Claim Specialist remote jobs - 606 jobs

Commercial Property Claims Examiner - Property & Casualty Insurance Remote but must be in NYC About the Role Handle commercial property claims by investigating losses; managing and controlling independent adjusters and experts; interpreting the policy to make proper coverage determinations; addressing reserves; writing coverage letter and reports; and providing good customer service. Assure timely reserving and handling of a claim from assignment to completion by investigating that claim and interpreting coverage. Manage independent adjusters and experts. Inside desk adjusting role - 100% Remote for now - NYC based. Responsibilities Investigate losses Manage and control independent adjusters and experts Interpret the policy to make proper coverage determinations Address reserves Write coverage letters and reports Provide good customer service Assure timely reserving and handling of a claim from assignment to completion Manage independent adjusters and experts Qualifications Bachelor's degree is required Required Skills 3-5 years of first party property claims handling is required Experience with Microsoft Office 365 is required Preferred Skills Experience with ImageRight is a plus Availability to work extended hours in a CAT situation

Why work with the OpTech family of companies? We are woman-owned, value your ideas, encourage your growth, and always have your back! When you work with us, you get health and dental benefits, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! Job Title: Workers' Compensation Indemnity Specialist Terms: Direct Hire, FTE Role (Salaried + Benefits + Bonus) We are seeking an experienced Indemnity Claims Specialist to manage a complex workers' compensation desk with a strong emphasis on Kentucky, Indiana, Illinois, and Michigan lost-time and litigated claims. This role handles primarily indemnity and complex files, with limited medical-only exposure, and requires collaboration with internal leadership and external stakeholders to ensure high-quality, compliant claim outcomes. RESPONSIBILITIES: Manage a caseload of approximately 135 open indemnity and complex workers' compensation claims, including lost-time files Handle a desk that is at least 50% litigated, working closely with defense attorneys Demonstrate strong working knowledge of Kentucky & Indiana Workers' Compensation regulations and practices Apply Michigan and Illinois jurisdictional knowledge as required by assigned files Investigate claims, determine compensability, establish reserves, and manage ongoing exposure Coordinate medical care, wage loss benefits, and return-to-work efforts Communicate effectively with all stakeholders, including attorneys, injured workers, employers, carriers, and medical providers Utilize claims management systems to document activity, manage workflows, and meet service expectations Adhere to quality standards, production benchmarks, and client service level agreements (SLAs) Participate in internal reviews, audits, and performance evaluations Performance Measures Compliance with quality and accuracy standards Meeting production expectations for claim handling and resolution Adherence to client service level agreements (SLAs) Stakeholders External: Defense attorneys, injured workers, employers, clients, carriers, medical providers Internal: Supervisor, Manager, Account Manager QUALIFICATIONS: Experience & Knowledge 2-3 years of workers' compensation claims experience, with a strong focus on indemnity and lost-time claims Extensive Kentucky and Indiana workers' compensation experience required Illinois claims experience required Michigan experience preferred and may be eligible for additional consideration Prior experience handling litigated claims is required Licenses & Education Michigan, Indiana, and Kentucky Adjuster's License required Reciprocal licenses (Florida or Texas) accepted Illinois Experienced Examiner Certification Bachelor's degree or equivalent relevant work experience Technical Skills Proficiency in Microsoft Office (Teams, Outlook/Email, Word) Experience using CareMC claims system preferred (not required) Strong documentation, organization, and time-management skills OpTech/GTech is an Equal Opportunity Employer (EOE), 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.

Create Music Group is currently looking for self-described viral internet culture enthusiasts to join our Viral Department. Viral Content Claiming Specialist perform administrative tasks such as YouTube copyright claiming and asset onboarding, as well as scope out trending memes and social media videos on a daily basis. This position requires a regular workload of data entry/administration in order to carry out the most basic functions of our department but there are plenty of opportunities for more creative and ambitious pursuits if you are so inclined. This is a full time position which may be done remotely, however our office is located in Hollywood, California, and we are currently only looking for job candidates who are located in California. In the future, you may be encouraged to come into our office for meetings or company functions, so it is best if you are located in the Los Angeles/Southern California area. Through our Viral team, we collaborate with some of the most prominent viral talent from the TikTok and meme world including Supa Hot Fire (Deshawn Raw), Welven Da Great (Deez Nuts), Verbalase, KWEY B, Hoodnews, presidentofugly1, 10k Caash, dimetrees, Zackass, Supreme Patty, The Man with the Hardest Name in Africa, ViralSnare, Adin Ross, and more. YouTube monetization provides an alternative consulting and revenue-generating resource for our clients to grow their audience and earnings. We have helped our clients monetize and collected millions in previously unclaimed revenue for content creators, artists and labels. REQUIREMENTS: 1-3 years work experience Excellent communication skills, both written and verbal Internet culture and social media platforms, especially YouTube Conducting basic level research Organizing large amounts of data efficiently Proficiency with Mac OSX, Microsoft Office, and Google Apps PLUSES: Strong understanding of the online video market (YouTube, Instagram, TikTok) Bilingual - any language, although Spanish, Mandarin, and Russian is preferred RESPONSIBILITIES: We work directly with our clients and their team to help them break down the data and find potential opportunities to build their career. Daily responsibilities include but are not limited to the following. Watching YouTube videos for several hours daily Content claiming Uploading and defining intellectual assets Administrative metadata tasks Researching potential clients Staying on top of accounts for current client roster As this is a remote position, you are required to have your own computer and reliable internet connection. This position may require you to download a great deal of video files (files which may be deleted once onboarding tasks are completed) so please make sure that you have a computer that is up to the task. Laptops are preferable if you would like to come into our office to work (snacks, soft drinks, and Starbucks coffee are provided at our physical office). BENEFITS: Paid company holidays, paid time off, and health benefits (medical, dental, vision, and supplementary policies) are included. TO APPLY: Send us your resume and cover letter (in one file). After you apply, you will be redirected to take our Culture Index survey here. Otherwise, copy and paste the link to your web browser: ********************************************************* Info.php?cfilter=1&COMPANY_CODE=cYEX5Omste Applications without a cover letter and Culture Index survey will not be considered. OPTIONAL: Link relevant social media campaigns and/or writing samples from your portfolio.

