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  • Entertainment Animatronic Specialist

    Six Flags Over Texas 4.1company rating

    Claim specialist job in Arlington, TX

    Six Flags Over Texas is looking for a qualified Animatronic Specialist. This position works in the Creative Services department, executing projects and maintaining attractions. Part Time Hourly with Benefits. Responsibilities: Qualifications: Essental Duties and Responsibilities Rehab, repair, inspect, and troubleshoot animatronic rides, displays, and exhibits to ensure their safe and efficient operation Diagnose, repair, maintain and install pneumatic, hydraulic, and servo systems Fabricate, install, and maintain animatronics Painting, coating, and repair of animatronics figures Respond to work orders and conduct mechanical repairs as required to maintain safe park operation Adhere to park policies and procedures
    $25k-34k yearly est. Auto-Apply 4d ago
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  • Injury Examiner

    USAA 4.7company rating

    Claim specialist job in San Antonio, TX

    Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Injury Examiner, you will be responsible to adjust complex bodily injury claims, UM/UIM, and small business claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy. This role is remote eligible in the continental U.S. with occasional business travel. However, individuals residing within a 60-mile radius of a USAA office will be expected to work on-site three days per week. What you'll do: Adjusts complex auto bodily injury claims with significant injuries (e.g. traumatic brain injury, disfigurement, fatality) and UM/UIM, and small business claims, as well as some auto physical damage associated with those claims. Identifies, confirms, and makes coverage decisions on complex claims. Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes. Prioritizes and manages assigned claims workload to keep members and other involved parties informed and provides timely claims status updates. Collaborates and supports team members to resolve issues and identifies appropriate matters for escalation. Partners and/or directs vendors and internal business partners to facilitate timely claims resolution. Serves as a resource for team members on complex claims. Delivers a best-in-class member service experience by setting appropriate expectations and providing proactive communication. Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed. Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. What you have: High School Diploma or General Equivalency Diploma. 4 years auto claims and injury adjusting experience. Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations. Advanced negotiation, investigation, communication, and conflict resolution skills. Demonstrated strong time-management and decision-making skills. Proven investigatory, prioritizing, multi-tasking, and problem-solving skills. Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims. Ability to exercise sound financial judgment and discretion in handling insurance claims. Advanced knowledge of coverage evaluation, loss assessment, and loss reserving. Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts. What sets you apart: 2 or more years of high-value catastrophic injury experience (e.g. traumatic brain injury, disfigurement, fatality) to include UM/UIM coverage College Degree (Bachelor's or higher). Insurance Designation. Compensation range: The salary range for this position is: $85,040 - $162,550. USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.). Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
    $42k-60k yearly est. 1d ago
  • Legal Hospital Claims Analyst

    Erisa Recovery

    Claim specialist job in Plano, TX

    ERISA Recovery are experts in collecting complex and aged claims through the Federal ERISA appeals process. We are a fast-growing organization located in Plano, TX. If you would like to join a friendly, passionate team with limitless potential, we'd love to meet you. This extraordinary opportunity to advance your career and make a difference is now. We are searching for a Legal Hospital Claims Analyst - someone who works well in a fast-paced setting. In this position, you'll provide support in analyzing comprehensive claims and identifying key metrics. You will be a subject matter expert in legal claims. You must be able to work both independently and as part of a team. Key attributes for the ideal candidate include working with intensity, focus, and being detail oriented. Essential responsibilities and duties Conducts legal research and investigation of claims Drafting legal documents Keeping track of changes in legal framework and providing timely updates on these changes Utilizes ERISA law enforcement Utilizes knowledge of health care standards appropriate to specific claim Ability to understand and apply medical reimbursement policies, procedures, and standards Ensures eligibility for claims is reasonable and correct by analyzing claims and providing supporting documentation Utilize a variety of EHR systems Thrives in a fast-paced environment Collaborates effectively with other team members Ability to adapt to changing needs Consistently applies knowledge relevant to claims Work intensely at a fast-paced rate Ability to communicate effectively with third party administrators Determine the status of medical claims through research Meet the standards of the department and quality standards Strong organizational skills Desired skills and Qualifications Bachelor's degree 3+ years working in the legal field 2+ years working with healthcare insurance claims (preferred) Strong Communication skills Working knowledge utilizing Microsoft software (Word, Excel, Outlook) Ability to work in a fast-paced environment Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance Paid lunches Bonus ERISA Recovery is an Equal Opportunity Employer
    $34k-55k yearly est. 16h ago
  • Specialty Claims Examiner

    Staffing Now 4.2company rating

    Claim specialist job in Austin, TX

    Staffing Now is looking for a detail-oriented and customer-focused contract to hire Specialty Claims Examiner to join our clients team in the Austin area. In this role, you'll be responsible for accurately processing and adjudicating GAP and Anti-Theft claims while delivering an exceptional service experience. What You'll Do Review loan, insurance, and contract documents to confirm claim eligibility Process claims submitted through phone, email, and chat Document all claim interactions in our system with accuracy and clarity Provide timely updates on open and pending claims Manage your assigned queue to ensure efficient claim resolution Interpret insurance and dealership documents, including payment histories Maintain strong product knowledge and deliver high-quality customer service Support administrative tasks and assist with special projects as needed What You Bring High school diploma or equivalent 2+ years of claims experience in a call center or insurance setting Working knowledge of GAP and Anti-Theft claims Strong communication skills, critical thinking, and the ability to read and interpret contracts Ability to manage high contact volume (40+ calls/emails/chats daily) Preferred Qualifications Active Claims Adjuster License Previous experience in the insurance industry If you're driven, organized, and ready to make an impact, this could be the perfect next step in your career.
    $26k-31k yearly est. 3d ago
  • Claims Coordinator

    Morgan Benjamin Search Group

    Claim specialist job in Houston, TX

    Claims & Safety Coordinator 📍 Houston, TX | In-Office 77073 We're partnering with a growing manufacturing/service organization to hire a Claims & Safety Coordinator who will own the day-to-day management of insurance claims for the business and serve as the central point of contact between internal teams, carriers, and adjusters. This role is ideal for someone with hands-on experience in worker's compensation claims, fleet claims, and property claims who enjoys staying organized, following claims through resolution, and keeping leadership informed every step of the way. What You'll Be Doing Manage auto, property, general liability, workers' compensation, and fleet-related claims from intake through resolution File, track, and monitor claims while communicating directly with carriers, adjusters, and brokers Maintain accurate, audit-ready claim files and tracking systems Provide regular claim status updates and cost visibility to internal stakeholders Track claim costs, reimbursements, and settlements Assist with documentation for renewals, audits, and carrier requests Gather incident details and supporting documentation from internal teams Support trend reporting related to claims activity and costs What We're Looking For 2+ years of experience in claims coordination or claims administration Strong organizational and follow-up skills with the ability to manage multiple open claims Clear, professional communication skills Comfort working with claims systems and Microsoft Excel High attention to detail and confidentiality 💼 In-office role 💰 Competitive salary Starting at $60k (based on experience) + excellent benefits 🏢 Stable, employee-focused environment
    $60k yearly 2d ago
  • Construction Claim Coordinator

    Servpro Team Shaw

    Claim specialist job in Grapevine, TX

    SERVPRO Team Shaw - Ranked #69 Fastest Growing Construction/Restoration Company in US by Inc 5000 and #2 Best Place to Work by Dallas Business Journal SERVPRO Team Shaw is one of the largest SERVPROs in Texas and has grown from one location in 2019 to 30 locations today. We have grown 10x in the last 3 years and are looking to double in growth in near future. We are a full turnkey provider for our customers doing everything from Water and Fire Emergency Services, Moving and Storage of Contents, and Textile Cleaning all the way to Reconstruction. Growth opportunities can arise through any of the above-mentioned divisions, as well as specializations for commercial large loss, fire damage restoration, Reconstruction and Capital Improvement Projects. If you have a sense of urgency and want to grow with a company that has seen 10x growth over the last 2 years, look no further and apply today! As a Construction Claims Coordinator with SERVPRO, you will be responsible for ensuring the highest quality of service is provided to all customers, insurance partners, and internal teams. In this role, you will manage a wide range of administrative and communication functions that support the insurance claims process from start to finish. This position will work heavily within carrier portals, documentation systems, and in close partnership with Estimators, Project Managers, and Insurance Adjusters. Key Responsibilities: As a Construction Claims Coordinator, you will oversee essential file management and claims communication functions that keep insurance-related projects accurate, compliant, and moving forward efficiently. In this role you will: Manage all claims documentation, uploading and organizing required photos, estimates, invoices, and notes. Work heavily within insurance carrier portals (XactAnalysis) to update job status and submit required documents. Manage mortgage company authorization regarding ACV and depreciation. Create PO's and work within our construction software to manage payments and expenses. Communicate professionally with insurance adjusters regarding approvals, supplements, missing information, and claim status. Assist Estimators and Project Managers by ensuring job files are complete and meet carrier guidelines. Track claim progress, approvals, payments, and outstanding items to keep files moving efficiently. Provide homeowners with timely updates on claim status, required documents, and next steps. Coordinate re-inspections, supplemental requests, and additional documentation between field teams and adjusters. Maintain accurate digital file organization for all mitigation and reconstruction claims. Support internal reporting and compliance requirements related to carrier scores, timelines, and file accuracy. Schedule: Monday - Friday, 8:00 AM - 5:00 PM (Some overtime may be required) Qualifications: 1-3 years of experience in insurance claims, restoration, construction administration, or related office support. Strong written and verbal communication skills. High attention to detail and accuracy in documentation. Ability to prioritize, multitask, and manage deadlines in a fast-paced environment. Proficiency with Microsoft Office (Outlook, Excel, Word). Comfortable learning multiple software platforms and carrier portals. Strong customer service skills and professional phone/email presence. Preferred Experience: Experience with restoration software (Xactimate, PSA/CAM, BuilderTrend, Company Cam, etc.). Prior work in insurance, claims management, construction coordination, or mitigation/reconstruction support. Familiarity with insurance carrier requirements, SLAs, and documentation standards. Understanding of restoration industry workflows is a plus. Attributes for Success: Highly organized and detail-oriented. Strong communicator - clear, calm, and professional. Dependable with excellent follow-through. Able to stay calm under pressure and adapt quickly. Proactive about solving problems and closing gaps. Team-oriented with a positive, service-focused mindset. Comfortable juggling multiple open claims and deadlines. Benefits: Medical, Dental, Vision Insurance Paid Time Off + Sick Leave 401K with Company Matching Professional Development & Training Opportunities Growth potential in a rapidly expanding company
    $34k-43k yearly est. 2d ago
  • HSE SPECIALIST

    CTCI Americas Inc. 4.0company rating

    Claim specialist job in Houston, TX

    Develops HSE information packs for main subcontractors, and associated safety campaign material. Maintains the project training plan and associated records. Analyzes and reports HSE performance statistics in accordance with company and group requirements. Maintains the project risk register and reports status of actions. Establishes and maintains register of project audit findings and reports close out status of findings. Develops HSE presentations. Prepares HSE status reports. Develops, reviews, and updates HSE deliverables. Identifies trends regarding the recurrence of accidents and incidents and provides feedback as necessary. Duties/Responsibilities Receives very limited direction on new assignments and acts independently to develop methods and procedures. Receives direction from Construction and/or Project Manager. Develops and implements Project's HSE initiatives and programs. Capable of advising other groups on small to very complex projects from start to finish. Uses job-specific expertise to contribute to the objectives of the organization. Works on complex problems which require analysis and evaluation. Independently makes decisions and is responsible for the outcome. Plans individual work to accomplish objectives. Continuously improves efficiency and performance. Review existing policies and procedures, making recommendations for improvement. Supervises the development of new HSE policies and procedures to meet Project and overall CTCIA needs. Utilize CTCIA audit protocols for all project locations. Participate in incident investigation and root cause analysis processes and prepare required report(s). Assist supervision and craft crews in the planning, recognition, evaluation, and mediation of risks in projects. Gain knowledge and understanding of applicable legislative, client, and CTCIA requirements for the project. Engage in the HSE Training process for the Project. Communicate effectively and regularly with Project supervisors and employees. Provide injury care and case management reporting Assist with implementation of the CTCIA Drug & Alcohol Program. Support the needs of the Project HSE Department. Participates willingly as a team member, contributes individual share of work, and may be called to perform other work-related duties as assigned. Required Skills Extensive knowledge of OSHA General and Construction Standards. Seeks expertise, advice, and perspectives from a variety of sources internally and externally. Involves others in solving problems. Nationally recognized certifications (CSST, CSP, ASP. CHST, or OHST) and/or Degree in Occupational Safety & Health or related field. Understanding of basic construction work practices. Excellent written and verbal communication; includes use of proper grammar, spelling, etc. Excellent computer skills, to include working knowledge and familiarity with Microsoft Word, Excel, and PowerPoint. Maintain relationships with internal organizations (e.g., engineering, constructions, and subcontracts), Client, and subcontractor to coordinate technical/scientific issues and implementation of HSSE functions into project proposals, designs, and construction plans. Actively seeks feedback from customers and takes action to improve processes. Builds trust, credibility, and respect quickly across all levels of the organization in the Office and CTCIA. Works to find professional resolutions for conflicts. High level of integrity for reporting as well as upholding company policy, personal activities, to independently manage multiple HSE related tasks or new assignments. Ability to objectively audit compliance in the workplace, understand the results and develop mitigation for items found out of compliance. Maintains contact with other professional personnel, colleagues, and organizations in government and industry to keep abreast of changing requirements and/or advancements in HSE. Has a network of outside experts to resolve technical problems in area of expertise. Member of technology organization (i.e., ASSP councils and committees) Occasional travel may be required. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, governmental regulations, or comparable publications. Ability to write reports, business correspondence, and procedure manuals. Education and Experience Extensive knowledge of OSHA General and Construction Standards. BA or BS degree in engineering or specialized scientific field (Safety, Industrial Hygiene, Public Health) or process, and mechanical engineering. Minimum of 10 years of relevant work experience with at least 4-6 years of supervisory experience. This position is often referred to as the Lead HSE. Nationally recognized certifications (CSST, CSP, ASP, CHST, or OHST) and/or Degree in Occupational Safety & Health or related field High school diploma or GED, with very extensive practical work experience with the discipline performing the responsibilities associated with this position (this candidate should have more than enough work experience for this position). CPR/AED/First Aid qualified, OSHA 500 Trainer (or within 1 year), and other training specified by the HSE Manager. Physical Requirements Ability to walk, stand, and move about the job site for extended periods of time Ability to bend, stoop, kneel, crouch, and reach to inspect work areas, equipment, and work practices at various heights and positions. May be required to lift and carry items weighing no more than 25-50 pounds. Must be able to move in and around confined spaces and uneven areas. Must be able to climb and maintain balance on stairs, ladders, scaffolds, and steel framework. Must be able to adequately hear and respond to voice commands and alerts from other employees, alarms, and other job-related noises. Pay range and compensation package Pay Range is depending on experience Medical / Dental / Vision plans Basic Life & AD&D - company paid STD / LTD - company paid EAP Program - company paid 401k Program - with company match Equal Opportunity Statement CTCIA is an equal opportunity employer and is committed to creating a diverse and inclusive work environment. We do not discriminate on the basis of race, color, religion, gender, gender identity, sexual orientation, age, disability, national origin, veteran status, or any other characteristic protected by law. All employment decisions are made without regard to these factors. We encourage individuals from all backgrounds and experiences to apply, as we believe a diverse workforce fosters innovation and success.
    $42k-76k yearly est. 5d ago
  • Architecture Specialist

    SLI Group, Inc. 4.3company rating

    Claim specialist job in Houston, TX

    SLI Group, Inc., established in 1976, is a Texas-based integrated design-build firm serving civic and financial institution clients. We design and build fire stations, schools, churches, and bank branches across Texas. We are hiring a full-time Architectural Production and Rendering Specialist to support our architectural and marketing teams with Revit and AutoCAD production and exterior renderings. This is a fast-paced, in-office role for a technically strong production professional who enjoys collaborative work and high-quality visual output. Responsibilities Create exterior renderings for client presentations Build and maintain Revit and AutoCAD models Assist with architectural drawing production Support marketing and proposal teams Requirements Proficiency in Revit and AutoCAD Experience producing exterior renderings Ability to work in a fast-paced, collaborative office Licensure not required. Experience with SketchUp, Lumion, Enscape, or similar tools is welcome. What We Offer Generous starting salary 401K, medical, dental, vision, life and disability insurance Paid time off Maternity and paternity leave Profit sharing based on personal and company performance Long-term career growth and advancement Merit-based culture that recognizes initiative and results
    $42k-76k yearly est. 4d ago
  • Maximo Specialist

    Brooksource 4.1company rating

    Claim specialist job in Fort Worth, TX

    Our Federal Systems integrator is seeking an experienced Maximo Specialist to support a aviation asset management program with a government partner. This role supports a highly regulated, mission-critical environment and requires a consistent on-site presence in Fort Worth, TX. The Maximo Specialist will serve as a key on-site resource responsible for coordinating delivery activities, supporting system operations, and acting as a liaison between business stakeholders and technical delivery teams. This individual will play a critical role in ensuring the stability, enhancement, and effective use of IBM Maximo in support of aviation operations. Key Responsibilities Serve as the primary on-site Maximo subject matter resource for day-to-day operations Coordinate delivery activities related to IBM Maximo enhancements, sustainment, and operational support Work closely with functional consultants, developers, and stakeholders to support Maximo workflows Translate operational requirements into actionable tasks and priorities for delivery teams Manage timelines, dependencies, and risks across Maximo-related workstreams Facilitate on-site meetings, status updates, and stakeholder communication Support documentation, reporting, and compliance requirements in a regulated environment Ensure system reliability and alignment with operational and regulatory needs Required Qualifications Hands-on experience working with IBM Maximo in a delivery or operational capacity Strong understanding of enterprise asset management (EAM) systems and processes Experience supporting complex or regulated environments Ability and willingness to work on-site full-time in Fort Worth, TX Strong communication and stakeholder coordination skills Preferred Qualifications Experience supporting aviation, transportation, defense, or government programs Familiarity with Maximo modules such as Asset Management, Work Management, or Preventive Maintenance Experience supporting long-term operational or sustainment-based programs Experience working in client-facing or consulting environments Why This Role Long-term, stable aviation program with strong stakeholder engagement High-impact, on-site role supporting mission-critical operations Opportunity to serve as a trusted Maximo expert within a complex delivery environment
    $56k-106k yearly est. 3d ago
  • Estimating Specialist

    The Gund Company 4.0company rating

    Claim specialist job in Euless, TX

    Ready to take your career to the next level? At The Gund Company, we're more than just an electrical insulation manufacturer-we're a team of passionate problem-solvers who love what we do! If you're looking for a workplace where innovation meets collaboration, and where your ideas truly matter, this is the place for you. Our Motto: Take Care of Each Other. Take Care of the Customer. Take Care of the Business. Position Details Shift: 1st Shift Schedule: Monday to Friday, 8:00 AM - 4:30 PM Location: Euless, Texas Salary: Starting at $64,000 per year Why You'll Love Working Here Be part of a fun, driven team that values growth and creativity. Enjoy employee ownership through our ESOP program-your success is our success! Competitive pay, great benefits, and a culture that celebrates continuous improvement. Requirements What You'll Do As a Manufacturing Estimating Specialist, you'll be the go-to expert for creating accurate, competitive cost estimates that help us win business and delight customers. You'll work closely with engineering, production, and sales teams to: Analyze customer requirements, specs, and drawings. Develop and improve costing models and calculators for efficiency. Prepare detailed quotes using our advanced tools like Visual Estimating Window and PCM automated quoting module. Participate in Kaizen events and process improvement initiatives to keep us ahead of the game. Lead Gross Profit Review processes and collaborate on pricing strategies. Document best practices and mentor others in estimating excellence. What We're Looking For 3-5 years' experience in custom manufacturing quoting processes. Strong Excel skills (formulas, lookup tables, ODBC links). Ability to create clear documentation of manufacturing processes. Familiarity with ERP systems, MS Office, and ISO quality environments. Bonus points for experience in low-volume, high-variety manufacturing, machining, or craftsmanship. Associate degree or relevant certifications preferred. Perks & Benefits Employee Stock Ownership Plan (ESOP) - You own part of the company! Health, Dental, Vision, Life & Disability Insurance 401(k) with 50% employer match Competitive wages & safe work environment Career development through Individual Development Plans (IDP) Ready to join a world-class team ranked high in employee engagement? Apply today and let's build something amazing together! EEO Statement: It is the policy of The Gund Company to recruit, hire, train, and promote employees without discriminating based on race, gender, age, religion, national origin, veteran status, sexual preference, or disability. Key Skills & Keywords Cost Estimation • Manufacturing Processes • ERP Systems • Excel Expert • Process Improvement • Kaizen • Lean Manufacturing • Quoting • Pricing Strategy • Continuous Improvement • ISO Standards • Engineering Collaboration
    $64k yearly 2d ago
  • Technical Claims Specialist

    Berkley 4.3company rating

    Claim specialist job in Texas

    Company Details Berkley Oil & Gas, (a W.R. Berkley Company) is an insurance underwriting manager providing unique property and casualty products and risk services to customers engaged in the energy sector. Our customers recognize the importance of the expertise we provide and appreciate the opportunity to work with professionals who understand their business. We are in turn committed to delivering innovative products and exceptional service to them, our valued agents and brokers, Berkley Oil & Gas is dedicated in its efforts to be well-informed of the changing dynamics of the industry; support industry efforts to minimize and mitigate risks and hazards in the ‘oil patch', and to constantly seek ways to improve our products and services to meet customer needs. Company URL: *************************** The company is an equal opportunity employer. Responsibilities The Technical Claims Specialist position will be responsible for handling, negotiating and resolving first and third party commercial general liability, property, Inland Marine and automobile bodily injury and property damage claims to conclusion. This position may also handle worker's compensation claims. This would include coverage verification, policy interpretation, contract interpretation, liability investigation and evaluation and negotiation of claims consistent with company policies and state regulations. Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant internal and external parties. Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution. Demonstrate understanding of medical terms, medical treatment and injury descriptions. Recognition and evaluation of potential damages related to injuries. Manage the claim authorization process. Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence. Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction. Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements. Verify, analyze, and correctly apply coverage. Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures. Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law. Keep policyholders, underwriting and agents advised of file status and other matters as required. Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues. Successfully complete relevant continuing education as required. Qualifications Minimum of 7 years of multi-line experience Must possess a current Texas claims adjuster licenses; additional licenses a plus. Multi-jurisdictional experience preferred. Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws Ability to follow detailed procedures and ensure accuracy in documentation and data. Excellent written and verbal communications; with ability to listen well. Recognizes differences in opinions and misunderstandings and encourages open discussion while working towards resolution. Accepts individual responsibility for all actions taken. Holds self and others accountable to the organization and stakeholders. Excellent organizational skills; ability to prioritize workload Ability to think critically and solve problems, including the ability to interpret related documentation Strong negotiation skills leading to best claim outcomes Demonstrate proficiency in computer programs, such as Microsoft Word, Outlook and Excel Education Requirement Bachelor's Degree required or equivalent work experience. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $90,000 - $140,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. The application window for this role is estimated to be open through January 30, 2026, but may be extended, if necessary, please submit your application as soon as possible prior to January 30, 2026. Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.
    $90k-140k yearly Auto-Apply 32d ago
  • Claims Specialist

    Pearl Street Dental Group 4.0company rating

    Claim specialist job in Dallas, TX

    Do you have 5+ years of dental office administrative experience with an emphasis on Insurance Billing, Collections, and Revenue Cycle Management? We are seeking an experienced Insurance Billing/Collections Specialist from a dental office to join our support team in Dallas, TX. This position will require phone contact with insurance company representatives and dental practices. Specific Job Skills and Responsibilities Must have knowledge of Insurance Billing, Collections, and Revenue Cycle Management in a dental office Employ measures to expedite claim adjudication by resolving issues that may delay processing Expert knowledge of outgoing and incoming insurance processes and insurance follow-up Demonstrates continuous effort to improve operations, decrease turnaround times, streamline work processes, and works cooperatively and jointly to provide quality seamless customer service Follow up with insurance carriers on special insurance billings and claims Knowledge of CDT coding and terminology is a plus Must be detail-oriented, organized, and work with little supervision Knowledge of dental/medical industry and insurance plans Ability to read and write in a clear and concise manner Ability to multi-task effectively under stress, prioritize and meet deadlines with strong attention paid to detail of work produced Pleasant and professional phone etiquette Must have knowledge of computer programs and operations (Word, Excel, PowerPoint, Outlook) Knowledge and experience working with public and private insurance companies Ability to maintain client and patient confidentiality Open Dental knowledge is a plus Education and/or Experience Associate's or Bachelor's degree; Or two-five years related experience or equivalent combination of education and experience in the dental insurance billing processing environment. Dental experience is required In addition to full medical, dental, and vision we provide life insurance, paid vacation, standard holidays, and 401K. About Pearl Street Pearl Street is a small group of partner dentists with dental practices throughout Texas. We are working to empower the dentists in our group with the best tools for their practice. Additionally, we have a centralized business team that handles many of the non-clinical services, including Human Resources, Operations, Billing, Training, Finance & Bookkeeping, Credentialing, Facilities Support, IT, and Marketing. Pearl Street is reimagining group dentistry and preserving the private practice! We are bringing a fresh perspective and providing exceptional dental care. We are passionate about creating extraordinary experiences for our dental providers, our loyal team members, and our patients. Job Type: Full-time Benefits: 401(k) 401(k) matching Dental insurance Employee discount Flexible spending account Health insurance Life insurance Paid time off Vision insurance Schedule: Monday to Friday Experience: Dental: 5 years (Preferred) Dental RCM: 5 years (Preferred) Work Location: In person Qualifications Experience: Dental: 2 years (Preferred) Dental RCM: 2 years (Preferred) Work Location: In person
    $37k-65k yearly est. 9d ago
  • Risk Claims Specialist

    Maya Management Group LLC 4.1company rating

    Claim specialist job in Dallas, TX

    Job Description Key Responsibilities: Customer Claims: • Manage Customer Injury and Liability Claims: Oversee the investigation, documentation, and resolution of customer claims related to personal injury, property damage, or any other incidents occurring on organization premises. • Coordinate with Insurance Providers: Liaise with insurance companies to ensure proper claims filing and coordinate the resolution of claims involving external parties. • Customer Support: Handle escalated customer claims and provide appropriate resolutions while ensuring the store's best interests are maintained. • Documentation & Compliance: Ensure that all claims are properly documented in compliance with company policies and legal requirements. Keep detailed records of each customer-related claim. • Risk Prevention: Identify trends or recurring incidents that may contribute to customer claims and work with store management to implement safety measures or preventive actions. Employee Claims: • Workers' Compensation Claims: Oversee and manage all workers' compensation claims, ensuring compliance with state and federal regulations, and ensuring employees receive appropriate benefits. • Workplace Injury Claims: Manage the investigation of employee injury claims, including gathering evidence, interviewing witnesses, and ensuring all necessary forms are completed and submitted on time. • Fleet Claims Management: Manage the investigation of employee fleet claims, support employee's injuries if any, gather witness statements • Support and Guidance: Provide support to injured employees, ensuring they are informed throughout the claims process and are aware of their rights and available benefits. • Collaboration with HR and Legal: Work with HR and legal teams to ensure employee-related claims are handled correctly and in compliance with labor laws, insurance regulations, and company policies. • Collaboration with Safety Team: Work with the Safety Team to consistently do store visits, conduct safety audits, checklists and investigations as needed. Development: • Process Improvement: Identify opportunities to improve the claims process, whether through more efficient systems, better documentation, or enhanced communication strategies. Risk Management and Reporting: • Claims Analysis and Reporting: Review and analyze the data on claims to identify trends, recurring issues, or areas for improvement. Prepare detailed reports for management regarding claim frequency, costs, and risk mitigation efforts. • Collaboration with Risk and Safety Teams: Work closely with the Risk Management and Safety teams to address underlying causes of incidents that may lead to claims and develop preventive strategies. • Compliance: Ensure that all claims are processed in line with company policies, industry standards, and legal requirements, including managing documentation for audits or regulatory reviews. • Invoices: Reconcile and verify all invoices generated from claims. • Safety Monitor Report: Complete Safety Monitor report and communicate all parties involved to resolve an issue related to an investigation. Qualifications: • Bachelor's degree in Business, Risk Management, Insurance, or a related field (or equivalent experience). • 3-5 years of experience in claims management, risk management, or a specialist role, preferably in a retail or supermarket environment. • Strong understanding of risk management principles, insurance claims processes, and workers' compensation regulations. • Strong problem-solving and analytical abilities to investigate and resolve complex claims efficiently. • Excellent communication skills, both written and verbal, with the ability to manage sensitive issues with customers and employees. • Attention to detail and ability to maintain accurate records and reports. • Proficient in Microsoft Office and experience with claims management software or risk management tools. Physical Requirements: • Ability to stand for extended periods • Ability to lift up to 50 lbs as needed Work Environment: • Fast-paced, high-volume environment • Occasional evening, weekend, or holiday work may be required • Occasional travel to different company locations Physical Demands: Some lifting, carrying, pushing, and/or pulling; some stooping, kneeling, crouching, and/or crawling; and significant fine finger dexterity. Generally, the job requires 70% sitting, 20% walking, and 10% standing. This job is performed in a generally clean and healthy office environment.
    $37k-65k yearly est. 3d ago
  • Claims Specialist - Auto

    Philadelphia Insurance Companies 4.8company rating

    Claim specialist job in Plano, TX

    Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
    $82.8k-97.3k yearly Auto-Apply 60d+ ago
  • Paralegal/Claims Specialist

    Sundt Construction 4.8company rating

    Claim specialist job in Irving, TX

    As a 100% employee-owned contractor, when you work at Sundt, you're not just hiring on at a company, you're joining a culture. Because everyone at Sundt is part owner, you'll join a team of people who are deeply invested in their work. From apprentices to managers, we're passionate about the details and deliberate in everything we do. At Sundt we focus on building long-term prosperity for our clients, communities, and employee-owners. We offer competitive pay, industry-leading benefits including a 401k and employee stock ownership plan, incentive programs for craft and administrative employees as well as training that focuses on your personal and professional growth. We're driven by skill, grit and purpose. Join us as we strive to be the most skilled builder in America. Job Summary The Paralegal / Claims Specialist supports the company's Legal and Risk Management functions by assisting attorneys and insurance professionals in the investigation, evaluation, and resolution of claims and lawsuits. The role involves direct collaboration with outside counsel, insurance adjusters, and internal Safety and Operations teams. The Paralegal/Claims Specialist will independently manage the day-to-day handling of routine litigation and claims matters, including discovery, documentation, and coordination with defense counsel. Key Responsibilities 1. Assists attorneys with trial preparation, exhibits, witness coordination, and logistics. 2. Assists company attorneys with responding to non-party subpoenas and regulatory inquiries. 3. Attends mediations, depositions, and hearings as appropriate to support counsel, our internal personnel and maintain awareness of case progress. 4. Communicates directly with claimants, witnesses, experts, and internal personnel to obtain and analyze relevant information, including managing internal electronic data preservation in coordination with IT team, and oversee transfer of preserved data for discovery. 5. Coordinates with Safety personnel regarding incident intake, documentation, and potential claims escalation. 6. Drafts and edits legal documents including correspondence, discovery requests and responses, routine pleadings, affidavits, and case summaries. 7. In conjunction with attorneys, manages litigation, including coordinating discovery and e-discovery, tracking deadlines, managing document production, approving and processing legal invoices and maintaining organized case files. 8. Maintains accurate and up-to-date records in Risk Information Management Systems {RIMS) or other claims databases. 9. Reviews and analyzes claims in coordination with legal and risk management professionals determine liability, damages, and insurance coverage. 10. Works closely with company attorneys, outside counsel, and insurance adjusters to investigate, evaluate, and resolve claims and lawsuits. Minimum Job Requirements 1. 5-10 Years of Experience 2. Bachelor's degree 3. Knowledge working for a law firm or an insurance company representing clients in responding to claims and lawsuit preferred. 4. Paralegal certification Note: is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 50Ibs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Note: Job Description is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 501bs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Equal Opportunity Employer Statement: Sundt is committed to the equal treatment of all employees, and/or applicants for employment, and prohibits discrimination based on race, religion, sex (including pregnancy), sexual orientation, gender identity, color, age, disability, national origin, covered veteran status, genetic information; or any other classification protected by applicable Federal, state, or local laws. Benefit list: Market Competitive Salary (paid weekly) Bonus Eligibility based on company, group, and individual performance Employee Stock Ownership Plan & 401K Industry Leading Health Coverage Starting Your First Day Flexible Time Off (FTO) Medical, Health Savings, and Wellness credits Flexible Spending Accounts Employee Assistance Program Workplace Wellness Programs Mental Health Program Life and Disability Insurance Employee-Owner Perks Educational Assistance Sundt Foundation - Charitable Employee-Owner's program #LI-KA1
    $45k-61k yearly est. Auto-Apply 46d ago
  • Loss Claims Specialists/ Project Manager

    Puroclean 3.7company rating

    Claim specialist job in Shreveport, LA

    About the Role PuroClean of Shreveport is seeking a high-character individual to join our team as a Loss Claims Specialist. This is more than a job-it's a leadership role designed for someone who can take full ownership of a project from start to finish and align with our mission of providing empathetic, efficient, and professional restoration services to our community. As a Loss Claims Specialist, you will serve in a project manager capacity, overseeing the execution of all services related to water damage, mold, biohazard, contents handling, and reconstruction. This role demands strong organizational skills, technical knowledge, and a commitment to both customer care and team collaboration. Why Join Us * Profit Sharing Position - your success is our success * Annual Draw of $50,000 + laptop + software subscriptions * Be part of a purpose-driven company that values integrity, excellence, and service * Opportunities for growth and advancement in a fast-paced industry What You'll Need * A personal vehicle and reliable transportation * A working phone * A desire to learn and align with our SOPs and company goals * Willingness to take ownership and be accountable for job outcomes * Ability to manage multiple claims and ensure timely completion of each project What You'll Do * Manage restoration projects from intake through completion * Coordinate and execute all mitigation and reconstruction services: * Water Damage * Mold Remediation * Biohazard Cleanup * Contents Pack-Out and Cleaning * Reconstruction/Build-Back * Estimate, invoice, and track jobs using software including: * Xactimate * Estimate * Time and Materials platforms * Learn and apply our internal SOPs with consistency and accuracy * Meet or exceed quarterly performance goals Preferred (but not required): * Prior construction or restoration experience * Familiarity with insurance claims processes or property loss mitigation Who We're Looking For We're looking for someone with more than just technical skills. We value character, accountability, and alignment with our company vision. If you take pride in your work, can lead by example, and are looking to grow in an environment that rewards dedication and results-you may be exactly who we're looking for.
    $50k yearly 60d+ ago
  • Auto Claims Specialist I

    Cox Enterprises 4.4company rating

    Claim specialist job in Euless, TX

    Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $16.59 - $24.86/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto. That's where you come in. We're looking for an Auto Claims Specialist I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details! Benefits * We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with flexible time-off policies. * How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program. * 10 days of free child or senior care through your complimentary Care.com membership. * Generous 401(k) retirement plans with up to 6% company match. * Employee discounts on hundreds of items, from cars to computers to continuing education. * Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance. * Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so. * We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well. At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits. What You'll Do From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include: * Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. * Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making. * Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. * Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. * Uses appropriate levels/limits of financial approval authority to resolve cases. * Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information. * Prepares and facilitates communication for resolution via telephone, email, and in-person discussion. * Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. * Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements. * Engages with supervisor/manager to determine if escalation is required. * Performs other duties as assigned. Who You Are You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications: Minimum * A high school diploma or GED and less than 2 years of related experience. * Accuracy and attention to detail. * Organizational and time management skills. * The ability to adapt in a fluid and changing environment. Preferred * 1+ years of automotive or body shop experience. * Claims adjuster experience. Cox is a great place to be, wouldn't you agree? Apply today! MSCOX Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
    $16.6-24.9 hourly Auto-Apply 10d ago
  • Mechanical Claims Processing Specialist

    Roadvantage

    Claim specialist job in Austin, TX

    Title: Mechanical Claims Processing Specialist Reports to: Mechanical Claims Supervisor Department: Operations Direct Reports: No Exempt Status: Non-Exempt Position Type: Full-Time, Hybrid Schedule Claims Hours of Operation: Monday - Friday, 7 am - 7 pm, Saturday, 8 am - 3:30 pm Job Purpose The Mechanical Claims Processing Specialist role is responsible for providing essential clerical and administrative assistance to the Mechanical Claims Team. This position is not directly responsible for adjudicating claims, but plays a critical role in ensuring efficient and accurate claims processing. Essential Job Functions Review, upload, and organize mechanical claims-related documents into internal systems for review and processing Review service invoices and repair orders for accuracy and completeness prior to processing payment Process claims payments accurately and in a timely manner Coordinate with Claims Examiners on open or pending claims to resolve outstanding issues Perform accurate data entry and maintenance of claims records Monitor workflow to ensure claims and documents are processed within established timelines Communicate professionally with internal teams and external partners, as needed, regarding claim statuses and updates Other tasks as assigned by Management Minimum Qualifications Previous experience as Warranty Administrator, Automotive Service Advisor, or similar role preferred Familiarity with Vehicle Service Contracts and mechanical claims processes Experience handling financial transactions, invoice verification, and payment reconciliation Ability to read and understand contractual language as well as automotive repair terminology Ability to interpret automotive service invoices and repair orders Proficiency in data entry and Microsoft Office Suite (Excel, Outlook, Word) Excellent verbal and written communication skills High attention to detail and accuracy Maintain production level as assigned The information contained herein is not intended to be an all-inclusive list of the duties and responsibilities of the job, nor are they intended to be an all-inclusive list of the skills and abilities required to do the job. Management may, at its discretion, assign or reassign duties and responsibilities to this job at any time due to reasonable accommodation or other reasons.
    $27k-36k yearly est. 4d ago
  • Claims Processing Specialist - Kelsey Seybold Clinic - Pearland Admin Office

    Unitedhealth Group 4.6company rating

    Claim specialist job in Pearland, TX

    **Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses.** Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind **Caring. Connecting. Growing together. ** Position in this function is under the supervision of the Business Services Supervisor, the Claim Processing Specialist is responsible for processing the electronic claims edits, "front end "edits, as well as claims edits from secondary claims. In the event a claim edit does not pass, the Specialist must determine the required action and steps necessary to resolve the claim issue. The Claim Processing Specialist will be expected to review and resolve a No-Activity Work file/Work queue, which consist of accounts that have no payment or rejection posted on the account and follow Kelsey-Seybold Clinic Central Business Office policies and procedures to determine the appropriate action. The Specialist will be expected to follow up with daily workloads and also be able to meet work standards and performance measures for this position. **This position has potential of Hybrid schedule. Hours may be flexible. Candidates must reside in Texas.** You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School diploma or GED + 3+ years of billing experience, knowledge of healthcare business office functions and their relationships to each other. (i.e. billing, collections, customer service, payment posting) and insurance products such as managed care, government and commercial products + Familiar with laws and regulations governing Medicare billing practices, medical billing systems, and claims processing **Preferred Qualifications:** + 3+ years of experience in a healthcare business office setting, preferably in electronic claims billing, or insurance follow up + IDX/EPIC, PC skills, and understanding of billing invoice activity such as credits, debits, adjustments, contractual agreements, etc. + Additional training as a medical office assistant, medical claims processor, or medical claims follow up specialist Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $xx,xxx to $xx,xxx annually based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $29k-33k yearly est. 13d ago
  • Revenue Cycle - Pre-Billing/Claims Processing Specialist

    Physicians' Group Laboratories 4.5company rating

    Claim specialist job in Houma, LA

    Pre-Billing / Claims Processing Specialist (On-Site - Houma, LA) The Pre-Billing / Claims Processing Specialist is responsible for preparing, reviewing, and submitting clean, accurate claims to insurance companies for payment. This role is critical to minimizing denials and ensuring timely reimbursement. Key Responsibilities Review charges, patient demographics, diagnosis codes, and insurance information for accuracy Process and submit insurance claims using CollaborateMD Ensure claims meet payer and regulatory requirements prior to submission Identify and correct errors before claims are released Collaborate with AR and Billing Admin teams to resolve pre-billing issues Maintain timely claim submission and productivity standards Address claim rejections related to data entry or formatting errors Why Work at PGL Play a key role in a high-impact function where clean claims drive financial success Gain hands-on experience with CollaborateMD and laboratory billing workflows Work in a structured environment that prioritizes accuracy, training, and process consistency Be part of a growing organization that values career development and internal growth opportunities Work Location This position is on-site in Houma, Louisiana This is not a remote position Qualifications & Skills Experience in medical billing or claims processing preferred Knowledge of CPT, ICD-10, and insurance guidelines Strong attention to detail and organizational skills Ability to manage volume while maintaining accuracy
    $33k-41k yearly est. 6d ago

Learn more about claim specialist jobs

How much does a claim specialist earn in Lake Charles, LA?

The average claim specialist in Lake Charles, LA earns between $20,000 and $60,000 annually. This compares to the national average claim specialist range of $27,000 to $67,000.

Average claim specialist salary in Lake Charles, LA

$35,000
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