Claim processor jobs in Port Saint Lucie, FL

Calling all innovators and people ready to take a proactive approach to claims handling in a digital world!!! Slide is a cutting-edge Tampa-based insurtech company (have you seen us in the news lately?!) and we are looking for tech-savvy Claims professionals! Slide is an insurtech bringing together top talent, cutting-edge technology, world-class data science, and a human-centric approach. We work and think differently, leveraging Big Data, AI, and machine learning to simplify and hyper-personalize every part of the insurance process. Why? Because modern consumers expect and deserve more from the insurance experience. And we have what it takes to deliver it. Rebuilding every part of the insurance process to modernize the way it is written, explained, and managed is no small feat, but we are up for the challenge….are you? Job Summary: The position is responsible for the investigation, evaluation, negotiation, and settlement of personal lines property claims including dispute resolution and/or recovery. Duties and Responsibilities: Proactively communicate and set accurate claims expectations with customers throughout the Claims process while providing high quality customer service. Research, analyze, and interpret policy language and state law as it applies to submitted claims. Examine and appropriately interpret policies, forms, and other records to determine coverage and extent of company's exposure or liability. Appropriately apply knowledge of multiple state statutes, including the insurance code of ethics, rules, regulations, and guidelines. Draft, approve, and adjust estimates of damage and loss amounts. Negotiate and settle claims in accordance with Slide's best practices, guidelines, and industry standards. Assign, direct, and monitor vendors conducting mitigation and/or other services during the adjustment process. Model ethical behavior and execute job responsibilities in accordance with Slide's core values, ethics, and information protection policies. Document all relevant information in the electronic claims management system. Contribute to the business production goals and objectives. Establish timely and appropriate claim reserves in accordance with claim standards. Appropriately represent the company by executing a high level of service and always maintaining professionalism. Perform other duties, as assigned. Education, Experience and Licensing Requirements: Bachelor's degree in a field with skills transferable to insurance preferred; HS Diploma required. Active Florida 6-20 Resident All Lines Adjuster License required. 3+ years of first-party property claims adjusting experience. 2+ years of experience working directly for a carrier Working knowledge of Florida insurance laws and Florida good faith claims handling experience. Technical savviness. Xactimate proficiency a plus Proficiency in Microsoft Windows environment. Industry designations or certifications a plus. Qualifications/Skills and Competencies: Excellent interpersonal and critical thinking skills. Data-driven, analytical approach necessary. Working knowledge to interpret and apply laws, rules, regulations, policies and procedures, and department operational guidelines in daily functions. Possesses strong customer service skills and can address customer escalations. Strong analytical, organizational, negotiation and communication skills. Ability to work independently, multi-task and adapt to frequent priority changes. Ability to plan, prioritize workload, organize, and coordinate multiple tasks and projects. Must possess excellent writing skills. Desire to live Slide's Core Values. What's in it for you?? A paycheck of course but really, much more! The Slide Vibe - An opportunity to be a part of a fun and innovation-driven Culture fueled by Passion, Purpose and Technology! Benefits - We have extensive and cost-effective benefits that cover you and your family from every angle... Physical Health, Emotional Health, Financial Health, Social Health, and Professional Health.

DETAILS Claims Examiner II Department: Property & Casualty Reports To: Claims Supervisor P&C FLSA Status: Exempt in all states but CA Job Grade: 11 Career Ladder Next step in progression could include Senior Claims Examiner ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Examiner II to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA, and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. As an Inside Property and Casualty Claims Examiner II, this candidate will be responsible for the review, analysis, and process of moderate to severe commercial auto claims with an opportunity to handle Commercial Property, Inland Marine, and General Liability claims. These claims are typically moderate exposure and may entail litigation and coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills. Investigate, evaluate, and determine settlement value or denial of liability for moderate to severe level commercial auto claims Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure. Ensure appropriateness of all payments Coordinate and work with a vendor service such as appraiser, independent adjusting firms, contractors, social media and private investigation and various other field service vendors Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims Exchange information with clients, claimants, insurance brokers, inspectors, producers, and account managers Attend meetings and educational seminars for professional development Maintain required licenses Conduct quarterly claim reviews with the client ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL Additional State Adjuster License(s) may be required within 180 days Maintain licenses and continuing education requirements in all states. Minimum of 5 years of commercial auto handling experience Knowledge of tort law, civil procedure, and contract law Knowledge of auto insurance laws, codes, procedures, and liability concepts Knowledge of property and casualty insurance policies Proficiency in investigation and resolution of minor to medium level auto physical damage claims. Limited minor BI claims may be optional Negotiation skills Relies on extensive experience and judgment to plan and accomplish goals in a fast-paced environment Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here

