Staffing Now is looking for a detail-oriented and customer-focused contract to hire
Specialty Claims Examiner
to join our clients team in the Austin area. In this role, you'll be responsible for accurately processing and adjudicating GAP and Anti-Theft claims while delivering an exceptional service experience.
What You'll Do
Review loan, insurance, and contract documents to confirm claim eligibility
Process claims submitted through phone, email, and chat
Document all claim interactions in our system with accuracy and clarity
Provide timely updates on open and pending claims
Manage your assigned queue to ensure efficient claim resolution
Interpret insurance and dealership documents, including payment histories
Maintain strong product knowledge and deliver high-quality customer service
Support administrative tasks and assist with special projects as needed
What You Bring
High school diploma or equivalent
2+ years of claims experience in a call center or insurance setting
Working knowledge of GAP and Anti-Theft claims
Strong communication skills, critical thinking, and the ability to read and interpret contracts
Ability to manage high contact volume (40+ calls/emails/chats daily)
Preferred Qualifications
Active Claims Adjuster License
Previous experience in the insurance industry
If you're driven, organized, and ready to make an impact, this could be the perfect next step in your career.
$26k-31k yearly est. 3d ago
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Injury Examiner
USAA 4.7
Claim processor job in San Antonio, TX
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated Injury Examiner, you will be responsible to adjust complex bodily injury claims, UM/UIM, and small business claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy.
This role is remote eligible in the continental U.S. with occasional business travel. However, individuals residing within a 60-mile radius of a USAA office will be expected to work on-site three days per week.
What you'll do:
Adjusts complex auto bodily injury claims with significant injuries (e.g. traumatic brain injury, disfigurement, fatality) and UM/UIM, and small business claims, as well as some auto physical damage associated with those claims. Identifies, confirms, and makes coverage decisions on complex claims.
Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes.
Prioritizes and manages assigned claims workload to keep members and other involved parties informed and provides timely claims status updates.
Collaborates and supports team members to resolve issues and identifies appropriate matters for escalation.
Partners and/or directs vendors and internal business partners to facilitate timely claims resolution.
Serves as a resource for team members on complex claims.
Delivers a best-in-class member service experience by setting appropriate expectations and providing proactive communication.
Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
What you have:
High School Diploma or General Equivalency Diploma.
4 years auto claims and injury adjusting experience.
Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations.
Advanced negotiation, investigation, communication, and conflict resolution skills.
Demonstrated strong time-management and decision-making skills.
Proven investigatory, prioritizing, multi-tasking, and problem-solving skills.
Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims.
Ability to exercise sound financial judgment and discretion in handling insurance claims.
Advanced knowledge of coverage evaluation, loss assessment, and loss reserving.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
What sets you apart:
2 or more years of high-value catastrophic injury experience (e.g. traumatic brain injury, disfigurement, fatality) to include UM/UIM coverage
College Degree (Bachelor's or higher).
Insurance Designation.
Compensation range: The salary range for this position is: $85,040 - $162,550.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
$42k-60k yearly est. 1d ago
Legal Hospital Claims Analyst
Erisa Recovery
Claim processor job in Plano, TX
ERISA Recovery are experts in collecting complex and aged claims through the Federal ERISA appeals process. We are a fast-growing organization located in Plano, TX. If you would like to join a friendly, passionate team with limitless potential, we'd love to meet you. This extraordinary opportunity to advance your career and make a difference is now.
We are searching for a Legal Hospital Claims Analyst - someone who works well in a fast-paced setting. In this position, you'll provide support in analyzing comprehensive claims and identifying key metrics. You will be a subject matter expert in legal claims. You must be able to work both independently and as part of a team. Key attributes for the ideal candidate include working with intensity, focus, and being detail oriented.
Essential responsibilities and duties
Conducts legal research and investigation of claims
Drafting legal documents
Keeping track of changes in legal framework and providing timely updates on these changes
Utilizes ERISA law enforcement
Utilizes knowledge of health care standards appropriate to specific claim
Ability to understand and apply medical reimbursement policies, procedures, and standards
Ensures eligibility for claims is reasonable and correct by analyzing claims and providing supporting documentation
Utilize a variety of EHR systems
Thrives in a fast-paced environment
Collaborates effectively with other team members
Ability to adapt to changing needs
Consistently applies knowledge relevant to claims
Work intensely at a fast-paced rate
Ability to communicate effectively with third party administrators
Determine the status of medical claims through research
Meet the standards of the department and quality standards
Strong organizational skills
Desired skills and Qualifications
Bachelor's degree
3+ years working in the legal field
2+ years working with healthcare insurance claims (preferred)
Strong Communication skills
Working knowledge utilizing Microsoft software (Word, Excel, Outlook)
Ability to work in a fast-paced environment
Benefits:
401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance
Paid lunches
Bonus
ERISA Recovery is an Equal Opportunity Employer
$34k-55k yearly est. 11h ago
Claims Coordinator
Morgan Benjamin Search Group
Claim processor job in Houston, TX
Claims & Safety Coordinator
📍 Houston, TX | In-Office 77073
We're partnering with a growing manufacturing/service organization to hire a Claims & Safety Coordinator who will own the day-to-day management of insurance claims for the business and serve as the central point of contact between internal teams, carriers, and adjusters.
