Claim specialist jobs in Moore, OK - 30 jobs

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 PL CLAIM SPECIALIST **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim settlement up to designated authority level. + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge** + In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent negotiation skills + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** **:** Computer keyboarding, travel as required **Auditory/Visual** **:** Hearing, vision and talking _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 $117,000 - $125,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. 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**

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.

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.

Job Posting Title Examiner Agency 630 DEPARTMENT OF SECURITIES Supervisory Organization Department of Securities Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Estimated Appointment End Date (Continuous if Blank) Full/Part-Time Full time Job Type Regular Compensation Level I - $75,000/yr Basic Purpose The Examiner is responsible for conducting examinations of registered broker-dealer and investment-adviser firms and representatives to ensure compliance with the Oklahoma Uniform Securities Act of 2004. Typical Functions * Conduct examinations of registered broker-dealers and investment advisers to ensure compliance with the Oklahoma Uniform Securities Act of 2004. * Review and analyze financial and non-financial records obtained through the Department's examination process. * Draft correspondence relating to deficiencies found during examinations. * Review enforcement related filings against registered broker-dealers and investment advisers and representatives. * Respond to inquiries from investment advisers, broker-dealers, their counsel, and the public. Level Descriptor This position consists of three (3) levels which are distinguished based on the complexity of job assignments, the expertise required to complete assigned duties, and the responsibilities assigned to the incumbent. * Level I - Education and experience requirements consist of a bachelor's degree in business, accounting, finance, economics, or a closely related field from an accredited college or university; or equivalent combination of education substituting one (1) year of securities industry experience for each year of the required education. * Level II - Those requirements identified in Level I plus demonstrated knowledge of securities laws and three (3) additional years of qualifying experience. * Level III - Those requirements identified in Level II plus demonstrated knowledge of securities laws and three (3) additional years of qualifying experience. Education and Experience Minimum education and experience requirements consist of a bachelor's degree in business, accounting, finance, economics, or a closely related field from an accredited college or university; or equivalent combination of education substituting one (1) year of securities industry experience for each year of the required education. Special Requirements Strong interpersonal and writing skills required. Must have reliable transportation as some travel will be required. Additional Job Description Preference may be given to candidates with: * Experience with Central Registration Depository (CRD) and/or Investment Adviser Registration Depository (IARD). * Experience working for a registered broker-dealer or investment adviser in the compliance area. * Experience working for a securities regulator. * Designation as a Certified Fraud Examiner. * Experience with financial accounting or designation as a certified public accountant. For questions regarding specific duties or details of this position, please email ********************. Reasonable accommodation to individuals with disabilities may be provided upon request. An Equal Opportunity Employer. Equal Opportunity Employment The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability. Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub. If you are needing any extra assistance or have any questions relating to a job you have applied for, please click the link below and find the agency for which you applied for additional information: Agency Contact

Job Posting Title Examiner Agency 630 DEPARTMENT OF SECURITIES Supervisory Organization Department of Securities Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Estimated Appointment End Date (Continuous if Blank) Full/Part-Time Full time Job Type Regular Compensation Level I - $75,000/yr Basic Purpose The Examiner is responsible for conducting examinations of registered broker-dealer and investment-adviser firms and representatives to ensure compliance with the Oklahoma Uniform Securities Act of 2004. Typical Functions Conduct examinations of registered broker-dealers and investment advisers to ensure compliance with the Oklahoma Uniform Securities Act of 2004. Review and analyze financial and non-financial records obtained through the Department's examination process. Draft correspondence relating to deficiencies found during examinations. Review enforcement related filings against registered broker-dealers and investment advisers and representatives. Respond to inquiries from investment advisers, broker-dealers, their counsel, and the public. Level Descriptor This position consists of three (3) levels which are distinguished based on the complexity of job assignments, the expertise required to complete assigned duties, and the responsibilities assigned to the incumbent. Level I - Education and experience requirements consist of a bachelor's degree in business, accounting, finance, economics, or a closely related field from an accredited college or university; or equivalent combination of education substituting one (1) year of securities industry experience for each year of the required education. Level II - Those requirements identified in Level I plus demonstrated knowledge of securities laws and three (3) additional years of qualifying experience. Level III - Those requirements identified in Level II plus demonstrated knowledge of securities laws and three (3) additional years of qualifying experience. Education and Experience Minimum education and experience requirements consist of a bachelor's degree in business, accounting, finance, economics, or a closely related field from an accredited college or university; or equivalent combination of education substituting one (1) year of securities industry experience for each year of the required education. Special Requirements Strong interpersonal and writing skills required. Must have reliable transportation as some travel will be required. Additional Job Description Preference may be given to candidates with: Experience with Central Registration Depository (CRD) and/or Investment Adviser Registration Depository (IARD). Experience working for a registered broker-dealer or investment adviser in the compliance area. Experience working for a securities regulator. Designation as a Certified Fraud Examiner. Experience with financial accounting or designation as a certified public accountant. For questions regarding specific duties or details of this position, please email ********************. Reasonable accommodation to individuals with disabilities may be provided upon request. An Equal Opportunity Employer. Equal Opportunity Employment The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability. Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub. If you are needing any extra assistance or have any questions relating to a job you have applied for, please click the link below and find the agency for which you applied for additional information: Agency Contact

