Claim processor jobs in Phoenix, AZ - 86 jobs

Company Details As an elite Excess and Surplus Lines market, Nautilus Insurance Group offers commercial property and casualty insurance solutions to appointed wholesale surplus lines producers countrywide. We have specialized in providing these solutions for more than 35 years. We have more flexible policy terms and premium rates on a non-admitted basis. Our focus is small to medium Property and Casualty risks on both an admitted and a non-admitted basis. Our offerings are distributed through partnerships with appointed wholesale surplus lines producers. Our relationships are defined by mutual success, speed to market, customer-centric focus and an expanded appetite. Coverage placed by Nautilus Insurance Group is provided by Nautilus Insurance Company and Great Divide Insurance Company, both W. R. Berkley Corporation members with A.M. Best (Superior) A+ XV ratings. Benefit Highlights: Paid Parental Leave! At Nautilus, we offer Childbirth Recovery Leave as well as Primary Caregiver Leave, for up to a maximum of 12 weeks of paid leave. Nautilus offers Medical, Dental, and Vision coverage options, along with Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) choices We help our employees feel secure by providing a 401(k) program, profit sharing, stock purchase plan, life insurance, and travel accident insurance options. One of our core values is “Committed to Serve” and these aren't idle words. We provide every employee one paid day off per year to volunteer at a local charity. That's serving with a smile! We take risk management excellence and your professional growth seriously by offering Tuition Assistance and Industry-Related Education and Exam programs. Can you hear us now? Employees are eligible for special cell phone service discounts with Verizon and AT&T. We've got a plum position for you! We participate in the Plum Benefits program offering employees cost-free access to thousands of exclusive travel and entertainment discounts. Flexible work arrangements On site newly renovated fitness center - free to use for employees. Yoga and other classes available for a nominal fee. Responsibilities Nautilus Insurance is seeking a Claims Examiner I or II to join our team. This role can be located in our Scottsdale office or remotely for a highly qualified candidate. The Claims Examiner I's primary job function includes efficiently and effectively handling primarily basic, commercial first-party property and/or third-party general liability losses in a “paperless” environment. The assigned caseload may include up to one-half intermediate-level losses. An ability to communicate both verbally and in written form in a prompt, courteous and professional manner is essential. • Reviews and sets up new loss assignments in a timely manner in compliance with Department guidelines and best practices. • Establishes appropriate initial loss and expense reserves and continues to regularly evaluate the file for adequacy, accuracy and adherence to reserving guidelines. • Analyzes and interprets policy language in conjunction with specific loss facts to reach appropriate coverage decisions. • Drafts frequent coverage correspondence, including reservation of rights and coverage disclaimers in compliance with various state statutes and regulations. • Composes a variety of other detailed correspondence to insureds, claimants, attorneys, agents and Regulatory agencies. • Proactively manages claim files from inception to closure, including identification and investigation of coverage, liability and damage issues, determination and efficient execution of an appropriate plan of action, and prompt, economical file resolution, in compliance with Department guidelines and best practices. • Appropriately and clearly documents all claim file activity, including current strategy, plan of action and exit plan in file notes. • Consistently demonstrates coverage analysis, investigation, evaluation and negotiation skills at a basic and frequently higher level. • Directs and controls the activities and costs of numerous outside vendors including independent adjusters, defense counsel and coverage counsel. • Effectively presents and discusses loss facts and issues in roundtable discussions to peers and members of management. • Composes and transmits in a regular and timely basis Large Loss Reports and other detailed reporting documents as appropriate. • Manages and monitors file caseload through the use of various resources. • Obtains all required state adjuster licenses and maintain them as required via compliance with mandatory continuing education requirements. • Demonstrated experience working with business users. • Other duties may be assigned. • Occasional participation in projects and initiatives lead by other departments and/or W. R. Berkley companies, including audits, workshops, focus groups, task forces, etc. • Initiates appropriate communication with members of management and other Departments. • Attends internal and external seminars and other training events and provide feedback to peers and/or members of management. Qualifications Must have at least five (5) years of insurance experience. Certificates as required by states. Must have intermediate knowledge of computer programs in a Windows environment, including Word, Excel and E-mail. Education Requirement • High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience. Some college preferred. • CPCU, AIC, AEI or completion of other insurance-related classes is preferred. Additional Company Details The Company is an equal employment opportunity employer. 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. 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. Sponsorship Details Sponsorship not Offered for this Role

