Claims Processor -w2 only
Claim specialist job in Reston, VA
Terms of Employment
• W2 Contract, 5 Months
• Candidates must reside in the Eastern or Central Time Zone.
Work with a leading healthcare organization's Federal Employee Program (FEP) Claims Department to make a direct impact on their operations. Due to a recent platform upgrade and an expansion of services, the claims team is facing a significant inventory backlog. We are seeking multiple detail-oriented and adaptable Claims Processors to join this team and help them drive down the inventory and ensure timely processing. This is a vital role where your contributions will be immediately felt. The team prides itself on being collaborative and supportive, even in a remote setting. You will…
• Process a high volume of HMO and PPO claims within the Facets system.
• Adapt to daily shifting priorities, processing various claim types including Medicare claims, paper claims, and subscriber-submitted claims.
• Utilize multiple applications daily to research and process claims, including Transaction Insight (TI Portal) for electronic claims and the Stored Information Retrieval (SIR) system for paper claims.
• Search for member authorizations using the Guiding Care database.
• Analyze claim data and interpret medical terminology from supporting documentation provided by clinical staff.
• Use Microsoft Excel spreadsheets to receive and manage claim inventories.
Required Qualifications
• High School Diploma or GED
• 1-3 years Claims processing, billing, or medical terminology experience.
• Hands-on experience processing claims directly within the Facets platform (legacy or G6).
• Demonstrated experience with the following systems:
o TI Portal (Transaction Insight)
o SIR (Stored Information Retrieval System)
o HealthEdge Guiding Care
o SharePoint
• A strong understanding of medical terminology.
• Proficiency with Microsoft Office, including Excel and Word.
• Excellent analytical skills and the ability to multitask in a fast-paced environment.
Life Insurance Specialist - Port Huron, MI
Claim specialist job in Washington, DC
$5,000 Sign-On Bonus
Payment Terms: $2,500 paid after 30 days of employment, $2,500 paid after 90 days of employment.
Join America's most trusted brand with over 100 years of service
HOW WE REWARD OUR EMPLOYEES
UNLIMITED Income Potential
*Average Earnings $75,000 - $100,000 (base plus commissions)
Pay Structure
· UNLIMITED LEADS, at no cost
· Elevated tiered commissions for the first 12 months
· Annual Base Pay $26,000 (non-exempt, eligible for overtime)
ACG offers excellent and comprehensive benefits packages:
· Medical, dental and vision benefits
· 401k Match
· Paid parental leave and adoption assistance
· Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
· Paid volunteer day annually
· Tuition assistance program, professional certification reimbursement program and other professional development opportunities
· AAA Membership
· Discounts, perks, and rewards and much more
Why Choose AAA The Auto Club Group (ACG)
· Lead generation of 14+ million members
· Access to unlimited walk-in traffic and referrals
· Online lead generation
· Annual Sales Incentive Trip
A DAY IN THE LIFE of a Field Life Agent
The Auto Club Group is seeking a Field Life Agent who will customarily and regularly be engaged in outside sales activities away from their assigned AAA branch. You will be challenged to drive new business with competitive products and help retain The Auto Club Groups 14+ million members.
· Solicit and sell Life & Health insurance and Annuity products under minimal supervision primarily within ACG branch location.
· Thorough knowledge of various product features and marketing and sales techniques, achieve established sales goals.
· Develop leads and prospects for new accounts through various marketing activities (outbound/inbound phone calls, mailings, referrals, networking, website, seminars, etc.)
· Prepare proposals, and close sales of Life, Health, Annuity, Membership, and Financial Services products.
· Complete appropriate applications, forms and follow internal processing procedures to ensure transactions are handled in accordance with company policies and practices.
· Work collaboratively with others in the Branch to reach business goals, maximize leads, sales opportunities and take advantage of cross-sell opportunities.
· Assist Underwriting and Brokerage Departments in satisfying requirements.
· Respond to customer inquiries and problems and ensure sound sales practices are used.
· Prepare reports documenting prospecting and sales activities, maintain specified production standards and persistency levels for all required products.
What it's like to work for The Auto Club Group:
· Serve our members by making their satisfaction our highest priority
· Do what's right by sustaining an open, honest and ethical work environment
· Lead in everything we do by offering best-in-class products, benefits and services
· ACG values our employees by seeking the best talent, rewarding high performance and holding ourselves accountable
WE ARE LOOKING FOR CANDIDATES WHO
· Possession of valid State Life Sales licenses
· Ability to take and pass LUTC or CLU coursework
· Maintain Life and Health licenses required to sell products
· Possession of a valid State driver's license
· Must qualify, obtain, and maintain all applicable state licenses and appointments required for selling and/or servicing Auto Club Group Membership products
Education
· High School diploma or equivalent
Work Experience
· Minimum of 2 years' experience with a proven record of successfully soliciting and selling life insurance products
· Experience selling intangible products
Successful candidates will possess:
· Strong working knowledge of Life Insurance and Annuity products and services
· Ability to listen to and analyze customer needs and make recommendations to customers that best fit customers' needs and to promote a positive Member experience.
