Claim specialist work from home jobs - 387 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

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.

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.

We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! 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 lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, 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 claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. 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

DETAILS Complex Claims Specialist - Property & Casualty Department: Property and Casualty Claims Reports To: Claims Supervisor FLSA Status: Exempt Job Grade: 14 Career Ladder: Next step in progression could include Claims Supervisor ATHENS ADMINISTRATORS Since our founding in 1976, Athens Administrators has been a recognized leader in third-party claims administration services. However, more important than what we do is how we do it. Athens employees provide service that translates into real and lasting benefits-every single day! With offices throughout the United States, Athens Administrators offers Workers' Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a third-generation family-owned company and is dedicated to its core values of honesty and integrity, a commitment to service and results, and a caring family culture. We are so proud that our employees have consistently voted Athens as a Best Place to Work! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Complex Claims Specialist to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). This position does allow for work from home if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week. The Complex Claim Specialist is responsible for the review, investigation, analysis, and processing of complex claims within assigned authority limits and consistent with policy and legal requirements. These claims are typically high exposure and often entail litigation and complex coverage. There is particular emphasis on runoff program claims for this desk. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Advanced knowledge in the following areas: 1) Complex Auto or General Liability claims handling concepts, practices and techniques, to include but not limited to complex coverage issues, and product line knowledge, 2) advanced, functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills. Analyze, investigate, and evaluate losses to determine appropriate layers of coverage, settlement value and disposition strategy, including claim merits or denial of liability Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to clients and senior level management Manage the litigation process through the retention of selected counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment Document and manage claims (i.e.: statements, diaries, write reports) from inception to closure Ensure appropriateness of all coverage memorandums and payments Coordinate and work with dedicated vendor services such as law professionals, industry experts, county officials and client executives to manage professional claims and communications Facilitate interactions between insured entities, claimants, client contacts, and attorneys in resolution of severe and complex claims Lead and conduct comprehensive claim reviews and case analysis discussions with various committees or district level authorities Provide superior customer service to all layers of authorities within the county Meet with clients, attend hearings, and assist senior management with planning, forecasting and new business opportunities that may arise in the servicing of the account. May assist management in hiring other account dedicated examiners Provide guidance and serve as a technical expert to less experienced examiners May conduct meetings or training sessions to help develop less experienced examiners Attend all required meetings and educational seminars for professional development Maintain required licenses ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Possesses a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL preferred Additional State Adjuster License(s), may be required within 180 days Maintain licenses and continuing education requirements in all states Relies on extensive experience and judgement to plan and accomplish goals with a minimum of 10 years complex/major claims experience, including proficiency in investigation and resolution of severe to major casualty and general liability claims Experience with relevant insurance laws, codes, and procedures Experience with property and casualty insurance policies, insurance tort laws, codes, and procedures Understanding Auto and General Liability exposure and unique coverage endorsements Understanding of medical, legal terminology and liability concepts Proficiency in investigation and resolution of severe to major level casualty claims Time Management and project management skills Strong negotiation and litigation management skills Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at *************************************************

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ***************** How YOU will make a Difference: As a Claims Specialist, you'll be at the heart of our mission to deliver exceptional service. Working alongside a dedicated team, you'll ensure the accurate and timely processing of medical, dental, vision, and short-term disability claims that HMA administers for our members. Your role goes beyond handling claims, you'll be a key player in shaping a positive healthcare experience for our members. Every claim you interact with helps someone navigate their healthcare journey with confidence, making your work both meaningful and impactful. What YOU will do: Research and process ITS claim adjustments, returned checks, refunds and stop payment in an accurate and timely manner Communicate with local Blue plans utilizing real time chat Process priority claims and general inquiries Respond to appeals and correspondence regarding claims functions Support team members and be open to providing assistance when and where neede Become a SME regarding BCBS network Requirements High school diploma required 3-5+ years of claims processing experience 2+ years of BCBS claims processing experience required Strong interpersonal and communication skills Strong attention to detail, with high degree of accuracy and urgency Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving Previous success in a fast-paced environment Benefits Compensation: The base salary range for this position in the greater Seattle area is $28/hr - $32/hr for a level II and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: *****************

Liberty Mutual has an immediate opening for a Complex Claims Specialist with Managed Care, Errors & Omissions (E&O) and Directors & Officers (D&O) Professional Liability claims experience. The Complex Claims Specialist, with minimal supervision, handles a book of specialty lines claims under E&O and D&O policies issued to health plans and other Managed Care Organizations throughout the entire claim's life cycle. In this role, you will be responsible for conducting investigations, evaluating coverage, setting adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed authority limits for the line of business. *This position may have an in-office requirement and other travel needs depending on candidate location. If you reside within 50 miles of one of the following offices, you will be required to go to the office twice a month: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; Westborough, MA; or Weatogue, CT. Please note this policy is subject to change. Responsibilities Analyzes, investigates and evaluates the loss to determine coverage and claim disposition. Utilizes proprietary claims management system to document claims and to diary future events or follow up. Issue detailed coverage position letters for all new claims within prescribed time frames. Within prescribed settlement authority, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level. Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting. Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment. Pro-actively manages the case resolution process. Actively participates in mediations and arbitrations, as well as negotiation discussions within limit of settlement authority. Participates in the claims audit process. Provides claims marketing services by meeting with brokers and insureds. As required, maintains insurance adjuster licenses Qualifications Bachelors' and/or advanced degree 7 + years claims/legal experience, with at least 2 years within a technical specialty preferred (Managed Care, Errors & Omissions and Directors & Officers) Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge Functional knowledge of law and insurance regulations in various jurisdictions Demonstrated advanced verbal and written communications skills Demonstrated advanced analytical, decision making and negotiation skills 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 can recommend jobs specifically for you! Click here to get started.

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. Researches and resolves co-worker process questions and concerns. 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 Graduate or equivalent. 2. HFMA Certified Revenue Cycle Representative (CRCR) Certification within 90 days of hire. 3. Completes sixteen hours of revenue cycle continuing education required annually. EXPERIENCE: 1. Six (6) years medical billing/medical office experience with Nine (9) months directly working with hospital insurance claims. PREFERRED QUALIFICATIONS: EXPERIENCE: 1. Six (6) years medical billing/medical office experience, preferably related to claims billing and insurance follow-up. 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. Accesses and utilizes all necessary computer software, applications and equipment to perform job role. 11. Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth. 12. Attends department meetings, teleconferences and webcasts as necessary. 13. Researches and processes mail returns and claims rejected by the payer. 14. Reconciles billing account transactions to ensure accurate account information according to established procedures. 15. Processes billing and follow-up transactions in an accurate and timely manner. 16. Develops and maintains working knowledge of all federal, state and local regulations pertaining to hospital billing. 17. Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts. 18. Maintains work queue volumes and productivity within established guidelines. 19. Provides excellent customer service to patients, visitors and employees. 20. Participates in performance improvement initiatives as requested. 21. Works with supervisor and manager to develop and exceed annual goals. 22. Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information. 23. Communicates problems hindering workflow to management in a timely manner. 24. Researches and resolves staff questions and concerns. Summarizes for supervisors/managers and works with leadership to resolve/improve workflows. 25. Works with HB Trainer to identify training opportunities for staff. 26. Works with Revenue Cycle Systems Coordinators to optimize Quadax and other PFS specific applications for end users. 27. Works with managers/supervisors and Contracting to prepare for payer meetings and calls by summarizing issues and collecting staff concerns. 28. Represents end users for vendor demonstrations, training sessions, payer workshops and educational sessions and communications information back to staff. 29. Exceeds productivity measures in like work group as demonstrated by Epic dashboards. 30. Leads special projects and/or other work assignments as assigned by Manager/Supervisor. 31. Assists supervisor with delegate staff work assignments. 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. 4. Visual acuity must be within normal range. 5. Must be able to communicate effectively. 6. 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 third party payers required. 5. Knowledge of business math preferred. 6. Knowledge of ICD-10 and CPT coding processes preferred. 7. Excellent customer service and telephone etiquette. 8. Ability to use tact and diplomacy in dealing with others. 9. Maintains current knowledge of third party payer and managed care billing requirements and contracts. 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 SYSTEM Patient Financial Services

Overview Advanced Hearing Providers (“AHP”) coordinates hearing healthcare services for employees with workers' compensation claims. We connect patients with our nationwide network of qualified hearing healthcare providers on behalf of our clients; the payers and third-party administrators of workers' compensation claims. We are seeking hard-working, self-motivated candidates with a positive attitude who like the idea of being involved in the process of helping people hear better. The position of Claims Specialist (“CS”) I plays a critical role in the operation of the organization. The main function of an AHP CS I is coordinating authorized hearing healthcare for covered employees. AHP staff work as a TEAM - this is crucial! We expect team members to build trust and respect for each other by producing consistent results and going above and beyond, especially to help each other. Even though each CS will be working on their own assigned cases, interaction with other team members, clients, providers, and patients will occur often. Responsibilities - Obtain a complete, thorough understanding of the workers' compensation claims administration process, fees and participants. - Adhere to customer Service Level Agreements (SLAs) by maintaining contact with clients, providers, and claimants/patients as prescribed to ensure all parties are kept informed of the process status. - Successfully prioritize the workday utilizing our task-based systems, resulting in achieving daily completion of all required tasks (ensuring SLA compliance). - Ensure orders are properly documented in a timely manner. - Demonstrate an understanding of the workers' compensation referral and RFA process - Demonstrate an understanding of navigating client/claimant requirements to ensure billable item eligibility is reviewed prior to submitting requests to client - Perform verification of all HCPC/CPT codes that will be requested. This includes not only verifying eligibility but confirming whether NCCI edits and/or a state fee schedule (SFS), is applicable. - Coordinate the completion of necessary documentation to be filed with state agencies when applicable. - Maintain a high degree of detail and accuracy throughout the claim administration process. - Cross utilize phone, email, and fax for communication to ensure efficient processing time. - Assist with phone answering and intake related duties. - Demonstrate basic to intermediate level process understanding and ability to critically think and solution for complex situations that arise. - Other duties as assigned by the manager Qualifications - Advanced knowledge and experience with computer systems and business software programs, in particular Salesforce, Word, Excel, Outlook, Office 365 Apps and Adobe Acrobat - Previous workers' compensation, insurance claims management, and/or hearing healthcare industry experience is preferred - Bilingual skills will be extremely helpful with some patients - Excellent grammar and written skills - Ability to type at a minimum of 40 WPM - Ability to travel for training and occasional on-site meetings Other Personal Characteristics and Experience - Communicate clearly, professionally and in a timely manner. - Manage multiple tasks simultaneously in a proficient manner. - Ability to maintain professional client and provider relationships. - Work collaboratively with colleagues, including regularly providing direct support by completing team members' tasks for them as needed. - Understand when situational discretion must be employed in the handling and sharing of client, provider, and/or claimant information. - Self-motivated; ability to work independently - Must have a high attention to detail - Must be coachable and receptive to feedback - Must be dependable and consistent - Ability to take a proactive approach to all situations - Driven by a focus on reaching a specific objective or accomplishing a given task - Eagerness to adapt to new methods - Obtain satisfaction from delivering great customer service - Willing to try new things/operate outside of your comfort zone EDUCATION - HS Diploma or equivalent Company Values We Create Trust- We value the opinions of our customers and colleagues. We promote a work environment based on inclusion, honesty, integrity and respect. We always keep our promises. We are Team Players- We collaborate and network effectively across Demant. We take initiative and help each other to achieve our ambitious goals. We Create Innovative Solutions- We challenge ourselves to improve and find new, value-adding solutions. We are curious to share ideas and insights to increase our collective innovativeness. We Apply a Can-do attitude- We always look for opportunities to win the business and do our best to add value to our customers. We find solutions and act. What we have to offer: Medical, dental, prescription, and vision benefits 24/7 virtual medical care Employee Assistance Program for you and your family 401(k) with company match Company-paid life insurance Supplemental insurance for yourself, your spouse/partner, and your children Short-term and long-term disability insurance Pre-tax Health Savings Account and Flexible Spending Accounts for Health Care or Dependent Care Pet Insurance Commuter accounts The Company is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status. The pay range for this position is expected to be between $18.90-22.05 hourly; however, while the salary range is effective as of the date of this posting, fluctuations in the job market may necessitate adjustments to pay ranges. Further, final pay determinations will depend on various factors, including but not limited to experience level, knowledge, skills, and abilities. The total compensation package for this position may also include other elements, such as bonus, commissions, or discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. #Birdsong #LI-JB1 #LI-REMOTE

