Claim processor jobs in Wilmington, DE

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary The Claims Division is seeking a team member to join the Shared Services Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of commercial first and third party low complexity claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence. Responsibilities: Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution Review and analyze supporting damage documentation Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions Establish appropriate loss and expense reserves with documented rationale Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines Experience & Qualifications Hands-on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint, and Word Knowledge of ImageRight preferred Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines Ability to work well independently and in a team environment Texas Claim Adjuster license preferred, but not required for posting. Upon employment candidate would be required to obtain Texas Claim Adjuster license within six months of hire date. Education Bachelor's degree preferred 3-5 years' experience handling the process of commercial insurance claims #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $71,900 - $97,110/year Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service. Key Responsibilities Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures. Review and interpret policy language to determine coverage and consult with coverage counsel when needed. Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies. Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information. Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts. Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards. Participate in file reviews, team meetings, and ongoing training to support continuous learning. Qualifications Minimum of 3 years of trucking industry experience. Experience with bodily injury and/or cargo exposures. Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices. Strong analytical and negotiation skills, with the ability to manage multiple priorities. Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism. Possession of applicable state adjuster licenses. Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.

Job DescriptionOur client is seeking a skilled Multiline Auto Claims Examiner to join their team. This key role focuses on investigating and resolving moderate to complex auto liability and bodily injury claims, ensuring fair and efficient outcomes while maintaining compliance with all regulatory standards. The ideal candidate will have a strong background in casualty claims, particularly auto liability, and will demonstrate excellent judgment in evaluating exposures and negotiating settlements.Key Responsibilities: Investigate and evaluate Auto Liability and Bodily Injury claims to determine coverage, liability, and damages. Manage claims through all stages, including litigation, negotiation, and settlement. Review and analyze medical records, accident reports, and legal documentation to accurately assess claims. Collaborate with defense counsel and other experts to ensure cost-effective and timely resolutions. Provide clear communication and updates to policyholders, claimants, and brokers. Maintain accurate claim documentation in the claims management system. Ensure all claim handling complies with regulatory requirements and internal company guidelines. Requirements: 3 - 8+ years of experience handling Commercial or Personal Auto Liability and Bodily Injury claims, preferably with an insurance carrier. Active adjuster license strongly preferred. Strong negotiation and litigation management skills with a proven ability to drive equitable settlements. Solid analytical, organizational, and problem-solving skills. Proficiency with claims management software and Microsoft Office Suite. Bachelor's degree preferred. Salary & Benefits: $70,000 to $90,000+ annual base salary (depending on experience) plus bonus potential Generous PTO and paid holidays Competitive 401k with employer matching contributions Comprehensive health, dental, and vision coverage Professional growth opportunities within a supportive team environment