· Effectively communicate complex information with prospective clients in a clear manner
· Ability to prepare proposals and conduct closing interviews to sell Life and Annuity products.
· Assessing and reflecting customer insurance requirements consistent with company standards when writing policies
· Ability to perform mathematical calculations to determine premiums and values of Life insurance and financial products
· Ability to build and maintain strong relationships with customers
· Prospecting and developing new sales opportunities and meeting production requirements
· Ability to work collaboratively with all team members to attain business goals.
· Strong communication skills with others in the Branch to keep partners and branch management informed on sales and the disposition of any partner generated leads
· Understands and can articulate to customers the tax and legal impacts the products have on Members
· Strong organization, planning, time management and administrative skills
· Representing Auto Club Life in a professional and positive manner
· Safely operating a motor vehicle to travel to various locations to attend meetings or community events
· Proficient writing skills to compose routine correspondence
· Working independently with minimal supervision
· Good PC skills including working knowledge of word processing, spreadsheet, presentation, and email.
Work Environment
· Works in a temperature-controlled office environment.
· Limited travel required for community events, with exposure to road hazards and temperature extremes
#appcast
Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit
Important Note:
ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all its affiliated companies, is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
Disability claims processor
Claim specialist job in Vienna, VA
Job Description
Hybrid: Pensacola, FL, Vienna, VA, or Winchester, VA - 3x a week starting in April 2026.
Shared Services Advisor - Make a Meaningful Impact
Join a dynamic team as a Shared Services Advisor where you'll provide essential guidance and support across various shared services functions. In this pivotal role, you'll optimize operations and serve as a trusted resource for employees navigating disability claims.
Key Responsibilities:
Employee Support & Communication: Serve as the first point of contact for employees after vendor approval of disability claims. Respond to incoming calls and make outbound calls to provide accurate information and compassionate guidance.
Case Management: Skillfully manage and resolve employee-submitted cases, including those requiring complex information and detailed guidance, ensuring timely and satisfactory outcomes.
Reporting & Data Validation: Create comprehensive reports and perform meticulous validations to ensure accuracy and compliance across all processes.
System Updates: Review and update employment statuses in Oracle HCM to maintain accurate records and ensure data integrity.
Vendor & Stakeholder Collaboration: Work closely with vendors, contractors, and advisors involved in processing disability payments to ensure seamless coordination and timely resolution of issues.
What You'll Bring:
Knowledge of shared services models and operational efficiency practices
Strong problem-solving and process improvement skills
Excellent communication and advisory abilities
Understanding of compliance and regulatory standards
Join this collaborative team where your contributions will directly impact employee experience and operational excellence. The client offers professional growth opportunities in a supportive environment where your expertise will be valued.
CC Pace is an equal opportunity employer. The organization celebrates diversity and is committed to creating an inclusive environment for all employees. CC Pace does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information, or any other protected characteristic under federal, state, or local laws.
CC Pace is committed to employing only candidates who are legally authorized to work in the United States. To comply with the Immigration Reform and Control Act of 1986, all new employees, as a condition of employment, must complete the Employment Eligibility Verification Form I-9 and provide documentation that establishes identity and authorization to work. E-Verify will be used for employment verification as part of your onboarding process.
CC Pace values integrity throughout the hiring process. As part of standard verification procedures, candidates will be asked to provide documentation confirming employment history, education, and work authorization.
Experienced Outside Property Claim Representative
Claim specialist job in Washington, DC
**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$67,000.00 - $110,600.00
**Target Openings**
1
**What Is the Opportunity?**
LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.
**What Will You Do?**
+ Handles 1st party property claims of moderate severity and complexity as assigned.
+ Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
+ Broad scale use of innovative technologies.
+ Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
+ Establishes timely and accurate claim and expense reserves.
+ Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
+ Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
+ Writes denial letters, Reservation of Rights and other complex correspondence.
+ Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
+ Meets all quality standards and expectations in accordance with the Knowledge Guides.
+ Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
+ Manages file inventory to ensure timely resolution of cases.
+ Handles files in compliance with state regulations, where applicable.
+ Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
+ Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
+ Identifies and refers claims with Major Case Unit exposure to the manager.
+ Performs administrative functions such as expense accounts, time off reporting, etc. as required.
+ Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
+ May provides mentoring and coaching to less experienced claim professionals.
+ May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
+ CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
+ Must secure and maintain company credit card required.
+ In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
+ On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
+ This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Bachelor's Degree preferred.
+ General knowledge of estimating system Xactimate preferred.
+ Two or more years of previous outside property claim handling experience preferred.