* Evaluates and processes claims that require routine judgement and investigation such as Diagnostic Testing, Wellness, Physician Expense, URM, GAP, Hospital Indemnity, Medlink, Dental, Triage/Incomplete or Pregnancy claims in accordance with Company policy terms, insurance laws, regulatory requirements and adjusting guidelines. * Provides appropriate verbal and/or written communication to internal and external Customers in a positive and knowledgeable manner to ensure a high standard of Customer service. Meets standards established in department performance metrics for appropriate handling of Customer phone calls. * Acts as a direct contact and communicates with Customers and medical providers in a positive, knowledgeable and professional manner, providing them with direction and assistance in all facets of insurance coverage and needs. Education & Certification High school diploma or general education degree (GED) Technical Skills & Requirements Prompt and reliable Good medical terminology preferred Possesses General PC Windows-based software knowledge with the ability to learn new applications and work in a paperless environment Good understanding of anatomy and physiology Good contract knowledge Familiarity with CPT and ICD10 coding Possesses good analytical skills and judgment Ability to be flexible in work schedule, including a willingness to work overtime as needed Good oral and written communication skills Ability to handle fast-paced environment Professional attitude Dedicated to providing world-class Customer service Ability to work well within a team environment #AFC

Department: Billing Claims Resolution Specialist Employee Category: Non-Exempt Reporting Relationship: Manager of Revenue Cycle Management Character First qualities: * Decisiveness- The ability to recognize key factors and finalize difficult decisions. * Dependability- Fulfilling what I consented to do, even if it means unexpected sacrifice * Initiative - Recognizing and doing what needs to be done before I am asked to do it. * Thoroughness - Knowing what factors will diminish the effectiveness of my work or words, if neglected. * Flexibility - Willingness to change plans or ideas without getting upset. Summary of Duties and Responsibilities: The Bilingual Claims Resolution Specialist will be responsible for working directly with patients and third-party payers to effectively resolve all unpaid claims. The primary focus is to maximize revenue for the organization and consistently work to improve the overall health of the Accounts Receivable (AR). Primary Duties and Responsibilities: * Works collaboratively with the Senior Claims Resolution Specialist and the Manager of Revenue Cycle Management to determine the focus of collection efforts after running the weekly AR report. * Contacts third-party payers about outstanding balances and provide requested documentation to achieve resolution. * Contacts patients with outstanding balances to obtain payment or set up payment plan. * Sends patient statements and collection letters on past due balances. * Tracks and follow-up monthly on payment plans to ensure compliance. * Performs write-offs, adjustments, and refunds as directed. * Works closely with the Billing team to initiate and respond to billing inquiries, requests for additional information, and outstanding balance resolution. * Answers patient calls and billing questions. * Processes medical records requests for payers from attorneys. * Assists front desk staff with patient inquiries. * Assists front desk staff with obtaining correct patient addresses. * Meets established daily, weekly, monthly, and annual deadlines. * Manages and maintains relationships with all payors to improve patient revenue. * Upholds Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information. * Follows written and verbal instructions from the Manager of Revenue Cycle Management and Sr. Claims Resolution Specialist. * Exhibits professionalism in communication with patients, clients, insurance companies and co-workers. * Participates in special projects as assigned. * Supports Variety Care's accreditation as a Patient Centered Medical Home and our commitment to provide care to all Variety patients that is Safe, Effective, Patient Centered, Timely, Efficient, and Equitable. Provides leadership and work with all staff to achieve the goals of the "Triple Aim" of healthcare reform-to improve the experience of care, improve health outcomes, and decrease healthcare costs. * Embodies the strength of personal character. Places value on being an open and honest communicator who displays high moral and ethical conduct, integrity, adaptability, and sound judgment. Must be a leader in the department and community. Result-oriented problem solver who is responsible and accountable. * Performs other duties as assigned. Essential Functions: * Must be able to lift and/or move up to 25 pounds. * While performing the duties of this job, the employee is frequently required to sit, stand, walk and talk. * Frequently required to bend and reach to fulfill job duties.

