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Experienced Outside Property Claim Representative
Travelers Insurance Company 4.4
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?**
Come learn more about this role at our Open House Event on 1/14!
Click here to register - **************************************************************************************
This position could be eligible for a sign on bonus.
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 ******************************************************** .
$67k-110.6k yearly 60d+ ago
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Experienced Outside Property Claim Representative - Washington, DC
Msccn
Claim specialist job in Washington, DC
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.
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.
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
This position could be eligible for a sign on bonus.
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.
Additional Qualifications/Responsibilities
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.
$67k-110.6k yearly 9d ago
Claims Specialist
Healthcare Legal Solutions LLC
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.
$41k-72k yearly est. Auto-Apply 60d+ ago
Senior Claims Analyst
Coast and Harbor Associates
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
The Senior ClaimsSpecialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior ClaimsSpecialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads.
This role is remote.
Grade 13-14 blended role handling all claims segments.
Workers compensation experience should be residing in Maryland.
Responsibilities:
Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Refers to claim to subrogation group or Special Investigations Unit as appropriate.
Assesses 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.
Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company.
Acts as senior technical professional on team, assisting team members with escalated issues. Mentors and trains new team members. Participates in Quality Review process.
Participates in conducting Suit Committees, Roundtables, Arbitrations, Mediations, field investigations and may assist in conducting closed file reviews.
Performs other duties as assigned.
Qualifications
Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required.
Demonstrated leadership ability and time management skills to delegate work appropriately and organize resources effectively.
Demonstrates an expert level knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally acquired through a bachelor`s degree or equivalent training plus 4 to 6 years directly related work experience (at least two of which should ordinarily be in a team leader capacity).
Licensing required in some states.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
California
Los Angeles Incorporated
Los Angeles Unincorporated
Philadelphia
San Francisco
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$75k-101k yearly est. Auto-Apply 14d ago
Insurance Specialist
Radiology Partners 4.3
Claim specialist job in Arlington, VA
RAYUS now offers DailyPay! Work today, get paid today!
RAYUS Radiology is looking for an Insurance Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As an Insurance Specialist, you will provide expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information. Develops and maintains positive relationships with referring physicians and patients. This is a full-time position working 8:00 AM - 4:30 PM.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
(65%) Insurance Administration
Prioritizes work load to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority
Determines if patient's insurance is a part of the provider network
Makes outgoing calls to insurance companies for pre-certification or any authorization
Receives pre-authorization from patients and/or insurance companies and documents
Contacts patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed
Accurately enters a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system
Maintains positive interactions with referring offices, patients and staff
Backs up front desk reception and scheduling area as needed
(30%) Price Quotes
Completes payor-related information i.e., payor, payor class, date of appointment
Obtains all workers compensation approvals from insurance companies prior to scheduled exam
Obtains signs and symptoms in order to support medical necessity
(5%) Completes other duties as assigned
$36k-50k yearly est. 3d ago
PL CLAIM SPECIALIST
Sedgwick 4.4
Claim specialist job in Washington, DC
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
PL CLAIMSPECIALIST
**PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
+ Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
+ Negotiates claim settlement up to designated authority level.
+ Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
+ Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
+ Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
+ Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
+ Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
+ Represents Company in depositions, mediations, and trial monitoring as needed.
+ Communicates claim activity and processing with the client; maintains professional client relationships.
+ Ensures claim files are properly documented and claims coding is correct.
+ Refers cases as appropriate to supervisor and management.
+ Delegates work and mentors assigned staff.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred.
**Experience**
Six (6) years of claims management experience or equivalent combination of education and experience required.
**Skills & Knowledge**
+ In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business
+ Excellent oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Analytical and interpretive skills
+ Strong organizational skills
+ Excellent negotiation skills
+ Good interpersonal skills
+ Ability to work in a team environment
+ Ability to meet or exceed Performance Competencies
**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 $117,000 - $125,000. 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.
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**
$41k-58k yearly est. 7d ago
Claims Examiner. Workers' Comp
Amergis
Claim specialist job in Columbia, MD
Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions.
The Claims Examiner Workers' Comp understands and participates in every aspect of the WC claim process. Working in a team approach, the Claims Examiner WC will make decisions concerning reserve adjustments, develop a plan of action, and determine claim resolution. The Claims Examiner WC also works with the Adjusters, WC Manager, and fellow Amergis team members.
Essential Duties and Responsibilities:
+ Manages full cycle claim management for assigned states to resolution
+ Participates in conference calls with local offices, third-party administrators (TPAs), medical providers, and other Amergis employees in order to communicate status plans
+ Ensures legal deadlines are met
+ Monitors TPA's file resolution plans
+ Represents Amergis in depositions, mediation, and conference calls regarding assigned claim files
+ Provides analysis on the financial aspects of assigned claims files
+ Provides excellent customer service to injured workers
+ Prepares WC claim reports for department management team
+ Reviews, identifies and makes recommendations for maintaining control and/or reducing the claims experience (loss history) of the company
+ Authorizes or revise reserve requests
+ Coordinates with Benefits team during employee's absence
+ Coordinates with state programs and internal departments for transitional duty
+ Educates branch offices about all aspects of Workers' Compensation
+ Assists Manager in achieving overall department goals
+ Performs other duties as assigned/necessary
Minimum Requirements:
+ College degree preferred; or equivalent work experience
+ 5 to 10 years of Workers' Compensation experience preferred
+ Some legal experience strongly preferred
+ Good organizational skills and attention to detail
+ Ability to work independently and cooperatively in a team environment
+ Ability to communicate effectively and provide excellent customer service with individuals at all levels of the organization
+ Computer proficiency, including Microsoft Office applications, required
+ Prior experience performing internet research
+ Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language is required
At Amergis Healthcare Staffing, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:
Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical), Health Advocate Employee Assistance Program, Health Savings Account , 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death and Dismemberment Insurance, Voluntary Life and Accidental Death and Dismemberment Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Accident Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance, Pet Insurance, MilkStork, Transportation Benefit, Educational Assistance Program, College Partnership Program, Paid Time Off/Company Holidays
*Benefit eligibility is dependent on employment status.
Amergis Healthcare Staffing is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
This posting will remain active on job boards for 5 days from date of posting unless there is a good faith basis to extend the posting date.
Please note that this pay range represents a good faith estimate of the compensation that will be offered for this position based on the circumstances. The actual pay offered to a successful candidate will take into account a wide range of factors, including but not limited to location, experience, and other variable factors.
"Pursuant to the San Francisco Fair Chance Initiative, Amergis will consider for employment qualified applicants with arrest and conviction records"
$37k-65k yearly est. 38d ago
Claims Examiner
Harriscomputer
Claim specialist job in Washington, DC
Responsibilities & Duties:Claims Processing and Assessment:
Evaluate incoming claims to determine eligibility, coverage, and validity.
Conduct thorough investigations, including reviewing medical records and other relevant documentation.
Analyze policy provisions and contractual agreements to assess claim validity.
Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
Ensure compliance with company policies, procedures, and regulatory requirements.
Maintain accurate records and documentation related to claims activities.
Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
Identify opportunities for process improvement and efficiency within the claims department.
Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
Generate reports and provide data analysis on claims trends, processing times, and outcomes.
Contribute to the development of management reports and presentations regarding claims operations.
$29k-51k yearly est. Auto-Apply 32d ago
Claims Examiner
Healthcare Support Staffing
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
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.
$42k-73k yearly est. Auto-Apply 29d ago
Claims Reviews Specialist (Workers Compensation)
Aerotek 4.4
Claim specialist job in Severn, MD
**Aerotek has an immediate opening for a Claims Review Specialist (Workers Compensation) at the corporate office in Hanover, MD.** Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek's workers compensation program to ensure the maximum cost containment. Seek to ensure that Third Party Administrator (TPA) is managing claims efficiently.
