Claim processor jobs in Wichita Falls, TX

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Claims Supervisor (Bodily Injury)
Geico 4.1
Claim processor job in Richardson, TX
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Join a team where your expertise truly matters!Our Casualty Claims department is seeking a highly motivated and experienced Claims Supervisor (Bodily Injury). As a key leader within our Casualty organization, you will be responsible for empowering a team that handles attorney-represented automotive liability claims. Your team will manage: complex investigations coverage determinations liability assessments bodily injury claim resolutions-through both settlement and litigation. This role requires advanced knowledge of litigation processes and the ability to strategically support litigated and attorney-represented claims. If you're passionate about developing talent, driving results, and making an impact in the automotive liability space, we'd love to hear from you.Success in this role is built on the foundation of GEICO's core leadership behaviors: Ownership: You take responsibility for outcomes in all scenarios. Adaptability: You navigate dynamic environments with creativity and resilience. Leading People: You empower individuals and teams to achieve their best. Collaboration: You build and strengthen partnerships across organizational lines. Driving Value: You use data-driven insights to align actions with strategic goals. What You'll Do: Lead, mentor, and inspire a team of associates to deliver exceptional customer service while building trust. Leverage your property and casualty insurance expertise to guide team members in resolving complex customer inquiries and claims. Provide authority on evaluations that exceed your adjusters personal, assigned authority and work with others on claims that exceed your authority Personalize your leadership approach to develop team members' skills, fostering their growth and ensuring they consistently exceed customer expectations. Monitor and evaluate team performance using key performance indicators (KPIs) to enhance efficiency, customer satisfaction, and retention. Hold your team accountable for achieving results, maintaining compliance with insurance regulations, and delivering outstanding service. Address escalated customer concerns with professionalism and empathy, modeling GEICO's dedication to service excellence. Collaborate with leadership and cross-functional teams to identify and implement process improvements. Serve as a resource for team members on insurance-related questions providing mentorship and training to build their industry knowledge. What We're Looking For: Minimum of 2 years of leadership experience in Bodily Injury claims, including direct oversight of litigated cases. Active Adjuster license (required) Expertise in Casualty claims, including knowledge of industry regulations and best practices Strong ability to assess needs and guide associates in negotiating claim settlements as needed Experienced in the use of various claims tools with ability to assist associates Strong adherence to compliance and regulatory requirements Proven ability to motivate, inspire, and develop high-performing teams in a customer-centric environment Strong results orientation, with a history of meeting or exceeding performance goals Excellent interpersonal and communication skills, with the ability to adapt leadership styles to diverse individuals and situations Ability to analyze data and metrics to inform decision-making and improve customer outcomes Collaborative mindset with a commitment to fostering a culture of inclusivity and excellence Why Join GEICO? Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Inclusive Culture: Join a company that values diversity, collaboration, and innovation. Workplace Flexibility: This is a M-F, 8:00am - 4:30pm position offering a Hybrid work model based in Richardson, TX. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Licensing and continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Increased Earnings Potential: Pay Transparency: The starting salary for this position is between $97,735 annually and $151,700 annually. Incentives and Recognition: Corporate wide bonus programs are in place to reward top performers. Beware of scams! As a recruiter, I will only contact you through a @geico.com email address and will never ask you for financial information during the hiring process. If you think you are being scammed or suspect suspicious activity during the hiring process, please contact us at ***********************. keywords: litigation, auto liability, liability claims#geico300#LI-AL2 At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
$49k-73k yearly est. Auto-Apply 2d ago
Legal Claims Analyst
Erisa Recovery
Claim processor job in Plano, TX
ERISA Recovery are experts in collecting complex and aged claims through the Federal ERISA appeals process. We are a fast-growing organization located in Plano, TX. If you would like to join a friendly, passionate team with limitless potential, we'd love to meet you. This extraordinary opportunity to advance your career and make a difference is now. We are searching for a Legal Hospital Claims Analyst - someone who works well in a fast-paced setting. In this position, you'll provide support in analyzing comprehensive claims and identifying key metrics. You will be a subject matter expert in legal claims. You must be able to work both independently and as part of a team. Key attributes for the ideal candidate include working with intensity, focus, and being detail oriented. Essential responsibilities and duties Conducts legal research and investigation of claims Drafting legal documents Keeping track of changes in legal framework and providing timely updates on these changes Utilizes ERISA law enforcement Utilizes knowledge of health care standards appropriate to specific claim Ability to understand and apply medical reimbursement policies, procedures, and standards Ensures eligibility for claims is reasonable and correct by analyzing claims and providing supporting documentation Utilize a variety of EHR systems Thrives in a fast-paced environment Collaborates effectively with other team members Ability to adapt to changing needs Consistently applies knowledge relevant to claims Work intensely at a fast-paced rate Ability to communicate effectively with third party administrators Determine the status of medical claims through research Meet the standards of the department and quality standards Strong organizational skills Desired skills and Qualifications Bachelor's degree 3+ years working in the legal field 2+ years working with healthcare insurance claims (preferred) Strong Communication skills Working knowledge utilizing Microsoft software (Word, Excel, Outlook) Ability to work in a fast-paced environment Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance Paid lunches Bonus ERISA Recovery is an Equal Opportunity Employer
$34k-55k yearly est. 23h ago
Specimen Processor
Pride Health 4.3
Claim processor job in Lewisville, TX
Join Pride Health as a Specimen Technician/lab Assistant at Lewisville TX 75067 This is a 2.5 months contract role (with high possibility of extension or conversion) offering a great opportunity for experience to excel in a dynamic environment. Role: Specimen Technician /lab Assistant Location: Lewisville TX 75067 Shift Schedule: 10PM-630AM CST , Su We Th Fr Sa Pay Range : $17/hr to $17.88/hr Contract : 2.5 months + Possible extension... Job Description: The SPT I is responsible for general support functions within the Specimen Processing Department. This position requires a data entry background. Functions performed may include but are not limited to A-station, presort, pickup and delivery of processed specimens to the laboratory, imaging/microfilming, centrifugation and aliquoting. All functions must be performed with confidence, accuracy and in a timely manner. Job is complex and requires that employee have good organization skills and is able to learn and understand specimen types related to test(s) ordered by client. The SPT I must have to the ability learn and understand the compliance regulations related to test ordering which may change on a daily basis. This position is critical to quality for customer satisfaction. Additionally, since many changes do occur from day to day, great flexibility on the part of the SPT I is required. The SPT I will be exposed to many different demands made by the customer. Majority of SPT I work on the nightshift but based on staffing needs, weekends, holidays, on call and overtime availability is a requirement. Department is a production environment, with emphasis on productivity/quality standards and departmental completion times. Position requires data background with abilities to enter 6,000 alphanumeric keystrokes/hour. Works in a biohazard environment, practicing good safety habits. Able to sit or stand for long periods. Communicates effectively with all levels of staff. Adheres to core values, safety and compliance policies and procedures. Keeps work area neat and clean. Demonstrates strong interpersonal skills that foster a positive environment. Demonstrates flexibility and ability to adapt to change. Education: HS diploma or equivalent. Required Knowledge: Basic understanding of computers with a preferred knowledge of laboratory testing and/or laboratory specimen processing. Work Experience: required , but previous laboratory experience required. Medical background preferred which includes medical terminology applicable to a clinical laboratory. Previous hospital laboratory experience is a plus but not required. Previous experience in a production environment preferred. Interested? Apply now! About Pride Health Pride Health is Pride Global's healthcare staffing branch, providing recruitment solutions for healthcare professionals and the industry at large since 2010. As a minority-owned business that delivers exceptional service to its clients and candidates by capitalizing on diverse recruiting, account management, and staffing backgrounds, Pride Health's expert team provides tailored and swift sourcing solutions to help connect healthcare talent with their dream jobs. Our personalized approach within the industry shines through as we continue cultivating honest and open relationships with our network of healthcare professionals, creating an unparalleled environment of trust and loyalty. Equal Employment Opportunity Statement As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts.
$17 hourly 1d ago
Claims Processor
Pennymac 4.7
Claim processor job in Fort Worth, TX
PENNYMAC Pennymac (NYSE: PFSI) is a specialty financial services firm with a comprehensive mortgage platform and integrated business focused on the production and servicing of U. S. mortgage loans and the management of investments related to the U. S. mortgage market. At Pennymac, our people are the foundation of our success and at the heart of our dynamic work culture. Together, we work towards a unified goal of helping millions of Americans achieve aspirations of homeownership through the complete mortgage journey. Job Overview The Claims Processor is a specialized role within the mortgage industry, primarily focused on the financial aspects and reimbursement of fees, costs and advances that incurred during the foreclosure process. A Typical Day The Claims Processor will take direction from the department supervisor for post-sale functions, such as: evictions, property maintenance, conveyance of title, title delivery, and adherence to GSE servicing requirements during the REO process. As the Claims Processor, you will be responsible for filing MI, investor, and insurer claims timely and accurately, providing all back-up as requested, and the reconciliation and posting of claim proceeds. The Claims Processor will: Perform post-foreclosure servicing functions as required by MI, investor, insurer, and internal guidelines including: eviction management, property inspection and maintenance, conveyance of title, title delivery, maintenance of HOA, taxes, and property insurance during the GSE REO process File claims for reimbursement of expenses Reconcile claim proceeds File supplemental claims as needed Ensure data accuracy Perform other related duties as required and assigned Demonstrate behaviors which are aligned with the organization's desired culture and values What You'll Bring High School Diploma / GED 1+ years of relevant work experience Default-related experience preferred Demonstrated aptitude for data, reporting, and working with numbers, desired Familiar with GSE and Insurer servicing guidelines Must be highly proficient in Excel and Word Why You Should Join As one of the top mortgage lenders in the country, Pennymac has helped over 4 million lifetime homeowners achieve and sustain their aspirations of home. Our vision is to be the most trusted partner for home. Together, 4,000 Pennymac team members across the country are guided by our core values: to be Accountable, Reliable and Ethical in all that we do. Pennymac is committed to conducting a business that makes positive contributions and promotes long-term sustainable growth and to fostering an equitable and inclusive environment, where all employees and customers feel valued, respected and supported. Benefits That Bring It Home: Whether you're looking for flexible benefits for today, setting up short-term goals for tomorrow, or planning for long-term success and retirement, Pennymac's benefits have you covered. Some key benefits include: Comprehensive Medical, Dental, and Vision Paid Time Off Programs including vacation, holidays, illness, and parental leave Wellness Programs, Employee Recognition Programs, and onsite gyms and cafe style dining (select locations) Retirement benefits, life insurance, 401k match, and tuition reimbursement Philanthropy Programs including matching gifts, volunteer grants, charitable grants and corporate sponsorships To learn more about our benefits visit: ********************* page. link/benefits For residents with state required benefit information, additional information can be found at: ************ pennymac. com/additional-benefits-information Compensation: Individual salary may vary based on multiple factors including specific role, geographic location / market data, and skills and experience as defined below: Lower in range - Building skills and experience in the role Mid-range - Experience and skills align with proficiency in the role Higher in range - Experience and skills add value above typical requirements of the role Some roles may be eligible for performance-based compensation and/or stock-based incentives awarded to employees based on company and individual performance. Salary $39,000 - $55,000 Work Model OFFICE
$39k-55k yearly Auto-Apply 11d ago
Claims Examiner
Partnered Staffing
Claim processor job in Wichita Falls, TX
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 Claims Processor BASIC FUNCTION: Under supervision, this position is responsible for processing complex paper and electronically submitted claims requiring further investigation and coding; resolving pended claims and processing adjustments. JOB REQUIREMENTS: 1 High School diploma or GED 2 At least one year office environment experience 3 Data entry and/or typing experience 4 Clear and concise written and verbal communication skills 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
$28k-43k yearly est. 60d+ ago
Technical Claims Specialist
Berkley 4.3
Claim processor job in Houston, TX
Company Details Berkley Oil & Gas, (a W.R. Berkley Company) is an insurance underwriting manager providing unique property and casualty products and risk services to customers engaged in the energy sector. Our customers recognize the importance of the expertise we provide and appreciate the opportunity to work with professionals who understand their business. We are in turn committed to delivering innovative products and exceptional service to them, our valued agents and brokers, Berkley Oil & Gas is dedicated in its efforts to be well-informed of the changing dynamics of the industry; support industry efforts to minimize and mitigate risks and hazards in the ‘oil patch', and to constantly seek ways to improve our products and services to meet customer needs. Company URL: *************************** The company is an equal opportunity employer. Responsibilities The Technical Claims Specialist position will be responsible for handling, negotiating and resolving first and third party commercial general liability, property, Inland Marine and automobile bodily injury and property damage claims to conclusion. This position may also handle worker's compensation claims. This would include coverage verification, policy interpretation, contract interpretation, liability investigation and evaluation and negotiation of claims consistent with company policies and state regulations. Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant internal and external parties. Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution. Demonstrate understanding of medical terms, medical treatment and injury descriptions. Recognition and evaluation of potential damages related to injuries. Manage the claim authorization process. Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence. Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction. Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements. Verify, analyze, and correctly apply coverage. Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures. Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law. Keep policyholders, underwriting and agents advised of file status and other matters as required. Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues. Successfully complete relevant continuing education as required. Qualifications Minimum of 7 years of multi-line experience Must possess a current Texas claims adjuster licenses; additional licenses a plus. Multi-jurisdictional experience preferred. Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws Ability to follow detailed procedures and ensure accuracy in documentation and data. Excellent written and verbal communications; with ability to listen well. Recognizes differences in opinions and misunderstandings and encourages open discussion while working towards resolution. Accepts individual responsibility for all actions taken. Holds self and others accountable to the organization and stakeholders. Excellent organizational skills; ability to prioritize workload Ability to think critically and solve problems, including the ability to interpret related documentation Strong negotiation skills leading to best claim outcomes Demonstrate proficiency in computer programs, such as Microsoft Word, Outlook and Excel Education Requirement Bachelor's Degree required or equivalent work experience. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $90,000 - $140,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. The application window for this role is estimated to be open through January 30, 2026, but may be extended, if necessary, please submit your application as soon as possible prior to January 30, 2026. Sponsorship Details Sponsorship not Offered for this Role
$90k-140k yearly Auto-Apply 60d+ ago
Claims HMO - Claims Examiner 140-1031
Communitycare 4.0
Claim processor job in Tulsa, OK
The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or adjust the claim. Examiners are expected to meet performance expectations in accuracy and efficiency. KEY RESPONSIBILITIES: Examining and adjudicating claims that have pended for review utilizing resources, tools, knowledge and decision-making in determining appropriate actions. Identify claims requiring additional resources and route to the team lead, supervisor or other departments as needed. Enter claims information using the processing software to compute payments, allowable amounts, limitations, exclusions and denials. Identify and communicate trends or problems identified during adjudication process. Contribute to the creation of a pleasant working environment with peers and other departments. Assist in investigating and solving claims that require additional research. Consistently learn and adapt to changes related to claims processing, benefits, limits and regulations. Perform other duties as assigned. QUALIFICATIONS: Self-motivated and able to work with minimal direction. Ability to read and understand claims processing manuals, medical terminology, CPT codes, and perform basic processing procedures. Ability to read and understand health benefit booklets. Demonstrated learning agility. Successful completion of Health Care Sanctions background check. Knowledge in the contracted managed care plan terms and rates. General understanding of unbundling methods, COB, and other over-billing methodologies. Must have high attention to detail. Proficient in Microsoft applications. Ability to perform basic mathematical calculations. Possess strong oral and written communication skills. EDUCATION/EXPERIENCE: High School Diploma or Equivalent required. Two years related work experience in claims processing, claims data entry or medical billing OR medical related education to meet minimum two years required.
$29k-36k yearly est. 10d ago
Insurance Claims Specialist
DPR Construction 4.8
Claim processor job in Dallas, TX
The Claims Specialist will be responsible for assisting with the management of the Fleet Vehicle Safety & Operations Policy for DPR (and DPR related entities) across the US, as well as first and third-party auto physical damage and low severity property damage claims as requested by, and under the supervision of, DPR's Insured Claims Manager. Specific Duties include: Claims & Incident Management: Initial processing of first and third-party auto and low severity property damage incidents involving DPR (and DPR related entities), including but not limited to: Input and/or review all incidents reported in DPR's RMIS system. Maintain incident records in Insurance Team's document management system. Ensure all necessary information is compiled to properly manage the claims, including working with the internal teams to identify culpable parties, potential risk transfer to the culpable trade partner, if applicable, collecting documents such as incident reports, root cause analyses, if any, and vehicle lease or rental agreements. Report, with all appropriate documents and information, all claims for DPR (and DPR related entities) to all potentially triggered insurance policies for various types of programs (traditional, CCIP, OCIP), including analyzing contractual risk transfer opportunities. Assess potential risk transfer opportunities and ensure additional insured tenders or deductible responsibility letters are sent, where applicable. Liaison with the carriers in evaluating whether claims reported directly to the carriers are appropriate. Manage all auto and low severity property damage claims, as assigned, in the DPR RMIS system for DPR (and DPR related entities), including ensuring that all information is kept up to date. Provide in-network aluminum certified repair shop information to drivers following an incident. Act as a liaison between our carriers, auto repair shops, Operations, Fleet and EHS teams related to claim progress, strategy, expenses and settlement. When required, notify the applicable State's Department of Motor Vehicles office of motor vehicle accidents by preparing and mailing the specific State form. Work with Insurance Controller on auto program claim reports Liaison with Operations, Fleet and EHS teams on new incident reporting processes, as needed. Fleet Vehicle Safety & Operations Policy Management: Manage the Fleet Risk Index scores for authorized drivers, ensuring its accurate and up to date based on incidents and MVRs Assign training to authorized drivers based on MVA incidents, MVRs and citations, as well as managing completion of the training Ensure authorized driver list is kept current Liaison with internal HR, Fleet, EHS and Business Unit Leaders, where appropriate, on suspending vehicle usage permissions Responsible for working with internal teams on implementing appropriate updates to the Fleet Vehicle Safety & Operations Policy Key Skills: Strategic thinking Ability to mentor and inspire others Integrity Team player Strong writing and communication skills Self-Starter Highly organized and responsive - ability to meet deadlines Detail Oriented Basic working knowledge in all of the following coverages/programs: auto insurance, commercial general liability, property insurance, and controlled insurance programs. Risk and dispute management - insured claims Qualifications: A minimum of five years relevant insurance industry experience Previous experience in auto claims management highly desired DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************
$57k-73k yearly est. Auto-Apply 60d+ ago
Executive Claims Examiner
Markel Corporation 4.8
Claim processor job in Plano, TX
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.
$36k-50k yearly est. Auto-Apply 23h ago
Risk Claims Specialist
Maya Management Group LLC 4.1
Claim processor job in Dallas, TX
Job Description Key Responsibilities: Customer Claims: • Manage Customer Injury and Liability Claims: Oversee the investigation, documentation, and resolution of customer claims related to personal injury, property damage, or any other incidents occurring on organization premises. • Coordinate with Insurance Providers: Liaise with insurance companies to ensure proper claims filing and coordinate the resolution of claims involving external parties. • Customer Support: Handle escalated customer claims and provide appropriate resolutions while ensuring the store's best interests are maintained. • Documentation & Compliance: Ensure that all claims are properly documented in compliance with company policies and legal requirements. Keep detailed records of each customer-related claim. • Risk Prevention: Identify trends or recurring incidents that may contribute to customer claims and work with store management to implement safety measures or preventive actions. Employee Claims: • Workers' Compensation Claims: Oversee and manage all workers' compensation claims, ensuring compliance with state and federal regulations, and ensuring employees receive appropriate benefits. • Workplace Injury Claims: Manage the investigation of employee injury claims, including gathering evidence, interviewing witnesses, and ensuring all necessary forms are completed and submitted on time. • Fleet Claims Management: Manage the investigation of employee fleet claims, support employee's injuries if any, gather witness statements • Support and Guidance: Provide support to injured employees, ensuring they are informed throughout the claims process and are aware of their rights and available benefits. • Collaboration with HR and Legal: Work with HR and legal teams to ensure employee-related claims are handled correctly and in compliance with labor laws, insurance regulations, and company policies. • Collaboration with Safety Team: Work with the Safety Team to consistently do store visits, conduct safety audits, checklists and investigations as needed. Development: • Process Improvement: Identify opportunities to improve the claims process, whether through more efficient systems, better documentation, or enhanced communication strategies. Risk Management and Reporting: • Claims Analysis and Reporting: Review and analyze the data on claims to identify trends, recurring issues, or areas for improvement. Prepare detailed reports for management regarding claim frequency, costs, and risk mitigation efforts. • Collaboration with Risk and Safety Teams: Work closely with the Risk Management and Safety teams to address underlying causes of incidents that may lead to claims and develop preventive strategies. • Compliance: Ensure that all claims are processed in line with company policies, industry standards, and legal requirements, including managing documentation for audits or regulatory reviews. • Invoices: Reconcile and verify all invoices generated from claims. • Safety Monitor Report: Complete Safety Monitor report and communicate all parties involved to resolve an issue related to an investigation. Qualifications: • Bachelor's degree in Business, Risk Management, Insurance, or a related field (or equivalent experience). • 3-5 years of experience in claims management, risk management, or a specialist role, preferably in a retail or supermarket environment. • Strong understanding of risk management principles, insurance claims processes, and workers' compensation regulations. • Strong problem-solving and analytical abilities to investigate and resolve complex claims efficiently. • Excellent communication skills, both written and verbal, with the ability to manage sensitive issues with customers and employees. • Attention to detail and ability to maintain accurate records and reports. • Proficient in Microsoft Office and experience with claims management software or risk management tools. Physical Requirements: • Ability to stand for extended periods • Ability to lift up to 50 lbs as needed Work Environment: • Fast-paced, high-volume environment • Occasional evening, weekend, or holiday work may be required • Occasional travel to different company locations Physical Demands: Some lifting, carrying, pushing, and/or pulling; some stooping, kneeling, crouching, and/or crawling; and significant fine finger dexterity. Generally, the job requires 70% sitting, 20% walking, and 10% standing. This job is performed in a generally clean and healthy office environment.
$37k-65k yearly est. 28d ago
Claims Specialist - Auto
Philadelphia Insurance Companies 4.8
Claim processor job in Plano, TX
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 *****************************************
$82.8k-97.3k yearly Auto-Apply 60d+ ago
Paralegal/Claims Specialist
Sundt Construction 4.8
Claim processor job in Irving, TX
As a 100% employee-owned contractor, when you work at Sundt, you're not just hiring on at a company, you're joining a culture. Because everyone at Sundt is part owner, you'll join a team of people who are deeply invested in their work. From apprentices to managers, we're passionate about the details and deliberate in everything we do. At Sundt we focus on building long-term prosperity for our clients, communities, and employee-owners. We offer competitive pay, industry-leading benefits including a 401k and employee stock ownership plan, incentive programs for craft and administrative employees as well as training that focuses on your personal and professional growth. We're driven by skill, grit and purpose. Join us as we strive to be the most skilled builder in America. Job Summary The Paralegal / Claims Specialist supports the company's Legal and Risk Management functions by assisting attorneys and insurance professionals in the investigation, evaluation, and resolution of claims and lawsuits. The role involves direct collaboration with outside counsel, insurance adjusters, and internal Safety and Operations teams. The Paralegal/Claims Specialist will independently manage the day-to-day handling of routine litigation and claims matters, including discovery, documentation, and coordination with defense counsel. Key Responsibilities 1. Assists attorneys with trial preparation, exhibits, witness coordination, and logistics. 2. Assists company attorneys with responding to non-party subpoenas and regulatory inquiries. 3. Attends mediations, depositions, and hearings as appropriate to support counsel, our internal personnel and maintain awareness of case progress. 4. Communicates directly with claimants, witnesses, experts, and internal personnel to obtain and analyze relevant information, including managing internal electronic data preservation in coordination with IT team, and oversee transfer of preserved data for discovery. 5. Coordinates with Safety personnel regarding incident intake, documentation, and potential claims escalation. 6. Drafts and edits legal documents including correspondence, discovery requests and responses, routine pleadings, affidavits, and case summaries. 7. In conjunction with attorneys, manages litigation, including coordinating discovery and e-discovery, tracking deadlines, managing document production, approving and processing legal invoices and maintaining organized case files. 8. Maintains accurate and up-to-date records in Risk Information Management Systems {RIMS) or other claims databases. 9. Reviews and analyzes claims in coordination with legal and risk management professionals determine liability, damages, and insurance coverage. 10. Works closely with company attorneys, outside counsel, and insurance adjusters to investigate, evaluate, and resolve claims and lawsuits. Minimum Job Requirements 1. 5-10 Years of Experience 2. Bachelor's degree 3. Knowledge working for a law firm or an insurance company representing clients in responding to claims and lawsuit preferred. 4. Paralegal certification Note: is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 50Ibs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Note: Job Description is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 501bs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Equal Opportunity Employer Statement: Sundt is committed to the equal treatment of all employees, and/or applicants for employment, and prohibits discrimination based on race, religion, sex (including pregnancy), sexual orientation, gender identity, color, age, disability, national origin, covered veteran status, genetic information; or any other classification protected by applicable Federal, state, or local laws. Benefit list: Market Competitive Salary (paid weekly) Bonus Eligibility based on company, group, and individual performance Employee Stock Ownership Plan & 401K Industry Leading Health Coverage Starting Your First Day Flexible Time Off (FTO) Medical, Health Savings, and Wellness credits Flexible Spending Accounts Employee Assistance Program Workplace Wellness Programs Mental Health Program Life and Disability Insurance Employee-Owner Perks Educational Assistance Sundt Foundation - Charitable Employee-Owner's program #LI-KA1
$45k-61k yearly est. Auto-Apply 12d ago
Medical Coding Appeals Analyst
Carebridge 3.8
Claim processor job in Grand Prairie, TX
Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$44k-65k yearly est. Auto-Apply 60d+ ago
Claims Specialist
Kelly Services 4.6
Claim processor job in Wichita Falls, TX
**What's next for you?** **This great job.** Finding a job that fits your lifestyle isn't always easy. That's where Kelly Professional & Industrial comes in. We're seeking **Claims Specialist** to work in a temporary to hire opportunity with a Top Healthcare Client in **Wichita Falls, TX** . We're here to help you find something great that works for you-so you won't miss a moment of what really matters in your life. **Snapshot:** + Temp to Hire! + Start Date: February 9, 2026 + Pay rate is $17.00/hour (pay increase to $17.75/hour once hired) + Shift Information: Monday through Friday 8:00AM until 4:30PM for training. + Flexible Schedule after Training (8-hour shift between 7AM-6PM) + The position will be fully ONSITE for training. + Paid training is a minimum of 8 weeks. + After training, you will have the opportunity to work a hybrid schedule (remote for two weeks and onsite for one week rotation). + You must have HIGH SPEED internet at home to do this position **Job Duties:** + Processing complex claims requiring investigation and coding + Resolving pending claims in a timely manner + Processing adjustments + Utilizing multiple applications simultaneously + Sitting at a cubicle for extended periods of time **What the position is NOT** : + A customer service position. You will NOT be taking phone calls from members + Not merely a data entry position **Job Specific Qualifications:** + High School Diploma or GED + Computer proficiency a must! + Be able to navigate between multiple programs simultaneously + Solid computer skills - basic typing, navigation of toolbar + Solid data entry skills average: 7,000+ keystrokes/hour + 6+ months of office clerical, medical, or insurance claims experience + Clear and concise written and verbal communication skills + Detail oriented with strong Interpersonal, analytical, and organizational skills + Independent decision-making skills + Adapts well to change + Member-focused and highly engaged + Ability to meet and/or exceed performance expectations for quality and production + Ability to sit for long periods of time **What happens next?** Once you apply, you'll proceed to next steps if your skills and experience look like a good fit. But don't worry-even if this position doesn't work out, you're still in our network. That means all of our recruiters will have access to your profile, expanding your opportunities even more. Helping you discover what's next in your career is what we're all about, so let's get to work. Apply to be a Claims Specialist today! As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here (********************************************************************* for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community. Trust the office staffing pioneer. Finding the right job isn't always easy. Kelly Professional & Industrial takes the guesswork out of your job search by connecting you with great opportunities that work for you. That means your schedule, your interests, and your career plan. In fact, our company created the staffing industry with the goal of connecting people with great office jobs-so you could say we're pretty good at it! About Kelly Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life-just ask the 300,000 people we employ each year. Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly's Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment.
$17-17.8 hourly 11d ago
Claims Processing Specialist
Saferide Health
Claim processor job in San Antonio, TX
SafeRide Health is looking for a hands-on Claims Specialist to scale SafeRide. We are looking for a leader with deep experience managing Medicare and Medicaid programs as we scale past $100M in annual revenue. The Billing Specialist is responsible for elevating SafeRide's billing function and continuously enhancing the effectiveness of the organization. Strong business and financial orientation as well as a passion for growth and development are critical for this role. Responsibilities: Facilitates data processing and processes claims for NEMT and GMR rides. Performs reconciliation of billing data to encounter data. Works closely with the operations team to resolve issues. Work with internal operations and project teams to solve claims-related problems, benefit plans research and provider contract interpretation and configurations. Communicate and work with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines. Receive incoming calls from providers, customers, vendors, and internal groups, to successfully analyze the caller's needs, research information, answer questions, and resolved issues and/or disputes in a timely and accurate manner. Identify issues negatively impacting the provider community including but not limited to system set up, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules. Develops and implements policies, processes and procedures that incorporate industry best practices, and reinforces high quality standards within the Billing team. Served as the Billing team's subject matter expert and primary contact for claims related projects and critical activities. Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues. Implement: Scalable and accurate billing operations systems leveraging best in class technology. This includes financial reporting for management, clients and designated state and federal agencies (e.g., HHSC in Texas). Champion and reinforce SafeRide's culture. Required Education/Experience: Minimum 1 years of experience in billing/claims management Must be bilingual Spanish Speaking Preferred NEMT/transportation background preferred Knowledge of CMS/HHSC regulations preferred Skills Strong data skills in Excel/Sheets, including pivot tables, v-lookups, etc. Self-starter, ability to work independently and in a team environment. Strength in problem solving, applying hard data and qualitative insight to frame problems and develop novel solutions Ability to adapt to unforeseen circumstances quickly Keen attention to detail Ability to work with a variety of stakeholders What we offer you An inclusive, encouraging and collaborative company culture Strong support for career growth, including access to our investor communities Competitive compensation with upside for growth (including stock options and performance grants) Competitive benefits including health/vision/dental insurance, 401k match and 18 day's PTO About SafeRide Health: SafeRide's mission is to restore access and dignity to care. SafeRide is transforming access to care for the nations sick, poor and underserved. We are a high growth, tech enabled services firm that's growing past 400 employees. SafeRide is backed by premier investors like NEA and clients like Fresenius. We operate nationally and now deliver over 5M rides per year. Learn more at ***********************
$27k-36k yearly est. 38d ago
Auto Claims Specialist
Toyota Insurance Management Solutions
Claim processor job in Plano, TX
Who are we: Toyota Insurance is a brand name of Toyota Insurance Management Solutions USA, LLC (TIMS). We are an independent agency specializing in property and casualty insurance for Toyota vehicle owners. We offer insurance through our trusted carrier partners to provide coverage for your Toyota vehicle, home and other assets. Our mission is to improve the Toyota ownership experience by improving the insurance experience. Job Overview: We are seeking a detail-oriented and proactive Auto Claims Specialist to join our team and support the auto property damage claims process. This role combines technical expertise in auto damage assessment with advocacy and coordination between internal and external stakeholders to ensure timely, accurate, and fair resolution. The ideal candidate will possess strong analytical skills, attention to detail, and excellent communication abilities with the desire to grow within the claims and insurance operations field. Job Responsibilities: Claims Intake & Documentation: Receive initial auto claim and damage information from internal teams or external parties. Collect, review, and validate all relevant supporting documentation such as police reports, First Notice of Loss (FNOL), recorded statements, and any other applicable claims information for accuracy and completeness. Accurately enter claims and damage data into the claims management system (Nexure). Must have a solid understanding of rideshare insurance policies, including how coverage exclusions apply and impact claims. File Management & Reporting: Organize and maintain secure auto claim files and records in compliance with company and regulatory standards. Submit loss notices and report claims promptly to insurance carriers. Prepare and submit any additional applicable claims or inquiries as required. Damage Review & Estimation: Review and document auto damages thoroughly. Analyze and validate repair estimates for vehicle damages. Coordinate with repair shops to discuss damages and confirm accuracy of estimates. Repair Process Oversight: Examine and evaluate repair processes and timelines. Monitor repairs through completion, ensuring quality and adherence to agreed timelines. Communication & Collaboration: Serve as the primary liaison between internal departments, vendors, external stakeholders, attorneys, and carriers. Provide clear and timely updates to all parties involved in the claim process. Claims Evaluation & Escalation: Review claim settlement recommendations for accuracy and fairness. Collaborate with senior claims analyst on complex or high-risk claims and escalate as necessary. Required Education and Experience: Licensed as an Adjuster in the State of Texas. 3 to 5 years of experience in auto insurance claims, auto claims adjusting, advocacy and/or auto claims estimation. Strong knowledge of insurance policies, auto repair processes and claims regulations. Knowledge of and experience in auto claims involving public or livery passenger conveyance policy exclusions and endorsements. Excellent organizational, time management skills, and communication skills. Strong understanding of the complete auto claims process, from initial intake to final resolution. Ability to work independently with minimal supervision. Preferred Skills: Strong analytical and problem-solving abilities. Excellent written and verbal communication skills. Proficiency in Microsoft Office Suite (Excel, Word, Outlook) and claims management systems. Ability to manage multiple priorities and meet deadlines in a fast-paced environment. Insurance agency, brokerage, or agent knowledge and/or experience is a plus. Strong attention to detail and organizational skills. Core Competencies: Analytical Thinking: Ability to interpret complex data, identify trends, and make informed decisions to resolve claims efficiently. Attention to Detail: Ensures accuracy in documentation, compliance with regulatory requirements, and thorough investigation of claims. Problem-Solving: Skilled in evaluating claim scenarios and developing effective solutions to minimize risk and optimize outcomes. Communication Skills: Strong written and verbal communication for interacting with internal teams, external partners, and clients. Work Environment and Physical Demands: Ability to work within a Team environment under tight schedules. Willingness to work evenings or weekends, as dictated by the needs of the business. Compensation: Base Salary: $46,000-$60,000 based on skills and experience Onsite-Plano office What are the Perks? Medical, Dental & Vision Insurance Paid Time Off, Paid Holidays and Sick Days 401(k) Match FSA and HSA Pet Insurance Life Insurance Degree of Travel: None Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Work Authorization: Applicants must be authorized to work for any employer in the U.S. This position does not offer sponsorship or the transfer of sponsorship of employment Visa. Learn More: Visit our website Toyota Insurance: *********************************** to learn more about our company culture and career opportunities. FLSA Job Status: ☒ Exempt ☐Non-Exempt All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. An Equal Opportunity Employer: Female / Minority / Disability / Protected Veteran / Sexual Orientation / Gender Identity EEOC is The Law' Information: ******************************************************************************
$46k-60k yearly 18d ago
US Retail Markets Claims Specialist Development Program-(January, June 2026)
Law Clerk In Cincinnati, Ohio
Claim processor job in Plano, TX
Description Advance your career at Liberty Mutual - A Fortune 100 Company! Manages, investigates and resolves claims assigned and assists in providing service to policyholders. Responsibilities: Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports. Ensures adequacy of reserves. Accountable for security of financial processing of claims, as well as security information contained in claims files. Makes effective use of loss management techniques. Negotiates settlements with attorneys, claimants, and/or co-defendants. Arranges for expert inspections involving third party or potential fraud actions as needed. Updates files and provides comprehensive reports as required Qualifications Qualifications: Strong written and oral communications skills required. Good interpersonal, analytical, investigative, and negotiation skills required. Customer service experience preferred. Basic knowledge of legal liability, general insurance policy coverage and State Tort Law. Bachelor's degree is required. Ability to obtain proper licensing as required. We can recommend jobs specifically for you! Click here to get started.
$28k-48k yearly est. Auto-Apply 8d ago
Provider Claims Infusion Specialist
Lantern 3.9
Claim processor job in Dallas, TX
Lantern is the specialty care platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation's top specialists for surgery, cancer care, infusions and more, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation's largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com. About You: You use LOGIC in your decision making and understand that progress is critical to making change. You focus on the execution of your content while balancing a fast-paced environment and you take the time to celebrate both the small & big wins. INCLUSION is a core tenant of your personal beliefs. A diverse and inclusive environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with. You have the GRIT, drive and ambition to tackle big problems. Big problems require big ideas and a team that supports new ideas. You care deeply for your customers are driven to keep HUMANITY in all decisions. Your customers aren't just the individuals using your product. They are the driving factor in your motivation to make a change. Integrity guides you in life. Focusing on the TRUTH vs. giving people the answers they want to hear. You thrive in a Team Environment. Collaboration is key in innovation and creating change. These pillars of LIGHT are a reminder to our team that we are making a difference by providing guidance and support in navigating the often complex and confusing landscape of healthcare. We hope that through this LIGHT, individuals can find their way to the best care, resources, and support they need to get back to life. If this sounds like you, we would love to connect to speak further about career opportunities at Lantern. Please apply to our role & someone from our Talent Acquisition Team will reach out to help you navigate our interview process. Job Overview Our Reimbursement Specialists are a central points of contact for our provider network. The primary responsibility of the role is to deliver effective, accurate payment and communication to our providers. The day-to-day responsibilities of our Reimbursement Specialists include payment processing, researching, accurate billing/payment disbursement, and ensuring payment data accuracy and integrity. The desired candidate is articulate, empathetic, pragmatic, self-starting and ambitious. In addition, our Reimbursement Specialists are horizontal thinkers, analytical, organized and detail oriented. Key Responsibilities: Processes provider payments in accordance with company policies and procedures. Serves as primary contact to Finance Department regarding payment, determinations and payment processing activities. Assist in the final determination on claim disposition and payment determination. Serves as liaison to internal departments regarding provider related inquiries on claims related content. Processes adjustments or provider disputes providing timely follow-up. Coordinates research and responds to system inquiries from providers regarding payment, reimbursement determination, provider contact information and claims billing procedures. Communicates with supervisor on a daily and/or weekly basis regarding any outstanding claims issues related to system, authorizations, reimbursement/payment errors or internal approvals. Works with provider contracting staff when new/modified reimbursement contracts are needed Performs pre-adjudication claims reviews to ensure proper terms and schedules were used. Initiate necessary actions regarding pending claims or payment documentation. Follow up on open items reports to timely and accurate resolution. Respond proactively to provider issues and concerns and give feedback to management. Provide feedback to the manager regarding proper claims billing procedures in accordance with company policy and procedures. Assist in training new Payment Specialists. Initiate change requests to resolve system issues impacting claims/payment processing or issue resolution Runs and analyzes daily activity reports. Analyze, develop and deliver claims resolutions quickly and accurately according to company policies and procedures. Requirements: Minimum Bachelor's degree in healthcare, business, marketing or related field; or HS Diploma (or GED) and 4 years' applicable experience Minimum 2 years of experience in previous claims, health insurance or healthcare practice Knowledge of medical coding systems (i.e., CPT, ICD-9/10, revenue codes) preferred Knowledge of commonly used medical data resources preferred Knowledge of payor contracts and interpretation Knowledge of general office operations and/or experience with standard medical insurance claim forms preferred Strong communication (verbal, written and listening), teamwork, negotiation and organizational skills Ability to commit to providing a level of customer service within established standards Ability to provide attention to detail to ensure accuracy including mathematical calculations Ability to organize workload to meet deadlines and participate in department/team meetings Ability to analyze data and arrive at a logical conclusion Ability to identify issues and determine appropriate course of action for resolution Ability to display professionalism by having a positive demeanor, proper telephone etiquette and use of proper language and tone Ability to use software and hardware related to job responsibilities, including MS Office Suite and database software Ability to work with accuracy in a fast-paced environment Ability to work independently and handle PHI and confidential information Ability to process detailed verbal and written instructions Benefits Medical Insurance Dental Insurance Vision Insurance Short & Long Term Disability Life Insurance 401k with company match Paid Time Off Paid Parental Leave Lantern does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.
$30k-35k yearly est. Auto-Apply 60d+ ago
Veterans Certification Specialist, Veteran Affairs
Cameron University 4.2
Claim processor job in Lawton, OK
POSTED JOB TITLE: Veterans Certification Specialist The Veterans Certification Specialist provides services related to the certification of students to the Department of Veterans Affairs (DVA) for Educational Benefits. This position is responsible for administrative duties associated with the administration and coordination of student certification and providing assistance to students. The Veterans Certification Specialist reports to the Coordinator of Veterans Affairs. Job Duties include, but are not limited to: Professional and efficient execution of Cameron University's commitment to student success KNOWLEDGE RESPONSIBILITIES Understand and comply with rules and regulations of the Department of Veterans Affairs as they relate to the GI Bill and student accessibility. Maintain student confidentiality in accordance with FERPA regulations. Maintain knowledge of policies of other departments (Registrar, Business Office, Admissions, etc.) and understand the impact on a student's GI Bill eligibility. Maintain knowledge academic program requirements. FUNCTIONAL RESPONSIBILITIES Accurately enter certification information in compliance with Federal regulations. Accurately calculate adjustments to certifications. Complete and/or file information to meet end of semester reporting requirements. Accurately calculate and reconcile tuition and fee costs for certifications and adjustments and disseminate information as appropriate with the Business office, including Debt Letter tracking. Accurately track Tungsten system approvals and associated notifications and tasks. Work collegially with all internal and external stakeholders. Assist with preparation and execution of any events hosted by the Veterans Affairs office. Assist with supervision of student staff, duties associated with the student staff and outstanding delivery of student customer assistance. Participate on university committees as assigned. Perform other related duties necessary to support the mission of Cameron University. CUSTOMER SERVICE RESPONSIBILITIES Ensure that students are served efficiently with courtesy and respect. Assist students, and their families, with maximizing student aid, entitlements, and other financial resources to make college attendance as affordable as possible. Coordinate Parent School Letter approvals and assist students with the tracking elements. MINIMUM QUALIFICATIONS: Bachelor's degree from a regionally accredited college or university. Proven track record of excellence in customer service. Ability to communicate diplomatically, clearly, and effectively, both verbally and in writing. Strong interpersonal and communication skills Demonstrated skills in Microsoft Office PREFERRED QUALIFICATIONS: Prior experience processing VA education benefits Military Affiliation Three years of Accounting Experience One or more years directly related experience with Oracle and Ellucian (Banner) system. Demonstrated understanding of educational, administrative and personnel policy and practices within higher education as well as the regional university mission and unique needs of Veterans. Bilingual: Spanish SALARY: Position funded at $30,500/annually plus benefits. Opportunity for performance compensation subject to approval and budgetary availability. PHYSICAL REQUIREMENTS: Ability to lift objects under 15 pounds including using the upper body to raise objects from a lower position to a higher position; ability to reach including extending the arm and hand; ability to stand for short or extended periods of time; ability to engage in repetitive motions including finger dexterity; ability to speak, hear and see. Ability to crouch, climb and walk stairs. INSTITUTION: Cameron University (**************** is a state-supported regional institution located in Lawton, Oklahoma, that offers undergraduate and graduate degrees. Dedicated to excellence, the university provides a wide range of economic, cultural, and educational opportunities for the betterment of all citizens. Master's-level graduate degrees are offered in business, behavioral sciences, and education; baccalaureate programs are offered in more than forty disciplines, and associate degrees are offered in many other studies. The close proximity of Fort Sill contributes to an area rich in cultural diversity and provides the opportunity for frequent cooperative efforts. The combined community of Lawton/Fort Sill has a population of more than 100,000 and is located adjacent to the picturesque Wichita Mountains Wildlife Refuge. A copy of the University's Annual Security Report, listing crime statistics and university policies, is available by contacting the Office of Public Safety or by accessing the report online at ******************** APPLYING: Attachments must include a cover letter indicating experience applicable to position, resume, transcripts (unofficial are acceptable at this point), names, addresses, and telephone numbers of three professional references. Incomplete applications might not be reviewed. DEADLINE: Applications will be accepted until the position is filled. EEO/AA Employer/Vets/Disability JOB #-A1302J
$30.5k yearly 60d+ ago
Claims Supervisor (Bodily Injury)
Geico 4.1
Claim processor job in Dallas, TX
At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Join a team where your expertise truly matters!Our Casualty Claims department is seeking a highly motivated and experienced Claims Supervisor (Bodily Injury). As a key leader within our Casualty organization, you will be responsible for empowering a team that handles attorney-represented automotive liability claims. Your team will manage: complex investigations coverage determinations liability assessments bodily injury claim resolutions-through both settlement and litigation. This role requires advanced knowledge of litigation processes and the ability to strategically support litigated and attorney-represented claims. If you're passionate about developing talent, driving results, and making an impact in the automotive liability space, we'd love to hear from you.Success in this role is built on the foundation of GEICO's core leadership behaviors: Ownership: You take responsibility for outcomes in all scenarios. Adaptability: You navigate dynamic environments with creativity and resilience. Leading People: You empower individuals and teams to achieve their best. Collaboration: You build and strengthen partnerships across organizational lines. Driving Value: You use data-driven insights to align actions with strategic goals. What You'll Do: Lead, mentor, and inspire a team of associates to deliver exceptional customer service while building trust. Leverage your property and casualty insurance expertise to guide team members in resolving complex customer inquiries and claims. Provide authority on evaluations that exceed your adjusters personal, assigned authority and work with others on claims that exceed your authority Personalize your leadership approach to develop team members' skills, fostering their growth and ensuring they consistently exceed customer expectations. Monitor and evaluate team performance using key performance indicators (KPIs) to enhance efficiency, customer satisfaction, and retention. Hold your team accountable for achieving results, maintaining compliance with insurance regulations, and delivering outstanding service. Address escalated customer concerns with professionalism and empathy, modeling GEICO's dedication to service excellence. Collaborate with leadership and cross-functional teams to identify and implement process improvements. Serve as a resource for team members on insurance-related questions providing mentorship and training to build their industry knowledge. What We're Looking For: Minimum of 2 years of leadership experience in Bodily Injury claims, including direct oversight of litigated cases. Active Adjuster license (required) Expertise in Casualty claims, including knowledge of industry regulations and best practices Strong ability to assess needs and guide associates in negotiating claim settlements as needed Experienced in the use of various claims tools with ability to assist associates Strong adherence to compliance and regulatory requirements Proven ability to motivate, inspire, and develop high-performing teams in a customer-centric environment Strong results orientation, with a history of meeting or exceeding performance goals Excellent interpersonal and communication skills, with the ability to adapt leadership styles to diverse individuals and situations Ability to analyze data and metrics to inform decision-making and improve customer outcomes Collaborative mindset with a commitment to fostering a culture of inclusivity and excellence Why Join GEICO? Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Inclusive Culture: Join a company that values diversity, collaboration, and innovation. Workplace Flexibility: This is a M-F, 8:00am - 4:30pm position offering a Hybrid work model based in Richardson, TX. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Licensing and continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Increased Earnings Potential: Pay Transparency: The starting salary for this position is between $97,735 annually and $151,700 annually. Incentives and Recognition: Corporate wide bonus programs are in place to reward top performers. Beware of scams! As a recruiter, I will only contact you through ************ email address and will never ask you for financial information during the hiring process. If you think you are being scammed or suspect suspicious activity during the hiring process, please contact us at ...@geico.com. keywords: litigation, auto liability, liability claims#geico300#LI-AL2 At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
$49k-73k yearly est. 1d ago

Learn more about claim processor jobs

How much does a claim processor earn in Wichita Falls, TX?

The average claim processor in Wichita Falls, TX earns between $23,000 and $53,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Wichita Falls, TX

$35,000

$23,00010%

$35,000Median

$53,00090%

What are the biggest employers of Claim Processors in Wichita Falls, TX?

The biggest employers of Claim Processors in Wichita Falls, TX are:

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Claim processor jobs in Wichita Falls, TX

Claims Supervisor (Bodily Injury)

Legal Claims Analyst

Specimen Processor

Claims Processor

Claims Examiner

Technical Claims Specialist

Claims HMO - Claims Examiner 140-1031

Insurance Claims Specialist

Executive Claims Examiner

Risk Claims Specialist

Claims Specialist - Auto

Paralegal/Claims Specialist

Medical Coding Appeals Analyst

Claims Specialist

Claims Processing Specialist

Auto Claims Specialist

US Retail Markets Claims Specialist Development Program-(January, June 2026)

Provider Claims Infusion Specialist

Veterans Certification Specialist, Veteran Affairs

Claims Supervisor (Bodily Injury)

Learn more about claim processor jobs

How much does a claim processor earn in Wichita Falls, TX?

What are the biggest employers of Claim Processors in Wichita Falls, TX?