Job Responsibilities and Requirements Obtains and analyzes information to make claim decisions and payments on LTD, Voluntary disability and Waiver of Premium claims. The goal of the position/role is to consistently render appropriate claim determinations based on a review of all available information and the terms and provisions of the applicable policy. Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim. Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards based on product line. Utilizes appropriate medical and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner. Conducts in-depth pre-existing condition or contestable investigations if applicable. Calculates benefit payments, which may include partial disability benefits, integration with other income sources, survivor benefits, residual disability benefits, etc. Develops and maintains on-line claim data (and paper file if applicable). Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands. Analysis and Adjudication Fully investigates and adjudicates a large volume simple to complex claims. Identifies and investigates change in Total Disability definition (any occ). Independently reviews and manage claims with high degree of complexity within the $1,500 per month approval authority limit. Independently makes the determination if a policyholder with life policy up to $125,000 is eligible for a waiver of premium. Majority of work is not subject to supervisor review and approval. Case Management Consistently manage assigned case load of 60-80 simple to complex cases independently. Collaborates with team members and management in identifying and implementing improvement opportunities. REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR RELATED EXPERIENCE *or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience* Required Knowledge, Skills, Abilities and/or Related Experience High School Diploma or GED. Associates degree in Business, Finance, Social Work, or Human Resources preferred. Level I LOMA designation preferred. 2 years experience processing long term disability claims. Demonstrated understanding of claim management techniques and critical thinking in activities requiring analysis and/or investigation. Experience working in confidential/protected identification environments. Knowledge of medical terminology. Good math and calculation skills. Proven ability to work well in a high-visibility, public-oriented environment. Ability to Travel: None The expected hiring range for this position is $52,450.00 - $65,570.00 annually for work performed in the primary location (Phoenix, AZ). This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future. Work location may be flexible if approved by the Company. What We Offer At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you. That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing. Our Benefits: An annual performance bonus for all team members Generous 401(k) company match that is immediately vested A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account Multiple options for dental and vision coverage Company provided Life & Disability Insurance to ensure financial protection when you need it most Family friendly benefits including Paid Parental Leave & Adoption Assistance Hybrid work arrangements for eligible roles Tuition Reimbursement and Continuing Professional Education Paid Time Off - new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service. Volunteer days, community partnerships, and Employee Assistance Program Ability to connect with colleagues around the country through our Employee Resource Group program Our Values: Integrity Empowerment Compassion Collaboration Fun EEO Statement Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications. #LI-Remote #LI-MR1

Who is Federated Insurance? At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own. Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values. What Will You Do? Customer-focused, source of knowledge and comfort, desire to help, professional - Does that sound like you? We are seeking someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss. No previous insurance or claims experience needed! Federated provides an exceptional training program to teach you the fundamentals of claims and will prepare you to assist clients. This is an in-office position that will work out of our Glendale, AZ office, located at 5701 W. Talavi Blvd. A work from home option is not available. Responsibilities Work with policyholders, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair and courteous way. Explain policy coverage to policyholders and third parties. Complete thorough investigations and document facts relating to claims. Determine the value of damaged items or accurately pay medical and wage loss benefits. Negotiate settlements with policyholders and third parties. Resolve claims, which may include paying, settling, or denying claims, defending policyholders in court, compromising or recovering outstanding dollars. Minimum Qualifications Current pursuing, or have obtained a four-year degree Experience in a customer service role in industries such as retail, hospitality, logistics, banking, automotive dealerships, vehicle rental, sales or similar fields Ability to make confident decisions based on available information Strong analytical, computer, and time management skills Excellent written and verbal communication skills Leadership experience is a plus Salary Range: $63,800 - $78,000 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information can be discussed with a with a member of the Recruiting team. What We Offer We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You. Employment Practices All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization. If California Resident, please review Federated's enhanced Privacy Policy.

