and attends Risk Control Workshops when requested by agency partners or insureds. These could be in person or by phone.
Performs special projects and other duties as requested.
Qualifications:
Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU.
Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Willingness and ability to obtain additional state specific licenses during duration of employment as needed.
Experience: 2-4 years claims experience with strong background in Workers' Compensation coverage.
Technical Competencies: Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims.
Here's a little bit about us:
At Creative Risk Solutions, you'll be part of a collaborative, innovative team that values trust, communication, and client focus. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth within the Holmes Murphy family.
Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as:
Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey!
Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow.
401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for.
Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first.
Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you.
DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish!
Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing.
Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?!
The salary range for this role is $45,800- $78,800. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development.
Holmes Murphy & Associates is an Equal Opportunity Employer.
#LI-SM1
Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers' Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred.
Essential Responsibilities:
Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner.
Investigates, evaluates, and resolves Workers' Compensation claims.
Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching coverage issues.
Enters and maintains accurate information on a computer system during the claim process, to include final settlement information.
Generates checks for indemnity and medical payments daily.
Develops and monitors consistency in procedural matters of the claims handling process with CRS.
Compiles and interprets Workers' compensation reports on designated accounts, as requested.
Ability to adjudicate lost time claims.
Participates in claim reviews and attends Risk Control Workshops when requested by agency partners or insureds. These could be in person or by phone.
Performs special projects and other duties as requested.
Qualifications:
Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU.
Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Willingness and ability to obtain additional state specific licenses during duration of employment as needed.
Experience: 2-4 years claims experience with strong background in Workers' Compensation coverage.
Technical Competencies: Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims.
Here's a little bit about us:
At Creative Risk Solutions, you'll be part of a collaborative, innovative team that values trust, communication, and client focus. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth within the Holmes Murphy family.
Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as:
Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey!
Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow.
401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for.
Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first.
Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you.
DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish!
Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing.
Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?!
The salary range for this role is $45,800- $78,800. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development.
Holmes Murphy & Associates is an Equal Opportunity Employer.
#LI-SM1
$45.8k-78.8k yearly Auto-Apply 18d ago
Workers Compensation Claims Specialist, East
CNA Holding Corporation 4.7
Claim processor job in Wyomissing, PA
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).
JOB DESCRIPTION:
Essential Duties & Responsibilities:
Performs a combination of duties in accordance with departmental guidelines:
Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols.
Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
May serve as a mentor/coach to less experienced claim professionals
May perform additional duties as assigned.
Reporting Relationship
Typically Manager or above
Skills, Knowledge & Abilities
Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
Demonstrated ability to develop collaborative business relationships with internal and external work partners.
Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
Demonstrated investigative experience with an analytical mindset and critical thinking skills.
Strong work ethic, with demonstrated time management and organizational skills.
Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
Developing ability to negotiate low to moderately complex settlements.
Adaptable to a changing environment.
Knowledge of Microsoft Office Suite and ability to learn business-related software.
Demonstrated ability to value diverse opinions and ideas
Education & Experience:
Bachelor's Degree or equivalent experience.
Typically a minimum four years of relevant experience, preferably in claim handling.
Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
Professional designations are a plus (e.g. CPCU)
#LI-AR1
#LI- Hybrid
In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut,
Illinois
,
Maryland,
Massachusetts
,
New York and Washington,
the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
$54k-103k yearly Auto-Apply 3d ago
Claims Specialist
Henderson Brothers Inc. 3.8
Claim processor job in Pittsburgh, PA
Job Description
Details
Job Title: Claims Specialist
Department: Commercial Lines
Division: Risk Control/Claims
Reports To: Claims Supervisor
Contract: No
FLSA status: Exempt
Position Description
The Claims Specialist will provide heroic claims service by assisting with the management of all claims from the initial report of the claim to the closing to ensure the best outcome for all our customers.
Primary Responsibilities & Duties
Support and manage claim process for clients who are/and are not on a Client Service Plan. This includes initial claim reporting, carrier correspondence, data collection, and internal documentation.
Manage daily client correspondences in regard to claims and claim updates.
Manage data entry in agency management system.
Aid clients through property damage restoration process.
All other duties as assigned.
Position-specific Competencies
Effective Communication: Can clearly articulate oneself in a professional manner with the ability to read the audience and adapt. Possesses the intuition on what information to communicate, feedback to provide, and the right manner of delivery. Practices active listening with patience and can restate opinions accurately, as needed.
Attention to Detail: Ability to achieve thoroughness and accuracy when accomplishing a task. Strong ability to focus and provide thorough attention.
