Claim specialist jobs in Greece, NY - 23 jobs

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* The Claims Examiner I obtains and analyzes data for thorough, fair, objective, and timely processing of New York State statutory Short-Term Disability and Paid Family leave claims. The goal of the position/role is to consistently pay the accurate amount for each claim in accordance with the current laws/regulations. Research Develop an understanding and working knowledge of disability and paid family leave Develop an understanding of the applicable claim definitions and relevant provisions, clauses, exclusions, riders and waivers for the necessary requirements. Develop an operating knowledge of the applicable claims system(s). Develop basic claims skills and an understanding of claim practices and procedures. Utilizes most efficient means to obtain claim information. Analysis and Adjudication Fully investigates all relevant claim issues with oversight by Manager when needed. Provides payment or denials promptly and in full compliance with department procedures and regulations. Researches specifics regarding eligibility and pre-existing formulas in reference to specific claim. Pro-actively communicates with claimants, policyholders, and physicians when applicable Case Management Utilizes appropriate intervention for the characteristics of each claim. Manages assigned case load and processes within the specified time requirements. Good written documentation that provides clear, concise and accurate information to claimants as well as within the claims administrative system. Customer Service Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands. Establishes, communicates, and manages claimant and policyholder expectations. Documents claim file actions and telephone conversations appropriately. Ability to handle confidential information with the utmost judgment and discretion REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR RELATED EXPERIENCE *or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience* Required Knowledge, Skills, Abilities and/or Related Experience High school diploma (or equivalent) Must have 1-3 years of New York State statutory Disability and Paid Family leave claims processing experience to be considered for this role. Experience with Microsoft Office Work experience in decision-making and information analysis. Demonstrated prioritization and organization skills. Ability to communicate clearly and succinctly verbally and in writing Must be able to work in a team oriented environment. Meet and exceed production, attendance, quality and service Ability to organize work, manage time and follow through Availability to work overtime when required Ability to Travel: None PHYSICAL REQUIREMENTS When used in the description below, the following terms are defined as: “Occasional”: done only from time to time, but necessary when it is performed “Frequent”: regularly performed; generally an act that is required on a daily basis “Continuous”: typically performed for the majority of an employee's shift Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objecting and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones. Reliance Matrix will provide qualified employees with a reasonable accommodation in accordance with applicable law. CORE VALUES Collaboration Compassion Empowerment Integrity Fun The above description reflects the general details considered necessary to describe the principle responsibilities and functions of the job identified and shall not be construed as a detailed description of all the work requirements that may be inherent to this job. The expected hiring range for this position is $22.41 - $28.02 hourly for work performed in the primary location (Canandaigua, NY). This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate's starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future. Work location may be flexible if approved by the Company. What We Offer At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you. That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing. Our Benefits: An annual performance bonus for all team members Generous 401(k) company match that is immediately vested A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account Multiple options for dental and vision coverage Company provided Life & Disability Insurance to ensure financial protection when you need it most Family friendly benefits including Paid Parental Leave & Adoption Assistance Hybrid work arrangements for eligible roles Tuition Reimbursement and Continuing Professional Education Paid Time Off - new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service. Volunteer days, community partnerships, and Employee Assistance Program Ability to connect with colleagues around the country through our Employee Resource Group program Our Values: Integrity Empowerment Compassion Collaboration Fun EEO Statement Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications. #LI-Remote #LI-AS1

Claims Adjuster Salary :$75 K to $85 K Benefits Yes Bonus No Must-Haves 1 2-4 years of adjudicating worker's compensation and general liability claims at a high volume 2 Risk management experience 3 Associates Degree in Business, Risk Management or related field Nice-To-Haves 1 Experience managing a third party insurance agent like Traveler's insurance Job Description Are you a skilled professional with 2-4 years of experience in Worker's Compensation? We're seeking a dynamic and knowledgeable individual to join our team and make a significant impact in incident claim liability mitigation through collaborative efforts with internal and external stakeholders and managing high case loads Key Responsibilities: Conduct thorough investigations into worker's compensation claims. Assess and analyze claim information to ensure accurate and fair settlements. Collaborate with internal teams and external stakeholders for effective claims resolution. Stay updated on industry regulations and compliance standards. Provide expert guidance and support to ensure a smooth claims process. Qualifications: Associates degree in Business, Risk Management or related field is required 2-4 years of hands-on experience primarily in Worker's Compensation and General liability claims. In-depth knowledge of claim investigation and settlement processes. Familiarity with relevant laws, multi-state regulations, and industry best practices. Strong analytical and problem-solving skills. Excellent communication and interpersonal abilities. Bonus Points: Experience working at an insurance firm, especially with Travelers. What We Offer: Exciting and challenging work environment. Competitive compensation package. Opportunities for professional growth and development. Flexible work schedule Much more! If you're passionate about making a difference in Worker's Compensation and have the experience to match, we want to hear from you! Join us in ensuring a safe and fair workplace for all. Apply today by sending your resume. Let's build a safer and healthier workplace together!

