Claims account manager jobs near me - 717 jobs

Account Manager - Healthcare Supply Chain 📍 Remote (U.S.) | Occasional Travel to Clearwater, FL 🕒 Full-Time | Sales (SRG) Surgical Resources Group (SRG) delivers innovative healthcare supply chain solutions that help hospitals, ambulatory surgery centers (ASCs), and healthcare systems reduce costs while improving efficiency. We specialize in surgical product sales, surplus liquidation, inventory management, and cost-saving supply chain solutions. The Opportunity We're looking for a motivated Account Manager to help grow our healthcare client base and strengthen existing relationships. In this role, you'll act as a strategic partner to healthcare leaders, helping them solve procurement challenges through smart, cost-effective supply chain solutions. This is an ideal opportunity for a sales professional who thrives in relationship-based selling, enjoys working independently, and wants to make a measurable impact in healthcare. What You'll Do Prospect and develop new healthcare accounts within hospitals, ASCs, and healthcare systems Manage and grow an assigned territory and existing account list Build strong relationships with supply chain, clinical, and executive decision-makers Lead virtual meetings to assess needs and present SRG solutions Develop customized proposals, pricing, and cost-savings analyses Negotiate and close contracts for surgical supplies and supply chain services Collaborate with Operations, Customer Service, and Marketing teams Maintain accurate CRM data, forecasts, and sales activity reporting Consistently meet or exceed sales goals What We're Looking For 2+ years of quota-carrying sales experience (healthcare, medical device, or medical supply preferred) Proven success by closing and managing accounts Experience selling to mid-level and senior healthcare decision-makers Strong communication, presentation, and negotiation skills Ability to manage the full sales cycle independently Comfortable working remotely and managing a territory Bachelor's degree preferred Nice to Have Medical device, surgical supply, or healthcare distribution experience Healthcare supply chain or hospital procurement background Compensation & Perks Competitive base salary Performance-based commission structure Growth and advancement opportunities Work-from-home flexibility Why Join SRG? Being part of a growing healthcare organization is making a real impact Work with industry-leading hospitals and surgical centers Join a collaborative, results-driven sales team

The MDU Account Manager is a critical, high-impact role responsible for maximizing subscriber penetration and driving revenue within a dedicated portfolio of Multi-Dwelling Unit (MDU) properties across multiple markets. This position requires a candidate with a minimum of 2+ years of direct, prior experience in an Account Management or Business Development capacity specifically within the MDU sector (e.g., Telecom/Broadband, Property Management, or Real Estate industries serving MDUs). The successful candidate will act as the primary relationship owner, tasked with building and strengthening partnerships with key property stakeholders, including Owners, Property Managers, and Leasing teams. A core function of this role involves developing and executing strategic sales plans, hosting frequent on-site resident engagement events (including evenings and weekends), and managing a multi-market territory, which requires up to 50% travel. This role is essential for converting signed access agreements into active, high-penetration properties and requires a self-starter who has successfully performed this exact job function previously. Classification: Exempt. Non-Bargaining Location: Remote in the ME, NH or VT territory Responsibilities Build, grow, and strengthen professional relationships with key decision-makers, including Property Managers, Leasing Managers, Community/HOA Boards, and Property Owners. Serve as the primary point of contact for all assigned MDU properties, addressing their needs and ensuring a high level of satisfaction with our services. Conduct regular on-site visits to assigned properties to maintain visibility and reinforce partnerships. Travel regularly between assigned markets to manage a multi-market portfolio effectively. Drive subscriber penetration and revenue growth within properties where we have active access agreements. Develop and execute strategic, property-specific sales and marketing plans to achieve penetration goals. Collaborate with the sales team to transition properties from the contract signing phase to the penetration phase successfully. Plan, coordinate, and host engaging on-site events for residents at properties with access agreements or bulk internet agreements (e.g., resident appreciation events, open houses, launch parties). Manage marketing collateral distribution and ensure optimal placement of promotional materials on-site. Utilize events and other marketing initiatives to generate leads and sign-up new subscribers. Monitor contract compliance and ensure all access agreement terms are met. Track and report on key performance indicators (KPIs) such as penetration rates, event attendance, and property relationship strength. Provide regular updates to leadership on portfolio performance and potential risks/opportunities. Qualifications Minimum of 2+ years of prior, direct experience operating in an Account Manager or Business Development capacity specifically within the Multi-Dwelling Unit (MDU) space (e.g., Telecom/Broadband, Property Management, or Real Estate industries serving MDUs). Candidate must have prior experience focused on driving penetration, building property relationships, and hosting resident engagement events. Proven track record of meeting or exceeding sales/penetration goals. Exceptional interpersonal and relationship-building skills. Strong presentation and communication skills (written and verbal). Self-motivated, proactive, and capable of managing a large portfolio of accounts independently. Proficiency in CRM software (e.g., Salesforce) and Microsoft Office Suite. Ability to plan and execute successful resident-facing events. Bachelor's Degree in Business, Marketing, or a related field (or equivalent work experience). Must have a valid driver's license and reliable transportation. Travel requirement is estimated to be up to 50%, involving frequent site visits and travel between assigned markets. Ability to work flexible hours, including some evenings and weekends to host resident events. Benefits Offered We are proud to offer a comprehensive and competitive benefits package: 401(k) matching Medical, Rx, Dental and Vision insurance Disability insurance Flexible spending account Health savings account Life insurance Tuition reimbursement Paid vacation and personal days Paid holidays Employee Assistance Program Annual bonus program to eligible employee's based upon organization performance Salary Pay range (commensurate with skills and experience): $55,000 - $65,000 + commission Equal Opportunity Employer All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, sexual orientation, national origin, marital status, familial status, genetics, disability, age, veteran status or any other characteristic protected by law.

Grow with Confidence. Pro Ag Management, Inc. (“ProAg”) is seeking an experienced insurance claims manager to lead and oversee our national claims operations as National Claims Manager. This position manages a team of almost 200 loss adjustment professionals operating in 42 states, ensures regulatory compliance while delivering a high level of customer service, and drives results within claims. Reporting directly to the COO, the successful candidate will demonstrate exceptional leadership and decision-making skills, along with a proven track record of effectively managing claims operations. This Exciting Opportunity, You Will: Drive Excellence in Claims Operations: Establish and maintain high standards to drive accurate and timely adjustment of crop insurance loss claims within regulations while providing a high level of customer satisfaction in claims handling with both agents and insureds. Implement best practices while understanding ProAg's systems, procedures, and claims handling philosophy to optimize workflows, reduce cycle times, and ensure compliance with regulatory and company standards. Provide People Leadership: Build a high-performing team through coaching, mentoring, and succession planning. The ideal candidate will possess a strong drive and a genuine interest in achieving both company and personal development goals. Provide Thought Leadership: Serve as a strategic advisor on claims trends, regulatory changes, and industry innovations. Influence organizational direction through insights and expertise. Collaborate with internal departments and external partners to resolve complex claim issues. Lead Process Improvement and Innovation Initiatives: Identify opportunities to streamline processes, enhance automation, and improve overall claims performance, utilizing process optimization and technology resources. What You'll Bring: 8-10 years of claims management. 5+ years of leadership experience involving large teams Bachelor's degree in business or insurance, or equivalent experience Strong knowledge of insurance regulations, claims processes, and industry standards. Excellent analytical, problem-solving, and decision-making skills. Exceptional communication and leadership abilities. Proficiency in claims management systems, Microsoft Office Suite, and data management technology. The Company: ProAg, a member of the Tokio Marine HCC group of companies, is positioned as a financially strong and well-capitalized insurer with an AM Best rating of A++. With more than 90 years of service to our agents & insureds, we stand committed to continuing the principles that ProAg was founded on: Integrity, Loyalty and Customer Service. What We Represent: Part of something bigger: We offer a career with purpose as you support the foundation of risk management for farmers and ranchers who create food and fiber for the world. Personal connections: We are built on strong relationships and appreciation of your individuality. A team who cares: We look out for each other personally and professionally because we care about each other. Innovators by trade: We're committed to a brighter tomorrow for our team members and agriculture. The best of both worlds: We combine personal connections with powerful resources, thanks to our culture and the backing of Tokio Marine HCC. The pay range for this role is $120,000 to $180,000 annually, commiserate with experience and expertise. This role may also be eligible to participate in the discretionary annual bonus program. As a part of the Tokio Marine HCC Group of Companies, ProAg offers a competitive salary and employee benefit package. We are a successful, dynamic organization experiencing rapid growth and are seeking energetic and confident individuals to join our team of professionals. The Tokio Marine HCC Group of Companies is an equal-opportunity employer. Please visit ********************** for more information about our companies. #LI-MK1

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ************************** How YOU will make a Difference: The Claims Operations Manager will oversee the end-to-end processing of healthcare claims. The manager is responsible for leading the HMA Claims Operations staff and their daily work requirements. Leveraging metrics and forecasts; they prioritize workload and resourcing to maximize operational production in partnership with vendor resources and liaisons. The manager will lead a team responsible for claims intake, pricing, adjudication, coordination of benefits and issue resolution while driving operational excellence What YOU will do: Direct supervisory responsibilities: Manages and coaches individual contributor's performance and quality. Assess and manages claims inventory: Tracks and manages inventory trends and proactively adjusts resource levers as needed to maximize productivity Manage daily operations of claims processing, ensuring accuracy, timeliness, and compliance with healthcare policies and federal guidelines Create daily updates for management team flagging production rates, critical issues and areas of escalation in real time Monitor and resolve pricing discrepancies impacting claims adjudication and provider payments. Lead initiatives to improve pricing workflows, automation, and system performance. Vendor auditing &QA: Leads vendor audits and manages reporting to ensure vendor quality. Apply subject matter expertise to the business of claims processing and operations Manage to vendor agreements, proactively identify and flag issues, escalate appropriately Develop and maintain workflows and documentation specific to claims processing. Train and coach staff and vendors on claims processes as needed Motivate talent: Ability to motivate and lead team members and vendors in accordance with HMA values and objectives Talent planning: Proactively review and assess talent. Continually develop and/or recruit talent to meet objectives Requirements Knowledge, Experience and Attributes: Bachelor's Degree or equivalent work experience Minimum 5 years' of claims operations experience, self-funded health plan experience is a plus Minimum 2 years' of people leading experience Experience with claims platforms such as HealthEdge, Mphasis, or Facets Knowledge of CPT, HCPCS, ICD-10 coding, and reimbursement methodologies. Strong understanding of provider contract terms, fee schedules, and pricing models (e.g., DRG, APC, RBRVS). Proven ability to manage and develop a team of highly skilled staff Proven ability to manage and interact with vendors to support execution of work within the SLA's established Benefits Compensation: The base salary range for this position in the greater Seattle area is $100,000-$123,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit

Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Director I Claims is responsible for directing the auditing of claim payments. Provides guidance on the most complex claims. How you will make an impact: * Develop strategies to improve claims efficiency. * Develop short/long-term objectives and monitor procedures to ensure these are met by staff. * Ensures area is staffed and trained. * Familiarity of state and federal regulations. * Hires, trains, coaches, counsels and evaluates performance of direct reports. * Light travel may be required. Minimum Requirements: Requires a BA/BS and 7 years leadership experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: * In depth knowledge of claim processes preferred. * Experience in claim auditing preferred. * Knowledge of claims systems (CIW and/or WGS) preferred. * Understanding of insurance policies preferred. * Strong leadership and team management skills to effectively lead and motivate a team preferred. * Excellent analytical and problem-solving skills to evaluate claims and develop improvement strategies preferred. * Strong organizational and multitasking abilities to manage multiple projects and deadlines preferred. * Strong written and oral communication skills, problem solving skills, attention to detail and well organized preferred. * Knowledge of stop loss product is preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $129,096 to $193,644. Locations: Minnesota. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

About Us All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 401k plan. Additional employee paid coverage options available. Job purpose The Director of Claims Audits is responsible for post and pre auditing institutional and professional claims according to established line of business guidelines, policies and procedures. This job includes achieving 95% or higher claims compliance. Process improvement of the claims process to achieve quality claims adjudication within CMS, DHCS and DMHC timeliness guidelines. Duties and responsibilities Institutional Claims Review for accuracy and timeliness using HP audit tools to capture Root Cause, Remediation and QA monitoring. Professional Claims Review for accuracy and timeliness using HP audit tools to capture Root Cause, Remediation and QA monitoring. Claims system quality improvement collaboration (all departments that touch a claim) Collaborative Claims team training on items found during audits for process improvement Claims workflow monitoring (all departments that touch a claim) Other requests as needed Qualifications 10+ years or more experience in processing HMO claims in a managed care environment. Proficient in rate application for all payments methods by lines of business. (Medicare, Commercial, Medi-Cal). Including but not limited to, NCCI/CCI edits, CMS Medicare, Medi-Cal, RNC, outpatient PPS & Inpatient DRG facility, ASC, APC, Interim Rate Payment Expert with all regulatory requirements including CMS, DMHC and DHS. Proficient with all Federal and state requirements in claim processing. Knowledge of medical terminology and coding. Recognize the difference between Shared Risk and Full Risk claims. Proficient in applying Division of Financial Responsibility. Knowledgeable in applying Health Plan Benefit Matrices. Proficient understanding of AB1324. Proficient understanding of AB1455 Claims Settlement Practice & Dispute and Resolution regulations. Medical Record Coding Review as it pertains to administrative billing and coding. Excellent communication skills including reports, correspondence, and verbal communications. Demonstrated proficiency with Microsoft Word and Excel.

Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike. We have ambitious (but attainable!) goals and need adjusters who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can't wait to meet you. About the role As a Director of Commercial Transportation Claims at Reserv, you will be responsible for a team of Claims Professionals overseeing a wide variety of Commercial Transportation claims, including but not limited to Trucking, Garage Keeper, Specialty Vehicle, Rideshare/TNC, and Delivery claims. We want your background and experience to drive operational effectiveness, with a focus on leveraging technology and analytics to improve efficiency and performance in the Commercial Transportation space. In this role, you will play a critical part in working with your team, customers, and clients to ensure high-quality standards are maintained, while adhering to regulatory requirements and both internal and external contractual SLAs. This position requires exceptional leadership skills and a strong understanding of state and federal transportation rules and regulations, ideally with experience managing or handling large, complex claims portfolios. Who you are Highly motivated and growth-oriented Subject matter expert. You have deep technical and subject matter experience in the world of commercial transportation claims, including coverage and litigation. Experienced in reviewing and analyzing contracts Tech-oriented. You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics Passionate claims professional who cares about their team, the customer, and their experience Empathetic leader. You exercise empathy and patience towards everyone you interact with Sense of urgency - at all times. That does not mean working at all hours Creative. You challenge existing assumptions and find ways of leveraging technology and the talents of your team to address problems Curious. You want to know the whole story so you can make the right decisions early and be decisive when it counts. Problem solver. You have the ability to take a ‘deep dive' into the details of the business while staying focused on the big picture Anti-status quo. You don't just wish things were done differently, you action on it Communicative. You are comfortable with and understand the importance of phone communications throughout the claims process And did we mention, a sense of humor. Claims are hard enough as it is. What we need We need you to do all the things typical to the role: Manage a unit of Commercial Transportation claims professionals at the management and desk level. Be consistently dependable in achieving or exceeding goals and overcoming obstacles Implement and maintain best practices for claims handling, including: claim intake, investigation, evaluation, settlement, and recovery Monitor and analyze claims data to identify trends, patterns, and areas for process improvement Align team with client and customer expectations of the claims process Serve as a resource for escalated claims Responsible for accuracy and adequacy of all aspects of claim reserving Develop and implement strategies to mitigate fraudulent claims and ensure compliance with legal and regulatory requirements Foster a positive work environment, promote teamwork, and encourage professional growth and development Execute on performance management; attract, hire, retain and provide high level of training Collaborate with internal teams, such as Account Management, Compliance, and Claim Operations, to resolve complex or escalated claims-related issues Establish and maintain strong relationships with external stakeholders, including policyholders, agents, brokers, and legal representatives Prepare and present comprehensive claims reports, metrics, and analysis to clients and customers; advise clients on claim trends and loss mitigation Requirements Bachelor's degree in insurance, business administration, or a related field; relevant certifications (e.g., CPCU, AIC) as well as a JD are a plus 10+ years in insurance claims management experience in Commercial Transportation Minimum of 5 years of experience concentrated in commercial claims, ideally with: 5+ years management experience with preference for experience managing in a remote environment 5+ years of detailed coverage analysis and policy interpretation is a plus Active home state adjusters license Comfortable with technology and the ability to evolve the claims systems and processes to drive better efficiencies and outcomes Demonstrated commitment to quality, accuracy, and attention to detail Integrity, ethics, and a strong sense of accountability in handling confidential and sensitive information Benefits Generous health-insurance package with nationwide coverage, vision, & dental 401(k) retirement plan with employer matching Competitive PTO policy - we want our employees fresh, healthy, happy, and energized! Generous family leave policy Work from anywhere to facilitate your work life balance paired with frequent, regular corporate retreats to build team cohesion, reinforce culture, and have fun Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder! Additionally, we will Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role Work toward reducing and eliminating all the administrative work from an adjuster role Foster a culture of empathy, transparency, and empowerment in a remote-first environment At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency: English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: A Complex Claims Manager - Construction Defect and Environmental is responsible for investigating, evaluating, and resolving insurance claims related to environmental damage, as well as claims involving General Liability (GL) and Excess Liability. This role involves analyzing coverage, assessing liability, negotiating settlements, and managing legal defense strategies, all while ensuring compliance with environmental regulations and minimizing the company's financial exposure. Additionally, the Claims Manager will collaborate with underwriting on marketing, portfolio management, and other strategic initiatives. Thoroughly investigate environmental claims, GL and Excess Liability by gathering information on the incident, site assessment, potential pollutants, and impacted parties to determine the scope of damage and liability. Review insurance policies to determine coverage applicability for environmental, general liability and excess liability claims, including policy limits and exclusions. Evaluate potential liability based on the investigation findings, legal precedents, and environmental regulations. Calculate and assign appropriate claim reserves based on the potential damages and liability assessment to accurately reflect the financial exposure. Negotiate settlements with claimants or their legal representatives to reach a fair and cost-effective resolution. Coordinate with legal counsel to manage legal defense strategies, including assigning attorneys, reviewing legal documents, and monitoring litigation progress. Manage consultants and contractors, including reviewing environmental work plans, remedial designs, and other technical aspects of environmental projects. Identify and implement cost-saving measures during the claims process, such as utilizing preferred vendors or negotiating favorable settlement terms. Investigate potential fraudulent claims related to environmental and non-environmental damages. Ensure adherence to all relevant environmental regulations and reporting requirements throughout the claims process. Maintain clear communication with policyholders, brokers, adjusters, legal counsel, and internal stakeholders regarding claim status and updates. Identify patterns and trends within environmental claims to inform risk management strategies and proactive measures. Oversee a portfolio of claims for the Environmental Division, prioritizing critical cases, and monitoring overall claim performance. Provide underwriting teams with insights on environmental risks and participate in risk assessment meetings. Collaborate on marketing strategies and contribute real-world examples for marketing materials. Analyze claims portfolio performance and recommend risk mitigation strategies. Share claims insights for new product development and refine policy language. Conduct training on claims handling and regulatory changes. Liaise between claims, underwriting, and other departments to ensure cohesive risk management. EDUCATION AND EXPERIENCE The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Bachelor's Degree required, Juris Doctorate preferred. Minimum of 5 years' experience required. CERTIFICATIONS, LICENSES, REGISTRATIONS n/a FUNCTIONAL SKILLS Extensive knowledge of environmental laws, regulations, and compliance standards. Knowledge of Construction Defect Proven experience in managing complex insurance claims, including investigation, evaluation, and resolution. Ability to analyze complex data, assess environmental impacts, and make informed decisions. Strong negotiation skills to reach favorable settlements with claimants and legal counsel. Understanding of legal principles related to environmental liability and insurance coverage. Strong interpersonal skills to build and maintain relationships with internal and external stakeholders. Ability to represent the company in market-facing activities, including client meetings, industry conferences, and networking events. General Description of Available Benefits for Eligible Employees of CRC Group: All regular teammates (not temporary or contingent workers) working 20 hours or more per week are eligible for benefits, though eligibility for specific benefits may be determined by the division of CRC Group offering the position. CRC Group offers medical, dental, vision, life insurance, disability, accidental death and dismemberment, tax-preferred savings accounts, and a 401k plan to teammates. Teammates also receive no less than 10 days of vacation (prorated based on date of hire and by full-time or part-time status) during their first year of employment, along with 10 sick days (also prorated), and paid holidays. Depending on the position and division, this job may also be eligible for restricted stock units, and/or a deferred compensation plan. As you advance through the hiring process, you will also learn more about the specific benefits available for any non-temporary position for which you apply, based on full-time or part-time status, position, and division of work. CRC Group supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC Group is a Drug Free Workplace. EEO is the Law Pay Transparency Nondiscrimination Provision E-Verify

Insight Global is looking for a Sr. Business Analyst working remotely for a company in Virginia Beach, VA. This candidate will be working with the business side of the company helping the many migration projects and helping to finalize implementations for medical plans and looking in system for inconsistencies. They will be sending out files and receiving back error reports in which they will be updating the reports for the members. Compensation: $52.00/hr to $56.00/hr Exact compensation may vary based on several factors, including skills, experience, and education. Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements - 3-5 years as a Business Analyst - Experience with QNXT - Experience with SQL - Experience with Power BI -a very analytical thinker -experience with claims, benefits, or enrollment -EDI 834/837 experience -Edifecs experience -Strong Excel knowledge -Strong communication skills