Job DescriptionDescriptionPosition: Production Public Adjuster (Licensed) Location: Primary Locations: KS City, Des Moines IA, State of CO, State of CA, St. Louis, State of IL with emphasis on ChicagoCompensation: $75,000 - $100,000 compensation + Performance-based bonuses QUICK FACTS: Must have Public Adjuster License Must have experience with Xactimate Must have network of Condo, Apartment, Property Management partners Must be able to physically examine all buildings top to bottom (roofs as well) About the Company:A well-established, industry-leading public adjusting firm is seeking motivated and driven Outside Sales Representatives to join our growing team. We specialize in advocating for policyholders, ensuring they receive fair settlements for property damage claims. Our sales team plays a critical role in developing strong client relationships and driving company growth. Position Overview:We are looking for a results-oriented Outside Sales Representative with a strong background in direct-to-consumer (D2C) or business-to-business (B2B) sales. This role requires a motivated self-starter who thrives in building and maintaining client relationships while working in a fast-paced, competitive environment. Key ResponsibilitiesKey Responsibilities: Identify and pursue new business opportunities with homeowners, contractors, and referral partners. Educate prospective clients on our services and guide them through the insurance claims process. Develop and maintain a pipeline of leads through prospecting and networking efforts. Conduct presentations and training sessions to build brand awareness and establish partnerships. Provide exceptional customer service to existing clients, ensuring their satisfaction and retention. Work closely with internal teams to optimize the sales process and improve closing rates. Maintain accurate records of sales activities and client interactions. Skills, Knowledge and ExpertiseQualifications & Experience: 3+ years of proven sales experience as a licensed Public Adjuster Strong ability to generate leads, manage relationships, and close deals. Bachelor's degree in Business, Marketing, Communications, or equivalent experience. Familiarity with CRM tools, Microsoft Office Suite, and digital communication platforms. Highly organized with strong follow-through skills in a fast-paced environment. Public Adjuster license BenefitsWhat We Offer: Extensive training and support to help you succeed. Flexible work environment with opportunities for growth and career advancement. A team-oriented culture with strong leadership and professional development opportunities. If you're a highly motivated sales professional looking for a rewarding career with a company that makes a difference, apply today!

Are you looking for a company where you can learn, grow, and advance your career? At Claims Management Resources, we believe in putting our employees first. Come join our team and be part of a fast-growing company with many opportunities for advancement. Claims Management Resources is seeking a charismatic team player for our Downtown OKC office. Applicants must be willing to work onsite, Monday - Friday 8:00 a.m. to 5:00 p.m. Who We Are We are in the business of subrogation - companies trust us to recover payments on damage claims so that the party responsible is the one paying for the damage that was caused. We strive to provide excellent customer service to both our customers and the other parties involved in a claim. In short, we help our customers focus on theirs. Our business is driven by our Core Four principles: Process, Results, Culture, and Experience. Our dedication to practicing these has enabled our current and future success. We're passionate about throwing company events that bring us together and celebrate each other's achievements. We're also big on taking time out to give back to the community and host several volunteer events throughout the year. We believe in a healthy work-life balance. Join our team and thrive in an environment that values both efficiency and effective processes as well as a casual, comfortable atmosphere. Who We're Looking For The Claims Service Representative answers incoming calls in a professional manner and is professional in appearance and demeanor. They are also responsible for processing claim documents and a variety of other clerical duties. This position is based in-office and is not eligible for work from home/remote. On a Typical Day, You'll Greet visitors and applicants in a professional, friendly and hospitable manner; directing them to the right person or department Uphold company security access policy by vetting all visitors to the building via outside monitor system Manage a visitors log and issue security passes Direct callers to the appropriate adjuster or manager to resolve claims File documents to the appropriate database Effectively work and cooperate with co-workers, supervisors and clients Maintain an organized reception area Qualifications Required Skills: Excellent attendance and punctuality Professional in appearance and demeanor Ability to effectively communicate with visitors, employees and supervisors in a professional and courteous manner Excellent listening skills Ability to handle difficult calls professionally Intermediate knowledge of Microsoft Office Suite Accurate data review and data entry skills Organized, thorough and detail oriented Ability to multi task Ability to work independently with minimal supervision Available for 8:00 AM - 5:00 PM shift Monday thru Friday Experience: 1 - 2 years of receptionist experience required 1 - 2 years experience with multi-line phone system required Education: High school diploma or equivalent Okay, But What Are the Perks Full menu of benefits including matched 401K Tiered bonus system based on team accomplishments, paid per pay period in which it is earned Paid time off as well as paid holidays CMR pays $50/month towards your internet service costs CMR is a Oklahoman Top Workplaces winner for the 5th consecutive year in 2024! Pre-employment drug screenings and criminal background checks are mandatory. CMR is an Equal Opportunity Employer