This role is ideal for someone with hands-on experience in worker's compensation claims, fleet claims, and property claims who enjoys staying organized, following claims through resolution, and keeping leadership informed every step of the way.
What You'll Be Doing
Manage auto, property, general liability, workers' compensation, and fleet-related claims from intake through resolution
File, track, and monitor claims while communicating directly with carriers, adjusters, and brokers
Maintain accurate, audit-ready claim files and tracking systems
Provide regular claim status updates and cost visibility to internal stakeholders
Track claim costs, reimbursements, and settlements
Assist with documentation for renewals, audits, and carrier requests
Gather incident details and supporting documentation from internal teams
Support trend reporting related to claims activity and costs
What We're Looking For
2+ years of experience in claims coordination or claims administration
Strong organizational and follow-up skills with the ability to manage multiple open claims
Clear, professional communication skills
Comfort working with claims systems and Microsoft Excel
High attention to detail and confidentiality
💼 In-office role
💰 Competitive salary Starting at $60k (based on experience) + excellent benefits
🏢 Stable, employee-focused environment
$60k yearly 2d ago
Construction Claim Coordinator
Servpro Team Shaw
Claim processor job in Grapevine, TX
SERVPRO Team Shaw - Ranked #69 Fastest Growing Construction/Restoration Company in US by Inc 5000 and #2 Best Place to Work by Dallas Business Journal
SERVPRO Team Shaw is one of the largest SERVPROs in Texas and has grown from one location in 2019 to 30 locations today. We have grown 10x in the last 3 years and are looking to double in growth in near future. We are a full turnkey provider for our customers doing everything from Water and Fire Emergency Services, Moving and Storage of Contents, and Textile Cleaning all the way to Reconstruction.
Growth opportunities can arise through any of the above-mentioned divisions, as well as specializations for commercial large loss, fire damage restoration, Reconstruction and Capital Improvement Projects. If you have a sense of urgency and want to grow with a company that has seen 10x growth over the last 2 years, look no further and apply today!
As a Construction Claims Coordinator with SERVPRO, you will be responsible for ensuring the highest quality of service is provided to all customers, insurance partners, and internal teams. In this role, you will manage a wide range of administrative and communication functions that support the insurance claims process from start to finish. This position will work heavily within carrier portals, documentation systems, and in close partnership with Estimators, Project Managers, and Insurance Adjusters.
Key Responsibilities:
As a Construction Claims Coordinator, you will oversee essential file management and claims communication functions that keep insurance-related projects accurate, compliant, and moving forward efficiently.
In this role you will:
Manage all claims documentation, uploading and organizing required photos, estimates, invoices, and notes.
Work heavily within insurance carrier portals (XactAnalysis) to update job status and submit required documents.
Manage mortgage company authorization regarding ACV and depreciation.
Create PO's and work within our construction software to manage payments and expenses.
Communicate professionally with insurance adjusters regarding approvals, supplements, missing information, and claim status.
Assist Estimators and Project Managers by ensuring job files are complete and meet carrier guidelines.
Track claim progress, approvals, payments, and outstanding items to keep files moving efficiently.
Provide homeowners with timely updates on claim status, required documents, and next steps.
Coordinate re-inspections, supplemental requests, and additional documentation between field teams and adjusters.
Maintain accurate digital file organization for all mitigation and reconstruction claims.
Support internal reporting and compliance requirements related to carrier scores, timelines, and file accuracy.
Schedule:
Monday - Friday, 8:00 AM - 5:00 PM
(Some overtime may be required)
Qualifications:
1-3 years of experience in insurance claims, restoration, construction administration, or related office support.
Strong written and verbal communication skills.
High attention to detail and accuracy in documentation.
Ability to prioritize, multitask, and manage deadlines in a fast-paced environment.
Proficiency with Microsoft Office (Outlook, Excel, Word).
Comfortable learning multiple software platforms and carrier portals.
Strong customer service skills and professional phone/email presence.
Preferred Experience:
Experience with restoration software (Xactimate, PSA/CAM, BuilderTrend, Company Cam, etc.).
Prior work in insurance, claims management, construction coordination, or mitigation/reconstruction support.
Familiarity with insurance carrier requirements, SLAs, and documentation standards.
Understanding of restoration industry workflows is a plus.
Attributes for Success:
Highly organized and detail-oriented.
Strong communicator - clear, calm, and professional.
Dependable with excellent follow-through.
Able to stay calm under pressure and adapt quickly.
Proactive about solving problems and closing gaps.
Team-oriented with a positive, service-focused mindset.
Comfortable juggling multiple open claims and deadlines.