The nation's leading administrator of insurance services is looking for YOU. This is your opportunity to join a company with a culture that promotes respect for people, integrity, learning and initiative. WE ARE THE KIND OF EMPLOYER YOU DESERVE. Illumifin is a leading provider of business process outsourcing for the insurance industry, managing policies for the nation's largest insurers. We also provide clients with unique risk management insight built upon our proprietary databases. Reviews internal databases, client guidelines, and policy contract language to evaluate routine home and facility-based claims, in accordance with department processes and standards. Communicate clearly and routinely with claimants, representatives, third parties, physicians, and other health care providers as needed. Demonstrated interviewing skills which include the professional judgment to probe as necessary to uncover underlying concerns from the claimant or representative. Queries service providers to obtain licensure information, proof of loss, and dates of service. Verifies that provider and/or care is appropriate base on the claimant's diagnosis and is in accordance with contract language and government regulations regarding healthcare providers. Keeps clear and concise documentation of all claim activity within the required databases. Creates plans of care and refers for review and Chronic Illness Certification as appropriate. Uses time effectively to achieve expected productivity and efficiency. Demonstrates ability to prioritize workload. Performs work accurately and efficiently under deadline pressures. Always provides prompt, courteous and excellent customer service to internal and external customers Demonstrates effective communication skills, level of attentiveness, and use of appropriate lines of authority. Promptly shares accurate and complete information to others who need it, based on HIPAA and legal documents regarding release. Attends or is responsible for information provided at meetings and through other organizational channels. Maintains appropriate organizational confidentiality. Communicates with other team members and management on cases as needed. Meets quality and production metrics as established and communicated by the department. Works independently and seeks assistance as appropriate.

At Ledgebrook, we believe a career in claims can be so much more. You bring the passion, discipline, and entrepreneurial spirit; we'll provide the environment to unleash your best work. Together, we'll celebrate and reward success. If you're ready to shape the future of claims and join a high-performing team that truly values ownership and innovation - read on and apply now. Ledgebrook is seeking an experienced Claim Manager to oversee its portfolio of General Liability and Unsupported Excess Liability claims. You'll play a key role in ensuring that our Third-Party Administrators (TPAs) deliver timely, thorough, and cost-effective claim resolutions, while maintaining Ledgebrook's commitment to excellence and integrity. As part of our Claim team, you'll collaborate with leadership, underwriting, actuarial, and technology teams to refine our state-of-the-art claim management platform and reporting capabilities. This role offers an opportunity to help define best practices across multiple casualty market segments - including construction, hospitality, manufacturing, real estate, retail, and habitational risks. We're looking for someone with a strong technical foundation in E&S casualty claims, a data-driven approach, and the ability to manage relationships with both internal and external partners to achieve outstanding claim outcomes. Here at Ledgebrook, we're passionate about building a team that thrives on learning, collaboration, and the excitement of building something from the ground up. You bring: A passion for delivering world-class service to both internal and external customers Intellectual curiosity and a desire for innovation, rather than following the status quo A hunger for continuous learning and personal growth Agile prioritization skills and a sense of urgency - you balance getting it right with getting it done A strong drive to win together as a high-performing team A moral compass to “do the right thing, period.” We have zero tolerance for toxic behaviors An eagerness to connect and collaborate across remote teams Transparent, honest communication A proactive, solution-oriented mindset - you focus on solving, not blaming Experience working successfully in a fully remote, fast-paced environment As a future Ledgebrook Claim Manager, you'll bring deep technical expertise, sound judgment, and an entrepreneurial mindset to help us redefine what claims excellence looks like in the E&S market. We're looking for someone with: 10+ years handling Commercial General Liability (CGL) Bodily Injury, Property Damage, and Personal & Advertising Injury claims 5+ years managing litigated CGL claims, developing and executing defense strategies 3+ years handling non-admitted market Excess & Surplus Lines claims 2+ years overseeing claims handled by Third-Party Administrators (TPAs) 2+ years supervising claim professionals - coaching, mentoring, and driving performance Proven ability to analyze coverage and prepare reservation of rights or coverage decision letters Strong litigation management skills - selecting, directing, and evaluating defense counsel Experience participating in quality assurance claim file reviews and process improvements Analytical mindset: You dissect complex claims, evaluate exposure, and create actionable strategies Coverage expertise: You interpret and apply policy language with precision and clarity Collaborative communicator: You build alignment across underwriting, legal, product, and operations teams Technology & innovation: You're proficient with modern claims systems, data, and analytics tools - and eager to implement workflow improvements that drive speed, accuracy, and customer satisfaction Customer focus: You combine empathy and responsiveness with professionalism Entrepreneurial drive: You take ownership, challenge the status quo, and help build scalable, forward-thinking solutions Decisive leadership: You make informed, timely decisions with confidence and accountability Exposure to Allied Healthcare and/or Professional Liability claims (a plus) Important - note is only for candidates applying from the U.S.: Please note: This position is open only to candidates who are authorized to work in the United States without the need for current or future employer-sponsored work authorization. We are unable to offer visa sponsorship at this time. Competitive salary and meaningful equity ownership Health insurance - 100% employer-paid option available Additional benefits including 401(k), dental, vision, and other coverage options Remote work and flexible hours - work from where you perform best Unlimited time off policy - we trust you to manage your time and energy Culture of ownership, autonomy, and purpose - where your impact is visible and valued

