Claims adjuster jobs in Euless, TX

Duration:6 Months+ Roles & Responsibilities Maximize customer satisfaction by providing prompt actions to customer's need and obtain quality photos/data to determine root cause of claim to defend or accommodate customer's claim Provide efficient solutions to customer-facing agents by developing and operating guide and contents Use various tools/dashboard/systems to quantify the agent's performance of customer care and develop appropriate actions to improve performance and quality Spanish speaking agent recommended but not a requirement. [Customer Experience Management] Analyze end-to-end processes that customers experience and participate in providing suitable resolutions accordingly and in controlled & monitored turnaround time for each action of customer claim process [Quality Management] Monitor and review customer calls/tickets for customer care quality control, carry out activities to secure quality competitiveness of our company and customers Maintains and improves operational quality by monitoring system performance; identifying and resolving problems; preparing and completing action plans. Qualifications & Experience College Graduate 3~5 Years in customer experience Case management for MX/CE claims CE Tender management Pending Management (KPI, LTP) Case Tracker Management for special issue CPSC claim management (Customer care/tracker) (CE) Monitoring FCCM report quality (ACQ/OS Reports) Special Projects Customer Care Resolution EnR Submission/Management Work to de-escalate customer situations while finding an appropriate solution; involve upper management as needed Skills Customer Care Experience (Call Center) Claims Management Experience Insurance Claims or Adjuster background beneficial About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name: P Praveen Chary Email: **************************** Internal Id: 25-54476

At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Join a team where your expertise truly matters!Our Casualty Claims department is seeking a highly motivated and experienced Claims Supervisor (Bodily Injury). As a key leader within our Casualty organization, you will be responsible for empowering a team that handles attorney-represented automotive liability claims. Your team will manage: complex investigations coverage determinations liability assessments bodily injury claim resolutions-through both settlement and litigation. This role requires advanced knowledge of litigation processes and the ability to strategically support litigated and attorney-represented claims. If you're passionate about developing talent, driving results, and making an impact in the automotive liability space, we'd love to hear from you.Success in this role is built on the foundation of GEICO's core leadership behaviors: Ownership: You take responsibility for outcomes in all scenarios. Adaptability: You navigate dynamic environments with creativity and resilience. Leading People: You empower individuals and teams to achieve their best. Collaboration: You build and strengthen partnerships across organizational lines. Driving Value: You use data-driven insights to align actions with strategic goals. What You'll Do: Lead, mentor, and inspire a team of associates to deliver exceptional customer service while building trust. Leverage your property and casualty insurance expertise to guide team members in resolving complex customer inquiries and claims. Provide authority on evaluations that exceed your adjusters personal, assigned authority and work with others on claims that exceed your authority Personalize your leadership approach to develop team members' skills, fostering their growth and ensuring they consistently exceed customer expectations. Monitor and evaluate team performance using key performance indicators (KPIs) to enhance efficiency, customer satisfaction, and retention. Hold your team accountable for achieving results, maintaining compliance with insurance regulations, and delivering outstanding service. Address escalated customer concerns with professionalism and empathy, modeling GEICO's dedication to service excellence. Collaborate with leadership and cross-functional teams to identify and implement process improvements. Serve as a resource for team members on insurance-related questions providing mentorship and training to build their industry knowledge. What We're Looking For: Minimum of 2 years of leadership experience in Bodily Injury claims, including direct oversight of litigated cases. Active Adjuster license (required) Expertise in Casualty claims, including knowledge of industry regulations and best practices Strong ability to assess needs and guide associates in negotiating claim settlements as needed Experienced in the use of various claims tools with ability to assist associates Strong adherence to compliance and regulatory requirements Proven ability to motivate, inspire, and develop high-performing teams in a customer-centric environment Strong results orientation, with a history of meeting or exceeding performance goals Excellent interpersonal and communication skills, with the ability to adapt leadership styles to diverse individuals and situations Ability to analyze data and metrics to inform decision-making and improve customer outcomes Collaborative mindset with a commitment to fostering a culture of inclusivity and excellence Why Join GEICO? Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Inclusive Culture: Join a company that values diversity, collaboration, and innovation. Workplace Flexibility: This is a M-F, 8:00am - 4:30pm position offering a Hybrid work model based in Richardson, TX. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Licensing and continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Increased Earnings Potential: Pay Transparency: The starting salary for this position is between $97,735 annually and $151,700 annually. Incentives and Recognition: Corporate wide bonus programs are in place to reward top performers. Beware of scams! As a recruiter, I will only contact you through ************ email address and will never ask you for financial information during the hiring process. If you think you are being scammed or suspect suspicious activity during the hiring process, please contact us at ...@geico.com. keywords: litigation, auto liability, liability claims#geico300#LI-AL2 At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.

