Claim processor jobs in Round Rock, TX

The claims auditor is responsible for providing customer service to policy holders and beneficiaries and facilitating the claims process. Essential Functions Receive notification of death of policyholder Process death benefits for life and annuity claims Order and review policyholder files Complete worksheet of policy information Send information about requirements and options for payment of benefits to beneficiary or appropriate persons Provide all required written correspondence in a timely, accurate and professional manner Answer requests regarding policy provisions, billing, bank drafts, interest rates, cash value, and accounting Calculate interest payments on death benefits where it is a state requirement Calculate and report any taxable gain on annuity or life insurance distributions Enter address and billing, and any other pertinent information changes into database Request checks from accounting and send to beneficiary Answer information calls regarding claims Send follow-up notices on pending claim files Send notification of death benefits to states when required Perform other duties as assigned Knowledge, Skills & Abilities Previous insurance experience preferred Strong interpersonal skills Must have advanced computer skills in Microsoft Office. Education & Experience High school diploma or equivalent Associate's degree strongly preferred Licenses & Certifications None required Supervision & Leadership This position does not require supervisory responsibilities Work Environment This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Regular and predictable attendance is required. Overtime may be required at peak times. The employee is regularly required to use hands to handle or feel. The employee is regularly required to talk or hear. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of their job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Auto/Bodily Injury **PRIMARY PURPOSE** : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly. + Responsible for litigation process on litigated claims. + Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims. + Reports large claims to excess carrier(s). + Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution. + Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage. + Communicates claim action/processing with insured, client, and agent or broker when appropriate. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position. **Experience** Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws. **Skills & Knowledge** + In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills + Ability to work in a team environment + Ability to meet or exceed Service Expectations **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical:** Computer keyboarding, travel as required **Auditory/Visual:** Hearing, vision and talking _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $75,000_ _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

Looking for a new career? Interested in changing industries? Searching for opportunities to grow? Are you ambitious and eager to learn? Then, this might be the job for you! We are currently seeking a class of potential Claims Examiners to be trained to become our next generation leaders at TWIA/TFPA.

UI Claims Examiner (Austin) - (826035) Description WHO WE ARE:Texas Workforce Commission connects people with careers across the state. While we are based in downtown Austin, TX just north of the Texas State Capitol, we have offices statewide. We're a Family Friendly Certified Workplace with great work-life balance, competitive salaries, extensive opportunities for training and development, and fantastic benefits. This position is based in our main office in downtown Austin, Texas at 101 E. 15th Street. TWC is not considering applications from individuals who require sponsorship for an employment visa, including those currently on student or postgraduate visas. You must be a Texas resident to work for the Texas Workforce Commission or willing to relocate to Texas. WHO YOU ARE:A person with an eye for details, who is able to calmly explain facts and laws to customers. You are a problem solver and good listener, who communicates effectively and who understands the need to empathize with people who may be in difficult situations. Someone who is eager to assist people and provide them with essential information relating to their unemployment benefit debts. WHAT YOU WILL DO:The Interstate Unemployment Insurance (UI) Claims Examiner II - III performs complex to advanced (senior level) unemployment insurance overpayment collection work. Work involves reviewing unemployment insurance benefit overpayments for accuracy and completeness, verifying balance due and getting claimants to agree to a payment plan, or explaining collection action affecting their claim. This position will have a focus on receiving and referring interstate overpayments. Works under general to limited supervision, with moderate to considerable latitude for the use of initiative and independent judgment. YOU WILL BE TRUSTED TO:-Respond to external and internal communications via telephone, letter or e-mail and provide thorough, timely information.-Review the TWC Unemployment Benefits automated system to relay to parties how overpayments were established, encourage payment, and to provide payment options.-Provide claimants with information on collection actions taken on their benefit overpayments and the consequences of that action.-Receive overpayment data from Unemployment Agencies in other states and logging into TWC system in order to collect overpayments from current Texas claimants. -Keep reports and other production documentation up to date, based on time frames indicated by supervisor or other management.-Perform other duties as assigned. YOU QUALIFY WITH: -UI Claims Examiner II: Three years of full-time experience in the gathering of information, interviewing, counseling, or in the instruction, demonstration, and interpretation of policies in a public or private enterprise; in unemployment insurance work; or in workforce development issues and programs. -UI Claims Examiner III: Four years of full-time experience in the gathering of information, interviewing, counseling, or in the instruction, demonstration, and interpretation of policies in a public or private enterprise; in unemployment insurance work; or in workforce development issues or programs. -Both Levels: Relevant academic credits may be applied toward experience qualifications for this position. YOU ARE A GREAT FIT WITH:-Basic billing or collections experience -Basic experience with use of MS Excel, Word, Outlook, and SharePoint or their equivalents-Experience in taking calls from a shared phone queue line-Good conversational/listening skills and/or verbal “de-escalation” skills-Familiarity with the TWC Unemployment Benefits system, ICON and or IRORA is a plus YOU GAIN-A Family Friendly Certified Workplace. -Competitive starting salary: $3,100.00-$4,500.00/month-Defined Retirement Benefit Plan-Optional 401(k) and 457 accounts-Medical Insurance-Paid time off, including time for vacation, sick and family care leave-Additional benefits for active employees can be found at *********************************************************** VETERANS:Use your military skills to qualify for this position or other jobs! Go to ************************* to translate your military work experience and training courses into civilian job terms, qualifications, and skill sets. Also, you can compare this position to military occupations (MOS) at the Texas State Auditor's Office by pasting this link into your browser: *************************************************************************** HOW TO APPLY: To be considered, please complete a State of Texas Application for Employment and apply online at ******************* or on Taleo. TWC is not considering applications from individuals who require sponsorship for an employment visa, including those currently on student or postgraduate visas. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. A position utilizing this classification will be designated as security sensitive according to the Texas Labor Code, Section 301.042. Primary Location: United States-Texas-AustinWork Locations: Austin:101 E 15th St (320-4001) 101 E 15th St Austin 78778-0001Job: Tax Examiners and CollectorsOrganization: TWC Business UnitSchedule: Full-time Employee Status: RegularJob Type: StandardJob Level: Non-ManagementTravel: NoJob Posting: Jun 20, 2025, 5:00:00 AMWork From Home: No