**ESSENTIAL FUNCTIONS**
+ Conducts and properly document all incident /accident investigations into our RIMIS system. Ensures the TPA thoroughly and properly investigates all initial claims. Monitor to ensure that TPA follows appropriate state workers compensation laws and defenses
+ Within the scope of authority, reviews and authorizes worker's compensation settlement offers to be made by the TPA
+ Effectively monitors medical and disability claim authorizations and payments to ensure their appropriate and accurate
+ Reviews costs associated with all claims handling and develops strategies to improve performance
+ Works with TPA to move claims toward closure
+ Partners with Safety, Human Resources and Corporate Legal to drive claims management
+ Makes appropriate referrals to outside vendors such as defense attorneys, nurse case managers and investigator
+ Collect OSHA data and update OSHA field in GRA
+ Coordinates the colleague's release to transitional duty with the Return to Work Specialist and the Field Office;
+ Obtains evidence in contested and/or litigated claims to assist outside attorneys to defend claim and to prepare for trial
+ Initiates subrogation where appropriate with management's authorization
+ Prepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of Actions
+ Review reserves and provide authorization to TPA, where appropriate within authority
+ Reviews performance of external vendors in the areas of claims administration, manages litigation and make recommendation to Workers Compensation Compliance Supervisor for adjustments
+ Monitors and reviews workers compensation claims and the claims processing; identifies claims management trends and inefficiencies and make recommendation as needed
+ Participates in developing strategies to reduce claims frequency and severity
+ Establishes and maintains a file and diary on all open claims
+ Participates in communicating claims trends to Regional Safety Manager
+ Working with Compliance Supervisor to develop and conduct training to field offices regarding workers compensation issues and process
+ Attends training sessions, conferences and workshops to keep abreast of current practices, programs and legal issues for the purpose of conveying and/or gathering information required to perform functions
+ Authority level for settlements up to $70,000
+ Authority level for reserves up to $80,000
**QUALIFICATIONS**
+ High School Diploma required
+ 3 years work experience in insurance, workers compensation claim management or risk management or
+ Ability to learn TPA system & generate requested reports
Per Pay Transparency Acts:
The range for this position is $60,000 - $80,000 + annual bonus potential of $4,000
Benefits are subject to change and may be subject to specific elections, plan, or program terms. This role is eligible for the following:
Medical, dental & vision
401(k)/Roth
Insurance (Basic/Supplemental Life & AD&D)
Short and long-term disability
Health & Dependent Care Spending Accounts (HSA & DCFSA)
Transportation benefits
Employee Assistance Program
Tuition Assistance
Time Off/Leave (PTO, Primary Caregiver/Parental Leave)
Connect With Us! (**********************************************************************************************************************************************************
Cookie Notice (***************************************** Cookie Settings Privacy Notices (******************************************* CA Notice at Collection CA Notice at Collection (for Employees and Job Applicants) (************************************************************************************ Your Privacy Choices
Our People Are Everything. Aerotek Inc. provides staffing and services solutions in manufacturing, logistics, construction, aviation, facilities and maintenance. We provide the expertise, solutions and people required to rise to the challenges of North American industry. Headquartered in Hanover, Md., Aerotek operates a unified network of over 200 offices across North America, supporting more than 14,000 clients each year. Aerotek is an operating company within Allegis Group, a global leader in talent solutions. To learn more, visit: Aerotek.com .
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call ************ or email accommodation@aerotek.com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.
**Job ID** _2026-13045_
**Category** _Risk & Compliance_
**Location : Location** _US-MD-Hanover_
$23k-30k yearly est. 5d ago
Independent Insurance Claims Adjuster in Arlington, Virginia
Milehigh Adjusters Houston
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.
$45k-57k yearly est. Auto-Apply 60d+ ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claim specialist job in Arlington, VA
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.
$44k-56k yearly est. Auto-Apply 41d ago
CLAIMS ADJUSTER AS COMMERCIAL SALES ADVISOR
Coverage, Inc.
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.
$44k-57k yearly est. 26d ago
CLAIMS ADJUSTER AS COMMERCIAL SALES ADVISOR
Keystone Insurers Group, Inc. 3.9
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.