Highlight Health is a mission-driven company that protects consumer rights and controls healthcare costs exclusively for self-funded employers and their stop loss carriers. We are a profitable, fast-growing company without private equity investors. We are looking for a health coverage large and complex claims analysis expert - an expert who has scrutinized hospital and other claims with millions of dollars of charges, knows where the medical billing and pricing skeletons are found, and is tired of business as usual. Your deep knowledge has likely been developed over decades of diverse work with a claims repricing organization, a claims audit department or organization, special investigations unit (SIU), and/or an Office of the Inspector General (OIG). Highlight Health engineers new ways to protect consumer rights and control healthcare costs for self-funded employers. Nearly every American has felt the pain of the skyrocketing cost of healthcare. Highlight Health brings them solutions. We use our subject-matter expertise to reduce costs for employers and relieve ordinary Americans of burdensome medical costs. Highlight Health is proud of its inclusive workplace that brings together highly skilled leadership and employees from all walks of life. Our company is headquartered in two cities along the Northeast Corridor with an affordable cost of living: Philadelphia, PA and Newark, NJ. If you are experienced in and passionate about fighting fraud, waste, and abuse in medical billing, this is the job for you. We are seeking a motivated and hard-working individual to guide and optimize the most crucial department of our business-claims analysis and resolutions. In addition to an extensive background in medical billing and claims analysis, this role requires strong communication skills, both written and verbal, and organizational aptitude. The ability to prioritize and satisfy deadlines in this position is a must. Essential Duties and Responsibilities Analyze large and complex claims that need special attention Comprehensively review claims for fraud, waste, abuse, and overpayment Manage ad hoc Medicare pricing using APC Read, understand, and analyze comprehensive medical records and itemized bills Make and present claim resolution recommendations to manager or executive leadership Complete the claims resolution process Help Highlight Health improve claims analysis and resolution processes Requirements Typical Backgrounds Claims repricing organization Claims audit department or organization SIU unit OIG Required Experience/Knowledge Cynicism of our current healthcare finance system and a willingness to challenge the status quo More than 10 years of hands-on claims review experience More than 5 years of hands-on hospital (facility) claim review experience - both inpatient and outpatient More than 2 years of hands-on large facility claim review experience More than 2 years of hands-on commercial claims experience (Medicare/Medicaid experience is not sufficient) In depth knowledge of commercial price structures In depth knowledge of facility claims coding In depth knowledge of hospital billing rules and claim edits Insights into hospital fraud, waste, abuse, and overbilling as experienced by commercial payers Medical literacy Advanced Excel skills and understanding of advanced Excel functions including VLOOKUP, pivot tables, etc. Report writing skills Nice to have Clinical credentials Claim coding certificates (AHIMA, AAPC, ACDIS, etc.) Database query skills Medicare and/or Medicaid claims experience Experience managing ERISA appeals NSA IDR experience Team/department management experience Professional claim experience, particularly related to hospital care and J-code drugs Benefits Compensation and Benefits Salary Range: $110,000+ Highlight Health offers an attractive benefits package, with healthcare cost reimbursement, paid time off, commuting benefits, short term disability, an employer 401(k) contribution, and bonuses After 90 days of employment, you may work from home 1 day/week Location and Hours North New Jersey or Philadelphia areas preferred, but remote work is possible for a highly qualified applicant. Full-time employee relationship preferred but will consider flexible hours or contract work for a highly qualified applicant. How to Apply Submit your resume Include a MANDATORY cover letter that also includes a story of your role in identifying and stopping or recovering a hospital overpayment. (Please de-identify any HIPAA information.)

