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  • Stop Loss Claims Clerk

    BCS Financial Corporation 4.2company rating

    Claim processor job in Oakbrook Terrace, IL

    Claims Clerk Full TimeSME/Specialist Oakbrook Terrace, IL, US Salary Range:$50,500.00 To $57,500.00 Annually The Claims Clerk will be responsible for accurate, timely screening and distribution of incoming electronic claims correspondence. This role will aid the Analysts in timely processing of the claims and help secure a manageable turnaround time for the entire Claims Department. This position will report to the Claims Manager. Essential Elements Manage the Secure File Transfer Portal (SFTP) site ensure all reporting received is processed in a timely manner Download and pivot reports from Power BI, to locate all possible medical and prescription claims. Identify and review claims data ensuring data integrity Distributing claim requests for processing Convert the PDF claims received into an Excel Template for the Claims Analyst to upload and process Additional duties as assigned Requirements Education and Certifications Associates degree or commensurate experience required Experience Excel, Microsoft Office Suite, Power BI, Clerical functions Travel Required May need to travel to the home office quarterly Hybrid workplace
    $50.5k-57.5k yearly 19h ago
  • Case File Processor

    Diversified Services Network, Inc. 4.2company rating

    Claim processor job in Springfield, IL

    Diversified Services Network, Inc. (DSN) is seeking a full-time Case File Processor to join our team in Springfield, IL! We offer full benefits, PTO, 401k, and more! This position prepares foster care applications for a title IV-E eligibility determination by collecting the required documentation to satisfy the eligibility requirements. This is accomplished by utilizing multiple systems including but not limited to: Department of Children and Family Services' Child Welfare systems (CYCIS & SACWIS), Department of Human Services/Healthcare and Family Services' systems (PACIS, IES, KIDS), Social Security Administration system (SOLQ), and Department of Labor systems (DOL/AWVS). In addition, Case Managers and Supervisors are contacted to resolve discrepancies or request additional information. This position requires the ability to multi-task and to adapt to changes daily. Candidates for this position must be very detail-oriented and possess the ability to process, discern, and retain information across multiple sources. Reading comprehension is a must. The ability to assess a process or situation and recommend an enhancement or change is a plus. Preparing Case Files for Submission to the DCFS Eligibility Determination Unit Job Duties: Check out cases ready for determination (court documentation present in the file). Review and interpret all gathered information. Follow up with the Case Manager and Supervisor if there are any discrepancies or further information is required. Routinely follow up on any outstanding requests for information or documentation. Complete all fields of information on the Cover Sheet for each case. Document any additional information relevant to the determination of eligibility. Ensure all documents are in the case file and are in the correct order. Submit the file to the supervisor for a quality control check. Correct any issues found during the quality control check, if applicable. Assist with all filing duties. Other duties as assigned. The expectation for a fully trained Case File Processor is to complete an average of at least 7 cases a day and with a less than 5% error rate. Required Skills Excellent verbal and written communication skills. Attention to detail. Organizational skills. Ability to take direction and follow instructions. Critical thinking skills. BENEFITS: • 401(k) • Dental insurance • Vision Insurance • Disability insurance • Employee assistance program • Health insurance • Health savings account • Life insurance • Paid time off • Paid Holidays
    $31k-38k yearly est. 2d ago
  • Claims Specialist, Lawyers Professional Liability

    Swiss Re 4.8company rating

    Claim processor job in Chicago, IL

    Do you have experience handling Lawyers Professional Liability or other Professional Liability claims? Are you motivated by working in a collaborative environment? If so, this role may be for you! We are looking for a strategic thinker with leadership skills to join our U.S. Lawyers Claims team. About the Role This role has responsibility for handling Lawyers Professional Liability claims while also supporting internal and external customers. You will manage a caseload of claims from receipt to final resolution. Our team works closely with the U.S. Agents Claims team, and you may have the opportunity to handle Agents Claims, as well. Additional key responsibilities include: * Maintain strong client focus by aggressively and proactively analyzing issues, providing support, and assuring client satisfaction in a timely fashion. * Complying with legal and regulatory requirements, investigate, evaluate, and settle claims, applying technical knowledge and people skills to reach fair and prompt claim resolution. * Complete detailed reviews of claim related issues, including coverage, liability, and damage assessments, and document the claim file appropriately. * Set and maintain appropriate and timely indemnity and expense reserves. * Formulate and execute negotiation and resolution strategies. * Evaluate claims data to assist with identifying claim trends. * Support Underwriting in connection with Claims information and consultation on coverages. * In this role, you will be working with other Claims Handlers dedicated to working on Lawyers Professional Liability Claims. Our team also handles other types of claims, including U.S. Agents claims, and has a strong emphasis on quality and customer service. About the Team We are a highly skilled, professional, and experienced claims team. Our department works closely with colleagues in Client Markets, Underwriting, Products, Actuary, and HR and we collaborate with various offices throughout the US and other places in the world. We are proud to deliver unparalleled customer service to our business partners and clients. We are looking for a new colleague to help us continue to raise the bar! About You Focused, self-motivated, and a confident professional with a hardworking sales mindset to develop insights, propose solutions, and build growth opportunities for clients and Swiss Re. You are a proactive and well-organized decision maker who works well both independently and as part of a team. You also have the following: Additional requirements include: * Bachelor's degree or equivalent industry experience. * 3+ years' Claims handling experience or equivalent industry experience. * Possess solid coverage, liability, damage investigation, evaluation, and claims resolution skills. * Excellent negotiation skills. * Excellent customer service skills and experience collaborating with underwriters, clients, brokers, and internal and external business partners. * Strong data analytic skills. * Experience with handling claims in a paperless environment. * Interest in developing leadership and management skills. * Possess, or willing to obtain, adjuster licenses as needed for various jurisdictions. * Ability to successfully deliver the Swiss Re Claims Commitment. Our company uses a hybrid work model requiring a minimum of three days in the office each week, with the option of working onsite full-time if preferred. The estimated base salary range for this position is $84,000 to $140,000. The specific salary offered for this or any given role will take into account a number of factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget. At Swiss Re, we take a "total compensation approach" when making compensation decisions. This means that we consider all components of compensation in their totality (such as base pay, short-and long-term incentives, and benefits offered), in setting individual compensation. About Swiss Re Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world. Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability. If you are an experienced professional returning to the workforce after a career break, we encourage you to apply for open positions that match your skills and experience. Keywords: Reference Code: 136177 Nearest Major Market: Chicago Job Segment: Liability, Claims, Underwriter, Accounting, Actuarial, Insurance, Finance
    $84k-140k yearly 17d ago
  • Auto and GL Claim Specialist