Relationship Management: Possesses the ability to create and maintain strong relationship with business owners and contacts.
Decision Quality: Consistently makes good decisions. Through analysis, wisdom, experience, and judgement can accurately act in the best interest of colleagues and clients.
HBI Competencies
Integrity: Conducts business with the utmost moral decency. A trusted advisor who displays the highest standard of ethics.
Heroic Service: White glove approach to client service and satisfaction. Can anticipate needs, and consistently exceeds expectations.
Teamwork: Works well with others towards a shared goal. Actively participates, shares responsibilities and rewards, and contributes to the effectiveness of the group.
Kindness: Shows concern and consideration for others. Is generous with time, talent, and overall possess a willingness to help.
Qualifications
Bachelor's degree or insurance designation preferred
1-3 years of claims experience required
CIA, ARM, CLA, etc. preferred but not required
*if you are not licensed, you will be required to obtain licensure within first 90 days of hire*
An insurance background or understanding of different types of insurance coverage is beneficial, but not required
Strong verbal communication and listening skills
Proficient in Microsoft Office products such as Word, PowerPoint, and Excel
Proficient virtual communication skills-preferably Zoom
Work Environment
This position requires travel capabilities. A valid driver's license is necessary to provide self-transportation to client meetings, events, and seminars. Local travel up to 50%.
While performing the responsibilities of the job, these work environment characteristics are representative of the environment the job holder will encounter. Reasonable accommodations may be made to enable people with disabilities to perform the essential functions of the job.
EEO Statement
Henderson Brothers supports workplace diversity and does not discriminate on the basis of race, color, religion, gender identity or expression, national origin, age, military service eligibility, veteran status, sexual orientation, marital status, physical or mental disability, or any other protected class.
Powered by JazzHR
ao IpIQUs2U
$61k-98k yearly est. 25d ago
Claims Specialist - Auto
Philadelphia Insurance Companies 4.8
Claim processor job in Harrisburg, PA
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 *****************************************
$82.8k-97.3k yearly Auto-Apply 60d+ ago
Auto Claims Specialist I (Manheim)
Cox Enterprises 4.4
Claim processor job in Manheim, PA
Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $16.59 - $24.86/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program.
Job Description
This position facilitates the resolution of customer claims and concerns (includes all physical and digital/online transactions) after a sale and is responsible for the timely and successful arbitration of vehicles between buyer and seller in accordance with auction and NAAA policies. The role will work to gain familiarity with fundamental arbitration concepts, procedures, standards, policies and systems. This position requires organization and management of sale day activities including post sale inspections and sale day arbitrations.
Job Responsibilities:
Basic Functional Duties
* With guidance, performs basic Arbitrator duties, including:
* Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines.
* Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision making.
* Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases.
* Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution.
* Uses appropriate levels/limits of financial approval authority to resolve cases.
* Evaluates claims by obtaining, comparing, evaluating, and validating various forms of information.
* Prepares and facilitates communications for resolution via telephone, email, and in-person discussion.
* Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold.
* Monitors and maintains accurate files for each arbitration case, verifying accuracy of all required documentation, including invoices and settlement agreements.
* Engages with supervisor/manager to determine if escalation is required.
Knowledge & Subject Matter Milestones
* Demonstrates an understanding of investigating claims and negotiating and influencing others while maintaining a positive client experience.
* Gains familiarity and understanding of Arbitration concepts and procedures.
* Gains foundational understanding of auction-specific operational and administrative processes.
* Learns and adheres to National Auto Auction Association (NAAA) arbitration standards, Manheim Marketplace Policies, and relevant legal requirements.
Client Interaction/Communication Responsibilities
* Advises clients of the arbitration claim process, company policies, any auction- or account-specific guidelines, and NAAA guidelines.
* Facilitates both written and verbal communications between buyers, sellers, and various auction team members and third parties to actively gather information necessary to guide parties toward agreement and resolution, while maintaining an awareness of goals and objectives.
* Provides relevant information such as claim status to clients.
Other Duties
* Demonstrates safety commitment by following all safety and health procedures and modeling the appropriate behaviors.
* Participates in support of all safety activities aligned with Safety Excellence.
* Performs other duties as assigned.
Qualifications and Experience
* Education
* High School Diploma or equivalent required.
* Bachelor's degree preferred.
* Experience
* Previous experience in claims management and/or problem and conflict resolution preferred. Claim adjuster experience is a plus.
* 1-2 years of experience in areas of responsibility.
* 1+ years of automotive, mechanical, and/or body shop experience preferred.
