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Claim specialist jobs in Pennsylvania - 248 jobs

  • Pharmacy Claims Specialist

    Blinkrx

    Claim specialist job in Pittsburgh, PA

    This is a full-time, onsite position based in Robinson Township. Responsibilities: Process pharmacy claims accurately and timely to meet client expectations Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage Maintain compliance with patient assistance program guidelines Document all information and data discovery according to operating procedures Research required information using available resources Maintain confidentiality of patient and proprietary information Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering Requirements: High school diploma or GED required, Bachelor's degree strongly preferred One year of Pharmacy Experience, having resolved third party claims Healthcare industry experience with claims background Strong verbal and written communication skills Attention to detail and a strong operational focus A passion for providing top-notch patient care Ability to work with peers in a team effort and cross-functionally Strong technical aptitude and ability to learn complex new software Location/Hours Full time position hourly, on-site role in Pittsburgh (Robinson) Availability for Monday-Friday across various 8 hours shifts : 8am- 4pm EST , 9am- 5pm EST, 1pm- 9pm EST Availability for rotating Saturday shifts 9am-5pm Scheduling flexibility, as your schedule may change over time according to business needs Benefits Medical, dental, and vision insurance plans that fit your needs 401(k) retirement plan Daily snack stipend for onsite marketplace Pre-tax transit benefits and free onsite parking
    $38k-66k yearly est. 4d ago
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  • Claims Examiner Liability 1468569

    Adecco Us, Inc. 4.3company rating

    Claim specialist job in Philadelphia, PA

    Adecco is assisting a local client recruiting General Liability Claims Analyst opportunities in Philadelphia, PA (Remote Role). This is an excellent opportunity to join a winning culture and get your foot in the door for being known Helping people, restoring property, preserving brands and empowering performance. If General Liability Claims Analyst sounds like something you would be interested in, and you meet the qualifications listed below, apply now! **Key Responsibilities** · To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **Required Skills** : · Analyze and process complex general liability claims by investigating and gathering information to determine exposure. · Develop and execute action plans to achieve timely and appropriate resolution of claims. · Assess liability and resolve claims within evaluation guidelines. · Negotiate settlements within designated authority. · Calculate and assign timely and appropriate reserves, monitor reserve adequacy throughout the claim lifecycle. · Approve and process timely claim payments and adjustments within authority limits. · Prepare and submit necessary state filings within statutory deadlines. · Manage litigation process to ensure timely and cost-effective resolution. · Coordinate vendor referrals for investigations and litigation management. · Utilize cost containment strategies, including strategic vendor partnerships, to reduce overall claim costs. · Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security/Medicare offsets. · Report claims to excess carriers and respond to requests promptly and professionally. · Maintain communication with claimants and clients; foster professional client relationships. · Ensure proper documentation and accurate coding of claim files. · Refer cases to supervisors or management as appropriate. What's in this General Liability Claims Analyst position for you? Pay: $ 35.71/hr. Shift: Remote Role // 8:00 AM-5:00 PM EST Mon- Fri // Philadelphia, PA Weekly paycheck Dedicated Onboarding Specialist & Recruiter · Access to Adecco's Aspire Academy with thousands of free upskilling courses. This General Liability Claims Analyst is being recruited by one of our Centralized Delivery Team and not your local Branch. For instant consideration for this General Liability Claims Analyst position and other opportunities with Philadelphia, PA(Remote Role) apply today! **Pay Details:** $35.71 per hour Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to ********************************************** The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: + The California Fair Chance Act + Los Angeles City Fair Chance Ordinance + Los Angeles County Fair Chance Ordinance for Employers + San Francisco Fair Chance Ordinance **Massachusetts Candidates Only:** It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $35.7 hourly 2d ago
  • Claims Service Sales Representative

    CWA Recruiting

    Claim specialist job in Montgomery, PA

    Property & Casualty Insurance Montgomery County, Pennsylvania As a sales representative, your role involves taking initiative and providing guidance throughout the recovery journey. Your support will help build trust, making it easier to finalize the sale. Our skilled team will handle all the necessary paperwork, while you play a crucial role on the front lines, assisting homeowners and business owners as they navigate the aftermath of disasters like fire, water, or storms. Familiarity with the Xactimate system would be beneficial, along with strong writing abilities. The ideal candidate should not only understand property claims but also possess the ability to persuade clients effectively. It is essential to live within the designated territory, which includes Allentown, NE PA, Schuylkill, Lebanon, Reading, Bucks, and Montgomery counties, among others. Since 1964, our company has employed 20 staff members. Candidates must have a clear background, a valid driver's license, and a willingness to obtain an adjuster's license. Availability is required on both weekdays and weekends. We strive for a quick resolution, responding to emergencies, referrals, and opportunities with speed and efficiency.
    $34k-40k yearly est. 3d ago
  • Insurance Company Examiner 1

    Commonwealth of Pennsylvania 3.9company rating

    Claim specialist job in Harrisburg, PA

    Are you interested in a role that serves to protect insurance consumers? If so, consider advancing your professional career by becoming an Insurance Company Examiner 1 for the Insurance Department. Your professional experience and knowledge of accounting, business law, and finance or economics will be essential for determining if insurance companies in Pennsylvania are operating in compliance with relevant state laws, rules, and regulations. Apply today and start a new chapter in your career with our Financial Examinations team! DESCRIPTION OF WORK As an Insurance Company Examiner 1, your primary responsibility is to review and evaluate insurers' business processes and controls, including the quality and reliability of corporate governance; assist in assessing solvency; and monitor current financial condition and prospective risks. Work involves visiting examination sites to assist experienced Examiners in conducting risk-focused examinations of records, documents, financial statements, and other related materials. You will have the opportunity to communicate and collaborate with the examiner in charge, management, and the insurer regarding potential concerns and findings discovered during the examination. Additional responsibilities include: Reviewing regulatory filings Conducting interviews with management and discussing operations with company personnel Preparing examination work papers to provide accurate and complete documentation of observations, work performed, and examination findings in accordance with Department and NAIC standards and guidelines Assisting in identifying and assessing current and prospective solvency risks facing the company Assisting in reviewing and assessing the effectiveness of the insurer's audit function as well as the enterprise risk management (ERM) function to leverage existing work and gain efficiency in conducting examinations Assisting in identifying relevant controls and/or risk mitigation strategies to address identified risks and perform tests of controls to evaluate their effectiveness Interested in learning more? Additional details regarding this position can be found in the position description. Work Schedule and Additional Information: Full-time employment Work hours are 8:00 AM to 4:30 PM, Monday - Friday, with a 60-minute lunch. Telework: This position is home headquartered. In order to be home headquartered, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. Salary: Selected candidates who are new to employment with the Commonwealth of Pennsylvania will begin employment at the starting annual salary of $59,345 (before taxes). You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices. REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY QUALIFICATIONS Minimum Experience and Training Requirements: One year of experience as an Insurance Company Examiner Trainee (Commonwealth job title or equivalent Federal Government job title, as determined by the Office of Administration); or One year of professional experience in the audit or examination of the financial conditions and operations of insurance companies and a bachelor's degree that includes 6 college credits in accounting, 3 college credits in finance or economics, and 3 college credits in business law; or An equivalent combination of experience and training that includes 6 college credits in accounting, 3 college credits in finance or economics, and 3 college credits in business law. Other Requirements: You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency. You must be able to perform essential job functions. How to Apply: Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education). If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable. Your application must be submitted by the posting closing date . Late applications and other required materials will not be accepted. Failure to comply with the above application requirements may eliminate you from consideration for this position. Veterans: Pennsylvania law (51 Pa. C.S. *7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to ************************************************ and click on Veterans. Telecommunications Relay Service (TRS): 711 (hearing and speech disabilities or other individuals). If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date. The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply. EXAMINATION INFORMATION Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam). Your score is based on the detailed information you provide on your application and in response to the supplemental questions. Your score is valid for this specific posting only. You must provide complete and accurate information or: your score may be lower than deserved. you may be disqualified. You may only apply/test once for this posting. Your results will be provided via email.
    $59.3k yearly 5d ago
  • Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations

    Stout 4.2company rating

    Claim specialist job in Philadelphia, PA

    At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include: Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support. Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team. What You Bring Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You'll Thrive Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions. Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment. Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
    $27k-33k yearly est. 2d ago
  • Workers' Compensation Claims Specialist (Remote - MN, SD, WI, PA, IA)

    Holmes Murphy 4.1company rating

    Claim specialist job in Pennsylvania

    Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers' Compensation Claims Specialist to join our team. Experience handling claims in Minnesota, South Dakota, Wisconsin, Pennsylvania, and Iowa is preferred. Essential Responsibilities: Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. Investigates, evaluates, and resolves Workers' Compensation claims. Mediates situations as they arise between the insured and the insurance company, with some support from leader as needed, to include researching coverage issues. Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. Generates checks for indemnity and medical payments daily. Develops and monitors consistency in procedural matters of the claims handling process with CRS. Compiles and interprets Workers' compensation reports on designated accounts, as requested. Ability to adjudicate lost time claims. Participates in claim reviews and attends Risk Control Workshops when requested by agency partners or insureds. These could be in person or by phone. Performs special projects and other duties as requested. Qualifications: Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Willingness and ability to obtain additional state specific licenses during duration of employment as needed. Experience: 2-4 years claims experience with strong background in Workers' Compensation coverage. Technical Competencies: Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Invests in the understanding and application of claims principles and practices and insurance coverage interpretation as it relates to consulting, evaluating, and resolving claims. Here's a little bit about us: At Creative Risk Solutions, you'll be part of a collaborative, innovative team that values trust, communication, and client focus. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth within the Holmes Murphy family. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! The salary range for this role is $45,800- $78,800. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development. Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $45.8k-78.8k yearly Auto-Apply 22d ago
  • Claims Specialist - Auto

    Philadelphia Insurance Companies 4.8company rating

    Claim specialist job in Harrisburg, PA

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

    HTSS, Inc.

    Claim specialist job in Allentown, PA

    Are you an insurance professional with experience in claims handling? Do you have a strong understanding of state regulations and a proven record of providing excellent customer service? If so, we want you on our team! We are seeking a Damage Claims Specialist to manage and process customer property damage claims related to utility service operations. This role is responsible for ensuring accurate and timely claims processing while maintaining compliance with state regulations and the Company's tariff. From the initial claim submission to final resolution, you will oversee the entire claims process, ensuring proper documentation, maintaining tracking reports, and addressing customer inquiries. Job Qualifications: Bachelor's Degree (preferred); High School Diploma or equivalent (required) Minimum of three (3) years experience in claims handling Proficiency in Microsoft Office Suite, especially Word and Excel Strong verbal and written communication skills Excellent problem-solving and conflict-resolution abilities High attention to detail and ability to work independently Pay: Based on experience This is a full-time, temporary role expected to last at least 6 months. If you are ready to take on this role, we encourage you to apply today through the HTSS website or by emailing resume to ********************
    $40k-71k yearly est. Easy Apply 3d ago
  • Workers Compensation Claims Specialist, East

    CNA Holding Corporation 4.7company rating

    Claim specialist job in Wyomissing, PA

    You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices. Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. Demonstrated ability to develop collaborative business relationships with internal and external work partners. Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. Demonstrated investigative experience with an analytical mindset and critical thinking skills. Strong work ethic, with demonstrated time management and organizational skills. Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. Developing ability to negotiate low to moderately complex settlements. Adaptable to a changing environment. Knowledge of Microsoft Office Suite and ability to learn business-related software. Demonstrated ability to value diverse opinions and ideas Education & Experience: Bachelor's Degree or equivalent experience. Typically a minimum four years of relevant experience, preferably in claim handling. Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Professional designations are a plus (e.g. CPCU) #LI-AR1 #LI- Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois , Maryland, Massachusetts , New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.
    $54k-103k yearly Auto-Apply 7d ago
  • Third Party Claims Specialist

    DCS Asset Maintenance 4.5company rating

    Claim specialist job in Hazleton, PA

    DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family! To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about! Job Description Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management. This is an onsite position located at the corporate office in Hazleton PA. Duties include - but not limited to: Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies. Coordinate with project offices to obtain accurate information, records and photos needed to create invoices. Creation and submission of accurate invoices to insurance carriers and vehicle owners. Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days. Accurately updating claim records for any contact or actions taken on claim invoice. Create and run reports as necessary for claim tracking and follow-up Support to project offices as necessary - including police report investigation and contacting insurance companies. Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage. Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager. Other duties as assigned. Qualifications EDUCATION: High School Diploma is required. EXPERIENCE: Prior experience in insurance claims preferred - 2 years or more relative experience Excellent computer skills - Proficient in Microsoft Office Word & Excel Customer service focused Detail oriented Self-starter - ability to work independently. Ability to interact productively and positively in a team environment. Ability to communicate effectively and professionally in both verbal and written form. PHYSICAL REQUIREMENTS: Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone. Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices. Able to see and read on computer screens and paper, close vision. Ability to lift and carry items up to 10 pounds. Ability to sit at a desk comfortably while working on a computer for extended periods of time. Additional Information Benefit Highlights: Challenging and rewarding work environment Competitive Compensation Excellent Medical, Dental, Vision and Prescription Drug Plan 401(K) Generous Paid Time Off Career Development Pay rate: $20.00-23.00/hour depending on experience Come be a part of the DeAngelo family, today! DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.
    $20-23 hourly 9d ago
  • Third Party Claims Specialist

    Deangelo Brothers, LLC 4.1company rating

    Claim specialist job in Hazleton, PA

    DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family! To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about! Job Description Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management. This is an onsite position located at the corporate office in Hazleton PA. Duties include - but not limited to: Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies. Coordinate with project offices to obtain accurate information, records and photos needed to create invoices. Creation and submission of accurate invoices to insurance carriers and vehicle owners. Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days. Accurately updating claim records for any contact or actions taken on claim invoice. Create and run reports as necessary for claim tracking and follow-up Support to project offices as necessary - including police report investigation and contacting insurance companies. Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage. Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager. Other duties as assigned. Qualifications EDUCATION: High School Diploma is required. EXPERIENCE: Prior experience in insurance claims preferred - 2 years or more relative experience Excellent computer skills - Proficient in Microsoft Office Word & Excel Customer service focused Detail oriented Self-starter - ability to work independently. Ability to interact productively and positively in a team environment. Ability to communicate effectively and professionally in both verbal and written form. PHYSICAL REQUIREMENTS: Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone. Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices. Able to see and read on computer screens and paper, close vision. Ability to lift and carry items up to 10 pounds. Ability to sit at a desk comfortably while working on a computer for extended periods of time. Additional Information Benefit Highlights: Challenging and rewarding work environment Competitive Compensation Excellent Medical, Dental, Vision and Prescription Drug Plan 401(K) Generous Paid Time Off Career Development Pay rate: $20.00-23.00/hour depending on experience Come be a part of the DeAngelo family, today! DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.
    $20-23 hourly 2d ago
  • Adjuster

    United Envelope

    Claim specialist job in Pennsylvania

    United Envelope's Mount Pocono, PA facility is seeking candidates for full time Adjuster/Machinery Mechanic positions. Candidates will be responsible to handle machinery repairs and set-ups as required to complete production orders. Prior mechanical experience in a production setting and/or related field is required. On the job training will be provided in regards to machinery safety, set-up quality processes, machinery changeovers. Up to $30.86 per hour to start. Comprehensive benefit package includes medical, dental, vision, disability, 401(k)w/company match, paid life ins., and no limit on new hire referral bonuses up to $3000. Beginning pay of $22.02 up to $30.86 with $1.25 night shift add on. Union facility, paid vacation, sick days, 12 hour shifts with every other Friday, Saturday, and Sunday off, 24/7 schedule which results in an extra 80 days off per year. United Envelope is an EOE
    $30.9 hourly 60d+ ago
  • Auto Claims Specialist I (Manheim)

    Cox Enterprises 4.4company rating

    Claim specialist job in Manheim, PA

    Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $16.59 - $24.86/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description This position facilitates the resolution of customer claims and concerns (includes all physical and digital/online transactions) after a sale and is responsible for the timely and successful arbitration of vehicles between buyer and seller in accordance with auction and NAAA policies. The role will work to gain familiarity with fundamental arbitration concepts, procedures, standards, policies and systems. This position requires organization and management of sale day activities including post sale inspections and sale day arbitrations. Job Responsibilities: Basic Functional Duties * With guidance, performs basic Arbitrator duties, including: * Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. * Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision making. * Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. * Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. * Uses appropriate levels/limits of financial approval authority to resolve cases. * Evaluates claims by obtaining, comparing, evaluating, and validating various forms of information. * Prepares and facilitates communications for resolution via telephone, email, and in-person discussion. * Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. * Monitors and maintains accurate files for each arbitration case, verifying accuracy of all required documentation, including invoices and settlement agreements. * Engages with supervisor/manager to determine if escalation is required. Knowledge & Subject Matter Milestones * Demonstrates an understanding of investigating claims and negotiating and influencing others while maintaining a positive client experience. * Gains familiarity and understanding of Arbitration concepts and procedures. * Gains foundational understanding of auction-specific operational and administrative processes. * Learns and adheres to National Auto Auction Association (NAAA) arbitration standards, Manheim Marketplace Policies, and relevant legal requirements. Client Interaction/Communication Responsibilities * Advises clients of the arbitration claim process, company policies, any auction- or account-specific guidelines, and NAAA guidelines. * Facilitates both written and verbal communications between buyers, sellers, and various auction team members and third parties to actively gather information necessary to guide parties toward agreement and resolution, while maintaining an awareness of goals and objectives. * Provides relevant information such as claim status to clients. Other Duties * Demonstrates safety commitment by following all safety and health procedures and modeling the appropriate behaviors. * Participates in support of all safety activities aligned with Safety Excellence. * Performs other duties as assigned. Qualifications and Experience * Education * High School Diploma or equivalent required. * Bachelor's degree preferred. * Experience * Previous experience in claims management and/or problem and conflict resolution preferred. Claim adjuster experience is a plus. * 1-2 years of experience in areas of responsibility. * 1+ years of automotive, mechanical, and/or body shop experience preferred. * Skills and Abilities * Active Listening * Accuracy and Attention to Detail * Resilience/Adaptability * Demonstrates Empathy * Verbal and Written Communication * Decision Making * Customer Focus * Time Management * Conflict Resolution * Builds Positive Relationships YDGCOX Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
    $16.6-24.9 hourly Auto-Apply 12d ago
  • Auto Claims Specialist I (Manheim)

    Cox Holdings, Inc. 4.4company rating

    Claim specialist job in Manheim, PA

    Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $16.59 - $24.86/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description This position facilitates the resolution of customer claims and concerns (includes all physical and digital/online transactions) after a sale and is responsible for the timely and successful arbitration of vehicles between buyer and seller in accordance with auction and NAAA policies. The role will work to gain familiarity with fundamental arbitration concepts, procedures, standards, policies and systems. This position requires organization and management of sale day activities including post sale inspections and sale day arbitrations. Job Responsibilities: Basic Functional Duties With guidance, performs basic Arbitrator duties, including: Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision making. Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. Uses appropriate levels/limits of financial approval authority to resolve cases. Evaluates claims by obtaining, comparing, evaluating, and validating various forms of information. Prepares and facilitates communications for resolution via telephone, email, and in-person discussion. Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. Monitors and maintains accurate files for each arbitration case, verifying accuracy of all required documentation, including invoices and settlement agreements. Engages with supervisor/manager to determine if escalation is required. Knowledge & Subject Matter Milestones Demonstrates an understanding of investigating claims and negotiating and influencing others while maintaining a positive client experience. Gains familiarity and understanding of Arbitration concepts and procedures. Gains foundational understanding of auction-specific operational and administrative processes. Learns and adheres to National Auto Auction Association (NAAA) arbitration standards, Manheim Marketplace Policies, and relevant legal requirements. Client Interaction/Communication Responsibilities Advises clients of the arbitration claim process, company policies, any auction- or account-specific guidelines, and NAAA guidelines. Facilitates both written and verbal communications between buyers, sellers, and various auction team members and third parties to actively gather information necessary to guide parties toward agreement and resolution, while maintaining an awareness of goals and objectives. Provides relevant information such as claim status to clients. Other Duties Demonstrates safety commitment by following all safety and health procedures and modeling the appropriate behaviors. Participates in support of all safety activities aligned with Safety Excellence. Performs other duties as assigned. Qualifications and Experience Education High School Diploma or equivalent required. Bachelor's degree preferred. Experience Previous experience in claims management and/or problem and conflict resolution preferred. Claim adjuster experience is a plus. 1-2 years of experience in areas of responsibility. 1+ years of automotive, mechanical, and/or body shop experience preferred. Skills and Abilities Active Listening Accuracy and Attention to Detail Resilience/Adaptability Demonstrates Empathy Verbal and Written Communication Decision Making Customer Focus Time Management Conflict Resolution Builds Positive Relationships YDGCOX Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
    $16.6-24.9 hourly Auto-Apply 11d ago
  • Professional Liability Adjuster