+ Interpersonal and customer service skills - Advanced
+ Organizational and time management skills- Advanced
+ Ability to work independently - Intermediate
+ Judgment, analytical and decision making skills - Intermediate
+ Negotiation skills - Intermediate
+ Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate
+ Investigative skills - Intermediate
+ Ability to analyze and determine coverage - Intermediate
+ Analyze, and evaluate damages -Intermediate
+ Resolve claims within settlement authority - Intermediate
+ Valid passport preferred.
**What is a Must Have?**
+ High School Diploma or GED required.
+ A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required.
+ Valid driver's license required.
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit ******************************************************** .
Claims Specialist-WC
Claim specialist job in Fairfax, VA
Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims. Documents and monitors open case inventory and ensures proper and timely closing of files. Makes decisions on claims within delegated limited authority.
College degree or the equivalent of education and experience.
Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized courses of study (Associate in Claim designation, etc).
Demonstrates a thorough working knowledge of claim processing and claim policies and procedures.
Demonstrates an understanding of basic medical terminology and appropriate medical tests for claimed conditions
Demonstrates effective and diplomatic oral and written communication skills.
Demonstrates a customer-focused approach including the ability to identify and understand customer needs, and interacts effectively with others.
Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster/supervisory/management level. Must possess a valid driver's license. Must complete continuing education requirements as outlined by Crawford Educational Services. Additional courses may be required by jurisdiction for maintenance of license.
#LI-RG1
Conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages. Works closely with claimants, witnesses and members of the medical profession and other persons pertinent to the investigation and processing of claims.
Verifies policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim.
Identifies wage loss expenses and wage exposures on medical claims.
Documents receipt and contents of medical reports. Interacts frequently with claimant to understand nature and extent of injury and medical conditions. Reviews and handles other correspondence within authority including material from the team members, and/or clients.
Approves payments of medical bills on lost time disability claims within area of payment authority up to, but not exceeding, $2,500 after compensability has been determined.
Evaluates medical claims for potential fraud issues, loss control and recovery in accordance with insurance policy contracts, medical bill coding rules and state regulations.
Keeps Team Manager informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to Team Manager for direction.
With the team managers guidance, provides input on the completion of status reports, initiate's activity checks and/or widow's statement of dependency forms.
Completes all reporting forms and file documentation.
Adheres to client and carrier guidelines and prepares written updates for supervisor to review.
Performs other related duties as required or requested.
Auto-ApplyClaims Specialist
Claim specialist job in Washington, DC
This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously submitted appeals.
DUTIES AND RESPONSIBILITIES:
Investigates Claims Denials.
Handles large volumes of documents, including accurately scanning and mailing documents.
Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement.
Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue.
Is comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals.
Opens, sorts, and imports incoming correspondence into the office database.
Navigates through various computer systems and applications to find information about insurance claims.
Greets and assists onsite guests.
Answers calls for Claim status and Appeal status.
Performs any other administrative duties as may be necessary.
Performs other related duties as assigned by management.
QUALIFICATIONS:
Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience.
Other skills required :
Previous experience in office administration or another related field.
Basic working knowledge of the US healthcare system.
Ability to prioritize and multitask.
Excellent written and verbal communication skills.
Proficiency in Microsoft Office, including Word and Excel.
Highly attentive to detail.
Excellent organizational and time management skills.
Clear, concise, and logical writing style.
Computer-savvy, able to learn new applications/software quickly.
Please remove paragraph before using in Workplace
COMPETENCIES: Select which competency categories are necessary for this position. We strongly recommend diversity and ethics to be included in each . Then select an additional 3-5 of the most critical competencies for the specific job title.
Please note: You may remove complete statements and complete sub-title sections however the verbiage/content may not be altered nor can wording be inserted as this is standard in all ADP Job Descriptions and are compliant.
COMPETENCIES:
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results.
Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
Auto-ApplyClaims Specialist
Claim specialist job in Rockville, MD
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.
This is a Hybrid role.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives claims, confirms policy coverage and acknowledgment of the claim
Determines validity and compensability of the claim
Establishes reserves and authorizes payments within reserving authority limits
Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision
Communicates claim status with the customer, claimant and client
Adheres to client and carrier guidelines and participates in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Requires regular and consistent attendance
Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”)
Additional projects and duties as assigned
KNOWLEDGE & SKILLS:
Excellent written and verbal communication skills
Ability to learn rapidly to develop knowledge and understanding of claims practice
Ability to identify, analyze and solve problems
Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
Strong interpersonal, time management and organizational skills
Ability to meet or exceed performance competencies
Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
Bachelor's degree or a combination of education and related experience
Minimum of 1 year of industry experience and claims management preferred
State Certification as an Experienced Examiner
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $51,807 - $83,551
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL
CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Hybrid
Senior Claims Analyst
Claim specialist job in Washington, DC
Owner's project management firm is seeking an experienced SENIOR CLAIMS ANALYST for work on construction claims. Candidates qualifications must include demonstrated experience with:
Furnishes reports with supporting information necessary to resolve disputes or defend against the claims,
Prepares and assembles appeal files,
Participates in meetings or negotiations with claimants,
Appears in legal proceedings,
Prepares cost estimates for use in claims negotiations,
Prepares risk assessments/analysis relative to claim exposures,
Prepares findings of fact and other documentation required by the CO.