    Cannon Cochran Management 4.0company rating

    Claim processor job in Chicago, IL

    Multi-Line Claim Specialist (Auto and GL) Schedule: Monday-Friday, 8:00 AM-4:30 PM CT Compensation: $75,000-$85,000 annually 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 liability claim experience is required. Bachelor's Degree is preferred. Experience with handling injury claims. 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. Object Handling Categories 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. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #ClaimsJobs #LiabilityAdjuster #RemoteJobs #InsuranceCareers #ChicagoJobs #LI-Remote We can recommend jobs specifically for you! Click here to get started.
    $75k-85k yearly Auto-Apply 6d ago
  • Associate Claims Specialist

    Liberty Mutual 4.5company rating

    Claim processor job in Hoffman Estates, IL

    Under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Assists in providing service to policyholders/customers on mid-sized and/or large commercial accounts. This is a hybrid position requiring twice a month in-office with preference on candidates residing within 50 miles of Suwanee, GA office. Please note this is subject to change. Responsibilities * Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly. * Establishes action plans based on case facts, best practices, protocols, jurisdictional issues and available resources. * Manages an inventory of property/casualty and disability claims (e.g. workers` compensation, general liability, commercial automobile, property, group benefits), evaluates compensability/liability and losses, and negotiates settlements within prescribed limits. * Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols. * Confirms or denies coverage based on facts obtained during the investigation and advises policyholders as to proper course of action. * Makes effective use of loss management techniques (e.g. Immediate Contact Plan, L9 check, Disability Management, open end release, first call settlements) and other resources. * Updates files and provides comprehensive reports as required. Qualifications * Effective interpersonal, analytical and negotiation abilities required. * Ability to provide information in a clear, concise manner with an appropriate level of detail. * Demonstrated ability to build and maintain effective relationships. * Demonstrated success in a professional environment; success in a customer service/retail environment preferred. * Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent. * Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory. * Licensing may be required in some states. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco
    $55k-76k yearly est. Auto-Apply 8d ago
  • Associate Claims Examiner - Equine

    Markel Corporation 4.8company rating

    Claim processor job in Milwaukee, WI

    What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. Job Responsibilities * Confirms coverage of claims by reviewing policies and documents submitted in support of claims. * Conducts, coordinates and directs investigation into loss facts and extent of damages. * Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure. * Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents. * Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting. Required Qualifications * This role will is responsible for Equine claims; equine knowledge or hands-on experience working with horses is strongly preferred. * Must have or be eligible to receive claims adjuster license. * Successful completion of basic insurance courses or achievement of industry designations. * Ability to be trained in insurance adjusting up to two years of claims experience. * 2-4 years of experience in general liability, construction defect, or related liability lines preferred. * Bachelor's degree preferred * Excellent written and oral communication skills. * Strong organizational and time management skills. #LI-Hybrid US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. * We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. * All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. * We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose 'Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: * All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. * All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.
    $37k-52k yearly est. Auto-Apply 11d ago
  • Auto Casualty Claims Specialist

    FCIC

    Claim processor job in Oak Brook, IL

    Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Bodily Injury Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to First Chicago Insurance Company! We offer: Competitive Salaries Excellent benefits Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! If you are an experienced AUTO CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! We are seeking an experienced Auto Bodily Injury Claims Specialist! The Auto Bodily Injury Claims Specialist will be responsible for investigating and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. DUTIES & RESPONSIBILITIES: Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability status, and damages that are applicable for each claim Process Bodily Injury, and coverage claims in accordance with established office procedures Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation Research case and statutory law in order to conduct proper claim investigation Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims Prepare and present claim evaluations for the appropriate settlement authority Maintain reasonable expense factors Handle other duties as assigned QUALIFICATIONS REQUIRED: 3-5 Years in Auto Casualty claims experience a MUST! Non-Standard Auto Claims experience a plus, not required Knowledge of legal and medical terminology Excellent negotiation, communication, written, organizational and interpersonal skills Ability to pass written examinations where required by state statutes to become a licensed claims adjuster Proficiency in Microsoft Office products First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental and Vision Reimbursement Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $54,750/year-$97,500/year* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.
    $54.8k-97.5k yearly 60d+ ago
  • Medical Device Cybersecurity Analyst