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 the acknowledged technical expert and be responsible for the resolution of high complexity and high exposure claims. The position will have significant responsibility for decision making and work autonomously within their authority. Responsibilities: * High complexity coverage interpretation, liability investigation, multiple vehicles, potential extra-contractual, litigation or significant injuries. * Direct involvement in litigation claims management to reach desired outcomes and minimize expenses * Investigate, negotiate and settle complex liability cases. Maintain and make sure alignment to Markel's guidelines and procedures. * Ensure proper adherence to internal large loss reporting requirements. * Promptly communicate with Claims Manager on case developments and provide information on issues affecting the lines of business * Chip in and assist in the implementation of a range of initiatives, discussion and action plans brought forth by the Claims Manager * Connect with underwriting as needed to handle claims and to alert of any significant developments * Participate in agent related functions and meetings as required Requirements: * 7-10+ years of Liability claims handling experience with a commercial insurance company * Successful Liability claim handling experience is critical * College degree and/or professional designation preferred * Sound comprehension of personal and commercial liability coverages. * Excellent written and oral communication skills. * Experience in resolving contractual obligations, coverage analyses, and investigations. * Ability to run sophisticated large liability exposures, set loss and expense reserves and evaluate settlement values. * Ability to proactively self-manage an active caseload. * Ability to analyze and convey summations of complex issues; recognize alternative approaches and develop action plans, both orally and in written form. * Travel required as necessary (less than 15%). * Adjuster license in multiple states or across the US strongly preferred. US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The salary for the position is $97,520 - $134,000 with a 25% bonus potential. 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.

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. - Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. - Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. - Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. - Assists in reviews of state and federal complaints related to claims. - Collaborates with other internal departments to determine appropriate resolution of claims issues. - Researches claims tracers, adjustments, and resubmissions of claims. - Adjudicates or readjudicates high volumes of claims in a timely manner. - Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. - Meets claims department quality and production standards. - Supports claims department initiatives to improve overall claims function efficiency. - Completes basic claims projects as assigned. **Required Qualifications** - At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. - Research and data analysis skills. - Organizational skills and attention to detail. -Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

We're excited you're considering joining a great place to work! Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect and is proud to be an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to age, race, color, national origin, religion, sex, gender identity, sexual orientation, genetic information, veteran status, or any other basis protected by local, state, or federal law. About this Position At Texas Mutual, we're working to create a stronger, safer Texas. As the Supervisor of Claims for our Austin Regional Office, you will supervise and monitor the daily operations of claims processing in accordance with the Texas Workers' Compensation Act, rules of the Division of Workers' Compensation and internal procedures. You will manage the personnel, equipment, facilities and finances of assigned operations and ensure coordination and support of the overall goals and objectives of the division. Responsibilities & Qualifications In this role you will: * Supervise and monitor the daily operations of claim processing in accordance with the Texas Workers' Compensation Act, rules of the DWC, and internal procedures. * Provide guidance to staff regarding claim handling and desired outcomes. * Recruit, retain, coach and mentor employees. * Contribute to the development and implementation of division goals and objectives, policies, standards, procedures and budgets. It is required that you have: * Bachelor's degree. * Texas workers' compensation or all lines adjuster's license. * Related experience in the range of four to six years (Texas preferred). Preferred Qualifications * Industry-related designation. Texas Mutual Pay Transparency The base pay range is based on the market evaluation of the job and may include pay for multiple levels. Individual base pay within the range is determined by a variety of factors, including experience, performance, education, and demonstration of skills and competencies required for each role. Your recruiter can discuss the full value of our total compensation package with you, including our generous bonus plans and flex-hybrid work model. Base Pay Range: $99,985.50 - $123,511.50 Per Year Flex-Hybrid Work Environment: Texas Mutual's flex-hybrid schedule allows you to bring your best self to work by working remotely and collaborating in the office based on business needs. All Texas Mutual employees are required to have Texas residency and travel to their designated office as needed. Our Benefits: * Annual performance bonus and merit-based pay increase * Lifestyle Savings Account ($1,000 per year) * Automatic 4% employer contribution to retirement plan * 401k plan with 100% employer match up to 6% * Student loan repayment matching in 401k plan * Three weeks' time off for vacation * Nine paid holidays and two personal days each year * Day one health, Rx, vision and dental insurance * Life and disability insurance * Flexible spending account * Pet insurance and pet Rx discounts * Free on-site gym, fitness classes, and health and wellness resources * Free identity theft protection * Free student loan repayment and refinancing consultation * Professional development and tuition reimbursement * Employee referral bonus * Free onsite snacks

