Claim processor jobs in Sanford, FL - 68 jobs

Details Claims Examiner I - Commercial Auto Department: Property & Casualty Reports To: Claims Supervisor FLSA Status: Exempt in all state except California Job Grade: 9 Career Ladder: Next step in progression could include Claims Examiner II ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Examiner I to support our Property & Casualty department. Employees who live less than 26 miles from the San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. The Claims Examiner I is responsible for the timely investigation, evaluation and determination of settlement or denial of minor to moderate multi-line auto property and casualty claims. They will be handling claims from inception to closure. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated analytical, decision making and negotiation skills. Investigate coverage, including evaluate insurance coverage problems and/or disputes Investigate, evaluate and determine settlement value or denial of liability for all claims Develop a measure of damage for each loss, establish and maintain appropriate reserves Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure Ensure appropriateness of all payments Negotiate settlement of claim within individual authority ($15,000 unless otherwise noted) Maintain and update action plans for each claim May assign and coordinate with vendors, legal counsel, appraisers or experts as necessary Facilitate between claimants, clients, brokers and attorneys in resolution of liability claims Exchange information with clients, claimants, insurance brokers, inspectors, producers and account managers Provide customer service and support to insureds and claimants Assist in training of new employees Attend meetings and educational seminars for professional development Maintain required licenses ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL Additional State Adjuster License(s) may be required within 180 days Maintain licenses and continuing education requirements in all states Minimum of three years auto-claims handling experience, at least one-year commercial auto required Knowledge of property and casualty insurance policies Knowledge of auto insurance laws, codes, procedures, and liability concepts Proficiency in investigation and resolution of minor to medium level auto physical damage casualty claims Strong negotiation skills and ability to achieve optimal settlement results for clients. Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************* This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here

Commercial Auto - Multi Line Claim Specialist Hours: Monday - Friday, 8:00 AM to 4:30 PM ET Salary Range: $83,000-$100,000 (commensurate based on experience) Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. Experience in commercial trucking with litigation and/or the ability to handle attorney represented settlements and some litigation. This role will be for a dedicated trucking client that will require consistent communication and trust building. Adjuster will need to be able to be available for calls but also provide reasoning and recommendation in a consultative manner. This role will join a small but mighty dedicated team. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10+ years multi-line claim experience is required. Bachelor's Degree is preferred. Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Nice to Have: • Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Why You'll Love Working Here • 4 weeks PTO (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) • Career growth: Internal training and advancement opportunities • Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions Compliance & audit performance - adherence to jurisdictional and client standards Timeliness & accuracy - purposeful file movement and dependable execution Client partnership - proactive communication and strong follow-through Professional judgment - owning outcomes and solving problems with integrity Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. 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. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #ClaimsSpecialist #LiabilityClaims #HybridWork #FloridaJobs #InsuranceCareers #GeneralLiability #AutoClaims #MultiJurisdiction #FLAdjusters #CommercialAuto #NowHiring #InsuranceJobs #FLLiability #IND123 #LI-Hybrid We can recommend jobs specifically for you! Click here to get started.