Reliant Health Partners is an innovative medical claims repricing service provider, helping employers achieve maximum health plan savings with minimum noise. We tailor our services to each client's needs, providing everything from individual specialty claims repricing, to full plan replacement as a high-performance, open-access network alternative. As a Medical Claims Appeal Specialist, you are responsible for contacting providers to educate on NSA process/payments, respond to appeals for various products, and negotiate these post pay appealed claims to resolve payment disputes. Primary Responsibilities Monitor and manage your post payment queues. Conduct outreach, education, and negotiation calls to providers for post payment claims. Effectively communicate with providers to verify/confirm understanding of NSA claims payments and regulations. Effectively communicate with providers to explain claim payments for various pricing products. Maintain compliance, including but not limited to Confidentiality and HIPAA requirements. Maintain acceptable levels of production including but limited to turn around time standards as mandated by the regulation(s). Document all conversations and record name, phone number, and email of contact person if available, payment rates offered on behalf of clients, and any counter offers by the provider. Adhere to client specific and Reliant protocols, scripts, and other requirements. Develop a comprehensive understanding of the state and federal regulations that will impact payments to providers. Develop a comprehensive understanding of our various products. Perform other job-related duties and special projects as required. Qualifications 2-3 years of related job experience - appeals, negotiations, medical billing. Experience conducting outreach to providers via phone calls or other communication means. Experience understanding Reliant critical behaviors and compliance requirements. Broad healthcare policy and payment understanding. Experience with claims workflow tools or systems. Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role. Pay Transparency$50,000-$60,000 USDBenefits: Comprehensive medical, dental, vision, and life insurance coverage 401(k) retirement plan with employer match Health Savings Account (HSA) & Flexible Spending Accounts (FSAs) Paid time off (PTO) and disability leave Employee Assistance Program (EAP) Equal Employment Opportunity: At Reliant, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business-and our society-stronger. Reliant Health Partners is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.

We are looking to add a Liability Claims Specialist to join our Creative Risk Solutions team. This team member will provide high-quality claims handling and expertise for CRS customers, including investigating, evaluating, and resolving auto and general liability claims, potentially involving litigated files. We offer a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Creative Risk Solutions! Essential Responsibilities: · Review coverage for commercial auto and general liability claims. · Adjudicate claims, investigate bodily injury/liability claims, and negotiate settlements using "Best Practices for Claims." · Maintain accurate loss information and establish/maintain reserves within authority. · Research and respond to questions and complaints from insureds, claimants, agency partners, and carriers. · Monitor and control litigated claims, ensuring timely responses and protection of insureds' and carriers' interests. · Participate in claim reviews and Risk Control Workshops. · Identify and pursue subrogation and report fraud when applicable. · Train and mentor Liability Claims Specialists I and II. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Licensing: Active state specific Life & Health/Property Casualty Insurance agent's license required or the ability to acquire license within three months of hire. · Experience: 5+ years of adjusting property and casualty claims. Prior agency involvement preferred. · Skills & Technical Competencies: Knowledge of both general and auto liability coverages, claims processing procedures, perform complex mathematical calculations, ability to learn multiple state insurance regulations and pass state licensing exams. Understand and apply claims principles, practices, and insurance coverage interpretation for consulting, evaluating, and resolving claims. Contributes to workflows while utilizing resources to deliver a world-class client experience and ensure compliance. Fosters relationships by understanding relevant parties, prioritizing problem-solving, and collaborating to deliver impactful solutions. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1

