Claim specialist jobs in Dundalk, MD - 199 jobs

Maryland Auto Insurance is a Property & Casualty Insurance carrier and independent agency of the State of Maryland. We're located in the Locust Point neighborhood of Baltimore, featuring a variety of restaurant and shopping options in walking distance from the office. This position is ideal for candidates who desire flexible work schedules. The incumbent will be required to come into the office a minimum of two days per month. We offer an excellent benefit package including comprehensive health and dental coverage, pension plan, 401(k) plan and incentive program tied to strategic corporate and departmental goals. Generous leave package, tuition reimbursement and free onsite parking available. This role is open to applicants residing in Maryland, Delaware, Pennsylvania, or New Jersey. Position Summary This position will be responsible for recovering monies due to Maryland Automobile Insurance from responsible parties, including uninsured motorists and insurance companies. The Subrogation Specialist will manage a steady case load of Subrogation files. The Subrogation Specialist may manage arbitration and be responsible for recovery of consumer subrogation claims. Essential Functions: Negotiate payment in full, settlement in full, or a payment plan Attend hearings, mediations, settlement conferences, pre-trial hearings and fraud trials. Pursue applicant arbitration, defend respondent arbitration and counter claims. Competencies: Strong written and verbal negotiation skills required. Experienced, professional and creative writing skills and the ability to effectively communicate and persuade by printed word. Must demonstrate the ability to write a professional contention. Strong negotiation skills Ability to work independently and professionally. Professional demeanor and dependability. Accuracy and attention to detail. Critical thinker Exercise considerable independent judgment Strong organizational skills and the ability to prioritize and multi-task PC skills required Basic math skills Ability to be receptive and responsive to change and to embrace continuous improvement. Qualifications Education & Experience: High School Diploma or GED and 8 years of experience in automobile claims, automobile appraisal, law enforcement, or work involving conducting investigations or equivalent combination of education & experience. Subrogation and/or Arbitration experience preferred. Maryland Auto Insurance is a drug-free workplace and an equal opportunity employer, committed to diversity in the workplace. We do not discriminate on the basis of race, color, religion, age, sex, marital status, national origin, physical or mental disability, familial status, genetic information, gender identity or expression, sexual orientation, or any other characteristic protected by State or federal law. Applicants who need an ADA accommodation for an interview should request the accommodation when notified of a request to be interviewed. Applicants must be United States citizens or eligible to work in the United States.

**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $67,000.00 - $110,600.00 **Target Openings** 1 **What Is the Opportunity?** LOCATION REQUIREMENT: This field position services Insureds/Agents in the Maryland area. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. *You will be issued a company vehicle for this position.* Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. **What Will You Do?** + Handles 1st party property claims of moderate severity and complexity as assigned. + Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. + Broad scale use of innovative technologies. + Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate. + Establishes timely and accurate claim and expense reserves. + Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. + Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits. + Writes denial letters, Reservation of Rights and other complex correspondence. + Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. + Meets all quality standards and expectations in accordance with the Knowledge Guides. + Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. + Manages file inventory to ensure timely resolution of cases. + Handles files in compliance with state regulations, where applicable. + Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. + Identifies and refers claims with Major Case Unit exposure to the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as required. + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. + May provides mentoring and coaching to less experienced claim professionals. + May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. + CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. + Must secure and maintain company credit card required. + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. + On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. + This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + General knowledge of estimating system Xactimate. + Two or more years of previous outside property claim handling experience. + Interpersonal and customer service skills - Advanced. + Organizational and time management skills- Advanced. + Ability to work independently - Intermediate. + Judgment, analytical and decision making skills - Intermediate. + Negotiation skills - Intermediate. + Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate. + Investigative skills - Intermediate. + Ability to analyze and determine coverage - Intermediate. + Analyze, and evaluate damages -Intermediate. + Resolve claims within settlement authority - Intermediate. + Valid passport. **What is a Must Have?** + High School Diploma or GED. + One year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program. + Valid driver's license. **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 ******************************************************** .

Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: * Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. * Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. * Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. * Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. * Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. * Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. * Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. * Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. * Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. * Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. * May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities * Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices. * Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. * Demonstrated ability to develop collaborative business relationships with internal and external work partners. * Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. * Demonstrated investigative experience with an analytical mindset and critical thinking skills. * Strong work ethic, with demonstrated time management and organizational skills. * Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. * Developing ability to negotiate low to moderately complex settlements. * Adaptable to a changing environment. * Knowledge of Microsoft Office Suite and ability to learn business-related software. * Demonstrated ability to value diverse opinions and ideas Education & Experience: * Bachelor's Degree or equivalent experience. * Typically a minimum four years of relevant experience, preferably in claim handling. * Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. * Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. * Professional designations are a plus (e.g. CPCU) #LI-AR1 #LI- Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: * Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim * The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions * Maintain claim block and meet departmental production and quality metrics * An awareness of industry claim practices * Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records * Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. * Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process * Establish cooperative and productive relationships with professional resources What you will bring with you: * Bachelor's degree preferred * A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing * Demonstrated ability to work as part of a cohesive team * Strong written and verbal communication skills * Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in negotiation, persuasion, and solutions-based underwriting * Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism * Overall knowledge of health care industry * Proficiency using the Microsoft Office suite of products * Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026

ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers . If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $67,000.00 - $110,600.00 This position could be eligible for a sign on bonus. LOCATION REQUIREMENT: This position services Insureds/Agents in and around Washington DC. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. What Will You Do? Handles 1st party property claims of moderate severity and complexity as assigned. Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. Broad scale use of innovative technologies. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate. Establishes timely and accurate claim and expense reserves. Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits. Writes denial letters, Reservation of Rights and other complex correspondence. Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. Meets all quality standards and expectations in accordance with the Knowledge Guides. Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. Manages file inventory to ensure timely resolution of cases. Handles files in compliance with state regulations, where applicable. Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. Identifies and refers claims with Major Case Unit exposure to the manager. Performs administrative functions such as expense accounts, time off reporting, etc. as required. Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. May provides mentoring and coaching to less experienced claim professionals. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. Must secure and maintain company credit card required. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position. Perform other duties as assigned. Additional Qualifications/Responsibilities What Will Our Ideal Candidate Have? Bachelor's Degree preferred. General knowledge of estimating system Xactimate preferred. Two or more years of previous outside property claim handling experience preferred. Interpersonal and customer service skills - Advanced Organizational and time management skills- Advanced Ability to work independently - Intermediate Judgment, analytical and decision making skills - Intermediate Negotiation skills - Intermediate Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate Investigative skills - Intermediate Ability to analyze and determine coverage - Intermediate Analyze, and evaluate damages -Intermediate Resolve claims within settlement authority - Intermediate Valid passport preferred. What is a Must Have? High School Diploma or GED required. A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required. Valid driver's license required.

Established in 1991, Collabera is one of the fastest growing end-to-end information technology services and solutions companies globally. As a half a billion dollar IT company, Collabera's client-centric business model, commitment to service excellence and Global Delivery Model enables its global 2000 and leading mid-market clients to deliver successfully in an increasingly competitive marketplace. With over 8200 IT professionals globally, Collabera provides value-added onsite, offsite and offshore technology services and solutions to premier corporations. Over the past few years, Collabera has been awarded numerous accolades and Industry recognitions including. Collabera awarded Best Staffing Company to work for in 2012 by SIA. (hyperlink here) Collabera listed in GS 100 - recognized for excellence and maturity Collabera named among the Top 500 Diversity Owned Businesses Collabera listed in GS 100 & ranked among top 10 service providers Collabera was ranked: 32 in the Top 100 Large Businesses in the U.S 18 in Top 500 Diversity Owned Businesses in the U.S 3 in the Top 100 Diversity Owned Businesses in New Jersey 3 in the Top 100 Privately-held Businesses in New Jersey 66th on FinTech 100 35th among top private companies in New Jersey *********************************************** 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 Claims Initiation Analyst II: Receives incoming calls and assists customers with questions or issues regarding potential fraudulent activity on a deposit account (checking, savings) . Takes appropriate action based on an evaluation of the customer's needs which may include, filing a new claim(s), updating and follow-up on existing claim(s), and/or reviewing appeals on denied claims. Takes personal ownership to ensure that customer requests are processed quickly and efficiently, while maintaining compliance with industry regulations and bank procedures. Responsibilities include but are not limited to: initiating claims using multiple systems and tools, providing first call resolution on inquiries, and may assist the customer in resolving disputes directly with the merchant. May debit or credit customer's accounts, as appropriate. May research and resolve other general customer account inquiries as appropriate and/or escalate issues on the customer's behalf while providing world class customer service. Understand and adhere to established service level agreements and set appropriate expectation with the clients and customers regarding the claims process. Ideal candidate will have credit card knowledge in a customer service contact center. Qualifications Critical Skills: * Claims experience (in financial industry, preferrably but not required) * Customer service experience (in a call center environment, preferred but not required) * credit card experience (preferred but not required) Additional Information Should you have any questions, please feel free to call me on ************. Email your resume to: ********************************