Reports to: Community Manager is eligible for overtime. The Certification Specialist will receive general supervision, direction and guidance from the Community Manager. CRM Residential requires a background and drug screening as a condition of employment. Certification Specialist will be required to travel to all necessary training sessions. A valid driver's license and reliable transportation are required. Qualifications: Education: High School diploma or equivalent education required. Experience: Previous certification experience. Experience level may vary due to the special needs of the property. Skills: The position requires the ability to deal well with people and get them to feel comfortable quickly. Proficiency in MS Office (MS Excel and MS PowerPoint, in particular). Must be fluent in Spanish. Attendance: Due to the property staffing limitations, it is extremely critical that the individual be able to work their scheduled hours plus any other hours necessary to complete the job. In addition, the position requires the following: Professional image Be able to multi-task Excellent communication skills and upbeat attitude Strong customer service orientation Good organizational and time management skills Strong administrative ability The Certification Specialist will comply with established policies and authorized approval. Certification Specialist responsibilities include, but are not limited to the following: 1. Resident selection and orientation. In accordance with the Resident Selection Plan. 2. The assistance of leasing of vacant apartments in an expeditious manner per company policy striving for 100% occupancy. 3. The timely recertification and interim recertifications of residents in accordance with HUD regulation and Low Income Housing Tax Credit Program. 4. Maintaining the waiting list book and keeping it up to date in the computer following HUD regulations. 5. Assist with the development of goals and objectives for the property. 6. Resident Files Maintain resident files according to policy outlined in CRM's Occupancy Manual Assist Property Manager in preparation of various file reviews such as: Management Review Mortgagee Inspection 7. Accept daily resident requests and write up corrective work orders as directed by the Maintenance Plus program. 8. Daily management of office duties Open office at prescribed time Immediately handles daily work orders that come in Take applications for prospective residents Compute applications for eligibility, with supporting documents Send out billing notices Greet in-coming guests, respond to mail and handle all incoming telephone calls 9. Additional Skills and Responsibilities Have strong time-management skills Strong communication skills Maintain a professional demeanor Attend required training 10. In absence of the Community Manager, enforcement of the lease and the rules and regulations. 11. Attend training courses as required by CRM Residential. 12. Completion of all required reports as directed by various departments of CRM Residential. 13. Required to observe all federal and local Fair Housing Laws 14. Perform other related duties, as assigned. Job Descriptions are intended to present an illustrative description of the range of duties, the scope of responsibility and the required level of knowledge, skills and abilities necessary to describe the primary functions of the job; they are not intended to reflect all duties performed by those assigned to this classification. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship. Requirements HUD Background required Salary Description $19.00

Department: Billing Claims Resolution Specialist Employee Category: Non-Exempt Reporting Relationship: Manager of Revenue Cycle Management Character First qualities: Decisiveness- The ability to recognize key factors and finalize difficult decisions. Dependability- Fulfilling what I consented to do, even if it means unexpected sacrifice Initiative - Recognizing and doing what needs to be done before I am asked to do it. Thoroughness - Knowing what factors will diminish the effectiveness of my work or words, if neglected. Flexibility - Willingness to change plans or ideas without getting upset. Summary of Duties and Responsibilities: The Bilingual Claims Resolution Specialist will be responsible for working directly with patients and third-party payers to effectively resolve all unpaid claims. The primary focus is to maximize revenue for the organization and consistently work to improve the overall health of the Accounts Receivable (AR). Primary Duties and Responsibilities: Works collaboratively with the Senior Claims Resolution Specialist and the Manager of Revenue Cycle Management to determine the focus of collection efforts after running the weekly AR report. Contacts third-party payers about outstanding balances and provide requested documentation to achieve resolution. Contacts patients with outstanding balances to obtain payment or set up payment plan. Sends patient statements and collection letters on past due balances. Tracks and follow-up monthly on payment plans to ensure compliance. Performs write-offs, adjustments, and refunds as directed. Works closely with the Billing team to initiate and respond to billing inquiries, requests for additional information, and outstanding balance resolution. Answers patient calls and billing questions. Processes medical records requests for payers from attorneys. Assists front desk staff with patient inquiries. Assists front desk staff with obtaining correct patient addresses. Meets established daily, weekly, monthly, and annual deadlines. Manages and maintains relationships with all payors to improve patient revenue. Upholds Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information. Follows written and verbal instructions from the Manager of Revenue Cycle Management and Sr. Claims Resolution Specialist. Exhibits professionalism in communication with patients, clients, insurance companies and co-workers. Participates in special projects as assigned. Supports Variety Care's accreditation as a Patient Centered Medical Home and our commitment to provide care to all Variety patients that is Safe, Effective, Patient Centered, Timely, Efficient, and Equitable. Provides leadership and work with all staff to achieve the goals of the “Triple Aim” of healthcare reform-to improve the experience of care, improve health outcomes, and decrease healthcare costs. Embodies the strength of personal character. Places value on being an open and honest communicator who displays high moral and ethical conduct, integrity, adaptability, and sound judgment. Must be a leader in the department and community. Result-oriented problem solver who is responsible and accountable. Performs other duties as assigned. Essential Functions: Must be able to lift and/or move up to 25 pounds. While performing the duties of this job, the employee is frequently required to sit, stand, walk and talk. Frequently required to bend and reach to fulfill job duties. Qualifications Requirements, Special Skills or Knowledge: High School Diploma or GED. Two years prior billing and collections experience. Working knowledge of CPT codes. Ability to read and understand Explanation of Benefits (EOB) issued by insurance carriers. Expert critical independent thinking, analytics, problem-solving and sound decision-making skills. Experience interacting and communicating effectively with individuals at various levels both inside and outside the organization, often in sensitive situations. Proficient with Microsoft Office and practice management software systems. Preferred Requirements, Special Skills or Knowledge: Bilingual (English/Spanish). Associate degree or equivalent combination of experience and education. Prior medical billing and insurance collections or healthcare revenue cycle experience including diversified experience with payers, managed care contracts, and payer methodology.