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere! As an ESIS Claims Specialist, your primary responsibility will be to investigate and resolve claims efficiently and fairly under the guidance of the Claims Team Leader. Your goal is to ensure that all claims are processed in accordance with established best practices, while delivering exceptional service to our clients. Major Duties & Responsibilities: As a Claims Specialist, your duties will encompass the following responsibilities (but are not limited to): Claim Assignment and Review: Promptly receive and review new assignments, analyzing claim and policy information to set the foundation for thorough investigations, while assessing the policy's obligations based on the specific line of business. Information Gathering: Conduct in-depth interviews and secure statements (both recorded and in-person) from insured parties, claimants, witnesses, healthcare providers, legal representatives, and law enforcement to collect essential claim information. Expert Coordination: Collaborate with experts and arrange for surveys when necessary to support claims investigations. Liability Evaluation: Assess the facts obtained during investigations to determine the insured's liability, if applicable, and the extent of the company's obligations under the policy contract. Reporting and Documentation: Prepare comprehensive reports that encompass investigation findings, claim settlements, denials, and evaluations of involved parties to maintain accurate and current records. Reserve Management: Set reserves within your authority limits and recommend changes to reserves to the Claims Team Leader as appropriate. Claims Progress Review: Regularly discuss the status and progress of claims with the Claims Team Leader, addressing any challenges and proposing solutions. Litigation Management: Oversee litigation files proactively to ensure timely and appropriate management, while striving to settle claims before progressing to trial. Assist with Legal Preparations: Support the Team Leader and company attorneys in trial preparations by organizing witness attendance and collecting statements, while actively seeking opportunities to settle claims prior to litigation. Subrogation Referrals: Identify and refer claims for subrogation as relevant to recover costs. File Audits and Reviews: Participate in claim file reviews and audits alongside customers, insured parties, and brokers to ensure compliance and accuracy. Timely Benefits Administration: Administer benefits promptly and fairly, while maintaining control of the claims resolution process to mitigate risk and exposure. Customer Relationship Management: Establish and uphold strong relationships with all stakeholders, including agents, underwriters, insured parties, and industry experts, to enhance customer satisfaction. Additional Responsibilities (Depending on Line of Business): Maintain accurate system logs. Investigate compensability and benefits entitlement. Review and authorize medical bill payments or coordinate external assessments as necessary. Manage vocational rehabilitation processes as needed. Scope of Position: This position reports directly to a Claims Team Leader or another member of the claims management team, offering opportunities for collaboration and professional growth within our dynamic environment. Qualifications Educational Background: A bachelor's degree in a relevant field or comparable work experience, with additional qualifications (e.g., MBA) being a valuable asset. Extensive Claims Expertise: A minimum of 5 years of proven experience in claims handling, preferably within ESIS or a similar organization. Expertise in Workers' Compensation claims is essential, demonstrating thorough technical knowledge and competence. Comprehensive Understanding of Products: In-depth knowledge of Workers' Compensation products, services, coverages, and relevant legal principles that govern them. Cost Containment Proficiency: Familiarity with Workers' Compensation cost containment strategies and a track record of effective account management are crucial for this role. Professional Designations: Relevant insurance designations such as Associate in Claims (AIC), Associate in Risk Management (ARM), or AICPCU are highly desirable and reflect commitment to professional development. Strong Business and People Management Skills: Possess the ability to plan, organize, and implement effective business and personnel management practices. This should be evidenced through successful completion of management or technical programs or equivalent practical work experience. Exceptional Communication Skills: Proven ability to communicate effectively and build relationships with diverse stakeholders, including subordinates, ESIS personnel, attorneys, producers, and clients. Team Building Experience: Demonstrated understanding of team dynamics and the application of team-building principles in both ongoing and planned activities. Analytical Evaluation Skills: Ability to assess the effectiveness of various programs and procedures, identifying opportunities for improvement while facilitating and leading group initiatives. Evaluative and Critical Thinking: Strong evaluative thinking abilities, adept at sourcing and analyzing multiple data points to make informed conclusions and determine actionable strategies. Personal Effectiveness: Evidence of cultivating personal effectiveness through confidence, credibility, and a commitment to the organization's established strategies and values. Creativity and Initiative: A proactive approach to work, showcasing creativity and self-motivation in claims handling and related functions, driving engagement and improvement. Resource Management Acumen: Demonstrated capability to manage activities and resource allocation effectively, prioritizing timely, high-quality service alongside long-term benefits related to claims processing. An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam. The pay range for the role is $72,400 to $123,100. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled. ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS' innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients' unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.

The Billing and Claims Specialist will be responsible for managing all aspects of customer billing, including preparing invoices, reconciling accounts, claims and resolving billing discrepancies. The ideal candidate will have a minimum of 3 years of experience in billing or accounts receivable within a fast-paced environment. Key Responsibilities: Prepare, review, and process accurate customer invoices in a timely manner. Reconcile billing statements and resolve discrepancies with internal teams and customers. Maintain accurate and organized billing and claims records. Collaborate with operations and sales teams to ensure proper billing for services rendered. Respond to customer inquiries regarding billing issues professionally and promptly Continuously identify and implement process improvements in billing operations. Identify process improvements to streamline billing and claims management. Qualifications: Minimum of three (3) years billing or accounts receivable experience, preferably in logistics or warehousing. Strong attention to detail and accuracy. Proficiency in Microsoft Office, especially Excel. Experience with billing software is a plus. Excellent communication and customer service skills. Ability to work independently and as part of a team. Strong organizational and time-management skills. Schedule: Full-time, Monday - Friday (with flexibility).