This position is responsible for investigating claim denials; performing claim rebills; scanning & mailing documents; handling large volumes of documents; researching using hospital and insurance portals; opening, sorting, and importing incoming correspondence; contacting health insurance companies in order to obtain the status of previously submitted appeals. DUTIES AND RESPONSIBILITIES: Investigates Claims Denials. Handles large volumes of documents, including accurately scanning and mailing documents. Utilizes increased knowledge of the industry, hospital revenue cycle, and payers/insurance companies to document the account and provide information and details to support paralegal's/attorney's pursuit for additional reimbursement. Works within the client's Patient Accounting system, payer portals and/or websites, and will utilize proprietary software to research accounts in the work queue. Is comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals. Opens, sorts, and imports incoming correspondence into the office database. Navigates through various computer systems and applications to find information about insurance claims. Greets and assists onsite guests. Answers calls for Claim status and Appeal status. Performs any other administrative duties as may be necessary. Performs other related duties as assigned by management. QUALIFICATIONS: Bachelor's Degree (BA) from four-year college or university, or one to two years of related experience and/or training, or equivalent combination of education and experience. Other skills required : Previous experience in office administration or another related field. Basic working knowledge of the US healthcare system. Ability to prioritize and multitask. Excellent written and verbal communication skills. Proficiency in Microsoft Office, including Word and Excel. Highly attentive to detail. Excellent organizational and time management skills. Clear, concise, and logical writing style. Computer-savvy, able to learn new applications/software quickly. Please remove paragraph before using in Workplace COMPETENCIES: Select which competency categories are necessary for this position. We strongly recommend diversity and ethics to be included in each . Then select an additional 3-5 of the most critical competencies for the specific job title. Please note: You may remove complete statements and complete sub-title sections however the verbiage/content may not be altered nor can wording be inserted as this is standard in all ADP Job Descriptions and are compliant. COMPETENCIES: Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures. Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals. Business Necessity - The needs of the employer may be dependent on responding to and anticipating rapidly changing external and internal demands in all aspects of how business is conducted. This may include, but is not limited to, organization structure, finances, goals, personnel, work processes, technology, and customer demands. Therefore, it may become necessary to make modifications to how business is conducted, and work is accomplished, with minimal or no advance notice to employees. Accordingly the employee must be capable of adapting, with minimal or no advance notice, to changes in how business is conducted, and work is accomplished, with no diminishment in work performance. Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities; Provides recognition for results. Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan. Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce. Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values. Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions. Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality. Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness. Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly. Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