    Intelas

    Claim processor job in New Lenox, IL

    Job Description Medical Device Cybersecurity Analyst- New Lenox, IL Salary: $70,000 to $90,000/yr Other Forms of Compensation: Join Intelas, a Compass One Healthcare company. Intelas, a Compass One Healthcare company, delivers smarter asset management by blending expert service teams with intelligent, data-driven strategies that help hospitals improve uptime, simplify oversight, and make more informed capital decisions. Our programs support 100% regulatory compliance and drives 98% equipment uptime-so clinicians can focus on care, not equipment issues. We support nearly 4,500 healthcare sites nationwide-from large, campus-based acute care hospitals to system-integrated outpatient clinics. With more than 1.15 million medical devices managed, we provide the clarity and consistency needed in today's rapidly evolving healthcare environment. Join Intelas-where your career thrives, your potential is unleashed, and your work directly supports patient care. Whether you're just starting out or are a seasoned professional, our people-first approach ensures opportunities for continuous growth, development, and fulfillment. Explore more at intelashealth.com. Job Summary Please note:This is an on site position SUMMARY The Medical Device Cybersecurity Analyst will be involved in response to cybersecurity alerts, ensuring Client KPI's are met, perform audits and risk assessments of medical devices, and provide subject matter expertise with Intelas's resources for medical device cybersecurity. ESSENTIAL DUTIES AND RESPONSIBILITIES: • Monitors and responds to Intelas's comprehensive medical device asset and cybersecurity management platform findings and mitigating steps. •Strong knowledge of computers, operating systems, security, and networking •Ability to interpret technical documentation and manuals •Generate and build bi-weekly, monthly, and quarterly client reports •Correlate and perform GAP analysis on discovered medical devices with Intelas's CMMS •Create security work orders in Intelas's CMMS and assign to the field as applicable •Triage, respond and assign work orders generated from Intelas's CMMS cybersecurity module as appropriate •Ensure work orders are completed within defined KPI's and assist on site Crothall resources if needed for successful completion •Research and engage OEM's for available approved patches and firmware upgrades •Proactively collect most current MDS2 forms •Maintain database of approved patches, firmware upgrades and MDS2 forms •Collaborate and work with Clients to respond and coordinate mitigating steps and compensating controls on contracted medical devices that may arise from Clients passive asset discovery and risk assessment technology •Participate and contribute to Intelas's CEIT Council •Maintains operational security metrics to measure the effectiveness of security controls and identify opportunities for improvement •Assist in threat intelligence gathering, monitoring of zero-day and correlate to clients CMMS inventory •Assist in development and implementation of continued best practices and risk management of inventoried connected medical devices •Assures compliance with all regulatory standards including patient safety and all relative criteria governing the safe and appropriate use, testing and management of medical devices. MINIMUM QUALIFICATIONS: •Knowledge of the operation and prior hands-on experience in the maintenance and repair of wide variety of medical equipment and systems •High attention to detail and exceptional work quality •Experience with process improvement •Proven ability to work effectively in an unstructured, fast-paced environment •Excellent written and verbal communication skills •Overnight travel may be required for Client visits or industry conferences or workshop. PREFERRED QUALIFICATIONS: • Healthcare experience; General knowledge of Biomedical and Diagnostic Imaging • Knowledge of healthcare cybersecurity is considered a plus • Experience with Computerized Maintenance Management Systems (CMMS) • Knowledge of connected medical device asset discovery and risk analysist platforms EDUCATION: • Associates degree in Information Technology or Biomedical Engineering required • Security+ within 3 years of employment • BMET preferred Apply to Intelas today! Intelas is a member of Compass Group USA Click here to Learn More about the Compass Story Associates at Intelas are offered many fantastic benefits. • Medical • Dental • Vision • Life Insurance/ AD • Disability Insurance • Retirement Plan • Flexible Time Off • Holiday Time Off (varies by site/state) • Associate Shopping Program • Health and Wellness Programs • Discount Marketplace • Identity Theft Protection • Pet Insurance • Commuter Benefits • Employee Assistance Program • Flexible Spending Accounts (FSAs) • Paid Parental Leave • Personal Leave Associates may also be eligible for paid and/or unpaid time off benefits in accordance with applicable federal, state, and local laws. For positions in Washington State, Maryland, or to be performed Remotely, click here for paid time off benefits information. Compass Group is an equal opportunity employer. At Compass, we are committed to treating all Applicants and Associates fairly based on their abilities, achievements, and experience without regard to race, national origin, sex, age, disability, veteran status, sexual orientation, gender identity, or any other classification protected by law. Qualified candidates must be able to perform the essential functions of this position satisfactorily with or without a reasonable accommodation. Disclaimer: this job post is not necessarily an exhaustive list of all essential responsibilities, skills, tasks, or requirements associated with this position. While this is intended to be an accurate reflection of the position posted, the Company reserves the right to modify or change the essential functions of the job based on business necessity. We will consider for employment all qualified applicants, including those with a criminal history (including relevant driving history), in a manner consistent with all applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and the New York Fair Chance Act. We encourage applicants with a criminal history (and driving history) to apply. Applications are accepted on an ongoing basis. Intelas maintains a drug-free workplace. Req ID: 1467914 Intelas ASHLEY VAVROCK [[req_classification]]
    $70k-90k yearly 10d ago
  • Auto Casualty Claims Specialist

    Warrior Insurance Network

    Claim processor job in Chicago, IL

    Job Description Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Bodily Injury Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to Warrior Insurance Network! We offer: Competitive Salaries Excellent benefits Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! If you are an experienced Auto CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! The Auto Bodily Injury Claims Specialist will be responsible for investigating and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. DUTIES & RESPONSIBILITIES: Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability status, and damages that are applicable for each claim Process Bodily Injury, and coverage claims in accordance with established office procedures Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation Research case and statutory law in order to conduct proper claim investigation Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims Prepare and present claim evaluations for the appropriate settlement authority Maintain reasonable expense factors Handle other duties as assigned QUALIFICATIONS REQUIRED: 3-5 Years in Auto Bodily Injury/Casualty claims experience a MUST! Non-Standard Auto Claims experience a plus, not required Knowledge of legal and medical terminology Excellent negotiation, communication, written, organizational and interpersonal skills Ability to pass written examinations where required by state statutes to become a licensed claims adjuster Proficiency in Microsoft Office products Warrior Insurance Network (WIN) provides a competitive benefits package to all full- time employees. Following are some of the perks Warrior Insurance Network (WIN) employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental and Vision Reimbursement Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $54,750/year-$97,500/year* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location. Job Posted by ApplicantPro
    $54.8k-97.5k yearly 11d ago
  • Claims Prevention Coordinator - Full Time - $19/Hour