Benefits:
Medical, Dental, Vision Insurance
Paid Time Off + Sick Leave
401K with Company Matching
Professional Development & Training Opportunities
Growth potential in a rapidly expanding company
$34k-43k yearly est. 2d ago
Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
Stout 4.2
Claim processor job in Houston, TX
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.
$35k-44k yearly est. 5d ago
Technical Claims Specialist
Berkley 4.3
Claim processor job in Texas
Company Details
Berkley Oil & Gas, (a W.R. Berkley Company) is an insurance underwriting manager providing unique property and casualty products and risk services to customers engaged in the energy sector. Our customers recognize the importance of the expertise we provide and appreciate the opportunity to work with professionals who understand their business. We are in turn committed to delivering innovative products and exceptional service to them, our valued agents and brokers, Berkley Oil & Gas is dedicated in its efforts to be well-informed of the changing dynamics of the industry; support industry efforts to minimize and mitigate risks and hazards in the ‘oil patch', and to constantly seek ways to improve our products and services to meet customer needs.
Company URL: ***************************
The company is an equal opportunity employer.
Responsibilities
The Technical Claims Specialist position will be responsible for handling, negotiating and resolving first and third party commercial general liability, property, Inland Marine and automobile bodily injury and property damage claims to conclusion. This position may also handle worker's compensation claims. This would include coverage verification, policy interpretation, contract interpretation, liability investigation and evaluation and negotiation of claims consistent with company policies and state regulations.
Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant internal and external parties.
Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution.
Demonstrate understanding of medical terms, medical treatment and injury descriptions.
Recognition and evaluation of potential damages related to injuries.
Manage the claim authorization process.
Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence.
Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction.
Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements.
Verify, analyze, and correctly apply coverage.
Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures.
Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law.
Keep policyholders, underwriting and agents advised of file status and other matters as required.
Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues.
Successfully complete relevant continuing education as required.
Qualifications
Minimum of 7 years of multi-line experience
Must possess a current Texasclaims adjuster licenses; additional licenses a plus.
Multi-jurisdictional experience preferred.
Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws
Ability to follow detailed procedures and ensure accuracy in documentation and data.
Excellent written and verbal communications; with ability to listen well.
Recognizes differences in opinions and misunderstandings and encourages open discussion while working towards resolution.
Accepts individual responsibility for all actions taken. Holds self and others accountable to the organization and stakeholders.
Excellent organizational skills; ability to prioritize workload
Ability to think critically and solve problems, including the ability to interpret related documentation
Strong negotiation skills leading to best claim outcomes
Demonstrate proficiency in computer programs, such as Microsoft Word, Outlook and Excel
Education Requirement
Bachelor's Degree required or equivalent work experience.
Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include:
• Base Salary Range: $90,000 - $140,000
• Eligible to participate in annual discretionary bonus.
• Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
The application window for this role is estimated to be open through January 30, 2026, but may be extended, if necessary, please submit your application as soon as possible prior to January 30, 2026. Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.
$90k-140k yearly Auto-Apply 31d ago
Risk Claims Specialist
Maya Management Group LLC 4.1
Claim processor job in Dallas, TX
Job Description
Key Responsibilities:
Customer Claims: • Manage Customer Injury and Liability Claims: Oversee the investigation, documentation, and resolution of customer claims related to personal injury, property damage, or any other incidents occurring on organization premises.
• Coordinate with Insurance Providers: Liaise with insurance companies to ensure proper claims filing and coordinate the resolution of claims involving external parties.
• Customer Support: Handle escalated customer claims and provide appropriate resolutions while ensuring the store's best interests are maintained.
• Documentation & Compliance: Ensure that all claims are properly documented in compliance with company policies and legal requirements. Keep detailed records of each customer-related claim.
• Risk Prevention: Identify trends or recurring incidents that may contribute to customer claims and work with store management to implement safety measures or preventive actions.
Employee Claims:
• Workers' Compensation Claims: Oversee and manage all workers' compensation claims, ensuring compliance with state and federal regulations, and ensuring employees receive appropriate benefits.
• Workplace Injury Claims: Manage the investigation of employee injury claims, including gathering evidence, interviewing witnesses, and ensuring all necessary forms are completed and submitted on time.
• Fleet Claims Management: Manage the investigation of employee fleet claims, support employee's injuries if any, gather witness statements
• Support and Guidance: Provide support to injured employees, ensuring they are informed throughout the claims process and are aware of their rights and available benefits.
• Collaboration with HR and Legal: Work with HR and legal teams to ensure employee-related claims are handled correctly and in compliance with labor laws, insurance regulations, and company policies.
• Collaboration with Safety Team: Work with the Safety Team to consistently do store visits, conduct safety audits, checklists and investigations as needed.
Development:
• Process Improvement: Identify opportunities to improve the claims process, whether through more efficient systems, better documentation, or enhanced communication strategies.
