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  • Michigan Homeowners Claim Representative II

    The Auto Club Group 4.2company rating

    Claim specialist job in Fargo, ND

    Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager IWhat you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss. Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Employees assigned to the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update. Supervisory Responsibilities: None How you will benefit: A competitive annual salary between $64,000 - $72,000 ACG offers excellent and comprehensive benefits packages, including: 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 We're looking for candidates who:Required Qualifications (these are the minimum requirements to qualify) Education: Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members. Experience: One year of experience or equivalent training in the following: Negotiating claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advance knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Knowledge of building construction and repair techniques Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG Claim policies, procedures and guidelines Work within assigned ACG Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Research, analyze, and interpret subrogation laws in various states Strong negotiating skills Ability to work outside normal business hours as needed Preferred Qualifications: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Xactimate software experience/training or experience in an equivalent software Claims adjuster experience specifically in home/property claims preferred Experience working within a customer service setting Call center experience or experience handling high volume calls preferred, but not required Excellent communication skills both oral and written Experience working within an insurance or claims-based role for one year or more Full claims cycle experience preferred Work Environment This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. 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 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.
    $25k-29k yearly est. 1d ago
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  • Benefit and Claims Analyst

    Highmark Health 4.5company rating

    Claim specialist job in Bismarck, ND

    This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements. **ESSENTIAL RESPONSIBILITIES** + Coordinate, analyze, and interpret the benefits and claims processes for the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties. + Investigate benefit/claim information and provide technical guidance to clinical and claims staff regarding the final adjudication of complex claims. Research and investigate conflicting benefit structures in multi-payor situations. + Provide prompt, thorough and courteous replies to written, electronic and telephonic inquiries from internal/external customers (e.g., clinical, sales/marketing, providers, vendors, etc.) Follow-up on all inquiries in accordance with corporate and regulatory standards and timeframes. + Must have the ability to apply knowledge about the business operations of the area within the defined scope of the job. Assess benefit limitations in accordance with Medical Policy Guidelines. + Monitor and identify claim processing inaccuracies. Bring trends to the attention of management. + Assist with handling inbound calls and strive to resolve customer concerns received via telephone or written communication. + Work independently of support, frequently utilizing resources to resolve customer inquiries. + Collaborate with Clinical Strategy, Sales/Client Management and other areas across the enterprise to respond to client questions and concerns about care/case management and high-cost claimants. + Gather information and develop presentation/training materials for support and education. + Other duties as assigned or requested. **EDUCATION** **Required** + High School or GED **Substitutions** + None **Preferred** + Associate's degree in or equivalent training in Business or a related field **EXPERIENCE** **Required** + 3 years of customer service, health insurance benefits and claims experience. + Working knowledge of Highmark products, systems (e.g., customer service and clinical platforms, knowledge resources, etc.), operations and medical policies + PC Proficiency including Microsoft Office Products + Ability to communicate effectively in both verbal and written form with all levels of employees **Preferred** + Working knowledge of medical procedures and terminology. + Complex claim workflow analysis and adjudication. + ICD9, CPT, HPCPS coding knowledge/experience. + Knowledge of Medicare and Medicaid policies **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services + Knowledge of administrative and clerical procedures and systems such as managing files and records, designing forms and other office procedures + The ability to take direction, to navigate through multiple systems simultaneously + The ability to interact well with peers, supervisors and customers + Understanding the implications of new information for both current and future problem-solving and decision-making + Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate and not interrupting at inappropriate times + Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems + Ability to solve complex issues on multiple levels. + Ability to solve problems independently and creatively. + Ability to handle many tasks simultaneously and respond to customers and their issues promptly. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $21.53 **Pay Range Maximum:** $32.30 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273827
    $21.5-32.3 hourly 34d ago
  • Workers' Compensation Claims Specialist (Remote - MN, SD, WI, PA, IA)

    HMA Group Holdings 3.7company rating

    Claim specialist job in South Dakota

    Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers' Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred. Essential Responsibilities: Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves Workers' Compensation claims. Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching coverage issues. Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. Generates checks for indemnity and medical payments daily. Develops and monitors consistency in procedural matters of the claims handling process with CRS. Compiles and interprets Workers' compensation reports on designated accounts, as requested. Ability to adjudicate lost time claims. Participates in claim reviews and attends Risk Control Workshops when requested by agency partners or insureds. These could be in person or by phone. Performs special projects and other duties as requested. Qualifications: Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Willingness and ability to obtain additional state specific licenses during duration of employment as needed. Experience: 2-4 years claims experience with strong background in Workers' Compensation coverage. Technical Competencies: Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Here's a little bit about us: At Creative Risk Solutions, you'll be part of a collaborative, innovative team that values trust, communication, and client focus. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth within the Holmes Murphy family. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! The salary range for this role is $45,800- $78,800. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development. Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $45.8k-78.8k yearly Auto-Apply 22d ago
  • Workers' Compensation Claims Specialist (Remote - MN, SD, WI, PA, IA)

    Holmes Murphy 4.1company rating

    Claim specialist job in South Dakota

    Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers' Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred. Essential Responsibilities: Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves Workers' Compensation claims. Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching coverage issues. Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. Generates checks for indemnity and medical payments daily. Develops and monitors consistency in procedural matters of the claims handling process with CRS. Compiles and interprets Workers' compensation reports on designated accounts, as requested. Ability to adjudicate lost time claims. Participates in claim reviews and attends Risk Control Workshops when requested by agency partners or insureds. These could be in person or by phone. Performs special projects and other duties as requested. Qualifications: Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Willingness and ability to obtain additional state specific licenses during duration of employment as needed. Experience: 2-4 years claims experience with strong background in Workers' Compensation coverage. Technical Competencies: Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Here's a little bit about us: At Creative Risk Solutions, you'll be part of a collaborative, innovative team that values trust, communication, and client focus. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth within the Holmes Murphy family. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! The salary range for this role is $45,800- $78,800. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development. Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $45.8k-78.8k yearly Auto-Apply 22d ago
  • Field Claims Adjuster

    EAC Claims Solutions 4.6company rating

    Claim specialist job in Bismarck, ND

    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.
    $43k-51k yearly est. Auto-Apply 39d ago
  • Independent Insurance Claims Adjuster in Bismarck, North Dakota

    Milehigh Adjusters Houston

    Claim specialist job in Bismarck, ND

    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.
    $42k-50k yearly est. Auto-Apply 60d+ ago
  • Claims Representative (IAP) - Workers Compensation Training Program

    Sedgwick 4.4company rating

    Claim specialist job in Bismarck, ND

    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 Representative (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _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 25.65/hr. 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. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ 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**
    $27k-33k yearly est. 28d ago
  • General Liability Claim Representative

    The Travelers Companies 4.4company rating

    Claim specialist job in Geddes, SD

    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? Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process. As of the date of this posting, Travelers anticipates that this posting will remain open until 4/1/2026. What Will You Do? Provide quality claim handling of General Liability claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. Determine claim eligibility, coverage, liability, and settlement amounts. Ensure accurate and complete documentation of claim files and transactions. Identify and escalate potential fraud or complex claims for further investigation. Coordinate with internal teams such as investigators, legal, and customer service, as needed. What Will Our Ideal Candidate Have? * Bachelor's Degree. * Three years of experience in insurance claims, preferably General Liability claims. * Experience with claims management and software systems. * Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. * Strong analytical and problem-solving skills. * Proven ability to handle complex claims and negotiate settlements. * Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. What is a Must Have? * One-year bodily injury liability claim handling experience, or one year of liability claim experience, or successful completion of Travelers Claim Representative training program. 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 5d ago
  • Claims Examiner

    Harriscomputer

    Claim specialist job in South Dakota

    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-44k yearly est. Auto-Apply 34d ago
  • Property Claim Representative

    IMT Insurance

    Claim specialist job in Sioux Falls, SD

    WHO WE ARE IMT is proud of our heritage and will never forget where our roots are firmly planted. Locally run from its office in West Des Moines, Iowa, IMT has been a Midwest company since it was founded in Wadena, Iowa in 1884. That s over 140 years! Today, IMT continues to offer a strong line of personal and commercial insurance products for which it has always been known, along with exceptional service for a competitive price. Our products are offered through Independent Agents throughout a six-state territory Iowa, Illinois, Minnesota, Nebraska, South Dakota and Wisconsin. PROPERTY CLAIM REPRESENTATIVE IMT Insurance is now taking applications for the position of a Property Claim Representative in Sioux Falls, South Dakota area. This individual will conduct investigations and attempt settlement of claims submitted by policyholders for property losses. The ideal candidate will be an analytical, detailed worker, who can manage time and work on multiple projects while maintaining accuracy and service. IMT Property Claims Representatives investigate and evaluate claims involving personal and commercial property to determine proper policy coverages and apply best claims practices to ensure accurate settlements in accordance with company guidelines. If you're interested in joining our claims department, apply online today! A DAY IN THE LIFE Conduct interviews with insureds, claimants and other interested parties Conduct thorough investigations and examine insurance policies to determine coverage Inspect damages and prepare written estimates of repair or replacement Correspond with insureds, claimants and other interested parties Prepare and report findings and negotiate settlements DESIRED QUALIFICATIONS 0 - 3 years Property claims experience preferred Bachelor's Degree Excellent verbal and written communication skills Excellent problem-solving and negotiation skills Good keyboard/PC skills Excellent organizational and prioritization skills Ability to climb ladder to assess roof damage Ability to lift minimum 30 lbs Must maintain valid driver s license Able to travel/stay overnight for storm claim duty BENEFITS & PERKS IMT Insurance is committed to our employees and their families. When you work for IMT, you earn far more than just a paycheck. The IMT office was new in 2018 and offers a fitness room, game room and a variety of collaboration areas. This position includes learning and development opportunities and more! Below is a list of what IMT offers our employees: Medical, dental, and vision insurance, Life & A D & D insurance, 401K retirement savings accounts, spending accounts, long and short-term disability, profit share, paid vacation & sick time, employee assistant program and additional voluntary benefits. The salary range for this position is $53,000.00 - $99,000.00 Starting salary and level of position will depend on level of experience This position is not eligible for tips or commission but may be eligible for additional bonuses WHAT DEFINES US Our vision is to provide peace of mind in the moments that matter. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant based on race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state or local protected class. Our agents and customers come from all walks of life and so do we. Our goal is to hire great people from a wide variety of backgrounds, because it makes our team stronger. If you share our values and our passion for creating a Worry Free life for others, we want to talk to you!
    $32k-43k yearly est. 60d+ ago
  • Surveillance / Claims Investigator - Part-Time

    Allied Universal Compliance and Investigations

    Claim specialist job in Fargo, ND

    Overview Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference. Job Description Allied Universal is hiring a Surveillance / Claims Investigator. Surveillance / Claims Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation. No office to go to - travel daily to cases in the field! Must possess a valid driver's license with at least one year of driving experience Will require Claims and Surveillance investigations as needed to ensure a full schedule RESPONSIBILITIES: Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters Run appropriate database indices if necessary and verify the accuracy of results found QUALIFICATIONS (MUST HAVE): Must possess one or more of the following: Bachelor's degree in Criminal Justice Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims Ability to be properly licensed as a Private Investigator as required by the states in which you work Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country Special Investigative Unit (SIU) Compliance knowledge Ability to type 40+ words per minute with minimum error Flexibility to work varied and irregular hours and days including weekends and holidays Proficient in utilizing laptop computers and cell phones PREFERRED QUALIFICATIONS (NICE TO HAVE): Military experience Law enforcement Insurance administration experience One or more of the following professional industry certifications Certified Fraud Investigator (CFE) Certified Insurance Fraud Investigator (CIFI) Fraud Claim Law Associate (FCLA) Fraud Claim Law Specialist (FCLS) Certified Protection Professional (CPP) Associate in Claims (AIC) Chartered Property Casualty Underwriter (CPCU) BENEFITS: Medical, dental, vision, basic life, AD&D, and disability insurance Enrollment in our company's 401(k)plan, subject to eligibility requirements Seven paid holidays annually, sick days available where required by law Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law. Closing Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: *********** If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices. Requisition ID 2025-1500467
    $41k-50k yearly est. 27d ago
  • Surveillance / Claims Investigator - Part-Time

    Security Director In San Diego, California

    Claim specialist job in Fargo, ND

    Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference. Job Description Allied Universal is hiring a Surveillance / Claims Investigator. Surveillance / Claims Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation. No office to go to - travel daily to cases in the field! Must possess a valid driver's license with at least one year of driving experience Will require Claims and Surveillance investigations as needed to ensure a full schedule RESPONSIBILITIES: Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters Run appropriate database indices if necessary and verify the accuracy of results found QUALIFICATIONS (MUST HAVE): Must possess one or more of the following: Bachelor's degree in Criminal Justice Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims Ability to be properly licensed as a Private Investigator as required by the states in which you work Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country Special Investigative Unit (SIU) Compliance knowledge Ability to type 40+ words per minute with minimum error Flexibility to work varied and irregular hours and days including weekends and holidays Proficient in utilizing laptop computers and cell phones PREFERRED QUALIFICATIONS (NICE TO HAVE): Military experience Law enforcement Insurance administration experience One or more of the following professional industry certifications Certified Fraud Investigator (CFE) Certified Insurance Fraud Investigator (CIFI) Fraud Claim Law Associate (FCLA) Fraud Claim Law Specialist (FCLS) Certified Protection Professional (CPP) Associate in Claims (AIC) Chartered Property Casualty Underwriter (CPCU) BENEFITS: Medical, dental, vision, basic life, AD&D, and disability insurance Enrollment in our company's 401(k)plan, subject to eligibility requirements Seven paid holidays annually, sick days available where required by law Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law. Closing Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: *********** If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices. Requisition ID 2025-1500467
    $41k-50k yearly est. Auto-Apply 27d ago
  • To-Go Specialist

    Cbrlgroup

    Claim specialist job in Bismarck, ND

    They say you are the company you keep - and at Cracker Barrel, we take that seriously. Whether you're greeting guests, rolling out biscuits, or keeping things humming behind the scenes, you make the moments that matter, both big and small. Here, the work means more because we take pride in doing it together. So, join our team and find your place, because here...we're all in good company. What You'll Do - You'll Make the Moment Our hospitality doesn't stop at the table, it goes wherever our guests are. As a To-Go Specialist, you'll thoughtfully take orders and double-check every detail, making sure guests experience the goodness of country hospitality wherever they're headed. This is a fast-paced, guest-facing role - and a tipped one, too - because great service deserves a little something extra! So if you're someone who…. Has a team-first mindset Can juggle a few things at once Has a knack for details Brings a positive attitude … we've got an apron just for you! No restaurant experience? No worries. We'll teach you everything you need to know. Focus on You We're all about making sure you're taken care of too. Here's what's in it for you: Good Work Deserves Good Pay: Competitive pay every week | Same day pay access Support That Goes Beyond the Clock: Health insurance eligibility on day 1 - Full and Part-time employees | Vacation time | Employee assistance program (EAP) Grow and Thrive Your Way: Growth and development opportunities begin Day 1 with our industry-leading PAR training program | 401k plan with company matching contributions at 90 days | Employee Stock Purchase Program Culture of Belonging: Support that starts on day one | Onboarding, training, and development to help you thrive | Recognition programs and employee events that bring us together More Perks, Just Because: 35% Discount on Cracker Barrel Food and Retail items | Exclusive Biscuit Perks like discounts on home, travel, cell phones, and more! A Little About Us Since 1969, Cracker Barrel has been a place to gather around delicious food, abundant servings, unexpected finds, and a warm welcome. Over time, it's become even more - somewhere folks can reconnect and feel at home. With more than 70,000 team members nationwide, we take pride in our roots -- always serving up more than a meal. See for yourself. Apply now. Cracker Barrel is an equal opportunity employer. Qualified applicants are considered for all positions without regard to race, color, religion, sex, sexual orientation, genetic information, national origin, age, marital status, medical condition, disability or any other class expressly protected by law.
    $32k-56k yearly est. Auto-Apply 60d+ ago
  • Mortgage Insuring Specialist

    Plains Commerce Bank 3.3company rating

    Claim specialist job in Sioux Falls, SD

    Mortgage Insuring Specialist Managing the post-closing insurance processes for all loan products that insurance is required for. This role ensures that all mortgage loans meet the necessary insurance requirements, including Conventional, FHA, VA and RD insuring, and are properly registered with the Mortgage Electronic Registration System (MERS). This involves coordinating with various departments, lenders, and insurance entities to secure and verify insurance coverage. Qualities of the successful candidate include: High School diploma or general education degree (GED) is required. Post-secondary education is helpful. Prior accounting, secretarial and/or bank lending experience is helpful. Must be a mature, responsible individual with a professional appearance, be dependable and take pride in their work. Attention to detail is a must in this position. General PC knowledge and the Internet is required, must be capable of accurate typing, and learning various computer software programs. Familiarity with loan documentation requirements is helpful; however, detailed knowledge is not a mandatory prerequisite. Must enjoy helping customers and fellow employees. Must be trustworthy and maintain a high level of confidentiality. Must be able to multi-task and work under stress and pressure. Must be able to communicate effectively, get along with co-workers and deal with colleagues effectively and professionally. Responsibilities of this position include (but not limited to): Conventional, FHA, VA and RD Insuring: Review closed loan files to ensure they meet Conventional, FHA, VA and RD insurance requirements. Review conventional closed loan files and activate insurance on the coordinating MI company website. Pay upfront premiums on any Government loan required prior to activation. Prepare and submit insurance applications to FHA and VA for mortgage insurance, and guaranty. Manage any corrections as needed with the appropriate Agency. Ensure accurate and timely registration of mortgage loans with the Mortgage Electronic Registration System (MERS). Update MERS with any changes to the loan status or servicing rights. Reconcile MERS reports to ensure all loans are correctly registered and any discrepancies are resolved promptly. Ensure all insurance policies and registrations comply with federal, state, and investor guidelines. Maintain up-to-date knowledge of Conventional, FHA, VA, RD and MERS regulations and requirements. We offer a competitive benefits package that includes Medical, Dental and Vision; FSA or Dependent Care; Supplemental Accident, Hospital, or Critical Illness Plans; Employer paid Life Insurance, Short Term Disability, and Long-Term Disability; and Additional Voluntary Life Insurance Options. Paid Vacation, Sick and Volunteer leave; 401K and Profit Sharing. Compensation for positions is based on the specific position and may be paid in the form of an hourly wage, a semi-monthly salary, commissions, or a combination of them. Depending on the specific position, some may be paid solely on commissions or others may include a bonus structure. Plains Commerce Bank is an Affirmative Action/Equal Opportunity Employer committed to providing equal employment opportunity without regard to an individual's race, religion, color, gender, national origin, ancestry, age, sexual orientation, disability, or veteran status.
    $32k-37k yearly est. 10d ago
  • Reconciliation Specialist

    The Goal Family of Companies 4.3company rating

    Claim specialist job in Sioux Falls, SD

    Description: Bring Your Focus. Bring Your Precision. Bring Your Problem-Solving Mindset. At Goal Solutions, we're on a mission to transform the consumer finance industry with data, technology, and a talented team. Our company is growing fast - and so is our need for a Reconciliation Specialist who likes focus, structure and solving puzzles with data. How This Role Fits In As a Reconciliation Specialist, you'll spend much of your day working in Excel and internal systems to balance accounts, research discrepancies, and make sure funds are applied correctly. This is not a fast-paced “variety every hour” role - it's a steady, detail-heavy position where accuracy matters more than speed. Some people find this work bring. Others love it. We're looking for the people who love it. What You'll Do Reconciling daily and monthly transactions is all about playing financial detective-comparing data across systems and bank accounts, tracking down discrepancies, and figuring out where things went off course. Impact You'll Make in This Role • Bring consistency and reliability to structured, rules-based workflows • Maintain deep focus to accurately manage detailed, repetitive tasks • Solve problems using data to identify and resolve issues quickly • Uphold a high standard for accuracy and consistency across processes • Create stability and trust without needing constant change to stay engaged Key Role Responsibilities Reconciling daily and monthly transactions across systems and bank accounts Researching discrepancies and figuring out where things went wrong Working in Excel to compare, balance, and track data Ensure payments are applied correctly?by lender and payment type (ACH, check, auto-draft, etc.) Use platforms such as NetSuite, processor websites, banking portals, and internal platforms to validate transactions? Following defined procedures - and knowing when to ask for help Partnering with Operations when information is missing or unclear What You'll Bring High attention to detail Ability to research and solve discrepancies Clear written and verbal communication Why You'll Love Working Here People stay at Goal Solutions because they can grow, innovate, lead, and make meaningful impact. We take care of our people so they can take care of our customers. Benefits include · Competitive salary + bonus eligibility · 401(k) with 4% company match · Long-Term Incentive Program · Medical, dental, and vision · Annual HSA contribution: $1,700 · Life insurance, disability, and critical illness coverage · Birthday holiday · Two Community Days · Free snacks and beverages in the office · Paid Parental Leave · Generous PTO · Tuition reimbursement · $2,000 Vacation Incentive after 3 years + Sabbatical · Wellness funds, community funds, and more About Goal Solutions Goal Solutions (“Goal”) provides innovative loan servicing, asset management, collections oversight, treasury services, and analytics for clients across solar, home improvement, personal loans, and student finance markets. We work with hedge funds, traditional banks, ABS investors, insurance companies, and universities, with over $30B in assets under management through Goal and our subsidiaries: GSS Data Services, Launch Servicing, and Turnstile Capital Management. Headquartered in San Diego, Goal has been named a Best Place to Work by the San Diego Business Journal every year since 2015. Apply today and help us build the future of Goal Solutions, one great hire at a time. The Job Description is intended to be a general representation of the responsibilities and requirements of the job. However, the description may not be all-inclusive, and responsibilities and requirements are subject to change. Requirements: High attention to detail and accuracy. Strong ability to research, analyze, and resolve discrepancies. Clear written and verbal communication skills. Comfort working with structured, repetitive tasks requiring sustained focus. Preferred Experience Degree and/or professional experience in Accounting or Finance. Prior reconciliation or transactional accounting experience. Knowledge, Skills & Abilities Strong Excel comfort (sorting through formulas, comparing data, tracking)
    $30k-51k yearly est. 8d ago
  • ACH Specialist II

    Central Payments 3.9company rating

    Claim specialist job in Sioux Falls, SD

    Job Description Are you detail-driven and passionate about keeping payment operations running smoothly? Join Central Payments, where collaboration, accuracy, and continuous improvement power everything we do. As an ACH Specialist II, you'll play a key role in supporting and maintaining our ACH operations while working closely with cross-functional teams to ensure seamless processing. What You'll Do Support the daily operation, maintenance, and exception processing of the ACH Processing System (ACHPS) Assist with ACH system changes, including risk limit updates, testing, and documentation Complete daily ACH processing checklists to ensure timely and accurate inbound and outbound transactions Monitor and resolve ACH exceptions, including unpostable transactions, returns, risk limit violations, WSUDs, and reclamations Own and manage the ACH Inbox, ensuring timely responses and compliance with all requests Prepare monthly reports and analyze Partner activity to identify trends and potential risks Maintain and update ACH procedures to ensure regulatory and Nacha compliance Support internal teams and Partners by troubleshooting issues and providing ACH and Nacha guidance Identify opportunities to improve processes, efficiency, and service delivery across ACH operations Why You Should Join Us Be part of a collaborative fintech team supporting critical payment operations Work in a role that combines operational execution with analytical problem-solving Gain exposure to complex ACH systems, compliance, and Partner-facing processes Contribute to continuous improvement in a growing payments organization What You Bring Familiarity with ACH operations and Nacha Rules (preferred) Strong analytical and problem-solving skills High attention to detail and commitment to accuracy Clear written and verbal communication skills Strong organizational and time-management abilities Proficiency with Microsoft Office applications Ability to work independently while collaborating across teams Qualifications Associate degree in Accounting, Finance, or a related field or equivalent experience 1-3 years of experience in ACH processing, account reconciliation, or related financial roles Experience with ACHPS (FIS/eFunds) preferred but not required Working knowledge of banking regulations and ACH functionality preferred What We Offer A hybrid work environment with flexibility Opportunities for professional growth and development A supportive team culture where your voice is heard
    $28k-37k yearly est. 21d ago
  • Bakery Specialist (Early AM)

    The Hub Convenience Stores

    Claim specialist job in Dickinson, ND

    Full-time, Part-time Description This is an early morning position that's centered around making donuts, muffins, pastires, and cookies, and also includes baking bread. Requirements No experience necessary.
    $32k-55k yearly est. 60d+ ago
  • Donor Door Specialist

    Dakota Boys & Girls Ranch 3.8company rating

    Claim specialist job in Fargo, ND

    If you want to make a difference in the lives of children and their families and want to learn new skills, consider working at Dakota Boys and Girls Ranch Thrift Stores. Ranch thrift stores support our community and give the children served by the Ranch the tools they need for hope and healing. Because of our supportive, hardworking staff, children can see the world differently and feel love through those who care for them in our residential treatment and educational centers. Why choose Dakota Boys and Girls Ranch? Dakota Boys and Girls Ranch cultivates a culture of purpose, caring, and learning. The accepting and compassionate work environment unites employees around a common mission. Staff are encouraged to learn new things, share new ideas, and explore alternatives. The warm, collaborative, and inviting work environment supports teamwork, trust, and positive relationships. Our Culture of Purpose is exemplified by idealism and altruism. We are tolerant, compassionate, and respectful people trying to do good for the long-term future of children and families. Our Culture of Caring is built on relationships and mutual trust. We are warm, welcoming, collaborative, and supportive of each other. We are united by loyalty, and leaders emphasize sincerity, teamwork, and positive relationships. We respect all voices, cultures, and perspectives. We treat all with dignity. Our Culture of Learning is exemplified by exploration, expansiveness, and creativity. We are inventive and open-minded, explore alternatives, and encourage new ideas. We are united by curiosity; leaders emphasize innovation, knowledge, and adventure. We own our mistakes, learn from them, and move on. Schedule: Ability to work 10 a.m.-6:30 p.m. shift and rotating weekends. Responsibilities: Provide excellent customer service by assisting customers and donors in a pleasant and efficient manner. Assists donors in a pleasant and efficient manner. Lifts and carries goods for donors from and to their vehicles. Loads and unloads trucks with bags and/or boxes of donated goods. Sort through donations and allocate them to appropriate storage areas. Work closely with other team members and communicate clearly with the store management when needed. Pricing of goods/items as needed. Maintains a safe working environment. May occasionally supervise volunteer and community service workers. Willingness to train new team members. Job Requirements: At least 18 years old Ability to stand and walk for extended periods, as well as lift, stoop, bend, and twist. Employment Contingencies: National Registry Check Motor Vehicle Insurance Check Part-time benefits include: 403(b) Retirement Savings Plan Employee Assistance Program through Telus Health Paid Time Off (accrual based on hours worked) Voluntary Vision Insurance 20% discount on donated items at all Ranch Thrift Stores Opportunity for full-time work if a position becomes available. The duties of this position may change from time to time. Dakota Boys and Girls Ranch reserves the right to add or delete duties and responsibilities at the discretion of the Ranch or its managers. This job description is intended to describe the general level of work being performed. It is not intended to be all-inclusive.
    $33k-39k yearly est. Auto-Apply 7d ago
  • Firearms Specialist (Part-Time) - Pierre, SD

    Runnings 4.3company rating

    Claim specialist job in Pierre, SD

    The Firearms Specialist will assist with customer service/sales in the Sporting Goods Department and will be ultimately responsible for the timely and accurate completion of all records involving firearm sales, maintaining compliance with FFL regulations. Must be legally able to handle and be involved in the sale of firearms. Previously experience with FFL regulations preferred. Must be able to work weekends and maybe 2 nights a week. Pay Range: $15.00-$17.00 Depending on Experience Greet customers as they shop in the retail store, assisting with customer service questions. Price store merchandise and make price changes as requested by store management. Stock and face merchandise on shelves as requested by store management. Assist in receiving freight and organize incoming products as directed by store management. Responsible for assisting in cycle counts. Must keep store prepared for ATF and/or internal audits Must have a good understanding of and assist training other staff on: A&D log requirements and best practices Filing of denied and no transfer 4473's Standardized filing of completed 4473's What is an AR and how a multiple sale is recorded Multiple handgun sales and proper recording How to properly make corrections on a 4473 by employees and customers Acceptable forms of identification customers can use When a sale should be refused What constitutes a “Straw Sale” and how to complete
    $15-17 hourly 3d ago
  • Claims Examiner

    Harriscomputer

    Claim specialist job in North Dakota

    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.
    $25k-39k yearly est. Auto-Apply 34d ago

Learn more about claim specialist jobs

How much does a claim specialist earn in Bismarck, ND?

The average claim specialist in Bismarck, ND earns between $19,000 and $45,000 annually. This compares to the national average claim specialist range of $27,000 to $67,000.

Average claim specialist salary in Bismarck, ND

$30,000
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