DEPT OF REVENUE Funding Arizona's future through excellence in innovation, exceptional customer service and public servant-led continuous improvement. All Arizona State employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government. Our goal is for every ADOR team member to reflect on individual and team performance, reduce waste, and commit to continuous improvement with sustainable progress. Through AMS, every ADOR team member seeks to understand customer needs, identify problems, improve processes, and measure results. Claims Specialist 2 Job Location: Address: 1600 W Monroe St., Phoenix AZ 85007 Posting Details: Salary: $19.71 an hour ($41,000 annualized) Grade: 17 Closing Date: Open until filled Job Summary: The Claims Review Specialist 2, is responsible for reviewing, investigating, and processing unclaimed property claims. This role researches and analyzes applicable State laws, statutes, rules, regulations, policies, and procedures, in addition to utilizing investigative tools of miscellaneous records, to advise the Unclaimed Property Specialist 3's and management on the determination and outcome of claims. This position is hybrid role which works onsite two days/week.. The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State's Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance. Job Duties: Claims Review and Investigations Completes unclaimed property claims reviews and investigations and to advise Unclaimed Property Specialist 3's and management on claims determinations and outcomes Researches and analyzes applicable State laws, statutes, rules, regulations, policies, and procedures regarding unclaimed property, probate, and domestic relations matters Utilizes investigative tools to review public, court, real property, vital statistic, corporate, and other miscellaneous records Service Delivery Communicates information to claimants and property holders of the determined ownership of unclaimed property in and accurate and professional manner Writes correspondences, including requests for evidence, formal decision notices, and explanations of policies, procedures, and practices to claimants Conducts initial and follow-up claimant interviews and investigations, primarily through phone but sometimes in-person, to elicit information to assist with claim determinations Resolves routine issues and complaints from claimants Agency/Department Compliance & Continuous Improvement Remains current on all laws, regulations, policies, and best practices related to taxation through regular engagement in activities such as: self-directed research, conferring with other practitioners and technical experts; subscriptions to regulatory/legal/industry newsletters and briefs; membership industry associations and attendance at meetings/events; and or participation in training and others continuing education opportunities. Actively contributes to team and individual effectiveness through the following: Attends staff meetings and huddles of work unit or district; and may cascade and track information as indicated Completes all required training in a timely manner. Participates in assigned work teams as appropriate. May complete periodic metrics, projects, huddle boards and reports as requested. Prepares for and actively participates in 1:1 coaching with supervisor Maximizes work processes and deliverables through lean principles within the Arizona Management System (AMS); and provides recommendations for process improvement, and engages in continuous improvement efforts as assigned. Knowledge, Skills & Abilities (KSAs): Education & Experience Any combination that meets the knowledge, skills and abilities (KSA); typical ways KSAs are obtained may include but are not limited to: a relevant degree from an accredited college or university such as Associate's Degree (e.g., A.A.), training, coursework, and work experience relevant to the assignment. Minimum of one year experience with unclaimed property and/or claims/audit related work Knowledge/Understanding Basic knowledge of Federal and State laws, statutes, rules, regulations, policies, and procedures regarding unclaimed property, probate, and domestic relations matters Basic knowledge of Federal and State laws, statutes, rules, regulations, policies, and procedures regulating confidentiality requirements Basic knowledge of investigative and research techniques Basic knowledge of all required supporting documentation necessary to make unclaimed property claims determinations Skills Effective verbal, written, and active listening skills Strong customer service skills to service taxpayers in a courteous and professional manner Effective interpersonal skills and demeanor Effective organization and time management skills with the ability to make measurable progress on several tasks simultaneously and work in high-pressure situations Strong mathematical skills such as addition, subtraction, multiplication, division, percentage, and averages Proficient in the use of a PC in a Windows environment; in the use of the Internet; in the use of MS Office Applications such as Outlook, Word and Excel; and in the use of Google Suite applications such as Gmail, Sheets, Docs, and Drive Abilities Ability to clear a comprehensive background and clearance process that includes an Arizona tax compliance verification, and a criminal background check through the FBI via level one fingerprint clearance through the Arizona Department of Public Safety Ability to work with a high degree of autonomy and also participate collaboratively as part of a team Ability to work in a confidential manner, ensuring information is shared with internal and external individuals in an appropriate manner Ability to convey unclaimed property related terminology and information in layman's terms Ability to understand and solve problems by applying intermediate analytical skills to include collecting all the relevant information and data needed to address the problem; organizing, classifying and synthesizing the data into fundamental issues; from the information, identifying the most probable causes of the problem; reducing the information down into manageable components; identifying the logical outcomes from the analyses of the data collected; and, identifying the options and solutions for addressing the problems analyzed Ability to learn and apply LEAN concepts, principles, and tools Willingness and ability to embody ADOR's core values of Do the Right Thing, Commit to Excellence, and Care About One Another Additional Job Demands In the course of performing the essential duties one must be able to exert up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. No substantial exposure to adverse environmental conditions (such as in typical office or administrative work.) Selective Preference(s): Associate's Degree in Business, Public Administration, or a related field Pre-Employment Requirements: The final candidate will be required to abide by the the following pre-employment checks: -Employment Verification and Reference Checks -State and Federal Criminal Background Check, including fingerprinting -Arizona Tax Filing Records Check If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver's License Requirements. All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify). Benefits: The State of Arizona provides a world class comprehensive benefits package including: -Paid time off for holidays, sick days, annual leave, military leave, bereavement leave, and civic duty leave -Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program). -A robust and affordable insurance plan that includes medical, dental, vision, life insurance, short-term, and long-term disability options. -Higher education discounts for State employees and tuition reimbursement up to $5,250 per fiscal year, available to seek further career advancement or certification in Continuing Professional Education. -Work-life balance and additional options for life betterment such as the Infant at Work Program, State Wellness Program, Public Transit Discounts, Alternate Work Schedules, and Telework opportunities. By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion. Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page Retirement: Top ranked Arizona State Retirement System (ASRS) provides 100% employer matched contributions (enrollment eligibility will be effective after 27 weeks of State employment). ASRS provides a lifelong benefit based on years of service earned, or worked, and your ending salary. Learn more about ASRS at: *********************************************************** Contact Us: If you have any questions, need assistance, or would like to request a reasonable accommodation, please contact the ADOR Talent Team at *********************. *The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.