Claims Manager (Professional Liability) Counterpart is an insurtech platform reimagining management and professional liability for the modern workplace. We believe that when businesses lead with clarity and confidence, they become more resilient, more innovative, and better prepared for what's ahead. That's why we built the first Agentic Insurance™ system - where advanced AI and deep insurance expertise come together to proactively assess, mitigate, and manage risk. Backed by A-rated carriers and trusted by brokers nationwide, our platform helps small businesses grow with confidence. Join us in shaping a smarter future, helping businesses Do More With Less Risk . As a Claims Manager (Professional Liability), you will be responsible for managing a large and diverse caseload of professional liability claims. In this role, you will apply and further develop your expertise by investigating, evaluating, and resolving claims in a way that reinforces our brand and values. You will also play a vital part in supporting the advancement of our systems and processes through ongoing feedback and collaboration with internal partners. In addition, you will be a key feedback provider for our active claims management processes and systems. Your input will help to shape and improve how we fulfill our mission of providing world-class service through tightly managing legal costs, making data-driven decisions when analyzing a claim's value, and ensuring that other potentially responsible parties pay their fair share. YOU WILL Achieve or exceed claims management case load and goals, applying sound judgment and legal knowledge to produce efficient and fair outcomes. Complete accurate and timely investigations into the coverage, liability, and damages for each claim assigned to you. Actively manage each claim assigned to you in a way that produces the most timely and cost-effective resolution. Build and maintain positive and productive working relationships with internal and external customers, including policyholders, brokers, carrier partners, and Risk Engineers (underwriters). Direct and monitor assignments to experts and outside counsel, and hold those vendors accountable for meeting or exceeding our service standards. Support our data collection efforts and models by effectively using our Agentic Claim Experience (ACE) system to fully and accurately capture critical details about each claim assigned to you. Identify and escalate insights into emerging claims trends across industries, geographies, and key business segments. Offer user-level feedback and insights to support the continuous improvement of our claim handling processes, guidelines, and systems. Ensure that every touchpoint with our insureds and brokers is representative of our brand, mission, and vision. YOU HAVE At least 10 years of professional experience, with at least 5 years of experience litigating or managing professional liability claims. Previous carrier experience is a plus. Bachelor's degree required; law degree (J.D.) and professional designations (RPLU, AIC, etc.) highly preferred. Must possess all required state claim adjuster licenses, or be able to obtain them within 90 days of hire. Proven ability to work both independently on complex matters and collaboratively as a team player to assist others as needed. High level of personal initiative and leadership skills. Exceptional time management, problem solving and organizational skills. Comfort and skill operating in a paperless claims environment. Familiarity with Google Workplace is preferred, but not required. Willingness to quickly adapt to change and use creative thinking and data-driven insights to overcome obstacles to resolution. Strong communication skills, both verbal and written. Ability to succeed in a full remote workplace environment, and travel as necessary (approximately 10-15%). WHO YOU WILL WORK WITH Eric Marler, Head of Claims: An industry veteran, Eric has more than 20 years of experience working with or for insurers offering management liability solutions. He is a licensed attorney who began his career in private practice before transitioning in-house. Prior to joining Counterpart, Eric held leadership roles at Great American Insurance Group and The Hanover Insurance Group. Jaclyn Vogt, Senior Claims Manager: Jaclyn is a licensed adjuster with over 15 years of experience handling Employment Practices Liability, Management Liability and Workers Compensation claims. Jaclyn received her bachelor's degree from Centre College. Katherine Dowling, Claims Manager: Katherine is a licensed attorney, mediator and adjuster with over a decade of experience handling professional liability and management liability litigation and claims. Katherine practiced law for several years with two of Atlanta's largest insurance defense firms prior to joining a wholesale specialty insurance carrier where she managed complex Professional Liability and Commercial General Liability claims. WHAT WE OFFER Stock Options: Every employee is able to participate in the value that they create at Counterpart through our employee stock option plan. Health, Dental, and Vision Coverage: We care about your health and that of your loved ones. We cover up to 100% of your monthly contributions for health, dental, and vision insurance and up to 80% coverage for family members. 401(k) Retirement Plan: We value your financial health and offer a 401(k) option to help you save for retirement. Parental Leave: Birthing parents may take up to 12 weeks of parental leave at 100% of their regular pay following the birth of the employee's child, and can choose to take an additional 4 unpaid weeks. Non-birthing parents will receive 8 weeks of parental leave at 100% of their regular pay. Unlimited Vacation: We offer flexible time off, allowing you to take time when you need it. Work from Anywhere: Counterpart is a fully distributed company, meaning there is no office. We allow employees to work from wherever they do their best work, and invite the team to meet in person a couple times per year. Home Office Allowance: As a new employee, you will receive a $300 allowance to set up your home office with the necessary equipment and accessories. Wellness stipend: $100 per month to spend toward an item or service that supports your wellness (i.e. massage or gym membership, meditation app subscription, etc.) Book stipend: To support your intellectual development, we offer a book stipend that allows you to purchase books, e-books, or educational materials relevant to your role or professional interests. Professional Development Reimbursement: We provide up to $500 annually for you to invest in relevant courses, workshops, conferences, or certifications that will enhance your skills and expertise. No working birthdays: Take your birthday off, giving you the opportunity to relax, enjoy your special day, and spend time with loved ones. Charitable Contribution Matching: For every charitable donation you make, we will match it dollar for dollar, up to a maximum of $150 per year. This allows you to amplify your charitable efforts and support causes close to your heart. COUNTERPART'S VALUES Conjoin Expectations - it is the cornerstone of autonomy. Ensure you are aware of what is expected of you and clearly articulate what you expect of others. Speak Boldly & Honestly - the only failure is not learning from mistakes. Don't cheat yourself and your colleagues of the feedback needed when expectations aren't being met. Be Entrepreneurial - control your own destiny. Embrace action over perfection while navigating any obstacles that stand in the way of your ultimate goal. Practice Omotenashi (“selfless hospitality”) - trust will follow. Consider every interaction with internal and external partners an opportunity to develop trust by going above and beyond what is expected. Hold Nothing As Sacred - create routines but modify them routinely. Take the time to reflect on where the business is today, where it needs to go, and what you have to change in order to get there. Prioritize Wellness - some things should never be sacrificed. We create an environment that stretches everyone to grow and improve, which is fulfilling, but is only one part of a meaningful life. Our estimated pay range for this role is $150,000 to $180,000. Base salary is determined by a variety of factors, including but not limited to, market data, location, internal equitability, and experience. We are committed to being a welcoming and inclusive workplace for everyone, and we are intentional about making sure people feel respected, supported and connected at work-regardless of who you are or where you come from. We value and celebrate our differences and we believe being open about who we are allows us to do the best work of our lives. We are an Equal Opportunity Employer. We do not discriminate against qualified applicants or employees on the basis of race, color, religion, gender identity, sex, sexual preference, sexual identity, pregnancy, national origin, ancestry, citizenship, age, marital status, physical disability, mental disability, medical condition, military status, or any other characteristic protected by federal, state, or local law, rule, or regulation.

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Manager, Medicare Claims. In this role, you will oversee end-to-end claims services for provider segments, ensuring we meet our business goals. Your leadership will help establish performance targets and manage the claims processing and financial aspects, while also maintaining compliance. Your collaboration with claims leadership will be vital in aligning with customer needs and fulfilling contractual obligations, ultimately enhancing the experience for all stakeholders involved.Accountabilities Streamline shared processing to reduce management by exception Set operational processes to align with market trends and customer demand Manage accounting and financial reporting functions to ensure compliance with standard practices Participate in projects to enhance claims processing and recovery functions Oversee financial recovery activities including refunds and collections Lead team and staff to optimize work volume and engagement Resolve complex claims appeals by coordinating with stakeholders Collaborate with Audit and Payment Integrity to ensure accuracy and quality Develop tools and techniques for process improvements Serve as the Medicare Claims Subject Matter Expert and primary contact for performance monitoring Represent Claims Operations in monthly calls with CMS and provide updates and expertise Engage with Compliance and regulatory entities, particularly CMS Requirements Bachelor's degree or advanced degree in a relevant field 8+ years of experience in a related field, with 10+ years in lieu of degree Strong analytical skills and ability to manage operations effectively Experience in Medicare and Medicaid or highly regulated environments is a plus Familiarity with accounting principles and compliance policies Skills in claims management and resolution Benefits Opportunity to work at the forefront of health care delivery Work-life balance, flexibility, and autonomy Medical, dental, and vision coverage with various wellness programs Parental leave support and assistance for adoption and surrogacy Career development programs and tuition reimbursement 401k matching with an annual contribution Why Apply Through Jobgether? We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.#LI-CL1We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

The SouthState story is one of steady growth, deep community roots, and an unwavering commitment to helping our customers move forward. Since our beginnings in the 1930s to becoming a trusted financial partner across the South and beyond - we are known for combining personal relationships with forward-thinking solutions. We are committed to helping our team members find their success while maintaining the integrity of our values: building trust, fostering lasting relationships and pursuing excellence. At SouthState, individual contributions are recognized, potential is cultivated and team members are inspired to achieve their greater purpose. Your future begins here! SUMMARY/OBJECTIVES This position is primarily responsible for handling Government Lending Guaranty Claims. This position must possess a strong knowledge of loan credit review, loan documentation, and loan compliance. This individual must also be able to identify issues and provide workable solutions, in addition to answering questions, regarding loan file documentation, loan exceptions, loan status, and other related loan issues. This position may also include special projects and other duties that are essential in delivering excellent service and maintaining the data integrity of their function. ESSENTIAL FUNCTIONS * Manager functions as coordinator for compiling comprehensive claims on government guaranteed loans that have failed and where the bank is seeking reimbursement on the guaranteed portion of the loan. * Facilitates strict compliance with government requirements and performs a detailed analysis of each failed loan. * This position requires extensive industry knowledge in a variety of disciplines including originating, underwriting, portfolio management and workout experience to strategically craft a compelling case for honoring the guaranty. * Must be able to analyze and identify claim vulnerabilities and pre-emptively determining proper responses, (rationale) to mitigate the chances of a monetary repair on the claim or a full denial of the claim. * Recognizes problem areas and carefully articulates steps that the bank took to either correct or mitigate the impact of these issues. * The Manager submits the approved claim package to the government and serves as the primary point of contact for the agency on requests for additional information or clarification of documentation submitted. * Completed claim packages are reviewed in a tiered approval format that adds additional reviewers based upon the size of the claim. Manager submits claims once the appropriate internal approval is obtained. * Manager must respond to the government quickly and thoroughly requiring both efficiency and skill to accurately understand the nature of the request and quickly provide supplementary information in a timely manner. * Manager will be responsible to attend and complete all Training as defined by Management. * Manager will be responsible to follow and adhere to SouthState Banking and compliance policies. * Manager will be responsible to Report to manager any compliance banking policies violations found in your daily workflow. * Manager will be responsible to keep the SAM Governance and Practices Manager or Director of Special Assets apprised of any issues that may result in a claim repair or denial. * Manager will be responsible to help with all document's exceptions from time to time. * Manager will be responsible to research and respond to audit requests related to all loans as needed. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. COMPETENCIES * Ability to work in PCFS Loan Manager, Excel, Word, Adobe, ETRAN, Navigator Fiserv. Must have knowledge of the SBA's most recent SOP servicing release. Must be capable of working independently. Qualifications, Education, and Certification Requirements * Education: High School and some College * Experience: Minimum of 5 years' experience in SBA * Certifications/Specific Knowledge: SBA Loan Servicing SOP processes & procedures TRAINING REQUIREMENTS/CLASSES Included, but not limited to required SouthState Bank, NA annual compliance training, New Employee Orientation and continued SBA SOP training. PHYSICAL DEMANDS Must be able to effectively access and interpret information on computer screens, documents, reports, and cash denominations, and identify customers. This position requires a large amount of time in front of a computer. This can be done sitting or standing with use of the right desk. WORK ENVIRONMENT This position is 100% remote. Candidate must have a secure home office environment that is free from background noise and distractions. They must also have a reliable private internet connection that is not supplied by use of cellular data (hot spot). Cable or fiber connections are preferred. Requirements are subject to change, as new systems and technology are delivered. Travel may be required to come to meetings as needed. Equal Opportunity Employer, including disabled/veterans.

OMS National Insurance Co. is a nationwide company in search of nationwide talent. We have one simple mission at OMSNIC - We are dedicated to serving and protecting oral and maxillofacial surgeons and dental professionals nationwide. If you are an experienced medical malpractice claims professional based in the U.S, and would like to join us in our mission, we invite you to apply for this remote opportunity. Our claims analysts have direct contact with our policyholders and are regarded as trusted partners, managing an assigned caseload of claims. This includes the investigation, evaluation, and resolution of both pre-litigation and litigated matters. ESSENTIAL DUTIES AND RESPONSIBILITIES: Evaluate coverage Assign, collaborate with, and oversee outside defense counsel Review and analyze medical records Investigate and evaluate issues of liability, causation, and damages, proactively moving the files toward resolution Participate in the formulation of case strategy Negotiate claims in a settlement posture Evaluate indemnity and expense reserves Prepare comprehensive claims reports Present claims to management and for internal review Regularly communicate with policyholders, keeping them informed of status and strategies Timely and accurately document claim files Help maintain claim file data for accurate reporting Review and approve invoices General: Contribute to departmental and company goals, initiatives and projects May attend or participate in training and development programs Planning and participation in Risk Management and Defense Counsel Seminars May participate in the training and development of new hires May participate in planning, development, and testing of technology solutions Competencies: Strong organizational and time management skills, ability to meet deadlines Effective written and oral communication skills to provide information in a clear and concise manner and to communicate with a variety of stakeholders Effective analytical and critical thinking skills to analyze facts and draw conclusions to make recommendations and resolve issues Ability to prepare robust reporting yet provide a broad scope overview and summary, when appropriate Superior customer service skills and ability to actively listen Strong interpersonal skills with ability to interact with policyholders, legal professionals, management, co-workers, agents, committee and board members, and external vendors Strong mediation and negotiation skills Microsoft Office Suite proficiency with emphasis on Word, Excel, and PowerPoint Education and Experience: Bachelor's Degree required JD preferred but not required Minimum 5 years' experience in medical professional liability claims management field Work Environment: Fully remote Travel required as needed Salary : $100,000-$140,000 The salary range represents the entirety of the pay grade for this role. Specific salaries will be determined using a variety of factors, including specific skills, years of experience, location, and comparison to team members already in this role Benefits: Medical, Dental, and Vision Insurance 401(k) Short and Long-term disability Life Insurance Employee Assistance Program Long-term incentive plan Educational Assistance and rewards program Paid Time Off Paid Holidays Paid parental leave Home office stipend #LI-Remote

Recruiters & Staffers - We prefer to hire direct. Please do not solicit your services to any member of our organization. Interested Applicants - The hiring team for this position will handle all applicants and communications through our Applicant Tracking System. Resumes emailed direct to other members of our company will not be considered. Description The Claims Manager is a fully remote role responsible for serving as a liaison for clients in the management of Workers' Compensation claims. On behalf of the client, you will communicate (through phone and email as necessary) with doctors, insurance adjusters, and workers ' comp attorneys in order to use our process and strategies to get the best results for clients on each claim. You will also provide strategy and status updates to clients following our process, in quarterly reports, and upon their request. The Claims Manager will also analyze patterns and trends in a client's claims history to ensure that our strategies are adjusted as necessary and continue to produce the highest level of results. This role will: Educate Clients on Claims Management Procedures Coordinate Claims Strategy with Clients, Adjusters, Attorneys, and Doctors Analyze Claims & Financial data to provide a summary and strategy to clients Please Note: At this time, we are not accepting unsolicited contact from recruiters, staffing agencies, or headhunters. We respectfully request that third parties refrain from reaching out regarding this position. Our hiring team is focused on sourcing and engaging directly with candidates, and we prefer to manage our recruitment efforts internally. Thank you for your understanding. Responsibilities Provide exceptional customer service by delivering proactive, thoughtful, and professional communication to clients, ensuring their expectations for high-level service are consistently met. Communicate effectively with all parties involved in insurance claims, including adjusters, attorneys, and medical professionals, to ensure accurate and timely updates while advocating for the best outcomes for clients. Use strong negotiation and problem-solving skills to tactfully redirect claims processes when necessary, aligning them with the client's best interests. Analyze client claims data and overall claim histories to identify patterns, trends, and optimal strategies, leveraging basic mathematical and analytical skills to support decision-making. Clearly explain claims strategies to clients, demonstrating an understanding of underlying concepts and calculations. Utilize Salesforce and other tools to manage claims efficiently, access and analyze claims data, and generate reports as needed. Perform day-to-day tasks using Microsoft Word, Excel, Outlook, Adobe, and other Microsoft Office applications, ensuring accuracy and efficiency in all computer-related activities. Qualifications Customer Service skills. Clients are used to a very high level of service, and we need the clients to receive proactive and thoughtful communication from our team. Strong communication skills. Sometimes the job is as simple as relaying information at the right time, following our process, or making a simple status request from an insurance adjuster so we're up to date on a claim. In some instances, the other parties involved in a claim (doctors, adjusters, attorneys, etc) may try to steer the claim in a direction that isn't the best for clients. You'll need to be able to tactfully direct the claim back into the best interest of the client. Training will be provided on when to do this, and tips can be provided on how, but strong communication/negotiation skills will be very useful. Basic Mathematical & Analytical skills. We review clients' claims data to determine what strategy is best for each claim. We also review their overall claim history to determine patterns and trends and continue to deliver better results. Our system will do most of the math for you, but you'll need to understand the concepts behind the calculations in order to explain our strategy to clients. Basic Computer skills. We manage claims through Salesforce. You'll access a number of websites to gather claims data. You'll also use Microsoft Word, Adobe, PDFs, Outlook, and other Microsoft Office apps. Compensation $55,000 - $65,000 yearly About Whiteboard Risk & Insurance Solutions We are a modern commercial insurance agency with a very unique platform of services that helps businesses that struggle with workers ' compensation injuries. We've spent the last ten years honing our niche and developing a highly unique product that drives unrivaled results for clients. We solve challenges that business owners typically don't even know exist until they meet us. It makes it difficult to get our foot in the door - but once we have the opportunity to educate them on Workers' Comp and how our platform resolves a number of common problems with their insurance, most of them wish they'd heard of this much sooner! Employee Benefits: Competitive Compensation Monthly Health & Wellness Credit Employer-Sponsored Health Care Plan Retirement Plan with a 5% match Flexible Paid Time Off Training & Development Support

Ready to lead and shape Hospital Professional Liability claims strategy? Apply to this senior-level claims leader position, Claims Manager II. Join a high-performing team leading the Hospital Professional Liability claims unit for IronHealth/NAS Claims. We're looking for a seasoned Claims Manager with deep Hospital Professional Liability experience who wants to lead a technical team, shape claims strategy, and drive measurable improvements across a portfolio of complex and high-severity matters consistent with the standards of Liberty International Underwriters. *This position may have in-office requirements and other travel needs depending on candidate location. You will be required to go into an office twice a month if you reside within 50-miles of one of the following offices: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; or Westborough, MA. This policy is subject to change. The salary range reflects the varying pay scale that encompasses each of the Liberty Mutual regions, and the overall cost of labor for that region, and based on you location you may not qualify for the top salary listed in the range. Responsibilities Responsible for performance, development and coaching of staff (including hiring, terminating, performance and salary management). Serve as technical resource not only for claims staff, but also cross-functional partners, including Underwriting (UW), Actuarial, Finance and Operations. Work with claims team and external attorneys to review coverages, investigate claims, analyze liability and damages, establish adequate indemnity and expense reserves, develop strategies and resolve claims, including, but not limited to direct participation in mediation and arbitration and active participation in settlement discussions. Perform quality assurance reviews/observations and provide feedback to team as well as action plan for development of team, where necessary. Actively pursue all avenues of recovery including, but not limited to timely recovery of deductibles from insureds and manage subrogation activities. Provide regular reports to claims management regarding losses either exceeding or likely to exceed the authority level in accordance with best practices. Must be able to present effectively, produce appropriate reports and develop team and train team in these skills Partner with underwriting managers/team to provide excellent customer service and to market and meet with brokers, risk managers and reinsurers. Serve as external face claims leader for product line and demonstrate ability to forge and maintain relationships with external customers, effectively resolving concerns where necessary. Ability to effectively articulate the claims value proposition in claims advocacy meetings, account renewals and new business prospecting. Present at industry conferences or publishes external industry content. Lead short to medium-term strategic claims activities/priorities for the product line, with alignment with the strategic priorities of IronHealth and NAS Claims. Oversee projects assigned by the department head. Direct and manage the Claims participation and content for multidisciplinary reviews, monthly UW connectivity meetings, and quarterly actuarial meetings. Ensure timely feedback to senior management, underwriting and actuaries regarding relevant losses, account issues, and trends. Assist and coordinate with underwriting team regarding new policy forms, product development and/or product rollouts and provide timely feedback to senior management and underwriting regarding recommendations. Ability to achieve fluency in Loss Triangle interpretation and Product Level Profitability Understanding/Awareness. Other duties as assigned, including delivery on established operational goals and objectives. Qualifications Qualifications - what will make you successful! Bachelors' degree or equivalent training; advanced degrees or certifications preferred. A minimum of 8+ years of relevant and progressively more responsible work experience required, including at least 2 years of supervisory experience. At least 5 years claims handling within a technical specialty. Requires advanced knowledge of claims handling concepts, practices, procedures and techniques, including, but not limited to coverage issues, product lines, marketing, computers and product competition within the marketplace. Requires advanced knowledge of a technical specialty. Knowledge of law and insurance regulations in various jurisdictions. The ability to effectively interact with brokers and internal departments is also required. Strong verbal and written communications and organizational skills. Strong negotiation, analytical and decision-making skills also required. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

The SouthState story is one of steady growth, deep community roots, and an unwavering commitment to helping our customers move forward. Since our beginnings in the 1930s to becoming a trusted financial partner across the South and beyond - we are known for combining personal relationships with forward-thinking solutions. We are committed to helping our team members find their success while maintaining the integrity of our values: building trust, fostering lasting relationships and pursuing excellence. At SouthState, individual contributions are recognized, potential is cultivated and team members are inspired to achieve their greater purpose. Your future begins here! SUMMARY/OBJECTIVES This position is primarily responsible for handling Government Lending Guaranty Claims. This position must possess a strong knowledge of loan credit review, loan documentation, and loan compliance. This individual must also be able to identify issues and provide workable solutions, in addition to answering questions, regarding loan file documentation, loan exceptions, loan status, and other related loan issues. This position may also include special projects and other duties that are essential in delivering excellent service and maintaining the data integrity of their function. ESSENTIAL FUNCTIONS Manager functions as coordinator for compiling comprehensive claims on government guaranteed loans that have failed and where the bank is seeking reimbursement on the guaranteed portion of the loan. Facilitates strict compliance with government requirements and performs a detailed analysis of each failed loan. This position requires extensive industry knowledge in a variety of disciplines including originating, underwriting, portfolio management and workout experience to strategically craft a compelling case for honoring the guaranty. Must be able to analyze and identify claim vulnerabilities and pre-emptively determining proper responses, (rationale) to mitigate the chances of a monetary repair on the claim or a full denial of the claim. Recognizes problem areas and carefully articulates steps that the bank took to either correct or mitigate the impact of these issues. The Manager submits the approved claim package to the government and serves as the primary point of contact for the agency on requests for additional information or clarification of documentation submitted. Completed claim packages are reviewed in a tiered approval format that adds additional reviewers based upon the size of the claim. Manager submits claims once the appropriate internal approval is obtained. Manager must respond to the government quickly and thoroughly requiring both efficiency and skill to accurately understand the nature of the request and quickly provide supplementary information in a timely manner. Manager will be responsible to attend and complete all Training as defined by Management. Manager will be responsible to follow and adhere to SouthState Banking and compliance policies. Manager will be responsible to Report to manager any compliance banking policies violations found in your daily workflow. Manager will be responsible to keep the SAM Governance and Practices Manager or Director of Special Assets apprised of any issues that may result in a claim repair or denial. Manager will be responsible to help with all document's exceptions from time to time. Manager will be responsible to research and respond to audit requests related to all loans as needed. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. COMPETENCIES Ability to work in PCFS Loan Manager, Excel, Word, Adobe, ETRAN, Navigator Fiserv. Must have knowledge of the SBA's most recent SOP servicing release. Must be capable of working independently. Qualifications, Education, and Certification Requirements Education: High School and some College Experience: Minimum of 5 years' experience in SBA Certifications/Specific Knowledge: SBA Loan Servicing SOP processes & procedures TRAINING REQUIREMENTS/CLASSES Included, but not limited to required SouthState Bank, NA annual compliance training, New Employee Orientation and continued SBA SOP training. PHYSICAL DEMANDS Must be able to effectively access and interpret information on computer screens, documents, reports, and cash denominations, and identify customers. This position requires a large amount of time in front of a computer. This can be done sitting or standing with use of the right desk. WORK ENVIRONMENT This position is 100% remote. Candidate must have a secure home office environment that is free from background noise and distractions. They must also have a reliable private internet connection that is not supplied by use of cellular data (hot spot). Cable or fiber connections are preferred. Requirements are subject to change, as new systems and technology are delivered. Travel may be required to come to meetings as needed. In accordance with Colorado law: Colorado pay for this position is anticipated to be between $66,440.00 - $106,131.00 , actual offers to be determined based on applicant's skills, experience and education.While the anticipated deadline for the job posting is 02-15-2026, we encourage you to submit your application as we may still consider qualified candidates beyond this date. Benefits | SouthState Careers Equal Opportunity Employer, including disabled/veterans.

Shape Your Future With UsGeneral Re Corporation, a subsidiary of Berkshire Hathaway Inc., is a holding company for global reinsurance and related operations, with more than 2,000 employees worldwide. It owns General Reinsurance Corporation and General Reinsurance AG, which conducts business as Gen Re. Gen Re delivers reinsurance solutions to the Life/Health and Property/Casualty insurance industries. Represented in all major reinsurance markets through a network of 38 offices, we have earned superior financial strength ratings from each of the major rating agencies. Gen Re currently offers an excellent opportunity for a Claims Manager in our Life Health Global Claims unit to work remotely based out of our Stamford, CT office. Role Description The Claims Manager in Life Global Claims oversees the unit claims business, including the protection of Gen Re's fiduciary interest. The incumbent is an expert claims resource with comprehensive claim knowledge and experience. Managerial duties include hiring as well as overseeing performance and development of employees. As a senior claim resource, the incumbent also acts as a teacher, developer, mentor and leader in the Unit and the claims department. Responsibilities: Human Resources: The Claims Manager completes performance appraisals, provides salary planning recommendations and implements training/educational plans for the Unit. Additionally, the incumbent manages the interviewing, hiring and performance management. Claims Leadership & Expertise: The Claims Manager is expected to demonstrate superior analytical and claim handing skills and to have strong knowledge of changes in case law, jurisdictions, coverage, and recognition of exposures for timely financial reporting purposes. The Claims Manager acts as a senior resource, teacher and technical claim advisor to the team and others within the Global Claims LH Organization. Performance Standards & Goals: The Claims Manager is expected to set the tone for the unit's performance via team and individual goals and client centric activity. Existing and potential future client relationship management, trend analysis and proactive inventory management, along with the establishment of and adherence to proper claim controls is the responsibility of the Claims Manager. The incumbent also is responsible for the development and implementation of process improvements and workflow within the product lines assigned. Professional Development: The Claims Manager oversees the professional development of the staff. The incumbent ensures individuals have the necessary skills and developmental opportunities to continually meet the business needs of the Unit, Department and Division. Unit Management: The Claims Manager coordinates all administrative and procedural aspects of the Unit. The incumbent acts as the unit champion and fosters a supportive and results oriented environment. As the unit leader, incumbent manages the unit in accordance with all Gen Re policies, procedures, philosophies, and goals. Regulatory: The Claims Manager is responsible for ensuring overall compliance with various reporting and auditing of controls. Claim Management Reporting: The Claims Manager partners with his/her internal constituents to ensure claims data collected is analyzed and claim statistics reported to senior management in a timely, proactive, consolidated and solution-oriented fashion. Responsible for managing multiple work streams and influencing a variety of constituents at various levels, not solely within one's direct employ. Accountable for the effective development, ongoing maintenance and consistent application of client communications and relationships. The Claims Manager is a client facing position with accountability to ensure his/her staff is visible and present in the reinsurance work performed. Flexibility to travel frequently and on short notice. Incumbent ensures appropriate representation occurs in the industry conference work that may require committee representation, networking with client, hosting client events oriented at the claims discipline, effective delivery of presentation material and travel on short notices. Role Qualifications and Experience Prior experience managing claims and people. Broad understanding of insurance/reinsurance life cycle and intersection with claims. Ability to perform complex multitasking with short/medium/long term deadlines - with need for contingencies. Analytical, strategic, and organized thinker with demonstrated ability to deliver results. Proven ability to develop staff, resource allocation and planning. Exposure to managing people and claims in multiple products lines. Demonstrated leadership abilities. Highly refined analytical skills and business acumen. Demonstrated abilities to operate strategically or tactically depending on the situation at hand. Strong claim technical abilities. Prior experience with claim audit activity. Audit work of reinsured claims in client locations is an expectation. The audit process requires the ability to quickly adapt to the multitude of imaged systems in use by clients. The audit process may involve analyzing and verifying coverage and/or corresponding payments issued. The audit process may consist of managing internal and external communication with client executives in various areas such as claims, financial and legal resources, actuarial resources, etc. Thus, demonstrating an ability to emphasize and implement solutions to help clients manage risk and developing an in-depth knowledge of the management and organization of each assigned account. Exceptional communication and presentation skills. Ability to work as a member of a team or independently. Similarly, strong oral and written communication skills are required. Proven ability to analyze and problem solve client needs, system failures and strategy projections. College degree (preferred) or equivalent work experience Salary Range 155,000.00 - 259,000.00 USD The annual base salary range posted represents a broad range of salaries around the US and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. Our Corporate Headquarters Address General Reinsurance Corporation 400 Atlantic Street, 9th Floor Stamford, CT 06901 (US) At General Re Corporation, we celebrate diversity and are committed to creating an inclusive environment for all employees. It is the General Re Corporation's continuing policy to afford equal employment opportunity to all employees and applicants for employment without regard to race, color, sex (including childbirth or related medical conditions), religion, national origin or ancestry, age, past or present disability , marital status, liability for service in the armed forces, veterans' status, citizenship, sexual orientation, gender identity, or any other characteristic protected by applicable law. In addition, Gen Re provides reasonable accommodation for qualified individuals with disabilities in accordance with the Americans with Disabilities Act.