$44k-55k yearly est. Auto-Apply 60d+ ago
Training and Certification Specialist - Red Team
Oak Grove Technologies, LLC 4.3
Claim specialist job in Fort Belvoir, VA
Oak Grove Technologies, LLC, a dynamic and fast-growing federal contractor, is seeking a highly skilled and motivated Red Team Training and Certification Specialist to join our team! In this role you will support certification and accreditation efforts with a DoD Cyber Red Team program, oversee training curricula of Cyber Red Team personnel, and develop training courses for red cyber operations at the novice, advanced, and master level.
Oak Grove Technologies is a Service-Disabled Veteran-Owned Business based in Raleigh, NC, with a Test and Training Center located near Fort Bragg and Camp Mackall. With over 20 years of expertise in training, consulting, technology, and operational support, the company provides services to the military, government, and law enforcement. Committed to excellence, innovation, and national security, Oak Grove Technologies fulfills federal defense contracts and actively supports veterans through sponsorships and events. Driven by its mission-focused approach, the company seeks top talent to develop impactful solutions.
Oak Grove Technologies offers a competitive compensation and benefits package.
Requirements
What You'll Be Doing:
* Coordinate and support the Cyber Red Team through the Certification and Accreditation (C&A) process.
* Perform technical writing to support documentation, reporting, and compliance requirements.
* Contribute to policy development related to cyber operations and red team activities.
* Develop, implement, and maintain tracking dashboards to monitor progress, performance, and key metrics.
* Oversee training curricula for Cyber Red Team personnel.
* Develop and deliver training courses in red cyber operations at the novice, advanced, and master levels.
* Stay current on emerging trends and developments in red cyber operations, offensive operations, and defensive cybersecurity practices across government and industry.
* Coordinate internal and external training for Cyber Red Team personnel.
What Desired Skills You'll Bring:
* Experience working with a DoD Certified and Accredited Cyber Red Team program.
* Experience in policy development, adjudication, and/or writing procedures to comply with specific policies and standards.
* Experience in developing and maintaining tracking dashboards.
* Experience in developing cybersecurity or cyber operations curricula.
What Required Skills You'll Bring:
* U.S. Citizenship and an active Top Secret clearance with SCI eligibility are required. (Highly qualified candidates with a Secret Clearance may also be considered.)
* 5+ years of relevant experience.
* Familiarity with red teaming, mission assurance, cyberspace operations, and/or information assurance.
* Strong communication skills, high attention to detail, and proficiency in Microsoft Office Suite.
* Proven technical writing experience.
* Willingness and ability to travel 15% (CONUS/OCONUS).
Security Clearance Requirements:
U.S. Citizenship and an active Top Secret clearance with SCI eligibility are required. (Highly qualified candidates with a Secret Clearance may also be considered.)
Compensation and Benefits:
Competitive Pay, PTO, Health Benefits.
If you are a highly motivated Red Team Training and Certification Specialist and ready to apply your expertise in a high-impact role, we encourage you to join our mission.
Oak Grove Technologies is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.
Oak Grove Technologies, LLC participates in E-Verify to determine an individual's identity and employment eligibility to work in the United States. E-Verify is a service of DHS and SSA.
$60k-99k yearly est. Auto-Apply 60d+ ago
DNA Examiner
Ideal Innovations, Inc. 4.4
Claim specialist job in Quantico, VA
Highlights:
You'll be…
Joining a dynamic forensics team with many opportunities to grow professionally
Working with other forensic experts in various fields to support the FBI and TEDAC missions
Experiencing a unique opportunity to work with the FBI laboratory
Obtaining some or enhancing your experience working in a fully functional government laboratory working closely with other forensics experts
Typical Day:
Working in a fully operational forensic laboratory. Receiving evidence, examining evidence, processing evidence, analyzing results and documenting findings.
Tasks:
Receive and account for boxes of evidence and related materials from contributors.
Visually inspect and process evidence and related materials for mitochondrial and / or nuclear DNA as appropriate; isolate and collect materials for analysis from appropriate areas of various evidentiary materials; prepare samples for instrumental analysis; and associate samples with other existing submissions (as appropriate).
Make an initial determination of the types of samples suitable for analysis and select appropriate protocols for conducting the examination of materials.
Conduct DNA examinations on items of evidence.
Calibrate instruments used for forensic examinations and analysis.
Maintain proper chain-of-custody of all forensic material under examination
Follow all QA/QC procedures, protocols and adhere to policies and procedures related to its accreditation and safety standards.
Conduct DNA analysis and comparisons of profiles or sequences as appropriate.
Author forensic reports to include all laboratory notes and supporting documentation.
Provide all generated profiles or sequences in a format necessary for inclusion, storage, and searching of the appropriate DNA databases.
Conduct technical and administrative reviews of all work.
Required Qualifications:
Education:
BA in Biology, Chemistry, or related field of biological science from an accredited university/college.
Successfully completed coursework in the following subject areas: nine (9) semester hours in the fields of biochemistry, genetics, and molecular biology as well as coursework and/or training in statistics and/or population genetics as it applies to forensic DNA analysis.
Experience:
At least one (1) year as a DNA Examiner in an accredited forensic laboratory.
Skills:
Basic computer skills, to include use of Microsoft Office programs (Word, Excel, Access, and Outlook); organization skills; flexibility and adaptability to changing priorities; demonstrated ability to study and pass training, examination, and testing assessments; verbal and written communication skills
Clearance: Ability to obtain US Top Secret Clearance (US citizenship required)
Shift: Normal day shift
Location: Quantico, VA
Ideal Innovations, Inc. is an Equal Opportunity Employer:
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or veteran status.
Ideal Innovations, Inc. is a VEVRAA Federal Contractor
.
Benefits:
Competitive salary
Dental insurance
Health insurance
Opportunity for advancement
Paid time off
Signing bonus
Vision insurance
SIGNING BONUS $3000 Psychiatric Rehabilitation Program (PRP) Specialist
Reports to: Clinical Coordinator
Classification: Exempt
Status: Full-Time, W-2 Employee
Work Location: On-Site
Overview:
At K&I Healthcare Services, our primary goal is to empower individuals, families, and communities to take charge of their mental well-being. K&I Healthcare Services has three Maryland facilities located in Waldorf, Baltimore, and Landover. K&I Healthcare Services supports the recovery of individuals with mental illness and substance abuse. We are a collective of like-minded individuals, who emphasize the importance of the clinician along with the client. Our team prioritizes our clients. We approach everyone with compassion and an open mind to encourage them to thrive in their healing process.
Position Purpose: The Psychiatric Rehabilitation Program (PRP) Director is responsible for the day-to-day oversight and administration of the PRP in accordance with Maryland's COMAR 10.63 and other relevant regulatory frameworks, including guidelines from the Behavioral Health Administration (BHA), Medicaid, and accreditation bodies. The Director ensures that the program delivers high-quality rehabilitative services to individuals with serious mental illness, fosters recovery and community integration, and complies with all standards set forth by COMAR and the Community Rehabilitation and Affiliates of Maryland (CRAF). Duties and Responsibilities:· Provide overall leadership and strategic direction for the Psychiatric Rehabilitation Program.· Ensure full compliance with COMAR 10.63.03 (PRP regulations) and all applicable Medicaid and Behavioral Health Administration standards.· Oversee the development and implementation of individualized rehabilitation plans for each participant.· Supervise PRP staff and ensure all personnel meet qualification and training requirements per COMAR and CRAF guidelines.· Maintain documentation and records to ensure accuracy, confidentiality, and compliance with state regulations and audits.· Monitor and ensure compliance with quality assurance, incident reporting, and program evaluation procedures.· Coordinate with clinical providers, case managers, and other community services to support continuity of care.· Facilitate internal audits, prepare for external audits, and develop corrective action plans as needed.· Manage the PRP budget, billing, and reporting in accordance with Medicaid billing standards.· Develop and implement policies and procedures that reflect COMAR and CRAF expectations.· Represent the agency in professional meetings and forums, including those hosted by BHA or CRAF.· Ensure that all direct care staff receive and maintain appropriate PRP training, including but not limited to documentation, ethics, and recovery-based practices.· Prepare productivity reports to ensure agency benchmarks are being met.· Collaborate with internal and external treatment team providers and maintain a multi-systemic approach to ensuring the dissemination of quality care of each individual being served.· Identify and facilitate enrollment of all eligible clients into the program. Assist the Clinical Director in identifying and marketing to relevant referral sources that could benefit from PRP.· Maintain accurate and current information on all client databases.· Maintained consistent and open communication with the Clinical Director on all relevant and pertinent clinical and administrative issues related to the program.
Required Education, Licensing:· Certified Psychiatric Rehabilitation Practitioner (CPRP/CFRP)· Master's Degree in Social Science or related field;· Licensure in the social science and/ or related discipline (LGPC/LCPC or LGSW/LCSW)· Two (2) years of experience in administrative management within a behavioral health setting.
Qualifications: · Demonstrated knowledge of CARF standards, COMAR regulations, HIPAA compliance, and Maryland Medicaid billing requirements. · Require strong attention to detail and follow through with time sensitive matters · Excellent leadership, communication, and team management skills. · Experience with clinical documentation standards, Medicaid regulations, and behavioral health compliance. · Strong organizational, communication, and teaching skills. · Proficiency with Electronic Health Records (EHRs) and compliance documentation. · HIPAA training required within 30 days of hire · Respect for and adherence to client confidentiality and HIPAA compliance · Ability to work well independently and collaboratively · CPR/First Aid Certification Preferred (or willing to obtain within first 6 months of hire)
Working Conditions and Environment:· Maintain a clean, safe, and drug-free working environment · Must pass a criminal background check, drug screening & TB testing · Always maintain a professional appearance and demeanor · Office work includes commuter work, documentation, planning, and team meetings
Compensation: $70,000 - $90,000
Weekly Schedule: · Employment Type: Full-time 40hrs weekly, W-2 Employee · Weekly Schedule: Monday through Wednesday, 9:00 AM - 6:00 PM (1-hour mandatory lunch break) · Attendance in team meetings as appropriate
Physical Requirements The position requires clear and articulate speech and ability to hear. Required to sit for long periods of time, as well as reading and typing on the computer.
Equal Opportunity Employer K&I Healthcare Services is an equal opportunity employer. We value a diverse workforce and an inclusive culture. We encourage applications from all qualified individuals and do not discriminate, and will not tolerate discrimination, on the basis of race, ethnicity, color, religion, sex, pregnancy, gender, gender identity or expression, national origin, sexual orientation, age, national origin or ancestry, genetic information, political affiliation, physical or mental disability, military or veteran status, or any other protected status under federal, state or local law. Our employment decisions are solely made according to qualifications for the positions. Compensation: $70,000.00 - $90,000.00 per year
Job DescriptionBenefits:
Competitive salary
Dental insurance
Health insurance
Opportunity for advancement
Paid time off
Signing bonus
Vision insurance
SIGNING BONUS $3000
Psychiatric Rehabilitation Program (PRP) Specialist
Reports to: Clinical Coordinator
Classification: Exempt
Status: Full-Time, W-2 Employee
Work Location: On-Site
Overview:
At K&I Healthcare Services, our primary goal is to empower individuals, families, and communities to take charge of their mental well-being. K&I Healthcare Services has three Maryland facilities located in Waldorf, Baltimore, and Landover. K&I Healthcare Services supports the recovery of individuals with mental illness and substance abuse. We are a collective of like-minded individuals, who emphasize the importance of the clinician along with the client. Our team prioritizes our clients. We approach everyone with compassion and an open mind to encourage them to thrive in their healing process.
Position Purpose:
The Psychiatric Rehabilitation Program (PRP) Director is responsible for the day-to-day oversight and administration of the PRP in accordance with Marylands COMAR 10.63 and other relevant regulatory frameworks, including guidelines from the Behavioral Health Administration (BHA), Medicaid, and accreditation bodies. The Director ensures that the program delivers high-quality rehabilitative services to individuals with serious mental illness, fosters recovery and community integration, and complies with all standards set forth by COMAR and the Community Rehabilitation and Affiliates of Maryland (CRAF).
Duties and Responsibilities:
Provide overall leadership and strategic direction for the Psychiatric Rehabilitation Program.