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Claims Analyst/Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Daily Responsibilities: • Investigate rejected claims and analyze results • Review large data spreadsheets, analyze provider claims submissions and researching websites Hours for this Position: • Monday-Friday 9:00am- 6:00pm • Start Date: 10/26 Advantages of this Opportunity: • Competitive salary, negotiable based on relevant experience ($22-$24/hr.) • Benefits offered, Medical, Dental, and Vision • Fun and positive work environment Qualifications • Bachelor's degree in related field or equivalent experience • Moderate Excel user • Analytical experience • System savvy • Must have Claims experience • Must have Healthcare experience preferred knowledge Medicaid, Medicare Requirements • Strongly prefer Managed Care experience • Preferred- experience with one or all of following software's - Viso, Amysis or Agile. (Systems that support management, delivery, and administration of healthcare services and healthcare benefits.) Additional Information Interested in being considered? If you are interested in applying to this position, please contact Sheena Lagaylay @ 407-965-2843 and click the Green I'm Interested Button to email your resume.

At MCI we are committed to fostering an environment where professionals can build meaningful careers, access continuous learning and development opportunities and contribute to the success of a globally expanding, industry-leading organization. We are seeking a detail-oriented and analytical On-Site Claims Adjudication Specialist to join our team! If you have strong critical thinking skills, a passion for exceptional customer service, and the ability to thrive in a fast-paced environment, we want to hear from you. This role involves handling inbound communications, evaluating warranty claims, and working closely with customers and service partners to ensure timely and accurate resolutions. Shift & Schedule: Training Schedule (2-3 weeks): Monday to Friday: 8:00 AM - 5:00 PM (Weekends Off) Post-Training Shift: Saturday to Tuesday: 8:00 AM - 6:00 PM (Wednesday - Friday Off) Must be available for weekends shift hours and days cannot be modified. Full-time, 40 hours per week. To be considered for this role, you must complete a full application on our company careers page, including all screening questions and a brief pre-employment test. POSITION RESPONSIBILITIES Key Responsibilities: Engage with existing customers through inbound calls and email. Evaluate and process warranty claims with precision, ensuring adherence to policy terms and conditions. Apply critical thinking and analytical skills to make informed, evidence-based decisions quickly. Handle escalated claims and conduct thorough investigations to resolve complex issues efficiently. Collaborate with customers, service partners, and internal teams to deliver an outstanding customer experience. Adapt to evolving processes and technology in a fast-growing business environment. Maintain accurate records of claim resolutions and customer interactions using email management systems and customer service software. Expectations: Effectively multitask while managing a high volume of inbound communications via phone, email, and other channels. Clearly and concisely communicate complex claim details and decisions to customers and internal teams. Provide empathetic and professional customer service, even in high-pressure situations. Ensure timely and precise claim resolutions while maintaining high performance standards. Navigate multiple systems with proficiency and accuracy. CANDIDATE QUALIFICATIONS WONDER IF YOU ARE A GOOD FIT FOR THIS POSITION? All positive, and driven applicants are encouraged to apply. The Ideal candidates for this position are highly motivated and dedicated and should possess the below qualities: High school diploma or equivalent (additional certifications are a plus). 1-3 years of experience in one or more of the following: call center, claims adjudication, insurance adjusting, or technical customer service (preferably in a high-volume or protection plan environment). Proficiency with computers is essential. Proficiency in claims management systems, contact center platforms, and MS Office products. Strong verbal and written communication skills, with attention to grammar and clarity. Strong critical thinking and problem-solving skills with the ability to make well-informed decisions under pressure. Must be able to complete a writing skills test, including sending an email recap of a conversation. CONDITIONS OF EMPLOYMENT All MCI Locations Must be authorized to work in the country where the job is based. Subject to the program and location of the position Must be willing to submit up to a LEVEL II background and/or security investigation with a fingerprint. Job offers are contingent on background/security investigation results. Must be willing to submit to drug screening. Job offers are contingent on drug screening results. COMPENSATION DETAILS WANT AN EMPLOYER THAT VALUES YOUR CONTRIBUTION? At MCI, we believe that your hard work deserves recognition and reward. Our compensation and benefits packages are designed to be competitive and to grow with you over time. Starting compensation is based on experience, and we offer a variety of benefits and incentives to support and reward our team members. What You Can Expect from MCI: We understand the importance of balance and support, which is why we offer a variety of benefits and incentives that go beyond a paycheck. Our team members enjoy: Paid Time Off: Earn PTO and paid holidays to take the time you need. Incentives & Rewards: Participate in daily, weekly, and monthly contests that include cash bonuses and prizes ranging from electronics to dream vacations and sometimes even cars! Health Benefits: Full-time employees are eligible for comprehensive medical, dental, and vision coverage after 60 days of employment, and all employees have access to MEC medical