Risk Management and Reporting:
• Claims Analysis and Reporting: Review and analyze the data on claims to identify trends, recurring issues, or areas for improvement. Prepare detailed reports for management regarding claim frequency, costs, and risk mitigation efforts.
• Collaboration with Risk and Safety Teams: Work closely with the Risk Management and Safety teams to address underlying causes of incidents that may lead to claims and develop preventive strategies.
• Compliance: Ensure that all claims are processed in line with company policies, industry standards, and legal requirements, including managing documentation for audits or regulatory reviews.
• Invoices: Reconcile and verify all invoices generated from claims.
• Safety Monitor Report: Complete Safety Monitor report and communicate all parties involved to resolve an issue related to an investigation.
Qualifications:
• Bachelor's degree in Business, Risk Management, Insurance, or a related field (or equivalent experience).
• 3-5 years of experience in claims management, risk management, or a specialist role, preferably
in a retail or supermarket environment.
• Strong understanding of risk management principles, insurance claims processes, and workers' compensation regulations.
• Strong problem-solving and analytical abilities to investigate and resolve complex claims efficiently.
• Excellent communication skills, both written and verbal, with the ability to manage sensitive issues with customers and employees.
• Attention to detail and ability to maintain accurate records and reports.
• Proficient in Microsoft Office and experience with claims management software or risk management tools.
Physical Requirements:
• Ability to stand for extended periods
• Ability to lift up to 50 lbs as needed
Work Environment:
• Fast-paced, high-volume environment
• Occasional evening, weekend, or holiday work may be required
• Occasional travel to different company locations
Physical Demands:
Some lifting, carrying, pushing, and/or pulling; some stooping, kneeling, crouching, and/or crawling; and significant fine finger dexterity. Generally, the job requires 70% sitting, 20% walking, and 10% standing.
This job is performed in a generally clean and healthy office environment.
$37k-65k yearly est. 2d ago
General Liability Claims Specialist
CNA Holding Corporation 4.7
Claim processor job in Plano, TX
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).
This position enjoys a flexible, hybrid work schedule and is available in any location near a CNA office.
JOB DESCRIPTION:
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-LG1
#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 60d+ ago
Claims Specialist - Auto
Philadelphia Insurance Companies 4.8
Claim processor job in Plano, TX
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
Paralegal/Claims Specialist
Sundt Construction 4.8
Claim processor job in Irving, TX
As a 100% employee-owned contractor, when you work at Sundt, you're not just hiring on at a company, you're joining a culture. Because everyone at Sundt is part owner, you'll join a team of people who are deeply invested in their work. From apprentices to managers, we're passionate about the details and deliberate in everything we do.
At Sundt we focus on building long-term prosperity for our clients, communities, and employee-owners. We offer competitive pay, industry-leading benefits including a 401k and employee stock ownership plan, incentive programs for craft and administrative employees as well as training that focuses on your personal and professional growth. We're driven by skill, grit and purpose. Join us as we strive to be the most skilled builder in America.
Job Summary
The Paralegal / Claims Specialist supports the company's Legal and Risk Management functions by assisting attorneys and insurance professionals in the investigation, evaluation, and resolution of claims and lawsuits. The role involves direct collaboration with outside counsel, insurance adjusters, and internal Safety and Operations teams. The Paralegal/Claims Specialist will independently manage the day-to-day handling of routine litigation and claims matters, including discovery, documentation, and coordination with defense counsel.
Key Responsibilities
1. Assists attorneys with trial preparation, exhibits, witness coordination, and logistics.
2. Assists company attorneys with responding to non-party subpoenas and regulatory inquiries.
3. Attends mediations, depositions, and hearings as appropriate to support counsel, our internal personnel and maintain awareness of case progress.
4. Communicates directly with claimants, witnesses, experts, and internal personnel to obtain and analyze relevant information, including managing internal electronic data preservation in coordination with IT team, and oversee transfer of preserved data for discovery.
5. Coordinates with Safety personnel regarding incident intake, documentation, and potential claims escalation.
6. Drafts and edits legal documents including correspondence, discovery requests and responses, routine pleadings, affidavits, and case summaries.
7. In conjunction with attorneys, manages litigation, including coordinating discovery and e-discovery, tracking deadlines, managing document production, approving and processing legal invoices and maintaining organized case files.
8. Maintains accurate and up-to-date records in Risk Information Management Systems {RIMS) or other claims databases.
9. Reviews and analyzes claims in coordination with legal and risk management professionals determine liability, damages, and insurance coverage.
10. Works closely with company attorneys, outside counsel, and insurance adjusters to investigate, evaluate, and resolve claims and lawsuits.
Minimum Job Requirements
1. 5-10 Years of Experience
2. Bachelor's degree
3. Knowledge working for a law firm or an insurance company representing clients in responding to claims and lawsuit preferred.
4. Paralegal certification
Note: is subject to change at any time and may include other duties as assigned.
Physical Requirements
1. May stoop, kneel, or bend, on an occasional basis
2. Must be able to comply with all safety standards and procedures
3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis
4. Will interact with people and technology frequently during a shift/work day
5. Will lift, push or pull objects up to 50Ibs on an occasional basis.
6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day.