    Dohrn Transfer 4.4company rating

    Claim processor job in Janesville, WI

    Dohrn Transfer is a leading Midwest LTL Carrier providing less-than-truckload, truckload, and value-added services throughout our 10-state service area. Join our team and become a part of our new growth and bright future. We offer competitive salary and a great benefit package in an exciting, rewarding industry. Dohrn is currently seeking a Full Time Claims Prevention Coordinator at our Janesville, WI terminal. Hours: Monday - Friday, 8:00am - 4:30pm Pay: $19.00/Hour Benefits: Health / Vision / Dental insurance, 401k matching, life insurance, short/long term disability and more. POSITION SUMMARY: Locating and correctly placing over, short, damaged, and missing freight as well as preventing claims. Responsibilities ESSENTIAL DUTIES Daily telephone and written communication with internal and external customers Locate missing freight and overages, shortages, and damaged freight Monitor the OS&D webs 4.5 hours daily in addition to answering the OS&D and Driver lines Review manifests, bills of lading, delivery receipts, and drivers' green sheets Assist terminals in regards to all OS&D freight Research miss-delivered freight and ensure it gets delivered correctly Request dispositions, re-delivery charges, and re-consignment charges to ensure freight keeps moving to its destination May assist with customer service/pick up calls and set appointments as needed Other duties as needed Qualifications MINIMUM REQUIREMENTS High School completion or equivalent Computer skills including Microsoft Office Ability to multi-task in a fast paced environment Detail-oriented, problem-solver, self-motivated Excellent verbal and written communication skills Ability to establish and maintain great relationships with customers Ability to work in a team as well as individually Excellent attendance WORKING CONDITIONS/PHYSICAL DEMANDS Primarily sedentary work, which involves sitting most of the time May be occasionally required to exert up to 20 pounds of force and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects The general office environment is favorable; Lighting and temperature are adequate, and there are minimal hazardous or unpleasant conditions caused by noise, dust, etc; Visual Acuity including regular use of items including a computer screen or monitor Manual dexterity is regularly required including fingering, grasping, and typing; manual dexterity includes repetitive motion of the wrists, hands, and fingers Talking and hearing required to communicate with and listen to others to share or receive information; May be occasionally exposed to noise including telephone, office machinery, and conversations of others Dohrn Transfer Company, LLC is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, color, religion, age, sex, sexual orientation, gender, gender identity or expression, national origin, geographic background, physical and/or mental disability, protected veteran status, or any other classification protected by applicable law.
    $19 hourly Auto-Apply 3d ago
  • Auto Property Damage Claims Specialist

    First Chicago Insurance Company (FCIC

    Claim processor job in Oak Brook, IL

    Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Liability Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to First Chicago Insurance Company! We offer: * Competitive Salaries * Excellent benefits * Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! If you are an experienced AUTO CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! We have openings in our Bedford Park, IL and Oak Brook, IL offices! This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First and Third Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims. DUTIES & RESPONSIBILITIES: * Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss * Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim * Honor/decline/negotiate first and third party liability claims upon completion of coverage/policy investigation and analysis of damages and liability * Work directly with internal and external customers to develop evidence and establish facts on assigned claims * Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims * Prepare and present claim evaluations for the appropriate settlement authority * Notify the Underwriting Department of any adverse information uncovered in the course of the investigation * Familiarity with unfair claim practices in states where doing business * Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service * Provide customer service both to internal and external customers * Handle other duties as assigned QUALIFICATIONS REQUIRED: * 4 years previous auto liability and PD claims experience A MUST! * Prior Non-Standard Auto Claims experience a plus, not required * Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills * General working knowledge of policies, file procedures, state rules and regulations * Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster * On-Site position Preferred: * College degree * Prior claims experience * Ability to use on-line claims system * Bi-lingual a plus! First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: * Competitive Salaries * Commitment to your Training & Development * Medical and Dental and Vision Reimbursement * Short Term Disability/Long Term Disability * Life Insurance * Flexible Spending Account * Telemedicine Benefit * 401k with a generous company match * Paid Time Off and Paid Holidays * Tuition Reimbursement * Wellness Program * Fun company sponsored events * And so much more! Estimated Compensation Range: $41,600/year-$75,000/year* * Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.
    $41.6k-75k yearly 11d ago
  • Claims Specialist