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! * Competitive compensation * Healthcare benefits package that begins on first day of employment * 401K retirement plan with company match * Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays * Up to 6 weeks of parental and bonding leave * Hybrid work schedule (3 days in the office, 2 days from home) * Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) * Tuition reimbursement after 6 months of employment * Numerous opportunities for continued training and career advancement * And much more! Responsibilities Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service. Key Responsibilities * Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures. * Review and interpret policy language to determine coverage and consult with coverage counsel when needed. * Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies. * Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information. * Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts. * Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards. * Participate in file reviews, team meetings, and ongoing training to support continuous learning. Qualifications * Minimum of 3 years of trucking industry experience. * Experience with bodily injury and/or cargo exposures. * Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices. * Strong analytical and negotiation skills, with the ability to manage multiple priorities. * Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism. * Possession of applicable state adjuster licenses. * Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.

Job Details The Ambulatory Care Capacity Analyst provides strategic support for provider access initiatives across the Jefferson Medical Group (JMG). This role provides internal schedulers and patients a standard, comprehensive approach to appointment availability across the enterprise. Job Description Essential Functions: Responsible for building, maintaining, and modifying centralized scheduling templates for all scheduling providers, including resource providers · Ensure all approved template changes follow change management procedures and protocols and align with Jefferson's template strategy guidelines Provide impact analysis for master template changes Report, review, and reschedule patient appointments as indicated by the Reschedule List Collaborate with Ambulatory practice administrative and clinical leadership on template optimization through the use of Epic Cadence functionality and advise on best practices Participate in department meetings that address patient access-related metrics Identify potential access limiting factors and develop possible solutions for department collaboration Monitor the effectiveness of access-related initiatives using data analysis via Qlik Reporting, Epic Reporting Workbench, and excel Strategize operational and technical methodologies to enhance patient self-scheduling for both patients and the ambulatory practices Present, demonstrate, and train internal staff on access and capacity strategies and initiatives On-board providers on scheduling decision tree and open scheduling platforms Rotate with peers for on-call schedule Education and Experience: High School Diploma Required; Bachelor's Degree preferred. Epic Cadence or other Epic application certification - plus. Minimum 2-3 years experience in an ambulatory care or IT setting preferred. Prior scheduling template management experience preferred. Work Shift Workday Day (United States of America) Worker Sub Type Regular Employee Entity Jefferson University Physicians Primary Location Address 1101 Market, Philadelphia, Pennsylvania, United States of America Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years. Jefferson is committed to providing equal educa tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. Benefits Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance. For more benefits information, please click here

Job DescriptionRisk Intermediary located in New Jersey seeks a VP of Claims for a Municipal Insurance fund. Claims handled are Workers Comp, Property and Liability and Professional Liability. Fund has 28 members submitting New Jersey based Public Entity based claims. This position will lead operational and administrative claims functions including reserving. Will also manage TPA relationships and direct TPA's Workers Comp activities. Will also manage staff Liability Litigation Managers and lead claims reporting. Require JD with 20 years experience in an Insurance Claims Department, TPA or Risk Management Department. Knowledge of New Jersey Civil Tort and Workers Comp claims systems. Advanced skills in Coverage Analysis, Litigation Management and Negotiation. Auto Liability, General Liability and Employer Liability claims. Knowledge needed in MS Office Products (Word, Excel and Powerpoint). Will work remote but must be within driving distance of office. Will manage 9-12 people. Minimal travel. Salary $150-200k no bonus opportunity.