Who is Federated Insurance? At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own. Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values. What Will You Do? Customer-focused, source of knowledge and comfort, desire to help, professional - Does that sound like you? We are seeking someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss. No previous insurance or claims experience needed! Federated provides an exceptional training program to teach you the fundamentals of claims and will prepare you to assist clients. This is an in-office position that will work out of our North Richland Hills, TX office, located at 9001 Airport Freeway. A work from home option is not available. Responsibilities Work with policyholders, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair and courteous way. Explain policy coverage to policyholders and third parties. Complete thorough investigations and document facts relating to claims. Determine the value of damaged items or accurately pay medical and wage loss benefits. Negotiate settlements with policyholders and third parties. Resolve claims, which may include paying, settling, or denying claims, defending policyholders in court, compromising or recovering outstanding dollars. Minimum Qualifications Current pursuing, or have obtained a four-year degree Experience in a customer service role in industries such as retail, hospitality, logistics, banking, automotive dealerships, vehicle rental, sales or similar fields Ability to make confident decisions based on available information Strong analytical, computer, and time management skills Excellent written and verbal communication skills Leadership experience is a plus Salary Range: $61,700 - $75,400 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information can be discussed with a with a member of the Recruiting team. What We Offer We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You. Employment Practices All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization. If California Resident, please review Federated's enhanced Privacy Policy.

Amwins Specialty Auto is seeking career-oriented candidates to join a claims team within our rapidly growing company. In the Express Claims Adjuster role, you will learn to review and medically manage PIP claims in accordance with company procedures. In the fast-paced environment of auto claims this role requires strong oral, written, analytical, decision making and organizational skills and lends itself to considerable career growth potential. Along with competitive salary, Amwins Specialty Auto offers a full range of benefits including insurance, retirement, and educational reimbursement programs. Amwins Specialty Auto is part of Amwins Group, the largest specialty broker in the United States, with over $14 billion of premium. This is a hybrid position based out of our Plano, TX location! Responsibilities: Receive new claims files Conduct coverage and liability investigations Assign inspections Work claims to conclusion Qualifications: Fluent in English and Spanish preferred Associates degree or above preferred 1-3 years of professional office experience Must be willing to obtain Texas adjuster license Ability to multi-task in a fast-paced environment Strong communication skills and ability to clearly document and communicate the basis for decisions made Excellent written skills that demonstrate clear, professional and succinct communications for file documentation, internal communications and external correspondence Strong organizational and time-management skills Courteous and professional telephone communications Ability to work in a team environment and maintain calm demeanor even during heated circumstances Benefits: Amwins Specialty Auto seeks to attract career-oriented individuals, and as such provides competitive pay and considerable opportunity for merit-based advancement. Our comprehensive benefits package includes the following: 401K with Company match Medical, dental & vision coverage Paid time-off Pay-for-Performance Flexible spending accounts Tuition reimbursement Work/Life resources Employee and Dependent life insurance Disability insurance Accidental death and dismemberment insurance No direct inquiries, please.

Job Description WHO WE ARE: At CITON Claims Solutions, we don't just stand out for what we do - we shine because of how we do it. By integrating cutting-edge, proprietary technology, innovative solutions, and compassion for serving our customers, we are redefining the insurance experience. Our vision is to be the global premier provider of insurance solutions, and our mission is to deliver an exceptional insurance experience through innovative technology, unparalleled customer service, and a comprehensive suite of products. Join Us as an Seasonal Claims Desk Adjuster Are you a detail-oriented investigator with a passion for helping others? We're looking for an Seasonal W2 Desk Adjuster to work in our office located in Florida and or/Irving, TX. In this role, you'll play a pivotal part in investigating, evaluating, and resolving insurance claims, ensuring fair and efficient processing in line with policy terms and company guidelines. WHAT YOU'LL DO: Review Claims: Assess and analyze submitted claims documentation to determine validity and coverage. Gather Essential Information: Communicate with policyholders, witnesses, and other involved parties to collect relevant details for claims evaluation. Document Findings Thoroughly: Create detailed reports and maintain comprehensive notes to support claims assessments. Analyze Coverage: Review insurance policies to determine applicable coverage and assess liability. Prepare Reports: Submit thorough reports with findings and well-supported recommendations for claim settlements. Negotiate Settlements: Work with policyholders and third parties to negotiate settlements that ensure fair and just outcomes. Resolve Disputes: Handle disputes professionally and efficiently, ensuring favorable resolutions. Maintain Clear Communication: Foster transparent and professional communication with policyholders and all stakeholders throughout the claims process. Collaborate Across Teams: Partner with internal teams, including underwriters and legal advisors, to resolve complex claims. Ensure Compliance: In all claims processes, comply with state and federal regulations and company policies. Support Catastrophe Response: Provide critical support for claims management efforts during disaster events as needed. WHAT WE'RE LOOKING FOR: Experience: Minimum of 3+ years in desk claims adjusting or related fields, with experience dealing with public adjusters. Technical Skills: Proficiency with Xactimate and other Xactware products; strong analytical and problem-solving abilities; familiarity with local building codes and repair processes. Licensing and Certifications: Valid adjuster's license in Texas and/or Florida Insurance Knowledge: Strong understanding of insurance policies and claims processes. Negotiation Skills: Excellent negotiation skills and experience in dispute resolution. WHAT'S IN IT FOR YOU: Dynamic Environment: Thrive in a fast-paced, collaborative, and results-driven office where your contributions make a real impact. Career Growth: Opportunities for professional development and advancement within a supportive company culture. If you're excited to join a company that values innovation, teamwork, and your technical expertise, we'd love to hear from you. Take the next step in your IT career and help us keep our technology running smoothly! Apply Now and Become a Key Player in Our Success Story! CITON Claims Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Job Description The VSC Mechanical Claims Adjuster is responsible for handling incoming claims calls, evaluating mechanical failures, and determining coverage under Vehicle Service Contracts (VSC). This role is part of our Claims Assistance Center and requires strong analytical and communication skills to interpret contract terms, assess shop diagnostics and repair estimates, and negotiate with repair facilities. The adjuster will play a key role in delivering a positive customer experience while supporting service level goals. Minimum Qualifications: Bachelor's degree or equivalent work experience. 2-4 years of experience in automotive claims adjudication, preferably related to VSC or extended warranty claims. Prior experience in a dealership service department (e.g., service advisor, technician, warranty administrator) is highly valuable. Hands-on experience as an automotive technician or mechanic is a strong plus. Experience as a warranty administrator, insurance adjuster, or within a third-party administrator (TPA) is beneficial. Background in parts management, fleet maintenance coordination, or service writing is also relevant. Familiarity with automotive diagnostics, repair procedures, and labor/parts pricing. Comfortable working across multiple claims management and estimating systems. ASE certifications, factory training, or other industry certifications are a plus. Previous experience in a claim's assistance center or high-volume claims environment is preferred. Industry certifications, factory training, and ASE certifications are a plus. Primary Job Functions: Investigate, evaluate, and adjudicate vehicle service contract (VSC) claims in accordance with contract terms and coverage guidelines. Determine coverage based on shop diagnostics, repair estimates, and inspection findings. Authorize or deny repairs within settlement authority; escalate claims that exceed authority limits to a supervisor with recommendations. Communicate professionally with repair facilities, dealership personnel, and agreement holders throughout the claims process. Review labor times and parts pricing to ensure estimate accuracy and cost control. Negotiate scope of work and pricing with shops when necessary. Escalate any gray-area coverage issues or concerns to management that may impact the customer or dealer experience. Work across multiple claims systems to research, document, and adjudicate claims efficiently. Ability to manage tasks across various platforms is essential. Review and approve TPA-submitted claims that exceed authority limits, ensuring proper documentation and contract alignment. The above-cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform. Periodic Job Functions: Other duties and special projects as needed. Participate in quality audits or peer reviews to ensure adherence to claims handling standards. Provide feedback on claims trends, system issues, or process improvements. Assist in onboarding and training new hires, including shadowing and answering procedural questions. Help develop and maintain troubleshooting guides and job aids for junior adjusters. Follow up on pending claims to ensure timely resolution and customer satisfaction. Collaborate with internal departments (e.g., underwriting, compliance, product) on escalated or complex claim issues. Support volume spikes or special initiatives, such as new business launches or system migrations. Attend refresher training or calibration sessions to stay aligned with current policy and process updates. #LI-Onsite