    Example Corp

    Claim processor job in Chicago, IL

    *** This is where your organization can create a consistent intro to all of your jobs, creating consistency in voice and messaging across all job posts *** C'est ici que votre organisation peut créer une introduction cohérente à tous vos emplois, en créant une cohérence dans la voix et la messagerie dans tous les postes. Overview The Claims Specialist position is responsible for Point of Sale (POS) data management and processing back-end pricing rebates/credits, including resolution of issues/disputes in a timely and accurate manner. Responsibilities Ingest and cleanse partner Point of Sale (POS) data in Vistex Go-to-Market Suite (GTMS). Upload manual POS files timely and track monthly progress. Review data for deficiencies or errors, correct any inaccuracies in POS daily. Investigate, research, and identify business entities with minimal information provided. Cleanse, enrich, and monitor master data elements (customer, product, and pricing). Collaborate with POS reporters to improve the completeness and accuracy of the data submitted in Electronic Data Interchange (EDI) or manual submissions. Identify issues related to master data that impact POS and/or claims data. Process and issue credits for incoming claims in an accurate and timely manner. Upload claim files timely and track weekly/monthly progress. Resolve and analyze claim errors/rejections; escalate to management and/or Bid Desk for further internal review as needed. Communicate discrepancies/denials to claim partner for review and alignment. Issue credits for approved claims and send claim discrepancy report to claim partner. Work with Accounts Receivable to reconcile discrepancies/denials for collection. Collaborate with claim partners to improve the claim submission data for processing efficiency. Address any internal and/or external issues or questions regarding data or claims in an accurate and timely manner. Validate and create credits honoring price protection in SAP. Qualifications High school diploma or GED required. Associate degree in Business or work-related experience. Minimum one year rebate/claim processing, data management, or equivalent experience. Demonstrated problem solving skills with a proficient understanding of processes. Proven detail-oriented individual who enjoys managing large amounts of data. Established strong process and organizational skills with the ability to process high volumes of transactions, research errors and exceptions, and manage to completion. Ability to interact with a variety of individuals/functions within the organization as well as with external customers. Ability to work independently in a fast-paced, professional team environment with minimal supervision. Demonstrated experience creating and managing reports that identify discrepancies. Proven capacity to identify and maintain consistent accuracy. Strong oral and written communication skills. Intermediate Microsoft application user including Outlook, Word, and especially Excel. Ability to multi-task and prioritize. Experience with Salesforce, Channel Data Management (CDM), SAP ECC6, Vistex is a plus. ABOUT US: Sharp Imaging and Information Company of America (SIICA) Sharp Imaging and Information Company of America (SIICA) is a division of Sharp Electronics Corporation, the U.S. subsidiary of Japan's Sharp Corporation, a global technology company which has been named to Fortune magazine's World's Most Admired Company List. Sharp strives to help businesses achieve Simply Smarter work by helping companies manage workflow efficiently, create immersive and engaging environments, and increase productivity. SIICA offers a full suite of secure printer and copier solutions, professional and commercial visual displays and projectors, software management and productivity software and markets durable Dynabook laptops. As a total solutions provider, Sharp has a reputation for innovation, quality, reliability, and industry-leading customer support expertise. Compensation for this position The compensation range for this role is $53,900 - $67,650. The listed salary range or contractual rate excludes bonuses, incentives, differential pay, and any other forms of compensation or benefits. The starting salary will be determined by several variables, including but not limited to experience, education, training, certification, and location. You may also be eligible to receive an annual discretionary incentive award, commissions, and program-specific awards, which are subject to the rules governing these programs. Employee perks Comprehensive, family-friendly healthcare plans (medical, dental, vision). 401k retirement plan with a competitive match and plenty of financial support tools. Employee Assistance Plan to care for you and your family's mental and behavioral health, balance, and support. Financial protection for you and your family (life insurance and disability insurance) Rewarding and wholistic wellness program. Training, professional development, and mentorship Full suite of voluntary insurance benefits for financial planning (auto, home, ID protection and legal) Dynamic culture eager to innovate, enhance diversity, and work smarter. Sharp Electronics Corporation is an equal opportunity employer - minority - female - disability - veteran. No agency resumes will be accepted or fees paid in the absence of an official written engagement agreement executed in advance by Human Resources for this particular position. All applicants must be authorized to work in the US without sponsorship. All applications must include compensation expectations in order to be considered. Local candidates only, please. #LI-SR1 #SIICA *** Similar to the introduction that can precede all job descriptions, an outro can also be formatted for consistency on all posts *** Semblable à l'introduction qui peut précéder toutes les descriptions de poste, une outro peut également être formatée pour la cohérence sur tous les messages
    $53.9k-67.7k yearly Auto-Apply 24d ago
  • Global Risk Solutions Claims Specialist Development Program (January, June 2026)

    Law Clerk In Cincinnati, Ohio

    Claim processor job in Hoffman Estates, IL

    Claims Specialist Program Are you looking to help people and make a difference in the world? Have you considered a position in the fast-paced, rewarding world of insurance? Yes, insurance! Insurance brings peace of mind to almost everything we do in our lives-from family trips to your first car to weddings and college graduations. As a valued member of our claims team, you'll help our customers get back on their feet and restore their lives when catastrophe strikes. The details When you're part of the Claims Specialist Program, you'll acquire various investigative techniques and work with experts to determine what caused an accident and who is at fault. You'll independently manage an inventory of claims, which may include conducting investigations, reviewing medical records, and evaluating damages to determine the severity of each case. You'll resolve cases by working with individuals or attorneys to settle on the value of each case. You will have required comprehensive training, one-on-one mentoring, and a strong pay-for-performance compensation structure at a global Fortune 100 company. Make a difference in the world with Liberty Mutual. Qualifications What you've got You have 0-2 years of professional experience. A strong academic record with a cumulative 3.0 GPA preferred You have an aptitude for providing information in a clear, concise manner with an appropriate level of detail, empathy, and professionalism. You possess strong negotiation and analytical skills. You are detail-oriented and thrive in a fast-paced work environment. You must have permanent work authorization in the United States. What we offer Competitive compensation package Pension and 401(k) savings plans Comprehensive health and wellness plans Dental, Vision, and Disability insurance Flexible work arrangements Individualized career mobility and development plans Tuition reimbursement Employee Resource Groups Paid leave; maternity and paternity leaves Commuter benefits, employee discounts, and more Learn more about benefits at ************************** A little about us As one of the leading property and casualty insurers in the country, Liberty Mutual is helping people embrace today and confidently pursue tomorrow. We were recognized as a ‘2018 Great Place to Work' by Great Place to Work US, and were named by Forbes as one of the best employers in the country for new graduates and women-as well as for diversity. Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information, or on any basis prohibited by federal, state, or local law. We can recommend jobs specifically for you! Click here to get started.
    $30k-51k yearly est. Auto-Apply 6d ago
  • Pharmacy Claims Adjudication Specialist