Commercial Auto - Multi Line Claim Specialist Hours: Monday - Friday, 8:00 AM to 4:30 PM ET Salary Range: $60,000-$85,000 NY License required At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. Reasons you should consider a career with CCMSI: Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10+ years multi-line claim experience is required. Bachelor's Degree is preferred. NY license required Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work requires the ability to sit or stand up to 7.5 or more hours at a time. Work requires sufficient auditory and visual acuity to interact with others. CORE VALUES & PRINCIPLES Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. #CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #ClaimsSpecialist #LiabilityClaims #HybridWork #FloridaJobs #InsuranceCareers #GeneralLiability #AutoClaims #MultiJurisdiction #FLAdjusters #CommercialAuto #NowHiring #InsuranceJobs #FLLiability #IND123 #LI-Hybrid

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

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

Remote Role - Live Anywhere in the United StatesBuild your best future with the Johnson Controls team As a global leader in smart, healthy and sustainable buildings, our mission is to reimagine the performance of buildings to serve people, places and the planet. Join a winning team that enables you to build your best future! Our teams are uniquely positioned to support a multitude of industries across the globe. You will have the opportunity to develop yourself through meaningful work projects and learning opportunities. We strive to provide our employees with an experience, focused on supporting their physical, financial, and emotional wellbeing. Become a member of the Johnson Controls family and thrive in an empowering company culture where your voice and ideas will be heard - your next great opportunity is just a few clicks away! What we offer Competitive salary Paid vacation/holidays/sick time Comprehensive benefits package Encouraging and collaborative team environment Dedication to safety through our Zero Harm policy JCI Employee discount programs (The Loop by Perk Spot) Check us Out: A Day in the Life of the Building of the Future ******************* ZMNrDJviY What you will do The Operations Claims Specialist is part of our Building Solutions business at Johnson Controls. Under general direction, works in concert with the Claims Consultants to ensure consistent delivery of services and assure customer expectations are being met as well as internal financial commitments. Responsible for Claim Status Reporting trend analysis along with recommendations on analysis of construction documents (i.e. certified payroll analysis, continuous improvement of process documentation, schedule collection and verification). Proactively track time horizons and claim deadlines to keep the Claims Consultants focused on client triage, recommending and implementing solutions where appropriate How you will do it Provides support for Claims Consultants and ensures completion of all phases of the Claim Identifies issues and recommends solutions to the appropriate processes. Participates in monthly Claims Status, Local Market Backlog Reviews, and Staff Meetings. Serve as Publisher and Editor of the team's affirmative and defensive claims. Initiates research and follow up on fact gathering, document retention and e-discovery. Provides feedback to Manager of Construction Claims and Claims Consultants as appropriate. Owns, maintains and ensures the integrity of the team's project data for purposes of forecasting, scheduling and staffing. Serves as the team's data historian. Prioritizes work activities based upon financial impact to desired business goals What we look for Required Bachelor's Degree in Construction Management, Business Administration, Finance, or equivalent directly related work experience plus two to three years' experience in the construction industry/contracting business performing similar contract and project management functions. Read copy or proof to detect and correct errors in spelling, punctuation, and syntax. Ability to effectively represent JCI and communicate with clients at varying levels. Demonstrated proficiency to simultaneously handle a large and diverse number of projects and issues with tact, cooperation, and persistence. Ability to prioritize work activities based upon financial impact to desired business goals. Innovative and conceptual thinker. High level of productivity and efficiency. HIRING SALARY RANGE: $85,000- 107,000(Salary to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, location and alignment with market data.) This position includes a competitive benefits package. For details, please visit the About Us tab on the Johnson Controls Careers site at ***************************************** #LI-MM1 #LI-Remote Johnson Controls International plc. is an equal employment opportunity and affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, genetic information, sexual orientation, gender identity, status as a qualified individual with a disability or any other characteristic protected by law. To view more information about your equal opportunity and non-discrimination rights as a candidate, visit EEO is the Law. If you are an individual with a disability and you require an accommodation during the application process, please visit here.