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

ERGO NEXT's mission is to help entrepreneurs thrive. We're doing that by building the only technology-led, full-stack provider of small business insurance in the industry, taking on the entire value chain and transforming the customer experience. Simply put, wherever you find small businesses, you'll find ERGO NEXT. Since 2016, we've helped hundreds of thousands of small business customers across the United States get fast, customized and affordable coverage. We're backed by industry leaders in insurance and tech, and we still have room to grow - that's where you come in. As a Claims Specialist, you will be deemed a subject matter expert in the Claims department. Your extensive experience in commercial claims will allow you to handle high-severity and high-complexity claims. You will also lead department roundtables and have the opportunity to serve as a valuable peer resource to other team members! What You'll Do: Extensive policy document and legal contract interpretation Ability to analyze and identify coverage and related coverage issues Leverage a working knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, claims best practices handling and management as part of your ongoing adjudication of claims Manage, investigate, and resolve claims within prescribed authority levels Recommend ultimate resolution on assigned cases in excess of authority to claims management Rely on a deep background of litigation handling experience in both General Liability and Casualty files to resolve claims Consistently drive litigation, attend mediations, trials, and other alternative dispute resolution avenues Communicate with policyholders, witnesses, and claimants in order to gather information regarding claims, refer tasks to auxiliary resources as necessary, and advise as to the proper course of action Preemptively communicate and respond to various written (email, SMS, fax, mail) and telephone inquiries, including status reports Present file materials for authority and roundtables Work with nurses, doctors, and attorneys on file reviews Comply with all statutory and regulatory requirements of all applicable jurisdiction Meet detailed quality assurance standards and meet set goals for performance Set and revise case reserves in accordance with the reserving policy Identify potentially suspicious claims and refer to SIU; identify opportunities for third-party subrogation Be accountable for the security of the financial processing of claims, as well as security information contained in claims files Work with, and provide claim-specific guidance to, independent field adjusters Partner closely with internal teams and advise leadership of key claim activities and exposures What We Need: BS/BA Degree required Advanced studies or insurance designation preferred At least 15+ years of directly related experience with Commercial General Liability and Litigation Strong written and oral communication skills required, as well as strong interpersonal, analytical, investigative, and negotiation skills In-depth knowledge of multi-jurisdictional claims handling issues Willingness to utilize and adapt to evolving technologies within the Claims operations Must be a self-starter and able to work independently Candidates must have, or be able to promptly obtain, a Texas Independent Adjuster License Effective communication, presentation, negotiation, and persuasion skills Ability to collaborate with cross-functional teams to achieve business results Proven success in delivering strong results in a rapidly changing claims environment Someone who achieves a standard of excellence with work processes and outcomes, honoring company policies and regulatory compliance Team orientation that emphasizes building strong working relationships and contributing to a positive work environment High degree of comfort with navigating sometimes ambiguous environments and a willingness to dive in and assist coworkers with workloads or contribute to organizational needs/projects when needed Receptivity to feedback and a willingness to learn, embracing continuous improvement, and having an openness to learning new and evolving proprietary and off-the-shelf software systems Some travel capability, likely up to 10% of capability Note on Fraudulent Recruiting We have become aware that there may be fraudulent recruiting attempts being made by people posing as representatives of Ergo Next Insurance. These scams may involve fake job postings, unsolicited emails, or messages claiming to be from our recruiters or hiring managers. Please note, we do not ask for sensitive information via chat, text, or social media, and any email communications will come from the *************************. Additionally, Next Insurance will never ask for payment, fees, or purchases to be made by a job applicant. All applicants are encouraged to apply directly to our open jobs via the careers page on our website. Interviews are generally conducted via Zoom video conference unless the candidate requests other accommodations. If you believe that you have been the target of an interview/offer scam by someone posing as a representative of Ergo Next Insurance, please do not provide any personal or financial information. You can find additional information about this type of scam and report any fraudulent employment offers via the Federal Trade Commission's website (********************************************* or you can contact your local law enforcement agency. The range displayed on this job posting reflects the minimum and maximum target for new hire salaries for the position across all US locations. Within the range, individual pay is determined by work location and additional factors, including, without limitation, job-related skills, experience, and relevant education or training. NEXT employees are eligible for our benefits package, consisting of our partially subsidized medical plan, fully subsidized vision/dental options, life insurance, disability insurance, 401(k), flexible paid time off, parental leave and more. US annual base salary range for this full-time position:$100,000-$130,000 USD Don't meet every single requirement? Studies have shown that some underrepresented people are less likely to apply to jobs unless they meet every single qualification. At NEXT, we are dedicated to building a diverse, inclusive and respectful workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles. One of our core values is 'Play as a Team'; this means making sure everyone has an equal chance to participate and make a difference. We win by playing together. Next Insurance is an equal opportunity employer and prioritizes building a diverse and inclusive workplace. We provide equal employment opportunities to all employees and applicants of any type and do not discriminate based on race, color, religion, national origin, gender, age, sexual orientation, physical or mental disability, genetic information or characteristic, gender identity and expression, veteran status, or other non-job-related characteristics or other prohibited grounds specified in applicable federal, state, and local laws. Next's policy is to comply with all applicable laws related to nondiscrimination and equal opportunity and will not tolerate discrimination or harassment based on any of these characteristics. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Responsible for managing patient account balances including accurate claim submission, compliance will all federal/state and third party billing regulations, timely follow-up, and assistance with denial management to ensure the financial viability of the WVU Medicine hospitals. Employs excellent customer service, oral and written communication skills to provide customer support and resolve issues that arise from customer inquiries. Supports the work of the department by completing reports and clerical duties as needed. Works with leadership and other team members to achieve best in class revenue cycle operations. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High School diploma or equivalent. PREFERRED QUALIFICATIONS: EXPERIENCE: 1. One (1) year medical billing/medical office experience CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Submits accurate and timely claims to third party payers. 2. Resolves claim edits and account errors prior to claim submission. 3. Adheres to appropriate procedures and timelines for follow-up with third party payers to ensure collections and to exceed department goals. 4. Gathers statistics, completes reports and performs other duties as scheduled or requested. 5. Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability and efficiency. 6. Complies with Notices of Privacy Practices and follows all HIPAA regulations pertaining to PHI and claim submission/follow-up. 7. Contacts third party payers to resolve unpaid claims. 8. Utilizes payer portals and payer websites to verify claim status and conduct account follow-up. 9. Assists Patient Access and Care Management with denials investigation and resolution. 10. Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth. 11. Attends department meetings, teleconferences and webcasts as necessary. 12. Researches and processes mail returns and claims rejected by the payer. 13. Reconciles billing account transactions to ensure accurate account information according to established procedures. 14. Processes billing and follow-up transactions in an accurate and timely manner. 15. Develops and maintains working knowledge of all federal, state and local regulations pertaining to professional billing. 16. Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts. 17. Maintains work queue volumes and productivity within established guidelines. 18. Provides excellent customer service to patients, visitors and employees. 19. Participates in performance improvement initiatives as requested. 20. Works with supervisor and manager to develop and exceed annual goals. 21. Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information. 22. Communicates problems hindering workflow to management in a timely manner. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Must be able to sit for extended periods of time. 2. Must have reading and comprehension ability. 3. Visual acuity must be within normal range. 4. Must be able to communicate effectively. 5. Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Office type environment. SKILLS AND ABILITIES: 1. Excellent oral and written communication skills. 2. Working knowledge of computers. 3. Knowledge of medical terminology preferred. 4. Knowledge of business math preferred. 5. Knowledge of ICD-10 and CPT coding processes preferred. 6. Excellent customer service and telephone etiquette. 7. Ability to use tact and diplomacy in dealing with others. 8. Maintains knowledge of revenue cycle operations, third party reimbursement and medical terminology including all aspects of payer relations, claims adjudication, contractual claims processing, credit balance resolution and general reimbursement procedures. 9. Ability to understand written and oral communication. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 544 UHA Patient Financial Services

Liberty Mutual has an immediate opening for a Complex Claims Specialist to join our Long-Term Care Claims Team. This is a high-visibility, hands-on role for an experienced Professional Liability claims handler with deep Long-Term Care (LTC) facility expertise. With minimal supervision, the Complex Claims Specialist will manage a book of specialty LTC Professional Liability Claims through the entire lifecycle, applying advanced coverage interpretation, clinical issue spotting, complex litigation management and prudent reserving to resolve high-exposure matters economically and defensibly. Why this role matters * Lead ownership of complex facility professional liability claims (nursing homes, assisted living, hospice, home health, ancillary providers). * Opportunity to shape claim strategy on high-severity matters, coordinate clinical/expert resources, and act as an internal subject-matter resource for underwriting, reinsurance and senior leadership. * Work in a collaborative environment with autonomy to influence outcomes and policy. Key Responsibilities * Own and manage LTC Professional Liability Claims from first notice through resolution: investigate, analyze coverage, evaluate liability and damages, establish and adjust reserves, negotiate settlements and close files within authority. * Perform advanced coverage analysis (duty to defend vs. indemnify, occurrence vs. claims-made, allocation, additional insured issues, contractual liability, tail exposures, endorsements) and prepare clear coverage opinions and reservation of rights/declination communications. * Document claims thoroughly using Claims Management System and proactively diary follow-up actions and deadlines. * Set indemnity and expense reserves within authority; escalate and recommend reserves for matters outside authority; review reserves regularly and justify reserve positions to management and auditors. * Manage litigation: retain and oversee outside defense counsel with LTC expertise, control budgets and billing, direct discovery strategy, and evaluate mediation/arbitration/trial risk to optimize resolution. * Coordinate clinical resources and expert consultants (nursing, pharmacy, infection control, medical specialists) for chart review, causation analysis and expert testimony. * Interface with regulatory, compliance and risk management teams on CMS/state surveys, licensing investigations and mandatory reporting; incorporate regulatory developments into case strategy. * Collaborate with underwriting, reinsurance and subrogation on allocation, ceded reporting and recovery opportunities. * Identify and report claim trends, coverage exposures and policy issues to management and underwriting; contribute to playbooks, training and process improvements. * Participate in mediations and arbitrations within settlement authority and support major loss response efforts. * Maintain required adjuster licenses and adhere to company litigation and billing guidelines. * This position may have in-office requirements and other travel needs depending on candidate location. You will be required to go into an office twice a month if you reside within 50-miles of one of the following offices: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; or Westborough, MA. This policy is subject to change. We are open to fill this position depending on related professional skills and experience. The salary range reflects the varying pay scale that encompasses each of the Liberty Mutual regions, the salary for both levels, and the overall cost of labor for that region. Please note your salary range may not fall at the top of the posted range, depending on your location. Qualifications * Minimum 7 years of claims/legal experience with substantive, hands-on LTC Professional Liability claim handling; experience managing high-severity, multi-claimant or regulatory matters required. * Demonstrated advanced knowledge of professional liability coverage interpretation and complex coverage issues. * Strong litigation management experience, including selection and supervision of outside defense counsel, bill oversight and cost control. * Practical understanding of clinical issues common to LTC (falls, pressure injuries, medication errors, infections/outbreaks, staffing/care plan issues) and relevant regulatory landscape. * Proven analytical, negotiation and written/verbal communication skills; able to present complex clinical and coverage positions to counsel, underwriters and senior management. * Bachelor's degree required, and advanced degree is a plus! About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

We are united in our mission to make a positive impact on healthcare. Join Us! South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2024 2024 Black Book Awards, ranked #1 EHR in 11 Specialties 2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold) 2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara) Who we are: We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany. ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine! Your Role: Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates Input and update patient account information and document calls into the Practice Management system Special Projects: Other duties as required to support and enhance our customer/patient-facing activities Skills & Requirements: High School Diploma or GED required Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST Minimum of 1-2 years of previous healthcare administration or related experience required Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs) Manage/ field 60+ inbound calls per day Bilingual is a requirement (Spanish & English) Proficient knowledge of business software applications such as Excel, Word, and PowerPoint Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone Ability and openness to learn new things Ability to work effectively within a team in order to create a positive environment Ability to remain calm in a demanding call center environment Professional demeanor required Ability to effectively manage time and competing priorities #LI-SM2 ModMed Benefits Highlight: At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits: India Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk, Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees, Allowances: Annual wellness allowance to support your well-being and productivity, Earned, casual, and sick leaves to maintain a healthy work-life balance, Bereavement leave for difficult times and extended medical leave options, Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave, Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind. United States Comprehensive medical, dental, and vision benefits 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep. Generous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. This is a remote work from home opportunity. Summit Risk Services is seeking a Professional Liability Adjuster, Attorney and /or JD required, to join our growing team! The Professional Liability Adjuster is responsible for evaluating coverage, managing claims, and overseeing defense strategies to ensure fair and cost-effective resolutions. This role involves interpreting policy language, assigning and supervising defense counsel, attending mediations, and providing high-quality claims handling in collaboration with an experienced legal and claims professional. How You Will Contribute: Reviewing various insurance policies; determine whether the carrier has a duty to provide a defense and/or indemnification to the insured; prepare coverage correspondence, if there is a duty to defend, assign approved defense counsel. Oversee the work of defense counsel who will report generally in 90-day intervals. Attend mediations. Determine the most cost-effective way to effectuate resolution of the claims. You will be working with and reporting to someone with 27 years legal and claims experience. Some travel required. Skills & Experience to Be Successful: Juris Doctorate degree (JD) from an accredited U.S. law school and licensed to practice law. Excellent verbal and written communication skills required. Excellent time management skills needed. Must have strong organizational skills and ability to multi-task. Excellent PC skills with working knowledge of Microsoft Office suite. About Us: Our group is a Claims Management Third Party Administrator Specializing in Professional Liability Claims Management. We are publicly traded on NYSE and our team includes lawyers who serve as Claim Management Specialists for various insurance companies in the United States. Pay Range $100,000 - $105,000 Annual The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.

Full-time Description Description Department: Claims Schedule: Monday to Friday; flexibility for additional hours as needed. Salary: $60,000 - $75,000; negotiable About Responsive Founded in 2007 and headquartered in Plantation, Florida, Responsive is a leading provider of personal auto insurance in Florida. We collaborate with thousands of agents from the most respected insurance agencies to deliver world-class service and claims experiences. Responsive stands for making auto insurance simple, affordable, and hassle-free; a promise we deliver through innovation, feedback, and a commitment to excellence. Why Join Responsive? At Responsive, we're committed to supporting our team with comprehensive benefits and a positive work environment, including: Employer-Paid Healthcare: Medical, dental, and vision plans with free preventative care. Retirement Savings: 401(k) with company match. Wellness Programs: Mental health support and wellness initiatives. Career Development: Training and growth opportunities in a collaborative environment. What You Will Do As a Bilingual PIP Adjuster, you'll work closely with customers, attorneys, medical providers, other insurance carriers, and vendors in resolving coverage, and liability from start to finish. You'll plan and schedule work needed to process claims, interview claimants and witnesses, investigate claims, negotiate to reach a fair and equitable settlement of the PIP exposure, and identify situations where claims may require special investigation. You'll maintain strong relationships with customers while resolving auto injury claims efficiently. You'll perform the duties below, along with other work as assigned. Investigate, evaluate, and settle insurance claims (e.g., establish coverage and qualification for injured parties; negotiate claims with providers to reach a fair and equitable settlement of the PIP exposure). Maintain a well-organized and accurate diary to ensure timeliness in handling claims as well as detailed, accurate, and timely records. Write clear and accurate responses in response to demands, requests, or questions. Display courtesy, accuracy, and uniformity when interacting with others (on the phone, in person). Be familiar with tools such as ISO, TLO, & other public sites such as buycrash.com, MDCC, BCC, FDHSMV, and Google Maps. Continuously develop knowledge and expertise (e.g., keep current on job-relevant laws, regulations, trends, and emerging issues). Conduct activities in compliance with applicable Federal & State laws, and company regulations and guidelines. Requirements At least 2 years PIP Adjuster experience with Automobile Property Damage Claims to operate in the state of Florida Licensed Adjuster - All Lines required (FL 620 license) Bi-lingual (English/Spanish) required Bachelor's degree preferred Demonstrated ability to develop and maintain relationships with others Oral communication skills, especially active listening Written communication skills Well organized Strong analytical, problem-solving, and critical thinking skills Demonstrated experiences in a production environment where time management, workload prioritization, case management, recordkeeping and documentation, accountability, and follow-up are key priorities Team player Curious (e.g., ability to identify the right questions to ask customers) Self-motivated Openness to feedback and a strong desire to learn Proficiency with software programs such as Word and Outlook Responsive provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, veteran, marital, or domestic partner status.

Overview Workers' Compensation Claim Consultant (CA Jurisdiction Only) - Remote Salary: $77,000-$87,000 annually Schedule: Monday-Friday, 8:00 AM-4:30 PM PST Experience Required: 5+ Years (Litigated & Some Complex Claims) 🚨 Please Note This is not an HR, risk management, or consulting position. This is an experienced California Workers' Compensation adjusting role requiring hands-on claim investigation, evaluation, negotiation, and settlement. Candidates must have direct experience investigating, evaluating, reserving, negotiating, and resolving claims as an adjuster or adjuster supervisor within a carrier, TPA, or similar claims environment. Applicants without hands-on adjusting experience will not be considered. Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We're seeking an experienced Workers' Compensation Claim Consultant to handle California jurisdiction claims for a multi-account desk supporting clients in the trucking & warehouse, valet/shuttle services, and staffing agency industries. This fully remote position requires strong litigated claim handling experience, the ability to independently manage complex files, and a commitment to CCMSI's best practice standards. You'll join a collaborative team of four other consultants, working together to deliver high-quality, timely, and accurate claim service to our clients. Responsibilities When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems. Conduct timely 3-point contact per CCMSI best practices. Investigate, evaluate, and adjust California workers' compensation claims with independence and sound judgment. Establish, maintain, and justify detailed reserve levels. Administer indemnity and award payments in accordance with CA jurisdictional requirements. Negotiate settlements consistent with corporate standards, client instructions, and state law. Maintain a current and thorough diary, ensuring all deadlines and statutory requirements are met. Pursue subrogation recovery as applicable. Prepare claim status reports, reserve analyses, and updates for client meetings. Conduct claim reviews with clients and participate in discussions as needed. Communicate effectively with injured workers, employers, providers, and attorneys throughout the claim lifecycle. Ensure all documentation meets CCMSI best practice requirements. Qualifications Qualifications - Required 5+ years of California WC adjusting experience, including litigated files and some complex exposure. Adjuster designation required. Strong working knowledge of California WC laws, timelines, benefits, and litigation processes. Proficiency with Microsoft Office (Word, Excel, Outlook). Excellent written and verbal communication skills, critical thinking, and decision-making ability. Nice to Have SIP certification preferred. Strong documentation habits per CCMSI best practices. Experience presenting or conducting client reviews. Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Work Environment & Travel Remote role reporting to the Irvine, CA branch. Occasional travel to the office may be required for rare mandatory in-office meetings. Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions • Compliance & audit performance - adherence to jurisdictional and client standards • Timeliness & accuracy - purposeful file movement and dependable execution • Client partnership - proactive communication and strong follow-through • Professional judgment - owning outcomes and solving problems with integrity • Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompJobs #CaliforniaAdjuster #RemoteJobs #ClaimsConsultant #InsuranceCareers #AdjusterLife #NowHiring #LI-Remote