Established in 2021, Independence Pet Holdings is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America. We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands. Pets Best, a subsidiary of IPH, is building a digital first pet e-commerce platform with the aim of connecting key market services such as adoption, lost pet and insurance to make pet care easy. Job Summary: Pets Best is seeking a Claims Processing Specialist who will report to the Supervisor, Claims. Claims Processing Specialists are responsible for reviewing invoices and pet medical documents and determining coverage in compliance with the current Underwriter's policy. Job Location: Remote - USA Main Responsibilities: Review individual policies to make an eligibility determination with high degree of accuracy Contact with internal departments as well as veterinarians and clinic staff Ensure compliance guidelines are met with both internal policies and procedures and contractual commitments Work independently and with others on a virtual team Drive a “Great Place to Work” culture, attend and participate in team meetings as well as engagement events Use PC based programs to enter data into claims system, communicate with leaders and teammates, and organize information Create and issue claim decisions to pet parents using proper spelling, grammar, and punctuation in line with the policy terms Calculate invoice totals, discounts, and tax rates Perform other duties and/or special projects as assigned Qualifications: High school diploma or equivalent 3+ years recent clinical veterinary experience (dog and cat) as a veterinary assistant, veterinary technician or veterinarian Knowledge of veterinary terms, abbreviations and conditions. Knowledge of medical conditions and associated symptoms, procedures, treatments, secondary conditions and pharmaceuticals used in veterinary medicine Knowledge of canine and feline breeds, anatomy and associated predispositions to illness. Ability to read and interpret medical diagnoses via medical records review both written and digital. Ability to work cross functionally with our internal and external resources Ability to handle multiple projects concurrently Ability to navigate Windows OS, Google Chrome, and corresponding applications Demonstrable Microsoft Office proficiency: Word, PowerPoint, Excel, Outlook, Teams Strong writing skills: organization, spelling, grammar and punctuation Strong mathematical and problem-solving skills #LI-Remote #petsbest All of our jobs come with great benefits including healthcare, parental leave and opportunities for career advancements. Some offerings are dependent upon the location of where you work and can include the following: Comprehensive full medical, dental and vision Insurance Basic Life Insurance at no cost to the employee Company paid short-term and long-term disability 12 weeks of 100% paid Parental Leave Health Savings Account (HSA) Flexible Spending Accounts (FSA) Retirement savings plan Personal Paid Time Off Paid holidays and company-wide Wellness Day off Paid time off to volunteer at nonprofit organizations Pet friendly office environment Commuter Benefits Group Pet Insurance On the job training and skills development Employee Assistance Program (EAP)

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.