    Guard Insurance Group

    Claim specialist job in Wilkes-Barre, PA

    Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! * Competitive compensation * Healthcare benefits package that begins on first day of employment * 401K retirement plan with company match * Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays * Up to 6 weeks of parental and bonding leave * Hybrid work schedule (3 days in the office, 2 days from home) * Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) * Tuition reimbursement after 6 months of employment * Numerous opportunities for continued training and career advancement * And much more! Responsibilities The Professional Liability Adjuster is responsible for conducting office investigations and adjusting Professional Liability and Error & Omission (E&O), Employment Practices Liability Insurance (EPLI), and Directors & Officers (D&O) Liability claims. The Adjuster is also responsible for, but not limited to: * Investigating losses and identifying coverage issues across Professional Liability, E&O, EPLO, and D&O lines * Obtaining and reviewing evidence, reports, and medical records * Establishing damages and reserves * Processing payments * Taking statements from insured's, claimants, and witnesses * Participating in Mediations Qualifications * Active attorney license with at least 5 years of professional liability experience * Prior experience adjusting Professional Liability, E&O, EPLI, and D&O claims * Experience with Legal Malpractice preferred * Active Adjuster license is preferred * Strong understanding of employment law and corporate governance as it relates to EPLI and D&O exposures * Excellent written and verbal communication skills * Strong organizational and computer skills * Excellent time management skills with the ability to prioritize
    $47k-69k yearly est. Auto-Apply 16d ago
  • Claims Processing Specialist

    Blackburn's Physicians Pharmacy 3.5company rating

    Claim specialist job in Tarentum, PA

    Job Opening: Claims Processing Specialist at Blackburn's Are you a detail-oriented professional with a passion for the healthcare industry? Blackburn's is looking for a Claims Processing Specialist to join our Corporate Claims department and perform third-party medical billing functions. If you thrive in a fast-paced environment and possess excellent organizational and communication skills, this could be the perfect opportunity for you! What You'll Do: Manage and verify third-party medical claims for accuracy and compliance. Collaborate with cross-functional teams to resolve billing discrepancies and insurance denials. Process claims efficiently while adhering to strict filing deadlines. Contribute to the improvement of billing processes to reduce denials and increase efficiency. Utilize your strong communication skills to work with internal teams and external clients. Why Join Us? At Blackburn's, we're committed to creating a positive impact in the healthcare industry by delivering quality products and services. As part of our team, you'll have access to in-house training, opportunities for career growth, and a collaborative work environment. We offer competitive pay, benefits, and the chance to be part of a company that values its employees. Work Hours: 8:00 a.m. - 4:30 p.m. or 8:30 a.m. - 5:00 p.m. If you have a passion for medical billing and enjoy working in a dynamic, fast-paced environment, we'd love to hear from you! Apply today and join us in making a difference at Blackburn's! Qualifications What We're Looking For: Prior experience in healthcare-related industries, preferably with third-party medical billing. Strong attention to detail, time management, and the ability to juggle multiple tasks. Excellent interpersonal skills, with the ability to work both independently and as part of a team. Proficiency in Microsoft Office, with knowledge of Word and Excel. Ability to work independently, prioritize workload, and adapt to changing environments.
    $25k-32k yearly est. 11d ago
  • Public Adjuster

    The Misch Group

    Claim specialist job in Philadelphia, PA

    Job DescriptionDescriptionQUICK 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 W2, Base Salary 70K+, and industry leading commission package 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!
    $47k-69k yearly est. 6d ago
  • Insurance Company Examiner Trainee

    Commonwealth of Pennsylvania 3.9company rating

    Claim specialist job in Harrisburg, PA

    The Pennsylvania Insurance Department is on the lookout for Insurance Company Examiner Trainees who are ready to kickstart their careers! These roles offer specialized on-the-job training where you will learn the skills necessary to review and inspect documents to determine if insurance companies in Pennsylvania are operating in compliance with relevant state laws, rules, and regulations. This is the perfect opportunity to learn the fundamentals of our industry, build valuable skills, and work alongside experienced professionals. Apply today and start a new chapter in your career with our Financial Examinations team! DESCRIPTION OF WORK As an Insurance Company Examiner Trainee, you will learn how to review and evaluate insurers' business processes and controls, including the quality and reliability of corporate governance; assist in assessing solvency; and monitor current financial condition and prospective risks. Work involves visiting examination sites to assist experienced Examiners in conducting risk-focused examinations of records, documents, financial statements, and other related materials. You will have the opportunity to communicate and collaborate with the examiner in charge, management, and the insurer regarding potential concerns and findings discovered during the examination. Performing these and other tasks will develop and enhance your understanding of insurer operations: Assisting with reviewing regulatory filings Observing discussions with department staff Participating in interviews with management and discussing operations with company personnel Reviewing public information, industry trends, and other sources of information Assisting in scaling the extent of review based on size, risk, and complexity of the insurer Work Schedule and Additional Information: Full-time employment Work hours are 8:00 AM to 4:30 PM, Monday - Friday, with a 60-minute lunch. Telework: This position is home headquartered. In order to be home headquartered, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. Salary: Selected candidates who are new to employment with the Commonwealth of Pennsylvania will begin employment at the starting annual salary of $51,971 (before taxes). You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices. REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY QUALIFICATIONS Minimum Experience and Training Requirements: A bachelor's degree that includes 6 college credits in accounting, 3 college credits in finance or economics, and 3 college credits in business law; or An equivalent experience and training that includes 6 college credits in accounting, 3 college credits in finance or economics, and 3 college credits in business law. Applicants will be considered to have met the educational requirements once they are within 3 months of graduating with a qualifying degree. Other Requirements: You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency. You must be able to perform essential job functions. How to Apply: Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education). If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable. Your application must be submitted by the posting closing date . Late applications and other required materials will not be accepted. Failure to comply with the above application requirements may eliminate you from consideration for this position. Veterans: Pennsylvania law (51 Pa. C.S. *7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to ************************************************ and click on Veterans. Telecommunications Relay Service (TRS): 711 (hearing and speech disabilities or other individuals). If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date. The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply. EXAMINATION INFORMATION Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam). Your score is based on the detailed information you provide on your application and in response to the supplemental questions. Your score is valid for this specific posting only. You must provide complete and accurate information or: your score may be lower than deserved. you may be disqualified. You may only apply/test once for this posting. Your results will be provided via email.
    $52k yearly 5d ago
  • Associate, Wage and Hour - Disputes, Claims & Investigations

    Stout 4.2company rating

    Claim specialist job in Philadelphia, PA

    At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. Associate - DCI (Disputes, Claims & Investigations), Wage & Hour Stout is seeking an Associate with 2-5 years of experience to join our Disputes, Claims & Investigations (DCI) Wage and Hour practice. This is a full-time role offering comprehensive benefits, a 401(k), and eligibility for annual bonuses. Stout brings deep expertise supporting clients in high-stakes business litigation and economic consulting matters. Associates work closely with experienced professionals and subject-matter experts to analyze complex data and deliver independent, thoughtful analyses. Impact You'll Make This role plays a critical part in delivering high-quality analytical support on complex wage and hour matters. Your work will directly contribute to successful client outcomes and the effectiveness of project teams. Execute and support complex data analyses related to wage and hour disputes and investigations. Contribute to the development of sound methodologies and analytical approaches that support defensible conclusions. Help ensure projects are completed on time, within scope, and with a high standard of quality. Build strong working relationships across project teams to drive collaboration and efficiency. Support client-facing deliverables that clearly communicate findings and insights. What You'll Do These responsibilities reflect the day-to-day work required to support engagements and achieve project objectives. Review, organize, and analyze large and complex datasets to support litigation and consulting engagements. Support multiple concurrent projects, anticipating scope, timing, and budget considerations. Assist in developing work plans, methodologies, and resource needs to optimize project outcomes. Collaborate closely with team members to meet deadlines and manage competing client expectations. Support written analyses, reports, and presentations prepared for clients and other stakeholders. Apply creative problem-solving techniques to manage risks and address analytical challenges. What You Bring This section outlines the qualifications and technical skills needed to succeed in the role. Bachelor's degree from an accredited college or university, preferably in Economics, Mathematics, or a related field. 2-5 years of experience in wage and hour consulting or a closely related field. Working knowledge of advanced data management and analytical tools such as SAS, SQL, STATA, R, or similar platforms. Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, and Access. Strong written and verbal communication skills with the ability to present complex information clearly. Demonstrated ability to manage multiple projects simultaneously and work effectively with cross-functional teams. How You'll Thrive These competencies and behaviors will help you excel and grow within Stout's collaborative culture. Maintain flexibility and adaptability in response to changing project requirements and timelines. Demonstrate strong organizational skills and rigorous attention to detail. Exhibit intellectual curiosity, self-motivation, and a commitment to quality control. Collaborate effectively with colleagues while managing competing priorities. Uphold Stout's core values and deliver Relentless Excellence in both client service and internal teamwork. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $74,000.00 - $135,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
    $33k-39k yearly est. 2d ago
  • Third Party Claims Specialist

    DCS Asset Maintenance 4.5company rating

    Claim specialist job in Hazleton, PA

    DCSAM is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe, and high-quality infrastructure/maintenance contracting services to State DOTs, railroads, and other commercial/residential customers across the entire United States. Employees receive generous compensation packages, employee engagement events & career development programs, just to name a few of the perks of being part of the DCSAM family! To provide quality service, we need top-of-the-line employees. That is why we offer great compensation, awesome benefits, and a work environment worth bragging about! Job Description Claims Specialist will support asset management projects by providing accurate billing, collection and payment processing for claims related to highway and bridge asset repairs and/or incident management. This is an onsite position located at the corporate office in Hazleton PA. Duties include - but not limited to: Contacting insurance companies to obtain claim information relative to incidents and/or open claims in instances where vehicle owners have not notified insurance companies. Coordinate with project offices to obtain accurate information, records and photos needed to create invoices. Creation and submission of accurate invoices to insurance carriers and vehicle owners. Contacting insurance companies for payment status and mailing follow-up letters to vehicle owners for claims that remain unpaid at 30, 60 & 90 days. Accurately updating claim records for any contact or actions taken on claim invoice. Create and run reports as necessary for claim tracking and follow-up Support to project offices as necessary - including police report investigation and contacting insurance companies. Ability to prioritize workload and assist coworkers as necessary for heavy workload and/or vacation coverage. Provides general office support as needed for mail, payment processing and assistance to 3rd Party Claims Manager. Other duties as assigned. Qualifications EDUCATION: High School Diploma is required. EXPERIENCE: Prior experience in insurance claims preferred - 2 years or more relative experience Excellent computer skills - Proficient in Microsoft Office Word & Excel Customer service focused Detail oriented Self-starter - ability to work independently. Ability to interact productively and positively in a team environment. Ability to communicate effectively and professionally in both verbal and written form. PHYSICAL REQUIREMENTS: Ability to talk, hear and speak to coworkers, insurance carriers and vehicle owners over the phone. Able to use hands and fingers to use keyboard, operative office equipment, phones, and mobile devices. Able to see and read on computer screens and paper, close vision. Ability to lift and carry items up to 10 pounds. Ability to sit at a desk comfortably while working on a computer for extended periods of time. Additional Information Benefit Highlights: Challenging and rewarding work environment Competitive Compensation Excellent Medical, Dental, Vision and Prescription Drug Plan 401(K) Generous Paid Time Off Career Development Pay rate: $20.00-23.00/hour depending on experience Come be a part of the DeAngelo family, today! DCSAM is an equal opportunity employer and complies with all hiring and employment regulations. In the event an ADA accommodation is needed, DCSAM is happy to help all employees achieve gainful employment in an atmosphere where they are appreciated and respected. DCSAM offers subcontracting services to government agencies as such, candidates may be subject to pre-employment screenings such as criminal background checks, pre-employment, post-accident & reasonable impairment drug screenings, motor vehicle record checks, etc. as such, DCSAM complies with all federal and state regulatory guidelines including the FCRA.
    $20-23 hourly 14d ago

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Top 10 Claim Specialist companies in PA

  1. Berkshire Hathaway

  2. CNA Insurance

  3. AXA

  4. DCS

  5. Universal Health Services

  6. HMA Group

  7. Philadelphia Insurance Companies

  8. Berkshire Hathaway GUARD Insurance Companies

  9. CNA Holding Corporation

  10. Cox Communications

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