Provides litigation support to include court boards, timelines, diagrams, static and electronic illustrations and three dimensional models.
Candidates should have demonstrated ability to work cooperatively and productively as a member of a project or claims defense team. Candidates must have 15 years experience and a Bachelor's Degree in Engineering, or Construction/Project Management. CCM and either P.E. or CPA necessary though all three are preferred.
Submit resumes and project list in MS Word or PDF format:
Please No Calls
Experienced Outside Property Claim Representative
Claim specialist job in Washington, DC
Who Are We?
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Job CategoryClaimCompensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range$67,000.00 - $110,600.00Target Openings1What Is the Opportunity?LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.
Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.What Will You Do?
Handles 1st party property claims of moderate severity and complexity as assigned.
Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates.
Broad scale use of innovative technologies.
Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
Establishes timely and accurate claim and expense reserves.
Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters.
Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits.
Writes denial letters, Reservation of Rights and other complex correspondence.
Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.
Meets all quality standards and expectations in accordance with the Knowledge Guides.
Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.
Manages file inventory to ensure timely resolution of cases.
Handles files in compliance with state regulations, where applicable.
Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners.
Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.
Identifies and refers claims with Major Case Unit exposure to the manager.
Performs administrative functions such as expense accounts, time off reporting, etc. as required.
Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
May provides mentoring and coaching to less experienced claim professionals.
May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.
Must secure and maintain company credit card required.
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work.
This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position.
Perform other duties as assigned.
What Will Our Ideal Candidate Have?
Bachelor's Degree preferred.
General knowledge of estimating system Xactimate preferred.
Two or more years of previous outside property claim handling experience preferred.
Interpersonal and customer service skills - Advanced
Organizational and time management skills- Advanced
Ability to work independently - Intermediate
Judgment, analytical and decision making skills - Intermediate
Negotiation skills - Intermediate
Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate
Investigative skills - Intermediate
Ability to analyze and determine coverage - Intermediate
Analyze, and evaluate damages -Intermediate
Resolve claims within settlement authority - Intermediate
Valid passport preferred.
What is a Must Have?
High School Diploma or GED required.
A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required.
Valid driver's license required.
What Is in It for You?
Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
Employment Practices
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit *********************************************************
Auto-ApplySubmarine Certification Specialist - Washington, D.C.
Claim specialist job in Washington, DC
Looking for an opportunity at a place you can have influence and make a difference every day? Then Serco has the right opportunity for you! As the Program Analyst (Submarines), you will provide programmatic support to one of our NAVSEA customers in the Washington, DC area. Bring your expertise and collaborative skills to make an impact towards our military defense and safety of our sailors.
Serco is the prime on the SHAPM contract which deals with acquisition and construction of submarines. The Team Submarine concept unifies once diverse submarine-related activities into a single submarine-centric organization with the goal of eliminating traditional stovepipe structures and processes that created impediments and inefficiencies in the submarine research, development, acquisition, and maintenance communities. Team Submarine provides improved communication among the various offices that contribute to the overall success of the United States Submarine Force.
**In this role, you will:**
+ Provide Engineering and Technical support coordinating all matters relating to preparation, review and approval of Ship Certification correspondence for Fast Cruise and Sea Trials, Follow-On certifications and URO certifications.
+ Coordinate routing and processing of all ship certification documents for concurrence and approval signatures.
+ Prepare coordinated reports, presentations and briefings in support of program actions.
+ Analyzes requirements to develop program reporting including specifications, data gathering and analytical techniques, and evaluation methodology.
+ Support studies, surveys, reviews, and/or research projects to evaluate program accomplishments, effectiveness, and/or compliance with meeting specific goals, objectives, rules, and regulations.
+ Develop evaluation plans, metrics, procedures, and methodology as a result of studies performed.
+ Provide Subject Matter Expert (SME) support and assist the Government with technical analyses, inquiries, research, testing, data validation for any matters relating to US submarines.
+ Maintain applicable Plans of Actions and Milestones (POA&M) as directed/required.
+ Interface with stakeholders to identify, assign, and track action items, leveraging initiatives to benefit submarine sustainment support.
+ Collect information and provide recommendations to senior decision-makers through well-written documents.
+ Communicate with various Program Office representatives within NAVSEA and other Department of Navy organization in supporting PM concerns.
+ Coordinate with the technical community and develop white papers and presentations for the Government and the Navy on program status or issues impacting the program.
+ Organize and maintain Program tracking files/tools on program status, actions items and issues.
+ Support the team in performing additional duties and responsibilities as assigned.
+ Provide timely and efficient responses for all urgent tasking.
+ Ensure program correspondence and deliverables are in accordance with Serco's Quality Assurance Program.
Meet Your Recruiter! (https://serco.kzoplatform.com/player/medium/**********002817285?embed=true&layout=fullscreen&overlay=false&auth=public)
**Qualifications**
**To be successful in this role you will have:**
+ Ability to obtain and maintain an active DoD Secret clearance.
+ US Citizenship
+ Bachelor's Degree
+ An Associate's Degree and 2 years of additional experience will be considered in lieu of Bachelor's Degree or a High School Diploma/GED and 4 years of additional experience will be considered in lieu of Bachelor's Degree.
+ 8 years of experience (Experience with Navy acquisition and/or In-Service Programs highly preferred)
+ Strong customer, interpersonal and organizational level communication skills (written and verbal).
+ Proficiency with Microsoft Office Suite programs, to include Excel and PowerPoint.
+ Written communication skills (e.g., drafting program impact statements and Congressional Appeals)
+ Experience leading a project and interfacing with an end item customer.
+ Ability to travel at least 10% of the time.
**Additional desired experience and skills:**
+ Active-Duty experience in submarine service (preferably SSN) is a plus.
+ Recent experience in Team Submarine would be ideal.
If you are interested in supporting and working with our military and sailors and a passionate Serco team- then submit your application now for immediate consideration. It only takes a few minutes and could change your career!
**Company Overview**
Serco Inc. (Serco) is the Americas division of Serco Group, plc. In North America, Serco's 9,000+ employees strive to make an impact every day across 100+ sites in the areas of Defense, Citizen Services, and Transportation. We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Serco serves every branch of the U.S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state, provincial and local governments, and commercial clients. While your place may look a little different depending on your role, we know you will find yours here. Wherever you work and whatever you do, we invite you to discover your place in our world. Serco is a place you can count on and where you can make an impact because every contribution matters.
To review Serco benefits please visit: *********************************************************** . If you require an accommodation with the application process please email: ******************** or call the HR Service Desk at ************, option 1. Please note, due to EEOC/OFCCP compliance, Serco is unable to accept resumes by email.
Candidates may be asked to present proof of identify during the selection process. If requested, this will require presentation of a government-issued I.D. (with photo) with name and address that match the information entered on the application. Serco will not take possession of or retain/store the information provided as proof of identity. For more information on how Serco uses your information, please see our Applicant Privacy Policy and Notice (**************************************** .
Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor. All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee. If you are interested in becoming an approved vendor at Serco, please email ********************* .
Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
**Pay Transparency**
Our Total Rewards package includes competitive pay, performance-based incentives, and benefits that promote well-being and work-life balance-so you can thrive both professionally and personally. Eligible employees also gain access to a wide range of benefits from comprehensive health coverage and health savings accounts to retirement plans, life and disability insurance, and time-off programs that support work-life balance. Program availability may vary based on factors such as contract type, location, hire date, and applicable collective bargaining agreements.
Salary range: The range for this position can be found at the top of the posting. This range is provided as a general guideline and represents a good faith estimate across all experience levels. Actual base salary will be determined by a variety of factors, including but not limited to, the scope of the role, relevant experience, job-related knowledge, education and training, key skills, and geographic market considerations. For roles available in multiple states, the range may vary to reflect differences in local labor markets. In addition to base salary, eligible positions may include other forms of compensation such as annual bonuses or long-term incentive opportunities.
Benefits HIGHLIGHTS - Comprehensible Benefits for Full-time Employees (Part-time members receive a customized package tailored to their role).
+ Medical, dental, and vision insurance
+ Robust vacation and sick leave benefits, and flexible work arrangements where permitted by role or contract
+ 401(k) plan that includes employer matching funds
+ Tuition reimbursement program
+ Life insurance and disability coverage
+ Optional coverages you can buy, including pet insurance, home and auto insurance, additional life and accident insurance, critical illness insurance, group legal, ID theft protection
+ Birth, adoption, parental leave benefits
+ Employee Assistance Plan that includes counseling conditions
+ Specific benefits are dependent upon the specific contract as well as whether the position is covered by a collective bargaining agreement or the Service Contract Act.
To review all Serco benefits please visit: ***************************************** .
Serco complies with all applicable state and local leave laws, including providing time off under the Colorado Healthy Families and Workplaces Act for eligible Colorado residents, in alignment with our policies and benefit plans. The application window for this position is for no more than 60 days. We encourage candidates to apply promptly after the posting date, as the position may close earlier if filled or if the application volume exceeds expectations. Please submit applications exclusively through Serco's external (or internal) career site. This is a U.S.-based role. If an applicant has any concerns with job posting compliance, please send an email to: ******************** .