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-CH1 #LI-HYBRID #LI-DNP #IN-DNI

Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed/Certified - Other Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

About us: Doodie Calls, LLC. provides sanitation services for residential, construction sites, special events and disaster relief. We believe that each staff member plays a vital role in our success, and we foster an environment of mutual respect. Our goal is to see our employees thrive and grow, as their success is our success. Whether in the field or in the office, our dispatch team, district managers, and office managers are consistently available to provide support and guidance. We believe in the power of collaboration and mutual support. Job Summary: We're seeking a detail-oriented Lien & Claims Specialist to join our team in St. Petersburg, FL. This position plays a vital role in protecting our company's financial interests by managing the lien process from start to finish, filing small claims, and ensuring all customer documentation is complete and compliant. Job Classification: Full-time non-exempt under the Fair Labor Standards Act. Location: St. Petersburg, FL Pay Range: $70,000 to $90,000, depending on experience Responsibilities: Prepare, file, and manage liens on properties through completion of the lien process. Review and execute lien releases accurately and promptly Prepare and file small claims actions when necessary Manage and track certificates of insurance (COIs) for customers Complete and maintain vendor packets and other required customer documentation Collaborate with internal teams and external partners to ensure all deadlines and compliance requirements are met Organize and maintain legal files and documents Qualifications/Requirements: Experience with the lien process from start to finish is required Knowledge of filing small claims and related procedures Background or experience in construction law or a related field is highly preferred JD or experienced paralegal preferred Strong attention to detail and excellent organizational skills Ability to manage multiple deadlines in a fast-paced environment Ability to read and understand contracts and other legal documents Strong knowledge of legal terminology and procedures Excellent research and writing skills Proficiency in Microsoft Office and legal research databases Ability to work independently and as part of a team Benefits: 401(k) & 401(k) matching Health Insurance Dental Insurance Life insurance Paid time off Vision insurance Employee Assistance Program Supplemental Plans Referral Bonus Eligibility Posting Notes: We are a veteran-friendly employer and proudly welcome applications from those who have served in the U.S. Armed Forces. We are not accepting unsolicited resumes from external recruiters or staffing agencies. We are an equal employment opportunity employer . The Company's policy is not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, veteran or uniformed service-member status, genetic information, or any other basis protected by applicable federal, state, or local laws.