Division or Field Office: Claims I Division Home & Auto Liability Dept Work from: Home in ERIE Operating Footprint Salary Range: $59,186.00 - $94,543.00 * salary range is for this level and may vary based on actual level of role hired for * This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment. At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia. Benefits That Go Beyond The Basics We strive to be Above all in Service to our customers-and to our employees. That's why Erie Insurance offers you an exceptional benefits package, including: * Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work. * Low contributions to medical and prescription premiums. We currently pay up to 97% of employees' monthly premium costs. * Pension. We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service. * 401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension. * Paid time off. Paid vacation, personal days, sick days, bereavement days and parental leave. * Career development. Including a tuition reimbursement program for higher education and industry designations. Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year. Position Summary Exercises independent discretion and judgement in claims handling involving complex liability issues, to include coverage issues and minor injury claims. * The selected candidate will work from home within the ERIE operating footprint, but will handle New York claims. Duties and Responsibilities * Conducts investigations, evaluate and make recommendations regarding coverage and liability. * Sets and maintains reserves. Obtains documents to establish the value of claims and negotiates settlement or declines claim. * Documents files and submits final report. * Identifies subrogation opportunities and initiates appropriate action. * Negotiates with all parties, or their representatives, within designated authority. * Completes required training. * Trains and mentors. * Travel for training may be required. The first five duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished. This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become evident. Capabilities * Values Diversity * Nimble Learning * Self-Development * Collaborates * Customer Focus * Cultivates Innovation * Information Management Skills * Instills Trust * Optimizes Work Processes (IC) * Job-Specific Knowledge * Ensures Accountability * Decision Quality Qualifications Minimum Educational and Experience Requirements * High school diploma or equivalent and two years of claims or customer service experience, preferably with casualty claims, required. * Equivalent educational experience will be considered. * Associate's or Bachelor's degree, preferred. Designations and/or Licenses * Appropriate license as required by state. Physical Requirements * Lifting/Moving 0-20 lbs; Occasional ( * Lifting/Moving 20-50 lbs; Occasional ( * Ability to move over 50 lbs using lifting aide equipment; Occasional ( * Pushing/Pulling/moving objects, equipment with wheels; Occasional ( * Climbing/accessing heights; Rarely * Driving; Occasional ( * Manual Keying/Data Entry/inputting information/computer use; Frequent (50-80%)

At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Multi-line Adjuster Trainee -New York City, NY, Buffalo, NY, Syracuse, NY Rochester, NY, Albany, NY Salary: "*Starting pay rate varies based upon position and location. Ask your Recruiter for details!" We are looking for a highly motivated and service-oriented individual to join our Multi-line Damage team as a Multi-line Property Damage Trainee! As an ambassador for GEICO's renowned customer service, you will work in a dynamic environment that may include repair shops, salvage yards, a customer's home or in a virtual estimating environment. You will be responsible for inspecting damage, estimating cost of repairs, negotiating settlements, issuing payments, and providing excellent customer service. This position primarily will include servicing boat, motorcycle, RV and other specialty claims. Our industry-leading, paid training, which includes 3-weeks of required hands-on experience at our Ashburn, VA training facility will teach you the ins and outs of physical damage adjusting. We will provide the resources and training so you can directly assist our customers after accidents or major disasters. We're looking for those who are equally as motivated as they are compassionate. Your unique skillset, along with the latest adjusting tools and tech, will help you. Qualifications & Skills: Valid driver's license (must meet company underwriting guidelines for at least the past 3 consecutive years) and the ability to maintain applicable state and federal certifications and permits Willingness to be flexible with primary work location - position may require either remote or field work Solid computer, mechanical aptitude, and multi-tasking skills Effective attention to detail and decision-making skills Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities Minimum of high school diploma or equivalent, college degree or currently pursuing preferred Annual Salary $25.44 - $45.28 The above annual salary range is a general guideline. Multiple factors are taken into consideration to arrive at the final hourly rate/ annual salary to be offered to the selected candidate. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations. At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. * Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. * Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. * Access to additional benefits like mental healthcare as well as fertility and adoption assistance. * Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. Essential Job Duties * Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. * Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. * Assists with reducing rework by identifying and remediating claims processing issues. * Locates and interprets claims-related regulatory and contractual requirements. * Tailors existing reports and/or available data to meet the needs of claims projects. * Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. * Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. * Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. * Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. * Works collaboratively with internal/external stakeholders to define claims requirements. * Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. * Fields claims questions from the operations team. * Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. * Appropriately conveys claims-related information and tailors communication based on targeted audiences. * Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. * Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. * Supports claims department initiatives to improve overall claims function efficiency. Required Qualifications * At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. * Medical claims processing experience across multiple states, markets, and claim types. * Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. * Data research and analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Ability to work cross-collaboratively in a highly matrixed organization. * Customer service skills. * Effective verbal and written communication skills. * Microsoft Office suite (including Excel), and applicable software programs proficiency. Preferred Qualifications * Health care claims analysis experience. * Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $22.81 - $46.42 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

CENCO is a trusted name in property claims solutions, working with leading insurance carriers to provide accurate, timely, and efficient adjusting services. We are currently seeking experienced Daily Property Claims Adjusters to handle residential and commercial claims throughout Rochester and the surrounding Western New York region. This position is ideal for independent adjusters looking for steady work and the flexibility of field-based assignments. Key Responsibilities: Conduct thorough inspections of property damage from wind, water, fire, hail, and other covered events. Document damages with detailed reports and high-quality photos. Create accurate estimates using Xactimate or Symbility. Maintain professional communication with policyholders, contractors, and insurance carriers. Manage claims efficiently and meet all required reporting deadlines. Requirements: Licensing: Active New York adjuster license is required. Software: Familiarity with Xactimate or Symbility preferred. Equipment: Reliable transportation, ladder, laptop, and standard field tools. Work Style: Self-motivated, detail-oriented, and able to work independently. Availability: Must be responsive to assignments and able to complete claims promptly. Why Join CENCO? Steady claim volume in Rochester and surrounding areas Competitive, on-time compensation Supportive internal team and efficient claims handling systems If you're an experienced adjuster looking for consistent work and the opportunity to grow with a respected industry leader, we want to hear from you!

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.

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.

SUMMARY DESCRIPTION: The Residential Field Adjuster is responsible for investigating, inspecting, negotiating, and bringing to final resolution property claims of all named-peril losses. For claims where the damage is less severe, the Property Field Adjuster may be assigned tasks, such as verification of damage. The role's primary duties include reviewing coverage, inspecting damaged property, and estimating repair/replacement costs in accordance with the client's and RENFROE's guidelines. The Property Field Adjuster is also responsible for documenting all activity, submitting proper claims paperwork, handling renters and personal property policies, meeting with contractors, effectively communicating with the client and all stakeholders, and ensuring compliance with legal and contractual obligations. REPORTS TO: Assigned RENFROE Manager ESSENTIAL JOB FUNCTIONS: Follows RENFROE and clients' policies and procedures to handle all assigned property claims Works with the RENFROE Manager and other adjusters to share knowledge and experience and to gain new skills Completes assigned property adjustments, such as property or contents inspections, verification of loss, and updates claims as new information becomes available using XactAnalysis, Xactimate, or other estimating platforms Manages the progression of claims/tasks and claim inventories assigned to the them Travels to the loss location to inspect the property, which could include climbing the roof, inspecting the attic, or other inspection points, to establish the cause and scope of the loss Works with contractors or another representative to reach an agreement on the scope of loss Reviews the insurance policy and endorsement details to confirm coverage Contacts and interacts with the insured to obtain documents such as property deeds, purchase receipts, warranties, photographs, or other documents to establish the existence, ownership, and value of the items claimed lost Assists the client and claims examiner in determining coverage and amounts for additional living expenses such as rental housing, travel, meals, etc. Writes closing reports, including recommendations for repair and/or replacement, the pursuit of subrogation, and salvage potential Maintains required jurisdictional adjusting licenses as required by the client and/or RENFROE Does not handle claims for which they do not have client authorization or for which they are not licensed Participates and communicates in client team meetings to discuss claim handling trends, team production, and any claim handling concerns or changes Makes suggestions on ways to improve process efficiency Participates in special projects and completes other duties as assigned Non-Authorized Activities: Field adjusters should not: Communicate training requirements to client staff adjusters and non-affiliated firms Communicate training requirements to