Click here to apply now (**************************************************************************************************************************************************************
**New to Serco?**
Join our Talent Community! (***************************************************
**ID** _72127_
**Recruiting Location : Location** _US-DC-Washington_
**Category** _Project/Program Management_
**Position Type** _Full-Time_
**Security Clearance** _Other_
**Clearance Details** _Ability to obtain and maintain an active DoD Secret clearance._
**Telework** _No - Teleworking not available for this position_
**Campaign** _LPMETS_
**Salary Range/Amount** _$103369.00 - $167974.00_
Easy ApplyClaim Representative, Workers' Compensation RTW - Hunt Valley, MD
Claim specialist job in Huntingtown, MD
ATTENTION MILITARY AFFILIATED JOB SEEKERS
- Our organization works with partner companies to source qualified talent for their open roles. The following position is available to
Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers
. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps.
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Compensation Overview
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
Salary Range
$67,000.00 - $110,600.00
What Is the Opportunity?
This role is eligible for a sign on bonus
Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery The injured worker is working modified duty and receiving ongoing medical treatment. The injured worker as returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and there has been a change in the current position. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered.
What Will You Do?
Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability
Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions.
Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment.in collaboration with internal nurse resources where appropriate.
Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome.
Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits.
Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment.
Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations.
Negotiate settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction.
In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
Perform other duties as assigned.
Additional Qualifications/Responsibilities
What Will Our Ideal Candidate Have?
2 years Workers Compensation claim handling experience.
Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making.
Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology.
Ability to effectively present file resolution to internal and/or external stakeholders.
Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise.
General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract.
Principles of Investigation: Intermediate investigative skills including the ability to take statements.
Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss.
Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves.
Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package.
Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed.
WC Technical:
Intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims.
Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state.
Intermediate knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
Customer Service:
Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes.
Teamwork:
Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result.
Planning & Organizing:
Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals.
Maintain Continuing Education requirements as required or as mandated by state regulations.
What is a Must Have?
High School Diploma or GED.
1 year Workers Compensation claim handling experience or successful completion of the WC trainee program.
Claims Examiner
Claim specialist job in Annapolis, MD
Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you!
Essential Functions:
Reviews providers' disputes and appeals for professional and hospital claims to determine resolution according to policies and procedures.
Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and resolution timeliness
Perform any projects delegated by claims supervisor
Qualifications
Minimum Education/ Licensures/Qualifications
High School Diploma or GED
1+ year experience handling provider disputes / appeals, preferably in PPO, Self-Funded and/or HMO setting
Healthcare Background
Understanding of Medical Terminology
Additional Information
Shift: M-F 8am-5pm
RTH or Temp-To-Perm (Any transition heavily depends on performance)
Pay Rate: Up to 20/hour
Chinese Triage Examiner
Claim specialist job in Bethesda, MD
Job Description
The National Solutions Sector is currently looking experienced
Chinese Triage
Examiners
in various languages to perform media exploitation (MEDEX) and triage in support a customer in the National Capital Region (NCR). Triage Examiners should be experienced in general linguist operations and Document and Media Exploitation (DOMEX) operations, and are expected to leverage language and analytical skills, as well as advanced computer systems aptitude in addressing triage examination projects. Triage Examiners will perform eDiscovery examinations of electronic media for content of interest using a suite of forensic examination tools and will identify and prioritize items of importance for further processing, in accordance with customer standard operating procedures. Examiners will also be expected to communicate effectively and provide ad-hoc notification to superiors on task progress and significant findings, and to produce a report of their findings for further dissemination to customer(s).
Required Language:
Chinese
Locations:
The NMEC-LEaRN program is located at the customer site in Bethesda, MD, and we also offer the option to work from different locations (JIRC sites).
The primary responsibilities of the Triage Examiners are:
Perform data discovery on large datasets of foreign language material and identify essential elements of information.
Convert, reformat, parse, and otherwise exploit media files using customer tools to ensure compatibility and readability for translation systems.
Prepare files and metadata for transfer to translation systems, including review of foreign-language data.
Produce report of findings and disseminate to customer, analysts, and liaison officers.
Prepare accurate written gists, translations, and/or transcriptions of general and technical material.
Candidate must have operational experience within the
Chinese
language.
Basic Qualifications
Must have the sufficient language skills, analytic skills, and technical aptitude to gain proficiency with job-required tools and processes (On-the-job training may be provided as needed to address customer-specific needs, with ongoing evaluations throughout train-up period).
Native-level proficiency in English.
Two years of overall experience in
Chinese
linguist operations (i.e. translation, language analysis), and two years of experience performing media examination for Document and Media Exploitation projects.
Willingness to perform occasional shift work to meet mission demands.
Achieve a minimum score of a 3/3 in Reading and Listening in
Chinese
and 3+/3+ for Reading and Listening in English.
BA degree and/or 4 prior relevant experience in lieu of degree, or Masters with 2 years of prior relevant experience.
Ability to compose summarizations of highly technical and complex subjects that are both succinct and accessible to a general reader.
Outcomes-based problem solving of ill-defined and abstract problems.
Ability to maintain project momentum while working independently with limited oversight over a long period of time.
Ability to quickly scan and process a large amount of material in a foreign language for essential elements of information.
Ability to comprehend customer prioritization requirements and apply them to files under review, as well as apply personal judgment when assessing the potential value of files and information.
Demonstrated history of working on screening or translation projects and in maintaining the integrity and meaning of the translated material.
Demonstrated ability to communicate in a professional manner (email, spoken, & reports).
Ability to make sound decisions and handle stress, while meeting deadlines and performing in a high-paced environment.
Familiarity with report writing styles for DOD and IC consumers.
Possess a working proficiency in standard computer systems and office programs, with additional experience in media examination tools.
Ability to use or train to proficiency on customer specific software programs and tools.
Clearance
Must currently possess at least an active TS/SCI clearance.
Current or recent SCI-level access is a significant advantage and preferred.
Must be able to pass a polygraph and Subject Interview.
Preferred Qualifications
Native-level proficiency in foreign language
Graduate of the Defense Language Institute Chinese Course.
An advanced degree in one of the following fields: Engineering, Computer Science, Chemistry, Physics, Legal, Medical, Banking and Financing, Foreign Military, Forensics
Familiarity with Digital Forensics/eDiscovery/Document and Media Exploitation (DOMEX) processes and specialized tools (i.e. FTK, en Case, or similar).
Past performance as a media examiner in support of DOD or IC customers.
Program NameProgram Name
LEaRN
AttachmentsBusiness Process History
We're not looking for perfectly polished resumes or perfect fits. We're looking for people who break limits, ask hard questions, and don't wait to be told what's next. At Leidos, we're not following the roadmap - we're redrawing it.
Original Posting:November 14, 2025
For U.S. Positions: While subject to change based on business needs, Leidos reasonably anticipates that this job requisition will remain open for at least 3 days with an anticipated close date of no earlier than 3 days after the original posting date as listed above.
Pay Range:Pay Range $72,150.00 - $130,425.00
The Leidos pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to) responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law.
Auto-ApplyClaims Analyst/Lead Claims Analyst/Senior Claims Analyst (Full-Time)
Claim specialist job in Vienna, VA
MBP is looking for Claims Analyst/Lead Claims Analyst/Senior Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Highly proficient in Oracle P6 and experienced with one or more of the following: Microsoft Project, Phoenix Project Manager, or similar.
Responsibilities
Main Duties:
Performs review and analysis of construction claims.
Assists with development of contractor claims.
Develops and/or review time extension requests.
Assist with development of expert reports and exhibits.
Qualifications
Education
B.S. in Civil Engineering, Construction Management, or relevant experience which equates to this degree.
P.E. license, Certified Construction Manager, Planning and Scheduling Profession, or similar, certification preferred.
Skills and Abilities
Experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts.
Experience drafting expert reports and deliverables.
Proficient in Oracle P6 required and experienced with Microsoft Project desired.
Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration.
Ability to relate technical knowledge to a non-technical audience.
Proficiency in reading/understanding construction plans and specifications.
Proficiency with Microsoft Office software programs including Word, Excel, and PowerPoint.
Experience providing training, supervision, proposal development, and business development desired.
Occasional overnight travel may be required.
STATUS:
Full-time
BENEFITS:
Competitive compensation with opportunities for semi-annual bonuses
Generous Paid Time Off and holiday schedules
100% Employer paid medical, dental, vision, life, AD&D, and disability benefits (for individual)
Health Savings Account with company contribution
401(k)/Roth 401(k) plan with company match
Tuition Assistance and Student Loan Reimbursement
Numerous Training and Professional Development opportunities
Wellness Program & Fitness Program Reimbursement
Applicants must be authorized to work in the U.S. without sponsorship.
MBP is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Protected veterans and individuals with disabilities are encouraged to apply.
Auto-ApplyField Claims Adjuster
Claim specialist job in Washington, DC
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
Claims Examiner - Auto/Bodily Injury
Claim specialist job in Alexandria, VA
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Claims Examiner - Auto/Bodily Injury
**PRIMARY PURPOSE** : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
+ Responsible for litigation process on litigated claims.
+ Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
+ Reports large claims to excess carrier(s).
+ Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
+ Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
+ Communicates claim action/processing with insured, client, and agent or broker when appropriate.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.
**Experience**
Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
**Skills & Knowledge**
+ In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws
+ Knowledge of medical terminology for claim evaluation and Medicare compliance
+ Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs.