Job Description CRM Residential has been a trusted name in the property management industry for over 46 years specializing in affordable housing. Our success story is a testament to the dedicated and talented individuals who have chosen to build their careers with us. We take great pride in our values, and we live and breathe them every day. Working at CRM Residential is so much more than a job, it is a career with purpose. No matter what department or level of the company you join, our mission is to provide a comfortable and reliable home environment for those who need it most and to provide excellent service to our customers. You will make a difference. Why Join the CRM Residential Team: Comprehensive Health Coverage Retirement Savings with employer contribution Bonus Potential Paid Time Off (PTO) Company Paid Holidays Once eligible for enrollment, the company will contribute a Safe Harbor match of 3% of your compensation to your 401(k) account, regardless of whether you choose to make your own contributions. Pay Rate: $16-$19 per hour What You'll Get To Do: The Compliance Specialist will be responsible for keeping abreast of all HUD, state agency, and tax credit rules and regulations concerning occupancy, recertifications, and tax credit related issues. The Compliance Specialist will deal directly with HUD and state agencies in reference to Section 8 contract renewals. This role will be responsible for but not limited to: Prepare monthly, quarterly, and annually reports for Tax Credit Properties Prepare Company Occupancy Reports weekly and for properties and owners Review and critique recertification move in packages at tax credit properties Prepare handouts for training classes and an assist in allocating the cost to each property that attended training Site visits may be required from time to time to offer assistance to onsite staff pertaining to occupancy, file compliance or other tax credit specific areas Attend educational seminars relating to tax credit compliance & other affordable housing Monitor the timely completion of annual recertifications for all sites. Advise Regional Manager of any potential problems Written correspondence with owners and agencies, relating to affordable housing Requirements: High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position. Valid driver's license and reliable transportation Ability to work with a variety of people and make them feel comfortable quickly Strong customer service skills required Must have strong organizational and time management skills Valid driver's license Proficiency at multi-tasking Organizational skills Working knowledge of Microsoft Office software Experience with verifications and renewals Other administrative duties as assigned Onsite Monday-Friday 8:30am-5:00pm Bi-lingual Spanish required About CRM Residential: CRM Residential is an award-winning full-service property management company which professionally manages 11,000+ apartments valued in excess of one billion. We are exclusively third-party so there is no conflict of interest between the properties that we manage for our clients and our own properties, because we do not own any properties. Our focus is dedicated to our clients. We are an equal opportunity employer and welcome applicants from all backgrounds to apply. If you have a passion for property management and a desire to work for a reputable company, we encourage you to apply for this exciting opportunity. Powered by JazzHR 1s7CCCZXVK

Community Hospital is hiring a PRN Insurance Specialist! We're offering an exciting opportunity to work alongside a dedicated, compassionate team - where you are valued just as much as the patients we serve. At Community Hospital, we are guided by our C.A.R.E.S. values where Compassion is required, Attitude is valued, Respect is demanded, Excellence is expected and Service is commended. Come be a part of a place where your hard work is recognized, your goals are supported, and your impact matters. Insurance Specialist financially secures accounts within established timeframes. Ensures that all notifications to payers are completed, authorizations obtained, verifies coverage and benefits, reviews and corrects each pre-registration for accuracy of financial information, and appropriately documents information in the system account notes. Maintains operational knowledge of all insurance payers and requirements necessary to ensure maximum and timely reimbursement. Responsible for participating in the efficient, complete and timely patient registration process that models the customer service philosophy of Community Hospital and Northwest Surgical Hospital. Community Hospital Only * Notify Case Management daily of all inpatient and observation patient admissions to ensure communication to insurance companies of patient's status. All Facilities * Accurately obtain via fax, telephone or personal interview, the required financial and insurance information from the patient, patient's representative, scheduling or physician's office. * Verify and obtain insurance coverage and benefits via insurance company website, insurance eligibility programs or by telephone for all patients registered for services for all payer types. Consistently strives to stay a minimum of three (3) business days in advance of patients arrival. * Perform notifications and obtain pre-authorizations and/or per-certifications for timely and accurate reimbursement. Determine appropriate financial class and accurately enter the data into the system. * Communicate insurance coverage details to patients and inform the patient/guarantor prior to service date regarding payment expectations related to co-payments, co-insurance, and/or deductible amounts. Establish payment arrangements as appropriate according to established guidelines. * Notify patients of any required and expected co-pay's, deductibles or co-insurance payments prior to their arrival. * Attempt to collect patient payments during initial phone contact in order to alleviate the amount of effort and time required on the day of service. * Log cash collections, generate receipts and maintain a balanced cash drawer at all times. Post payments to patient's account as required. * Document in the patients account notes any information that will assist the business office in their efforts to understand the issues that may impact efficient billing, questions about the status of the claim or other follow-up. * Provide assistance to patients when they present to the facility in person with questions regarding billing or open accounts. * Inform Department Director or Team Lead of potential problem accounts or additional requirements for reimbursement to receive direction on how to resolve situations. * Consistently demonstrate premier customer service and communication skills with all internal and external customers/contacts and ensure the patient and their family members have the best hospital encounter possible. * Consistently respond to all incoming calls within the third ring. * Meet established quality and productivity standards for self and for the team. * Anticipate and adapt to change (e.g., hospital policy changes, operational/procedures, insurance changes) in a positive manner. * Foster and reinforce team-based results. * Adhere to time and attendance standards as outlined in the Human Resource Policy manual. Provide proper notification of absence or tardiness within established departmental time frames. * Ensure patient confidentiality adhering to HIPAA guidelines. * Demonstrate the knowledge, skills and abilities (competencies) to perform the duties outlined above annually in the form of a test or as evidenced by daily quality review and direct observation of the Team Lead and/or the Department Director. * Track and monitor productivity as requested. * Keep Department Director apprised of any delays in the registration process. * Remain current on scheduling, registration, insurance verification, and other patient registration processes in order to cover in the absence of other team members. * Perform other duties as assigned. Qualifications: * High School graduate or equivalent required; 2 years college preferred. * Experience in patient registration, verification and authorization in a medical center or comparable required. * Working knowledge of managed care, Medicare, worker's compensation, indemnity and other third party payers required. * Working knowledge of governmental regulations and other reimbursement criteria required. * Ability to accurately type 40 WPM, complete forms, simple correspondence and enter data. * Excellent verbal and written communication as well as interpersonal skills required. * Demonstrated ability to handle multiple tasks with short time-lines, prioritize and organize work, and complete assignments in a timely and accurate manner. * Exceptional ability to interact and communicate effectively, tactfully, and diplomatically with patients, families, medical staff, co-workers, employers and insurance company representatives. * Must have a pleasant disposition, positive attitude and possess the ability to maintain a cordial and professional approach during periods of stress. * Skill in using office equipment: basic computer skills, photocopier, telephone, fax machine, and calculator. * Demonstrated ability to think and act decisively in a timely manner. * Ability to maintain operational knowledge of all insurance requirements necessary to achieve optimal reimbursement.

Join Our Team at Oklahoma Heart Hospital (OHH) ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we're shaping the future of heart care in Oklahoma by serving the state and leading the nation. Why You'll Love Working Here: * Comprehensive Benefits: * Medical, Dental, and Vision coverage * 401(k) plan with employer match * Long-term and short-term disability * Employee Assistance Programs (EAP) * Paid Time Off (PTO) * Extended Medical Benefits (EMB) * Opportunities for continuing education and professional growth Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day! We can't wait for you to join our heart-centered team! Responsibilities The Hospital Insurance Follow-up Specialist will be responsible for collections and follow-up with insurance company to obtain prompt /accurate payment on accounts. Functions include numerous phone calls with insurance companies and patients, extensive investigating for timely insurance payments, always cognizant of timely filing deadlines. Follow-up on Medicare, Medicaid, and Commercial encounters via the web portals and online systems. Supervises no employees. Makes independent decisions as to the management of accounts. Requires extensive contact with the public and employees. Handles confidential information. Performs all work in accordance with the mission, vision and values of Oklahoma Heart Hospital. * Using assigned work lists, contacts insurance companies to confirm claim receipt, obtain payment and estimated payment date within 90 days of billed date. * Works received correspondence weekly in order to obtain resolution of pending accounts. * Work with adjacent teams to ensure all EDI information is accurate and updated. * Update help desk tickets with statuses and outcomes. * Answer inquiries within 48 hours to maximize reimbursement timely. * Works denials from assigned Remittance Advices weekly & according to policy and procedure. * Document clearly and completely all actions taken on encounters promptly. Qualifications Education: High School Diploma or Equivalent Experience One (1) year job related experience in revenue cycle required. Knowledge of third-party reimbursement, including Medicare, Medicaid and commercial insurance required. Experience with the Medicare online system. Excellent Customer Service background. Good investigative skills and telephone techniques. Must have good oral and written communication skills. Proven organization skills needed. Working Knowledge: Must possess a foundational knowledge of information systems and claims management. experience in healtcare required. Knowledge of third-party reimbursement, including Medicare, Medicaid and commercial insurance required. Experience with the Medicare online system and Payer portals. Excellent Customer Service background Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care. Learn more about diversity at Oklahoma Heart Hospital. As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.

The Contestable Analyst reviews all aspects of a contestable claim and determines how to process. High exposure to a multitude of life claims is a norm for this position; Analyst needs to be able to identify claim benefits in regards to the specific policy and operates on multiple claims systems. The Analyst has a checklist of items to review before the claim can progress for further processing. Some of these items include; performing a name search to see if the insured has additional coverage, reinstating a policy if it has already been removed from the system, requesting various types of letters, reviewing application date versus effective date of policy, reviewing Medical Information Bureau reports, requesting recordings of contact with insured, ordering medical records, and reviewing medical records. The Contestable Analyst also determines if certain policies should be investigated by external third parties (i.e., RSB). Once the Analyst makes a claim determination, they either proceed with paying the claim or rescind the claim. A Contestable Analyst is responsible for keeping a claim moving through the processing procedures. Contestable Analyst is in contact with agents, funeral homes, coroners, medical providers, and police departments to gather and confirm information in regards to the claim. Investigates all contestable life claims and processes in accordance with policy provisions and Company procedures. Processes claims on a multiple claims system. Contacts outside 3rd parties and obtains additional claim information needed. Third parties consist of agents, beneficiaries, funeral homes, coroners, medical providers and police departments. Updates system notes with claim progress. Orders and reviews medical information. Responsible for claim movement and progression. Maintains production data and must meet the production quota set by the department. Other duties; as assigned by the supervisor. Required Skills: Must be PC/Windows literate and posses a working knowledge of MS Office (Outlook, Excel and Word). Strong communication skills. Detail oriented. Ability to work in a fast paced environment. Problem solving skills. Physical Requirements; While performing the duties of the job, the employee is regularly required to sit for extended lengths of time. The employee is frequently required to reach with hands and arms, occasionally required to stand and walk, occasionally lift and or move up to 25 lbs. Qualifications Must be PC/Windows literate and posses a working knowledge of MS Office (Outlook, Excel and Word). Strong communication skills. Detail oriented. Ability to work in a fast paced environment. Problem solving skills. Additional Information All your information will be kept confidential according to EEO guidelines.

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.

Job Posting Title Examiner Agency 630 DEPARTMENT OF SECURITIES Supervisory Organization Department of Securities Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Estimated Appointment End Date (Continuous if Blank) Full/Part-Time Full time Job Type Regular Compensation Basic Purpose The Examiner is responsible for conducting examinations of registered broker-dealer and investment-adviser firms and representatives to ensure compliance with the Oklahoma Uniform Securities Act of 2004. Typical Functions Conduct examinations of registered broker-dealers and investment advisers to ensure compliance with the Oklahoma Uniform Securities Act of 2004. Review and analyze financial and non-financial records obtained through the Department's examination process. Draft correspondence relating to deficiencies found during examinations. Review enforcement related filings against registered broker-dealers and investment advisers and representatives. Respond to inquiries from investment advisers, broker-dealers, their counsel, and the public. Level Descriptor This position consists of three (3) levels which are distinguished based on the complexity of job assignments, the expertise required to complete assigned duties, and the responsibilities assigned to the incumbent. Level I - Education and experience requirements consist of a bachelor's degree in business, accounting, finance, economics, or a closely related field from an accredited college or university; or equivalent combination of education substituting one (1) year of securities industry experience for each year of the required education. Level II - Those requirements identified in Level I plus demonstrated knowledge of securities laws and three (3) additional years of qualifying experience. Level III - Those requirements identified in Level II plus demonstrated knowledge of securities laws and three (3) additional years of qualifying experience. Education and Experience Minimum education and experience requirements consist of a bachelor's degree in business, accounting, finance, economics, or a closely related field from an accredited college or university; or equivalent combination of education substituting one (1) year of securities industry experience for each year of the required education. Special Requirements Strong interpersonal and writing skills required. Must have reliable transportation as some travel will be required. Additional Job Description Preference may be given to candidates with: Experience with Central Registration Depository (CRD) and/or Investment Adviser Registration Depository (IARD). Experience working for a registered broker-dealer or investment adviser in the compliance area. Experience working for a securities regulator. Designation as a Certified Fraud Examiner. Experience with financial accounting or designation as a certified public accountant. For questions regarding specific duties or details of this position, please email ********************. Reasonable accommodation to individuals with disabilities may be provided upon request. An Equal Opportunity Employer. Equal Opportunity Employment The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability. Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub. If you are needing any extra assistance or have any questions relating to a job you have applied for, please click the link below and find the agency for which you applied for additional information: Agency Contact