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: Please review the following job description: Process claims, which includes evaluating policy for coverage; working with the insured, outside adjusters, agents and attorneys on the claim and coordinating the payment of claims. In addition, prepare reports such as loss runs and monthly bordereau. ESSENTIAL DUTIES AND RESPONSIBILITIES Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. 1. Review policy to determine if loss is covered. If questionable, then hire attorney for coverage counsel for coverage analysis. 2. Settle claims within settlement authority, where applicable. 3. Work with adjusters, insureds, attorneys, agents and others to assure the claim is handled efficiently and professionally. 4. Attend mediations, when applicable and negotiate settlement within authority. 5. Oversight of vendors (attorneys/adjusters/experts) for accuracy in reporting. Audit invoices for accuracy. 6. Process incoming and outgoing claims and vendor payments. 7. Maintain loss fund. 8. Must review and recommend policy wording changes. 9. Perform claim status requests and updates. 10. Prepare daily, weekly and monthly reports. 11. Travel for meetings with clients, mediations and underwriters. Approximately 25% of time will be out of the office. QUALIFICATIONS Required Qualifications: 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. 1. High School Diploma 2. College degree or equivalent work experience 3. Claims Adjuster's license 4. Good organizational/time management skills 5. Ability to work under time constraints and meet deadlines 6. Strong verbal and written communications skills 7. Ability to operate a computer, calculator, multi-line phone, fax machine, copier and other office equipment 8. Knowledge and use of correct spelling and grammar 9. Ability to write legibly 10. Ability to effectively interact with employees at all levels of the organization and with a variety of people from diverse backgrounds 11. Ability to adhere to all organizational policies and procedures 12. Demonstrated proficiency in basic computer applications, such as Microsoft Office software products 13. Ability to travel, occasionally overnight Preferred Qualifications: 1. Previous administrative support experience 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 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 is a Drug Free Workplace. EEO is the Law Pay Transparency Nondiscrimination Provision E-Verify