plans after just 30 days. Benefit options vary by location. Retirement Savings: Secure your future with retirement savings programs, where available. Disability Insurance: Short-term disability coverage is available to help protect you during unexpected challenges. Life Insurance: Access life insurance options to safeguard your loved ones. Supplemental Insurance: Accident and critical illness insurance Career Growth: With a focus on internal promotions, employees enjoy significant advancement opportunities. Paid Training: Learn new skills while earning a paycheck. Fun, Engaging Work Environment: Enjoy a team-oriented culture that fosters collaboration and engagement. Casual Dress Code: Be comfortable while you work. Compensation & Benefits that Fit Your Life MCI takes pride in tailoring our offerings to fit the needs of our diverse team across subsidiaries and locations. While specific benefits and incentives may vary by geography, the core of our commitment remains the same: rewarding effort, providing growth opportunities, and creating an environment where every employee feels valued. If you're ready to join a company that recognizes your contributions and supports your growth, MCI is the place for you. Apply today! PHYSICAL REQUIREMENTS This job operates in a professional office environment. While performing the duties of this job, the employee will be largely sedentary and will be required to sit/stand for long periods while using a computer and telephone headset. The employee will be regularly required to operate a computer and other office equipment, including a phone, copier, and printer. The employee may occasionally be required to move about the office to accomplish tasks; reach in any direction; raise or lower objects, move objects from place to place, hold onto objects, and move or exert force up to forty (40) pounds. REASONABLE ACCOMMODATION Consistent with the Americans with Disabilities Act (ADA), it is the policy of MCI and its affiliates to provide reasonable accommodations when requested by a qualified applicant or employee with a disability unless such accommodations would cause undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment. If reasonable accommodations are needed, please contact Human Resources. DIVERSITY AND EQUALITY At MCI and its subsidiaries, we embrace differences and believe diversity is a benefit to our employees, our company, our customers, and our community. All aspects of employment at MCI are based solely on a person's merit and qualifications. MCI maintains a work environment free from discrimination, one where employees are treated with dignity and respect. All employees share in the responsibility for fulfilling MCI's commitment to a diverse and equal opportunity work environment. MCI does not discriminate against any employee or applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran status, race, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable laws, regulations, and ordinances. MCI will consider for employment qualified applicants with criminal histories in a manner consistent with local and federal requirements. MCI will not tolerate discrimination or harassment based on any of these characteristics. We adhere to these principles in all aspects of employment, including recruitment, hiring, training, compensation, promotion, benefits, social and recreational programs, and discipline. In addition, it is the policy of MCI to provide reasonable accommodation to qualified employees who have protected disabilities to the extent required by applicable laws, regulations, and ordinances where an employee works. ABOUT MCI (PARENT COMPANY) MCI helps customers take on their CX and DX challenges differently, creating industry-leading solutions that deliver exceptional experiences and drive optimal performance. MCI assists companies with business process outsourcing, staff augmentation, contact center customer services, and IT Services needs by providing general and specialized hosting, software, staff, and services. In 2019, Marlowe Companies Inc. (MCI) was named by Inc. Magazine as Iowa's Fastest Growing Company in the State of Iowa and was named the 452nd Fastest Growing Privately Company in the USA, making the coveted top 500 for the first time. MCI's subsidiaries had previously made Inc. Magazine's List of Fastest-Growing Companies 15 times, respectively. MCI has ten business process outsourcing service delivery facilities in Georgia, Florida, Texas, New Mexico, California, Kansas, Nova Scotia, South Africa, and the Philippines. Driving modernization through digitalization, MCI ensures clients do more for less. MCI is the holding company for a diverse lineup of tech-enabled business services operating companies. MCI organically grows, acquires, and operates companies that have synergistic products and services portfolios, including but not limited to Automated Contact Center Solutions (ACCS), customer contact management, IT Services (IT Schedule 70), and Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal & enterprise partners. MCI now employs 10,000+ talented individuals with 150+ diverse North American client partners across the following MCI brands: MCI BPO, MCI BPOaaS, MarketForce, GravisApps, Gravis Marketing, MarchEast, Mass Markets, MCI Federal Services (MFS), OnBrand24, The Sydney Call Center, Valor Intelligent Processing (VIP), BYC Aqua, EastWest BPO, TeleTechnology, and Vinculum. DISCLAIMER The purpose of the above is to provide potential candidates with a general overview of the role. It's not an all-inclusive list of the duties, responsibilities, skills, and qualifications required for the job. You may be asked by your supervisors or managers to perform other duties. You will be evaluated in part based upon your performance of the tasks listed in this . The employer has the right to revise this at any time. This job description is not a contract for employment, and either you or the employer may terminate employment at any time, for any reason.