* Skills and Abilities
* Active Listening
* Accuracy and Attention to Detail
* Resilience/Adaptability
* Demonstrates Empathy
* Verbal and Written Communication
* Decision Making
* Customer Focus
* Time Management
* Conflict Resolution
* Builds Positive Relationships
YDGCOX
Drug Testing
To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited.
Benefits
Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave.
About Us
Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.
Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
$16.6-24.9 hourly Auto-Apply 8d ago
Damage Claims Specialist
HTSS, Inc.
Claim processor job in Allentown, PA
Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries.
Job Qualifications:
Bachelor's Degree (preferred); High School Diploma or equivalent (required)
Minimum of three (3) years experience in claims handling
Proficiency in Microsoft Office Suite, especially Word and Excel
Strong verbal and written communication skills
Excellent problem-solving and conflict-resolution abilities
High attention to detail and ability to work independently
Pay: Based on experience
This is a full-time, temporary role expected to last at least 6 months.
If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************
$40k-71k yearly est. Easy Apply 6d ago
Damage Claims Specialist
HTSS
Claim processor job in Allentown, PA
Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries.
Job Qualifications:
Bachelor's Degree (preferred); High School Diploma or equivalent (required)
Minimum of three (3) years experience in claims handling
Proficiency in Microsoft Office Suite, especially Word and Excel
Strong verbal and written communication skills
Excellent problem-solving and conflict-resolution abilities
High attention to detail and ability to work independently
Pay: Based on experience
This is a full-time, temporary role expected to last at least 6 months.
If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************
$40k-71k yearly est. Easy Apply 60d+ ago
Ambulatory Care Capacity Analyst - Jefferson Medical Group - Center City
Kennedy Medical Group, Practice, PC
Claim processor job in Philadelphia, PA
Job Details
The Ambulatory Care Capacity Analyst provides strategic support for provider access initiatives across the Jefferson Medical Group (JMG). This role provides internal schedulers and patients a standard, comprehensive approach to appointment availability across the enterprise.
Job Description
Essential Functions:
Responsible for building, maintaining, and modifying centralized scheduling templates for all scheduling providers, including resource providers · Ensure all approved template changes follow change management procedures and protocols and align with Jefferson's template strategy guidelines
Provide impact analysis for master template changes
Report, review, and reschedule patient appointments as indicated by the Reschedule List
Collaborate with Ambulatory practice administrative and clinical leadership on template optimization through the use of Epic Cadence functionality and advise on best practices
Participate in department meetings that address patient access-related metrics
Identify potential access limiting factors and develop possible solutions for department collaboration
Monitor the effectiveness of access-related initiatives using data analysis via Qlik Reporting, Epic Reporting Workbench, and excel
Strategize operational and technical methodologies to enhance patient self-scheduling for both patients and the ambulatory practices
Present, demonstrate, and train internal staff on access and capacity strategies and initiatives
On-board providers on scheduling decision tree and open scheduling platforms
Rotate with peers for on-call schedule
Education and Experience:
High School Diploma Required; Bachelor's Degree preferred.
Epic Cadence or other Epic application certification - plus.
Minimum 2-3 years experience in an ambulatory care or IT setting preferred.
Prior scheduling template management experience preferred.
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Jefferson University Physicians
Primary Location Address
1101 Market, Philadelphia, Pennsylvania, United States of America
Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.
Jefferson is committed to providing equal educa tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.
For more benefits information, please click here
$33k-52k yearly est. Auto-Apply 60d+ ago
Employment Practice Liability Claim Manager
Questor Consultants, Inc.
Claim processor job in Philadelphia, PA
Job Description- National Insurance Carrier is looking for an experienced EPL Claims Manager that is currently managing a team. Prior experience in EPLI & professional liability claims is preferred but not mandatory. Will need a minimum of 5 to 7 years experience in EPL and or professional liability claims.
JD preferred with good interpersonal skills.
Call for additional details.
$43k-105k yearly est. 8d ago
Third Party Claims Specialist
DCS Asset Maintenance 4.5
Claim processor job in Hazleton, PA
DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family!
To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about!
Job Description
Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management. This is an onsite position located at the corporate office in Hazleton PA.
Duties include - but not limited to:
Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies.
Coordinate with project offices to obtain accurate information, records and photos needed to create invoices.
Creation and submission of accurate invoices to insurance carriers and vehicle owners.
Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days.
Accurately updating claim records for any contact or actions taken on claim invoice.
Create and run reports as necessary for claim tracking and follow-up
Support to project offices as necessary - including police report investigation and contacting insurance companies.
Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage.
Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager.