Job DescriptionDescription: The Subrogation Adjuster will take ownership of subrogation files from start to finish, ensuring timely and accurate resolution. This includes assessing coverage, conducting thorough investigations, analyzing liability and damages, and pursuing recovery through negotiation or coordination with involved parties and legal counsel. This role handles a portfolio of mid-level auto/general liability subrogation claims across various jurisdictions and is expected to apply strong technical judgment, clear communication, and a solution-oriented approach. The Adjuster maintains a solid understanding of Edge Claims' mission, vision, and values, and upholds the standards of the Company. Responsibilities: Conducts thorough investigations by promptly reaching out to all relevant parties, such as insureds, claimants, employers, witnesses, producers, and adverse carriers, to gather facts and confirm key details of the auto loss. Clearly documents claim activity, including investigative findings, action steps, and communication summaries, in a concise and objective manner. Evaluates liability based on jurisdictional standards and verifies negligence scenarios, seeking supervisory input when appropriate. Prepares position statements using appropriate language when needed. Initiates subrogation efforts by notifying all involved insurers, legal representatives, and other responsible parties of Edge Claims' recovery interests. Delivers timely, high-quality service to internal partners and external stakeholders throughout the life of the claim. Collaborates closely with internal or assigned legal counsel, fostering strong working relationships and adhering to company practices and expectations. Negotiates and resolves both litigated and non-litigated auto subrogation claims, using relationship-building and sound judgment to drive effective recovery outcomes. Demonstrates strong timing and rapport-building skills to gain cooperation during negotiations. Monitors and manages loss adjustment expenses to ensure cost-effective claim resolution. Uses critical thinking to analyze information, identify root causes, and make informed decisions throughout the investigative and recovery process. Organizes workload efficiently, maintains accurate diary management, and prioritizes tasks in a fast-paced environment. Performs other functional duties as assigned. Requirements: Education Requirements High School Diploma or equivalent required. Bachelor's degree/or equivalent work experience (with high school diploma) Experience Requirements Has 5 years Auto Insurance/General Liability Claims Handling Experience, preferably Commercial Auto Experience working Subrogation in commercial fleet operations. Appropriately licensed and/or certified in all states in which claims are being handled. Highly Organized and excellent time management skills required Excellent oral, written and interpersonal communication skills. Excellent MS Office, Word, Power Point, and Excel expertise. The above statements are intended to describe the general nature and level of work being performed by the incumbents of this job. They are not intended to be an exhaustive list of all responsibilities and activities required of this position.

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities Are you an experienced professional with a sharp eye for detail and a strong background in litigation? Join our team as a Liability Adjuster, where you'll play a crucial role in managing Complex commercial general liability claims with precision and expertise. Key Responsibilities: Conduct thorough investigations of losses, identifying coverage issues and ensuring accurate assessments. Review and analyze evidence, reports, and medical records to establish damages and reserves. Process payments efficiently, ensuring timely resolution of claims. Interview insureds, claimants, and witnesses to gather essential information and build strong cases. Collaborate with legal teams to navigate complex litigation processes and defend our insureds effectively. Qualifications Juris Doctor (JD) degree preferred or Bachelor's degree with prior experience adjusting liability claims and a proven track record in litigation. Licensing: Active TX All Lines License, or willingness to obtain one at company's expense. Exceptional written and verbal communication skills. Strong organizational and computer skills. Excellent time management skills with the ability to prioritize tasks effectively.

Are You Driven? We Are. We are a company of driven, enthusiastic, and determined people. We celebrate achievement and success. We foster innovation, determination, and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make daily. At GAINSCO, it is our people that set us apart. If you are looking for a place where you can make a difference, perceive how your work impacts the company, and be recognized for your efforts and passion, then GAINSCO is the company for you. Why Join GAINSCO? GAINSCO's work environment rewards engaged individuals who have a desire to contribute and succeed. That's because our culture encourages individuals to grow their skills as they build their careers. Come join us and become a Champion with GAINSCO. GAINSCO is looking to hire a Bodily Injury Claims Adjuster for our Claims department. This individual should be looking to build a continued career within the industry, as our company will be growing, and giving plenty of potential to make advancements. This role will investigate, evaluate, negotiate, and resolve auto claims. While maintaining full compliance with internal and external quality standards and state specific regulations. As a Bodily Injury Claims Adjuster, you'll help customers get back on the road after an accident. Building relationships with customers while working in a fast-paced environment and managing the claims process from start to finish is a key aspect of this role. You'll have the support of a collaborative team and ongoing coaching from leaders. What does a BODILY INJURY CLAIMS ADJUSTER NON-ATTORNEY REPRESENTED do at GAINSCO? Strong knowledge and applications of auto policies, as well as state specific coverages. Assigns field appraisers to assist with investigation. Conducts telephone and electronic investigations as well as handles non-attorney represented injury claims. Handles non-attorney rep soft tissue bodily injury claims. Handles moderate to complex liability and coverage investigations with the ability to interpret policy language. Efficiency in time management, multi-tasking, and organizational skills to handle a high volume of claims. Gathers and evaluates complex coverage information, takes recorded statements, secures police reports, repair estimates and other related documents. Evaluates property damage and bodily injury, determines coverage and liability. Negotiates and settles bodily injury and liability claims. Initiate investigation of claims involving complex coverage claims, complex liability, and/or bodily injury claims (non-attorney represented), as well as questionable claims. Ensures legal compliance by following guidelines, company policies, as well as state and federal insurance regulations. Resolves claim by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter. What is required? Education: High School Diploma or Equivalent; Bachelor's degree is preferred. Licenses/ Certifications: To perform the essential functions of this job an active Texas or Florida Adjuster License will be required to comply with state and GAINSCO requirements. Upon hire, additional license(s) may be required. If that is the case, license(s) must be obtained. All licenses must be maintained in accordance with state requirements. Professional Insurance and/or Claims Designations are a plus. Experience: Minimum of Two years of experience in Auto Insurance as a Claims Adjuster. Minimum of Two years of experience interpreting policy language and state statute is required. Minimum of Two years of experience handling minor to moderately complexity of claims is required. One or more years of experience handling bodily injury claims is required. Knowledge of ImageRight and Claims Manager preferre Strong track record of making sound coverage and liability decisions based on facts and investigations. Other skills and abilities: Ability to manage time while prioritizing multiple tasks. Have an aptitude for providing information in a clear, concise manner with an appropriate level of detail, empathy, and professionalism. Demonstrates a high commitment to quality. Possess strong negotiation and analytical skills. Ability to gather and analyze information to evaluate results and choose the best solution to the problem. What else do you need to know? Hybrid Excellent benefits package: medical, dental, & vision insurance, life insurance, short-term and long-term disability insurance. Parental Leave Policy 401K + Company Match PTO Plan + Paid Company determined Holidays. **Applicants are required to be eligible to lawfully work in the U.S. immediately; employer will not sponsor applicants for U.S. work authorization (e.g. H-1B visa) for this opportunity** All offers are contingent upon a successful background investigation (including employment, education, criminal and DMV verification- when applicable) and a pre-employment drug test with results satisfactory to GAINSCO. GAINSCO is an Equal Employment Opportunity Employer