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

Why Everstory At Everstory Partners, our mission is to create supportive spaces where individuals and families can find solace, meaning, and hope in the midst of loss. At the heart of our mission is a deep understanding of the profound and complex nature of grief. Every person's journey through loss is unique, and we are committed to providing compassionate and personalized support. We also believe that grief is not a problem to be solved or a burden to manage alone, but rather a natural and beautiful part of the human experience. Backed by our national strength and our local partners' role is to be a steady presence, a source of comfort and guidance, and a partner in celebrating the life and legacy of the person who has passed. The Impact You Will Make The Claims Specialist at Everstory will handle insurance claims for the Company, including general liability, auto and property damage claims, and assist with worker's compensation claims. The role reports to the Senior Litigation Counsel and works closely with the Legal Operations Manager. Essential Duties and Responsibilities: Investigate reported incidents to determine exposure and provide recommended action plans to manage incident or report the claim to Company's insurance carrier. Responsible for communicating with brokers and adjusters, facilitating contact with employees involved in a claim, gathering, and securing all needed information to effectively evaluate, investigate and resolve a claim. Making recommendations to members of the Everstory legal department with respect to reserves and excess authority. Responsible for evaluating claims, reviewing reserves, identifying and acting upon claims resolution opportunities within an assigned level of authority. Ensuring claims are properly documented and audited regularly. Work closely with internal counsel on General Liability claims by serving as the primary liaison between Everstory and the insurance carrier. The Claims Specialist will report incidents to the insurance carrier as directed by internal counsel and serve as the day-to-day point of contact with adjusters. Independently investigate and document claims by gathering statements, photos, and other evidence; coordinate with site operations to obtain necessary documentation; and provide detailed updates to internal counsel and Risk Management. Prepare and deliver written status reports on open General Liability claims; meet one-on-one with internal counsel to review strategy and progress; and participate in quarterly claim reviews with the insurance carrier and regular meetings with the broker. Analyze data from current incidents and claim trends to identify patterns, recommend corrective actions, and develop strategies to reduce losses and mitigate future risk exposure. Monitoring and reporting on trends in claims. The ideal candidate must have the ability and confidence to present on data, trends and recommendations to Everstory leadership team. Reviewing and evaluating claims-related expenses for reasonableness and necessity, and tracking/organizing broker and carrier invoices. Assisting with new vendor approvals by reviewing Certificates of Insurance (COI) for compliance with Everstory's coverage requirements. Providing administrative support to Legal Operations Manager on Workers' Compensation claims. Annually, working with departments to gather and secure all needed information to renew Everstory's insurance program, serving as the primary point of contact for Everstory's insurance broker. Adhering to Everstory's incident and claims reporting processes and procedures. Providing feedback and support to other departments. Requirements Bachelor's degree in a related field, such as business, finance, law, or health. 5 to 10 years of multi-line/multi-state insurance claims adjusting experience. 5+ years of experience in claims management, either with a corporate risk management department or with an insurance company. Must possess a valid Driver's License. Knowledge of property damage issues. Knowledge of relevant laws, regulations, and standards. Excellent research and communication skills. Able to handle complex claims. All-Lines License, preferred, but not required. Experience with multi-state, worker's compensation issues, including monopolistic states, preferred, but not required. Core Competencies: Compassion - Genuinely cares about people; is concerned about their work and non-work problems; is available and ready to help; is sympathetic to the plight of others not as fortunate; demonstrates real empathy with the joys and pains of others. Customer Focus - Is dedicated to meeting the expectations and requirements of internal and external customers; gets first-hand customer information and uses it for improvements in products and services; acts with customers in mind; establishes and maintains effective relationships with customers and gains their trust and respect. Ethics and Values - Adheres to appropriate (for the setting) and effective set of core values and beliefs during both good and bad times; acts in line with those values; rewards the right values and disapproves of others; practices what he/she preaches. Role Competencies: Organizing - Can marshal resources (people, funding, material, support) to get things done. Can orchestrate multiple activities at once to accomplish a goal. Uses resources effectively and efficiently. Arranges information and files in a useful manner. Functional/Technical Skills - has the functional and technical knowledge and skills to do the job at a high level of accomplishment. Problem Solving: uses rigorous logic and methods to solve difficult problems with effective solutions. Probes all fruitful sources for answer. Can see hidden problems. Excellent at honest analysis. Looks beyond the obvious and doesn't stop at the first answers. Presentation Skills - effective in a variety of formal presentation settings, one-on-one, small and large groups, with peers, direct reports, and bosses. Is effective both inside and outside the organization, on both data based and controversial topics. Commands attention and can manage group process during the presentation. Can change tactics midstream when something isn't working. Work Environment: On-Site M-F at our Altamonte Springs, FL Support Center. Our Investment in You Everstory Partners is proud to provide our employees with a quality work environment and opportunity for both personal and professional growth. As part of our ongoing commitment, we offer a competitive benefits package for our Full-Time Employees including: Medical, Dental, Vision, Life, AD&D and STD Insurance Tuition Reimbursement Career Advancement and Training Funeral and Cemetery Benefits Employee Referral Bonus 401k with Company Match Everstory Partners is an Equal Opportunity Employer and is committed to employing a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, national origin, age, sex, religion, disability, sexual orientation, marital status, military or veteran status, gender identity or expression, or any other basis protected by local, state, or federal law. The pay range for this role is based on a wide range of factors that are considered in making compensation decisions regardless of race, gender, age, religion, or any other protected characteristic. They include skill set, experience and training, licensure and certification, and other business and organizational needs. This range estimate has been adjusted for the applicable geographic differential associated with the location at which the position may be filled. Compensation decisions are dependent on the circumstances of each hire. Salary Description $80,000 - $85,000 per year