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

The Copay Support/Claims Processing Specialist is a critical role within the organization and is responsible for servicing inbound calls, EOB faxes, and mail (emails, USMail) from pharmacies, patients, Sites of Care, Health Care Providers, copay vendors (PDMI, FHA and Merchant Card processors) and other sources. Required engagement is with pharmacy claim adjudicators, third party medical claim administrators, merchant vendors, finance for manual claim reimbursement, Sites of Care and Health Care Providers. The Copay Support/Claims Processing Specialist will adjudication, troubleshoot claim rejections, claim reversals, allocation deficiencies, identifying group accumulator and maximizers, provide alternate payment processing method, handle paperwork related to medical procedures, treatments and services submitted by the site of care or health care providers that meet the program business rules for determination of approval, denial, or pending for submission of required information for final determination as well as claim appeal handling. Quality control of commercial copay programs. Collaborate with internal HUB teams on enrollment discrepancies (missing info and duplicates) Partners with claim adjudication vendors ensure proper claims processing and data integrity. Monitor and remediate medical and pharmacy manual data entry errors Serve as Subject Matter Expert for internal and external stakeholders on medical and pharmacy Copay claim adjudication issues and platform logic variations. Provide ongoing insights on specific program trends and system/process opportunities. Patient and Prescriber Support: Act as the primary point of contact for handling inquiries from prescribers, patients, external clients, and internal program team members. Subject Matter Expert on reviewing and processing of medical claims submitted for copay programs where the therapy is primarily processed through a medical benefit Thorough understanding of copay program design and elements eligible for payment processing Ensure proper CMS form and EOB is provided for each eligible item Validate required elements for payment approval are present If not partner with HUB to secure missing information Create manual medical reimbursement record for submission to finance Review Directive Analytics against Net-Suite and make necessary corrections Identify applicable programs and guide stakeholders through next steps for patient support. Accept inbound calls, team chats, and emails. Ensure one-call resolution for patients and providers. Communicate status updates across all patient support activities in a holistic, clear, and professional manner. Liaise with program-specific AssistRx resources to secure outcomes and resolve escalations. Maintain accurate documentation and ensure protection of patient and prescriber information. Requirements High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience. Associate's Degree (AA) or equivalent from a two-year college or technical school, or six months to one year related experience and/or training, or equivalent combination of education and experience. Computer skills required: Contract Management Systems; Microsoft Office Other skills required: Pharmacy Data Management (PDMI), PNC Card Platform COMPETENCIES: Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce. Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values. Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan. Initiative - Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Takes independent actions and calculated risks; Looks for and takes advantage of opportunities; Asks for and offers help when needed. Innovation - Displays original thinking and creativity; Meets challenges with resourcefulness; Generates suggestions for improving work; Develops innovative approaches and ideas; Presents ideas and information in a manner that gets others' attention. Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. Project Management - Develops project plans; Coordinates projects; Communicates changes and progress; Completes projects on time and budget; Manages project team activities. Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness. Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. Benefits Supportive, progressive, fast-paced environment Competitive pay structure Matching 401(k) with immediate vesting Medical, dental, vision, life, & short-term disability insurance Why Choose AssistRx: Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary. Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary. Impactful Work: Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications. Flexible Culture: Many associates earn the opportunity to work from home after 120 days. Enjoy a flexible and inclusive work culture that values work-life balance and diverse perspectives. Career Growth: We prioritize a “promote from within mentality”. We invest in our employees' growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization. Innovation: Contribute to the development of groundbreaking solutions that address complex challenges in the healthcare industry. Collaborative Environment: Work alongside talented professionals who are dedicated to collaboration, learning, and pushing the boundaries of what's possible. Tell your friends about us! If hired, receive a $750 referral bonus! Wondering how we recognize our employees for delivering best in class results? Here are some of the awards that our employees receive throughout the year! #TransformingLives Honor: This quarterly award program is a peer to peer honor that recognizes and highlights some of the amazing ways that our team members are transforming lives for patients on a daily basis. Values Award: This quarterly award program recognizes individuals who exhibit one, or many, of our core company values; Excellence, Winning, Respect, Inspiration, and Teamwork. Vision Award: This annual award program recognizes an individual who has gone above and beyond to support the AssistRx vision to transform lives through access to therapy. AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws. All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position. AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire.

Join Our Team as a Claims Processing Expert! Are you a data-driven marketer who thrives on turning insights into impactful strategies? We are looking for a Claims Processing Expert to analyze key performance metrics, optimize marketing campaigns, and drive data-backed decision-making. Why You'll Love This Role: 📊 Data-Driven Impact - Play a critical role in shaping marketing strategies through analytics. 🚀 Career Growth - Access professional development and leadership opportunities. ⏰ Work-Life Balance - Enjoy a flexible schedule with full-time opportunities. 💰 Competitive Compensation - Earn a stable income with performance-based incentives. Your Responsibilities: Analyze marketing campaign performance, customer behavior, and market trends. Develop and track key performance indicators (KPIs) to measure marketing effectiveness. Provide data-driven insights and recommendations to optimize marketing strategies. Work with cross-functional teams to ensure data accuracy and consistency. Utilize analytics tools (Google Analytics, Tableau, etc.) to generate reports and dashboards. A/B test campaigns and refine strategies based on data insights. What We're Looking For: Proven experience in marketing analytics, data analysis, or a related field. Proficiency in analytics tools such as Google Analytics, Tableau, or SQL. Strong analytical and problem-solving skills. Ability to translate complex data into actionable marketing strategies. Experience with digital marketing metrics, reporting, and performance optimization. Perks & Benefits: Professional development and continuous learning opportunities. Health insurance and retirement plans. Performance-based bonuses and recognition programs. Leadership growth and career advancement opportunities. 🚀 Ready to Turn Data into Growth? If you're passionate about leveraging data to drive marketing success, apply today! Join us and help shape data-driven marketing strategies that make an impact. Your journey as a Claims Processing Expert starts here-let's optimize for success together!

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

Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level of knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Candidates should be based in California with California Self-Insured Certification or based in West Region with experience in handling Alaska Workers Compensation claims. The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region. Responsibilities Investigates claims to determine whether coverage is provided, establish compensability and verify exposure. Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure. Establishes and maintains accurate reserves on all assigned files. Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority. Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds. Demonstrates the ability to understand new and unique exposures and coverages. Demonstrates the ability to understand key data elements and claims related data analysis. Confers directly with policyholders on coverage and resolution strategy issues. Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff. Qualifications A bachelor's degree or equivalent business experience is required In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skills required About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

Job DescriptionSalary: $23-25 per hour Rapidly growing healthcare technology company is looking for outgoing, energetic, and motivated individuals to join our team of Claim Analysts. If you possess these qualities and want to be part of a passionate team on a mission to drive change in healthcare, then Green Light could be a great fit for you. Ideal candidates will share our core values, be a team player, possess a strong work ethic, be a problem solver, have professional integrity and a sense of humor! JOB SUMMARY: The Claims Analyst position is responsible for collaborating with out-of-network healthcare providers (telephonically, in most cases) to finalize allowed amounts on out-of-network claims. Our health plan clients have implemented various controls to establish out-of-network allowances and to ensure that non-contracted providers are paid fairly according to market data, for services provided to their health plan members. The Claims Analyst role facilitates any exceptions for higher out-of-network allowances on behalf of the health plan, in cases where patient balance billing can be eliminated, while also ensuring that out-of-network allowances adhere to the overall provisions of the health plan. RESPONSIBILITIES: Foster and maintain relationships with the Provider community to facilitate current and future claim settlements with professionalism. Verbally and accurately communicate the various out-of-network pricing methodologies used by our health plan clients for establishing allowances on out-of-network claims. Generate settlement agreements based on written and verbal communication with the Provider, throughout the settlement process. Work with internal stakeholders, such as Client Services, to coordinate the necessary flow of information required to successfully obtain settlement of out-of-network healthcare claims. Meet and maintain individual and departmental performance metrics. Manage high volume of claims in a queue; keep current with all claim actions and meet client deadlines for working and settling claims. Initiate provider telephone calls with respect to settlement proposals, mediate objections and apply effective telephone communication skills to reach successful resolution on out-of-network claims. Address any counter offers and present proposals for resolution while adhering to client guidelines and department goals. Collaborate, coordinate, and communicate across the organization, as is necessary to obtain successful settlement of claims. Ensure compliance with HIPAA protocol. QUALIFICATIONS: 3-5 years customer service experience High school diploma or equivalent Excellent verbal and written skills Ability to multi-task and thrive in fast paced work environment Willingness to perform high volume of outbound calls to healthcare providers General knowledge of healthcare claims processing and medical terminology Healthcare billing and/or coding background is a PLUS

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you! Modivcare is looking for a Claims Specialist I to join our team. This position is responsible for processing and managing claims submitted by providers, including verifying the accuracy and completeness of documentation and attachments. This role… Reviews incoming claims and related documentation to ensure accuracy and completeness. Inputs claim data and pertinent information into the claims processing system. Reviews company policies to determine coverage and assess the validity of claims. Uses standard scripts or form letters to request missing information. Applies established guidelines and policies to determine claim eligibility and process accordingly. Communicates with providers when necessary to obtain additional information or clarify claim details. Adheres to departmental policies, deadlines, and procedures for claim handling. Reports suspected fraudulent claims to the Fraud, Waste, and Abuse (FWA) department. May participate in special projects or perform other duties as assigned. We are interested in speaking with individuals with the following… High School Diploma required. Zero (0) plus years of experience. Or equivalent combination of education and/or experience. Strong attention to detail and data entry skills to ensure claim accuracy. Basic computer proficiency, including Microsoft Word, Excel, and Outlook. Analytical mindset with the ability to interpret claim data and follow established procedures. Effective verbal and written communication skills with a superior customer-focused demeanor. Problem-solving skills to address claim discrepancies and issues. Ability to work both independently and as part of a collaborative team. Salary: Starting at $16/hr Modivcare's positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings. We value our team members and realize the importance of benefits for you and your family. Modivcare offers a comprehensive benefits package to include the following: Medical, Dental, and Vision insurance Employer Paid Basic Life Insurance and AD&D Voluntary Life Insurance (Employee/Spouse/Child) Health Care and Dependent Care Flexible Spending Accounts Pre-Tax and Post --Tax Commuter and Parking Benefits 401(k) Retirement Savings Plan with Company Match Paid Time Off Paid Parental Leave Short-Term and Long-Term Disability Tuition Reimbursement Employee Discounts (retail, hotel, food, restaurants, car rental and much more!) Modivcare is an Equal Opportunity Employer. EEO is The Law - click here for more information Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at ***************************

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 and flexible time-off policies. * We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. * 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! 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.

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Scottsdale, AZ. This will be a Full-Time position. This is a remote hybrid opportunity, after onsite training period. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $23.00 an hour and up Sign-On Bonus: $5,000 for employees starting before February 28, 2026. We offer a variety of benefits including: Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Company paid benefits - life; and short and long-term disability Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360... Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information.. Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information. Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim. Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible) Manages all funding related adjudications and works as a liaison to Onco360 Advocate team. Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment. Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable. Document and submit requests for Patient Refunds when appropriate. Pharmacy Adjudication Specialist Qualifications and Responsibilities... Education/Learning Experience Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience Work Experience Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills Desired: Knowledge of Foundation Funding, Specialty pharmacy experience Licenses/Certifications Required: Registration with Board of Pharmacy as required by state law Desired: Certified Pharmacy Technician (PTCB) Behavior Competencies Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills #Company Values: Teamwork, Respect, Integrity, Passion

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: * West Hartford, CT (preferred) * Atlanta, GA * Boston, MA * Chicago, IL * Los Angeles, CA * Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The Role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: * Reviewing and analyzing claim documentation and legal filings * Drafting coverage analyses for tech E&O, first and third party cyber claims * Strategizing and maximizing early resolution opportunities * Monitoring litigation and managing local defense and breach counsel * Attending mediations and/or settlement conferences, either in person or by phone as appropriate * Smartly managing and tracking third-party vendor and service provider spend * Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager * Liaising directly on daily basis with insureds and brokers * Maintaining timely and accurate file documentation/information in our claims management system Our Must-Haves: * 5+ years of professional lines claims handling experience * A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience * A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required * Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation * Advanced knowledge of coverage within the team's specialty or focus * Advanced knowledge of litigation process and negotiation skills * Excellent verbal and written communication skills * Advanced analytical skills * B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers: * Competitive salary and bonus (based on personal & company performance) * Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) * Company paid group term life, short-term disability and long-term disability coverage * 401(k) with competitive company matching * 24 Paid time off days with 2 Hiscox Days * 10 Paid Holidays plus 1 paid floating holiday * Ability to purchase 5 additional PTO days * Paid parental leave * 4 week paid sabbatical after every 5 years of service * Financial Adoption Assistance and Medical Travel Reimbursement Programs * Annual reimbursement up to $600 for health club membership or fees associated with any fitness program * Company paid subscription to Headspace to support employees' mental health and wellbeing * Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program * Dynamic, creative and values-driven culture * Modern and open office spaces, complimentary drinks * Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary Range: $125,000- $160,000 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. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture

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 and flexible time-off policies. We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. 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! 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.