Job Description Key Responsibilities: Customer Claims: • Manage Customer Injury and Liability Claims: Oversee the investigation, documentation, and resolution of customer claims related to personal injury, property damage, or any other incidents occurring on organization premises. • Coordinate with Insurance Providers: Liaise with insurance companies to ensure proper claims filing and coordinate the resolution of claims involving external parties. • Customer Support: Handle escalated customer claims and provide appropriate resolutions while ensuring the store's best interests are maintained. • Documentation & Compliance: Ensure that all claims are properly documented in compliance with company policies and legal requirements. Keep detailed records of each customer-related claim. • Risk Prevention: Identify trends or recurring incidents that may contribute to customer claims and work with store management to implement safety measures or preventive actions. Employee Claims: • Workers' Compensation Claims: Oversee and manage all workers' compensation claims, ensuring compliance with state and federal regulations, and ensuring employees receive appropriate benefits. • Workplace Injury Claims: Manage the investigation of employee injury claims, including gathering evidence, interviewing witnesses, and ensuring all necessary forms are completed and submitted on time. • Fleet Claims Management: Manage the investigation of employee fleet claims, support employee's injuries if any, gather witness statements • Support and Guidance: Provide support to injured employees, ensuring they are informed throughout the claims process and are aware of their rights and available benefits. • Collaboration with HR and Legal: Work with HR and legal teams to ensure employee-related claims are handled correctly and in compliance with labor laws, insurance regulations, and company policies. • Collaboration with Safety Team: Work with the Safety Team to consistently do store visits, conduct safety audits, checklists and investigations as needed. Development: • Process Improvement: Identify opportunities to improve the claims process, whether through more efficient systems, better documentation, or enhanced communication strategies. Risk Management and Reporting: • Claims Analysis and Reporting: Review and analyze the data on claims to identify trends, recurring issues, or areas for improvement. Prepare detailed reports for management regarding claim frequency, costs, and risk mitigation efforts. • Collaboration with Risk and Safety Teams: Work closely with the Risk Management and Safety teams to address underlying causes of incidents that may lead to claims and develop preventive strategies. • Compliance: Ensure that all claims are processed in line with company policies, industry standards, and legal requirements, including managing documentation for audits or regulatory reviews. • Invoices: Reconcile and verify all invoices generated from claims. • Safety Monitor Report: Complete Safety Monitor report and communicate all parties involved to resolve an issue related to an investigation. Qualifications: • Bachelor's degree in Business, Risk Management, Insurance, or a related field (or equivalent experience). • 3-5 years of experience in claims management, risk management, or a specialist role, preferably in a retail or supermarket environment. • Strong understanding of risk management principles, insurance claims processes, and workers' compensation regulations. • Strong problem-solving and analytical abilities to investigate and resolve complex claims efficiently. • Excellent communication skills, both written and verbal, with the ability to manage sensitive issues with customers and employees. • Attention to detail and ability to maintain accurate records and reports. • Proficient in Microsoft Office and experience with claims management software or risk management tools. Physical Requirements: • Ability to stand for extended periods • Ability to lift up to 50 lbs as needed Work Environment: • Fast-paced, high-volume environment • Occasional evening, weekend, or holiday work may be required • Occasional travel to different company locations Physical Demands: Some lifting, carrying, pushing, and/or pulling; some stooping, kneeling, crouching, and/or crawling; and significant fine finger dexterity. Generally, the job requires 70% sitting, 20% walking, and 10% standing. This job is performed in a generally clean and healthy office environment.