+ Strong oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Strong organizational skills
+ Strong interpersonal skills
+ Good negotiation skills
+ Ability to work in a team environment
+ Ability to meet or exceed Service Expectations
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical:** Computer keyboarding, travel as required
**Auditory/Visual:** Hearing, vision and talking
_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $75,000_ _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Independent Insurance Claims Adjuster in Arlington, Virginia
Claim specialist job in Arlington, VA
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
Auto-ApplySenior Veterans Benefits Claims Analyst
Claim specialist job in Haymarket, VA
Travel Requirement
Less than 10 percent.
VA Background Investigation Requirement
Candidate must hold or be eligible to undergo and pass a mandatory government background check.
Candidate must pass a pre-employment drug screening.
U.S. Citizenship may be required by certain federal customers.
Best Value Technology, Inc. (BVTI) is an established Service-Disabled Veteran-Owned Small Business (SDVOSB) with a 20-year track record delivering innovative data and technology solutions to the federal government.
BVTI is seeking an individual with strong experience in VBA Claims Processing to support an anticipated contract focused on delivering veteran benefits claims processing improvement efforts to programs within the Department of Veteran's Affairs. The candidate will provide subject matter expertise on VA disability compensation and/or pension claims processes, as well as VBA's documentation processes and workflows for these benefits. The candidate will also provide training and collaborate with Team Leaders supporting multiple project teams, providing direct support to the Department of Veterans Affairs, and contributing knowledge of VBA claims operations across various operational units. The ideal candidate will be a self-motivator who is attentive to details and possesses the training and problem-solving skills required to independently assess and advise a team, ensuring critical deadlines are met.
CLAIMS ADJUSTER AS COMMERCIAL SALES ADVISOR
Claim specialist job in Chantilly, VA
Job Description
Award Winning Northern Virginia Insurance Agency looking for CLAIMS ADJUSTER AS COMMERCIAL SALES ADVISOR
PRIMARY ROLE:
An award-winning independent insurance agency with Virginia locations in Chantilly and Williamsburg, is looking for an experienced claims adjuster for a position as a commercial lines sales advisor. This position is available at both of our locations. We gain the trust of our clients by educating and advising them on risk and claims management issues important to them. They place coverage with our agency because we educate them on facts and strategies no one else has. Your role would be advisor, educator and claims consultant. Our process, combined with remarkable market opportunities, will allow you to use your claims experience for great accomplishments on the sales side. We are confident that our process will lead you to success. Our carriers include Erie, Travelers, the Hartford, CNA, Nationwide, Donegal, Berkley, Penn National, Harford Mutual, Accident Fund, and more. Among our many accomplishments, we are a Donegal Group Signature Agency and Agency of Distinction, and an Erie Commercial Elite Agency, signifying a top 10 ranking in commercial business company wide. We need you as a key person to help us to continue our success and build upon it.
This is an extraordinary opportunity to use your claims background and expertise to achieve success in Commercial Sales
QUALIFICATIONS & EDUCATION:
At least two years carrier claims experience
Ability to learn risk and claims management processes and strategies and communicate them effectively with insureds and prospects.
Excellent verbal and written communication skills. Sales and prospecting methodology and training will be provided.
Two or four college degree desirable. A proven track record in claims services considered in lieu.
CLAIMS ADJUSTER AS COMMERCIAL SALES ADVISOR
Claim specialist job in Chantilly, VA
Award Winning Northern Virginia Insurance Agency looking for CLAIMS ADJUSTER AS COMMERCIAL SALES ADVISOR
PRIMARY ROLE:
An award-winning independent insurance agency with Virginia locations in Chantilly and Williamsburg, is looking for an experienced claims adjuster for a position as a commercial lines sales advisor. This position is available at both of our locations. We gain the trust of our clients by educating and advising them on risk and claims management issues important to them. They place coverage with our agency because we educate them on facts and strategies no one else has. Your role would be advisor, educator and claims consultant. Our process, combined with remarkable market opportunities, will allow you to use your claims experience for great accomplishments on the sales side. We are confident that our process will lead you to success. Our carriers include Erie, Travelers, the Hartford, CNA, Nationwide, Donegal, Berkley, Penn National, Harford Mutual, Accident Fund, and more. Among our many accomplishments, we are a Donegal Group Signature Agency and Agency of Distinction, and an Erie Commercial Elite Agency, signifying a top 10 ranking in commercial business company wide. We need you as a key person to help us to continue our success and build upon it.
This is an extraordinary opportunity to use your claims background and expertise to achieve success in Commercial Sales
QUALIFICATIONS & EDUCATION:
At least two years carrier claims experience
Ability to learn risk and claims management processes and strategies and communicate them effectively with insureds and prospects.
Excellent verbal and written communication skills. Sales and prospecting methodology and training will be provided.
Two or four college degree desirable. A proven track record in claims services considered in lieu.
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