any claim handler who is not deployed with RENFROE Discuss Human Resource issues with any client staff adjusters in any segment or any claim handler that is not deployed with RENFROE Discuss any of the following topics with a client staff adjuster or any claim handler that is not deployed with RENFROE: job openings, termination, prior work history, attendance, absence requests, daily work schedule, claim volume or workload, meal and rest break schedule, promotions, development, compensation, or mentoring of any kind EXPERIENCE/QUALIFICATIONS: Minimum of 1 year of property claims experience is preferred Participation in technical insurance coursework is preferred, such as CPCU Experience using various claims processing systems is preferred Appropriate licenses, depending on state requirements, and successful completion of required/applicable claims certification training classes Effective problem resolution and decision-making skills to include analyzing insurance policies and information, demonstrating sound judgment, and utilizing one's own experience and the experience of others Strong analytical skills and consistent attention to detail Knowledge of ISO forms, and client policy coverage, procedures, and systems Communicates clearly and effectively, both verbally and in writing Strong customer service orientation and good rapport with the insured Well-organized and hard-working, with the ability to thrive in a fast-paced work environment Strong interpersonal skills and proven ability to establish good relationships with clients, RENFROE management, employees, and others with whom they interact Computer skills, including but not limited to practical knowledge of Word and Excel PHYSICAL DEMANDS: Ability to operate an automobile and have a valid driver's license with a safe driving record Ability to travel by automobile or airplane Must be able to lift, carry, unfold/extend, and climb a ladder (which may exceed 50 lbs. in weight) that is approved by the appropriate regulatory agency or complies with legislative or regulatory occupational health and safety requirements Must be able to complete measurements of roofs and inspect interior as necessary, including attics, basements, and crawl spaces for residential and commercial structures Must be able to do the following while conducting an inspection: climb, bend, crawl, stoop, walk, reach, kneel, squat, and carry/lift objects (typically weighing less than 50 lbs.) Must be able to work outdoors in all types of weather Ability to operate a telephone and a computer for extended periods of time Must be able to work extended and varying work schedules, including working up to 12 hours a day, 7 days a week, for extended periods of time, including weekends and holidays Ability to work in a fast-paced, changing, and multi-tasking environment

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Contents Adjuster **PRIMARY PURPOSE** : To handle losses and claims for property and casualty insurers. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies and other records to determine insurance coverage. + Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim. + Consults police and hospital records and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance. + Estimates cost of repair, replacement, or compensation. + Prepares report of findings and negotiates settlement with claimant. + Recommends litigation by legal department when settlement cannot be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Assists in preparing loss experience report to help determine profitability and calculates adequate future rates. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Obtain IIA-AIC designation within 12 to 18 months. Appropriate state adjuster license is required. **Experience** None. **Skills & Knowledge** + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Demonstrated commitment to timely reporting + Strong customer service skills + Strong interpersonal skills + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently or in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** : Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** : + Must be able to stand and/or walk for long periods of time. + Must be able to kneel, squat or bend. + Must be able to work outdoors in hot and/or cold weather conditions. + Have the ability to climb, crawl, stoop, kneel, reaching/working overhead + Be able to lift/carry up to 50 pounds + Be able to push/pull up to 100 pounds + Be able to drive up to 4 hours per day. + Must have continual use of manual dexterity. **Auditory/Visual** : Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($50,000 - $70,000). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. **Job Location (Full Address):** 905 Elmgrove Rd, Rochester, New York, United States of America, 14624 **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500011 Patient Financial Services Work Shift: UR - Day (United States of America) Range: UR URC 206 H Compensation Range: $20.99 - $28.34 _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: Performs follow-up activities designed to bring all open account receivables to successful closure and obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. Mentors and trains new or lower-level staff. **LOCATION** + Rochester Tech Park (RTP), Gates, NY + Remote options available after in-person training. + Occasional onsite meetings / work at RTP are required. + Remote location must be within 2 hours of RTP and within New York State. **ESSENTIAL FUNCTIONS** + Independently determines the most effective method to follow up on disputed, unpaid, underpaid, or overpaid insurance or contracted service accounts in order to bring about prompt account resolution and revenue collection from complex claims, high dollar claims, and specialized services. Identifies and resolves problems related to primary and secondary accounts which are disputed, unpaid, underpaid or overpaid. + Determines cause of problem and initiatives corrective action through reviews of electronic medical records. + Works to