THIS IS DESCRIPTION THIS IS DESCRIPTION Do You Have What It Takes? Following are the preferred qualifications for opportunities in Customer Service at one of our call centers: High school diploma / equivalent. As career progresses, ongoing technical insurance coursework and/or undergraduate studies are desirable At least One year of related clerical or customer service work Effective oral and written communication skills (English/Spanish fluency a definite plus) Ability to evaluate customer inquiries and determine appropriate actions Ability to operate a personal computer and business-related software Skills & Requirements Do You Have What It Takes? Following are the preferred qualifications for opportunities in Customer Service at one of our call centers: High school diploma / equivalent. As career progresses, ongoing technical insurance coursework and/or undergraduate studies are desirable At least One year of related clerical or customer service work Effective oral and written communication skills (English/Spanish fluency a definite plus) Ability to evaluate customer inquiries and determine appropriate actions Ability to operate a personal computer and business-related software

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. The Appearance Claims Adjuster is responsible for evaluating and processing insurance claims related to property damage and personal injury. This role involves conducting thorough investigations, assessing damages, and determining liability based on policy coverage. The adjuster will collaborate with policyholders, service providers, and legal teams to ensure timely and accurate claim resolution. How You Will Contribute • Handles claims from initial contact through to conclusion. • Thoroughly investigates claims and verifies eligibility • Responsible for maintaining positive customer relationships seeking to enhance organizational skills. • Manages a high call volume with exception communication and customer service skills • Successfully works independently and in a team atmosphere. • Skillfully adapts and uses critical thinking and problem-solving issues. Skills & Experience to Be Successful · Excellent written and verbal communication skills · Proficient with Microsoft Office Suite and industry standard web applications · Ability to maintain a high level of confidentiality Preferred · Bilingual is a plus, not required · Service Advisor, Warranty, or Service Drive experience a plus · Basic mechanical knowledge of automotive systems. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services; Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.

We're thrilled that you are interested in joining us here at the Amynta Group! The WARRANTY CLAIMS ADJUSTER is responsible for interactions with customers, inspectors, repair facilities, and part vendors to support our auto warranty call center. The Warranty Claims Adjuster will be responsible for providing our innovative extended service plans and warranty programs to retailers, dealers, distributors and manufacturers in numerous consumer and automotive markets. ESSENTIAL JOB DUTIES AND RESPONSIBILITIES* Handle claims on a daily basis Work in a call center environment focused on handling calls daily with expected performance metrics, handle times, and volume Probe and troubleshoot mechanical breakdown claims to determine whether customer complaint, repair facility diagnosis, and failed parts meets the criteria for approval based on the terms and conditions of the extended service contract. Review and verify repair costs using standard “national labor guides” (including labor rates and time) to ensure estimates are within approval guidelines. Use other resources such as, technical bulletins, recalls and system comments, and other requirements during the adjudication process. Verify repair information to determine if coverage is within the guidelines of the service contract. Determine if a field inspection is necessary based on cause of failure and cost estimates submitted by repair facility. Document all interactions, research, verification and other claim-related information in the database system. Interface with customers, agents, dealers, and other relevant parties to complete all investigations of claims. Review claims using the adjudication process established by department. Partner with other departments, claim adjusters, and management staff to identify options that support claims resolution and approval. Maintain a continual working knowledge of our client's products, services and promotions. Retrieve information from company systems and communicate information back to the customers, dealers, repair facilities, and vendors in a clear and concise manner. BASIC AND PREFERRED QUALIFICATIONS (EDUCATION AND EXPERIENCE) 2+ year's minimum experience (Required) High School Diploma or GED (Required) Some college (Preferred) Proficient knowledge of Microsoft Office (Required) ASE Certification (Preferred) MINIMUM QUALIFICATIONS, JOB SKILLS, ABILITIES Mastery of the English language, both written and verbal. Strong attention to detail, is dependable and follows through. Ability to read and interpret information. High level of maturity to handle sensitive and confidential situations. Strong work ethic and excellent time management skills. Strong interpersonal skills and ability to work well with people throughout the organization. Willingness to maintain a professional appearance and provide a positive company image. Willingness to work non-traditional shifts which meet the needs of the team and company. Ability to think independently and make decisions. Ability to assist peers. The Amynta Group (the “Company”) is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of any ground of discrimination protected by applicable human rights legislation. The information collected is solely used to determine suitability for employment, verify identity and maintain employment statistics on applicants. Applicants with disabilities may be entitled to reasonable accommodation throughout the recruitment process in accordance with applicable human rights and accessibility legislation. A reasonable accommodation is an adjustment to processes, procedures, methods of conveying information and/or the physical environment, which may include the provision of additional support, in order to remove barriers a candidate may face during recruitment such that each candidate has an equal employment opportunity. The Company will accommodate a candidate to the point of undue hardship. Please inform the Company's personnel representative if you require any accommodation in the application process.