About BCforward BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 17 locations in North America as well as Hyderabad, India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. With 14+ years of uninterrupted growth, the addition of two brands (Stafforward and PMforward) and a team of more than 1400 resources our teams deliver services for multiple industries from both public and private sectors. BCforward's team of dedicated staffing professionals has placed thousands of talented people over the past decade, with retention rates that are consistently higher than the industry average. Job Description: The Insurance Examiner collects group insurance information needed to review HIPP cases for program eligibility. The information is analyzed to ensure it meets State requirements. Responsibilities: Reviews and evaluates paystubs, group insurance plan information and other documentation to determine client eligibility in HIPP program Calculates group insurance premium Contacts employers and Medicaid clients to request group insurance plan information Performs research to locate group insurance information needed to complete case reviews. Communicates with insurance carriers to verify coverage Observes professional standards of conduct, including attendance, professional behavior and dress code Develop and maintain professional business relationships through verbal and written communication with team members, employers, Medicaid clients and insurance companies. Multi-tasking; ability to prioritize work and work under time constraints. Qualifications Need one who can speak Spanish. Additional Information Thanks & Regards, Namratha Gandavarapu |Sr. IT Recruiter Direct: ************.

Residential Examiner At Enverus, we're committed to empowering the global quality of life by helping our customers make energy affordable and accessible to the world. We are the most trusted energy-dedicated SaaS company, with a platform built to maximize value from generative AI, and our innovative solutions are reshaping the way energy is consumed and managed. By offering anytime, anywhere access to analytics and insights, we're helping our customers make better decisions that help provide communities around the world with clean, affordable energy. The energy industry is changing fast. But we've continued to lead the way in energy technology, creating intelligent connections across the entire energy ecosystem, from renewables, power and utilities, to oil and gas and financial institutions. Our solutions create more efficient production and distribution, capital allocation, renewable energy development, investment and sourcing, and help reduce costs by automating crucial business operations. Of course, this wouldn't be possible without our people, which is why we have built a team of individuals from a diverse range of backgrounds. Are you ready to help power the global quality of life? Join Enverus, and be a part of creating a brighter, more sustainable tomorrow. We are currently seeking a Residential Examiner to join our Operations team. This role offers the opportunity to join a rapidly growing company delivering industry-leading solutions to customers in the world's most dynamic and fastest-growing sector. Performance Objectives + We are looking for a friendly, outgoing, well-organized person with strong work ethic and desire to find solutions to help customers have a truly remarkable experience with their real estate transactions. + Must create a positive image of the company through a professional appearance, actions and conduct to fellow employees and customers. + Ability to process a high volume of orders with accuracy with attention to detail. + Abiding sense of urgency in all tasks + Basic familiarity with title insurance search concepts and underwriting requirements for various transaction types. + Direct experience with examination in Texas. + The ability to research and interpret real estate documents, district court proceedings, probates, Affidavits of Heirships, and understand surveys. + The ability to communicate effectively with managers, underwriting attorneys, customers, and members of the title department. + Attention to detail combined with analytical and problem-solving skills. + The ability to make insurability decisions, understand and translate title insurance guidelines. + Other duties as required by manager. Competitive Candidate Profile + High School Diploma or equivalent. + Minimum of 5 years of experience in title examination + Experience with examination in the Texas area preferred + Must be able to multi-task, demonstrate exceptional written and verbal communication skills. + Proficient on computer and Microsoft Suite. Along with strong problem solving/analytical skills. + Title Industry: Familiarity with land title records (deeds, maps, Deed of Trust, Affidavits etc.) is a plus. Ramquest, File Scan, Integrity Title Plant and Soft Pro beneficial. Physical Requirements + Able to safely lift to 35 pounds at a time using safe lifting techniques. + Ability to communicate effectively with another person. + Regular and predictable attendance is required. + Ability to work in an office environment as required. + Travel requirements: 0% or as required for company needs/training. + Ability to sit for long periods, work on a computer with repetitive motions and utilize devices typically found in an office environment. Enverus offers comprehensive benefits to our employees to include: + Medical + Dental + Vision + Income Protection (disability, life/AD&D, critical illness, accident) + Employee Assistance Program (EAP) + Healthcare Spending Account (HSA), Commuter + Lifestyle & Wellbeing Program + Pet Insurance Enverus is proud to be an Equal Employment Opportunity and Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran, or any other characteristic protected by law. The Company provides equal employment and affirmative action opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability

Take your career further with McLane! McLane teammates, the driving force behind our success, are diverse professionals who work together seamlessly to keep our operations running smoothly. As a teammate, you will pair your dedication, expertise, and collaborative spirit with your fellow teammates to serve America's most beloved brands. McLane leaders think long-term, act with purpose, and inspire high performance. They lead with accountability, communicate clearly, and drive results through collaboration, innovation, and continuous growth. They empower each teammate to learn from industry leaders, develop their skills, and build lasting connections nationwide. The Claims Analyst will investigate, evaluate, negotiate and resolve higher exposure claims arising from automobile and general liability incidents generally involving auto and structural property damage claims. The investigation includes gathering facts of loss, determining and evaluating coverage, liability, and damages, with the setting of proper reserves and in compliance with all laws, insurance company guidelines and McLane policies and procedures. This position which will require the candidate to report and work from the office a minimum of four days a week. Therefore, interested candidates should be within a 50-minute radius from Temple, TX. Benefits you can count on\: Day 1 Benefits\: medical, dental, and vision insurance, FSA/HSA, and company-paid life insurance Paid time off begins day one. 401(k) Profit Sharing Plan after 90 days. Additional benefits\: pet insurance, maternity/paternity leave, employee assistance programs, discount programs, tuition reimbursement program, and more! What you'll do as a Claims Analyst II\: Investigate, evaluate and negotiate auto property damage and structural property damage claims. Effectively work with and communicate information to and from clients, claimants, vendors, outside adjusters, attorney(s) and other internal and external resources. Investigate losses to determine source, scope, and extent of liability and damages, as well as identify and handle recovery from responsible third parties. Evaluate claims for proper reserve, liability, settlement, and payments. Make simple to complex liability evaluations and decisions involving disputed claims by applying multi-jurisdictional negligence schemes. Handle Arbitration filing as applicant and respondent Document and communicate all claim activities timely and effectively and in a manner that supports the outcome of the claim. Achieve fair, equitable, and timely claim disposition that is consistent with company expectations. Maintain positive relationships and creates a high level of customer service. Other duties may be assigned. Qualifications you'll bring as a Claims Analyst II\: Have a high school diploma or GED. However, a four-year college degree is preferred, but commensurate experience may be considered. Have 2-3 years of experience handling property damage claims or other types of claims in a similar field. Have the ability to be an effective team member who possesses excellent communication, organizational, and developed customer service skills with a high degree of motivation, team orientation and demonstrated ability to multi-task and prioritize. This position requires the ability to read, write, and understand English at a level sufficient to perform job-related tasks effectively and safely. This includes understanding work instructions, safety protocols, and communications essential to the role. The requirement is directly related to the nature of the job and ensures compliance with workplace safety and operational standards. Fit the following? We want you here! Teamwork oriented Organized Problem solver Detailed Our roadmap. Our story. We've been forging our path as a leader in the distribution industry since 1894. Building an expansive nationwide network of team members for 130+ years has allowed us to stay agile for our clients across the restaurant, retail, and e-commerce industries. We look to the future and are ready to continue making industry-defining moves by embracing the newest technology into our practices, continuing team member training, and emphasizing our people-centered culture. Candidates may be subject to a background check and drug screen, in accordance with applicable laws. All applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. For our complete EEO and Pay Transparency statement, please visit https\://**********************************

The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems. **Knowledge/Skills/Abilities** + Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. + This role is involved in member enrollment, provider information management, benefits configuration and/or claims processing. + Responds to incoming calls from providers regarding claims inquiries and provides excellent customer service; documents calls and interactions. + Assists in the reviews of state or federal complaints related to claims. + Supports the other team members with several internal departments to determine appropriate resolution of issues. + Researches tracers, adjustments, and re-submissions of claims. + Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards. + Manages defect reduction by supporting the identifying and communicating error issues and potential solutions to management. + Handles special projects as assigned. + Other duties as assigned. Knowledgeable in systems utilized: + QNXT + Pega + Verint + Kronos + Microsoft Teams + Video Conferencing + Others as required by line of business or state **Job Function** Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating Molina values in their actions. Responsible for effectively managing and documenting calls and responding to providers regarding issues with claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience; **REQUIRED EXPERIENCE:** 2-3 years customer service, claims, provider and investigation/research experience. Outcome focused and knowledge of multiple systems. 1+ years of claims research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 4 years **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

We're excited you're considering joining a great place to work! Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect and is proud to be an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to age, race, color, national origin, religion, sex, gender identity, sexual orientation, genetic information, veteran status, or any other basis protected by local, state, or federal law. About this PositionAt Texas Mutual, we're working to create a stronger, safer Texas. As the Supervisor of Claims for our Austin Regional Office, you will supervise and monitor the daily operations of claims processing in accordance with the Texas Workers' Compensation Act, rules of the Division of Workers' Compensation and internal procedures. You will manage the personnel, equipment, facilities and finances of assigned operations and ensure coordination and support of the overall goals and objectives of the division.Responsibilities & Qualifications In this role you will: Supervise and monitor the daily operations of claim processing in accordance with the Texas Workers' Compensation Act, rules of the DWC, and internal procedures. Provide guidance to staff regarding claim handling and desired outcomes. Recruit, retain, coach and mentor employees. Contribute to the development and implementation of division goals and objectives, policies, standards, procedures and budgets. It is required that you have: Bachelor's degree. Texas workers' compensation or all lines adjuster's license. Related experience in the range of four to six years (Texas preferred). Preferred Qualifications Industry-related designation. Texas Mutual Pay Transparency The base pay range is based on the market evaluation of the job and may include pay for multiple levels. Individual base pay within the range is determined by a variety of factors, including experience, performance, education, and demonstration of skills and competencies required for each role. Your recruiter can discuss the full value of our total compensation package with you, including our generous bonus plans and flex-hybrid work model. Base Pay Range: $99,985.50 - $123,511.50 Per YearFlex-Hybrid Work Environment: Texas Mutual's flex-hybrid schedule allows you to bring your best self to work by working remotely and collaborating in the office based on business needs. All Texas Mutual employees are required to have Texas residency and travel to their designated office as needed. Our Benefits: Annual performance bonus and merit-based pay increase Lifestyle Savings Account ($1,000 per year) Automatic 4% employer contribution to retirement plan 401k plan with 100% employer match up to 6% Student loan repayment matching in 401k plan Three weeks' time off for vacation Nine paid holidays and two personal days each year Day one health, Rx, vision and dental insurance Life and disability insurance Flexible spending account Pet insurance and pet Rx discounts Free on-site gym, fitness classes, and health and wellness resources Free identity theft protection Free student loan repayment and refinancing consultation Professional development and tuition reimbursement Employee referral bonus Free onsite snacks

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Liability Claims Examiner - Auto & GL Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? * Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. * Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. * Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. * Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. * Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. * Enjoy flexibility and autonomy in your daily work, your location, and your career path. * Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. OFFICE LOCATIONS Hybrid (2 Days In-Office) PRIMARY PURPOSE: To analyze complex or technically difficult general liability and auto liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIES * Analyzes and processes complex or technically difficult general liability and auto liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. * Assesses liability and resolves claims within evaluation. * Negotiates settlement of claims within designated authority. * Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. * Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. * Prepares necessary state fillings within statutory limits. * Manages the litigation process; ensures timely and cost effective claims resolution. * Coordinates vendor referrals for additional investigation and/or litigation management. * Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. * Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. * Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. * Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. * Ensures claim files are properly documented and claims coding is correct. * Refers cases as appropriate to supervisor and management. QUALIFICATION Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Five (5) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge * Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. * Excellent oral and written communication, including presentation skills * PC literate, including Microsoft Office products * Analytical and interpretive skills * Strong organizational skills * Good interpersonal skills * Excellent negotiation skills * Ability to work in a team environment * Ability to meet or exceed Service Expectations TAKING CARE OF YOU * Flexible work schedule. * Referral incentive program. * Career development and promotional growth opportunities. * A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $75,000 - $90,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #Claims #ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1 Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Residential Examiner At Enverus, we're committed to empowering the global quality of life by helping our customers make energy affordable and accessible to the world. We are the most trusted energy-dedicated SaaS company, with a platform built to maximize value from generative AI, and our innovative solutions are reshaping the way energy is consumed and managed. By offering anytime, anywhere access to analytics and insights, we're helping our customers make better decisions that help provide communities around the world with clean, affordable energy. The energy industry is changing fast. But we've continued to lead the way in energy technology, creating intelligent connections across the entire energy ecosystem, from renewables, power and utilities, to oil and gas and financial institutions. Our solutions create more efficient production and distribution, capital allocation, renewable energy development, investment and sourcing, and help reduce costs by automating crucial business operations. Of course, this wouldn't be possible without our people, which is why we have built a team of individuals from a diverse range of backgrounds. Are you ready to help power the global quality of life? Join Enverus, and be a part of creating a brighter, more sustainable tomorrow. We are currently seeking a Residential Examiner to join our Operations team. This role offers the opportunity to join a rapidly growing company delivering industry-leading solutions to customers in the world's most dynamic and fastest-growing sector. Performance Objectives * We are looking for a friendly, outgoing, well-organized person with strong work ethic and desire to find solutions to help customers have a truly remarkable experience with their real estate transactions. * Must create a positive image of the company through a professional appearance, actions and conduct to fellow employees and customers. * Ability to process a high volume of orders with accuracy with attention to detail. * Abiding sense of urgency in all tasks * Basic familiarity with title insurance search concepts and underwriting requirements for various transaction types. * Direct experience with examination in Texas. * The ability to research and interpret real estate documents, district court proceedings, probates, Affidavits of Heirships, and understand surveys. * The ability to communicate effectively with managers, underwriting attorneys, customers, and members of the title department. * Attention to detail combined with analytical and problem-solving skills. * The ability to make insurability decisions, understand and translate title insurance guidelines. * Other duties as required by manager. Competitive Candidate Profile * High School Diploma or equivalent. * Minimum of 5 years of experience in title examination * Experience with examination in the Texas area preferred * Must be able to multi-task, demonstrate exceptional written and verbal communication skills. * Proficient on computer and Microsoft Suite. Along with strong problem solving/analytical skills. * Title Industry: Familiarity with land title records (deeds, maps, Deed of Trust, Affidavits etc.) is a plus. Ramquest, File Scan, Integrity Title Plant and Soft Pro beneficial. Physical Requirements * Able to safely lift to 35 pounds at a time using safe lifting techniques. * Ability to communicate effectively with another person. * Regular and predictable attendance is required. * Ability to work in an office environment as required. * Travel requirements: 0% or as required for company needs/training. * Ability to sit for long periods, work on a computer with repetitive motions and utilize devices typically found in an office environment. Enverus offers comprehensive benefits to our employees to include: * Medical * Dental * Vision * Income Protection (disability, life/AD&D, critical illness, accident) * Employee Assistance Program (EAP) * Healthcare Spending Account (HSA), Commuter * Lifestyle & Wellbeing Program * Pet Insurance This role is eligible for: Production Salary Range: 40,000 - 53,000 USD