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 and flexible time-off policies. We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. 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! 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.

**Aerotek has an immediate opening for a Claims Review Specialist (Workers Compensation) at the corporate office in Tempe, AZ.** Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek's workers compensation program to ensure the maximum cost containment. Seek to ensure that Third Party Administrator (TPA) is managing claims efficiently. **ESSENTIAL FUNCTIONS** + Conducts and properly document all incident /accident investigations into our RIMIS system. Ensures the TPA thoroughly and properly investigates all initial claims. Monitor to ensure that TPA follows appropriate state workers compensation laws and defenses + Within the scope of authority, reviews and authorizes worker's compensation settlement offers to be made by the TPA + Effectively monitors medical and disability claim authorizations and payments to ensure their appropriate and accurate + Reviews costs associated with all claims handling and develops strategies to improve performance + Works with TPA to move claims toward closure + Partners with Safety, Human Resources and Corporate Legal to drive claims management + Makes appropriate referrals to outside vendors such as defense attorneys, nurse case managers and investigator + Collect OSHA data and update OSHA field in GRA + Coordinates the colleague's release to transitional duty with the Return to Work Specialist and the Field Office; + Obtains evidence in contested and/or litigated claims to assist outside attorneys to defend claim and to prepare for trial + Initiates subrogation where appropriate with management's authorization + Prepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of Actions + Review reserves and provide authorization to TPA, where appropriate within authority + Reviews performance of external vendors in the areas of claims administration, manages litigation and make recommendation to Workers Compensation Compliance Supervisor for adjustments + Monitors and reviews workers compensation claims and the claims processing; identifies claims management trends and inefficiencies and make recommendation as needed + Participates in developing strategies to reduce claims frequency and severity + Establishes and maintains a file and diary on all open claims + Participates in communicating claims trends to Regional Safety Manager + Working with Compliance Supervisor to develop and conduct training to field offices regarding workers compensation issues and process + Attends training sessions, conferences and workshops to keep abreast of current practices, programs and legal issues for the purpose of conveying and/or gathering information required to perform functions + Authority level for settlements up to $70,000 + Authority level for reserves up to $80,000 **QUALIFICATIONS** + High School Diploma required + 3 years work experience in insurance, workers compensation claim management or risk management or + Ability to learn TPA system & generate requested reports Per Pay Transparency Acts: The range for this position is $60,000 - $80,000 + annual bonus potential of $4,000 Benefits are subject to change and may be subject to specific elections, plan, or program terms. This role is eligible for the following: Medical, dental & vision 401(k)/Roth Insurance (Basic/Supplemental Life & AD&D) Short and long-term disability Health & Dependent Care Spending Accounts (HSA & DCFSA) Transportation benefits Employee Assistance Program Tuition Assistance Time Off/Leave (PTO, Primary Caregiver/Parental Leave) Connect With Us! (********************************************************************************************************************************************************** Cookie Notice (***************************************** Cookie Settings Privacy Notices (******************************************* CA Notice at Collection CA Notice at Collection (for Employees and Job Applicants) (************************************************************************************ Your Privacy Choices Our People Are Everything. Aerotek Inc. provides staffing and services solutions in manufacturing, logistics, construction, aviation, facilities and maintenance. We provide the expertise, solutions and people required to rise to the challenges of North American industry. Headquartered in Hanover, Md., Aerotek operates a unified network of over 200 offices across North America, supporting more than 14,000 clients each year. Aerotek is an operating company within Allegis Group, a global leader in talent solutions. To learn more, visit: Aerotek.com . The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call ************ or email accommodation@aerotek.com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position. **Job ID** _2026-13046_ **Category** _Risk & Compliance_ **Location : Location** _US-AZ-Tempe_