AmTrust is a major player in the commercial P&C market and the third largest workers' compensation provider in the U.S. Our small business insurance product suite continues to expand with Cyber, BOP, Employment Practices Liability Insurance (EPLI), Package and other core coverages and capabilities, including more middle-market and large accounts. As a Workers' Compensation Claims Examiner Associate, you'll dive into investigating and resolving employee injury claims. You'll be the key link between injured workers, healthcare providers, employers, and legal teams, ensuring fair and efficient claim handling. Master examination by assessing liability through detailed evaluations, hone investigation skills by interviewing claimants and reviewing medical files and sharpen negotiation tactics for fair claim resolutions. Ultimately, you'll confidently settle claims using your investigative insights. Note, this is an in-office opportunity out of our Maitland, FL office. Responsibilities At AmTrust, we are excited about fostering organic growth and promoting from within! This training program is your gateway to an exciting Claims career journey. Our commitment to your growth doesn't stop when the training ends. AmTrust is dedicated to continually nurturing and training all adjusters to advance their careers in claims. Whether you're eager to climb the ranks in adjusting or aspire to leadership roles, we're here to develop top-notch adjusters and future leaders through this rewarding program! Qualifications Requirements 4-year degree OR 3 years of relevant experience - ideal candidate for the role is a recent graduate or early-career professional interested in a dynamic, intellectually engaging role. Strong analytical, communication, and problem-solving skills. Strong organizational abilities and attention to detail. Ability to work collaboratively and independently in a fast-paced environment. Interest in building a long-term career in insurance or claims management. Benefits 15-22 Paid Holidays and 18 days of PTO. Monday through Friday work schedule - no nights or weekends required. 401k Savings Plan Medical, Dental and Vision Health Benefits - including spouses and children. Internal Wellness Program with yearly discounts and incentives. Paid training and State Licensure. Why Claims? A Claims career is dynamic and intellectually stimulating, enhancing your skills in policy interpretation, legal understanding, and medical expertise. You'll collaborate with defense attorneys, engage in trials and mediations, and hone investigative, analytical, and negotiation skills. Exposed to facets like Underwriting, Loss Control, Managed Care, and SIU, Claims opens diverse career paths with technical and leadership growth-perfect for making an impact and building a lasting career. Why Insurance? AmTrust provides insurance protection, warranty programs and risk management expertise to small businesses, professional and financial services firms, retailers, and manufacturers worldwide. The insurance industry is vital for economic stability, offering financial protection and career opportunities with $932.5 billion in premiums and 2.98 million US employees in 2024. Careers include Claims, Loss Control, Underwriting, Actuary, and Sales, with resilience to economic fluctuations and skills transferable across sectors. The expected salary for this role is $26.50/hr. Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations. What We Offer AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off. AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future. Not ready to apply? Connect with us for general consideration.

Business Claim Examiner Visa GC/Citizen Division Pharmaceutical Pay Negotiable Contract 6 Month Timings Mon - Fri between 8.00AM - 5.00PM Qualifications · Verify member submitted claims forms, member's eligibility & pharmacy information is complete & accurate, updating system information as needed. · A high data entry proficiency is expected in order to provide accurate & timely processing of claims submitted by member, pharmacy or agencies. · Moderate knowledge of drugs & drug terms used daily. · Process claims according to client specific guidelines while identifying claims requiring exception. · Navigate daily through several platforms to research & finalize claim submissions. · Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. · Adhere to strict HIPPA regulations especially when communicating to others outside of ESI. · Prioritize & coordinate influx of daily workload for claims processing, returned mail & outgoing correspondence & e-mails to assure required turnaround time is met. · Assess accuracy of system adjudication & alert management of potential problems affecting the integrity of claim processing. · Analyze claims for potential fraud by member or pharmacy. · May be required to work on special projects for claims team. If you are available and interested then please reply me with your “ Chronological Resume” and call me on ************** . Additional Information Thanks & Regards, Ranadheer Murari | Team Recruitment | Mindlance, Inc. | W : ************ *************************

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage third party liability construction defect commercial claims with moderate to high complexity and exposure. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: * Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. * Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. * Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. * Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. * Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. * Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. * Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. * Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. * Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. * Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. * May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities * Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices. * Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. * Demonstrated ability to develop collaborative business relationships with internal and external work partners. * Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. * Demonstrated investigative experience with an analytical mindset and critical thinking skills. * Strong work ethic, with demonstrated time management and organizational skills. * Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. * Developing ability to negotiate low to moderately complex settlements. * Adaptable to a changing environment. * Knowledge of Microsoft Office Suite and ability to learn business-related software. * Demonstrated ability to value diverse opinions and ideas Education & Experience: * Bachelor's Degree or equivalent experience. * Typically a minimum four years of relevant experience, preferably in claim handling. * Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. * Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. * Professional designations are a plus (e.g. CPCU) #LI-KP1 #LI-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

This is a complex claims role responsible for end-to-end handling of small commercial Workers' Compensation claims, including high-severity and litigated matters. The position primarily supports CT, MA, NJ, PA, and RI and requires strong technical expertise and multi-jurisdiction experience. Key Responsibilities: * Investigate, evaluate, and resolve complex and litigated WC claims with accuracy and timeliness * Set and manage reserves; develop resolution strategies; negotiate settlements * Partner with defense counsel and vendors; manage litigation plans and outcomes * Ensure compliance with state statutes, regulations, and internal guidelines * Communicate effectively with insureds, brokers, medical providers, and internal stakeholders Strong Preference: * Required: Prior Workers' Compensation claims experience, including complex and litigated case handling * Proven negotiation, litigation management, and analytical skills * Excellent communication, organization, and decision-making abilities * May require state-specific claims adjuster licensing; candidates must hold (or be able to obtain and maintain) all necessary licenses for CT, MA, NJ, PA, and RI. Remote role. If you live within 50 miles of a USRM hub location, in-office presence is required twice per month. Qualifications * A Bachelors degree or equivalent business experience is required * In addition, the candidate will generally posses 5-7 years of related claims experience with 1-2 years of experience in complex claims * Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skill required About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

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

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims in a call center environment. * Respond to inbound calls to provide support for provider claims adjudication activities including responding to provider to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. * Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. * 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. * 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 re-adjudicates 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: $21.65 - $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.

The Insurance Claims Specialist will be responsible for assisting with the management of all aspects of complex Construction Defect and Property Damage incidents and claims for DPR (and DPR-related entities), as assigned. Reporting: Role reports to Insured Claims Manager and Insured Claims Leader Specific Duties Include: Claims & Incident Management (General): * Initial triage and processing of incidents received from project teams for DPR (and DPR-related entities). * Input and/or review all incidents reported in DPR's RMIS system. * Working with the incident triage group to ensure timely and appropriate review of all incidents * Ensure all necessary information is compiled to properly manage claims. This includes working with the DPR teams to collect relevant documents such as the Prime contract, Subcontracts, Certificates of Insurance, Owner Policy Documents, Project Documents and Project Specific Coverage information, etc. * Assess all potential risks, as well as identify all contractual risk transfer mechanisms. * Analyzing potential insurance coverage for all applicable lines of coverage and report, with all appropriate documents and information, potential claims for DPR (and DPR-related entities) to the broker for any applicable program (Traditional, CCIP, OCIP). * Assist with the development and training of other DPR Workgroups (and DPR-related entities) around CD/PD Best Practices. Construction Defect & Property Damage (CD/PD) Specific Claims Management: * Manage all assigned claims in DPR's RMIS system relating to Construction Defect and Property Damage matters for DPR (and DPR-related entities). This would include using all appropriate lines of coverage such as Commercial General Liability, Builder's Risk, Property, Contractor's Pollution Liability and Professional Liability, whether the policies are placed by DPR or our Clients. * Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements. * Management of and coordination with DPR's consultants and outside attorneys throughout the claim process. * Continuously analyze claim-specific details as the claim progresses to devise key strategies in conjunction with all internal stakeholders and outside consultants. * Proactive management and coordination of all phases of the DPR CD/PD Claims Workflow. Key Skills: * Basic working knowledge and familiarity of: * Commercial General Liability * Property Insurance (Including Inland Marine and Builder's Risk * Pollution Liability * Professional Liability * Controlled Insurance Programs (CCIP/OCIP) * RMIS Systems * Construction Industry Expertise * Strategic thinking * Strong written and oral communication skills * High level of EQ (Soft skills) * Self-Starter * Highly organized and responsive; ability to meet deadlines * Detail Oriented * Contractual risk assessment * Dispute management * Integrity * Ability to mentor and inspire others * Team player * Willingness to understand and advance the DPR Culture * Proactive Learner Qualifications: * 5-7 years relevant construction industry and/or insurance industry experience preferred. * Previous experience in construction company Risk Management highly desired. * Position location - TBD based on location of most qualified candidate. DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************

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

Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************

Introduction At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they're free to grow, lead, and innovate. You'll be backed by our digital ecosystem: a client-centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips. Here, you're not just improving clients' risk profiles, you're building trust. You'll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve. If you're ready to bring your unique perspective to a place where your work truly matters; think of Gallagher. Overview Ballator Insurance Group, now a part of Gallagher, is a national insurance organization that provides innovative insurance solutions to niche industry groups. We pride ourselves on cultivating lasting relationships with our clients by understanding their unique needs and providing tailored coverage that supports long-term success. As a Loss Control Specialist, you will play a vital role in providing consultative and analytical services to our clients. Your responsibilities will include reviewing and developing strategies to reduce risks and exposures through on-site evaluations and data-driven assessments. You will participate in claims reviews, collaborate with producers and attorneys, and help ensure the accuracy and effectiveness of our loss control programs. Success in this role requires a proactive and solution-oriented mindset, with a commitment to continuous improvement and cross-functional collaboration. This position is a hybrid role based out of the Orlando, Florida area. How you'll make an impact Claims Management * Monitor all lines of insurance claims via Third Party Administrator * Review claims for reserve accuracy and compliance with service instructions * Assist with action strategies to bring claims to cost effective resolution * Maintain detailed records of claims and prepare reports for management. * Identify claim trends and provide insights to improve risk strategies. Loss Control * Conduct risk assessments and safety audits for clients and internal operations. * Recommend corrective actions to minimize hazards and prevent losses. * Develop and deliver training programs on safety, compliance, and risk prevention. * Monitor effectiveness of loss control initiatives and adjust strategies as needed. Integrated Duties * Use claims data to inform and strengthen loss control strategies. * Provide a unified point of contact for clients on both claims and risk management. * Collaborate with internal teams to align claims handling with prevention efforts About You Required: Bachelor's degree or commensurate experience; 3 years' related experience in Safety, Risk, or Insurance. Ability to obtain appropriate licenses in all states where business is conducted. Excellent interpersonal, verbal and written communication skills. Proficiency in Microsoft Office. Moderate travel required, including some overnight travel. Ability to travel by automobile and aircraft and work outside or normal business hours as required. Ability to perform work on varied customer properties; entails negotiating non-public access areas, climbing, lifting, sitting, standing and walking for extended periods of time. Preferred: Associate in Risk Management (ARM), Associate in Safety Professional (ASP), Certified Safety Professional (CSP). " Behaviors: Interfaces effectively with management, clients, account teams and partners. Complies with all company policies and procedures, pro-actively protecting confidentiality of client and company information. Understands industry trends and governmental regulations. Efficiently organizes work and manages time in order to meet deadlines. Exercises discretion in confidential matters and uses independent judgment. Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you'll get, depending on your job level these benefits may improve: * Medical/dental/vision plans, which start from day one! * Life and accident insurance * 401(K) and Roth options * Tax-advantaged accounts (HSA, FSA) * Educational expense reimbursement * Paid parental leave Other benefits include: * Digital mental health services (Talkspace) * Flexible work hours (availability varies by office and job function) * Training programs * Gallagher Thrive program - elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing * Charitable matching gift program * And more... The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it's embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees' diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as "protected characteristics") by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

Job Description Cottingham & Butler Claims Services (CBCS) was built upon driven, ambitious people like yourself. "Better Every Day" is not just a slogan, it is a promise we make to ourselves and our clients. We are looking to hire an experienced Southeast Work Comp Claims Supervisor to our team. We are looking for someone who is eager to motivate and develop adjusters of all levels. If you're ready to make a significant impact and drive excellence, we want to hear from you! Key Expectations for the Claims Supervisor Role: Accountability and Feedback: Ensure that the team receives regular, high-quality feedback to drive accountability. Team Metrics: Maintain weekly metrics in the green. If a team member is not meeting expectations, develop and document plans with the Claims Manager to improve performance. Quality Service Review (QSR) Scores: Achieve monthly QSR scores of 90%+ for the team and address any underperformance with actionable plans. Monthly Meetings: Arrange monthly meetings with the team to align on goals, discuss challenges, provide training, and foster collaboration. Customer Service Survey Scores: Maintain an average score of 1.30 or less. Use survey results as coaching opportunities and ensure follow-up discussions. Mentorship and Teammate Development: Act as a mentor and actively contribute to developing your team of adjusters. Experience Requirements: The ideal candidate must have substantial experience in the Southeast region and possess a strong background in achieving results. We are looking for a critical thinker who is eager to collaborate with other like-minded professionals to drive growth and strengthen our business. A minimum of 1-5 years of claims supervision is required. Do you think this might be a fit for you? Send us your resume - we'd love to talk! Pay & Benefits Salary - Flexible based on your experience level. Most Benefits start Day 1 Medical, Dental, Vision Insurance Flex Spending or HSA 401(k) with company match Profit-Sharing/ Defined Contribution (1-year waiting period) PTO/ Paid Holidays Company-paid ST and LT Disability Maternity Leave/ Parental Leave Company-paid Term Life/ Accidental Death Insurance About the company At Cottingham & Butler Claims Services, we sell a promise to help our clients through life's toughest moments. To ensure we keep that promise, we hold ourselves to a set of principles that we believe position our clients and our company for long-term success. Our Guiding Principles are not just words on paper, they are a promise we make to ourselves and our clients. These principles have become a driving force of our culture and share many common themes with the values of our clients. First, we hire and develop amazing people that have an insatiable desire to succeed, are committed to learning, and thrive on challenges. Secondly, we pride ourselves on serving our clients' best interests through quality service, innovative solutions, and constantly evaluating our performance. Third, we have embraced and are guided by the theme of "better every day" constantly pushing ourselves to be better than yesterday. Ultimately, we get more energy from the future we are creating for our people, our clients, and our company than from our past success. As an organization, we are very optimistic about the future and have incredibly high expectations for our people and our performance. We also understand that our growth is fueled by becoming better, not bigger - growth funds investments in new resources to better serve our clients and provide the career opportunities our employees want and deserve. This is why we are a growth company and why we are committed to being better every day.

This job is with Florida Farm Bureau which is the Florida state office for Southern Farm Bureau Casualty Insurance Company, and we currently have an opening for an Inside Claims Representative to work in Maitland, FL. This position is responsible for resolving damage and injury claims caused by or incurred by insureds. Starting salary of $54,800. We offer many benefits including health, dental, vision, PTO, Extended Illness Leave, Pension and matching 401K. ESSENTIAL DUTIES AND RESPONSIBILITES: Include the following. Other duties may be assigned. Investigate, validate, evaluate, negotiate, and settle all claims as assigned. Maintain claim files and follow departmental reporting procedures. Submit reserve recommendations on assigned claims. Communicate with customers and other Claims personnel regarding procedures, problems, and coverages. Enroll in training and continuing education courses when and where required. Negotiate fair settlements with individual claimants or attorneys. Report risk reviews to Underwriting Department. Regular and predictable attendance is required. EDUCATION and/or EXPERIENCE: Bachelor's degree from four-year college or university Obtain Adjuster's license in 6 months SKILLS/ABILITY Strong Verbal communication & listening skills Effective negotiation skills Effective conflict management skills Ability to simultaneously handle multiple priorities Possesses strong product knowledge 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. While performing the duties of this job, the employee is occasionally required to sit at a desk or table with some walking, standing, bending, stooping or carrying of light objects. The employee frequently is required to perform continuous operations of personal computer for four hours or more and use their hands to finger, handle, or feel objects, tools, or controls; and talk or hear. Specific vision abilities required by this job include close vision.

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

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 - Liability (REMOTE- BI/Lit exp & licensed in any: NC, SC, VA, FL DE DC DE MD) ***Looking for bodily injury/ligation adjuster with auto- trucking claim, product claims, GL premises. Needs to be licensed in NC, SC, VA, FL DE DC DE MD. *** 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. **PRIMARY PURPOSE** **:** To analyze complex or technically difficult general 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 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. **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. **Experience** : 5 years of Liability claims management experience or equivalent combination of education and experience required. **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. 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. 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**

Investigates, determines liability, confirm coverage, establishes damages, and negotiates settlement of auto, property and light general liability claims for a Member based organization in accordance with approved policy & procedure and industry Best Practices. This position does not handle injury, complex or litigated claims. RESPONSIBILITIES AND DUTIES: Responsible for the investigation of assigned auto, non-complex general liability, and first-party property cases in compliance with prescribed industry best practices. This includes verifying coverage, determining liability, evaluating damages, establishing reserves, reporting status, and negotiating appropriate settlements for each claim. Possesses a certain level of financial authority to settle independently. Maintains an appropriate diary and documentation as to file activity. Makes determination and handles files with subrogation potential. Works with Independent Appraisers to estimate the cost of repair or replacement of damaged or stolen vehicles / damaged property. Reports theft, fraud, and arson losses as required to state and industry agencies, as appropriate. Performs most duties on an individual basis, and work has a direct bearing on Management results. Represents the Company from a public relations standpoint and must conduct oneself appropriately at all times. Personal contacts are a major part of activity and include Members, claimants, witnesses, vendors, repair facilities, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses and all other person's incident to the investigation and processing of claims. Attends required or necessary training sessions, courses to maintain their license credits and to maintain up to date knowledge & skills. Performs other duties as assigned. KNOWLEDGE, SKILLS AND ABILITIES: Excellent negotiation, analytical and interpretive skills Excellent oral, written communication and presentation skills Strong organizational and interpersonal skills Superior customer service skills Able to multitask and set own priorities Works well under pressure Should be used to and able to function effectively in a fast-paced environment. Able to establish and maintain effective working relationships with department heads, managers, employees, and vendors. Government claims background is a plus. Physical Requirements include: Bending, Pulling, Sorting, Carrying up to 20 lbs., Pushing, Speaking (English), Climbing, Reaching, Standing, Key entering, Reading (English), Walking, Kneeling, Seeing, Writing (English) Should be able to type 35 WPM. Spanish fluency is a plus. TRAINING AND EXPERIENCE: Position requires a degree from an accredited College/University in business or insurance preferred or equivalent experience in industry. One to three years of experience in insurance industry as a Customer Service Representative or Property or Auto Liability (no injury) adjuster. Knowledge of Microsoft Office products a must. Must have an active Florida Adjusters License. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. **PLEASE DO NOT APPLY IF YOU ARE A SMOKER** Classification: Exempt Dept: Property & Liability Reports to: Claims Supervisor

Job Description Customer Claims Representative - Orlando Join the Service Pros Auto Glass team inside our partnered dealerships! You'll engage customers, spot glass-replacement opportunities, and coordinate quick, professional service - all while building strong relationships and developing a personal team. This role is perfect for a teachable person who loves being part of a supportive, winning team. What You'll Do: Engage customers in the service drive and identify windshield replacement needs. Educate and guide customers through their options and next steps. Build strong relationships with service advisors, managers, and technicians. Encourage dealership referrals and hit daily/weekly sales goals. Schedule and coordinate on-site glass services. Keep accurate records of leads, interactions, and completed jobs. Represent the company with a professional, positive attitude. What Makes You a Great Fit: Experience in customer service or sales is a plus, but not required. Strong communication and people skills. A self-motivated, proactive approach - you enjoy taking the lead. Team-oriented mindset with a friendly, professional appearance. Valid driver's license and reliable transportation. What We Offer: A fun, energetic, team-first culture Ability to earn $1000 - $2500 per week You are paid on a weekly basis Promotion from within and clear growth paths Ongoing training and development Team events, company outings, and a culture that celebrates wins

Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer.