Disability Claims Specialist (Part Time 20 hours+)
Hays 4.8
Claim specialist job in Tampa, FL
We seek to make a meaningful impact in the lives of our customers and our communities. The LTD Claim Consultant evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the LTD Claims Consultant is required to exercise independent judgment, critical thinking skills, exemplary customer service skills as well as effective inventory management skills.
Essential Business Experience and Technical Skills:
Required:
**3+ years of LTD/IDI Insurance Claims experience
•Prior experience with independent judgement and decision making while relying on the available facts
•Be able to demonstrate the use of critical thinking and analysis when reviewing the information
•Creative problem-solving abilities and the ability to think outside the box
•Excellent interpersonal and communication skills in both verbal and written form
•Excellent customer service skills proven through internal and external customer interactions
•Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively
•Organizational and time management skills
• Bachelor's degree
Key Responsibilities:
•Effectively manages with some level of oversight an assigned caseload of moderately complex claims which consists of pending, ongoing/active and appeal reviews. The LTD CS will be evaluated for increases in their authority levels as they become more experienced in their decision-making and demonstrate consistency in meeting all key performance indicators
•Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations
• Provides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other information that may be pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skills
•Interacts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations
•Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available
•Collaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants as needed to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions.
•Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed
•Proficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, and Rehab Return to Work benefits, and other non-routine payments
•Provides timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determination.
•Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas.
$56k-88k yearly est. 17h ago
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Inside Claims Examiner-P&C Homeowners Insurance
Slide 2.8
Claim specialist job in Tampa, FL
Calling all innovators and people ready to take a proactive approach to claims handling in a digital world!!! Slide is a cutting-edge Tampa-based insurtech company (have you seen us in the news lately?!) and we are looking for tech-savvy Claims professionals!
Slide is an insurtech bringing together top talent, cutting-edge technology, world-class data science, and a human-centric approach.
We work and think differently, leveraging Big Data, AI, and machine learning to simplify and hyper-personalize every part of the insurance process. Why? Because modern consumers expect and deserve more from the insurance experience. And we have what it takes to deliver it.
Rebuilding every part of the insurance process to modernize the way it is written, explained, and managed is no small feat, but we are up for the challenge….are you?
Job Summary: The position is responsible for the investigation, evaluation, negotiation, and settlement of personal lines property claims including dispute resolution and/or recovery.
Duties and Responsibilities:
Proactively communicate and set accurate claims expectations with customers throughout the Claims process while providing high quality customer service.
Research, analyze, and interpret policy language and state law as it applies to submitted claims.
Examine and appropriately interpret policies, forms, and other records to determine coverage and extent of company's exposure or liability.
Appropriately apply knowledge of multiple state statutes, including the insurance code of ethics, rules, regulations, and guidelines.
Draft, approve, and adjust estimates of damage and loss amounts.
Negotiate and settle claims in accordance with Slide's best practices, guidelines, and industry standards.
Assign, direct, and monitor vendors conducting mitigation and/or other services during the adjustment process.
Model ethical behavior and execute job responsibilities in accordance with Slide's core values, ethics, and information protection policies.
Document all relevant information in the electronic claims management system.
Contribute to the business production goals and objectives.
Establish timely and appropriate claim reserves in accordance with claim standards.
Appropriately represent the company by executing a high level of service and always maintaining professionalism.
Perform other duties, as assigned.
Education, Experience and Licensing Requirements:
Bachelor's degree in a field with skills transferable to insurance preferred; HS Diploma required.
Active Florida 6-20 Resident All Lines Adjuster License required.
3+ years of first-party property claims adjusting experience.
2+ years of experience working directly for a carrier
Working knowledge of Florida insurance laws and Florida good faith claims handling experience.
Technical savviness.
Xactimate proficiency a plus
Proficiency in Microsoft Windows environment.
Industry designations or certifications a plus.
Qualifications/Skills and Competencies:
Excellent interpersonal and critical thinking skills.
Data-driven, analytical approach necessary.
Working knowledge to interpret and apply laws, rules, regulations, policies and procedures, and department operational guidelines in daily functions.
Possesses strong customer service skills and can address customer escalations.
Strong analytical, organizational, negotiation and communication skills.
Ability to work independently, multi-task and adapt to frequent priority changes.
Ability to plan, prioritize workload, organize, and coordinate multiple tasks and projects.
Must possess excellent writing skills.
Desire to live Slide's Core Values.
What's in it for you?? A paycheck of course but really, much more!
The Slide Vibe - An opportunity to be a part of a fun and innovation-driven Culture fueled by Passion, Purpose and Technology!
Benefits - We have extensive and cost-effective benefits that cover you and your family from every angle... Physical Health, Emotional Health, Financial Health, Social Health, and Professional Health.
$33k-44k yearly est. 60d+ ago
Claims Representative - Tampa, FL
Federated Mutual Insurance Company 4.2
Claim specialist job in Tampa, FL
Who is Federated Insurance? At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own.
Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values.
What Will You Do?
Are you looking to make a change to work for a company that values work/life balance? Federated Insurance has a career opportunity for you in this office-based Auto and Commercial Liability Claims Adjuster position. No specific state experience is required.
Responsibilities
* Gather evidence and document claims facts.
* Determine the value of damaged items.
* Understand and explain insurance policy coverage to clients and third parties.
* Negotiate settlements with clients or third parties.
* Resolve claims, which may include paying or denying claims.
* Communicate with clients, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair, and courteous way.
* Occasionally handle defending policyholders in court, compromising, or recovering outstanding dollars.
Minimum Qualifications
* Current pursuing, or have obtained a four-year degree
* 1-5 years' experience in handling auto or general liability claims.
* Strong analytical, computer, and time management skills
* Excellent written and verbal communication skills
Salary Range: $63,800 - $78,000
Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information can be discussed with a with a member of the Recruiting team.
What We Offer
We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You.
Employment Practices
All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization.
If California Resident, please review Federated's enhanced Privacy Policy.
$63.8k-78k yearly Auto-Apply 7d ago
Patient Claims Specialist - Bilingual Only
Modmed 4.5
Claim specialist job in Tampa, FL
We are united in our mission to make a positive impact on healthcare. Join Us!
South Florida Business Journal, Best Places to Work 2024
Inc. 5000 Fastest-Growing Private Companies in America 2024
2024 Black Book Awards, ranked #1 EHR in 11 Specialties
2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold)
2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara)
Who we are:
We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany.
ModMed is hiring a driven Patient ClaimSpecialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine!
Your Role:
Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections
Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates
Input and update patient account information and document calls into the Practice Management system
Special Projects: Other duties as required to support and enhance our customer/patient-facing activities
Skills & Requirements:
High School Diploma or GED required
Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST
Minimum of 1-2 years of previous healthcare administration or related experience required
Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs)
Manage/ field 60+ inbound calls per day
Bilingual required (Spanish & English)
Proficient knowledge of business software applications such as Excel, Word, and PowerPoint
Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone
Ability and openness to learn new things
Ability to work effectively within a team in order to create a positive environment
Ability to remain calm in a demanding call center environment
Professional demeanor required
Ability to effectively manage time and competing priorities
#LI-SM2
ModMed Benefits Highlight:
At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits:
India
Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk,
Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees,
Allowances: Annual wellness allowance to support your well-being and productivity,
Earned, casual, and sick leaves to maintain a healthy work-life balance,
Bereavement leave for difficult times and extended medical leave options,
Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave,
Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind.
United States
Comprehensive medical, dental, and vision benefits
401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
Generous Paid Time Off and Paid Parental Leave programs,
Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,
Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.
PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.
About us: Doodie Calls, LLC. provides sanitation services for residential, construction sites, special events and disaster relief. We believe that each staff member plays a vital role in our success, and we foster an environment of mutual respect. Our goal is to see our employees thrive and grow, as their success is our success. Whether in the field or in the office, our dispatch team, district managers, and office managers are consistently available to provide support and guidance. We believe in the power of collaboration and mutual support. Job Summary: We're seeking a detail-oriented Lien & ClaimsSpecialist to join our team in St. Petersburg, FL. This position plays a vital role in protecting our company's financial interests by managing the lien process from start to finish, filing small claims, and ensuring all customer documentation is complete and compliant. Job Classification: Full-time non-exempt under the Fair Labor Standards Act. Location: St. Petersburg, FL Pay Range: $70,000 to $90,000, depending on experience Responsibilities:
Prepare, file, and manage liens on properties through completion of the lien process.
Review and execute lien releases accurately and promptly
Prepare and file small claims actions when necessary
Manage and track certificates of insurance (COIs) for customers
Complete and maintain vendor packets and other required customer documentation
Collaborate with internal teams and external partners to ensure all deadlines and compliance requirements are met
Organize and maintain legal files and documents
Qualifications/Requirements:
Experience with the lien process from start to finish is required
Knowledge of filing small claims and related procedures
Background or experience in construction law or a related field is highly preferred
JD or experienced paralegal preferred
Strong attention to detail and excellent organizational skills
Ability to manage multiple deadlines in a fast-paced environment
Ability to read and understand contracts and other legal documents
Strong knowledge of legal terminology and procedures
Excellent research and writing skills
Proficiency in Microsoft Office and legal research databases
Ability to work independently and as part of a team
Benefits:
401(k) & 401(k) matching
Health Insurance
Dental Insurance
Life insurance
Paid time off
Vision insurance
Employee Assistance Program
Supplemental Plans
Referral Bonus Eligibility
Posting Notes:
We are a veteran-friendly employer and proudly welcome applications from those who have served in the U.S. Armed Forces.
We are not accepting unsolicited resumes from external recruiters or staffing agencies.
We are an equal employment opportunity employer
.
The Company's policy is not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, veteran or uniformed service-member status, genetic information, or any other basis protected by applicable federal, state, or local laws.
$70k-90k yearly 60d+ ago
Insurance Claims Specialist
DPR Construction 4.8
Claim specialist job in Tampa, FL
The ClaimsSpecialist will be responsible for assisting with the management of the Fleet Vehicle Safety & Operations Policy for DPR (and DPR related entities) across the US, as well as first and third-party auto physical damage and low severity property damage claims as requested by, and under the supervision of, DPR's Insured Claims Manager.
Specific Duties include:
Claims & Incident Management:
* Initial processing of first and third-party auto and low severity property damage incidents involving DPR (and DPR related entities), including but not limited to:
* Input and/or review all incidents reported in DPR's RMIS system.
* Maintain incident records in Insurance Team's document management system.
* Ensure all necessary information is compiled to properly manage the claims, including working with the internal teams to identify culpable parties, potential risk transfer to the culpable trade partner, if applicable, collecting documents such as incident reports, root cause analyses, if any, and vehicle lease or rental agreements.
* Report, with all appropriate documents and information, all claims for DPR (and DPR related entities) to all potentially triggered insurance policies for various types of programs (traditional, CCIP, OCIP), including analyzing contractual risk transfer opportunities.
* Assess potential risk transfer opportunities and ensure additional insured tenders or deductible responsibility letters are sent, where applicable.
* Liaison with the carriers in evaluating whether claims reported directly to the carriers are appropriate.
* Manage all auto and low severity property damage claims, as assigned, in the DPR RMIS system for DPR (and DPR related entities), including ensuring that all information is kept up to date.
* Provide in-network aluminum certified repair shop information to drivers following an incident.
* Act as a liaison between our carriers, auto repair shops, Operations, Fleet and EHS teams related to claim progress, strategy, expenses and settlement.
* When required, notify the applicable State's Department of Motor Vehicles office of motor vehicle accidents by preparing and mailing the specific State form.
* Work with Insurance Controller on auto program claim reports
* Liaison with Operations, Fleet and EHS teams on new incident reporting processes, as needed.
Fleet Vehicle Safety & Operations Policy Management:
* Manage the Fleet Risk Index scores for authorized drivers, ensuring its accurate and up to date based on incidents and MVRs
* Assign training to authorized drivers based on MVA incidents, MVRs and citations, as well as managing completion of the training
* Ensure authorized driver list is kept current
* Liaison with internal HR, Fleet, EHS and Business Unit Leaders, where appropriate, on suspending vehicle usage permissions
* Responsible for working with internal teams on implementing appropriate updates to the Fleet Vehicle Safety & Operations Policy
Key Skills:
* Strategic thinking
* Ability to mentor and inspire others
* Integrity
* Team player
* Strong writing and communication skills
* Self-Starter
* Highly organized and responsive - ability to meet deadlines
* Detail Oriented
* Basic working knowledge in all of the following coverages/programs: auto insurance, commercial general liability, property insurance, and controlled insurance programs.
* Risk and dispute management - insured claims
Qualifications:
* A minimum of five years relevant insurance industry experience
* Previous experience in auto claims management highly desired
DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world.
Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek.
Explore our open opportunities at ********************
$68k-88k yearly est. Auto-Apply 60d+ ago
Insurance Claims Specialist
Mid Florida Finance 4.1
Claim specialist job in Lakeland, FL
Mid Florida Financing is looking for an Insurance Specialist to join our team in Lakeland, FL. This position will provide insurance coverage to our new and existing clients. We are looking for someone who is self-motivated, organized, and has the ability to work independently.
Benefits:
401(k)
Dental insurance
Flexible schedule
Health insurance
Paid time off
Vision insurance
Responsibilities:
Provides exceptional customer service while investigating policy coverage, liability and damages in a timely manner
Gathers information and documents claim file to comply with company guidelines and state compliance and regulations
Negotiates timely and appropriate settlements with insurance companies
Manages pending claims to meet company quality criteria
Recognizes recovery opportunities in regards salvage vehicles
Performs other related duties as assigned or required.
Assists internal and external customers with problems or questions regarding claims by phone or through written correspondence while providing a high level of customer service.
Job Type:
Full-time
Pay:
$16.00 per hour
Expected hours:
40 per week
Schedule:
Monday to Friday
Work Location:
In person
We are an equal opportunity employer.
$16 hourly Auto-Apply 60d+ ago
Travel Orders and Claims Specialist
Lukos
Claim specialist job in Tampa, FL
Travel Orders and ClaimsSpecialist Please note: This position is contingent upon the award of a contract. We will provide updates on the status of the contract and next steps during the hiring process.
Minimum Qualifications Summary
Certification & Education
Must possess a current US Passport with ability to travel and work overseas
Must be able to meet COMSEC briefing and Local Element management certification requirements available under the OPNAVINST 2201.4, DoD Instruction 8523.01 and Air Force Manual 17-1301
Must possess a SECRET Security Clearance
Experience Required
Possess full understanding and experience of federal and DoD policies, processes, procedures and systems - including Defense Travel System - used to enable worldwide travel
Five years' military experience
Job Objective Under a five-year contract, the Travel Orders and ClaimsSpecialist will support the United States Marine Corps Forces, Central Command (MARCENT) and subordinate commands. The scope of the requirement includes professional services for MARCENT located aboard MacDill Air Force Base (AFB), Florida, which serves as a Component Command to U.S. Central Command (USCENTCOM). Specifically, the Travel Orders and ClaimsSpecialist will support the Manpower Directorate (G-1) within the continental United States (CONUS) and outside the continental United States (OCONUS). The G-1 performs analysis of manpower requirements to support operations. Additionally, the G-1 advises and assists the Commander in matters relating to personnel operations, management, policy, administration, awards, correspondence, travel management, the Government Travel Charge Card (GTCC) Program, and administrative support to all Marines stationed at MacDill AFB as well as individual augments in the USCENTCOM Area of Responsibility (AOR). Responsibilities
Provide travel orders processing support services
Execute travel arrangement coordination with travelers and designated DoD Commercial Travel Offices
Inform travelers on travel requirements, allowances, limitations, and process travel claims, coordinate settlement actions with associated finance/disbursing entities, assist the Government Travel Charge Program Manager, and support the Director, Personnel Admin Center
Provide a capability to process (from inception to settlement), a minimum of 450 up to a maximum of 2,800 travel claims per month
Coordinate and arrange travel logistics, ensuring all transportation, lodging, and meals are scheduled efficiently and in compliance with military regulations
Book airline tickets, ground transportation, hotel accommodations, and any other necessary travel-related services for military personnel
Develop, manage, and distribute detailed travel itineraries, ensuring all schedules are clearly communicated and updated as needed
Adjust travel plans in the event of changes or emergencies, ensuring MARCENT personnel are promptly informed of modifications
Ensure all travel arrangements comply with military regulations, including the Joint Travel Regulations (JTR) and Department of Defense (DoD) policies
Maintain and process all necessary travel documentation, including travel authorizations, vouchers, receipts, and expense reports
Assist in monitoring travel budgets and ensure that all travel expenses remain within allocated limits
Submit travel-related financial reports and keep accurate records of expenses.
Serve as the primary point of contact for travel-related inquiries
Liaise with transportation companies, lodging facilities, and other service providers to ensure smooth and cost-effective travel
Provide support and assistance during travel disruptions, such as cancellations, delays, or unexpected changes, to ensure travel needs are met promptly
Assist with rebooking travel and arranging alternative accommodations if necessary
Provide guidance to personnel on travel policies, entitlements, and procedures
Conduct travel training sessions or distribute materials to ensure MARECENT personnel understand the proper travel protocols
Maintain organized records of all travel-related documents, including tickets, itineraries, receipts, and travel authorizations
Generate and submit travel-related reports and summaries as required by supervisors or higher command
Address any travel-related concerns or complaints, providing prompt and professional solutions
Offer superior customer service by assisting with travel inquiries, changes, or issues during the travel process
Continuously evaluate and improve travel processes to enhance efficiency and minimize costs
Recommend changes to improve the overall effectiveness of the MARCENT travel program
Education & Certification
Must possess a current US Passport with ability to travel and work overseas
Must be able to meet COMSEC briefing and Local Element management certification requirements available under the OPNAVINST 2201.4, DoD Instruction 8523.01 and Air Force Manual 17-1301
Security Clearance
Must possess a SECRET Security Clearance
Work Location
MARCENT, MacDill Air Force Base, Tampa, Florida
Travel: Contractor personnel must support the projected travel in support of government requirements to MARCENT AOR and supporting locations, which includes but not limited to the following countries: Bahrain, United Arab Emirates (UAE), Saudi Arabia, Jordan, Egypt, France, Germany, United Kingdom, Oman, Qatar, Kuwait, Iraq, Israel, Afghanistan, Syria, Lebanon, Yemen, Pakistan, Turkmenistan, Uzbekistan, Kyrgyz Republic, Tajikistan, Kazakhstan, Djibouti, Cyprus, Turkey, Italy, and Greece. The ideal candidate will be available for travel on less than 24 hours-notice to support personnel recovery and training for forward deployed forces. The ideal candidate will possess the ability to execute OCONUS travel throughout the Central Command (CENTCOM) AOR.
About Lukos Lukos has been delivering professional services to the Federal Government for 15 years. We help a variety of federal agencies in areas such as national security, homeland security, international development, training, analytics, healthcare, and other professional services. Since our founding, we have grown to support all military services and multiple federal civilian agencies. About Our Name: Lukos is ancient Greek for “wolf”. The characteristics of the wolf match our approach to national security. The wolf is known for cunning, aggression, patience, and teamwork. An individual wolf is smart, strong, and resilient, but the true strength of wolves is their ability to work together as a wolfpack. Kipling said it best in The Law of the Jungle. "For the strength of the pack is the wolf, and the strength of the wolf is the pack." At Lukos we take care of our pack by offering full time employees competitive benefits to include: medical, dental, vision, 401(k), life insurance, short and long term disability coverage, paid time off and Federal holidays.
Lukos is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, disability, or national origin.
$33k-60k yearly est. 60d+ ago
Construction Defect Technical Claims Specialist
Frank Winston Crum Insurance
Claim specialist job in Clearwater, FL
FrankCrum is a Top Workplace!
Frank Winston Crum Insurance (FWCI) issues Workers' Compensation and General Liability policies by offering flexible coverage and payment options to meet the varied needs of businesses. Over the years, FWCI has grown from a single-state insurance carrier to one that is licensed in 45 states and continues to expand. In addition to regional and product line growth, FWCI has enhanced its value-added services. What has not changed though is the firm's commitment - echoed throughout the family of companies - "always to do the right things for the right reasons!"
Click here to learn more about FrankCrum!
The Role You'll Play to Create Success
We are eager to announce a Construction Defect Technical ClaimsSpecialist position filled with many exciting opportunities! This job contributes to the mission of FrankCrum by adjusting the most complex construction defect claims in the company's inventory and assisting in establishing the best and most cost-effective strategy for handling this claim type.
Investigates, evaluates and brings to timely resolution an inventory of the most complex construction defect claims in the company's inventory of which most are litigated and may involve large projects in accordance with established claim handling standards and applicable state regulations and laws.
Understands construction defect coverage issues and handles complex coverage issues related to sub-contractors, additional insured tenders by General Contractors and developers, Florida Chapter 558 process and issuing reservation of rights letters and denial of coverage letters
Understands and interprets construction contracts and applies risk transfer when appropriate.
Negotiates time on risk and the duty to defend and indemnify with liable insurers when appropriate.
Manages litigation proactively and works well with defense counsel and insureds to reach optimal outcomes.
Demonstrates a strong knowledge and utilization of resolution techniques such as high low agreements, proposals for settlement, offers of judgement to obtain optimal outcomes.
Demonstrates an understanding of how to evaluate and respond timely to time limit demands, consumer complaints and Department of Insurance Complaints including Civil Remedy Notices often filed in construction defect claims.
Demonstrates a strong knowledge of residential and commercial building construction, repair processes, and knows how to review and analyze the accuracy of damage reports prepared by contractors, engineers, and appraisers in order to assess property damage and construction defects damages.
Demonstrates strong negotiations skills in alternative dispute resolution forums such as mediations and assists in finding early resolutions in order to obtain optimal outcomes when appropriate.
Demonstrates an understanding of reserving requirements and philosophies and is able to maintain appropriate reserves on all assigned claim files.
Prepares reports detailing claim status, payments and reserves.
Engages in timely and effective communication with the appropriate parties and documents the claim file throughout the claim adjustment process which includes maintaining timely diaries on each claim.
Effectively assists, trains and mentor's lessor skilled team members in conjunction with management.
Assists managers with identifying trends and opportunities for improvement in processes and procedures and claim resolution to improve overall outcomes.
Collaborates with other departments such underwriting on projects or as needed or performs other duties as assigned.
The Attributes We Seek
Keys to success in this position include knowledge of construction defect claims handling and of applicable insurance policies claims systems and claims handling regulations, procedures, and laws in 48 states. Bachelor's degree in a related field or equivalent experience needed, Juris Doctorate a plus.
Ten (10) years of construction defect claims adjusting experience with exposure to a minimum of $100,000.
Must hold Proper adjuster licenses in Florida and other states with the ability to obtain additional licenses as needed.
Our Competitive Benefits
Along with this great opportunity, FrankCrum also provides exceptional benefits from top carriers including:
Health Insurance is zero dollar paycheck cost for employee's coverage and only one-hundred-forty-five dollars a month for family!
Dental and Vision Insurance
Short Term Disability and Term Life Insurance at no cost to the employee
Long Term Disability and Voluntary Term Life Insurance
Supplemental insurance plans such as Accidental, Critical Illness, Hospital Indemnity, Legal Services and Pet Insurance
401(k) Retirement Plan where FrankCrum matches 100% of the first 4% the employee contributes, and the employee is immediately vested in the employer match
Employee Assistance Program at no cost to the employee
Flexible Spending Accounts for Medical and Dependent Care Reimbursement
Health Savings Account funded by FrankCrum
Paid time off and holiday pay
Education reimbursement
PTO cash out
Tickets at Work
Access to the Corporate America Family Credit Union
Employee and client referral bonus programs
Disaster Relief Fund for employees
What's Special About FrankCrum
FrankCrum, a family-owned business-to-business entity since 1981 made of several companies: FrankCrum Corporate (a professional employer organization), FrankCrum Staffing, Frank Winston Crum Insurance Company, and the FrankCrum Insurance Agency - all based in Clearwater, Florida. This "family of employer solutions" employs approximately 500 people who serve over 4,000 clients throughout the United States. FrankCrum employees are trained to deliver high value through exceptional customer service and treat clients and coworkers like family. By living by our Brand Pillars (Integrity, Affinity, and Prosperity) employees are recognized at quarterly events for exceptional customer service and milestones in tenure.
The FrankCrum headquarters spans 14 acres and includes a cafe, subsidized for employees. Menus include made-to-order breakfast, hot lunch options and even dinners that can be ordered to-go, all at very affordable prices. The cafe also plays host to monthly birthday and anniversary celebrations, eating and costume contests, and yearly holiday parties. Through the input of its own employees, The Tampa Bay Times has recognized FrankCrum as a Top Place to Work for more than 10 years in a row! FrankCrum also supports several community efforts through Trinity Cafe, the Homeless Empowerment Program, and Clearwater Free Clinic!
If you want to play this role to positively impact our clients' day-to-day business, then apply now!
This job posting will remain open continuously and qualified applicants will be considered as applications are received.
Pay Data
As required by applicable state and/or local regulations the following pay data provides a reasonable estimate of the compensation range for this position at the time of posting. FrankCrum may ultimately pay more or less than the posted pay range due to many economic and individualized considerations. The pay offered to the selected candidate will be based on factors including, but not limited to qualifications, knowledge, licensure, skills, abilities, work experience, education, budget, training, employment trends, internal wage considerations, market dynamics, certifications, geographical location, assessments, and other business and organizational needs. The annualized pay range at the time of initial posting for this position is $105,000-$125,000. These figures represent the annualized pay for both hourly and salaried types of positions and does not indicate employment is on a yearly basis nor remove the employee's employment at-will status.
FrankCrum is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and pregnancy-related conditions), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, or any other characteristic protected by applicable federal, state or local laws and ordinances.
Privacy Policy CA Residents
#LI-GH1
$34k-60k yearly est. Auto-Apply 60d+ ago
Bilingual Claim Specialist
Contingentcrew
Claim specialist job in Tampa, FL
Full-time Description
Shift/Schedule: Monday through Friday 8-5 onsite; Saturdays onsite or remote
Essential Duties & Responsiblities:
Responsible for handling incoming claim requests. Need to have excellent communication skills- both written, verbal and interpersonal skills.
Strong work ethic and reliability a must.
Must be able to multitask.
Excellent computer skills including data entry.
Must pay attention to detail and be able to prioritize.
Must be able to engage with clients in friendly professional manner.
Ability to learn dispatch system and accurately enter information.
Must work well under pressure.
Ability to handle high volume intake and work in a fast-paced environment.
Must be an active listener.
Skills & Experience:
Customer service experience preferred.
Dispatching 1 year preferred.
Bilingual/ Spanish speaking candidates!
Salary Description $20/hour - $23/hour
$20 hourly 60d+ ago
Commercial Claims Examiner
Heritage Mga LLC
Claim specialist job in Tampa, FL
MUST HAVE COMMERCIAL CLAIMS EXPERIENCE IN P&C, ACTIVE LICENSE AND BE WILLING TO COME INTO THE OFFICE FULL TIME.
We are located at 1401 N Westshore Blvd, Tampa, FL 33607
Investigates, evaluates, reserves, negotiates and settles assigned commercial claims in accordance with Best Practices. Provides quality claim handling and superior customer service on assigned claims, while engaging in indemnity and expense management. Promptly manages claims by completing essential functions including contacts, investigation, damages development, evaluation, reserving, and disposition.
Essential Duties and Responsibilities:
Provides voice to voice contact within 24 hours of first report.
Conducts timely coverage analysis and communication with insured based on application of policy information, facts or allegations of each case. Consults with Unit Manager on use of Claim Coverage Counsel.
Investigates each commercial claim through prompt contact with appropriate parties such as policyholders, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Records necessary statements.
Identifies resources for specific activities required to properly investigate claims such as Subro, Fire or Fraud investigators and to other experts. Requests through Unit Manager and coordinates the results of their efforts and findings.
Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
Maintains effective diary management system to ensure that all claims are handled timely. Evaluates liability and damages exposure, and establishes proper indemnity and expense reserves, at required time intervals.
Utilizes evaluation documentation tools in accordance with department guidelines.
Responsible for prompt, cost effective, and proper disposition of all claims within delegated authority.
Negotiate disposition of claims with insured's and claimants or their legal representatives. Recognizes and implements alternate means of resolution.
Maintains and document claim file activities in accordance with established procedures.
Attends depositions and mediations and all other legal proceedings, as needed.
Protects organization's value by keeping information confidential.
Maintains compliance with Claim Department's Best Practices.
Provides quality customer service and ensures file quality
Supports workload surges and/or Catastrophe operations as needed to include working significant overtime during designated CATs.
Communicates with co-workers, management, clients, vendors, and others in a courteous and professional manner.
Participates in special projects as assigned.
Some overnight travel maybe required.
Maintains the integrity of the company and products offered by complying with federal and state regulations as well as company policies and procedures.
Job Qualifications:
Associate's Degree required; Bachelor's Degree preferred. A combination of education and significant directly related experience may be considered in lieu of degree.
620 Licensure required.
One to three years of commercial claims experience preferred; property and casualty segment experience required.
Experience with Xactware products preferred.
Demonstrated ability to research, conduct proactive investigations and negotiate successful resolutions.
Proficiency with Microsoft Office products required; internet research tools preferred.
Demonstrated customer service focus / superior customer service skills.
Excellent communication skills and ability to interact on a professional level with internal and external personnel
Results driven with strong problem solving and analytical skills.
Ability to work independently in a fast paced environment; meets deadlines, and manages changing priorities effectively.
Detail-oriented and exceptionally organized
Collaborative partner; ability to contribute to a positive work environment.
General Information:
All employees must pass a pre-employment background check. Other checks may be needed based on position: driving history, credit report, etc.
The preceding has been designed to indicate the general nature of work performed; the level of knowledge and skills typically required; and usual working conditions of this position. It is not designed to contain, or be interpreted as, a comprehensive listing of all requirements or responsibilities that may be required by employees in this job. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.
Heritage Insurance Holdings, Inc. is an Equal Opportunity Employer. We will not discriminate unlawfully against qualified applicants or employees with respect to any term or condition of employment based on race, color, national origin, ancestry, sex, sexual orientation, age, religion, physical or mental disability, marital status, place of birth, military service status, or other basis protected by law.
$29k-47k yearly est. Auto-Apply 60d+ ago
Claims Specialist
Healthcare Support Staffing
Claim specialist job in Clearwater, FL
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Assesses insurance reimbursement for individual supplies to ensure maximum reimbursement
Verifies that all appropriate supporting documentation are obtained prior to shipment and/or prior to billing
Audits configuration of supplies based on supporting documentation, formulary requirements and manufacturer compatibility
Qualifications
High school diploma or GED equivalent
Minimum of two years of medical billing/collections/claims experience necessary.
Must be knowledgeable of reimbursement processes and procedures.
Ability to work with other employees and provide assistance as needed
Proficient in basic PC skills (MS Office)
Additional Information
Shift:
8-5
Monday-Friday
Advantages of this Opportunity:
Competitive salary $15-$16, based on experience
Growth potential
Excellent benefits offered: Medical, Dental, Vision, 401k and PTOFun
Positive work environment
$15-16 hourly 3d ago
Licensed Public Adjuster Tampa
Rockwall National Public Adjusters
Claim specialist job in Tampa, FL
Job DescriptionSalary:
About Us
Rockwall National Public Adjusters is one of the most established public adjusting firms in the region. For more than 15 years, we have successfully advocated for property owners, supported by leadership with over 20 years of experience in the insurance claims industry.
We pride ourselves on our longevity, high retention, and reputation for excellence. Many of our adjusters and office staff have been with us for over 10 years, reflecting our supportive culture and commitment to long-term careers.
At Rockwall, our mission is simple: level the playing field, fight for our clients rights, and secure the settlements they deserve. By joining our team, you will become part of a well-respected firm with proven processes, unmatched administrative support, and a collaborative environment that fosters professional growth.
The Role
We are seeking a motivated and Licensed Public Adjuster in the Tampa area to join our team in a hybrid, commission-based role.
As a Public Adjuster, you will represent policyholders throughout the insurance claims process, guiding them through stressful property damage losses and securing fair settlements. You will play a vital role in soliciting referral business, signing clients, evaluating damages, preparing and negotiating claims, and advocating for clients best interests.
This position is designed to support all levels of experience:
Newly licensed adjusters benefit from structured training, mentorship, and back-office support.
Experienced adjusters gain access to qualified leads, advanced systems, and a trusted brand with a long-standing reputation.
Key Responsibilities
Collaboratively solicit residential and commercial new claims and referral partners
Sign, inspect, evaluate, and document property damage for residential and commercial claims
Prepare, submit, and negotiate insurance claims on behalf of policyholders
Communicate with clients, insurance carriers, contractors, and stakeholders to advance claims efficiently
Advocate for clients best interests and ensure fair settlements are achieved
Maintain accurate records, reports, and claim documentation
Deliver exceptional customer service while educating clients on the claims process
Generate new business and efficiently close provided leads
Required Qualifications
Active Florida Public Adjuster license (or ability to obtain one)
Prior experience in insurance adjusting, construction, restoration, or a related field preferred, but not required
Strong negotiation and communication skills
Organized, detail-oriented, and able to manage multiple claims simultaneously
Professional demeanor with a client-focused mindset
Valid drivers license and reliable transportation for field inspections
Compensation & Benefits
Commission-based structure with unlimited earning potential
Training and ongoing professional development
Career growth opportunities within a supportive and collaborative team
Hybrid work flexibility (field + office)
Full administrative and office support (contracts, compliance, claims, invoicing, mortgage company payments)
The Rockwall Difference
At Rockwall, we provide unmatched support at every stage of the claims process, allowing our adjusters to focus on serving clients and building careers.
Key Advantages:
Comprehensive adjuster onboarding and mentorship programs
Professional ongoing sales training to close contracts faster and expand referral networks
Proprietary lead generation sources and affiliate networks
Automated client onboarding to reduce paperwork
Access to advanced claims management software for streamlined workflows
Hands-on field training for residential and commercial claims
Xactimate training and estimate reviews to ensure complete assessments
Seamless invoicing and fee collection support
Regular updates on case law, legislation, and industry trends
A collaborative team environment that promotes growth and shared knowledge
Why Join Rockwall NPA
20+ years of insurance industry expertise
15+ years as a trusted, established firm
Strong reputation and high staff retention
Proprietary lead generation sources and long-standing affiliate networks
Full support systems that empower adjusters to succeed
A company culture built on professionalism, advocacy, and results
$39k-54k yearly est. 29d ago
Public Adjuster
The Misch Group
Claim specialist job in Tampa, FL
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!
$39k-54k yearly est. 23d ago
Liability Adjuster II
TWAY Trustway Services
Claim specialist job in Tampa, FL
JOIN THE ASSURANCEAMERICA TEAM
Do you want to be part of an organization where you are valued, and your ideas and opinions have an impact?
Join the AssuranceAmerica team.
For more than 25 years, AssuranceAmerica has provided superior property and casualty insurance products through contracted independent agents and directly to customers. Our team succeeds through diversity of thought, experiences, skills, and backgrounds.
Liability Adjuster II
The Liability Adjuster II is responsible for managing a caseload of complex liability and coverage claims, including those involving minor bodily injuries. This role requires the execution of thorough investigations to gather all necessary facts, along with a strong understanding of policy language to ensure accurate and timely coverage and liability determinations. While working with a degree of autonomy, the Adjuster will collaborate with their supervisor for guidance on more nuanced or high-exposure cases.
About the ROLE
Each day at AssuranceAmerica is different, but as a Liability Adjuster II you will:
Conduct thorough investigations and evaluations of coverage, liability, and damages across all lines of personal automobile insurance/.
Accurately assess exposure and evaluate injury claims in a fair, consistent, and equitable manner based on the facts and extent of damages.
Negotiate timely and appropriate settlements, ensuring all required documentation is obtained to support proper claim resolution and closure.
Manage low-complexity, attorney-represented injury claims with sound judgement and attention detail, maintaining compliance with internal guidelines and industry standards.
Control expenses and adhere to company reserving philosophy by maintaining proper reserves
on all pending claims/potential exposures.
Meet and maintain general file handling goals and procedures as outlined by the company including maintaining a 1:1 closing ratio and status on diary reviews.
Properly utilize underwriting and policy systems and understand its features and functionality, as needed.
Attend any available seminars and classes applicable to this position and the skills required to meet the job duties and responsibilities.
Continually ask questions and have a desire to develop additional skills to better investigate and evaluate claims.
About YOU
Excellent communication skills with demonstrative ease with both verbal and written formats.
Attention to detail and ability to multi-task.
A high degree of motivation and team orientation.
Direct, results driven, and dedicated to the success of the business and each other.
Required
Minimum three years of experience handling auto claims.
Minimum of two years of experience handling complex liability and coverage issues and unrepresented bodily injury cases.
Preferred
Bachelor's degree or equivalent.
Non-standard experience.
Adjuster's license in relevant state or the ability to obtain one quickly.
Bilingual (English-Spanish).
Physical Requirements
Prolonged periods sitting at a desk and working on a computer.
Must be able to lift 15 pounds at times.
Must be able to navigate various departments of the organization's physical premises.
About US
We are direct, results-driven, and dedicated to the success of our business and each other.
We are a diverse group of thinkers and doers.
We offer many opportunities to grow in your professional skills and career.
We fight homelessness by directing 5% of our earnings from each policy we sell to organizations that help those in need. We call it our Generous Policy.
WHAT WE OFFER
AssuranceAmerica provides these benefits to Associates:
Premium healthcare plans: All full-time Associates and part-time Associates working a regular schedule of 30 hours, or more, are eligible for benefits including Medical, Dental, Vision, Voluntary Life, Flexible Spending Accounts, and a Health Savings Account.
Employer Paid Benefits: We enroll all eligible Associates in Group Life and AD&D Insurance, Short- and Long-Term Disability Plans, Employee Assistance Program, Travel Assist, and the Benefit Resource Card which includes Teladoc™, Pet Insurance and Health Advocate.
Additional Benefits:
401(k) Employer Match: We want to help you prepare for the future, now. All full-time and part-time Associates over age 21 are eligible to participate in the 401(k) Savings Plan.
AssuranceAmerica will match 100% of the first 4% of an Associate's contributions.
Engagement Events. We make time for fun activities that strengthen Associate relationships in all our locations.
Annual Learning Credit: Want to learn something new? We'll reimburse you for approved educational assistance.
Time Off:
Paid Time Off (PTO), Parental Leave Pay, Volunteer Time Off (VTO), Bereavement Pay, Military Leave Pay, and Jury Duty Pay.
$39k-54k yearly est. Auto-Apply 50d ago
GL Litigation and Complex Claims Specialist
Frank Winston Crum Insurance
Claim specialist job in Clearwater, FL
FrankCrum is a Top Workplace!
Frank Winston Crum Insurance (FWCI) issues Workers' Compensation and General Liability policies by offering flexible coverage and payment options to meet the varied needs of businesses. Over the years, FWCI has grown from a single-state insurance carrier to one that is licensed in 45 states and continues to expand. In addition to regional and product line growth, FWCI has enhanced its value-added services. What has not changed though is the firm's commitment - echoed throughout the family of companies - "always to do the right things for the right reasons!"
Click here to learn more about FrankCrum!
The Role You'll Play to Create Success
We are eager to announce a GL Litigation and Complex ClaimsSpecialist position filled with many exciting opportunities! This job contributes to the mission of FrankCrum by adjusting the most complex General Liability claims in the company's inventory and assisting in establishing the best and most cost-effective strategy for handling this claim type.
Investigates, evaluates and brings to timely resolution of an inventory of the most severe and complex general liability claims in the company's inventory of which most are litigated and may involve large property damage, catastrophic bodily injury, and other coverages in accordance with established claim handling standards and applicable state regulations and laws.
Understands and is able to implement proactive litigation management principles and techniques and works well and proactively with defense counsel and insureds to reach optimal outcomes.
Understands and can analyze complex general liability coverage issues and handles complex coverage issues including issuing reservation of rights letters and denial of coverage letters.
Negotiates the duty to defend and indemnify with liable insurers when appropriate.
Demonstrates a strong knowledge and understanding of litigation defense strategy and trial preparation via proper utilization of experts, independent medical reviews or exams, evaluation of liability and damages regarding complex bodily injuries and property damage claims.
Demonstrates a strong knowledge and understanding of resolution techniques such as high-low agreements, proposals for settlement, offers of judgement to obtain optimal outcomes.
Demonstrates an understanding of how to evaluate and respond timely to time limit demands in various states such as Texas, Florida and Georgia, consumer complaints and Department of Insurance.
Complaints often filed and associated with general liability claims.
Demonstrates knowledge of residential and commercial building construction, repair processes, and understands how to review and analyze the accuracy of damage reports prepared by contractors, engineers, and appraisers in order to assess property damage.
Demonstrates strong negotiations skills in alternative dispute resolution forums such as mediations and assists in finding early resolutions in order to obtain optimal outcomes when appropriate.
Demonstrates an understanding of reserving requirements and philosophies and is able to maintain appropriate reserves on all assigned claim files.
Identifies claims effectively with potential severity and institutional risk and timely escalates those claims with proper detailed reports detailing claim exposure, status, payments, reserve, litigation
The Attributes We Seek
Bachelor's degree in a related field or equivalent experience preferred. Juris Doctorate a plus.
8-10 years of general liability claims adjusting experience with exposure of $500,000 or more
Holds Proper Public adjuster licenses in Florida and/or Texas and other states with the ability to obtain additional licenses as needed
Our Competitive Benefits
Along with this great opportunity, FrankCrum also provides exceptional benefits from top carriers including:
Health Insurance is zero dollar paycheck cost for employee's coverage and only one-hundred-ninety-five dollars a month for family!
Dental and Vision Insurance
Short Term Disability and Term Life Insurance at no cost to the employee
Long Term Disability and Voluntary Term Life Insurance
Supplemental insurance plans such as Accidental, Critical Illness, Hospital Indemnity, Legal Services and Pet Insurance
401(k) Retirement Plan where FrankCrum matches 100% of the first 4% the employee contributes, and the employee is immediately vested in the employer match
Employee Assistance Program at no cost to the employee
Flexible Spending Accounts for Medical and Dependent Care Reimbursement
Health Savings Account funded by FrankCrum
Paid time off and holiday pay
Education reimbursement
PTO cash out
Tickets at Work
Access to the Corporate America Family Credit Union
Employee and client referral bonus programs
Disaster Relief Fund for employees
What's Special About FrankCrum
FrankCrum, a family-owned business-to-business entity since 1981 made of several companies: FrankCrum Corporate (a professional employer organization), FrankCrum Staffing, Frank Winston Crum Insurance Company, and the FrankCrum Insurance Agency - all based in Clearwater, Florida. This "family of employer solutions" employs approximately 500 people who serve over 4,000 clients throughout the United States. FrankCrum employees are trained to deliver high value through exceptional customer service and treat clients and coworkers like family. By living by our Brand Pillars (Integrity, Affinity, and Prosperity) employees are recognized at quarterly events for exceptional customer service and milestones in tenure.
The FrankCrum headquarters spans 14 acres and includes a cafe, subsidized for employees. Menus include made-to-order breakfast, hot lunch options and even dinners that can be ordered to-go, all at very affordable prices. The cafe also plays host to monthly birthday and anniversary celebrations, eating and costume contests, and yearly holiday parties. Through the input of its own employees, The Tampa Bay Times has recognized FrankCrum as a Top Place to Work for more than 10 years in a row! FrankCrum also supports several community efforts through Trinity Cafe, the Homeless Empowerment Program, and Clearwater Free Clinic!
If you want to play this role to positively impact our clients' day-to-day business, then apply now!
This job posting will remain open continuously and qualified applicants will be considered as applications are received.
Pay Data
As required by applicable state and/or local regulations the following pay data provides a reasonable estimate of the compensation range for this position at the time of posting. FrankCrum may ultimately pay more or less than the posted pay range due to many economic and individualized considerations. The pay offered to the selected candidate will be based on factors including, but not limited to qualifications, knowledge, licensure, skills, abilities, work experience, education, budget, training, employment trends, internal wage considerations, market dynamics, certifications, geographical location, assessments, and other business and organizational needs. The annualized pay range at the time of initial posting for this position is $105,000-$125,000. These figures represent the annualized pay for both hourly and salaried types of positions and does not indicate employment is on a yearly basis nor remove the employee's employment at-will status.
FrankCrum is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and pregnancy-related conditions), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, or any other characteristic protected by applicable federal, state or local laws and ordinances.
Privacy Policy CA Residents
#LI-GH1
$34k-60k yearly est. Auto-Apply 57d ago
Complex Claims Examiner
Heritage Mga LLC
Claim specialist job in Tampa, FL
This is an in office role. We have an opportunity to hire in either Sunrise, FL or Tampa, FL.
Manages complex and/or large exposure files to bring them to resolution. Analyzes and reviews claims for accuracy, completeness and eligibility. Resolves claims by investigating losses, calculating and negotiating settlements. Prepares and maintains reports and records for processing.
Investigates, evaluates, reserves, negotiates and settles assigned claims in accordance with Best Practices. Provides quality claim handling and superior customer service on assigned claims, while engaging in indemnity and expense management. Promptly manages claims by completing essential functions including contacts, investigations, damages development, evaluations, reserving, litigation management, and disposition.
Essential Duties and Responsibilities:
Handles 1st party property claims within all Heritage Companies states of moderate severity and complexity along with claims with large exposures as assigned, with little direction and oversight.
Delivers outstanding customer service to all internal, external, current, and prospective Heritage Companies customers. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service.
Conducts timely coverage analysis and communication with insured based on application of policy information, facts or allegations of each case. Consults with Unit Manager on use of Claim Coverage Counsel.
Performs detailed investigations and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate.
Identifies resources for specific activities required to properly investigate claims such as Subro, Fire or Fraud investigators and other experts. Requests through Unit Manager and coordinate the results of their efforts and findings.
Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
Maintains diary system, capturing all required data and documents claim file activities in accordance with established company guidelines.
Responsible for prompt, cost effective, and proper disposition of all claims within delegated authority.
Manages file inventory to ensure timely resolution of claims. Reports on pending claims and findings to the Claims Manager
Communicate and interact with a variety of individuals to foster the timely resolution of claims, including, but not limited to, policyholders, public adjusters, attorneys, vendors, and experts.
Reviews the insurance policy contract, policy endorsements and related documents to make a proper coverage determination.
Opens, closes, and adjusts reserves according to company practices to ensure reserve adequacy. Adheres to file conferencing notification and authority procedures.
Settles claim by determining insurance carrier's liability and negotiating agreement with appropriate parties according to company policy provisions.
Collects, updates and maintains all claim documentation including statements, pictures, reports, estimates, etc. and verifies the accuracy and completeness of claim forms.
Negotiates disposition of claims with insured and claimants or their legal representatives. Recognizes and implements alternate means of resolution.
Attends depositions, EUOs, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
Attends large loss meetings to discuss any claim concerns, and prepares any claim review forms as needed.
Updates appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
Write denial letters, Reservation of Rights and other complex correspondence.
Maintains current knowledge of local industry repair procedures and local market pricing.
Maintains compliance with Claim Department's Best Practices.
Represent the company as a technical resource, attend legal proceedings as needed, act within established professional guidelines as well as applicable state laws
Supports workload surges and/or Catastrophe operations as needed to include working significant overtime during designated CATs.
May coach, counsel, and/or train less-experienced staff.
Assist management when required with projects or leadership requests including travel as needed.
May act as back up in leadership absence.
Some overnight travel may be required.
Maintains the integrity of the company and products offered by complying with federal and state regulations as well as company policies and procedures.
Job Qualifications:
Bachelor's Degree preferred. A combination of education and significant directly related experience may be considered in lieu of degree.
6-20 Licensure required.
Will be required to obtain Adjuster License in all Heritage Companies states.
Three to five years of experience processing claims; property and casualty segment preferred.
Experience with Xactware products preferred.
Flexibility to work nontraditional hours.
Demonstrated ability to research, conduct proactive investigations and negotiate successful resolutions.
Proficiency with Microsoft Office products required; internet research tools preferred.
Demonstrated customer service focus / superior customer service skills.
Excellent communication skills and ability to interact on a professional level with internal and external personnel
Results driven with strong problem solving and analytical skills.
Ability to work independently in a fast paced environment; meets deadlines, and manages changing priorities effectively.
Detail-oriented and exceptionally organized
Collaborative partner; ability to contribute to a positive work environment.
General Information:
All employees must pass a pre-employment background check. Other checks may be needed based on position: driving history, credit report, etc.
The preceding has been designed to indicate the general nature of work performed; the level of knowledge and skills typically required; and usual working conditions of this position. It is not designed to contain, or be interpreted as, a comprehensive listing of all requirements or responsibilities that may be required by employees in this job. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.
Heritage Insurance Holdings, Inc. is an Equal Opportunity Employer. We will not discriminate unlawfully against qualified applicants or employees with respect to any term or condition of employment based on race, color, national origin, ancestry, sex, sexual orientation, age, religion, physical or mental disability, marital status, place of birth, military service status, or other basis protected by law.
$29k-47k yearly est. Auto-Apply 60d+ ago
Claims Specialist
Healthcare Support Staffing
Claim specialist job in Clearwater, FL
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Assesses insurance reimbursement for individual supplies to ensure maximum reimbursement
Verifies that all appropriate supporting documentation are obtained prior to shipment and/or prior to billing
Audits configuration of supplies based on supporting documentation, formulary requirements and manufacturer compatibility
Qualifications
High school diploma or GED equivalent
Minimum of two years of medical billing/collections/claims experience necessary.
Must be knowledgeable of reimbursement processes and procedures.
Ability to work with other employees and provide assistance as needed
Proficient in basic PC skills (MS Office)
Additional Information
Shift:
8-5 Monday-Friday
Advantages of this Opportunity:
Competitive salary $15-$16, based on experience
Growth potential
Excellent benefits offered: Medical, Dental, Vision, 401k and PTOFun
Positive work environment
$15-16 hourly 60d+ ago
PIP Adjuster I
TWAY Trustway Services
Claim specialist job in Tampa, FL
Investigate and adjust PIP claims of moderate complexity through their conclusion. The PIP adjuster will investigate coverage, medically manage files, pay medical bill as warranted and identify potential fraud indicators. This is inclusive of both PIP and Medpay claims.
Key Responsibilities
Complete initial and ongoing contact with insureds, medical providers and attorneys.
Obtain recorded statements as warranted.
Review and analyze policy language, case law and statutes and apply to claims handling.
Complete accurate coverage investigations to proper resolution.
Coordinate Independent Medical Examinations as warranted.
Establish proper reserves in accordance with company reserving guidelines.
Identify potential fraud indicators and work closely with Special Investigations Unit when appropriate.
Ability to work in a high volume, fast paced environment while maintaining accurate and detailed file handling.
Experience/Education:
Education: Bachelor's Degree or equivalent work experience.
Experience: Minimum of 2 years handling non-standard insurance PIP claims.
Must have an active Florida Adjuster's License
How much does a claim specialist earn in Riverview, FL?
The average claim specialist in Riverview, FL earns between $26,000 and $77,000 annually. This compares to the national average claim specialist range of $27,000 to $67,000.
Average claim specialist salary in Riverview, FL
$45,000
What are the biggest employers of Claim Specialists in Riverview, FL?
The biggest employers of Claim Specialists in Riverview, FL are: