Claim specialist jobs in Cincinnati, OH - 72 jobs

The Claim Specialist serves as the primary contact for the processing and management of company accidents, injuries, or other insurance related matters. Responsibilities * Manage accidents for all lines of coverage including workers compensation, liability, auto, and property for the company * Analyze and evaluate accident/claim reports and work with others internally to understand extent of loss and applicability to insurance and/or liability * Identify and analyze employee first report of employee injuries to determine if they are compensable * Work with third party administrators in managing all workers compensation injuries based on state laws * Assist the Risk Manager with the analysis of cost regarding workers compensation injuries * Assist in the development and implementation of an effective post-loss injury program * Manage and oversee and TWAP light duty program * Oversee claims management and claim litigation processes * Collaborate with legal counsel, adjusters, and other appropriate personnel on pertinent claims matters * Assist the Risk Manager on losses and negotiate settlements, within established authority Qualifications * Possess a High School Diploma. * Possess knowledge of multi-state workers' compensation laws, cost management and return to work practices. * Possess good written and oral communication skills and the ability to present information in an appropriate manner to various groups including executive management, peers and external partners. Benefits * Stable and growing organization * Competitive weekly pay * Quick advancement * Professional, positive and people-centered work environment * Modern facilities * Comprehensive benefits package: Health, Dental, Vision, AD&D, 401(k), etc. * Paid holidays (8); paid vacation and personal days transportation, trucking, LTL, culture, family oriented, claims, insurance, accidents, workers comp, workers compensation

Since 1991, Collabera has been a leading provider of IT staffing solutions and services. We are known for providing the best staffing experience and taking great care of our clients and employees. Our client-centric model provides focus, commitment and a dedicated team to help our clients achieve their business objectives. For consultants and employees, we offer an enriching experience that promotes career growth and lifelong learning. Job Description General Function: Provide exceptional customer service and aid in problem resolution of outstanding AR balances. Assist with lockbox activity assigned by the Accounts Receivable Manager or Team Lead; perform the processing and posting of US checks, wires and other bank activity. Maintain a high level of customer service for both internal and external customers, ensuring timely collection and payment application on open receivables. Qualifications MAJOR DUTIES AND RESPONSIBILITIES: Responsible for providing excellent customer service to internal and external customers (see communications with others below) Responds to phone calls and/or emails from customers, research questions and/or problems and bring resolution to those items Ensure that the Customers needs are being met Return phone calls and/or emails within 24 hours Troubleshoot and run necessary customer reports (using SAP, queries and/or Business Objects) Assist with the daily entry of all checks and wires activity from multiple lockboxes Balance and reconcile to the clearing account Assume additional responsibilities and performs special projects as needed or directed COMMUNICATION WITH OTHERS: INTERNAL - Customers include: Collections Team, Cash Team, Billing, Accounting, Account Management and various other internal management and operational areas/staff. EXTERNAL - Customers Additional Information KNOWLEDGE AND SKILLS: Oral and written communication Superior organizational skills Analytical Customer Focus Computer/Software Skills (Advance MS Excel, SAP) EXPERIENCE: • 2+ Years collections experience preferred EDUCATION: • High School Diploma If you have questions or clarifications feel free to reach me at my phone number ************ or email me your most updated resume together with the best time to call you back.

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI #IN-DNI

Top 100 Agency for 2025 Best Agencies to Work for in 2024 by the Insurance Journal Big “I” Best Practices Agency in 2023 Annual bonus eligibility No weekends required - great work/life balance 3+ weeks of Paid Time Off 8 Paid Company Holidays We are looking for someone who will Manage the claims reporting process for agency clients. Report claims to the appropriate carrier and maintain records in the agency management system by documenting claim actions in accordance with established procedures. Follow up on claim to obtain the specific adjuster and claim number relevant to the reported loss. Notify appropriate parties when a claim is processed with carrier, providing accurate and timely claim information. Continuously monitor claims until claims are closed by the insurance carrier. Report any potential issues with a claim to the client's Account Manager and Producer, escalating to management as needed. Prepare reports by collecting and summarizing information as requested by management. Why Join AAA Club Alliance and the Energy Insurance team? A base rate of $20.00 to $25.00/hour, depending on experience and geographic location. Annual bonus potential Do you have what it takes? Minimum of 2 years experience handling claims for Commercial Insurance - general liability, workers compensation, commercial auto, etc. Strong communication skills (both verbal and written) and attention to detail Strong time management skills Ability to obtain property and casualty license within 60 days of hire Full time Associates are offered a comprehensive benefits package that includes: Medical, Dental, and Vision plan options Up to 2 weeks Paid parental leave 401k plan with company match up to 7% 2+ weeks of PTO within your first year Paid company holidays Company provided volunteer opportunities + 1 volunteer day per year Free AAA Membership Continual learning reimbursement up to $5,250 per year And MORE! Check out our Benefits Page for more information ACA is an equal opportunity employer and complies with all applicable federal, state, and local employment practices laws. At ACA, we are committed to cultivating a welcoming and inclusive workplace of team members with diverse backgrounds and experiences to enable us to meet our goals and support our values while serving our Members and customers. We strive to attract and retain candidates with a passion for their work and we encourage all qualified individuals to apply. It is ACA's policy to employ the best qualified individuals available for all positions. Hiring decisions are based upon ACA's operating needs, and applicant qualifications including, but not limited to, experience, skills, ability, availability, cooperation, and job performance. Job Category: Insurance

* Top 100 Agency for 2025 * Best Agencies to Work for in 2024 by the Insurance Journal * Big "I" Best Practices Agency in 2023 * Annual bonus eligibility * No weekends required - great work/life balance * 3+ weeks of Paid Time Off * 8 Paid Company Holidays We are looking for someone who will * Manage the claims reporting process for agency clients. * Report claims to the appropriate carrier and maintain records in the agency management system by documenting claim actions in accordance with established procedures. * Follow up on claim to obtain the specific adjuster and claim number relevant to the reported loss. Notify appropriate parties when a claim is processed with carrier, providing accurate and timely claim information. * Continuously monitor claims until claims are closed by the insurance carrier. Report any potential issues with a claim to the client's Account Manager and Producer, escalating to management as needed. * Prepare reports by collecting and summarizing information as requested by management. Why Join AAA Club Alliance and the Energy Insurance team? * A base rate of $20.00 to $25.00/hour, depending on experience and geographic location. * Annual bonus potential Do you have what it takes? * Minimum of 2 years experience handling claims for Commercial Insurance - general liability, workers compensation, commercial auto, etc. * Strong communication skills (both verbal and written) and attention to detail * Strong time management skills * Ability to obtain property and casualty license within 60 days of hire Full time Associates are offered a comprehensive benefits package that includes: * Medical, Dental, and Vision plan options * Up to 2 weeks Paid parental leave * 401k plan with company match up to 7% * 2+ weeks of PTO within your first year * Paid company holidays * Company provided volunteer opportunities + 1 volunteer day per year * Free AAA Membership * Continual learning reimbursement up to $5,250 per year * And MORE! Check out our Benefits Page for more information ACA is an equal opportunity employer and complies with all applicable federal, state, and local employment practices laws. At ACA, we are committed to cultivating a welcoming and inclusive workplace of team members with diverse backgrounds and experiences to enable us to meet our goals and support our values while serving our Members and customers. We strive to attract and retain candidates with a passion for their work and we encourage all qualified individuals to apply. It is ACA's policy to employ the best qualified individuals available for all positions. Hiring decisions are based upon ACA's operating needs, and applicant qualifications including, but not limited to, experience, skills, ability, availability, cooperation, and job performance. Job Category: Insurance

Claims Specialist needs 1 year claims system experience, preferably in the Healthcare industry Claims Specialist requires: College degree or equivalent experience required Minimum of 1 year claims system experience, preferably in the Healthcare industry Basic analytical and problem solving skills Good communication and interpersonal skills Ability to work independently and with others Ability to manage more than one assigned tasks at the same time Claims Specialist duties: Responsible for setting up new Managed Care groups in the claims system Responsible for fulfilling requested revisions to existing Managed Care group in the claims system (except Reseller product changes) Responsible for creating standard products in the system (using the Product Key Sheet method) Responsible for performing audits on client setup or maintenance requests (excludes complex product configuration requests) Follow the established corporate and industry audit controls (i.e. SOX, SSAE 18, etc.) when fulfilling setup and maintenance requests Resolve client structure setup questions/issues sent to the team with minimal supervisor guidance Maintain relationships with Implementation Managers and Account Managers to facilitate fulfillment of implementation questions and requests in a timely manner

**Location: Ohio.** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. _The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs._ The **Process Expert II** supports the claims issue research and resolution for Home & Community Based Services (HCBS) by participating in project and process work. **How you will make an impact** Primary duties may include, but are not limited to: + Researches operations workflow problems and system irregularities. + Develops tests, presents process improvement solutions for new systems, new accounts and other operational improvements. + Develops and leads project plans and communicates project status. **Minimum Qualifications:** + Requires a BA/BS and minimum of 5 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:** + Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred. + Claims issue research and resolution for Home & Community Based Services (HCBS) highly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $66,880.00 to $100,320.00. Location(s): Columbus, OH. In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Job Summary: The Claim Review Specialist is responsible for entering, reviewing, and proactively managing workers' compensation claims, including gathering medical and claim information, communicating with employers, providers, injured workers, and the BWC, and supporting early return-to-work efforts. This role requires strong attention to detail, confidentiality, customer service skills, and the ability to manage high call volumes while meeting quality and productivity standards. Principal Duties & Responsibilities: Reports directly to the Claim Review Specialist Team Leader. Enter and process initial claims in UniSource, complete initial and/or follow-up calls to employer, provider, IW, and BWC as appropriate while documenting the results of gathered information. Additionally, responsible for complete follow-up on claims, resulting in transition to the Return to Work Specialist or case closure as appropriate, including gathering any additional information on RTW, missing claims master fields, continued treatment, etc. Gather complete information on all mandatory UniSource system field requirements to ensure accurate transmission to the BWC. Gather all initial and subsequent medical documentation necessary to process potential claim updates. Assist in identifying RAW and Onsite Therapy candidates where appropriate. Proactive claims management, early RTW intervention, and transfer of claims to Return to Work Specialist for continued RTW management when appropriate. Assists other Claim Review Specialists on the team. Answering incoming and making outgoing phone calls. Provide excellent customer service to all internal and external customers. Required to meet team quality and productivity standards. Maintain and develop teamwork within all departments of UniComp. Other duties as assigned by Management. Maintain and exhibit Sheakley Core Values. Qualifications: Knowledge and skills at a level normally acquired through the completion of High School education or equivalent. Typing 50-60 WPM Ability to handle sensitive information and maintain a high level of confidentiality. Proficiency in Microsoft Office products including Word, Excel, Outlook, etc. Medical Terminology or equivalent experience. Previous customer service experience preferred. Requirements: Attention to detail, flexibility, and strong ability to multi-task. Problem solving ability. Physical and Mental Demands: Ability to sit for prolonged period of time. Ability to answer high call volume while maintaining accurate system notes. This job description is not intended to be all inclusive and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required. EQUAL OPPORTUNITY POLICY: It is our policy to seek and employ the best qualified personnel and to provide equal opportunity for the advancement of employees, including upgrading, promoting and training and to administer these activities in a manner which will not discriminate against any person because of race, color, religion, age, sex, marital status, national origin, disability or any other basis prohibited by law.

Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. PRIMARY DUTIES: * Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. * Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. * Translates medical policies into reimbursement rules. * Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits. * Coordinates research and responds to system inquiries and appeals. * Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. * Perform pre-adjudication claims reviews to ensure proper coding was used. * Prepares correspondence to providers regarding coding and fee schedule updates. * Trains customer service staff on system issues. * Works with providers contracting staff when new/modified reimbursement contracts are needed. Minimum Requirements: Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required. Preferred Skills, Capabilities and Experience: * CEMC, RHIT, CCS, CCS-P certifications preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Claims Processor needs 1+ years experience, Claims Processor requires: Onsite Medium-Advance level of expertise with Microsoft Excel Proficient with Outlook Familiar with Cloud-based applications (i.e. OneDrive) Ability to multi-task and perform duties using multiple sources or systems Data Entry experience preferred Claims Processor duties: Review incoming membership documents (Microsoft Excel and Word) to confirm accuracy in formatting and validity of data Communicate when updates are needed for successful membership enrollment and/or submission for processing.

Full-time Description General Job Summary: Responsible for performing a variety of clerical duties and responsible for insurance verification for patients with medical or auto insurance as well as authorizations. Essential Job Functions: Greets, screens, schedules, and directs patients/visitors to appropriate areas and demonstrates excellence with respect to treating and caring for customers in-person and over the phone. Responsible for performing a variety of clerical duties: answers phone calls, takes messages, fax, scan, etc. Verify that all forms, test results, and other paperwork are in the electronic health record system according to physician and office protocol. Obtain prior authorization for patients and verify all insurance based on patient schedules, practice management systems and insurance websites for non-automated insurances. Obtain, verify, and update patient information and provides support services to patients and medical staff. Maintain the practice management system. Collect payments for services rendered per policy, including copayments and balances on patient accounts. Daily drawer balancing. Obtain referral from the Primary Care Physician for insurances that require referrals and contact patient regarding missing referrals or inactive insurance coverage. Verify auto and liability eligibility with insurance carriers. Ensure all auto and/or liability forms are completed and received and compare with the schedule. Use these forms to record verification information and file in the chart. Compliance with HIPAA, OSHA, and safety standards of the organization. Performs other duties that may be necessary or in the best interest of the practice. Requirements Education/Experience: High school diploma or equivalent. Minimum one year of experience in a customer service position, preferably in a medical practice setting. Previous medical assisting knowledge preferred. CPR/AED and First Aid certification. Other Requirements: Schedules will change as department needs change, including overtime. Travel as needed. Performance Requirements: Knowledge: Knowledge and proper use of office equipment. Knowledge of practice management and electronic health records systems. Knowledge of HIPAA regulations. Knowledge of current terminology and anatomy. Knowledge of how to obtain insurance benefits and insurance reimbursement policies. Skills: Skilled in communicating effectively with providers, staff, patients and vendors. Use of a practice management software system. Accuracy in data entry. Detailed-oriented with excellent investigational/research skills. Excellent organizational and multi-tasking skills. Excellent adaptability skills. Basic math skills. Abilities: Ability to multi-task and analyze situations to respond appropriately. Ability to use math skills to accurately complete daily balancing and provide accurate change to the patient. Ability to work effectively and deal courteously with patients, staff, and others. Ability to organize work environment and work load to meet needs of the organization. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to accurately examine, understand and enter insurance documents. Ability to work independently with minimal or no supervision. Equipment Operated: Standard office equipment. Work Environment: Medical Office. Mental/Physical Requirements: Sitting about 90% in front of a computer screen. Fast paced high productivity environment.

Country USA State Ohio City Cincinnati Descriptions & requirements About the role: When you join TQL as a Claims Representative you will play a key role in protecting our business and customers. In this position, you will own an evolving portfolio of cargo claims from start to finish, resolving them through investigating issues and working with carriers, customers and insurance partners to resolve claims quickly and accurately. The Claims team is a critical part of TQL's commitment to reliability, service excellence, and trust in the fast-paced logistics industry. When unexpected disruptions occur, this group ensures swift resolution, minimizing financial impact, and preserving long-standing customer relationships through efficient, transparent claims management. Who we're looking for: * You're highly detail-oriented with a strong focus on accuracy * You communicate clearly and professionally * You have solid problem-solving and investigation skills * You make sound decisions independently while collaborating closely with your team * You bring a customer-first mindset and build strong relationships * You're comfortable working in a fast-paced environment with changing priorities * You have some professional experience in an office environment, customer service, claims, or insurance What you'll do: * Investigate reported cargo claims and determine validity * Manage documentation, submission, and communication for each claim in your portfolio * Follow up with carriers, insurance partners, and internal and external customers to drive timely resolutions * Gather all required documents and information to file, review, and resolve claims * Serve as the point of contact for internal teams and external partners regarding claim status * Contact carriers, insurance companies, salvage companies and internal/external customers regarding claims made by customers, receivers or shippers * Work with Accounting and Collections teams to resolve carrier and customer accounting issues related to claims What's in it for you: * Compensation starting at $17.50 - $22 per hour, depending on experience * Outstanding career growth potential with structured paths for advancement * Comprehensive benefits package * Health, dental and vision coverage * 401(k) with company match * Perks including employee discounts, financial wellness planning, tuition reimbursement and more * Certified Great Place to Work with 800+ lifetime workplace award wins Where you'll be: 4289 Ivy Pointe Boulevard, Cincinnati, Ohio 45245 Employment visa sponsorship is unavailable for this position. Applicants requiring employment visa sponsorship now or in the future (e.g., F-1 STEM OPT, H-1B, TN, J1 etc.) will not be considered. About Us Total Quality Logistics (TQL) is one of the largest freight brokerage firms in the nation. TQL connects customers with truckload freight that needs to be moved with quality carriers who have the capacity to move it. As a company that operates 24/7/365, TQL manages work-life balance with sales support teams that assist with accounting, and after hours calls and specific needs. At TQL, the opportunities are endless which means that there is room for career advancement and the ability to write your own paycheck. What's your worth? Our open and transparent communication from management creates a successful work environment and custom career path for our employees. TQL is an industry-leader in the logistics industry with unlimited potential. Be a part of something big. Total Quality Logistics is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, genetic information, disability or protected veteran status. If you are unable to apply online due to a disability, contact recruiting at ****************** *

Established in 1991, Collabera has been a leader in IT staffing for over 22 years and is one of the largest diversity IT staffing firms in the industry. As a half a billion dollar IT company, with more than 9,000 professionals across 30+ offices, Collabera offers comprehensive, cost-effective IT staffing & IT Services. We provide services to Fortune 500 and mid-size companies to meet their talent needs with high quality IT resources through Staff Augmentation, Global Talent Management, Value Added Services through CLASS (Competency Leveraged Advanced Staffing & Solutions) Permanent Placement Services and Vendor Management Programs. Collabera recognizes true potential of human capital and provides people the right opportunities for growth and professional excellence. Collabera offers a full range of benefits to its employees including paid vacations, holidays, personal days, Medical, Dental and Vision insurance, 401K retirement savings plan, Life Insurance, Disability Insurance. Job Description Position Details : Industry: (Eye Wear Company) Location: Mason - OH Job Title: Claim Processor Duration: 3 Months (possible extension) Roles and Responsibilities: • Accurately and efficiently processes manual claims and other simple processes such as matrix and bypass. • Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication. Major duties and responsibilities: • Processing - Efficiently and accurately processes standard claims or adjustments • Consistently achieves key internals with respect to production, cycle time, and quality • May participate on non-complex special claims projects initiatives, including network efforts • Understands and quickly operationalizes processing changes resulting from new plans, benefit designs. • Drive client satisfaction - Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include EyeMed Account Managers, Operations, Information Systems, Client Representatives and EyeMed leadership team. • Drives Key Performance Indications - Consistently meets or exceeds agreed upon performance standards in both productivity and accuracy. • Proactively works with supervisor to develop self-remediation plan when standards are not being met. Knowledge and skills: • Data entry and claims processing knowledge. Has a working knowledge of interface systems that include the EyeMed claims system, Metastorm Exclaim and EyeNet. Some basic working knowledge of software programs, specifically Excel and Access. • Understands third party benefits and administration. • Strong customer service focus. • Ability to work well under pressure and multi-task. Experience: • Claims processing/data entry experience. • Knowledge of PCs and spreadsheet applications. Education: • High school mandatory Qualifications Claims Processor Additional Information To know more about the position, please contact: Abhinav singh ************

Claims Healthcare Specialist needs 1 year claims system experience, in the Healthcare industry . Claims Healthcare Specialist requires: 1 year claims system experience, preferably in the Healthcare industry Basic analytical and problem solving skills Good communication and interpersonal skills Ability to work independently and with others Ability to manage more than one assigned tasks at the same time. Claims Healthcare Specialist duties: Resolve client structure setup questions/issues sent to the team with minimal supervisor guidance Maintain relationships with Implementation Managers and Account Managers to facilitate fulfillment of implementation questions and requests in a timely manner Self-manage completion of work inventory in the Plan Setup production queues within established quality and turnaround time guidelines Recommend process and system enhancements for the Plan Setup team to drive improvements to performance Support the management team with misc. projects and resolving assigned Plan setup issues

**Location: Ohio.** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. _The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs._ The **Process Expert II** supports the claims issue research and resolution for Home & Community Based Services (HCBS) by participating in project and process work. **How you will make an impact** Primary duties may include, but are not limited to: + Researches operations workflow problems and system irregularities. + Develops tests, presents process improvement solutions for new systems, new accounts and other operational improvements. + Develops and leads project plans and communicates project status. **Minimum Qualifications:** + Requires a BA/BS and minimum of 5 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:** + Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred. + Claims issue research and resolution for Home & Community Based Services (HCBS) highly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $66,880.00 to $100,320.00. Location(s): Columbus, OH. In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Job Summary: The RTW Examiner will be the key contact between our clients and non-profit partners. They will need to be motivated, results-oriented and responsible for identifying light duty opportunities with nonprofit organizations. Principal Duties & Responsibilities: Effectively communicate the details of our services with nonprofit organizations to help build our national network. Review work restrictions provided by our clients and coordinate job offers with our network of nonprofit organizations. Follow client service instructions for identifying light duty opportunities. Effectively communicate the details of the program with case managers, employers, attorneys and injured workers. Maintain detailed and accurate records. Prepare documentation outlining job offer details. Understanding of employment labor issues as they relate to state jurisdiction, laws and regulations. Ability to problem solve and communicate effectively related to client issues. Provide outstanding customer service to our clients, injured workers' and non-profit organizations. Prepare client and company reports. Sell and market our business to prospects and nonprofit organizations. Qualifications: Associates Degree or bachelor's degree in Business, Human Resources, Communications or other related field preferred Requirements Bilingual and able to communicate (verbal and written) in English and Spanish. 1-year prior customer support experience Workers' compensation experience preferred but not required Strong communication skills Goal oriented Problem solver Skills, Specialized Knowledge and Abilities Excellent customer service and telephone skills. Ability to handle sensitive information and maintain a high level of confidentiality. Ability to type 40 WPM with accuracy: data entry skills, both accurate and efficient. Able to perform at high levels of efficiency in a fast-paced production environment. Proficient with Microsoft Office products - Outlook, Word, Excel, PowerPoint. Organization, attention to detail, flexibility, and strong ability to multi-task. Ability to work in a fast-paced environment without direct supervision. Effectively work with others to build consensus and rapport. This job description is not intended to be all inclusive and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required.

Title: Claims Representative I (Health & Dental) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Claims Representative I responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How you will make an impact: * Learning the activities/tasks associated with his/her role. * Works under direct supervision. * Relies on others for instruction, guidance, and direction. * Work is reviewed for technical accuracy and soundness. * Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. * Researches and analyzes claims issues. Minimum Requirements * HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences * Good oral and written communication skills, previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

General Job Summary: Responsible for performing a variety of clerical duties and responsible for insurance verification for patients with medical or auto insurance as well as authorizations. Essential Job Functions: Greets, screens, schedules, and directs patients/visitors to appropriate areas and demonstrates excellence with respect to treating and caring for customers in-person and over the phone. Responsible for performing a variety of clerical duties: answers phone calls, takes messages, fax, scan, etc. Verify that all forms, test results, and other paperwork are in the electronic health record system according to physician and office protocol. Obtain prior authorization for patients and verify all insurance based on patient schedules, practice management systems and insurance websites for non-automated insurances. Obtain, verify, and update patient information and provides support services to patients and medical staff. Maintain the practice management system. Collect payments for services rendered per policy, including copayments and balances on patient accounts. Daily drawer balancing. Obtain referral from the Primary Care Physician for insurances that require referrals and contact patient regarding missing referrals or inactive insurance coverage. Verify auto and liability eligibility with insurance carriers. Ensure all auto and/or liability forms are completed and received and compare with the schedule. Use these forms to record verification information and file in the chart. Compliance with HIPAA, OSHA, and safety standards of the organization. Performs other duties that may be necessary or in the best interest of the practice. Requirements Education/Experience: High school diploma or equivalent. Minimum one year of experience in a customer service position, preferably in a medical practice setting. Previous medical assisting knowledge preferred. CPR/AED and First Aid certification. Other Requirements: Schedules will change as department needs change, including overtime. Travel as needed. Performance Requirements: Knowledge: Knowledge and proper use of office equipment. Knowledge of practice management and electronic health records systems. Knowledge of HIPAA regulations. Knowledge of current terminology and anatomy. Knowledge of how to obtain insurance benefits and insurance reimbursement policies. Skills: Skilled in communicating effectively with providers, staff, patients and vendors. Use of a practice management software system. Accuracy in data entry. Detailed-oriented with excellent investigational/research skills. Excellent organizational and multi-tasking skills. Excellent adaptability skills. Basic math skills. Abilities: Ability to multi-task and analyze situations to respond appropriately. Ability to use math skills to accurately complete daily balancing and provide accurate change to the patient. Ability to work effectively and deal courteously with patients, staff, and others. Ability to organize work environment and work load to meet needs of the organization. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to accurately examine, understand and enter insurance documents. Ability to work independently with minimal or no supervision. Equipment Operated: Standard office equipment. Work Environment: Medical Office. Mental/Physical Requirements: Sitting about 90% in front of a computer screen. Fast paced high productivity environment.

Global Channel Management is a technology company that specializes in various types of recruiting and staff augmentation. Our account managers and recruiters have over a decade of experience in various verticals. GCM understands the challenges companies face when it comes to the skills and experience needed to fill the void of the day to day function. Organizations need to reduce training and labor costs but at same requiring the best "talent " for the job. Qualifications KNOWLEDGE AND SKILLS: Oral and written communication Superior organizational skills Analytical Customer Focus Computer/Software Skills (Advance MS Excel, SAP) EXPERIENCE: 2+ Years collections experience preferred Additional Information $15/hr 6 months