> Employees Apply Here" onclick="window.location.href = '****************************** InternalUser=true&locale=en_US/';"/> Sr Claims Specialist - 90356824 - Washington Company: Amtrak Your success is a train ride away! As we move America's workforce toward the future, Amtrak connects businesses and communities across the country. We employ more than 20,000 diverse, energetic professionals in a variety of career fields throughout the United States. The safety of our passengers, our employees, the public and our operating environment is our priority, and the success of our railroad is due to our employees. Are you ready to join our team? Our values of 'Do the Right Thing, Excel Together and Put Customers First' are at the heart of what matters most to us, and our Core Capabilities, 'Building Trust, Accountability, Effective Communication, Customer Focus, and Proactive Safety & Security' are what every employee needs to know and do to be most impactful at Amtrak. By living the Amtrak values, focusing on our capabilities, and actively embracing and fostering diverse ideas, backgrounds, and perspectives, together we will honor our past and make Amtrak a company of the future. Job Summary Protect the fiduciary interests of the Corporation through collection efforts, prompt investigation and administrative handling of personal/bodily injury and property damage claims brought by passengers, employees and others. Essential Functions * Investigate liability and damage aspects of accidents/incidents involving reports of personal injury and property damage. * Make contact with claimants promptly, provide assistance, and monitor medical treatment. * Establish appropriate liability accruals/reserves and assure the claims database is accurate and current. * Evaluate claims/lawsuits with respect to liability and damages to determine corporate exposure. * Accomplish the fair and equitable disposition of claims and lawsuits by negotiating settlements with claimants and opposing counsel. * Assist outside counsel in prosecution/defense of lawsuits filed by and against the company. Minimum Qualifications * Bachelor's Degree or equivalent combination of education, training and/or relevant experience. * Plus 3 years of relevant work experience. Preferred Qualifications * Bachelor's Degree or equivalent combination of education, training and/or relevant experience. * Plus 5 years of relevant work experience. Knowledge, Skills, and Abilities * Effective negotiation skills to interact with claimants, attorneys and involved stakeholders * Ability to attend and pass required training to include RWP training and Claims School * Excellent interpersonal skills * Strong organizational skills * Excellent verbal and written communication skills * Proficient in Microsoft Office 365 Suite * Familiarity with medical terminology in managing litigation * Ability to work under stress and maintain professional composure The salary/hourly range is $78,600.00 - $101,844.00. Pay is based on several factors including but not limited to education, work experience, certifications, etc. Depending on an employee's assigned worksite or location, Amtrak may consider a geo-pay differential to be applied to the employee's base salary. Amtrak may offer additional incentive and pay programs to recognize and reward our employees, including a short-term incentive bonus based upon factors such as individual and company performance that is commensurate with the level of the position and/or long-term incentive plan compensation. In addition to your salary, Amtrak offers a comprehensive benefit package that includes health, dental, and vision plans; health savings accounts; wellness programs; flexible spending accounts; 401K retirement plan with employer match; life insurance; short and long term disability insurance; paid time off; back-up care; adoption assistance; surrogacy assistance; reimbursement of education expenses; Public Service Loan Forgiveness eligibility; Railroad Retirement sickness and retirement benefits; and rail pass privileges. Learn more about our benefits offerings here. Requisition ID:165934 Work Arrangement:06-Onsite 4/5 Days Click here for more information about work arrangements at Amtrak. Relocation Offered:No Travel Requirements:Up to 25% You power our progress through your performance. We want your work at Amtrak to be more than a job. We want your career at Amtrak to be a fulfilling experience where you find challenging work, rewarding opportunities, respect among colleagues, and attractive compensation. Amtrak maintains a culture that values high performance and recognizes individual employee contributions. Amtrak is committed to a safe workplace free of drugs and alcohol. All Amtrak positions requires a pre-employment background check that includes prior employment verification, a criminal history check and a pre-employment drug screen. Candidates who test positive for marijuana will be disqualified, regardless of any state or local statute, ordinance, regulation, or other law that legalizes or decriminalizes the use or possession of marijuana, whether for medical, recreational, or other use. Amtrak's pre-employment drug testing program is administered in accordance with DOT regulations and applicable law. In accordance with DOT regulations (49 CFR § 40.25), Amtrak is required to obtain prior drug and alcohol testing records for applicants/employees intending to perform safety-sensitive duties for covered Department of Transportation positions. If an applicant/employee refuses to provide written consent for Amtrak to obtain these records, the individual will not be permitted to perform safety-sensitive functions. In accordance with federal law governing security checks of covered individuals for providers of public transportation (Title 6 U.S.C. §1143), Amtrak is required to screen applicants for any permanent or interim disqualifying criminal offenses. Note that any education requirement listed above may be deemed satisfied if you have an equivalent combination of education, training and experience. Amtrak is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race/color, to include traits historically associated with race, including but not limited to, hair texture and hairstyles such as braids, locks and twists, religion, sex (including pregnancy, childbirth and related conditions, such as lactation), national origin/ethnicity, disability (intellectual, mental and physical), veteran status, marital status, ancestry, sexual orientation, gender identity and gender expression, genetic information, citizenship or any other personal characteristics protected by law. > Employees Apply Here" onclick="window.location.href = '****************************** InternalUser=true&locale=en_US/';"/>

Claims Processor - Entry Level Duration : 5 Months Total Hours/week : 40.00 1 st Shift Client: Medical Device Company Job Category: Customer Service Level of Experience: Entry Level Employment Type: Contract on W2 (Need US Citizens or GC Holders Only) Work days/hours: M - F 8am - 5pm Job Description: The primary responsibility of this position is the investigation, analysis, resolution, trending and corrective action of all claims/complaints. Specific responsibilities include maintaining claim/complaint files and supporting the resolution of claim/complaint CAPAs to closure and verification of CAPA effectiveness. Bachelor's degree required. Minimum of 2 years of experience in complaint investigation. Strong communications and problem solving skills. Ability to work independently. Competent using office software including Database management, MS Word, Excel, Internet Explorer, PowerPoint, and Outlook. Experience with SAP is required.

Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Essential Functions: Reviews providers' disputes and appeals for professional and hospital claims to determine resolution according to policies and procedures. Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and resolution timeliness Perform any projects delegated by claims supervisor Qualifications Minimum Education/ Licensures/Qualifications High School Diploma or GED 1+ year experience handling provider disputes / appeals, preferably in PPO, Self-Funded and/or HMO setting Healthcare Background Understanding of Medical Terminology Additional Information Shift: M-F 8am-5pm RTH or Temp-To-Perm (Any transition heavily depends on performance) Pay Rate: Up to 20/hour

Owner's project management firm is seeking an experienced SENIOR CLAIMS ANALYST for work on construction claims. Candidates qualifications must include demonstrated experience with: Furnishes reports with supporting information necessary to resolve disputes or defend against the claims, Prepares and assembles appeal files, Participates in meetings or negotiations with claimants, Appears in legal proceedings, Prepares cost estimates for use in claims negotiations, Prepares risk assessments/analysis relative to claim exposures, Prepares findings of fact and other documentation required by the CO. Provides litigation support to include court boards, timelines, diagrams, static and electronic illustrations and three dimensional models. Candidates should have demonstrated ability to work cooperatively and productively as a member of a project or claims defense team. Candidates must have 15 years experience and a Bachelor's Degree in Engineering, or Construction/Project Management. CCM and either P.E. or CPA necessary though all three are preferred. Submit resumes and project list in MS Word or PDF format: Please No Calls

The Claims Analyst will perform a variety of "changes and claims" related contract administration tasks. An ideal candidate requires experience in transit projects through design, construction and commissioning phases. The Claims Analyst will be responsible for coordinating and reviewing claims / changes and engaging, strategizing, and working with various Program / Project teams to undertake the merit assessment, mitigation, and resolution of claims. The role requires commercial claim knowledge, and preferably also technical understanding, of multiple subject areas related to implementation of a large transit infrastructure projects. Responsibilities Maintain claims and early warnings' register. Review alleged claims. Carry out initial triage and risk assessment of claims. Review project correspondence, and track and report on project claims. Interface with the contractor and other stakeholders, as required, to gather additional details etc. Attend various technical and commercial project working group meetings. Requirements Required Skills: Critical thinking skills sufficient to apply analytical techniques to assess claims. The ability to liaise effectively and to work closely with various multi-disciplinary technical and project controls teams Proficiency with Microsoft Office Suite, particularly Excel. Strong organization, time management, and prioritization skills with proven ability to balance competing tasks and meet deadlines. Self-directed, detail-oriented, excellent at meeting deadlines with well-developed time management skills. Excellent communication (both written and verbal), teamwork, and interpersonal skills. Required Qualifications: Bachelor's degree in engineering, business or other relevant degree. 1 - 4 years of relevant experience Position Location Field: Hybrid - 2 or 3 days in program office