Ensure full compliance with COMAR 10.63.03 (PRP regulations) and all applicable Medicaid and Behavioral Health Administration standards.
Oversee the development and implementation of individualized rehabilitation plans for each participant.
Supervise PRP staff and ensure all personnel meet qualification and training requirements per COMAR and CRAF guidelines.
Maintain documentation and records to ensure accuracy, confidentiality, and compliance with state regulations and audits.
Monitor and ensure compliance with quality assurance, incident reporting, and program evaluation procedures.
Coordinate with clinical providers, case managers, and other community services to support continuity of care.
Facilitate internal audits, prepare for external audits, and develop corrective action plans as needed.
Manage the PRP budget, billing, and reporting in accordance with Medicaid billing standards.
Develop and implement policies and procedures that reflect COMAR and CRAF expectations.
Represent the agency in professional meetings and forums, including those hosted by BHA or CRAF.
Ensure that all direct care staff receive and maintain appropriate PRP training, including but not limited to documentation, ethics, and recovery-based practices.
Prepare productivity reports to ensure agency benchmarks are being met.
Collaborate with internal and external treatment team providers and maintain a multi-systemic approach to ensuring the dissemination of quality care of each individual being served.
Identify and facilitate enrollment of all eligible clients into the program. Assist the Clinical Director in identifying and marketing to relevant referral sources that could benefit from PRP.
Maintain accurate and current information on all client databases.
Maintained consistent and open communication with the Clinical Director on all relevant and pertinent clinical and administrative issues related to the program.
Required Education, Licensing:
Certified Psychiatric Rehabilitation Practitioner (CPRP/CFRP)
Masters Degree in Social Science or related field;
Licensure in the social science and/ or related discipline (LGPC/LCPC or LGSW/LCSW)
Two (2) years of experience in administrative management within a behavioral health setting.
Qualifications:
Demonstrated knowledge of CARF standards, COMAR regulations, HIPAA compliance, and Maryland Medicaid billing requirements.
Require strong attention to detail and follow through with time sensitive matters
Excellent leadership, communication, and team management skills.
Experience with clinical documentation standards, Medicaid regulations, and behavioral health compliance.
Strong organizational, communication, and teaching skills.
Proficiency with Electronic Health Records (EHRs) and compliance documentation.
HIPAA training required within 30 days of hire
Respect for and adherence to client confidentiality and HIPAA compliance
Ability to work well independently and collaboratively
CPR/First Aid Certification Preferred (or willing to obtain within first 6 months of hire)
Working Conditions and Environment:
Maintain a clean, safe, and drug-free working environment
Must pass a criminal background check, drug screening & TB testing
Always maintain a professional appearance and demeanor
Office work includes commuter work, documentation, planning, and team meetings
Compensation: $70,000 $90,000
Weekly Schedule:
Employment Type: Full-time 40hrs weekly, W-2 Employee
Weekly Schedule: Monday through Wednesday, 9:00 AM 6:00 PM (1-hour mandatory lunch break)
Attendance in team meetings as appropriate
Physical Requirements
The position requires clear and articulate speech and ability to hear. Required to sit for long periods of time, as well as reading and typing on the computer.
Equal Opportunity Employer
K&I Healthcare Services is an equal opportunity employer. We value a diverse workforce and an inclusive culture. We encourage applications from all qualified individuals and do not discriminate, and will not tolerate discrimination, on the basis of race, ethnicity, color, religion, sex, pregnancy, gender, gender identity or expression, national origin, sexual orientation, age, national origin or ancestry, genetic information, political affiliation, physical or mental disability, military or veteran status, or any other protected status under federal, state or local law. Our employment decisions are solely made according to qualifications for the positions.
How much does a claim specialist earn in Alexandria, VA?
The average claim specialist in Alexandria, VA earns between $31,000 and $92,000 annually. This compares to the national average claim specialist range of $27,000 to $67,000.
Average claim specialist salary in Alexandria, VA
$53,000
What are the biggest employers of Claim Specialists in Alexandria, VA?
The biggest employers of Claim Specialists in Alexandria, VA are: