Claim specialist jobs in Louisville, KY - 32 jobs

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI #IN-DNI

Claims Examiner II Warranty About AIG Warranty AIG Warranty delivers a full range of service solutions including warranty management administration, extended service contracts and mobile insurance theft/loss programs, customer service support, service network management, claims processing services, and service contract underwriting. With over 20 years of experience, we are one of the Warranty and Service industry's leading providers, which is why many of the world's largest and most respected brands choose us. When retailers or manufacturers want flexible and innovative service solutions that will ensure the focus of building customer retention and customer satisfaction, they turn to us. The Claims Examiner Role Our Claims Examiner work directly with our Service Providers and our Customers to ensure that the project moves forward with the support they need. Claims Examiners are responsible for receiving incoming calls and emails from Service Providers needing authorization for repairs on major appliances, consumer electronics, heating and air, or other home systems. They also research part availability, and ensure pricing and quotes submitted are in line with industry standards. The Claims Examiners verify that failure and repairs are covered under the terms and conditions prior to authorizing the Service Providers to proceed with the project or reserving any payments. Claims Examiners are the ones our clients turn to in times of need. They act with speed, composure, compassion, and knowledge to solve problems and the work they do every day is the heart of our business. How you will create an impact Answer incoming phone calls and emails from service partners and contract holders seeking repair authorizations, contract and payment statuses, and a variety of other needs. Ask the right questions about the claim, evaluating each request to determine if Client should repair or replace the product. Research claims to determine what coverage options were purchased; make denial/approval of claims per the terms and conditions. Adjudicate claims for fair and reasonable repair charges. Purchase small appliances, plumbing products, and HVAC equipment if necessary to fulfill contract requirements. Maintain knowledge of covered equipment, as relates to the price/replacement value. Handle research assignments and reporting as delegated by management. Maintain good working relationship during all contacts with clients, even during difficult conversations. Take responsibility for continuously improving processes and product knowledge, understanding of program coverage and exclusions. What you'll need to succeed A record of providing outstanding customer service Excellent written and verbal communication skills with ability to adapt as the need requires Experience in conflict resolution, or the ability to de-escalate tense situations, and comfortable in a role that requires some negotiations Analytical skills and the ability to search the internet for answers and market data Results oriented, and able to perform in a fast-paced environment and perform a wide variety of tasks and change focus quickly as internal and external demands change. Excellent organizational skills- flexible with moving from project to project while keeping track of progress Professional attitude- we are looking for someone enthusiastic, reliable, and a team player. Basic Excel, Word, and Outlook skills Excellent interpersonal skills Ability to consistently meet deadlines Understanding of Warranty or Insurance products is recommended but not required. Prior claims experience preferred. High school diploma or GED required. #LI-HB1 At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike. Enjoy benefits that take care of what matters At AIG, our people are our greatest asset. We know how important it is to protect and invest in what's most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security-as well as your professional development-to bring peace of mind to you and your family. Reimagining insurance to make a bigger difference to the world American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world's most far-reaching property casualty networks. It is an exciting time to join us - across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become. Welcome to a culture of inclusion We're committed to creating a culture that truly respects and celebrates each other's talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIG's greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations. AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories. AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to *********************. Functional Area: CL - ClaimsService Net Warranty, LLC

Job Description Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer. Powered by JazzHR YCTGcj3095

The Phia Group provides, amongst other things, claim recovery services for health benefit plans. When a health benefit plan pays medical bills, and we later discover someone else should have paid those medical bills, The Phia Group - on behalf of the health plan - will seek to recover the funds. The Case Investigator plays an important role in this effort, by determining whether another proper payer exists, and obtaining the details needed to pursue fund reimbursement. The Health Claim Investigation Representative is responsible for communicating with plan members (insured participants) to determine potential sources of recovery (i.e. auto insurance, workers compensation, first party coverage, third party coverage, etc.). You will also be in contact with insurance carriers to collect adjuster and claim information while balancing communication with clients (health benefit plan sponsors, employers, and claims administrators) via phone and email. At The Phia Group, whose mission is to provide high quality yet affordable healthcare to American employees and their families, you can look forward to not only unparalleled benefits for yourself but also being immersed in a company that was named one of USA Today's Top Workplaces for 2025. Meanwhile, from a regional perspective, both The Boston Globe and Louisville Business First also recognized our unwavering commitment to upholding an internal culture of inclusivity, enjoyment, and empathy for our valued employees by listing The Phia Group in their respective lists for the Top Places to Work in 2025. Note: This is a hybrid position. Essential Duties and Responsibilities Calling members for accident details Drafting, mailing & faxing correspondence Calling insurance carriers for claim information (claim #, adjuster name, phone, fax & mailing address) Providing clients with accident details, payment ledgers, police reports, etc. Reviewing plan documents for possible exclusions Verifying first party, workers' compensation, third party and/or attorney representation and properly promoting and/or transferring the file to the appropriate CRS Will be responsible for consistency and accuracy on time-sensitive documents. Working on a team to efficiently handle tasks and keep the team up to date. Using MS Word, Excel, Microsoft Outlook and other programs in preparation of correspondence and/or other documents Experience and Qualifications Excellent attention to detail with the ability to multi-task Excellent communication skills High level of proficiency using Microsoft Word and Excel required Outstanding organizational, interpersonal, and administrative skills Excellent telephone, writing, and communication skills Must be self-motivated and able to meet deadlines under pressure Must have the ability to work as part of a team, as well as to work independently The Phia Group's Commitment to Diversity The Phia Group is committed to creating a diverse environment and we are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. The Phia Group is also committed to compliance with all fair employment practices regarding citizenship and immigration status. Working Conditions / Physical Demands Sitting at workstation for prolong periods of time. Extensive computer work. Workstation may be exposed to overhead fluorescent lighting and air conditioning. Fast paced work environment. Operates office equipment including personal computer, copiers, and fax machines. This job description is not intended to be and should not be construed as an all-inclusive list of all the responsibilities, skills or working conditions associated with the position. While it is intended to accurately reflect the position activities and requirements, the company reserves the right to modify, add or remove duties and assign other duties as necessary. External and internal applicants, as well as position incumbents who become disabled as defined under the Americans with Disabilities Act, must be able to perform the essential job functions (as listed here) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case by case basis. Salary: $47,000 - $50,000

CENCO Claims is currently seeking a Daily Property Claims Adjuster to support property claim assignments throughout the Louisville, Kentucky area. This is a field-based role offering steady claim volume, flexibility, and strong internal support to help keep your files moving efficiently. What You'll Be Doing: Perform on-site inspections to assess property damage Prepare accurate and detailed estimates using Xactimate Document damages with clear photos and well-written reports Communicate professionally with policyholders and carrier representatives Submit complete and timely claim files in accordance with carrier guidelines What We're Looking For: Proficiency with Xactimate Working knowledge of residential and commercial construction Strong communication, organization, and time-management skills Valid driver's license and reliable transportation Active Kentucky adjuster license or designated home state license What CENCO Offers: Competitive compensation Consistent daily claim assignments Flexible scheduling and independence in the field Support from a responsive and organized claims team Apply Today If you're looking for steady field work with a dependable claims partner, CENCO Claims would love to connect.

Elevate Claims Solutions is built on the knowledge that human experience and claim quality are the essence of profitable growth and retention for our adjuster partners, our clients, and ourselves. Are you ready, willing, and able to Elevate? If you are a daily field property adjuster based in Central Wisconsin, we want to talk to you. How will we Elevate you? We want to know and understand your unique skillset and goals. We are committed to receiving your feedback on how we can best support your progression and advancement towards those goals. Expand your career opportunities in a role where you can see that you are making a difference in people's lives. Meaningful work in a culture of continuous improvement. A diverse market of carriers Clear communication of service and quality expectations; internal and external. Guidelines that provide upfront understanding of each carrier's requirements. Continuous feedback, including real -time Quality Assurance and formalized quarterly coaching sessions to identify areas of strength and opportunity. Training and development opportunities tailored to individual growth objectives. A tenured foundation of industry experts with a wide knowledge base for you to consult. How will you Elevate? Prioritize policyholders during their time loss through demonstrated empathy and understanding. Valuing our partnerships with our carrier clients; recognizing and maximizing the ways in which our Elevated Claims Handling can support them and their policyholders. Outstanding work ethic. This is not a 9 -5 position and you will be called upon to maintain a flexible schedule to help meet the needs of insureds and carriers. Clear, consistent, and timely communication. We, and our carriers, want and need strong lines of communication. You must be open to receiving and providing feedback. The ability to effectively and independently manage workload while exercising good judgement. Strong written and verbal communication skills. Strong technological skills with the ability to work within various claims management systems. Minimum of three years of residential and commercial property adjusting experience. Carrier experience is desired. Liability experience is a plus. Current, active Xactimate license and experience writing both residential and commercial damage estimates in Xactimate. Ability to pass a background screen. Current, active license where required. Equipment and ability to access roofs. If you are ready to Elevate claims with a firm that truly values and supports you, let us know - we may be a fit.

At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Daily Responsibilities: • Post cash to patient and insurance accounts for services rendered • Identify, resolve and rebalance keying errors in patient accounts • Update insurance changes, read EOB's, preform insurance verification and file up for patients Qualifications Requirements : • HS diploma or GED • 1+ year experience in billing/claims background • Strong communication and Microsoft Office skills Additional Information Hours for this Position: Full time: M-F 8am-5pm 3+month contract (project based) Interested in being Considered? If you are interested in applying to this position, please click Apply Now or reach Stephanie Z directly at 407-636-7030 ext. 220.

IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: Monday - Friday; 8:30am-5:00pm Eastern Time The Subrogation Examiner is responsible for researching and examining routine health claims that may be related to Third Party Liability, Workers' Compensation and other subrogation/reimbursement recovery cases. How you will make an impact: * Initiates calls to groups, insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party. * Responds to inquiries regarding information on injury claims. * Utilizes various research methods and vendor systems to gather information. * Works with subrogation staff, other departments and outside clients to assist with the recovery process. * Prepares written communications. * Reviews diagnostic and procedure codes to determine claims relevant to each case. * Reviews internal systems/applications for various information needs. * Assists with small scale special projects. Minimum Requirements: * Requires a minimum of 1 year of inbound or outbound call experience; or any combination of education and experience, which would provide an equivalent background. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Re-certification Specialist Duties/Responsibilities: • Conduct file reviews for compliance with the applicable subsidy type (S8, LIHTC, etc.). • Prepares reports that summarizes items of non-compliance and works in conjunction with property staff to correct identified deficiencies. • Meets with residents and applicants to perform Initial, Annual or Interim interviews for the applicable subsidy type (S8, LIHTC, etc.). • Processes required verifications that are necessary to complete resident and applicant certifications. • Provides Senior Property Manager with file reviews and suggests items for employee training deficiencies. • Reviews quarterly/monthly EIV reports for accuracy and assist property staff with resolving discrepancies. • Prepare monthly/quarterly/annual LIHTC reports (i.e. qualified basis tracking) as required by state monitors and syndicators for submission to the Director of Compliance. • Reviews asset verifications for certifications that involve real estate and/or investment income for submission and final review • Assists staff with monthly voucher submissions, HAP payment errors and posting/reconciling within One Site. • Other duties as assigned. Qualifications: • Strong knowledge of affordable housing programs, to include Section 8/236; LIHTC; EIV and HUD Secure Systems; Fair Housing & Section 504 compliance. • Affordable Housing certifications; COS (or equivalent), C3P, HCCP or nationally recognized certification is required. • Three to five years of directly related experience as a property manager or compliance analyst/monitor required. • Strong written and verbal communication skills are required. • High level of organization and attention to detail is a must. • Ability to manage multiple priorities and deadlines. • Good Microsoft Office (Word, Excel) skills are required. Strong knowledge of OneSite, Yardi or Boston Post software highly desired.