Job Posting Title Examiner Agency 630 DEPARTMENT OF SECURITIES Supervisory Organization Department of Securities Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Estimated Appointment End Date (Continuous if Blank) Full/Part-Time Full time Job Type Regular Compensation Basic Purpose The Examiner is responsible for conducting examinations of registered broker-dealer and investment-adviser firms and representatives to ensure compliance with the Oklahoma Uniform Securities Act of 2004. Typical Functions * Conduct examinations of registered broker-dealers and investment advisers to ensure compliance with the Oklahoma Uniform Securities Act of 2004. * Review and analyze financial and non-financial records obtained through the Department's examination process. * Draft correspondence relating to deficiencies found during examinations. * Review enforcement related filings against registered broker-dealers and investment advisers and representatives. * Respond to inquiries from investment advisers, broker-dealers, their counsel, and the public. Level Descriptor This position consists of three (3) levels which are distinguished based on the complexity of job assignments, the expertise required to complete assigned duties, and the responsibilities assigned to the incumbent. * Level I - Education and experience requirements consist of a bachelor's degree in business, accounting, finance, economics, or a closely related field from an accredited college or university; or equivalent combination of education substituting one (1) year of securities industry experience for each year of the required education. * Level II - Those requirements identified in Level I plus demonstrated knowledge of securities laws and three (3) additional years of qualifying experience. * Level III - Those requirements identified in Level II plus demonstrated knowledge of securities laws and three (3) additional years of qualifying experience. Education and Experience Minimum education and experience requirements consist of a bachelor's degree in business, accounting, finance, economics, or a closely related field from an accredited college or university; or equivalent combination of education substituting one (1) year of securities industry experience for each year of the required education. Special Requirements Strong interpersonal and writing skills required. Must have reliable transportation as some travel will be required. Additional Job Description Preference may be given to candidates with: * Experience with Central Registration Depository (CRD) and/or Investment Adviser Registration Depository (IARD). * Experience working for a registered broker-dealer or investment adviser in the compliance area. * Experience working for a securities regulator. * Designation as a Certified Fraud Examiner. * Experience with financial accounting or designation as a certified public accountant. For questions regarding specific duties or details of this position, please email ********************. Reasonable accommodation to individuals with disabilities may be provided upon request. An Equal Opportunity Employer. Equal Opportunity Employment The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability. Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub. If you are needing any extra assistance or have any questions relating to a job you have applied for, please click the link below and find the agency for which you applied for additional information: Agency Contact

CRM Residential has been a trusted name in the property management industry for over 46 years specializing in affordable housing. Our success story is a testament to the dedicated and talented individuals who have chosen to build their careers with us. We take great pride in our values, and we live and breathe them every day. Working at CRM Residential is so much more than a job, it is a career with purpose. No matter what department or level of the company you join, our mission is to provide a comfortable and reliable home environment for those who need it most and to provide excellent service to our customers. You will make a difference. Why Join the CRM Residential Team: Comprehensive Health Coverage Retirement Savings with employer contribution Bonus Potential Paid Time Off (PTO) Company Paid Holidays Once eligible for enrollment, the company will contribute a Safe Harbor match of 3% of your compensation to your 401(k) account, regardless of whether you choose to make your own contributions. Pay Rate: $16-$19 per hour What You'll Get To Do: The Compliance Specialist will be responsible for keeping abreast of all HUD, state agency, and tax credit rules and regulations concerning occupancy, recertifications, and tax credit related issues. The Compliance Specialist will deal directly with HUD and state agencies in reference to Section 8 contract renewals. This role will be responsible for but not limited to: Prepare monthly, quarterly, and annually reports for Tax Credit Properties Prepare Company Occupancy Reports weekly and for properties and owners Review and critique recertification move in packages at tax credit properties Prepare handouts for training classes and an assist in allocating the cost to each property that attended training Site visits may be required from time to time to offer assistance to onsite staff pertaining to occupancy, file compliance or other tax credit specific areas Attend educational seminars relating to tax credit compliance & other affordable housing Monitor the timely completion of annual recertifications for all sites. Advise Regional Manager of any potential problems Written correspondence with owners and agencies, relating to affordable housing Requirements: High School diploma or equivalent education required. 3-4 years of experience can offset minimum educational requirements for this position. Valid driver's license and reliable transportation Ability to work with a variety of people and make them feel comfortable quickly Strong customer service skills required Must have strong organizational and time management skills Valid driver's license Proficiency at multi-tasking Organizational skills Working knowledge of Microsoft Office software Experience with verifications and renewals Other administrative duties as assigned Onsite Monday-Friday 8:30am-5:00pm Bi-lingual Spanish required About CRM Residential: CRM Residential is an award-winning full-service property management company which professionally manages 11,000+ apartments valued in excess of one billion. We are exclusively third-party so there is no conflict of interest between the properties that we manage for our clients and our own properties, because we do not own any properties. Our focus is dedicated to our clients. We are an equal opportunity employer and welcome applicants from all backgrounds to apply. If you have a passion for property management and a desire to work for a reputable company, we encourage you to apply for this exciting opportunity.