Requirements 2+ years handling property insurance claims required Candidate must have an active Xactimate account Can handle partial and full assignments Commercial and personal lines experience preferred A qualified candidate must have their own transportation, equipment and software Good writing and technology skills

JOIN THE ASSURANCEAMERICA TEAM Do you want to be part of an organization where you are valued, and your ideas and opinions have an impact? Join the AssuranceAmerica team. For more than 25 years, AssuranceAmerica has provided superior property and casualty insurance products through contracted independent agents and directly to customers. Our team succeeds through diversity of thought, experiences, skills, and backgrounds. Liability Adjuster II The Liability Adjuster II is responsible for managing a caseload of complex liability and coverage claims, including those involving minor bodily injuries. This role requires the execution of thorough investigations to gather all necessary facts, along with a strong understanding of policy language to ensure accurate and timely coverage and liability determinations. While working with a degree of autonomy, the Adjuster will collaborate with their supervisor for guidance on more nuanced or high-exposure cases. About the ROLE Each day at AssuranceAmerica is different, but as a Liability Adjuster II you will: Conduct thorough investigations and evaluations of coverage, liability, and damages across all lines of personal automobile insurance/. Accurately assess exposure and evaluate injury claims in a fair, consistent, and equitable manner based on the facts and extent of damages. Negotiate timely and appropriate settlements, ensuring all required documentation is obtained to support proper claim resolution and closure. Manage low-complexity, attorney-represented injury claims with sound judgement and attention detail, maintaining compliance with internal guidelines and industry standards. Control expenses and adhere to company reserving philosophy by maintaining proper reserves on all pending claims/potential exposures. Meet and maintain general file handling goals and procedures as outlined by the company including maintaining a 1:1 closing ratio and status on diary reviews. Properly utilize underwriting and policy systems and understand its features and functionality, as needed. Attend any available seminars and classes applicable to this position and the skills required to meet the job duties and responsibilities. Continually ask questions and have a desire to develop additional skills to better investigate and evaluate claims. About YOU Excellent communication skills with demonstrative ease with both verbal and written formats. Attention to detail and ability to multi-task. A high degree of motivation and team orientation. Direct, results driven, and dedicated to the success of the business and each other. Required Minimum three years of experience handling auto claims. Minimum of two years of experience handling complex liability and coverage issues and unrepresented bodily injury cases. Preferred Bachelor's degree or equivalent. Non-standard experience. Adjuster's license in relevant state or the ability to obtain one quickly. Bilingual (English-Spanish). Physical Requirements Prolonged periods sitting at a desk and working on a computer. Must be able to lift 15 pounds at times. Must be able to navigate various departments of the organization's physical premises. About US We are direct, results-driven, and dedicated to the success of our business and each other. We are a diverse group of thinkers and doers. We offer many opportunities to grow in your professional skills and career. We fight homelessness by directing 5% of our earnings from each policy we sell to organizations that help those in need. We call it our Generous Policy. WHAT WE OFFER AssuranceAmerica provides these benefits to Associates: Premium healthcare plans: All full-time Associates and part-time Associates working a regular schedule of 30 hours, or more, are eligible for benefits including Medical, Dental, Vision, Voluntary Life, Flexible Spending Accounts, and a Health Savings Account. Employer Paid Benefits: We enroll all eligible Associates in Group Life and AD&D Insurance, Short- and Long-Term Disability Plans, Employee Assistance Program, Travel Assist, and the Benefit Resource Card which includes Teladoc™, Pet Insurance and Health Advocate. Additional Benefits: 401(k) Employer Match: We want to help you prepare for the future, now. All full-time and part-time Associates over age 21 are eligible to participate in the 401(k) Savings Plan. AssuranceAmerica will match 100% of the first 4% of an Associate's contributions. Engagement Events. We make time for fun activities that strengthen Associate relationships in all our locations. Annual Learning Credit: Want to learn something new? We'll reimburse you for approved educational assistance. Time Off: Paid Time Off (PTO), Parental Leave Pay, Volunteer Time Off (VTO), Bereavement Pay, Military Leave Pay, and Jury Duty Pay.

About Us At Heartland, we are focused on results, not corporate politics. We foster a harmonious work environment where associates feel like family. We strive to be the employer of choice, and believe all of our associates should have fun at work! We are hardworking - but not at the expense of our families. At Heartland, you will find an entrepreneurial environment where we take the time to educate, coach and lead employees into further opportunities within our company. We want all of our associates to enjoy a good work-life balance and are welcomed in our environment. We strive to show our employees that they are more than just a number and viewed as an integral part of our organization. Heartland recognizes the importance of a quality benefits package, not only to our associates, but to their families. That's the Heartland way. Our generous benefit package includes (but is not limited to) Paid Time Off, Health Insurance, Life Insurance, Long Term Disability, Employee Assistance Program, and two retirement plans. At Heartland, we go out of our way to make our associates feel at home and celebrate their achievements and contributions to the company. Our environment consists of several appreciation events throughout the year and we encourage every employee, near & far, to join us with their families to enjoy good food, fun and comradery. Our benefits package, appreciation events, and fun work environment go above industry standard. We want our employees to feel like family - so we treat them like family. Adjuster Trainee Primary Responsibility The Adjuster Trainee will develop skills to handle an assigned caseload of workers' compensation claims. The position will be responsible for contacting injured workers, clients and any additional parties to determine compensability. Essential Functions & Responsibilities Participate in training introducing workers' compensation claims handling and applicable laws Learn to read and interpret complex documents including regulations, statutes, legal documents, investigative reports, medical records, medical bills and claims notes Learn to use claims management software and other related software for claims handling and reporting Manage medical treatment to provide the optimum level of care while controlling costs Learn skills such as investigative communication, negotiation, and decision-making Evaluate facts, write clear and concise reports and develop a plan of action. Calculate reserves for each claim and adjust as needed. Analyze and determine the eligibility of benefit payments Communicate effectively through telephone and electronic correspondence with managers, clients, providers and injured workers Required Qualifications High school diploma or equivalent 3 years or more of office experience Proficient in Microsoft Office Suite of products Experience working in a work from home environment Preferred Qualifications Bachelor's degree from a four year college or university preferred; or one to two years related experience and/or training; or equivalent combination of education and experience

External candidates: In order for your application to be correctly processed please sign-in before you apply Internal candidates: Please go to Workday and click "Find Jobs" link under Career Thank you for considering opportunities with us! Job Title Commercial Casualty Litigation Adjuster (Remote) Requisition Number R7516 Commercial Casualty Litigation Adjuster (Remote) (Open) Location Colorado - Home Teleworkers Additional Locations Alabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers, Nebraska - Home Teleworkers {+ 19 more} Job Information We're Mobilitas, a commercial insurance company created by CSAA Insurance. Our mission is to reinvent commercial insurance in the mobility space by providing technologically advanced solutions for today's way of doing business. At Mobilitas, we believe in what's possible, we use our inventive skills to create new opportunities - we're not chasing the status quo, we're chasing a shared vision. We're looking for motivated, innovative individuals who think big, move fast and are dedicated to creating a company from the ground up, without the constraints of a traditional insurance company. We're excited to push the boundaries of commercial insurance and are looking for enthusiastic team members to help us reimagine insurance. We are actively hiring for a Commercial Casualty Litigation Adjuster! Your Role: As a Commercial Casualty Litigation Adjuster, you will be assigned as owning adjuster when injury exposures are identified. Claims will include catastrophic injuries, fatalities, and litigation. In this role, you will be responsible for management of the claim through conclusion, including trial, of litigated claims. May own claims within other specialized lines of business or during catastrophes. You will provide input and direction to defense counsel and be responsible for ultimate resolution through providing settlement authority and participating in negotiations with limited oversight. You will also be responsible for effective management of defense costs and indemnity. May handle first party non-liability-based injury claim (Medical Payment, PIP, Inland Marine, auto physical damage). Your Work: Assigned as owning adjuster when injury exposure is identified. Handles complex 1st and 3rd party auto liability cases involving injury, including complexity litigated cases with defense attorney involvement. May handle 1st party medical payment and PIP claims. Responsible for managing, investigating, and negotiating claims, including collaborating with defense counsel to identify strategy for negotiations. Provides input as the face of the organization via phone or in attendance on video or in-person at mediations and settlement conferences for litigation claims. Interacts directly with defense counsel providing direction, authority for resolution (i.e., settle or go to trial) and ensures appropriate outcome in balancing defense costs and indemnity on litigation claims. Making coverage determinations and advising customers as to proper course of action related to coverage issues. Conducting investigative work of a complex nature (interviewing witnesses; obtaining and analyzing evidence, including medical records; deciding whether an independent medical examination is warranted; etc.). Direct defense counsel in non-litigated or litigated claims. May require appearing at and representing the insureds at arbitrations and trials. May require testimony in a deposition setting. Evaluate defense counsel fees and cost for reasonableness and resolve. Evaluating potential for subrogation and initiating initial notice of subrogation request. Making final decisions to settle within settlement authority, without supervisory approval, and developing negotiating strategies. Presenting cases in Committee setting when seeking above settlement authority level; thereafter, independently negotiating and settling the claim. Will develop and present executive summaries on individual claims to external clients and internal executives in a virtual setting to gain alignment with client on next steps, and settlements. Handles most commercial product types including but not limited to auto, fleet, last mile delivery, and trucking. Will handle claims in most geographic venues. Handles claims involving any vehicle types that may include, but is not limited to auto, motorcycles, scooters, recreational vehicles, trucks, and remote-controlled delivery vehicles. Understands and handles claims in line with any applicable insurance program agreements, claim service level agreements. Plays a direct role in the development of other adjusters through mentorship, training, and coaching. Required Experience, Education, & Skills: 6+ years of claims experience. 3+ years of experience in a Casualty claims role within P&C insurance industry with a minimum of 1 year in a Sr. Casualty role or equivalent Complex Casualty / Litigation experience. BA/BS in business, insurance or related area, or equivalent combination of education and experience. Must hold an Adjuster licensed for all applicable states or obtain license(s) within 90 days of filling position as a condition of employment. What would make us excited about you? 6+ years of Casualty claims adjusters experience. 3+ years of experience in a Commercial claims role Bilingual a plus. Proficiency or ability to obtain proficiency in the handling of minor, moderate and complex litigated claims. Strong analytical, problem-solving, and organizational skills. Proficient in ability to work independently. Strong decision-making ability. Extensive understanding of statutory and regulatory requirements, and ability to develop proficiency in standards of civil procedure. Ability to travel and to work extended hours and/or weekends. Proficient oral and written communication skills and ability to organize and present complex facts to executive management. Strong math skills, basic computer skills and ability to type at least 30 words per minute. Mobilitas Careers At Mobilitas, we're proudly devoted to protecting our customers, our employees, our communities, and the world at large. We are on a climate journey to continue to do better for our people, our business, and our planet. Taking bold action and leading by example. We are citizens for a changing world, and we continually change to meet it. Join us if you… BELIEVE in a mission focused on building a community of service, rooted in inclusion and belonging. COMMIT to being there for our customers and employees. CREATE a sense of purpose that serves the greater good through innovation. Recognition: We offer a total compensation package, performance bonus, 401(k) with a company match, and so much more! Read more about what we offer and what it is like to be a part of our dynamic team at careers.mobilitasinsurance.com In most cases, you will have the opportunity to choose your preferred working location from the following options when you join us: remote, hybrid, or in-person. Submit your application to be considered. We communicate via email, so check your inbox and/or your spam folder to ensure you don't miss important updates from us. If a reasonable accommodation is needed to participate in the job application or interview process, please contact *************************** As part of our values, we are committed to supporting inclusion and diversity. We actively celebrate colleagues' different abilities, sexual orientation, ethnicity, and gender. Everyone is welcome and supported in their development at all stages in their journey with us. We are always recruiting, retaining, and promoting a diverse mix of colleagues who are representative of the U.S. workforce. The diversity of our team fosters a broad range of ideas and enables us to design and deliver a wide array of products to meet customers' evolving needs. Mobilitas is an equal opportunity employer. If you apply and are selected to continue in the recruiting process, we will schedule a preliminary call with you to discuss the role and will disclose during that call the available salary/hourly rate range based on your location. Factors used to determine the actual salary offered may include location, experience, or education. Must have authorization to work indefinitely in the US Please note we are hiring for this role remote anywhere in the United States with the following exceptions: Hawaii and Alaska. #LI-CH1 .

A dynamic organization supplying quality claims outsource solutions to insurance carriers, countrywide is seeking multi-line adjusters in your area. There are many competing vendors in our marketplace, but we are not your typical “vendor”. Our company was built by insurance company claims executives to support insurance companies' claim operations to help them meet their organizations goal of providing quality claims solutions at a reasonable cost. We excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Position Summary: A national independent insurance adjusting firm has immediate openings for Multi-Line Claims adjusters that possess the ability to work remotely and have the experience to handle both property and liability claims. The candidate must possess the ability to adjust commercial and residential property losses and must also have a working knowledge of how to determine negligence and assess damages. The candidate should be able to perform all tasks with modest supervision. The candidate must possess the ability to understand coverage, how to investigate a variety of property and negligence claims, how to value and estimate property damage as well as the ability to evaluate Bodily Injury damages for settlement. Requirements: Minimum 5 years first-party commercial and/or residential property and liability adjusting experience Maintain own current estimating software; Xactimate preferred Working computer; internet access and Microsoft Word required Must demonstrate strong time management and customer service skills Ability to take recorded statements in the field or with legal representatives Experience in preparing Statements of Loss, Proofs of Loss, and denial letters State adjuster's license where required Must have valid driver's license Knowledge and Skills: In-depth knowledge of property and liability insurance coverage and industry standards Prepare full captioned reports by collecting and summarizing information required by client Strong verbal and written communications skills Prompt, reliable, and friendly service Must submit to background check; void in states where prohibited Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations Responsibilities: Completes residential and commercial field property inspections utilizing Xactimate software and general liability field investigations to determine negligence and damages Investigate claims by obtaining recorded statements from insureds, claimants or witnesses; by interviewing fire, police or other governmental officials as well as inspecting claimed damages Recommend claim reserves based on investigation, through well supported reserve report Obtain and interpret official reports Review applicable coverage forms and endorsement, providing thorough analysis of coverage and any coverage issues in well documented initial captioned report to client Maintain acceptable product quality through compliance with established Best Practices of client Preferred but Not Required: College Degree AIC, or other professional designations All candidates must pass a full background check

Loyalty MGA is seeking experienced Bilingual Auto Insurance Adjusters to join our team! This position offers a hybrid work schedule upon successfully completing the company's probation period. We are looking for professionals with expertise in Bodily Injury, Personal Injury Protection, Property Damage, Payment Adjustment, Appraisal, Special Investigation Units, and more. This is an excellent opportunity for individuals looking to grow their careers in a dynamic and supportive environment. Responsibilities: Investigate and assess auto insurance claims focused on property damage and collision coverage. Analyze damage reports, repair estimates, and supporting documents to determine coverage and liability. Establish accurate reserves and evaluate claim settlements within company guidelines. Conduct interviews with policyholders, claimants, and witnesses to gather critical information. Coordinate with repair facilities, appraisers, and external parties for efficient claim resolution. Maintain compliance with state regulations and company policies during claim handling. Provide exceptional customer service to policyholders and external stakeholders. Qualifications Minimum 6 months of experience handling property damage or collision coverage claims. Hold a valid all lines 6-20 license Bilingual proficiency in English and Spanish is required. Active insurance adjuster's license preferred; must obtain and maintain as needed. Strong communication, negotiation, and problem-solving skills. Basic proficiency in Microsoft Office and claims management systems. Must reside in or near Orlando, Florida, and have a reliable internet connection for remote work.