Summary/Objective This role focuses on minimizing loss and maximizing product credit by ensuring market inventory teams fully understand and accurately execute shipping claims processes across all shipping and vendor partners. Essential Functions Guide market inventory teams in following established shipping claims processes for all vendor and carrier partners in order to ensure compliance. Provide support and coaching to market inventory teams in order to improve their understanding and execution of claims procedures. Monitor claim submissions for accuracy and timeliness in order to minimize loss and maximize product credit. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Competencies Attention to Detail: Taking responsibility for a thorough and detailed method of working. Accountability: Accepting responsibility that results in anticipation/prevention of problem areas from actions, and problem solving inside and outside the department/organization. Planning and Organizing: Setting priorities and defining actions, time, and resources needed to achieve predefined goals. Results Orientation: Being persistent and showing perseverance on achieving concrete and tangible results out of personal responsibility; getting optimum results from situations and being ready to take action and show tenacity in case of obstacles or resistance. Customer Focus: Knowing the (internal and external) customer business needs and acting accordingly; anticipating customer needs and giving high priority to customer satisfaction and customer service. Initiative: Spotting opportunities within a circle of influence; anticipating threats and acting on them; self-starting rather than waiting passively until the situation demands action. Supervisory Responsibility This position has no supervisory responsibilities. Work Environment This job is in a back office/inventory environment. Physical Demands Must be able to perform repetitious hand/eye movement, Must be able to sit for long periods of time, Must be able to stand for long periods of time, Must be able to lift up to 50 lbs. 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. Position Type/Expected Hours of Work This is a full-time position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m. Travel 0-10% Required Education and Experience High school diploma or GED Must be comfortable with Microsoft Office products and able to work in an organized and efficient way. Preferred Education and Experience 4 Year Degree Experience with inventory, shipping claims, or reverse logistics processes would be beneficial. Additional Eligibility Qualifications (Knowledge, Skills, Abilities) Punctual with reliable transportation Good listening skills and ability to follow written and verbal instruction Consistently meet deadlines Self-starter with ability to work with minimal supervision as well as with a team AAP/EEO Statement Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Are you someone looking for professional career growth? Onco360 Pharmacy is looking for Pharmacy Benefit Verification Specialists for our Pharmacy located in Louisville, KY. Work Hours: Monday-Friday shifts available; some weekends as needed. **Starting salary at $22/hr and up** We also offer quarterly incentive bonuses. Sign-On Bonus: $5,000 for employees starting before March 1, 2026. Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking Pharmacy Benefit Verification Specialists who go above and beyond for our patients, and also passionate about helping others. We offer a variety of benefits including: Medical, Dental & Vision insurance 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Paid Volunteer Day Floating Holiday Referral Incentive Paid Life, and short & long-term disability insurance Pharmacy Benefit Verification Specialist Summary: The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders. Pharmacy Benefit Verification Specialist Major Responsibilities: Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information. Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information. Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile. Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy. Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims. Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws Contributes to team effort by accomplishing related tasks as needed and other duties as assigned. Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards. Pharmacy Benefit Verification Specialist Qualifications: Education/Learning Experience Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience Work Experience Required: 1+ years pharmacy or benefit verification experience Desired: 3+ years pharmacy or benefit verification experience Skills/Knowledge: Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. Behavior Competencies Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills #Company Values: Teamwork, Respect, Integrity, Passion

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Representative (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer.

The Phia Group provides, amongst other things, claim recovery services for health benefit plans. When a health benefit plan pays medical bills, and we later discover someone else should have paid those medical bills, The Phia Group on behalf of the health plan will seek to recover the funds. The Case Investigator plays an important role in this effort, by determining whether another proper payer exists, and obtaining the details needed to pursue fund reimbursement. The Health Claim Investigation Representative is responsible for communicating with plan members (insured participants) to determine potential sources of recovery (i.e. auto insurance, workers compensation, first party coverage, third party coverage, etc.). You will also be in contact with insurance carriers to collect adjuster and claim information while balancing communication with clients (health benefit plan sponsors, employers, and claims administrators) via phone and email. At The Phia Group, whose mission is to provide high quality yet affordable healthcare to American employees and their families, you can look forward to not only unparalleled benefits for yourself but also being immersed in a company that was named one of USA Today s Top Workplaces for 2025. Meanwhile, from a regional perspective, both The Boston Globe and Louisville Business First also recognized our unwavering commitment to upholding an internal culture of inclusivity, enjoyment, and empathy for our valued employees by listing The Phia Group in their respective lists for the Top Places to Work in 2025. Note: This is a hybrid position. Essential Duties and Responsibilities Calling members for accident details Drafting, mailing & faxing correspondence Calling insurance carriers for claim information (claim #, adjuster name, phone, fax & mailing address) Providing clients with accident details, payment ledgers, police reports, etc. Reviewing plan documents for possible exclusions Verifying first party, workers compensation, third party and/or attorney representation and properly promoting and/or transferring the file to the appropriate CRS Will be responsible for consistency and accuracy on time-sensitive documents. Working on a team to efficiently handle tasks and keep the team up to date. Using MS Word, Excel, Microsoft Outlook and other programs in preparation of correspondence and/or other documents Experience and Qualifications Excellent attention to detail with the ability to multi-task Excellent communication skills High level of proficiency using Microsoft Word and Excel required Outstanding organizational, interpersonal, and administrative skills Excellent telephone, writing, and communication skills Must be self-motivated and able to meet deadlines under pressure Must have the ability to work as part of a team, as well as to work independently The Phia Group s Commitment to Diversity The Phia Group is committed to creating a diverse environment and we are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. The Phia Group is also committed to compliance with all fair employment practices regarding citizenship and immigration status. Working Conditions / Physical Demands Sitting at workstation for prolong periods of time. Extensive computer work. Workstation may be exposed to overhead fluorescent lighting and air conditioning. Fast paced work environment. Operates office equipment including personal computer, copiers, and fax machines. This job description is not intended to be and should not be construed as an all-inclusive list of all the responsibilities, skills or working conditions associated with the position. While it is intended to accurately reflect the position activities and requirements, the company reserves the right to modify, add or remove duties and assign other duties as necessary. External and internal applicants, as well as position incumbents who become disabled as defined under the Americans with Disabilities Act, must be able to perform the essential job functions (as listed here) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case by case basis. Salary: $47,000 - $50,000

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated and experienced field claims professional to join our team. This job handles insurance claims in the field under general supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job requires mastery of claims-handling skills and requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability Handle multi-line property and casualty claims in an assigned territory with an emphasis on property claims Become familiar with insurance coverage by studying insurance policies, endorsements and forms Work toward the resolution of claims, and attend arbitrations, mediations, depositions, or trials as necessary Ensure that claims payments are issued in a timely and accurate manner Handle investigations by phone, mail and on-site investigations Desired Skills & Experience Bachelor's degree or direct equivalent experience handling property and casualty claims A minimum of 3 years handling multi-line property and casualty claims with an emphasis on property claims Field claims handling experience is preferred but not required Knowledge of Xactimate software is preferred but not required Above average communication skills (written and verbal) Ability to resolve complex issues Organize and interpret data Ability to handle multiple assignments Ability to effectively deal with a diverse group individuals Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents) Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. *Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNP #LI-Hybrid#IN-DNI

Summary/Objective This role focuses on minimizing loss and maximizing product credit by ensuring market inventory teams fully understand and accurately execute shipping claims processes across all shipping and vendor partners. Essential Functions Guide market inventory teams in following established shipping claims processes for all vendor and carrier partners in order to ensure compliance. Provide support and coaching to market inventory teams in order to improve their understanding and execution of claims procedures. Monitor claim submissions for accuracy and timeliness in order to minimize loss and maximize product credit. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Competencies Attention to Detail: Taking responsibility for a thorough and detailed method of working. Accountability: Accepting responsibility that results in anticipation/prevention of problem areas from actions, and problem solving inside and outside the department/organization. Planning and Organizing: Setting priorities and defining actions, time, and resources needed to achieve predefined goals. Results Orientation: Being persistent and showing perseverance on achieving concrete and tangible results out of personal responsibility; getting optimum results from situations and being ready to take action and show tenacity in case of obstacles or resistance. Customer Focus: Knowing the (internal and external) customer business needs and acting accordingly; anticipating customer needs and giving high priority to customer satisfaction and customer service. Initiative: Spotting opportunities within a circle of influence; anticipating threats and acting on them; self-starting rather than waiting passively until the situation demands action. Supervisory Responsibility This position has no supervisory responsibilities. Work Environment This job is in a back office/inventory environment. Physical Demands Must be able to perform repetitious hand/eye movement, Must be able to sit for long periods of time, Must be able to stand for long periods of time, Must be able to lift up to 50 lbs. 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. Position Type/Expected Hours of Work This is a full-time position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m. Travel 0-10% Required Education and Experience High school diploma or GED Must be comfortable with Microsoft Office products and able to work in an organized and efficient way. Preferred Education and Experience 4 Year Degree Experience with inventory, shipping claims, or reverse logistics processes would be beneficial. Additional Eligibility Qualifications (Knowledge, Skills, Abilities) Punctual with reliable transportation Good listening skills and ability to follow written and verbal instruction Consistently meet deadlines Self-starter with ability to work with minimal supervision as well as with a team AAP/EEO Statement Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.