HAAWK is looking for a Claiming Specialist to join our team. In this role you will be responsible for accuracy and integrity of music assets within YouTube's Content Management System (CMS), and play a critical part in ensuring proper monetization, rights enforcement, and conflict resolution across digital content platforms. The ideal candidate is highly detail-oriented, technically proficient, and possesses a strong understanding of YouTube's platforms and policies. What You Will Be Doing: Monitoring and troubleshooting issues related to claims, monetization, and policy enforcement within YouTube CMS. Investigating and resolving disputed claims, reference overlaps, and ownership conflicts to ensure proper asset management. Maintaining accurate metadata, confirming correct ownership, and applying appropriate policies across music assets. Serving as a point of contact for clients and partners, providing timely assistance with content-related issues and conflict resolution. Stay up-to-date and informed on YouTube platform developments, Content ID tools, and industry best practices. What Makes You Qualified: Proficiency in organizing and analyzing data using tools such as Microsoft Excel or Google Sheets. Strong attention to detail, with excellent organizational and analytical problem-solving abilities. Comfortable working with and learning new technologies. Proven ability to work collaboratively in a team environment with a positive, solutions-oriented attitude and a willingness to support others to achieve shared goals. Hands-on experience with YouTube CMS or similar content management systems. Background in music, digital rights management, or copyright is a plus. Solid understanding of popular music and awareness of current and emerging trends in the music industry. Exceptional communication skills with the ability to interact professionally in client-facing situations.

Shape Your Future With UsGeneral Re Corporation, a subsidiary of Berkshire Hathaway Inc., is a holding company for global reinsurance and related operations, with more than 2,000 employees worldwide. It owns General Reinsurance Corporation and General Reinsurance AG, which conducts business as Gen Re. Gen Re delivers reinsurance solutions to the Life/Health and Property/Casualty insurance industries. Represented in all major reinsurance markets through a network of 38 offices, we have earned superior financial strength ratings from each of the major rating agencies. Gen Re currently offers an excellent opportunity for a Claims Specialist in our Life Health Global Claims unit to work remotely based out of our Stamford, CT office. Role Description The Claim Specialist is responsible for the delivery of the reinsurance claim risk management on multiple lines of business to both internal and external Gen Re clients. This includes, but is not limited to, the risk assessment of reinsurance liability and may include client training development and delivery, audit activities as well as representing the company and/or speaking at various industry conferences, as requested. Responsibilities: Responsible timely decision making and accuracy of reinsurance determinations on multiple lines of claim submissions. Incumbent contributes to the accurate and efficient adjudication of claims by supporting the department and client's investigation or coaching/mentoring on claims in all ranges of complexity to ensure compliance with policy provisions, state/federal regulations and reinsurance treaties in effect. Maintains a working knowledge of state and federal regulatory issues and keeps on the cutting edge of changes within the incumbent's area of expertise. Deliver high levels of customer service to internal and external customers in a professional, reliable and responsive manner. The incumbent works with claims management to develop, prioritize and execute a claim management strategy for each assigned client. Responsible for influencing a variety of constituents at various levels and not within one's direct employ. Thus, being accountable for the effective development, ongoing maintenance and consistent application of client communications and relationships. As an expert claim resource within a specific line of business, the Claim Specialist monitors national verdict/settlement trends and legal developments pertaining to their particular line of business. The incumbent researches, drafts and publishes articles and training oriented to educating clients on best practices gleaned. Responds to ad hoc reporting /projects from manager. Timely and accurate reporting of statistical information to management. Provides a broad range of regular (monthly/quarterly) management information in support of the Claims Department. Responsible for synthesizing a large amount of information from a variety of sources. May participate in client / TPA due diligence activities such as supporting audit activity, identifying emerging trends and themes not only in the client's inventory but within the industry; supporting manager with industry gleaned best practices via building and delivering customer specific training programs and seminars; emphasizing and implementing technical solutions to business needs to achieve desired improvements when asked. May participate in client meetings or with prospective accounts. Role Qualifications and Experience Prior claims experience in insurance and/or reinsurance operations. Prior experience managing claims (preferably LTC or Income Protection) thereby equipping the incumbent with the ability to assess reinsurer responsibility in its broadest sense (e.g. reviewing and offering risk management insights and recommendations on facultative and consultative claim submissions). Experience auditing claim files. Audit work of reinsured claims remotely or in client locations is an expectation. The audit process requires the ability to quickly adapt to the multitude of imaged systems in use by clients. The audit process may involve analyzing and verifying coverage and/or corresponding payments issued. The audit process may consist of managing internal and external communication with client executives in various areas such as claims, financial and legal resources, actuarial resources, etc. Thus, demonstrating an ability to emphasize and implement solutions to help clients manage risk and developing an in-depth knowledge of the management and organization of each assigned account. Holds insurance adjuster's license or a willingness to secure same within 1 year of hire Strong working knowledge of key coverage lines especially health (Long Term Care, Individual Disability) type claims Strong written and verbal communication skills Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously or as an effective member of a team Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to detail Flexibility to travel for business purposes, approximately less than 10 trips per year Strong client relationship, influencing and interpersonal skills Proven initiative, prioritization, presentation, and training abilities. Experience with and proficiency in Microsoft Suite of Products (WORD, EXCEL, PowerPoint), Visio, Power BI, developing and running queries etc. Salary Range 91,000.00 - 152,000.00 USD The annual base salary range posted represents a broad range of salaries around the US and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. Our Corporate Headquarters Address General Reinsurance Corporation 400 Atlantic Street, 9th Floor Stamford, CT 06901 (US) At General Re Corporation, we celebrate diversity and are committed to creating an inclusive environment for all employees. It is the General Re Corporation's continuing policy to afford equal employment opportunity to all employees and applicants for employment without regard to race, color, sex (including childbirth or related medical conditions), religion, national origin or ancestry, age, past or present disability , marital status, liability for service in the armed forces, veterans' status, citizenship, sexual orientation, gender identity, or any other characteristic protected by applicable law. In addition, Gen Re provides reasonable accommodation for qualified individuals with disabilities in accordance with the Americans with Disabilities Act.

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 We can recommend jobs specifically for you! Click here to get started.

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”.

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

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 .

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.

Job Title: Total Loss Settlement Adjuster Company: Snapsheet Job Type: Full-time About Snapsheet: Snapsheet is claims technology the way it should be: purposeful, precise, and designed to deliver outcomes. Where others bolt things on, we engineer them in to our core systems and processes across cloud-based claims management, virtual vehicle appraisals, and elite loss and recovery services. Trusted by over 170+ P&C Carriers, MGAs, MGUs, TPAs, and logistics companies, our open architecture is built to fit how our companies work, not the other way around. What you'll get: Remote working environment - your new commute is however long it takes to walk to your desk! Flexibility - empathy is ingrained in who we are and we are happy to offer a flexible PTO policy, casual dress code, and more! Development - Mentorship programs, 1-on-1 management, promote when ready culture, quarterly internal promotion opportunities, and goal setting sessions. Fun - Celebrations just because, yearly in-person and remote events, Snapsheet Swag, Employee Resource Groups, and more! Job Overview: As a Total Loss Settlement Adjuster at Snapsheet, you are highly competitive and motivated by constant improvement. You are an effective communicator, whether you are emailing a request to your peer, talking with a body shop, lienholder or a carrier customer. You love working in an ever-evolving environment where openness to feedback and the ability to adapt is highly valued. You are a strong problem solver, identifying and resolving the day-to-day challenges involved in auto claims handling, specifically understanding total loss evaluations, settlements with carrier customers, salvage regulations and state compliance, as well as solving more complex problems. You want to work for a company where you can make a real impact and do it all from the comfort of your home office! Not licensed? We will license you prior to starting. Responsibilities: Settle Total Loss claims with owners and lienholders Secure vehicle releases, negotiate release fees, and relocate salvage Mitigate expenses for storage, rental, etc, within state compliance Process associated paperwork to transfer title and secure salvage returns Issue settlement payments to owners and lienholders Maintain working understanding of estimatics, policy and carrier guidelines, state and regional regulatory compliance and laws. Maintain working understanding of Actual Cash Value. Candidates should be able to confidently speak to options, condition ratings, unrelated prior damage, refurbishments, comparable vehicles and market availability to negotiate settlement agreement Utilize internal training tools and external resources to clearly document every claim with high attention to detail Maintain documentation of all interactions with internal and external customers or sources Work effectively with repair facilities, rental agencies and salvage yards while maintaining a positive and professional demeanor Manage and maintain virtual relationships with teammates, managers, and directors while working remotely from home Qualifications: Must be currently completing total loss settlements with an insurance carrier Must have a working understanding or background in estimating and evaluating total losses Thorough understanding of UPD estimates, parts costs, total loss classification, and fraud detection 2-5 years of Auto Total Loss Settlement experience in the Insurance Industry Extensive knowledge of Automobile Total Loss Conditioning and Optioning processes Thorough understanding of automobile terminology and vehicle construction. Working experience of estimating platforms: Mitchell UltraMate, CCC One and/or Audatex Excellent verbal and written communication skills Detail-oriented and organized, with a commitment to delivering accurate and timely results Excellent negotiation and communication skills to interact with customers, shops and vendors remotely Team player with positive attitude and ability to work well with others Ability to work independently and manage time efficiently in a virtual work environment We're Built to Grow With You - And That Starts With How We Support You At Snapsheet, we know that growth doesn't happen in a vacuum-it's fueled by the right support at the right time. That's why we've built a benefits experience designed to grow with you, wherever life takes you. Choose from 2 robust medical plans through Blue Cross Blue Shield-plus, we contribute to your HSA when you enroll in our high-deductible health plan. Offer two dental plans and one vision plan to keep you and your family healthy. Peace of mind with company-paid Short Term Disability, Long Term Disability, and Life Insurance. Additional protection through voluntary benefits like Accident Insurance, Hospital Indemnity, Critical Illness, and Legal Assistance. 401(k) with a 4% company match-because your future is worth investing in. Employee Assistance Program (EAP) with 6 sessions per life incident to support your mental well-being. Perks That Make Growing Here Even Better: Flexible PTO and 7.5 company-observed holidays to recharge on your terms. In-person connection points throughout the year including our annual Summit and Roadshows. Snapsheet SWAG and surprise mailers to keep the spirit alive. Endless opportunity to shape your path-career growth, learning, and real impact are all within reach. Health and wellness campaigns that evolve with you year over year. Compensation that Grows with You For this position, the base salary range is $50,000-$60,000. While this range serves as a guideline, your actual compensation will reflect your experience and skillset. At Snapsheet, we believe growth should be rewarded-our compensation and benefits are built to evolve with you as your career does. *Please note that we are unable to sponsor applicants for work visas for this position at this time. Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply for jobs unless they meet every single qualification. At Snapsheet, we are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. Snapsheet is committed to providing reasonable accommodations for candidates with disabilities in our recruiting process. If you need assistance or accommodations, please let us know by emailing [email protected]. Snapsheet is proud to be an Equal Opportunity employer. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender, gender identity, gender expression, transgender status, sexual stereotypes, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law. #BI-Remote #LI-Remote Snapsheet is an equal opportunity employer.

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.

As a Total Loss Adjuster, you will handle claims where coverage is resolved and the damages to a vehicle render it a total loss. If liability is not resolved this adjuster would only handle 1st party total losses until liability is resolved. This adjuster should evaluate and settle 1st and 3rd party auto and specialty vehicle total loss claims and effectively negotiate claims to conclusion in a timely manner. Under moderate supervision using company guidelines, this adjuster should make appropriate decisions regarding settlement and resolution of the claims assigned to them. Ready to get in the driver's seat? Join us! What you'll do Makes timely and appropriate contacts with necessary parties Determines and completes appropriate level of investigation which includes but is not limited to reviewing policy contracts and communicating with underwriting Sets timely total loss reserves Notifies underwriting of total loss vehicles Obtains salvage values of total loss vehicles Prepares total loss damage evaluation, total loss letter, determination, and actual cash value of vehicle when appropriate Prepare and secure all needed paperwork Consistently provides excellent customer service Determines settlement value and negotiates proper settlement of claims within authority Provides recommendations for settlement and disposition of claims exceeding authority level Pursues subrogation when appropriate Provides backup assistance to team members when necessary Effectively manages workload and tasks to keep claims current and documented appropriately Identifies claims in which state required letters must be sent and sends those letters in a timely manner with accurate and thorough information This might describe you Prior experience in a similar role required Effective and efficient use of computer applications including MS Office products Excellent organizational skills and written and verbal communication skills Experience in multiple jurisdictions is desired Exercise decisiveness and execution within their authority Must be detailed oriented Must be able to maintain a high level of accuracy Ability to work with highly confidential information Must be licensed and bondable Ability to work independently Familiarity of public company requirements, including Sarbanes Oxley and key regulations, if applicable. Other things to note This position can be worked as remote position within the United States. Say hello to Hagerty Hagerty is an automotive enthusiast brand and the world's largest membership organization. Along with being a best-in-class provider of specialty insurance for enthusiasts, Hagerty is also home to the Hagerty Drivers Foundation, Garage + Social, Hagerty Drivers Club, Marketplace and so much more. Committed to saving driving for future generations, each and every thing Hagerty does is dedicated to the love of the automobile. Hagerty is a rapidly growing company that values a winning culture. We provide meaningful work for and invest in every single team member. At Hagerty, we share the road. We are an inclusive automotive community where all are welcomed, valued and belong regardless of race, gender, age, or car preference. We are united by our shared passion for driving, our commitment to preserve car culture for future generations and our desire to make a positive impact in the world. If you reside in the following jurisdictions: Illinois, Colorado, California, District of Columbia, Hawaii, Maryland, Minnesota, Nevada, New York, or Jersey City, New Jersey, Cincinnati or Toledo, Ohio, Rhode Island, Vermont, Washington, British Columbia, Canada please email ********************** for compensation, comprehensive benefits and the perks that set us apart. #LI-Remote EEO/AA US Benefits Overview Canada Benefits Overview UK Benefits Overview If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!