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health. Sr. Audit Analyst Responsibilities: • Ensure the meeting of the timeline for external audits. • Address the most problematic and difficult functions associated with the External Audit function to ensure timely and complete execution of external audits in accordance with sound audit practices and regulations. • Review all internal responses from departments for accuracy and completeness. • Modify responses to address properly the audience for an internal or external party. • Prepare audit supporting documentation. • Perform and develop operational audits and provide results. • Monitor the resolution of systemic issues. • Serve as information resource to Audit and client management regarding audit requirements and processes. Qualifications/Skills: • BA/BS in Business Administration, Accounting, or related discipline, or equivalent knowledge acquired by on-the-job training and experience. • Five (5) or more years of healthcare claims audit or progressively more responsible experience in Customer Service, Enrollment, Claims, Provider Services, Medicare, Quality, or related administrative activities • Extensive Knowledge of audit procedures, requirements, and practices related to these audits. • Have familiarity and Acquire Working Knowledge Working with BCBSA guidelines for Member Touchpoint Measures (MTM), BCBSA Line Desk Level Audit (LDLA), and Multi-State Plan (MSP). • Extensive Knowledge of all key operating systems such as Interplan Teleprocessing System (ITS) and OSCAR for eligibility, customer service, enrollment, and claim processing issues. • Working Knowledge of benefits coding, and package types for the HMO and PPO products. • Working Knowledge of pharmacy services. IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Job Description Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer. Powered by JazzHR XgP5WY2DnT

Job Description CRM Residential has been a trusted name in the property management industry for over 46 years specializing in affordable housing. Our success story is a testament to the dedicated and talented individuals who have chosen to build their careers with us. We take great pride in our values, and we live and breathe them every day. Working at CRM Residential is so much more than a job, it is a career with purpose. No matter what department or level of the company you join, our mission is to provide a comfortable and reliable home environment for those who need it most and to provide excellent service to our customers. You will make a difference. Why Join the CRM Residential Team: Comprehensive Health Coverage Retirement Savings with employer contribution Bonus Potential Paid Time Off (PTO) Company Paid Holidays Once eligible for enrollment, the company will contribute a Safe Harbor match of 3% of your compensation to your 401(k) account, regardless of whether you choose to make your own contributions. Pay Rate: $22.00 per hour What You'll Get To Do: The Compliance Specialist will be responsible for keeping abreast of all HUD, state agency, and tax credit rules and regulations concerning occupancy, recertifications, and tax credit related issues. The Compliance Specialist will deal directly with HUD and state agencies in reference to Section 8 contract renewals. This role will be responsible for but not limited to: Prepare monthly, quarterly, and annually reports for Tax Credit Properties Prepare Company Occupancy Reports weekly and for properties and owners Review and critique recertification move in packages at tax credit properties Prepare handouts for training classes and an assist in allocating the cost to each property that attended training Site visits may be required from time to time to offer assistance to onsite staff pertaining to occupancy, file compliance or other tax credit specific areas Attend educational seminars relating to tax credit compliance & other affordable housing Monitor the timely completion of annual recertifications for all sites. Advise Regional Manager of any potential problems Written correspondence with owners and agencies, relating to affordable housing Requirements: High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position. Valid driver's license and reliable transportation Ability to work with a variety of people and make them feel comfortable quickly Strong customer service skills required Must have strong organizational and time management skills Valid driver's license Proficiency at multi-tasking Organizational skills Working knowledge of Microsoft Office software Experience with verifications and renewals Other administrative duties as assigned Onsite Monday-Friday 8:00am-4:30pm Excellent communication, writing and people skills Must have tax credit experience Experience with verifications and renewals About CRM Residential: CRM Residential is an award-winning full-service property management company which professionally manages 11,000+ apartments valued in excess of one billion. We are exclusively third-party so there is no conflict of interest between the properties that we manage for our clients and our own properties, because we do not own any properties. Our focus is dedicated to our clients. We are an equal opportunity employer and welcome applicants from all backgrounds to apply. If you have a passion for property management and a desire to work for a reputable company, we encourage you to apply for this exciting opportunity. Powered by JazzHR GYKHoNUwZ1

We are seeking a dedicated and detail-oriented Certification Specialist to join our team. This role offers an exciting opportunity to contribute to our community by ensuring compliance and maintaining high standards through certification processes. The ideal candidate will be proactive, organized, and capable of working independently under the guidance of the Community Manager. Must have at least 3 years of project based Section 8 experience, Real Page, TRACS, etc. Key Responsibilities: - Manage and coordinate certification processes for residents and staff, ensuring all documentation is accurate and up-to-date - Assist in preparing and submitting certification applications and renewals in accordance with regulatory requirements - Maintain organized records of certifications, licenses, and related documentation - Collaborate with community staff to facilitate certification-related training sessions and workshops - Travel to various training sessions and certification events as required, maintaining reliable transportation and a valid driver's license - Conduct background and drug screenings for new hires as part of the onboarding process - Stay informed about certification standards and updates relevant to the property and community needs Skills and Qualifications: - High School diploma or equivalent education required - Previous experience in certification processes or related administrative roles preferred - Strong organizational skills with attention to detail - Excellent communication and interpersonal skills - Ability to work independently and follow instructions accurately - Valid driver's license and reliable transportation for travel to training sessions - Ability to handle sensitive information with confidentiality and professionalism At CRM Residential, we foster a supportive and inclusive environment that values growth, teamwork, and excellence. We offer opportunities for professional development and a rewarding work environment dedicated to community well-being. Requirements HUD Background required Salary Description $22-$24/hr

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. This position is intended for a candidate seeking growth opportunity in a dynamic organization. The Associate Claims Examiner will join a specific business unit, as assigned, and will receive ongoing on-the-job training in their line of business. The Associate also will be part of the company's Early Career Program. The Early Career Program Claims Track is a one-year training program geared toward ambitious college graduates looking to launch a high-performing career in claims with a world-wide insurance leader. During the one-year program, associates receive specialized training that can position them for career advancement and valuable industry certifications. About This Role As the Associate develops skill and gains experience, on-the-job responsibilities will include but are not limited to: * Manage Claims on behalf of Arch Customers. * Receive exposure to other areas within the Administration and Operations of Claim handling, including but not limited to Special Investigations Unit, Analytics, Subrogation. * Perform claim handling responsibilities included but not limited to: Coverage analysis, Exposure analysis, Resolution strategies, Claims review, and Customer Service. Desired Skills * Actively completing or recently completed an area of study in Insurance & Risk Management, Business, Liberal Arts, Communications, Psychology, Linguistics, or relevant degree. * Minimum 3.0 GPA or higher. * Highly proficient with Microsoft Office tools including Word, Excel, and Outlook. * Exemplary oral and written communication skills. * Analytical, with keen ability to evaluate complex issues. * Proactive; able to organize and prioritize to meet multiple demands and commitments. * Demonstrates a strong work ethic, collaborative mindset, and potential for leadership. Location & Work Arrangement * The Early Careers Program (ECP) begins July 2026. A new hire for this role would start between January - June 2026. * This position is classified as a hybrid position. You will work 2 days onsite and 3 days from home. * This position can be located in Morristown, NJ, Jersey City, NJ, New York City, NY, or Philadelphia, PA. * Relocation and housing assistance is not provided for this role. #LI-AM2 #Hybrid For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $60,000 - $65,000/year * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service. Key Responsibilities Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures. Review and interpret policy language to determine coverage and consult with coverage counsel when needed. Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies. Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information. Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts. Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards. Participate in file reviews, team meetings, and ongoing training to support continuous learning. Qualifications Minimum of 3 years of trucking industry experience. Experience with bodily injury and/or cargo exposures. Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices. Strong analytical and negotiation skills, with the ability to manage multiple priorities. Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism. Possession of applicable state adjuster licenses. Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.

Job Description- National Insurance Carrier is looking for an experienced EPL Claims Manager that is currently managing a team. Prior experience in EPLI & professional liability claims is preferred but not mandatory. Will need a minimum of 5 to 7 years experience in EPL and or professional liability claims. JD preferred with good interpersonal skills. Call for additional details.

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

CRM Residential has been a trusted name in the property management industry for over 46 years specializing in affordable housing. Our success story is a testament to the dedicated and talented individuals who have chosen to build their careers with us. We take great pride in our values, and we live and breathe them every day. Working at CRM Residential is so much more than a job, it is a career with purpose. No matter what department or level of the company you join, our mission is to provide a comfortable and reliable home environment for those who need it most and to provide excellent service to our customers. You will make a difference. Why Join the CRM Residential Team: Comprehensive Health Coverage Retirement Savings with employer contribution Bonus Potential Paid Time Off (PTO) Company Paid Holidays Once eligible for enrollment, the company will contribute a Safe Harbor match of 3% of your compensation to your 401(k) account, regardless of whether you choose to make your own contributions. Pay Rate: $22.00 per hour What You'll Get To Do: The Compliance Specialist will be responsible for keeping abreast of all HUD, state agency, and tax credit rules and regulations concerning occupancy, recertifications, and tax credit related issues. The Compliance Specialist will deal directly with HUD and state agencies in reference to Section 8 contract renewals. This role will be responsible for but not limited to: Prepare monthly, quarterly, and annually reports for Tax Credit Properties Prepare Company Occupancy Reports weekly and for properties and owners Review and critique recertification move in packages at tax credit properties Prepare handouts for training classes and an assist in allocating the cost to each property that attended training Site visits may be required from time to time to offer assistance to onsite staff pertaining to occupancy, file compliance or other tax credit specific areas Attend educational seminars relating to tax credit compliance & other affordable housing Monitor the timely completion of annual recertifications for all sites. Advise Regional Manager of any potential problems Written correspondence with owners and agencies, relating to affordable housing Requirements: High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position. Valid driver's license and reliable transportation Ability to work with a variety of people and make them feel comfortable quickly Strong customer service skills required Must have strong organizational and time management skills Valid driver's license Proficiency at multi-tasking Organizational skills Working knowledge of Microsoft Office software Experience with verifications and renewals Other administrative duties as assigned Onsite Monday-Friday 8:00am-4:30pm Excellent communication, writing and people skills Must have tax credit experience Experience with verifications and renewals About CRM Residential: CRM Residential is an award-winning full-service property management company which professionally manages 11,000+ apartments valued in excess of one billion. We are exclusively third-party so there is no conflict of interest between the properties that we manage for our clients and our own properties, because we do not own any properties. Our focus is dedicated to our clients. We are an equal opportunity employer and welcome applicants from all backgrounds to apply. If you have a passion for property management and a desire to work for a reputable company, we encourage you to apply for this exciting opportunity.

We are seeking a dedicated and detail-oriented Certification Specialist to join our team. This role offers an exciting opportunity to contribute to our community by ensuring compliance and maintaining high standards through certification processes. The ideal candidate will be proactive, organized, and capable of working independently under the guidance of the Community Manager. Key Responsibilities: - Manage and coordinate certification processes for residents and staff, ensuring all documentation is accurate and up-to-date - Assist in preparing and submitting certification applications and renewals in accordance with regulatory requirements - Maintain organized records of certifications, licenses, and related documentation - Collaborate with community staff to facilitate certification-related training sessions and workshops - Travel to various training sessions and certification events as required, maintaining reliable transportation and a valid driver's license - Conduct background and drug screenings for new hires as part of the onboarding process - Stay informed about certification standards and updates relevant to the property and community needs Skills and Qualifications: - High School diploma or equivalent education required - Previous experience in certification processes or related administrative roles preferred - Strong organizational skills with attention to detail - Excellent communication and interpersonal skills - Ability to work independently and follow instructions accurately - Valid driver's license and reliable transportation for travel to training sessions - Ability to handle sensitive information with confidentiality and professionalism At CRM Residential, we foster a supportive and inclusive environment that values growth, teamwork, and excellence. We offer opportunities for professional development and a rewarding work environment dedicated to community well-being. Requirements HUD Background required Salary Description $20-$22/hr