    Onco360 3.9company rating

    Claim processor job in Woodridge, IL

    We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Woodridge, IL. This will be a Full-Time position. This position must be located within driving distance to our pharmacy, with a hybrid work style. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $23.00 an hour and up Sign-On Bonus: $5,000 for employees starting before January 1, 2026. We offer a variety of benefits including: Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Company paid benefits - life; and short and long-term disability Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360... Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information.. Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information. Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim. Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible) Manages all funding related adjudications and works as a liaison to Onco360 Advocate team. Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment. Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable. Document and submit requests for Patient Refunds when appropriate. Pharmacy Adjudication Specialist Qualifications and Responsibilities... Education/Learning Experience Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience Work Experience Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills Desired: Knowledge of Foundation Funding, Specialty pharmacy experience Licenses/Certifications Required: Registration with Board of Pharmacy as required by state law Desired: Certified Pharmacy Technician (PTCB) Behavior Competencies Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills #Company Values: Teamwork, Respect, Integrity, Passion
    $23 hourly 12d ago
  • Warranty and Claims Supervisor

    Raynor 4.5company rating

    Claim processor job in Dixon, IL

    Essential Duties and Responsibilities: Receive claims from customers via email or phone calls. Must be able to proficiently work inside Customer portals to read Customer claims and bring necessary information. Provide updates regarding Customer claims when requested and bring inputs to factory to support identification of true root cause so effective corrective action/s can be implemented for long term improvements. Be the key / primary contact to maintain /attend all email communications related to Customer Warranty that are managed through the service post email account for claims. Coordinate and track the return of warranties to the plant and support in the initial basic product evaluation to define next steps to continue with CPAR process. Manage the final disposition of material returned once the specific CPAR/ problem solving activities are completed, to secure that inventory adjustment and scrap are properly managed according to documented procedures. Directly supervise individuals in the warranty/claims function, provide direction to others in customer service who may be involved in specific claims activities Work with Quality Engineering Manager to analyze trends in claims frequency and cost, and develop appropriate communications for customers as relates to mitigation activities completed or in progress. Knowledge, Skills and Abilities: Must be self-motivated and able to work with minimal supervision. Coaching and mentoring skills required, previous supervision experience preferred. Must be able to interact effectively and cooperatively with employees at all levels. Exceptional communication skills, both verbal and written, problem solving and analytical skills. Core Values Deliver Service Be Positive Embrace Family Be a Team Player Show Integrity Have Grit Job Type: Full-time / Salaried Pay: $50,000-70,000 The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons. Benefits: 401(k) with company match Dental insurance Health insurance Vision insurance Health Savings Account (HSA) Voluntary Life Insurance Employee Assistance Program Wellness Program Paid holidays Paid time off
    $50k-70k yearly 11d ago
  • High Impact Claims Specialist

    Rosecrance 4.1company rating

    Claim processor job in Rockford, IL

    Become a champion of hope. At Rosecrance, we've been leading the way in behavioral health services for over a century. Our team empowers individuals and families to overcome substance use and mental health challenges through compassionate care and evidence-based therapies. If you're ready to make a meaningful impact, we're ready to welcome you! We are looking for dedicated individuals to join our team and help deliver on our mission of hope and recovery. Position Purpose: The High Impact Claims Specialist will serve as a primary resource to identify high dollar collection issues with our commercial payors, increase revenue and track and trend payor collection issues. This role will work closely with management to support the A/R team's collection efforts. Qualifications/Basic Job Requirements: • High School diploma or GED • Minimum of ten years' experience in researching and solving high dollar complex insurance claims and denials. • Computer proficiency in a Windows environment, knowledge of Microsoft Office products with an emphasis in Excel. • Adequate written skills to accurately complete required documentation within the time frames prescribed • Excellent organizational and customer service skills • Must be emotionally and medically able to perform essential job responsibilities • Must be free from active or infectious diseases Essential Responsibilities: 1. Review and process all BC/BS and Commercial high dollar claims (over $10,000) for denials, payor issues and payment trends. 2. Submit, process and track all appeals for BC/BS and commercial payors. Maintain knowledge of ERISA laws governing employee benefit plans and manage the appeal process for these claims. 3. Assist A/R staff with complex claim issues they are unable to resolve in a timely manner. 4. Track and trend all Single Case Agreements. Work closely with Contracting on any SCA payment issues / concerns. 5. Review payments for BC/BS and commercial payors for rate validation according to our contracts. 6. Track all denial outcomes for payment, write-offs and transfers to client liability. Identify the root cause for the adjustments to client accounts. Work with management to review adjustment trends and identify potential solutions. 7. Help maintain integrity of accounts receivable ledger, including aged receivable monitoring on an ongoing basis. 8. Responsible for maintaining current knowledge of revenue components including benefit plans, contract terms and rates and billing forms and codes. 9. Check status of claims through use of telephone, websites and/or other means available. 10. Document adjustments needed to patient accounts. 11. As needed, participate in phone conference calls with payors. 12. Pursue collection activities and follow up for balances outside of established norms. 13. Coordinate collection activities with outside agencies, including court appearances, as needed. 14. Provide feedback & education management with regards to issues that impact revenue flow. 15. Provide appropriate documentation and reports designed to assist in fiscal management of the agency. 16. Serve as a member of the SWAT Team and participate in team meetings. 17. Serve as a member of the Revenue Cycle Team and participate in all team meetings and activities. 18. Understand and comply with all of the principles established by the Rosecrance Corporate Compliance Program and Code of Ethics. 19. Perform all responsibilities in compliance with the mission, vision, values and expectations of Rosecrance. 20. Deliver exceptional customer service consistently to every customer. 21. Serve as a role model for other staff, clients and customers and demonstrate positive guest relations in representing Rosecrance. 22. Assume other related responsibilities as assigned by management. Physical Requirements/Percentage of Work Time: 1. Vision: Must be able to read printed and/or handwritten materials from a variety of sources 75-100% 2. Hearing: Must be able to hear well enough to communicate with coworkers 50-79%; answer incoming phone calls 25-49%; interact with the public 25-49% 3. Standing/Walking/Mobility: Must have mobility between departments within the facility 25-49% 4. Climbing/Stooping/Kneeling: 0-24% 5. Lifting/Pulling/Pushing: Must exert up to 20 pounds of force occasionally and/or up to 5 pounds of force frequently to lift or move objects 25-49% 6. Fingering/Grasping/Feeling: Must be able to finger keyboard for computer work and phone equipment for placing/receiving calls 50-74% 7. Sitting: must be able to sit for prolonged periods of time when using the computer 25-49% Environment: Exposure to bloodborne pathogens requiring the use of universal precautions and/or personal protective equipment. Exposure to computers. Schedule: `8-hour shifts Friday-Monday 830a-5p Compensation & Rewards Based on education, experience, and credentials Starting pay - $22.47/hr Work Location: Remote-Rockford, IL Our Benefits Rosecrance values its employees and offers a comprehensive benefits package for you and your family: Medical, dental, and vision insurance (multiple plan options to meet your needs) 401(k) with employer match & discretionary contribution Group Life Insurance, LTD and AD&D Tuition assistance & licensure/certification reimbursement Paid Time Off, sick time, bereavement leave Referral program earning up to $1,000 per hire! Wellness program, including an on-site gym at select facilities Discounts at participating retailers Daily pay available through UKG Wallet for financial flexibility Who We Are Rosecrance has been at the forefront of providing behavioral health services for over a century. Our mission is to empower individuals and families to overcome substance abuse and mental health challenges through evidence-based therapies and compassionate care. Join us in our mission to foster lasting recovery and transform lives. We are committed to providing careers that make a difference in the lives of the people we serve and the people we employ. We do this through the work we do, our core mission and values, our employee resources, and especially through our purpose-driven community of opportunity and hope. Our Health and Safety Commitment We maintain a zero-tolerance drug-free environment, including marijuana, to prioritize safety for staff and clients. All candidates must pass an occupational health screening, ensuring a secure and healthy workplace. Equal Employment Opportunity Rosecrance is an equal opportunity employer and values diversity in the workplace. We do not discriminate based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, marital status, veteran status, or any other legally protected status. Our hiring decisions are based solely on qualifications, skills, and experience relevant to the requirements of the position. Our Partnerships AARP Employer Pledge Program MSEP (Military Spouse Employment Partnership). Ready to Make a Difference? Apply today and be part o
    $22.5 hourly 32d ago
  • Auto and GL Claim Specialist

    Ccmsi 4.0company rating

    Claim processor job in Chicago, IL

    Multi-Line Claim Specialist (Auto and GL) Schedule: Monday-Friday, 8:00 AM-4:30 PM CT Compensation: $75,000-$85,000 annually 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 liability claim experience is required. Bachelor's Degree is preferred. Experience with handling injury claims. 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. Object Handling Categories 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. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #ClaimsJobs #LiabilityAdjuster #RemoteJobs #InsuranceCareers #ChicagoJobs #LI-Remote
    $75k-85k yearly Auto-Apply 17d ago
  • Associate Claims Specialist

    Liberty Mutual 4.5company rating

    Claim processor job in Hoffman Estates, IL

    Under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Assists in providing service to policyholders/customers on mid-sized and/or large commercial accounts. This is a hybrid position. You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Westborough, MA; Boston, MA; Suwanee, GA; Hoffman Estates, IL; Plano, TX. Please note this is subject to change. Responsibilities: * Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly. * Establishes action plans based on case facts, best practices, protocols, jurisdictional issues and available resources. * Manages an inventory of property/casualty and disability claims (e.g. workers` compensation, general liability, commercial automobile, property, group benefits), evaluates compensability/liability and losses, and negotiates settlements within prescribed limits. * Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols. * Confirms or denies coverage based on facts obtained during the investigation and advises policyholders as to proper course of action. * Makes effective use of loss management techniques (e.g. Immediate Contact Plan, L9 check, Disability Management, open end release, first call settlements) and other resources. * Updates files and provides comprehensive reports as required. * Work on resolution in early life of a claim to avoid attorney representation. * High volume of incoming claims. * Time management skills are in need. Qualifications * Effective interpersonal, analytical and negotiation abilities required * Ability to provide information in a clear, concise manner with an appropriate level of detail * Demonstrated ability to build and maintain effective relationships * Demonstrated success in a professional environment; success in a customer service/retail environment preferred * Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent * Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory * Licensing may be required in some states About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco
    $55k-76k yearly est. Auto-Apply 4d ago
  • Auto Property Damage Claims Specialist

    Warrior Insurance Network

    Claim processor job in Oak Brook, IL

    Job Description Are you unhappy at your present job? ? Is it time for a change? Are you an experienced Auto Liability Claims Specialist looking to join a growing company where you will be rewarded for your hard work, and have future upward career growth opportunities? If you answered YES to the above, it's time to talk to Warrior Insurance Network! We offer: Competitive Salaries Excellent benefits Growth opportunities! Apply only if you consider yourself a career professional who loves to work, because we work hard here! We have openings in our Bedford Park, IL and Oak Brook, IL offices! If you are an experienced Non-Standard Auto CLAIMS PROFESSIONAL (with many years of auto and especially nonstandard auto related experience) we'll make sure you are COMPENSATED AS A PROFESSIONAL!! This talented individual must possess previous experience in the investigation, determination of coverage, prompt evaluation of both First- and Third-Party auto property damage claims with an eye towards prompt, courteous and economical resolution of both First and Third Party related property damage claims. DUTIES & RESPONSIBILITIES: Review and determine course of action on each file assigned, utilizing technical knowledge and experience for the purpose of supporting final disposition of a loss Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage liability, status and damages that are applicable for each claim Honor/decline/negotiate first and third-party liability claims upon completion of coverage/policy investigation and analysis of damages and liability Work directly with internal and external customers to develop evidence and establish facts on assigned claims Organize, plan and prioritize work activities to keep up with current assignments and to ensure prompt conclusion of claims Prepare and present claim evaluations for the appropriate settlement authority Notify the Underwriting Department of any adverse information uncovered in the course of the investigation Familiarity with unfair claim practices in states where we do business Conduct business with vendors in a professional manner while maintaining a reasonable expense factor and upholding the company's reputation for quality service Provide customer service both to internal and external customers Handle other duties as assigned QUALIFICATIONS REQUIRED: Minimum 4 years previous auto liability and auto PD claims experience A MUST! Non-Standard auto claims experience a plus but not required. Excellent analytical, organizational, interpersonal and communication (verbal, written, phone) skills General working knowledge of policies, file procedures, state rules and regulations Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster On-Site position. Preferred: Prior claims experience Ability to use on-line claims system Bi-lingual a plus! Warrior Insurance Network (WIN) provides a competitive benefits package to all full- time employees. Following are some of the perks Warrior Insurance Network (WIN) employees receive: Competitive Salaries Commitment to your Training & Development Medical and Dental and Vision Reimbursement Short Term Disability/Long Term Disability Life Insurance Flexible Spending Account Telemedicine Benefit 401k with a generous company match Paid Time Off and Paid Holidays Tuition Reimbursement Wellness Program Fun company sponsored events And so much more! Estimated Compensation Range: $41,600/year-$75,000/year* *Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location. Job Posted by ApplicantPro
    $41.6k-75k yearly 11d ago
  • Trainee Casualty Claims Specialist

    First Chicago Insurance Company (FCIC

    Claim processor job in Bedford Park, IL

    We are Hiring for a Trainee to learn and handle Auto Bodily Injury Casualty Claims! Are you a high performing Auto Liability PD Claim Professional, seeking advancement within your career? Are you interested in learning how to handle injury claims, up to and included attorney represented complex casualty claims? Are you currently in a Claims role and feel that there is no opportunity to grow your Claims career? If you answered YES, then look no further! First Chicago Insurance is recruiting a training class of ambitious individuals who currently excel within the auto liability PD claims insurance industry. No prior auto bodily injury/casualty claims handling experience required! At the end of the training program, you will be expected to and able to successfully investigate, evaluate, negotiate, and resolve bodily injury, uninsured/underinsured motorist bodily injury, and medical payments claims. The training class will run approximately 4-6 weeks and will be a balanced mix of classroom instruction and on-the-job/side-by-side training. Following is more information about this unique opportunity to elevate your insurance career: The Casualty Specialist Trainee will be responsible for the investigation and settlement of automobile bodily injury claims. They will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. DUTIES & RESPONSIBILITIES: * Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss. * Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability, status, and damages that are applicable for each claim. * Process Bodily Injury, and coverage claims in accordance with established office procedures. * Work closely with Third Parties, plaintiff counsel, Claim Director and Chief Operating Officer to determine necessary injury and coverage investigation. * Research case and statutory law in order to conduct proper claim investigation. * Document policy status, coverage, liability and damages on all claims and notify re-insurer on qualifying claims. * Prepare and present claim evaluations for the appropriate settlement authority. * Maintain reasonable expense factors. * Handle other duties as assigned. QUALIFICATIONS REQUIRED: * 2+ years of auto liability property damage claim adjusting experience is required. * JD (Juris Doctorate) a plus! * Non-standard Auto Claims handling experience preferred is not required. * Excellent negotiation, written and verbal communication, organizational and interpersonal skills. * Ability to pass written examinations where required by state statutes to become a licensed claims adjuster. * Proficiency in Microsoft Office products. * Bilingual in Spanish preferred but not required. * On-Site position. First Chicago Insurance Company provides a competitive benefits package to all full- time employees. Following are some of the perks First Chicago employees receive: * Competitive Salaries * Commitment to your Training & Development * Medical and Dental * Short Term Disability/Long Term Disability * Life Insurance * Flexible Spending Account * Telemedicine Benefit * 401k with a generous company match * Paid Time Off and Paid Holidays * Tuition Reimbursement Training Programs * Wellness Program * Fun company sponsored events * And so much more! Estimated Compensation Range: $27.88/hr-$31.25/hr* * Published ranges are estimates. Offered compensation will be based on experience, skills, education, certifications, and geographic location.
    $27.9-31.3 hourly 11d ago

Learn more about claim processor jobs

How much does a claim processor earn in Rockford, IL?

The average claim processor in Rockford, IL earns between $22,000 and $55,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Rockford, IL

$34,000
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