Other duties as assigned.
Qualifications
EDUCATION:
High School Diploma is required.
EXPERIENCE:
Prior experience in insurance claims preferred - 2 years or more relative experience
Excellent computer skills - Proficient in Microsoft Office Word & Excel
Customer service focused
Detail oriented
Self-starter - ability to work independently.
Ability to interact productively and positively in a team environment.
Ability to communicate effectively and professionally in both verbal and written form.
PHYSICAL REQUIREMENTS:
Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone.
Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices.
Able to see and read on computer screens and paper, close vision.
Ability to lift and carry items up to 10 pounds.
Ability to sit at a desk comfortably while working on a computer for extended periods of time.
Additional Information
Benefit Highlights:
Challenging and rewarding work environment
Competitive Compensation
Excellent Medical, Dental, Vision and Prescription Drug Plan
401(K)
Generous Paid Time Off
Career Development
Pay rate: $20.00-23.00/hour depending on experience
Come be a part of the DeAngelo family, today!
DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.
$20-23 hourly 4d ago
Claims Processing Specialist
Blackburn's Physicians Pharmacy 3.5
Claim processor job in Tarentum, PA
Job Opening: Claims Processing Specialist at Blackburn's
Are you a detail-oriented professional with a passion for the healthcare industry? Blackburn's is looking for a Claims Processing Specialist to join our Corporate Claims department and perform third-party medical billing functions. If you thrive in a fast-paced environment and possess excellent organizational and communication skills, this could be the perfect opportunity for you!
What You'll Do:
Manage and verify third-party medical claims for accuracy and compliance.
Collaborate with cross-functional teams to resolve billing discrepancies and insurance denials.
Process claims efficiently while adhering to strict filing deadlines.
Contribute to the improvement of billing processes to reduce denials and increase efficiency.
Utilize your strong communication skills to work with internal teams and external clients.
Why Join Us? At Blackburn's, we're committed to creating a positive impact in the healthcare industry by delivering quality products and services. As part of our team, you'll have access to in-house training, opportunities for career growth, and a collaborative work environment. We offer competitive pay, benefits, and the chance to be part of a company that values its employees.
Work Hours: 8:00 a.m. - 4:30 p.m. or 8:30 a.m. - 5:00 p.m.
If you have a passion for medical billing and enjoy working in a dynamic, fast-paced environment, we'd love to hear from you!
Apply today and join us in making a difference at Blackburn's!
Qualifications
What We're Looking For:
Prior experience in healthcare-related industries, preferably with third-party medical billing.
Strong attention to detail, time management, and the ability to juggle multiple tasks.
Excellent interpersonal skills, with the ability to work both independently and as part of a team.
Proficiency in Microsoft Office, with knowledge of Word and Excel.
Ability to work independently, prioritize workload, and adapt to changing environments.
$25k-32k yearly est. 7d ago
Third Party Claims Specialist
Deangelo Brothers, LLC 4.1
Claim processor job in Hazleton, PA
DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family!
To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about!
Job Description
Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management.
This is an onsite position located at the corporate office in Hazleton PA.
Duties include - but not limited to:
Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies.
Coordinate with project offices to obtain accurate information, records and photos needed to create invoices.
Creation and submission of accurate invoices to insurance carriers and vehicle owners.
Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days.
Accurately updating claim records for any contact or actions taken on claim invoice.
Create and run reports as necessary for claim tracking and follow-up
Support to project offices as necessary - including police report investigation and contacting insurance companies.
Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage.
Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager.
Other duties as assigned.
Qualifications
EDUCATION:
High School Diploma is required.
EXPERIENCE:
Prior experience in insurance claims preferred - 2 years or more relative experience
Excellent computer skills - Proficient in Microsoft Office Word & Excel
Customer service focused
Detail oriented
Self-starter - ability to work independently.
Ability to interact productively and positively in a team environment.
Ability to communicate effectively and professionally in both verbal and written form.
PHYSICAL REQUIREMENTS:
Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone.
Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices.
Able to see and read on computer screens and paper, close vision.
Ability to lift and carry items up to 10 pounds.
Ability to sit at a desk comfortably while working on a computer for extended periods of time.
Additional Information
Benefit Highlights:
Challenging and rewarding work environment
Competitive Compensation
Excellent Medical, Dental, Vision and Prescription Drug Plan
401(K)
Generous Paid Time Off
Career Development
Pay rate: $20.00-23.00/hour depending on experience
Come be a part of the DeAngelo family, today!
DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.
$20-23 hourly 14h ago
Insurance Company Examiner Trainee
Commonwealth of Pennsylvania 3.9
Claim processor job in Harrisburg, PA
The Pennsylvania Insurance Department is on the lookout for Insurance Company Examiner Trainees who are ready to kickstart their careers! These roles offer specialized on-the-job training where you will learn the skills necessary to review and inspect documents to determine if insurance companies in Pennsylvania are operating in compliance with relevant state laws, rules, and regulations. This is the perfect opportunity to learn the fundamentals of our industry, build valuable skills, and work alongside experienced professionals. Apply today and start a new chapter in your career with our Financial Examinations team!
DESCRIPTION OF WORK
As an Insurance Company Examiner Trainee, you will learn how to review and evaluate insurers' business processes and controls, including the quality and reliability of corporate governance; assist in assessing solvency; and monitor current financial condition and prospective risks. Work involves visiting examination sites to assist experienced Examiners in conducting risk-focused examinations of records, documents, financial statements, and other related materials. You will have the opportunity to communicate and collaborate with the examiner in charge, management, and the insurer regarding potential concerns and findings discovered during the examination. Performing these and other tasks will develop and enhance your understanding of insurer operations:
Assisting with reviewing regulatory filings
Observing discussions with department staff
Participating in interviews with management and discussing operations with company personnel
Reviewing public information, industry trends, and other sources of information
Assisting in scaling the extent of review based on size, risk, and complexity of the insurer
Work Schedule and Additional Information:
Full-time employment
Work hours are 8:00 AM to 4:30 PM, Monday - Friday, with a 60-minute lunch.
Telework: This position is home headquartered. In order to be home headquartered, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania.
Salary: Selected candidates who are new to employment with the Commonwealth of Pennsylvania will begin employment at the starting annual salary of $51,971 (before taxes).
You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.
REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY
QUALIFICATIONS
Minimum Experience and Training Requirements:
A bachelor's degree that includes 6 college credits in accounting, 3 college credits in finance or economics, and 3 college credits in business law; or
An equivalent experience and training that includes 6 college credits in accounting, 3 college credits in finance or economics, and 3 college credits in business law.
Applicants will be considered to have met the educational requirements once they are within 3 months of graduating with a qualifying degree.
Other Requirements:
You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency.
You must be able to perform essential job functions.
How to Apply:
Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
Your application must be submitted by the posting closing date
.
Late applications and other required materials will not be accepted.
Failure to comply with the above application requirements may eliminate you from consideration for this position.
Veterans:
Pennsylvania law (51 Pa. C.S. *7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to ************************************************ and click on Veterans.
Telecommunications Relay Service (TRS):
711 (hearing and speech disabilities or other individuals).
If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.
The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.
EXAMINATION INFORMATION
Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
Your score is valid for this specific posting only.
You must provide complete and accurate information or:
your score may be lower than deserved.
you may be disqualified.
You may only apply/test once for this posting.
Your results will be provided via email.
$52k yearly 1d ago
Third Party Claims Specialist
DCS Asset Maintenance 4.5
Claim processor job in Hazleton, PA
DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family!
To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about!
Job Description
Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management. This is an onsite position located at the corporate office in Hazleton PA.
Duties include - but not limited to:
Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies.
Coordinate with project offices to obtain accurate information, records and photos needed to create invoices.
Creation and submission of accurate invoices to insurance carriers and vehicle owners.
Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days.
Accurately updating claim records for any contact or actions taken on claim invoice.
Create and run reports as necessary for claim tracking and follow-up
Support to project offices as necessary - including police report investigation and contacting insurance companies.
Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage.
Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager.
Other duties as assigned.
Qualifications
EDUCATION:
High School Diploma is required.
EXPERIENCE:
Prior experience in insurance claims preferred - 2 years or more relative experience
Excellent computer skills - Proficient in Microsoft Office Word & Excel
Customer service focused
Detail oriented
Self-starter - ability to work independently.
Ability to interact productively and positively in a team environment.
Ability to communicate effectively and professionally in both verbal and written form.
PHYSICAL REQUIREMENTS:
Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone.
Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices.
Able to see and read on computer screens and paper, close vision.
Ability to lift and carry items up to 10 pounds.
Ability to sit at a desk comfortably while working on a computer for extended periods of time.
Additional Information
Benefit Highlights:
Challenging and rewarding work environment
Competitive Compensation
Excellent Medical, Dental, Vision and Prescription Drug Plan
401(K)
Generous Paid Time Off
Career Development
Pay rate: $20.00-23.00/hour depending on experience
Come be a part of the DeAngelo family, today!
DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.