Aerotek has an immediate opening for a Claims Review Specialist (Workers Compensation) at the corporate office in Hanover, MD. Reporting to the Workers Compensation Compliance Supervisor and Workers Compensation Compliance Manager, the Claims Review Specialist will assist in the monitoring and administering of Aerotek's workers compensation program to ensure the maximum cost containment. Seek to ensure that Third Party Administrator (TPA) is managing claims efficiently. ESSENTIAL FUNCTIONS Conducts and properly document all incident /accident investigations into our RIMIS system. Ensures the TPA thoroughly and properly investigates all initial claims. Monitor to ensure that TPA follows appropriate state workers compensation laws and defenses Within the scope of authority, reviews and authorizes worker's compensation settlement offers to be made by the TPA Effectively monitors medical and disability claim authorizations and payments to ensure their appropriate and accurate Reviews costs associated with all claims handling and develops strategies to improve performance Works with TPA to move claims toward closure Partners with Safety, Human Resources and Corporate Legal to drive claims management Makes appropriate referrals to outside vendors such as defense attorneys, nurse case managers and investigator Collect OSHA data and update OSHA field in GRA Coordinates the colleague's release to transitional duty with the Return to Work Specialist and the Field Office; Obtains evidence in contested and/or litigated claims to assist outside attorneys to defend claim and to prepare for trial Initiates subrogation where appropriate with management's authorization Prepares for and attends Claim Review Conference with TPA to evaluate individual cases; reviews, and adjusts financial reserves of claims; negotiates with TPA the settlement of claims within established authority and work together to develop detailed and doable Plans of Actions Review reserves and provide authorization to TPA, where appropriate within authority Reviews performance of external vendors in the areas of claims administration, manages litigation and make recommendation to Workers Compensation Compliance Supervisor for adjustments Monitors and reviews workers compensation claims and the claims processing; identifies claims management trends and inefficiencies and make recommendation as needed Participates in developing strategies to reduce claims frequency and severity Establishes and maintains a file and diary on all open claims Participates in communicating claims trends to Regional Safety Manager Working with Compliance Supervisor to develop and conduct training to field offices regarding workers compensation issues and process Attends training sessions, conferences and workshops to keep abreast of current practices, programs and legal issues for the purpose of conveying and/or gathering information required to perform functions Authority level for settlements up to $70,000 Authority level for reserves up to $80,000 QUALIFICATIONS High School Diploma required 3 years work experience in insurance, workers compensation claim management or risk management or Ability to learn TPA system & generate requested reports Per Pay Transparency Acts: The range for this position is $60,000 - $80,000 + annual bonus potential of $4,000 Benefits are subject to change and may be subject to specific elections, plan, or program terms. This role is eligible for the following: Medical, dental & vision 401(k)/Roth Insurance (Basic/Supplemental Life & AD&D) Short and long-term disability Health & Dependent Care Spending Accounts (HSA & DCFSA) Transportation benefits Employee Assistance Program Tuition Assistance Time Off/Leave (PTO, Primary Caregiver/Parental Leave)

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.

CENCO is a trusted claims solutions provider, working with leading insurance carriers to deliver timely and accurate claims handling. We are currently seeking a Daily Claims Adjuster in the Baltimore, MD area to support residential property claims. This opportunity is ideal for adjusters looking for consistent daily assignments with the flexibility of independent field work. What You'll Do: Complete on-site inspections for residential property losses, including wind, hail, fire, and storm-related damage Document damages thoroughly with clear photos and detailed reports Write accurate estimates using Xactimate or Symbility Communicate effectively with policyholders, contractors, and carrier partners Manage claim files efficiently while meeting carrier timelines and expectations What We're Looking For: Licensing: Active Maryland adjuster license or designated home state license Software Experience: Working knowledge of Xactimate or Symbility Equipment: Reliable vehicle, ladder, laptop, and standard adjusting tools Work Style: Detail-oriented, self-motivated, and comfortable working independently Responsiveness: Ability to accept assignments promptly and meet reporting deadlines Why Work with CENCO? Consistent residential claim volume in the Baltimore market Competitive per-claim compensation with dependable payment Support from an experienced claims team and streamlined workflows Long-term opportunities for steady daily work If you're seeking reliable daily residential claims work in the Baltimore area and want to partner with a company known for professionalism and support, we'd love to connect.

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.

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.

RAYUS now offers DailyPay! Work today, get paid today! RAYUS Radiology is looking for an Insurance Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As an Insurance Specialist, you will provide expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information. Develops and maintains positive relationships with referring physicians and patients. This is a full-time position working 8:00 AM - 4:30 PM. ESSENTIAL DUTIES AND RESPONSIBILITIES: (65%) Insurance Administration Prioritizes work load to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority Determines if patient's insurance is a part of the provider network Makes outgoing calls to insurance companies for pre-certification or any authorization Receives pre-authorization from patients and/or insurance companies and documents Contacts patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed Accurately enters a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system Maintains positive interactions with referring offices, patients and staff Backs up front desk reception and scheduling area as needed (30%) Price Quotes Completes payor-related information i.e., payor, payor class, date of appointment Obtains all workers compensation approvals from insurance companies prior to scheduled exam Obtains signs and symptoms in order to support medical necessity (5%) Completes other duties as assigned