confer with external agencies. + Analyzes accounts and determines if correct proration of revenue has been collected, using detailed understanding and application of all payer contracts. + Contacts applicable agency, payer or department for resolution. + Decides when resubmitting efforts are complete, including writing an appeal using applicable content and supporting documentation to appropriately influence the highest level of revenue. + Acts as a resource for questions from assigned collection and billing staff on payer policies, procedures and methods of revenue collection. + Trains new staff on the use of the billing application, payer systems, and clearinghouse systems. + Demonstrates how to apply the knowledge of payer contracts and resources to resolve disputed, unpaid, underpaid, or overpaid accounts. + Provides feedback to leadership on results of training of new and existing staff. + Provides input for performance assessments based on observation, questions, and quality reviews of work performed. + Acts as area leader, when needed, including responding to payers, patients, and issues referred to the area from hospital departments or department representatives. + Researches and responds to clinical department inquiries on complex, high dollar, and specialized accounts and status of collection activities affecting departmental revenue. + Assesses if/when patients are contacted. + Resolves complex, high dollar, and specialized claim resolution issues due to coordination of benefits, eligibility issues, and authorizations. + Resolves accounts identified in third party audits involving retroactive approvals, resulting in adjustments, refunds, and subsequent secondary billing. + Researches, verifies, and/or obtains authorizations post-claim submittal. + Determines allocation of reimbursement applicable to multiple providers for global transplant payments and initiates transfer of money to each payer. + Identifies need for in-person meetings and phone conferences with third party insurance representatives due to claim and system issues requiring prompt attention for complex high dollar accounts. + Prepares information for and attends meeting with third-party insurance representatives on claims and systems issues for scheduled in-person meetings and phone conferences regarding complex high dollar claims. + Identifies and clarifies issues that require management and intervention to avoid loss of revenue. + Recommends filing of a formal complaint with the State's regulation commission or agency. + Determines when to change the account to a self-pay financial class after a review of previous efforts has not resulted in revenue collection and further attempts would not be successful without patient intervention. + Research and initiates suggestions to leadership to streamline processes and training materials. + Performs coverage for other positions as needed. Performs administrative office tasks and maintains records. Other duties as assigned. **MINIMUM EDUCATION & EXPERIENCE** + Associate's degree and 3 years of relevant experience required + Or equivalent combination of education and experience The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University's Mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law. Notice: If you are a **Current Employee,** please **log into my URHR** to search for and apply to jobs using the Jobs Hub. Your application, if submitted using this portal, cannot be moved forward. **Learn. Discover. Heal. Create.** Located in western New York, Rochester is our namesake and our home. One of the world's leading research universities, Rochester has a long tradition of breaking boundaries-always pushing and questioning, learning and unlearning. We transform ideas into enterprises that create value and make the world ever better. If you're looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals. At the University of Rochester, we are committed to fostering, cultivating, and preserving an inclusive and welcoming culture and are united by a strong commitment to be ever better-Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.

Collection Adjuster 1 - Consumer Reports To: Consumer Collection Manager Department: Retail Lending - Collections FLSA Status: Non-Exempt Purpose : The Consumer Collection Adjuster 1 is responsible for managing delinquency to acceptable levels in accordance with established Department goals and objectives. Must strictly adhere to all Bank policies and procedures, in addition to all State and Federal mandates and requirements. This position will work with borrowers in providing financial counseling and to implement structured repayment plans to bring the borrower's loan status to current and to encourage a future banking relationship. Supervisory Responsibilities : Degree of Supervision Received: Extensive Supervision Received (title): Consumer Collection Manager Degree of Supervision Given: None Supervision Given to (Titles): N/A Essential Functions : Contact delinquent borrowers to arrange for timely repayment. The majority of the contact is initiated though telephone contact. Letters and approved e-mails are other permissible contact options. A measurable goal is the expectation for borrower contact via telephone: Example - An average of 135 calls per day. Obtain updated borrower information. Verify information with each interaction. Utilize standard collection practices when attempting to located borrowers such as: skip tracing tools and techniques; approved social media outlets; and approved and authorized references and third parties. Fully, clearly and concisely document all borrower interactions and conversations. Fully disclose all collection activity. Solid knowledge of regulations governing collection activity such as, but not limited to: FDCPA, SCRA, Privacy, Fair Lending, and Identity Theft. Must ensure strict adherence is critical to avoid sanctions, fines and penalties both from a Bank and personal liability standpoint. Resolution of delinquency; NSF items; returned electronic payments; all for the purpose of reducing delinquency and avoiding losses. Creation of repayment/workout plans that are both good for and reasonable for the borrower and the Bank. Daily review of delinquent queues and borrowers to identify potential/y serious problems; to receive immediate repayment and to schedule future payments. A measurable goal is the expectation for acquiring electronic payments: Example - 200-250 per month. Define problems, collect data, establish facts. Promptly respond to all inquiries. Research borrower inquiries and resolve payment posting issues. Provide loan history information and explanations. Work closely with peers across the Bank to provide the best possible borrower experience. Develop solid working relationships with: Branches, Loan Servicing, Banking Center and Systems Analysts. Educate borrowers on the resolution process - provide assistance and alternatives, fully describe and detail eligibility for relief options: Extensions/deferments, government established relief programs, charitable organizations, and debt counseling agencies. Provide assistance to ensure the most accurate borrower information and records: Change of Address Forms, Extension/Deferment Forms, Due Date Change Requests, Authorization for Preauthorized Payments, and Repossession Request Forms. Identify potential loss situations by securing pertinent borrower information, and by analyzing financial data. Determine the probability of timely repayment - income vs debt. Proactively alert management to possible fraud situations. Formulate plans and seek approval by working closely with management. Must perform all tasks and responsibilities by working in a partnership with peers, management, Loan Servicing and Call Center teams. Values must align with working in a true team environment to consistently deliver a superior quality of service. Demonstrate the standards and principles of the Five Star Bank experience in every interaction with internal and external customers, associates, and stakeholders. Incorporate the high-performance behaviors of teamwork, leading by example, and service in every facet of work. This job description is not exhaustive. The Collection Adjuster 1 - Consumer may be required to perform other duties as assigned. Job Related Qualifications - Education and Prior Experience : Required: Education: High School Diploma or equivalent Prior Experience: 2+ years of Collection, Banking, Customer Service, Call Center, Sales, Auto Financing, Collection Agency, Law Firm, Credit Union Preferred: Education: Associate Degree in business or related field Prior Experience: 2+ years of Collection, Banking, Customer Service, Call Center, Sales, Auto Financing, Collection Agency, Law Firm, Credit Union Competencies : Strong verbal and written communication skills. Demonstrated customer service skills. Basic knowledge of the collection function. Working knowledge of Microsoft Office, Windows operating system, and Excel applications with the ability to learn new and existing Banking software. Analytical ability to interpret data and to make sound decisions and logical recommendations. Excellent negotiation skills with the ability to overcome objections. Strong organizational skills. Ability to work in a fast- paced, high volume environment with specific measurement performance goals. Follow through, accountability, integrity, empathy, accuracy, attention to detail and problem solving are required skills. Physical Requirements : Able to regularly sit for prolonged periods of time. Extensive computer usage is required. Ability to work: Evenings Occasionally Weekends Occasionally

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. The Crop Division of Great American has been helping generations of farmers take control of their risks since 1915. The Division is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI policies. With six regional offices throughout the U.S., the teams provide tremendous expertise in the specific needs of farmers and crops. ********************************** Great American is currently seeking Seasonal Crop Adjusters. These positions are seasonal and may not be eligible for full-time or part-time benefits. Qualified candidates will cover territory in one of the following states: * Alabama * Arkansas * California * Colorado * Florida * Georgia * Idaho * Illinois * Indiana * Iowa * Kansas * Kentucky * Louisiana * Michigan * Minnesota * Mississippi * Missouri * Montana * Nebraska * New York * North Carolina * North Dakota * Ohio * Oklahoma * Oregon * Pennsylvania * South Carolina * South Dakota * Tennessee * Texas * Washington * Wisconsin * Wyoming Schedule: Seasonal part-time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, you will: * Understand and can work claims for all major crops, policy/plan types, in all stages of growth. * Complete field inspections, reviews, and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company Crop insurance policies. * Review and evaluates coverage and/or liability. * Secure and analyze necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims. * Ensure compliant and cost effective application of Crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory requirements. * Accurately document, process and transmit loss information to determine potential. * Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions, or trials as necessary. * May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority. * Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. * Ensures that claims handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed. * Follow regulatory and company rules, policies, and procedures. * Performs other duties as assigned. Physical Requirements for employees in the Crop Business Unit/Crop Claims General Adjuster * Requires continuous and prolonged walking and standing. * Requires frequent lifting, carrying, pushing and pulling of objects up to 50 lbs. * Requires frequent climbing grain bins, bending, twisting, stooping, kneeling and crawling. * Requires overhead reaching and grabbing. * Requires regular and predictable attendance. * Requires ability to conduct visual inspections. * Requires work outdoors, in inclement weather conditions. * Requires frequent travel. * May require ability to operate a motor vehicle. Business Unit: Crop Salary Range: $0.00 -$0.00 Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryReviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. Additional Responsibilities: Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists. - Makes outbound calls to obtain required information for claim or reconsideration. Required Qualifications- New York Independent Adjuster License- Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. Preferred Qualifications- 18+ months of medical claim processing experience- Self-Funding experience- DG system knowledge Education- High School Diploma required- Preferred Associates degree or equivalent work experience. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$18. 50 - $42. 35This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/27/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. * Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. * Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. * Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. * Assists in reviews of state and federal complaints related to claims. * Collaborates with other internal departments to determine appropriate resolution of claims issues. * Researches claims tracers, adjustments, and resubmissions of claims. * Adjudicates or readjudicates high volumes of claims in a timely manner. * Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. * Meets claims department quality and production standards. * Supports claims department initiatives to improve overall claims function efficiency. * Completes basic claims projects as assigned. Required Qualifications * At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. * Research and data analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Customer service experience. * Effective verbal and written communication skills. * Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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.

Collection Adjuster 1 - Consumer Reports To: Consumer Collection Manager Department: Retail Lending - Collections FLSA Status: Non-Exempt Purpose: The Consumer Collection Adjuster 1 is responsible for managing delinquency to acceptable levels in accordance with established Department goals and objectives. Must strictly adhere to all Bank policies and procedures, in addition to all State and Federal mandates and requirements. This position will work with borrowers in providing financial counseling and to implement structured repayment plans to bring the borrower's loan status to current and to encourage a future banking relationship. Supervisory Responsibilities: Degree of Supervision Received: Extensive * Supervision Received (title): Consumer Collection Manager Degree of Supervision Given: None * Supervision Given to (Titles): N/A Essential Functions: * Contact delinquent borrowers to arrange for timely repayment. The majority of the contact is initiated though telephone contact. Letters and approved e-mails are other permissible contact options. A measurable goal is the expectation for borrower contact via telephone: Example - An average of 135 calls per day. * Obtain updated borrower information. Verify information with each interaction. Utilize standard collection practices when attempting to located borrowers such as: skip tracing tools and techniques; approved social media outlets; and approved and authorized references and third parties. Fully, clearly and concisely document all borrower interactions and conversations. Fully disclose all collection activity. * Solid knowledge of regulations governing collection activity such as, but not limited to: FDCPA, SCRA, Privacy, Fair Lending, and Identity Theft. Must ensure strict adherence is critical to avoid sanctions, fines and penalties both from a Bank and personal liability standpoint. * Resolution of delinquency; NSF items; returned electronic payments; all for the purpose of reducing delinquency and avoiding losses. Creation of repayment/workout plans that are both good for and reasonable for the borrower and the Bank. Daily review of delinquent queues and borrowers to identify potential/y serious problems; to receive immediate repayment and to schedule future payments. A measurable goal is the expectation for acquiring electronic payments: Example - 200-250 per month. * Define problems, collect data, establish facts. Promptly respond to all inquiries. Research borrower inquiries and resolve payment posting issues. Provide loan history information and explanations. Work closely with peers across the Bank to provide the best possible borrower experience. Develop solid working relationships with: Branches, Loan Servicing, Banking Center and Systems Analysts. * Educate borrowers on the resolution process - provide assistance and alternatives, fully describe and detail eligibility for relief options: Extensions/deferments, government established relief programs, charitable organizations, and debt counseling agencies. * Provide assistance to ensure the most accurate borrower information and records: Change of Address Forms, Extension/Deferment Forms, Due Date Change Requests, Authorization for Preauthorized Payments, and Repossession Request Forms. * Identify potential loss situations by securing pertinent borrower information, and by analyzing financial data. Determine the probability of timely repayment - income vs debt. Proactively alert management to possible fraud situations. Formulate plans and seek approval by working closely with management. * Must perform all tasks and responsibilities by working in a partnership with peers, management, Loan Servicing and Call Center teams. Values must align with working in a true team environment to consistently deliver a superior quality of service. * Demonstrate the standards and principles of the Five Star Bank experience in every interaction with internal and external customers, associates, and stakeholders. Incorporate the high-performance behaviors of teamwork, leading by example, and service in every facet of work. * This job description is not exhaustive. The Collection Adjuster 1 - Consumer may be required to perform other duties as assigned. Job Related Qualifications - Education and Prior Experience: Required: * Education: High School Diploma or equivalent * Prior Experience: 2+ years of Collection, Banking, Customer Service, Call Center, Sales, Auto Financing, Collection Agency, Law Firm, Credit Union Preferred: * Education: Associate Degree in business or related field * Prior Experience: 2+ years of Collection, Banking, Customer Service, Call Center, Sales, Auto Financing, Collection Agency, Law Firm, Credit Union Competencies: * Strong verbal and written communication skills. Demonstrated customer service skills. * Basic knowledge of the collection function. * Working knowledge of Microsoft Office, Windows operating system, and Excel applications with the ability to learn new and existing Banking software. * Analytical ability to interpret data and to make sound decisions and logical recommendations. Excellent negotiation skills with the ability to overcome objections. * Strong organizational skills. * Ability to work in a fast- paced, high volume environment with specific measurement performance goals. Follow through, accountability, integrity, empathy, accuracy, attention to detail and problem solving are required skills. Physical Requirements: * Able to regularly sit for prolonged periods of time. * Extensive computer usage is required. * Ability to work: * Evenings * Occasionally * Weekends * Occasionally

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. **Job Location (Full Address):** 905 Elmgrove Rd, Rochester, New York, United States of America, 14624 **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500011 Patient Financial Services Work Shift: UR - Day (United States of America) Range: UR URC 205 H Compensation Range: $19.62 - $26.49 _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: Performs follow-up activities designed to bring all open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. Resolves complex claims. Acts as a resource for lower level staff. **ESSENTIAL FUNCTIONS** + Completes follow up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage. + Follows up on unpaid accounts working claims. + Reviews reasons for claim denial. + Reviews payer website or contacts payer representatives to determine why claims are not paid. + Determines steps necessary to secure payment and completes and documents follow up by resubmitting claim or deferring tasks. + Researches and calculates under or overpaid claims; determines final resolution. + Contacts payers on incorrectly paid claims completing resolution and adjudication. + Adjusts accounts or processes insurance refund credits. + eviews and advises leadership on incorrectly paid claims from specific payers. + Works with leadership on communication to payer representatives regarding payment trends and issues. + Bills primary and secondary claims to insurance. + Identifies and clarifies billing issues, payment variances, and/or trends that require management intervention. + Assists department leadership with credit balances account reviews/resolutions and all audits. + Coordinates response and resolution to Medicaid and Medicare credit balances. + Requests insurance adjustments or retractions. + Reviews and works all insurance credits in electronic health record. + Enters electronic health record notes, documenting actions taken. + Researches and responds to third party correspondence, receives phone calls, and explains policies and procedures involving routine and non-routine situations. + Assists with patient related questions. + Communicates and coordinates with other departments to resolve claim issues. + Assists with all audits as needed. Other duties as assigned. **MINIMUM EDUCATION & EXPERIENCE** + Associate's degree and 2 years of relevant experience required + Or equivalent combination of education and experience The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University's Mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law. Notice: If you are a **Current Employee,** please **log into my URHR** to search for and apply to jobs using the Jobs Hub. Your application, if submitted using this portal, cannot be moved forward. **Learn. Discover. Heal. Create.** Located in western New York, Rochester is our namesake and our home. One of the world's leading research universities, Rochester has a long tradition of breaking boundaries-always pushing and questioning, learning and unlearning. We transform ideas into enterprises that create value and make the world ever better. If you're looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals. At the University of Rochester, we are committed to fostering, cultivating, and preserving an inclusive and welcoming culture and are united by a strong commitment to be ever better-Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. - Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. - Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. - Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. - Assists in reviews of state and federal complaints related to claims. - Collaborates with other internal departments to determine appropriate resolution of claims issues. - Researches claims tracers, adjustments, and resubmissions of claims. - Adjudicates or readjudicates high volumes of claims in a timely manner. - Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. - Meets claims department quality and production standards. - Supports claims department initiatives to improve overall claims function efficiency. - Completes basic claims projects as assigned. **Required Qualifications** - At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. - Research and data analysis skills. - Organizational skills and attention to detail. -Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.