7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors
Note: Job Description is subject to change at any time and may include other duties as assigned.
Physical Requirements
1. May stoop, kneel, or bend, on an occasional basis
2. Must be able to comply with all safety standards and procedures
3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis
4. Will interact with people and technology frequently during a shift/work day
5. Will lift, push or pull objects up to 501bs on an occasional basis.
6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day.
7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors
Equal Opportunity Employer Statement: Sundt is committed to the equal treatment of all employees, and/or applicants for employment, and prohibits discrimination based on race, religion, sex (including pregnancy), sexual orientation, gender identity, color, age, disability, national origin, covered veteran status, genetic information; or any other classification protected by applicable Federal, state, or local laws.
Benefit list:
Market Competitive Salary (paid weekly)
Bonus Eligibility based on company, group, and individual performance
Employee Stock Ownership Plan & 401K
Industry Leading Health Coverage Starting Your First Day
Flexible Time Off (FTO)
Medical, Health Savings, and Wellness credits
Flexible Spending Accounts
Employee Assistance Program
Workplace Wellness Programs
Mental Health Program
Life and Disability Insurance
Employee-Owner Perks
Educational Assistance
Sundt Foundation - Charitable Employee-Owner's program
#LI-KA1
$45k-61k yearly est. Auto-Apply 46d ago
Liability Claims Specialist (REMOTE - TX, FL)
Holmes Murphy 4.1
Claim processor job in Texas
We are looking to add a Liability Claims Specialist to join our Creative Risk Solutions team. This team member will provide high-quality claims handling and expertise for CRS customers, including investigating, evaluating, and resolving auto and general liability claims, potentially involving litigated files. We offer a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Creative Risk Solutions!
Essential Responsibilities:
· Review coverage for commercial auto and general liability claims.
· Adjudicate claims, investigate bodily injury/liability claims, and negotiate settlements using "Best Practices for Claims."
· Maintain accurate loss information and establish/maintain reserves within authority.
· Research and respond to questions and complaints from insureds, claimants, agency partners, and carriers.
· Monitor and control litigated claims, ensuring timely responses and protection of insureds' and carriers' interests.
· Participate in claim reviews and Risk Control Workshops.
· Identify and pursue subrogation and report fraud when applicable.
· Train and mentor Liability Claims Specialists I and II.
Qualifications:
· Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU.
· Licensing: Active state specific Life & Health/Property Casualty Insurance agent's license required or the ability to acquire license within three months of hire.
· Experience: 5+ years of adjusting property and casualty claims. Prior agency involvement preferred.
· Skills & Technical Competencies: Knowledge of both general and auto liability coverages, claims processing procedures, perform complex mathematical calculations, ability to learn multiple state insurance regulations and pass state licensing exams. Understand and apply claims principles, practices, and insurance coverage interpretation for consulting, evaluating, and resolving claims. Contributes to workflows while utilizing resources to deliver a world-class client experience and ensure compliance. Fosters relationships by understanding relevant parties, prioritizing problem-solving, and collaborating to deliver impactful solutions.
Here's a little bit about us:
Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members.
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?!
Holmes Murphy & Associates is an Equal Opportunity Employer.
#LI-SM1
$52k-79k yearly est. Auto-Apply 20d ago
Medical Coding Appeals Analyst
Elevance Health
Claim processor job in Grand Prairie, TX
Sign On Bonus: $1,000 **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. **Alternate locations may be considered if candidates reside within a commuting distance from an office.**
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
This position is not eligible for employment based sponsorship.
**Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.**
PRIMARY DUTIES:
+ Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code.
+ Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy.
+ Translates medical policies into reimbursement rules.
+ Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits.
+ Coordinates research and responds to system inquiries and appeals.
+ Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy.
+ Perform pre-adjudication claims reviews to ensure proper coding was used.
+ Prepares correspondence to providers regarding coding and fee schedule updates.
+ Trains customer service staff on system issues.
+ Works with providers contracting staff when new/modified reimbursement contracts are needed.
**Minimum Requirements:**
Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required.
**Preferred Skills, Capabilities and Experience:**
+ CEMC, RHIT, CCS, CCS-P certifications preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$40k-62k yearly est. 4d ago
Liability Claims Specialist (REMOTE - TX, FL)
HMA Group Holdings 3.7
Claim processor job in Texas
We are looking to add a Liability Claims Specialist to join our Creative Risk Solutions team. This team member will provide high-quality claims handling and expertise for CRS customers, including investigating, evaluating, and resolving auto and general liability claims, potentially involving litigated files. We offer a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Creative Risk Solutions!
Essential Responsibilities:
· Review coverage for commercial auto and general liability claims.
· Adjudicate claims, investigate bodily injury/liability claims, and negotiate settlements using "Best Practices for Claims."
· Maintain accurate loss information and establish/maintain reserves within authority.
· Research and respond to questions and complaints from insureds, claimants, agency partners, and carriers.
· Monitor and control litigated claims, ensuring timely responses and protection of insureds' and carriers' interests.
· Participate in claim reviews and Risk Control Workshops.
· Identify and pursue subrogation and report fraud when applicable.
· Train and mentor Liability Claims Specialists I and II.
Qualifications:
· Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU.
· Licensing: Active state specific Life & Health/Property Casualty Insurance agent's license required or the ability to acquire license within three months of hire.
· Experience: 5+ years of adjusting property and casualty claims. Prior agency involvement preferred.
· Skills & Technical Competencies: Knowledge of both general and auto liability coverages, claims processing procedures, perform complex mathematical calculations, ability to learn multiple state insurance regulations and pass state licensing exams. Understand and apply claims principles, practices, and insurance coverage interpretation for consulting, evaluating, and resolving claims. Contributes to workflows while utilizing resources to deliver a world-class client experience and ensure compliance. Fosters relationships by understanding relevant parties, prioritizing problem-solving, and collaborating to deliver impactful solutions.
Here's a little bit about us:
Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members.
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?!
Holmes Murphy & Associates is an Equal Opportunity Employer.
#LI-SM1
$38k-66k yearly est. Auto-Apply 20d ago
Claims Specialist III
Inshur 4.0
Claim processor job in Dallas, TX
Are you keen to work somewhere that's stimulating and friendly, with loads of opportunities for growth and plenty of freedom to make a real impact? This could be the place for you! We are looking for a Claims Specialist III (CS3) to join us at INSHUR! We're based in Dallas, TX , with offices in New York City and Westlake, CA ️ and our company embraces a hybrid working model, allowing you to thrive in both collaborative office settings and the comfort of your own home . You'll have the opportunity to work remotely while also connecting with your colleagues at our Dallas office 3 days a week initially and reducing to 1 day a week following your orientation, typically 90 days, fostering a dynamic and supportive environment.
Supported by (and reporting to) Claims Manager and Team Leaders, you'll be joining a friendly team of 29 specialists who believe in delivering great customer service at scale.
We value high performance and care deeply about making INSHUR a place where everyone is building something special, that we can all be proud of, while enjoying the ride.
What you'll do
As our Claim Specialist III (CS3) you will be responsible for handling and resolving commercial auto claims across the United States. The claims that are assigned to you will involve coverage investigations, liability negotiations, third-party bodily injury, and depending on your experience litigation. You will be responsible for setting and maintaining reserves, assigning defense counsel, negotiating settlements with attorneys, issuing payments, and interpreting policy contracts.
While we prioritise aptitude and passion over a strict checklist of requirements, we've outlined a core set of skills we believe will lead to success in this role. To make things clear, we've categorised them into "essentials to thrive in the role" and "additional skills that could set you apart"
We'd love to hear from you if you have
…these essentials to thrive in the role;
* Experience handling third-party bodily injury claims in a personal auto or commercial auto space at a recognized insurance carrier
* Have already secured an insurance license in Texas.
* Ability to secure a license in California and New York within 60 days.
* Enjoy working in a fast-paced environment.
* Understand that customer satisfaction and retention is driven by handling claims well.
* Are passionate about building a successful career in Claims.
* Helped resolve customer concerns in your most recent role.
* Understand the value of contributing to a team's shared success.
* Ability to work from our office in Irving, TX 3 days a week during your first 2 weeks and then 2 days a week for 90 days. After successful completion of trial period, this will reduce to 1 day a week.
… these additional skills that could set you apart
* A bachelor's degree is strongly preferred.
You'll love it here if you:
Thrive navigating ambiguity and finding clarity in uncertain situations.
Take pride in being accountable and owning your responsibilities.
Enjoy in a fast-paced environment where change happens quickly.
Are solutions-focused and driven to overcome challenges.
Embrace resilience and adapt to setbacks with a positive attitude.
Are intellectually curious, constantly seeking to learn, explore new ideas, and not afraid to question and improve your understanding.
You may not enjoy working here if:
Prefer a more structured, slow-moving environment.
Feel most comfortable when tasks and processes are clearly defined from the start.
Struggle with handling multiple challenges at once or adapting to frequent changes.
Tend to stick strictly to your defined role and avoid contributing outside of your responsibilities.
What to expect from the process:
Screen & Intro: 20-minute call with the Talent Team to discuss the role and your experience.
First Interview: 60- 90 minute onsite interview with a Claims Manager or Team Lead and People Partner to delve into the role, including technical questions and an opportunity for you to ask questions, followed by a brief case study to demonstrate your skill set in a practical setting.
What we offer
We offer all our employees a competitive salary and stock options. We've also built a benefits package that invests in our people's long-term personal and professional growth and wellbeing. Here's a sample of what this includes:
25 days of holiday (+5 days after 5 years), 5 sick days and 8 federal holidays
Medical, dental and vision health insurance plans
️ Life insurance, short-term, and long-term disability benefits
13 weeks fully paid parental leave for all new parents, regardless of your gender
401(k) with 4% company match
Commuter Benefits
Flexible working hours to fit your lifestyle
$650 annual training allowance & learning opportunities
️ $50 monthly wellbeing and home setup allowance
24/7 Employee Assistance Program and mental health benefits
It goes without saying that we provide everyone with a laptop, monitor, top of the range kit, and any software you need.
About Us
INSHUR is on a mission to be the leader in insurance solutions for the on-demand economy, making coverage fair and accessible for drivers.
Cutting edge technology & deep insurance know-how underpins our revolutionary offering for on-demand drivers, keeping premiums affordable and delivering results for partners. With a focus on embedded insurance solutions, and complementary technology integrations for digital platform providers such as Uber, Amazon, Bolt, FREENOW and OLA, we've been helping drivers stay on the road since 2016 through our data, technology and in-house insurance expertise.
Backed by some of the most forward thinking VC's including Viola Growth, JVP, Munich Re, Viola Fintech, MTech Capital, Antler, and MS&AD, we have secured over $113.5 million in funding as well as the acquisition of American Business Insurance in 2023. We have exciting plans to continue growing our portfolio and product lines and expand to new territories in the future.
As a global team of around 220 people based across the US, UK, and the Netherlands, we value:
Generosity, inclusivity, open-mindedness, and diversity
Delivering great results and learning in the open
Freedom to make long-term, high-impact decisions
The wellbeing of our teammates and the people around us
And… Enjoying the ride!
Equal opportunities
At INSHUR, we believe that having a diverse team where everyone can bring their authentic selves to work is key to our success. We're passionate about creating equal opportunities and making the tech industry a better place for all and we don't discriminate based on race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, marital status, disability, or age.
As at Aug 2025, our team consists of 46% women, 31% from BAME or BIPOC backgrounds, and 12% LGBTQ+ . We proudly represent 30+ nationalities and span multiple generations, including Baby Boomers, Gen X, Millennials, and Gen Z. We're proud to have been recognised for Diversity and Inclusion by the British Insurance Awards .
We recognise that some companies often hire people similar to the existing team-something we've worked hard to overcome. We follow a structured hiring process and ensure our interview teams are trained to foster inclusivity and equity.
While this position is advertised as full-time, we're flexible on specific arrangements and happy to discuss options like part-time, job-sharing, or other flexible work setups for the right candidate.
️ If you need any adjustments during the interview process, please let us know, and we'll do our best to accommodate your needs.
$37k-65k yearly est. 15d ago
Claim Specialist Clerk
Autobuses Ejecutivos
Claim processor job in Houston, TX
We are expanding our team and seeking a dedicated Claims Specialist with experience in insurance policy renewals to support our risk management and insurance operations.
The Claims Specialist will manage insurance claims related to company operations and oversee the renewal of insurance policies to ensure ongoing compliance, protection, and operational continuity.
Key Responsibilities:
*Process and manage insurance claims from initial report through final resolution.
*Review claim documentation, assess damages, and ensure alignment with insurance regulations and company procedures.
*Liaise with insurance carriers, adjusters, legal teams, and internal departments.
*Lead and coordinate the insurance policy renewal process, ensuring accurate documentation and timely submission.
*Maintain updated records for all claims and policy renewals.
*Provide internal support on claim status, policy requirements, and insurance-related inquiries.
*Identify opportunities to reduce risk and improve claims procedures.
Requirements:
*Proven experience as a Claims Specialist, preferably within the transportation or logistics industry.
*Strong background in insurance policy renewal management.
*Knowledge of insurance principles, claims workflows, and regulatory requirements.
*Excellent communication and negotiation abilities.
*Strong analytical and organizational skills with high attention to detail.
*Ability to work independently and manage multiple cases simultaneously.
*Proficiency with insurance platforms and MS Office Suite.
What Omnibus Express Offers:
*Competitive salary and comprehensive benefits package.
*Opportunities for professional development and career advancement.
*A collaborative and supportive workplace culture.
How to Apply:
Please send your resume and cover letter to ******************************** with the subject line: Claims Specialist - Omnibus Express. or apply in our website omnibusexpress.com or Indeed
Benefits:
401(k) 5% Match
Dental insurance
Employee discount
Health insurance
Paid time off
Vision insurance
Work Location: In person
$30k-53k yearly est. Auto-Apply 32d ago
Billing Procedure Claims Specialist
Summit Spine and Joint Centers
Claim processor job in Austin, TX
Summit Spine and Joint Centers is a rapidly expanding Pain Management Group looking to add an experienced Medical Billing Specialist to our team. With twelve ambulatory surgery centers and twenty-three clinic locations across the State of Georgia, Summit Spine is winning the race to become the largest comprehensive spine and joint care provider in the state. We are looking for a motivated and hard-working ClaimsProcessor who can join our growing team of professionals. Job Duties:
Audits and ensure claim information is complete and accurate.
claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
Ensures accurate and timely billing of HCFA 1500 claims.
Ensures that files are documented with appropriate information (i.e., date stamped, logged, signed, etc.).
Creates logs for providers of pending medical encounters and or encounters with errors.
Work directly with other billing staff and management to meet end of month closing deadlines.
Able to work with clearinghouse rejections, print, and mail secondaries.
Address inquiries from insurance companies, patients, and providers.
Understands CPT, ICD10, HCPCS coding and modifiers.
Knowledge of third-party payers, HMOs, PPOs, Medicare, Medicaid, Worker's Compensation, etc.
Knowledge of ERAs, EOBs
Knowledge of payer specific/LCD guidelines
Understanding of health plan benefits (deductibles, copays, coinsurance) and eligibility verification
Must be proficient with spreadsheets and word processing applications.
Qualifications:
Minimum of 3 years' experience with medical billing or revenue cycle in a medical setting
Experience with Medicare, Medicaid, Commercial insurance plans, Workers' comp, and Personal Injury cases.
Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management
Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required.
Excellent computer skills and familiarity with Microsoft Office
Comfortable working in a growing, dynamic organization and able to navigate change.
Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment.
Bachelor's degree preferred.
Experience using eClinicalWorks preferred.
Experience with high level procedure billing and coding for Pain Management preferred
The position is full time with competitive salary, PTO, health benefits and 401k match. The ideal candidate will be located in Georgia and able to be present at our administrative office, or near Austin, Texas where other members of the billing team are located.
$30k-53k yearly est. 29d ago
Mechanical Claims Processing Specialist
Roadvantage
Claim processor job in Austin, TX
Title: Mechanical Claims Processing Specialist Reports to: Mechanical Claims Supervisor Department: Operations Direct Reports: No Exempt Status: Non-Exempt Position Type: Full-Time, Hybrid Schedule Claims Hours of Operation: Monday - Friday, 7 am - 7 pm, Saturday, 8 am - 3:30 pm
Job Purpose
The Mechanical Claims Processing Specialist role is responsible for providing essential clerical and administrative assistance to the Mechanical Claims Team. This position is not directly responsible for adjudicating claims, but plays a critical role in ensuring efficient and accurate claims processing.
Essential Job Functions
Review, upload, and organize mechanical claims-related documents into internal systems for review and processing
Review service invoices and repair orders for accuracy and completeness prior to processing payment
Process claims payments accurately and in a timely manner
Coordinate with Claims Examiners on open or pending claims to resolve outstanding issues
Perform accurate data entry and maintenance of claims records
Monitor workflow to ensure claims and documents are processed within established timelines
Communicate professionally with internal teams and external partners, as needed, regarding claim statuses and updates
Other tasks as assigned by Management
Minimum Qualifications
Previous experience as Warranty Administrator, Automotive Service Advisor, or similar role preferred
Familiarity with Vehicle Service Contracts and mechanical claims processes
Experience handling financial transactions, invoice verification, and payment reconciliation
Ability to read and understand contractual language as well as automotive repair terminology
Ability to interpret automotive service invoices and repair orders
Proficiency in data entry and Microsoft Office Suite (Excel, Outlook, Word)
Excellent verbal and written communication skills
High attention to detail and accuracy
Maintain production level as assigned
The information contained herein is not intended to be an all-inclusive list of the duties and responsibilities of the job, nor are they intended to be an all-inclusive list of the skills and abilities required to do the job. Management may, at its discretion, assign or reassign duties and responsibilities to this job at any time due to reasonable accommodation or other reasons.
$27k-36k yearly est. 3d ago
Auto Claims Specialist I
Cox Enterprises 4.4
Claim processor job in Euless, TX
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
At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto.
That's where you come in.
We're looking for an Auto Claims Specialist I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details!
Benefits
* We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with flexible time-off policies.
* How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program.
* 10 days of free child or senior care through your complimentary Care.com membership.
* Generous 401(k) retirement plans with up to 6% company match.
* Employee discounts on hundreds of items, from cars to computers to continuing education.
* Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance.
* Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so.
* We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well.
At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits.
What You'll Do
From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include:
* 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.
* Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information.
* Prepares and facilitates communication 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 the accuracy of all required documentation, including invoices and settlement agreements.
* Engages with supervisor/manager to determine if escalation is required.
* Performs other duties as assigned.
Who You Are
You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications:
Minimum
* A high school diploma or GED and less than 2 years of related experience.
* Accuracy and attention to detail.
* Organizational and time management skills.
* The ability to adapt in a fluid and changing environment.
Preferred
* 1+ years of automotive or body shop experience.
* Claims adjuster experience.
Cox is a great place to be, wouldn't you agree? Apply today!
MSCOX
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 10d ago
Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
Stout 4.2
Claim processor job in Dallas, TX
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.
How much does a claim processor earn in Pharr, TX?
The average claim processor in Pharr, TX earns between $23,000 and $62,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.