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. * Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. * Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. * Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. * Assists in reviews of state and federal complaints related to claims. * Collaborates with other internal departments to determine appropriate resolution of claims issues. * Researches claims tracers, adjustments, and resubmissions of claims. * Adjudicates or readjudicates high volumes of claims in a timely manner. * Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. * Meets claims department quality and production standards. * Supports claims department initiatives to improve overall claims function efficiency. * Completes basic claims projects as assigned. Required Qualifications * At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. * Research and data analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Customer service experience. * Effective verbal and written communication skills. * Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Liability Claims Examiner - Auto & GL Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. + Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. + Enjoy flexibility and autonomy in your daily work, your location, and your career path. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. **ARE YOU AN IDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. **OFFICE LOCATIONS** Hybrid (2 Days In-Office) **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability and auto liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult general liability and auto liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Assesses liability and resolves claims within evaluation. + Negotiates settlement of claims within designated authority. + Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. + Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. + Prepares necessary state fillings within statutory limits. + Manages the litigation process; ensures timely and cost effective claims resolution. + Coordinates vendor referrals for additional investigation and/or litigation management. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. + Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. **QUALIFICATION** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. **Experience** Five (5) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Good interpersonal skills + Excellent negotiation skills + Ability to work in a team environment + Ability to meet or exceed Service Expectations **TAKING CARE OF YOU** + Flexible work schedule. + Referral incentive program. + Career development and promotional growth opportunities. + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in_ _this job posting only, the range of starting pay for this role is $75,000 - $90,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ \#Claims #ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1 Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

We're excited you're considering joining a great place to work! Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect and is proud to be an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to age, race, color, national origin, religion, sex, gender identity, sexual orientation, genetic information, veteran status, or any other basis protected by local, state, or federal law. About this PositionAt Texas Mutual, we are proud to create a stronger, safer Texas. That means helping injured workers return to a productive life, empowering businesses to excel, and giving back to our communities. Our Catastrophic Claims team contributes to our mission by managing complex and severe injury claims, coordinating medical care, long-term recovery plans, and administering benefits to ensure our injured workers receive the support they need during a critical time. We're looking for a Catastrophic Adjuster to manage complex, high-severity injury claims with compassion and professionalism. In this role, you'll investigate claims, coordinate benefits, and support injured employees and their families through critical situations. You'll use curiosity and critical thinking to navigate sensitive cases and provide excellent customer service every step of the way. If you're driven, thoughtful, and ready to make a real impact, we'd love to hear from you!Responsibilities & Qualifications In this role, you will: Investigate complex, catastrophic claims by interviewing injured workers, policyholders and witnesses. Determine compensability, manage reserves, and make recommendations on claim handling. Administer workers' compensation benefits to injured workers. Ensure regulatory compliance and proper handling of moderate to complex claims. Coordinate return-to-work efforts and vocational rehabilitation when necessary. Maintain regular contact with injured workers, employers, and medical providers to monitor claim progress. Prepare and participate in dispute resolution processes, such as Benefit Review Conferences and Contested Case Hearings. Evaluate and arrange for medical examinations and peer reviews. Demonstrate a high level of proficiency in claim file management and customer service. It is required that you have: Bachelor's degree or any equivalent combination of education, training, and experience. At least two years' experience adjusting workers' compensation claims in Texas for a level II; at least four years of experience required for a Senior. Extensive claims investigative skills and experience. Current Texas workers' compensation or all lines adjuster license. Texas Mutual Pay Transparency The base pay range is based on the market evaluation of the job and may include pay for multiple levels. Individual base pay within the range is determined by a variety of factors, including experience, performance, education, and demonstration of skills and competencies required for each role. Your recruiter can discuss the full value of our total compensation package with you, including our generous bonus plans and flex-hybrid work model. Base Pay Range: $75,120.45 - $112,283.85 Per YearFlex-Hybrid Work Environment: Texas Mutual's flex-hybrid schedule allows you to bring your best self to work by working remotely and collaborating in the office based on business needs. All Texas Mutual employees are required to have Texas residency and travel to their designated office as needed. Our Benefits: Annual performance bonus and merit-based pay increase Lifestyle Savings Account ($1,000 per year) Automatic 4% employer contribution to retirement plan 401k plan with 100% employer match up to 6% Student loan repayment matching in 401k plan Three weeks' time off for vacation Nine paid holidays and two personal days each year Day one health, Rx, vision and dental insurance Life and disability insurance Flexible spending account Pet insurance and pet Rx discounts Free on-site gym, fitness classes, and health and wellness resources Free identity theft protection Free student loan repayment and refinancing consultation Professional development and tuition reimbursement Employee referral bonus Free onsite snacks