The Claims Specialist will be responsible for assisting with the management of the Fleet Vehicle Safety & Operations Policy for DPR (and DPR related entities) across the US, as well as first and third-party auto physical damage and low severity property damage claims as requested by, and under the supervision of, DPR's Insured Claims Manager. Specific Duties include: Claims & Incident Management: Initial processing of first and third-party auto and low severity property damage incidents involving DPR (and DPR related entities), including but not limited to: Input and/or review all incidents reported in DPR's RMIS system. Maintain incident records in Insurance Team's document management system. Ensure all necessary information is compiled to properly manage the claims, including working with the internal teams to identify culpable parties, potential risk transfer to the culpable trade partner, if applicable, collecting documents such as incident reports, root cause analyses, if any, and vehicle lease or rental agreements. Report, with all appropriate documents and information, all claims for DPR (and DPR related entities) to all potentially triggered insurance policies for various types of programs (traditional, CCIP, OCIP), including analyzing contractual risk transfer opportunities. Assess potential risk transfer opportunities and ensure additional insured tenders or deductible responsibility letters are sent, where applicable. Liaison with the carriers in evaluating whether claims reported directly to the carriers are appropriate. Manage all auto and low severity property damage claims, as assigned, in the DPR RMIS system for DPR (and DPR related entities), including ensuring that all information is kept up to date. Provide in-network aluminum certified repair shop information to drivers following an incident. Act as a liaison between our carriers, auto repair shops, Operations, Fleet and EHS teams related to claim progress, strategy, expenses and settlement. When required, notify the applicable State's Department of Motor Vehicles office of motor vehicle accidents by preparing and mailing the specific State form. Work with Insurance Controller on auto program claim reports Liaison with Operations, Fleet and EHS teams on new incident reporting processes, as needed. Fleet Vehicle Safety & Operations Policy Management: Manage the Fleet Risk Index scores for authorized drivers, ensuring its accurate and up to date based on incidents and MVRs Assign training to authorized drivers based on MVA incidents, MVRs and citations, as well as managing completion of the training Ensure authorized driver list is kept current Liaison with internal HR, Fleet, EHS and Business Unit Leaders, where appropriate, on suspending vehicle usage permissions Responsible for working with internal teams on implementing appropriate updates to the Fleet Vehicle Safety & Operations Policy Key Skills: Strategic thinking Ability to mentor and inspire others Integrity Team player Strong writing and communication skills Self-Starter Highly organized and responsive - ability to meet deadlines Detail Oriented Basic working knowledge in all of the following coverages/programs: auto insurance, commercial general liability, property insurance, and controlled insurance programs. Risk and dispute management - insured claims Qualifications: A minimum of five years relevant insurance industry experience Previous experience in auto claims management highly desired DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************

As a 100% employee-owned contractor, when you work at Sundt, you're not just hiring on at a company, you're joining a culture. Because everyone at Sundt is part owner, you'll join a team of people who are deeply invested in their work. From apprentices to managers, we're passionate about the details and deliberate in everything we do. At Sundt we focus on building long-term prosperity for our clients, communities, and employee-owners. We offer competitive pay, industry-leading benefits including a 401k and employee stock ownership plan, incentive programs for craft and administrative employees as well as training that focuses on your personal and professional growth. We're driven by skill, grit and purpose. Join us as we strive to be the most skilled builder in America. Job Summary The Paralegal / Claims Specialist supports the company's Legal and Risk Management functions by assisting attorneys and insurance professionals in the investigation, evaluation, and resolution of claims and lawsuits. The role involves direct collaboration with outside counsel, insurance adjusters, and internal Safety and Operations teams. The Paralegal/Claims Specialist will independently manage the day-to-day handling of routine litigation and claims matters, including discovery, documentation, and coordination with defense counsel. Key Responsibilities 1. Assists attorneys with trial preparation, exhibits, witness coordination, and logistics. 2. Assists company attorneys with responding to non-party subpoenas and regulatory inquiries. 3. Attends mediations, depositions, and hearings as appropriate to support counsel, our internal personnel and maintain awareness of case progress. 4. Communicates directly with claimants, witnesses, experts, and internal personnel to obtain and analyze relevant information, including managing internal electronic data preservation in coordination with IT team, and oversee transfer of preserved data for discovery. 5. Coordinates with Safety personnel regarding incident intake, documentation, and potential claims escalation. 6. Drafts and edits legal documents including correspondence, discovery requests and responses, routine pleadings, affidavits, and case summaries. 7. In conjunction with attorneys, manages litigation, including coordinating discovery and e-discovery, tracking deadlines, managing document production, approving and processing legal invoices and maintaining organized case files. 8. Maintains accurate and up-to-date records in Risk Information Management Systems {RIMS) or other claims databases. 9. Reviews and analyzes claims in coordination with legal and risk management professionals determine liability, damages, and insurance coverage. 10. Works closely with company attorneys, outside counsel, and insurance adjusters to investigate, evaluate, and resolve claims and lawsuits. Minimum Job Requirements 1. 5-10 Years of Experience 2. Bachelor's degree 3. Knowledge working for a law firm or an insurance company representing clients in responding to claims and lawsuit preferred. 4. Paralegal certification Note: is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 50Ibs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Note: Job Description is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 501bs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Equal Opportunity Employer Statement: Sundt is committed to the equal treatment of all employees, and/or applicants for employment, and prohibits discrimination based on race, religion, sex (including pregnancy), sexual orientation, gender identity, color, age, disability, national origin, covered veteran status, genetic information; or any other classification protected by applicable Federal, state, or local laws. Benefit list: Market Competitive Salary (paid weekly) Bonus Eligibility based on company, group, and individual performance Employee Stock Ownership Plan & 401K Industry Leading Health Coverage Starting Your First Day Flexible Time Off (FTO) Medical, Health Savings, and Wellness credits Flexible Spending Accounts Employee Assistance Program Workplace Wellness Programs Mental Health Program Life and Disability Insurance Employee-Owner Perks Educational Assistance Sundt Foundation - Charitable Employee-Owner's program #LI-KA1

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

Lockton is currently seeking a Clinical Claims Specialist within our Specialty Practice unit. The objective of this role is to improve and reduce the severity of complex and catastrophic claims, reduce the cost of risk while improving the health of our employer client's employee health plan. * Provide explanation of disease states and associated costs to internal and external stakeholders. * Provide cost-of-care estimates used in the risk assessment of stop loss underwriting. * Consult with and advise underwriting on medical/clinical care approaches, standards of care and research of data for new business and renewals. * Serve as a resource regarding medical necessity issues, standards of care and analysis for the reimbursement of submitted stop loss claims. * Review claims and clinical documents to identify and monitor opportunities to increase member quality of care and overall cost reduction. * Collaborate with various key stake holders to strategize clinical and cost savings strategies and assist on execution of plan. * Coordinate implementation of claims savings solutions with Lockton Client Service Teams, TPAs, and stop loss carriers including regular tracking to measure savings and plan performance. * Manage and organize task lists and open items and cases. * Attend team clinical rounds to discuss cases and strategy solutions.

Lantern is the specialty care platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation's top specialists for surgery, cancer care, infusions and more, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation's largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com. About You: You use LOGIC in your decision making and understand that progress is critical to making change. You focus on the execution of your content while balancing a fast-paced environment and you take the time to celebrate both the small & big wins. INCLUSION is a core tenant of your personal beliefs. A diverse and inclusive environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with. You have the GRIT, drive and ambition to tackle big problems. Big problems require big ideas and a team that supports new ideas. You care deeply for your customers are driven to keep HUMANITY in all decisions. Your customers aren't just the individuals using your product. They are the driving factor in your motivation to make a change. Integrity guides you in life. Focusing on the TRUTH vs. giving people the answers they want to hear. You thrive in a Team Environment. Collaboration is key in innovation and creating change. These pillars of LIGHT are a reminder to our team that we are making a difference by providing guidance and support in navigating the often complex and confusing landscape of healthcare. We hope that through this LIGHT, individuals can find their way to the best care, resources, and support they need to get back to life. If this sounds like you, we would love to connect to speak further about career opportunities at Lantern. Please apply to our role & someone from our Talent Acquisition Team will reach out to help you navigate our interview process. Job Overview Our Reimbursement Specialists are a central points of contact for our provider network. The primary responsibility of the role is to deliver effective, accurate payment and communication to our providers. The day-to-day responsibilities of our Reimbursement Specialists include payment processing, researching, accurate billing/payment disbursement, and ensuring payment data accuracy and integrity. The desired candidate is articulate, empathetic, pragmatic, self-starting and ambitious. In addition, our Reimbursement Specialists are horizontal thinkers, analytical, organized and detail oriented. Key Responsibilities: Processes provider payments in accordance with company policies and procedures. Serves as primary contact to Finance Department regarding payment, determinations and payment processing activities. Assist in the final determination on claim disposition and payment determination. Serves as liaison to internal departments regarding provider related inquiries on claims related content. Processes adjustments or provider disputes providing timely follow-up. Coordinates research and responds to system inquiries from providers regarding payment, reimbursement determination, provider contact information and claims billing procedures. Communicates with supervisor on a daily and/or weekly basis regarding any outstanding claims issues related to system, authorizations, reimbursement/payment errors or internal approvals. Works with provider contracting staff when new/modified reimbursement contracts are needed Performs pre-adjudication claims reviews to ensure proper terms and schedules were used. Initiate necessary actions regarding pending claims or payment documentation. Follow up on open items reports to timely and accurate resolution. Respond proactively to provider issues and concerns and give feedback to management. Provide feedback to the manager regarding proper claims billing procedures in accordance with company policy and procedures. Assist in training new Payment Specialists. Initiate change requests to resolve system issues impacting claims/payment processing or issue resolution Runs and analyzes daily activity reports. Analyze, develop and deliver claims resolutions quickly and accurately according to company policies and procedures. Requirements: Minimum Bachelor's degree in healthcare, business, marketing or related field; or HS Diploma (or GED) and 4 years' applicable experience Minimum 2 years of experience in previous claims, health insurance or healthcare practice Knowledge of medical coding systems (i.e., CPT, ICD-9/10, revenue codes) preferred Knowledge of commonly used medical data resources preferred Knowledge of payor contracts and interpretation Knowledge of general office operations and/or experience with standard medical insurance claim forms preferred Strong communication (verbal, written and listening), teamwork, negotiation and organizational skills Ability to commit to providing a level of customer service within established standards Ability to provide attention to detail to ensure accuracy including mathematical calculations Ability to organize workload to meet deadlines and participate in department/team meetings Ability to analyze data and arrive at a logical conclusion Ability to identify issues and determine appropriate course of action for resolution Ability to display professionalism by having a positive demeanor, proper telephone etiquette and use of proper language and tone Ability to use software and hardware related to job responsibilities, including MS Office Suite and database software Ability to work with accuracy in a fast-paced environment Ability to work independently and handle PHI and confidential information Ability to process detailed verbal and written instructions Benefits Medical Insurance Dental Insurance Vision Insurance Short & Long Term Disability Life Insurance 401k with company match Paid Time Off Paid Parental Leave Lantern does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.