Job Details Experienced Ocala, FL (In-Office) - Ocala, FL Full TimeJob Description is fully on-site located at our Ocala, FL office. Work Schedule: Monday through Friday 8:30am - 5:00pm The Claims Specialist in Mortgage Servicing is responsible for preparing, filing, and managing claims on FHA, USDA, VA, and Conventional loans to maximize reimbursement and ensure compliance with loan guidelines. This role requires expertise in various claim types, including FHA Part A, Part B, and supplemental claims, along with loss mitigation claims such as modifications and partial claims. The Specialist will monitor critical deadlines, gather necessary documentation, and may also handle vendor coordination for REO claims and process invoices for recoverable default expenses. Core Competencies: Maintains highest level of professional behavior at all times even in stressful situations. Avoids behaviors, comments, and conversations that harm morale, productivity, customer satisfaction and teamwork. Meets confidentiality requirements related to company, customer and financial information. Communicates in writing, verbally and via email in a clear and positive way. Meets policy requirements governing communication content. Meets high-productivity requirements and constantly evaluates and prioritizes work throughout the day to meet frequent deadlines. Takes ownership of work and completes tasks projects accurately. Reviews and proofreads work thoroughly. Works well in a fast-paced team environment and communicates regularly with other team members to ensure deadlines are met. Remains up to date on best practices relevant to the position and uses work hours productively. Essential Duties: Claims Management with Leadership: Prepare and file claims on FHA, USDA, VA, and Conventional loans, demonstrating leadership by ensuring each claim meets loan-specific requirements and supports high standards in servicing. Documentation Assembly with Transparency: Collect and organize all necessary documentation for claim packages (foreclosure deeds, extensions, invoices, over-allowable approvals), maintaining transparency throughout the documentation process to ensure compliance and clarity. Expert Claims Knowledge for High Performance: Apply specialized knowledge to manage and optimize various claim types, including: Foreclosure Claims: FHA Part A and Part B, CWCOT, PFS; VA TOC, 1874; USDA; FNMA and FHLMC Initial/Final Claims; and Mortgage Insurance (MI) Claims. Loss Mitigation Claims: FHA Modifications, Partial Claims, and Special Forbearance; VA Modifications, Partial Claims, and Refunding; FNMA Modifications, Reinstatements, PIFs, and Deferments; FHLMC Modifications, Reinstatements, PIFs, and Deferments. Supplemental Claims: Manage various supplemental claims as required. Proactive Deadline Monitoring: Ensure timely submissions by monitoring critical timelines for claim filings, embodying a high-performance mindset and taking the initiative to meet all deadlines. Invoice Processing with Accountability: Review and process invoices related to default items, verifying their recoverability and compliance, reinforcing transparency and accuracy in all financial transactions. Vendor Coordination for Raving Fans: Collaborate with REO claim vendors to manage REO-related claims efficiently, fostering strong vendor relationships and enhancing service quality to create "raving fans." Data Management for Operational Excellence: Pull, review, and post claims data from loss mitigation files, ensuring data integrity and accuracy to support high-performance operations. Administrative Support and Adaptability: Complete administrative tasks and other assigned duties to contribute to the team's goals, maintaining flexibility and high performance in a dynamic servicing environment. Education and Experience Education: High School Diploma or equivalent required. Associate's or Bachelor's degree in Business, Finance, or a related field preferred. Experience: Minimum of 2 years in mortgage servicing, with a focus on claims management, foreclosure, or loss mitigation. Direct experience with FHA, VA, USDA, and Conventional loan claims is strongly preferred. Familiarity with claim processes for Part A, Part B, CWCOT, PFS, and supplemental claims is a plus. Demonstrated knowledge of invoice processing and vendor coordination in mortgage servicing, with an emphasis on recoverable default expenses. Computer and Equipment Skills Intermediate in Microsoft Office programs (Word, Excel, PowerPoint) Word processing (speed and accuracy) MSP or FICS' Mortgage Servicer a plus Email Internet software Use typical office equipment (computers, fax, phones, copiers, scanners, projectors, etc.) Physical Requirement: Vision (with or without correction) sufficient to read a computer screen and to operate office equipment Clear speaking voice on the telephone, in person, and recorded Hearing within normal ranges in noise environments typical of office Able to sit for long periods of time at computer or other work-station and in meetings Able to use computers and operate equipment Able to lift 10 pounds occasionally unassisted Work Authorization: Must be able to verify identity and employment eligibility to work in the U.S. without a visa sponsorship. EEO Statement: As part of our dedication to the diversity of our workforce, Essex Mortgage is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, national origin or ancestry, sex, gender, gender identity, gender expression, sexual orientation, age, physical or mental disability, medical condition, marital/domestic partner status, military and veteran status, genetic information or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances.

Description Advance your career at Liberty Mutual - A Fortune 100 Company! Manages, investigates and resolves claims assigned and assists in providing service to policyholders. Responsibilities: Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports. Ensures adequacy of reserves. Accountable for security of financial processing of claims, as well as security information contained in claims files. Makes effective use of loss management techniques. Negotiates settlements with attorneys, claimants, and/or co-defendants. Arranges for expert inspections involving third party or potential fraud actions as needed. Updates files and provides comprehensive reports as required Qualifications Qualifications: Strong written and oral communications skills required. Good interpersonal, analytical, investigative, and negotiation skills required. Customer service experience preferred. Basic knowledge of legal liability, general insurance policy coverage and State Tort Law. Bachelor's degree is required. Ability to obtain proper licensing as required. We can recommend jobs specifically for you! Click here to get started.

Reports to: Claims Supervisor Employment Status: Full-Time FLSA Status: Non-Exempt Job Summary: We are searching for a diligent Claims Follow-Up Specialist to ensure a timely and accurate collection of medical claims. The specialist will work closely with insurance companies to rectify payment denials, settle disputes, and receive due reimbursements. The ideal candidate will possess strong communication skills, a deep understanding of medical billing and coding, and the determination to resolve outstanding claims. Duties/Responsibilities: · Reviews and works on unpaid claims, identifying and rectifying billing issues. · Communicates with insurance companies regarding any discrepancy in payments if necessary. · Conducts research and appeals denied claims timely. · Reviews Explanation of Benefits (EOBs) to determine denials or partial payment reasons. · Provides detailed notes on actions taken and next steps for unpaid claims. · Collaborates with the billing team to ensure accurate claim submission. · Maintains a comprehensive understanding of the insurance follow-up process, payer guidelines, and compliance requirements. · Resubmits claims with necessary corrections or supporting documentation when needed. · Tracks and documents trends related to denials and work towards a resolution with the billing team. · Assists patients with inquiries related to their insurance claims, providing clear and accurate information. · All other duties as assigned. Required Skills/Abilities: · Proficiency in healthcare billing software. · Strong analytical, organizational, and multitasking skills. · Excellent verbal and written communication abilities. · Ability to navigate payer websites and use online resources to resolve outstanding claims. Education and Experience: · High school diploma or equivalent required. · Experience in medical billing collections or a similar role in a Behavioral Health industry specializing in Substance abuse and Mental Health is strongly preferred. · Knowledge of medical terminology, CPT and ICD-10 coding is a plus. · Knowledge of HIPAA and other healthcare industry regulations. Benefits · Health Insurance · Vision Insurance · Dental Insurance · 401(k) plan with matching contributions View all jobs at this company View all jobs at this company

FrankCrum is a Top Workplace! Frank Winston Crum Insurance (FWCI) issues Workers' Compensation and General Liability policies by offering flexible coverage and payment options to meet the varied needs of businesses. Over the years, FWCI has grown from a single-state insurance carrier to one that is licensed in 45 states and continues to expand. In addition to regional and product line growth, FWCI has enhanced its value-added services. What has not changed though is the firm's commitment - echoed throughout the family of companies - "always to do the right things for the right reasons!" Click here to learn more about FrankCrum! The Role You'll Play to Create Success We are eager to announce a Construction Defect Technical Claims Specialist position filled with many exciting opportunities! This job contributes to the mission of FrankCrum by adjusting the most complex construction defect claims in the company's inventory and assisting in establishing the best and most cost-effective strategy for handling this claim type. Investigates, evaluates and brings to timely resolution an inventory of the most complex construction defect claims in the company's inventory of which most are litigated and may involve large projects in accordance with established claim handling standards and applicable state regulations and laws. Understands construction defect coverage issues and handles complex coverage issues related to sub-contractors, additional insured tenders by General Contractors and developers, Florida Chapter 558 process and issuing reservation of rights letters and denial of coverage letters Understands and interprets construction contracts and applies risk transfer when appropriate. Negotiates time on risk and the duty to defend and indemnify with liable insurers when appropriate. Manages litigation proactively and works well with defense counsel and insureds to reach optimal outcomes. Demonstrates a strong knowledge and utilization of resolution techniques such as high low agreements, proposals for settlement, offers of judgement to obtain optimal outcomes. Demonstrates an understanding of how to evaluate and respond timely to time limit demands, consumer complaints and Department of Insurance Complaints including Civil Remedy Notices often filed in construction defect claims. Demonstrates a strong knowledge of residential and commercial building construction, repair processes, and knows how to review and analyze the accuracy of damage reports prepared by contractors, engineers, and appraisers in order to assess property damage and construction defects damages. Demonstrates strong negotiations skills in alternative dispute resolution forums such as mediations and assists in finding early resolutions in order to obtain optimal outcomes when appropriate. Demonstrates an understanding of reserving requirements and philosophies and is able to maintain appropriate reserves on all assigned claim files. Prepares reports detailing claim status, payments and reserves. Engages in timely and effective communication with the appropriate parties and documents the claim file throughout the claim adjustment process which includes maintaining timely diaries on each claim. Effectively assists, trains and mentor's lessor skilled team members in conjunction with management. Assists managers with identifying trends and opportunities for improvement in processes and procedures and claim resolution to improve overall outcomes. Collaborates with other departments such underwriting on projects or as needed or performs other duties as assigned. The Attributes We Seek Keys to success in this position include knowledge of construction defect claims handling and of applicable insurance policies claims systems and claims handling regulations, procedures, and laws in 48 states. Bachelor's degree in a related field or equivalent experience needed, Juris Doctorate a plus. Ten (10) years of construction defect claims adjusting experience with exposure to a minimum of $100,000. Must hold Proper adjuster licenses in Florida and other states with the ability to obtain additional licenses as needed. Our Competitive Benefits Along with this great opportunity, FrankCrum also provides exceptional benefits from top carriers including: Health Insurance is zero dollar paycheck cost for employee's coverage and only two-hundred-forty-five dollars a month for family! Dental and Vision Insurance Short Term Disability and Term Life Insurance at no cost to the employee Long Term Disability and Voluntary Term Life Insurance Supplemental insurance plans such as Accidental, Critical Illness, Hospital Indemnity, Legal Services and Pet Insurance 401(k) Retirement Plan where FrankCrum matches 100% of the first 4% the employee contributes, and the employee is immediately vested in the employer match Employee Assistance Program at no cost to the employee Flexible Spending Accounts for Medical and Dependent Care Reimbursement Health Savings Account funded by FrankCrum Paid time off and holiday pay Education reimbursement PTO cash out Tickets at Work Access to the Corporate America Family Credit Union Employee and client referral bonus programs Paid volunteer time What's Special About FrankCrum FrankCrum, a family-owned business-to-business entity since 1981 made of several companies: FrankCrum Corporate (a professional employer organization), FrankCrum Staffing, Frank Winston Crum Insurance Company, and the FrankCrum Insurance Agency - all based in Clearwater, Florida. This "family of employer solutions" employs approximately 500 people who serve over 4,000 clients throughout the United States. FrankCrum employees are trained to deliver high value through exceptional customer service and treat clients and coworkers like family. By living by our Brand Pillars (Integrity, Affinity, and Prosperity) employees are recognized at quarterly events for exceptional customer service and milestones in tenure. The FrankCrum headquarters spans 14 acres and includes a cafe, subsidized for employees. Menus include made-to-order breakfast, hot lunch options and even dinners that can be ordered to-go, all at very affordable prices. The cafe also plays host to monthly birthday and anniversary celebrations, eating and costume contests, and yearly holiday parties. Through the input of its own employees, The Tampa Bay Times has recognized FrankCrum as a Top Place to Work for more than 10 years in a row! FrankCrum also supports several community efforts through Trinity Cafe, the Homeless Empowerment Program, and Clearwater Free Clinic! If you want to play this role to positively impact our clients' day-to-day business, then apply now! This job posting will remain open continuously and qualified applicants will be considered as applications are received. Pay Data As required by applicable state and/or local regulations the following pay data provides a reasonable estimate of the compensation range for this position at the time of posting. FrankCrum may ultimately pay more or less than the posted pay range due to many economic and individualized considerations. The pay offered to the selected candidate will be based on factors including, but not limited to qualifications, knowledge, licensure, skills, abilities, work experience, education, budget, training, employment trends, internal wage considerations, market dynamics, certifications, geographical location, assessments, and other business and organizational needs. The annualized pay range at the time of initial posting for this position is $105,000-$125,000. These figures represent the annualized pay for both hourly and salaried types of positions and does not indicate employment is on a yearly basis nor remove the employee's employment at-will status. FrankCrum is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and pregnancy-related conditions), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, or any other characteristic protected by applicable federal, state or local laws and ordinances. Privacy Policy CA Residents

Business Claim Specialist Visa GC/Citizen Division Pharmaceutical Pay $16.00/hr. Contract 5 Month Timings Mon - Fri between 9.00AM - 6.00PM The primary function/purpose of this job. Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside the client. Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. ESSENTIAL FUNCTIONS: The 6-10 major responsibility areas of the job. Weight: (%) (Total = 100%) 1. Manage member and client expectations related to claim reimbursements. Input claim requests into adjudication platform maintaining compliance to performance guarantees, HIPAA guidelines and service standards, which include production and accuracy standards. Processing according to client guidelines making exceptions upon member appeal and client approval. Recognize and escalate appropriate system crises/problems and fraudulent claims to management. 40 % 2. Identify claims requiring additional research, navigate through appropriate system platforms to perform research and resolve issue or forward as appropriate 15 % 3. Research to define values for missing information not submitted with claim but required for processing. Identify drug form, type and strength to manually determine correct NDC number value which will allow claim to process. Continue researching values if system editing does not accept original assigned value. Utilize anchor platform, internet resources and/or contacting retail pharmacist as resources for missing values. 15 % 4. Initiate correspondence to members, pharmacies or other internal departments for missing information, claim denials or other claim issues. 15 % 5. Evaluate claim submission, ensure all required information is present and determine what action should be taken. Confirm patient eligibility and verify patient information matches system. Update member's address to match claim form if necessary. 5 % 6. Identify exception handling and process per client requirements. Monitor system to ensure client specific documentation related to claims processing and benefits is current and system editing is operating appropriately. 5 % 7. Variety of other miscellaneous duties as assigned 5 % SCOPE OF JOB Provide quantitative data reflecting the scope and impact of the job - such as budget managed, sales/revenues, profit, clients served, adjusted scripts, etc. Maintain an average of 30 Commercial claims per hour (cph) or 35 Work Comp claims per hour (cph). Qualifications Formal Education and/or Training: High school diploma or equivalent required, some college or technical training preferred Years of Experience: Two years' experience in P.B.M. environment is helpful but not required. Computer or Other Skills: Strong data entry, 10-key skills, general PC skills and MS Office experience Knowledge and Abilities: • Strong data entry and 10-key skills • Retail pharmacy, customer service experience helpful but not required • PC and MS Office literate • Strong attention to detail • Excellent retention and judgment ability • Proficient written and oral communication skills • Ability to work in fast-paced, production environment • Reliable, self-motivated with excellent attendance • Team player who has the ability to stay on task with little supervision Additional Information Thanks & Regards, Ranadheer Murari | Recruitment Executive | Mindlance, Inc. | W : ************ ***************************

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

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly. Job Description Kelly Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location. In addition to working with the world's most recognized and trusted name in staffing, Kelly employees can expect: Competitive pay Paid holidays Year-end bonus program Recognition and incentive programs Access to continuing education via the Kelly Learning Center Pay $15 - $16 per hour Schedule: Monday through Friday - 9:00am - 6:00pm Duration: 4 months possible extension (Possible temp - perm) Anticipated start date: 10/31/2016 to 03/31/2017 SUMMARY Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved. MAJOR JOB DUTIES AND RESPONSIBILITIES Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. EDUCATION/EXPERIENCE High School Diploma or GED Required 1-3 years of Call Center and Reimbursement experience required Knowledge of completed benefits verifications, submitted test claims, completed or reviewed prior authorizations required Strong data entry and 10-key skills Proficient in MS Word and Excel Additional Information Why Kelly? As a Kelly Services candidate you will have access to numerous perks, including: Exposure to a variety of career opportunities as a result of our expansive network of client companies Career guides, information and tools to help you successfully position yourself throughout every stage of your career Access to more than 3,000 online training courses through our Kelly Learning Center Group-rate insurance options available immediately upon hire* Weekly pay and service bonus plans

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 a plus (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