Claim specialist jobs in Sanford, FL - 114 jobs

$2,500 Sign-On Bonus Payment Terms: $1000 paid after 30 days of employment, $1500 paid after 90 days of employment. Join America's most trusted brand with over 100 years of service HOW WE REWARD OUR EMPLOYEES UNLIMITED Income Potential *Average Earnings $75,000 - $100,000 (base plus commissions) Pay Structure * UNLIMITED LEADS, at no cost * Elevated tiered commissions for the first 12 months * Annual Base Pay $29,000 (non-exempt, eligible for overtime) ACG offers excellent and comprehensive benefits packages: * Medical, dental and vision benefits * 401k Match * Paid parental leave and adoption assistance * Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays * Paid volunteer day annually * Tuition assistance program, professional certification reimbursement program and other professional development opportunities * AAA Membership * Discounts, perks, and rewards and much more Why Choose AAA The Auto Club Group (ACG) * Lead generation of 14+ million members * Access to unlimited walk-in traffic and referrals * Online lead generation * Annual Sales Incentive Trip A DAY IN THE LIFE of a Field Life Agent The Auto Club Group is seeking a Field Life Agent who will customarily and regularly be engaged in outside sales activities away from their assigned AAA branch. You will be challenged to drive new business with competitive products and help retain The Auto Club Groups 14+ million members. * Solicit and sell Life & Health insurance and Annuity products under minimal supervision primarily within ACG branch location. * Thorough knowledge of various product features and marketing and sales techniques, achieve established sales goals. * Develop leads and prospects for new accounts through various marketing activities (outbound/inbound phone calls, mailings, referrals, networking, website, seminars, etc.) * Prepare proposals, and close sales of Life, Health, Annuity, Membership, and Financial Services products. * Complete appropriate applications, forms and follow internal processing procedures to ensure transactions are handled in accordance with company policies and practices. * Work collaboratively with others in the Branch to reach business goals, maximize leads, sales opportunities and take advantage of cross-sell opportunities. * Assist Underwriting and Brokerage Departments in satisfying requirements. * Respond to customer inquiries and problems and ensure sound sales practices are used. * Prepare reports documenting prospecting and sales activities, maintain specified production standards and persistency levels for all required products. What it's like to work for The Auto Club Group: * Serve our members by making their satisfaction our highest priority * Do what's right by sustaining an open, honest and ethical work environment * Lead in everything we do by offering best-in-class products, benefits and services * ACG values our employees by seeking the best talent, rewarding high performance and holding ourselves accountable WE ARE LOOKING FOR CANDIDATES WHO * Possession of valid State Life Sales licenses * Ability to take and pass LUTC or CLU coursework * Maintain Life and Health licenses required to sell products * Possession of a valid State driver's license * Must qualify, obtain, and maintain all applicable state licenses and appointments required for selling and/or servicing Auto Club Group Membership products Education * High School diploma or equivalent Work Experience * Minimum of 2 years' experience with a proven record of successfully soliciting and selling life insurance products * Experience selling intangible products Successful candidates will possess: * Strong working knowledge of Life Insurance and Annuity products and services * Ability to listen to and analyze customer needs and make recommendations to customers that best fit customers' needs and to promote a positive Member experience. * Effectively communicate complex information with prospective clients in a clear manner * Ability to prepare proposals and conduct closing interviews to sell Life and Annuity products. * Assessing and reflecting customer insurance requirements consistent with company standards when writing policies * Ability to perform mathematical calculations to determine premiums and values of Life insurance and financial products * Ability to build and maintain strong relationships with customers * Prospecting and developing new sales opportunities and meeting production requirements * Ability to work collaboratively with all team members to attain business goals. * Strong communication skills with others in the Branch to keep partners and branch management informed on sales and the disposition of any partner generated leads * Understands and can articulate to customers the tax and legal impacts the products have on Members * Strong organization, planning, time management and administrative skills * Representing Auto Club Life in a professional and positive manner * Safely operating a motor vehicle to travel to various locations to attend meetings or community events * Proficient writing skills to compose routine correspondence * Working independently with minimal supervision * Good PC skills including working knowledge of word processing, spreadsheet, presentation, and email. Work Environment * Works in a temperature-controlled office environment. * Limited travel required for community events, with exposure to road hazards and temperature extremes. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

Commercial Auto - Multi Line Claim Specialist Hours: Monday - Friday, 8:00 AM to 4:30 PM ET Salary Range: $83,000-$100,000 (commensurate based on experience) Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. Experience in commercial trucking with litigation and/or the ability to handle attorney represented settlements and some litigation. This role will be for a dedicated trucking client that will require consistent communication and trust building. Adjuster will need to be able to be available for calls but also provide reasoning and recommendation in a consultative manner. This role will join a small but mighty dedicated team. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10+ years multi-line claim experience is required. Bachelor's Degree is preferred. Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Nice to Have: • Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Why You'll Love Working Here • 4 weeks PTO (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) • Career growth: Internal training and advancement opportunities • Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions Compliance & audit performance - adherence to jurisdictional and client standards Timeliness & accuracy - purposeful file movement and dependable execution Client partnership - proactive communication and strong follow-through Professional judgment - owning outcomes and solving problems with integrity Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #ClaimsSpecialist #LiabilityClaims #HybridWork #FloridaJobs #InsuranceCareers #GeneralLiability #AutoClaims #MultiJurisdiction #FLAdjusters #CommercialAuto #NowHiring #InsuranceJobs #FLLiability #IND123 #LI-Hybrid We can recommend jobs specifically for you! Click here to get started.

Details Claims Examiner I - Commercial Auto Department: Property & Casualty Reports To: Claims Supervisor FLSA Status: Exempt in all state except California Job Grade: 9 Career Ladder: Next step in progression could include Claims Examiner II ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Examiner I to support our Property & Casualty department. Employees who live less than 26 miles from the San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. The Claims Examiner I is responsible for the timely investigation, evaluation and determination of settlement or denial of minor to moderate multi-line auto property and casualty claims. They will be handling claims from inception to closure. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated analytical, decision making and negotiation skills. Investigate coverage, including evaluate insurance coverage problems and/or disputes Investigate, evaluate and determine settlement value or denial of liability for all claims Develop a measure of damage for each loss, establish and maintain appropriate reserves Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure Ensure appropriateness of all payments Negotiate settlement of claim within individual authority ($15,000 unless otherwise noted) Maintain and update action plans for each claim May assign and coordinate with vendors, legal counsel, appraisers or experts as necessary Facilitate between claimants, clients, brokers and attorneys in resolution of liability claims Exchange information with clients, claimants, insurance brokers, inspectors, producers and account managers Provide customer service and support to insureds and claimants Assist in training of new employees Attend meetings and educational seminars for professional development Maintain required licenses ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL Additional State Adjuster License(s) may be required within 180 days Maintain licenses and continuing education requirements in all states Minimum of three years auto-claims handling experience, at least one-year commercial auto required Knowledge of property and casualty insurance policies Knowledge of auto insurance laws, codes, procedures, and liability concepts Proficiency in investigation and resolution of minor to medium level auto physical damage casualty claims Strong negotiation skills and ability to achieve optimal settlement results for clients. Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************* This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here

My name is Pondsy Anthony , and I am Recruiting Specialist with Mindlance Inc . I have reviewed your resume and at a first glance find it to be a good fit for a Position that we are exclusively recruiting for. We are working very closely with our Client based in FL to fill this requirement urgently. This is a 4+ months of contract position with a possible extension depending on performance. You can get back to me at ************ to discuss in detail. Job Description Job Title: Claim Specialist Client Location : 255 Technology Park, Lake Mary, FL 32746 Contract Duration : 4+ months (High possibility of Extension) ***Info about Schedules: - Candidates being selected need to be open for the contractor shift of either 9a-6p or 10a-7p or 11-8. - If contractors are hired on, they have to be available for shifts like 11a-8p and 12p-9p. Please let candidates know this! Looking for :- Candidates must have reimbursement experience that is within the past 6 months Prior authorization - submission, review, support, completion, verification Appeal - submission, review, support, completion, verification, coordination Reimbursement - investigation, verification JOB SUMMARY: The primary function/purpose of this job:- Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside of Express Scripts. Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. SCOPE OF JOB Reimbursement verification of enrollments MINIMUM QUALIFICATIONS TO ENTER THE JOB: Formal Education and/or Training: High school diploma or equivalent required, some college or technical training preferred YEARS OF EXPERIENCE: Two years' experience in P.B.M. environment is helpful but not required. KNOWLEDGE AND ABILITIES: • Strong data entry and 10-key skills • Retail pharmacy, customer service experience helpful but not required • PC and MS Office literate • Strong attention to detail • Excellent retention and judgment ability • Proficient written and oral communication skills • Ability to work in fast-paced, production environment • Reliable, self-motivated with excellent attendance • Team player who has the ability to stay on task with little supervision Qualifications • Prior authorization - submission, review, support, completion, verification • Appeal - submission, review, support, completion, verification, coordination • Reimbursement - investigation, verification Additional Information All your information will be kept confidential according to EEO guidelines.

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). This position enjoys a flexible, hybrid work schedule and is available in any location near a CNA office. JOB DESCRIPTION: 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-LG1 #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 ***************************.

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 Claim Specialist 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.

Introduction At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they're free to grow, lead, and innovate. You'll be backed by our digital ecosystem: a client-centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips. Here, you're not just improving clients' risk profiles, you're building trust. You'll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve. If you're ready to bring your unique perspective to a place where your work truly matters; think of Gallagher. Overview Ballator Insurance Group, now a part of Gallagher, is a national insurance organization that provides innovative insurance solutions to niche industry groups. We pride ourselves on cultivating lasting relationships with our clients by understanding their unique needs and providing tailored coverage that supports long-term success. As a Loss Control Specialist, you will play a vital role in providing consultative and analytical services to our clients. Your responsibilities will include reviewing and developing strategies to reduce risks and exposures through on-site evaluations and data-driven assessments. You will participate in claims reviews, collaborate with producers and attorneys, and help ensure the accuracy and effectiveness of our loss control programs. Success in this role requires a proactive and solution-oriented mindset, with a commitment to continuous improvement and cross-functional collaboration. This position is a hybrid role based out of the Orlando, Florida area. How you'll make an impact Claims Management * Monitor all lines of insurance claims via Third Party Administrator * Review claims for reserve accuracy and compliance with service instructions * Assist with action strategies to bring claims to cost effective resolution * Maintain detailed records of claims and prepare reports for management. * Identify claim trends and provide insights to improve risk strategies. Loss Control * Conduct risk assessments and safety audits for clients and internal operations. * Recommend corrective actions to minimize hazards and prevent losses. * Develop and deliver training programs on safety, compliance, and risk prevention. * Monitor effectiveness of loss control initiatives and adjust strategies as needed. Integrated Duties * Use claims data to inform and strengthen loss control strategies. * Provide a unified point of contact for clients on both claims and risk management. * Collaborate with internal teams to align claims handling with prevention efforts About You Required: Bachelor's degree or commensurate experience; 3 years' related experience in Safety, Risk, or Insurance. Ability to obtain appropriate licenses in all states where business is conducted. Excellent interpersonal, verbal and written communication skills. Proficiency in Microsoft Office. Moderate travel required, including some overnight travel. Ability to travel by automobile and aircraft and work outside or normal business hours as required. Ability to perform work on varied customer properties; entails negotiating non-public access areas, climbing, lifting, sitting, standing and walking for extended periods of time. Preferred: Associate in Risk Management (ARM), Associate in Safety Professional (ASP), Certified Safety Professional (CSP). " Behaviors: Interfaces effectively with management, clients, account teams and partners. Complies with all company policies and procedures, pro-actively protecting confidentiality of client and company information. Understands industry trends and governmental regulations. Efficiently organizes work and manages time in order to meet deadlines. Exercises discretion in confidential matters and uses independent judgment. Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you'll get, depending on your job level these benefits may improve: * Medical/dental/vision plans, which start from day one! * Life and accident insurance * 401(K) and Roth options * Tax-advantaged accounts (HSA, FSA) * Educational expense reimbursement * Paid parental leave Other benefits include: * Digital mental health services (Talkspace) * Flexible work hours (availability varies by office and job function) * Training programs * Gallagher Thrive program - elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing * Charitable matching gift program * And more... The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it's embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees' diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as "protected characteristics") by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

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 *****************************************

126205 Zurich is seeking an individual interested in growing their claims career with our General Liability team. As a General Liability (GL) Senior Claims Specialist on our IPZ (international Program) team you will work with a team of claims professionals with diverse experiences and backgrounds. This environment will support your development as you hone your technical skill set in GL policy interpretation and coverage analysis to resolve your claims effectively. At this level, you will handle single and multi-party personal or commercial line claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled most efficiently and effectively while delivering a customer-centric claims service. You will be expected to collaborate and develop partnerships with internal and external points of contact including customers, vendors, suppliers, and brokers to provide a quality claims experience. Additionally, you will learn and develop knowledge of established protocols and industry best practices to ensure that claims are handled in the most efficient, effective way while delivering a quality customer-centric claims experience. This position will work from one of the following office locations: Parsippany, NJ; Rocky Hill, CT, Atlanta, GA; Schaumburg, IL; Maitland, FL; or New York, NY Basic Qualifications: + Bachelor's Degree and 6 or more years of experience in the Claims and/ or Litigation Management area OR + High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area OR + Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area OR + Zurich Certified Insurance Apprentice, including an associate degree with 6 or more years of experience in the Claims and/ or Litigation Management area OR + Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area AND + Must obtain and maintain required adjuster license(s) + Microsoft Office experience + Knowledge of insurance regulations, markets, and products Preferred Qualifications: + 8+ years of experience handling commercial general liability claims within the area that includes litigated and severity ibodily njury and PD claims + 8+ years of experince with litigation management + 8+ construction expereince handling Bodily Injury and Property Damage OCIP/CCIP wrap up policies + Currently hold an active adjusters license + Experience collaborating across work groups ability to develop and maintain strong relationships + Understands claims adjustment process and possesses the ability to determine scope/exposure for losses + Understands the use of vendors and how litigation strategies are developed + Understands and applies financial and actuarial/reserving concepts. + Familiarity with negotiation strategies and experience in suggesting alternative approaches + Negotiation skills + Organizational and time management skills + MS Office + Customer service experience + Strong analytical, critical thinking, and problem-solving skills + Strong verbal and written communication skills Compensation for roles at Zurich varies depending on a wide array of factors including but not limited to the specific office location, role, skill set, and level of experience. As required by local law, Zurich provides in good faith a reasonable range of compensation for roles. For additional information about our Total Rewards, Click here (****************************************** . Other rewards may include short term incentive bonuses and merit increases. **C** andidates with salary expectations outside of the range are encouraged to apply, and will be considered based on experience, skill, and education. The salary provided is a nationwide market range and has not been adjusted for the applicable geographic differential associated with the location where the position may be filled. The starting salary range for this position is $72,800.00 - $119,200.00. As an insurance company, Zurich is subject to 18 U.S. Code § 1033. As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time ( ************************************ ). A future with Zurich. What can go right when you apply at Zurich? Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500 . Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please click here (********************************* to learn more. As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers' expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission. Location(s): AM - Rocky Hill, AM - Atlanta, AM - New York, AM - Parsippany, AM - Addison, AM - Maitland Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No

The Senior Claims Research Analyst provides senior-level support for claims processing and claims research. The Sr. Analyst, Claims Research serves as a senior-level subject matter expert in claims operations and research, leading the most complex and high-priority claims projects. This role involves advanced root cause analysis, regulatory interpretation, project management, and strategic coordination across multiple departments to resolve systemic claims processing issues. The Sr. Analyst provides thought leadership, develops remediation strategies, and ensures timely and accurate project execution, all while driving continuous improvement in claims performance and compliance. Additionally, the Sr. Analyst will represent the organization internally and externally in meetings, serving as a key liaison to communicate findings and resolution plans effectively. **Job Duties** + Uses advanced analytical skills to conduct research and analysis for issues, requests, and inquiries of high priority claims projects + Assists with reducing re-work by identifying and remediating claims processing issues + Locate and interpret regulatory and contractual requirements + Expertly tailors existing reports or available data to meet the needs of the claims project + Evaluates claims using standard principles and applicable state specific policies and regulations to identify claims processing error + Act as a senior claims subject matter expert, advising on complex claims issues and ensuring compliance with regulatory and contractual requirements. + Leads and manages major claims research projects of considerable complexity, initiated through provider inquiries, complaints, or internal audits. + Conducts advanced root cause analysis to identify and resolve systemic claims processing errors, collaborating with multiple departments to define and implement long-term solutions. + Interprets regulatory and contractual requirements to ensure compliance in claims adjudication and remediation processes. + Develops, tracks, and / or monitors remediation plans, ensuring claims reprocessing projects are completed accurately and on time. + Provides in-depth analysis and insights to leadership and operational teams, presenting findings, progress updates, and results in a clear and actionable format. + Takes the lead in provider meetings, when applicable, clearly communicating findings, proposed solutions, and status updates while maintaining a professional and collaborative approach. + Proactively identifies and recommends updates to policies, SOPs, and job aids to improve claims quality and efficiency. + Collaborates with external departments and leadership to define claims requirements and ensure alignment with organizational goals. **Job Qualifications** **REQUIRED QUALIFICATIONS:** + 5+ years of experience in medical claims processing, research, or a related field. + Demonstrated expertise in regulatory and contractual claims requirements, root cause analysis, and project management. + Advanced knowledge of medical billing codes and claims adjudication processes. + Strong analytical, organizational, and problem-solving skills. + Proficiency in claims management systems and data analysis tools + Excellent communication skills, with the ability to tailor complex information for diverse audiences, including executive leadership and providers. + Proven ability to manage multiple projects, prioritize tasks, and meet tight deadlines in a fast-paced environment. + Microsoft office suite/applicable software program(s) proficiency **PREFERRED QUALIFICATIONS:** + Bachelor's Degree or equivalent combination of education and experience + Project management + Expert in Excel and PowerPoint + Familiarity with systems used to manage claims inquiries and adjustment requests To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $106,214 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

AmTrust is a major player in the commercial P&C market and the third largest workers' compensation provider in the U.S. Our small business insurance product suite continues to expand with Cyber, BOP, Employment Practices Liability Insurance (EPLI), Package and other core coverages and capabilities, including more middle-market and large accounts. As a Workers' Compensation Claims Examiner Associate, you'll dive into investigating and resolving employee injury claims. You'll be the key link between injured workers, healthcare providers, employers, and legal teams, ensuring fair and efficient claim handling. Master examination by assessing liability through detailed evaluations, hone investigation skills by interviewing claimants and reviewing medical files and sharpen negotiation tactics for fair claim resolutions. Ultimately, you'll confidently settle claims using your investigative insights. Note, this is an in-office opportunity out of our Maitland, FL office. Responsibilities At AmTrust, we are excited about fostering organic growth and promoting from within! This training program is your gateway to an exciting Claims career journey. Our commitment to your growth doesn't stop when the training ends. AmTrust is dedicated to continually nurturing and training all adjusters to advance their careers in claims. Whether you're eager to climb the ranks in adjusting or aspire to leadership roles, we're here to develop top-notch adjusters and future leaders through this rewarding program! Qualifications Requirements 4-year degree OR 3 years of relevant experience - ideal candidate for the role is a recent graduate or early-career professional interested in a dynamic, intellectually engaging role. Strong analytical, communication, and problem-solving skills. Strong organizational abilities and attention to detail. Ability to work collaboratively and independently in a fast-paced environment. Interest in building a long-term career in insurance or claims management. Benefits 15-22 Paid Holidays and 18 days of PTO. Monday through Friday work schedule - no nights or weekends required. 401k Savings Plan Medical, Dental and Vision Health Benefits - including spouses and children. Internal Wellness Program with yearly discounts and incentives. Paid training and State Licensure. Why Claims? A Claims career is dynamic and intellectually stimulating, enhancing your skills in policy interpretation, legal understanding, and medical expertise. You'll collaborate with defense attorneys, engage in trials and mediations, and hone investigative, analytical, and negotiation skills. Exposed to facets like Underwriting, Loss Control, Managed Care, and SIU, Claims opens diverse career paths with technical and leadership growth-perfect for making an impact and building a lasting career. Why Insurance? AmTrust provides insurance protection, warranty programs and risk management expertise to small businesses, professional and financial services firms, retailers, and manufacturers worldwide. The insurance industry is vital for economic stability, offering financial protection and career opportunities with $932.5 billion in premiums and 2.98 million US employees in 2024. Careers include Claims, Loss Control, Underwriting, Actuary, and Sales, with resilience to economic fluctuations and skills transferable across sectors. The expected salary for this role is $26.50/hr. Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations. What We Offer AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off. AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future. Not ready to apply? Connect with us for general consideration.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Complex Casualty Adjuster **PRIMARY PURPOSE** **:** Handles complex, technically challenging claims on automobile, homeowner, and excess liability policies. Adjusts claims with complex coverage issues involving liability, damages, evidence, or other complex legal issues, while providing an exceptional customer experience. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Adjusts claims that arise on Automobile, Homeowner and Excess Liability policies. + Develops exposures and evaluates injury claims based on damages, the insurance contract, company policies, and applicable state laws. + Investigates and evaluates coverage, liability and damages in handling of claims involving serious and catastrophic injuries, coverage, and other legal issues. + Ensures timely referral of suits to counsel and evaluates changes in exposure through the course of discovery, considering costs and strategic plan of actions to prepare for trial or determine settlement capability. + Responsible for managing defense counsel in litigation of serious and complex claim, litigated claims as well as complex coverage scenarios; manages defense counsel in litigation of serious and complex claims. + Formulates effective plans to bring the claims to resolution while focusing on indemnity and expense leakage. + Evaluates coverage and drafts coverage letters to include both reservation of rights and coverage denials. + Maintains proper reserves on all pending claims. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Travel as required **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. State mandated adjusting licenses as required. Insurance designations such as CPCU, AIC, ARM preferred. **Experience** Eight (8) years of related experience to include experience in personal lines claims, evaluating coverage and drafting coverage letters to include both reservation of rights and coverage denials, or equivalent combination of education and experience required. Experience with commercial lines claims and litigation in multiple states preferred. **Skills & Knowledge** + Exposure to and knowledge of affluent market segment + Strong knowledge of tort theories, legal concepts, negotiation strategies, and litigation management + Excellent oral and written communication skills, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Excellent interpersonal skills + Excellent negotiating skills + Ability to create and complete comprehensive, accurate and constructive written reports + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** **:** Computer keyboarding, travel as required **Auditory/Visual** **:** Hearing, vision and talking As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($85,000 - $120,000 USD annually). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly. Job Description Kelly Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location. In addition to working with the world's most recognized and trusted name in staffing, Kelly employees can expect: Competitive pay Paid holidays Year-end bonus program Recognition and incentive programs Access to continuing education via the Kelly Learning Center Pay $15 - $16 per hour Schedule: Monday through Friday - 9:00am - 6:00pm Duration: 4 months possible extension (Possible temp - perm) Anticipated start date: 10/31/2016 to 03/31/2017 SUMMARY Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved. MAJOR JOB DUTIES AND RESPONSIBILITIES Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. EDUCATION/EXPERIENCE High School Diploma or GED Required 1-3 years of Call Center and Reimbursement experience required Knowledge of completed benefits verifications, submitted test claims, completed or reviewed prior authorizations required Strong data entry and 10-key skills Proficient in MS Word and Excel Additional Information Why Kelly? As a Kelly Services candidate you will have access to numerous perks, including: Exposure to a variety of career opportunities as a result of our expansive network of client companies Career guides, information and tools to help you successfully position yourself throughout every stage of your career Access to more than 3,000 online training courses through our Kelly Learning Center Group-rate insurance options available immediately upon hire* Weekly pay and service bonus plans

Job Description Claims Adjuster Trainee Onsite in Lake Mary, FL At Frontline Insurance, we are on a mission to Make Things Better, and our Claims Adjuster Trainee plays a pivotal role in achieving this vision. We strive to provide high quality service and proactive solutions to all our customers to ensure that we are making things better for each one. What makes us different? At Frontline Insurance, our core values - Integrity, Patriotism, Family, and Creativity - are at the heart of everything we do. We're committed to making a difference and achieving remarkable things together. If you're looking for a role, as a Claims Adjuster Trainee, where you can make a meaningful impact and grow your career, your next adventure starts here! Our Claims Adjuster Trainee enjoy robust benefits: Health & Wellness: Company-sponsored Medical, Dental, Vision, Life, and Disability Insurance (Short-Term and Long-Term). Financial Security: 401k Retirement Plan with a generous 9% match Work-Life Balance: Four weeks of PTO and Pet Insurance for your furry family members. What you can expect as a Claims Adjuster Trainee: Orientation & Licensing - Complete onboarding and obtain required state licensing. Policy Interpretation - Learn insurance policy provisions and coverage details. Application & Assessment - Apply specific regulations and complete final evaluation. Customer Service & Communication - Develop skills for effective client interaction and support. Claims Lifecycle & Systems - Understand end-to-end claims process and system navigation. Property Construction & Materials - Gain knowledge of building components and materials Estimating- Learn fundamentals of property damage estimation. Investigation & Evidence - Acquire techniques for gathering and evaluating claim evidence. Coverage Evaluation - Assess policy coverage and determine claim applicability. Subrogation & Liability - Understand recovery processes and liability principles. Dispute Resolution - Learn strategies for resolving conflicts and claim disputes. Field Operations - Participate in on-site inspections and fieldwork procedures. Obtain the Florida Adjuster's license within 60 days of hire Obtain all other required state licenses within 90 days of hire. As necessary, upon acquisition of required licensing: Deliver empathetic, customer-focused service throughout the claim lifecycle: coverage analysis, investigation, evaluation, reserving, negotiation, and resolution. Apply policy interpretation and coverage evaluation skills to ensure fair and transparent claim outcomes. Conduct thorough claim investigations, including on-site inspections, recorded statements, and other evidence gathering. Utilize estimating tools and systems to assess property damage accurately. Collaborate with team members and stakeholders to resolve disputes and support subrogation and liability processes. Maintain compliance with internal quality standards and state regulations. Assist with catastrophe operations as required, including, but not limited to working extra hours during major events or deploying to affected areas to help policyholders. What we are looking for as a Claims Adjuster Trainee: Bachelor's degree is preferred or minimum one year of work or customer service experience. Strong organizational, time management, and communication skills. Proficiency in Microsoft Office (Word, Excel, Outlook) Ability to work independently and collaboratively in a fast-paced, high-volume environment. Why work for Frontline Insurance? At Frontline Insurance, we're more than just a workplace - we're a community of innovators, problem solvers, and dedicated professionals committed to our core values: Integrity, Patriotism, Family, and Creativity. We provide a collaborative, inclusive, and growth-oriented work environment where every team member can thrive. Frontline Insurance is an equal-opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

Job Description Cottingham & Butler Claims Services (CBCS) was built upon driven, ambitious people like yourself. "Better Every Day" is not just a slogan, it is a promise we make to ourselves and our clients. We are looking to hire an experienced Southeast Work Comp Claims Supervisor to our team. We are looking for someone who is eager to motivate and develop adjusters of all levels. If you're ready to make a significant impact and drive excellence, we want to hear from you! Key Expectations for the Claims Supervisor Role: Accountability and Feedback: Ensure that the team receives regular, high-quality feedback to drive accountability. Team Metrics: Maintain weekly metrics in the green. If a team member is not meeting expectations, develop and document plans with the Claims Manager to improve performance. Quality Service Review (QSR) Scores: Achieve monthly QSR scores of 90%+ for the team and address any underperformance with actionable plans. Monthly Meetings: Arrange monthly meetings with the team to align on goals, discuss challenges, provide training, and foster collaboration. Customer Service Survey Scores: Maintain an average score of 1.30 or less. Use survey results as coaching opportunities and ensure follow-up discussions. Mentorship and Teammate Development: Act as a mentor and actively contribute to developing your team of adjusters. Experience Requirements: The ideal candidate must have substantial experience in the Southeast region and possess a strong background in achieving results. We are looking for a critical thinker who is eager to collaborate with other like-minded professionals to drive growth and strengthen our business. A minimum of 1-5 years of claims supervision is required. Do you think this might be a fit for you? Send us your resume - we'd love to talk! Pay & Benefits Salary - Flexible based on your experience level. Most Benefits start Day 1 Medical, Dental, Vision Insurance Flex Spending or HSA 401(k) with company match Profit-Sharing/ Defined Contribution (1-year waiting period) PTO/ Paid Holidays Company-paid ST and LT Disability Maternity Leave/ Parental Leave Company-paid Term Life/ Accidental Death Insurance About the company At Cottingham & Butler Claims Services, we sell a promise to help our clients through life's toughest moments. To ensure we keep that promise, we hold ourselves to a set of principles that we believe position our clients and our company for long-term success. Our Guiding Principles are not just words on paper, they are a promise we make to ourselves and our clients. These principles have become a driving force of our culture and share many common themes with the values of our clients. First, we hire and develop amazing people that have an insatiable desire to succeed, are committed to learning, and thrive on challenges. Secondly, we pride ourselves on serving our clients' best interests through quality service, innovative solutions, and constantly evaluating our performance. Third, we have embraced and are guided by the theme of "better every day" constantly pushing ourselves to be better than yesterday. Ultimately, we get more energy from the future we are creating for our people, our clients, and our company than from our past success. As an organization, we are very optimistic about the future and have incredibly high expectations for our people and our performance. We also understand that our growth is fueled by becoming better, not bigger - growth funds investments in new resources to better serve our clients and provide the career opportunities our employees want and deserve. This is why we are a growth company and why we are committed to being better every day.

Our client is seeking to add a PIP Claims Examiner to their. This person would be responsible for directly handling moderate to complex New York PIP claims. Responsibilities of this position include coverage analysis, investigation, reserving, and settlement of assigned NY PIP claims. Develop plan of action to proactively conclude claims, timely evaluate damages, engage other parties in negotiations and settle claims pursuant to guidelines. Establish and maintain proper reserves for each claim to accurately reflect the financial exposure. Requirements: 8+ years of experience handling NY PIP claims NY License Required Experience handling PIP claims in other jurisdictions a plus! Bachelors Degree Preferred Need to be proficient in Microsoft Word and Excel Knowledge of applicable claim procedures, statutes, compliance, insurance laws and insurance coverage Salary/Benefits: $75,000- $85,000/+year (based on experience) Annual bonus potential Medical, Dental, and Vision benefits #LI-MW1 #LI-PR1

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

Job Description CLAIMS REPRESENTATIVE I Investigates, determines liability, confirm coverage, establishes damages, and negotiates settlement of auto, property and light general liability claims for a Member based organization in accordance with approved policy & procedure and industry Best Practices. This position does not handle injury, complex or litigated claims. RESPONSIBILITIES AND DUTIES: Responsible for the investigation of assigned auto, non-complex general liability, and first-party property cases in compliance with prescribed industry best practices. This includes verifying coverage, determining liability, evaluating damages, establishing reserves, reporting status, and negotiating appropriate settlements for each claim. Possesses a certain level of financial authority to settle independently. Maintains an appropriate diary and documentation as to file activity. Makes determination and handles files with subrogation potential. Works with Independent Appraisers to estimate the cost of repair or replacement of damaged or stolen vehicles / damaged property. Reports theft, fraud, and arson losses as required to state and industry agencies, as appropriate. Performs most duties on an individual basis, and work has a direct bearing on Management results. Represents the Company from a public relations standpoint and must conduct oneself appropriately at all times. Personal contacts are a major part of activity and include Members, claimants, witnesses, vendors, repair facilities, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses and all other person's incident to the investigation and processing of claims. Attends required or necessary training sessions, courses to maintain their license credits and to maintain up to date knowledge & skills. Performs other duties as assigned. KNOWLEDGE, SKILLS AND ABILITIES: Excellent negotiation, analytical and interpretive skills Excellent oral, written communication and presentation skills Strong organizational and interpersonal skills Superior customer service skills Able to multitask and set own priorities Works well under pressure Should be used to and able to function effectively in a fast-paced environment. Able to establish and maintain effective working relationships with department heads, managers, employees, and vendors. Government claims background is a plus. Physical Requirements include: Bending, Pulling, Sorting, Carrying up to 20 lbs., Pushing, Speaking (English), Climbing, Reaching, Standing, Key entering, Reading (English), Walking, Kneeling, Seeing, Writing (English) Should be able to type 35 WPM. Spanish fluency is a plus. TRAINING AND EXPERIENCE: Position requires a degree from an accredited College/University in business or insurance preferred or equivalent experience in industry. One to three years of experience in insurance industry as a Customer Service Representative or Property or Auto Liability (no injury) adjuster. Knowledge of Microsoft Office products a must. Must have an active Florida Adjusters License. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. **PLEASE DO NOT APPLY IF YOU ARE A SMOKER** Classification: Exempt Dept: Property & Liability Reports to: Claims Supervisor

**We Put the World on Vacation** Travel + Leisure Co. is the world's leading vacation ownership and travel membership company, with a dynamic and growing portfolio of resort, travel club, and lifestyle travel brands. Our dedicated associates help the company achieve its mission to put the world on vacation. Innovation and growth keep our work interesting and fun. Every day is a chance to learn something new and turn vacation inspiration into exceptional experiences for millions of travelers worldwide. The **Senior Property Claims Analyst** will play a crucial role as part of a high-performing, results-oriented Risk Management Team. The Senior Property Claims Analyst will be accountable for all aspects of property claim recordkeeping including catastrophic and complex claims projects as well as maintaining accurate cost estimation of claims within the deductible. This role also involves supporting coordination with all internal and external stakeholders to deliver exceptional services. The business partners may include Procurement, Legal, Accounting, Brand Services, IT, Resort Management, Sales & Marketing, Inventory Management, Architects, Interior Designers, Engineers, Contractors and Specialty Consultants. This role is hybrid in office Monday, Tuesday and Wednesday, and remote Thursday and Friday. **How You'll Shine:** + Functions with autonomy to support property claims meetings, evaluation of causation and damages to determine potential exposure; coaching properties to set appropriate estimates to reflect probable outcomes; and taking appropriate action to help the properties move claims toward resolution. Coordinates and liaises with internal and external project management, insurance brokers, adjusters and appropriate resort staff. + Maintain or capture new property data points such as valuations, claims, or organizational process improvements into the risk management information system (RMIS) to further drive analytics. + Maintain and provide daily loss reports reflecting aggregate claims activity, types of losses, location of losses, dollar amount of losses, payments received from insurance company and other information as necessary. + Assist in developing property underwriting submissions including gathering and assembling loss and exposure information from different segments of the company. + This position requires a proactive and collaborative mindset and the ability to work well in a team environment. Must have accountability to see that all responsibilities are carried out properly and expeditiously. + Other risk management and insurance responsibilities as assigned by the director risk finance. **Travel Requirements** + Very minimal travel, with potential for site visits post business interruption or attending risk related training or conference **What You'll Bring:** + Bachelor's degree preferred in related field + Risk Management Information System (RMIS) experience preferred but not required. Associate in Risk Management (ARM) a plus but not required. + Demonstrated ability to work under pressure and possess good written and oral communication skills. + Microsoft PowerPoint, Excel (intermediate), copilot a plus. + Prior experience in project management preferred. Cost Accounting experience is an advantage. + Experience building and renovating in the Hotel, Vacation Ownership or Multi-Family Resort Fields is preferred. + Knowledge in aspects of construction and renovation, including architectural, electrical, mechanical, plumbing and structural design is a plus. + 5 years of experience in either property claims management, accounting or project management preferably in the financial services and/or insurance industry. _Experience equivalent to the education requirement may be accepted in lieu of the education requirement._ **How You'll Be Rewarded:** We offer a diverse range of comprehensive health and welfare benefits to associates who work 30 or more hours per week to meet your needs and support you throughout your career with us. Travel + Leisure Co. benefits include: **_Note: Temporary and/or seasonal associates are ineligible for Paid Time Off._** + Medical + Dental + Vision + Flexible spending accounts + Life and accident coverage + Disability + Depending on position, paid time off, parental leave and holidays (speak to your recruiter for additional information) + Wish day paid time to volunteer at an approved organization of your choice + 401k with employer match (subject to eligibility requirements, including tenure - speak to your recruiter for additional information) + Legal and identify theft plan + Voluntary income protection benefits + Wellness program (subject to provider availability) + Employee Assistance Program **Where Memories Start with You** Hospitality is at the heart of all we do at Travel + Leisure Co. Here, you'll find an inclusive environment where we deliver excellence and take time to have fun, celebrate together, and support one another. We're always looking ahead to what's next and how we can strengthen our business, its neighboring communities, and the customer experience. Join our global team and build a career where memories start with you. We are an equal opportunity employer, and all applications will be considered for employment without attention to their membership in any protected class. If you require any reasonable accommodation to complete your application or any part of the recruiting process, please email your request to ***************************** , including the title and location of the position for which you are applying.