Patterson Companies was founded in 1985 and has grown from a single office specializing in transporting perishable goods to a comprehensive supply chain solutions company. Serving thousands of customers annually, Patterson expertly handles Full Truckload (FTL), Less-Than-Truckload (LTL), Expedited, Refrigerated, Flatbed, and Dry Van transport markets. The company is committed to ensuring every shipment is delivered efficiently and in optimal condition. In addition to being a leading logistics company, Patterson boasts large asset divisions with refrigerated and dry van fleets, as well as warehouse and distribution locations.
Role Description
This is a full-time, on-site role located in Plant City, FL, for a Transportation Claims & Carrier Qualifications Specialist that plays a critical role in protecting Patterson Companies from operational, financial, and reputational risk. This position is responsible for managing all Overages, Shortages, and Damages (OS&D), processing and resolving freight claims, qualifying and onboarding carriers, maintaining carrier insurance compliance, and overseeing organizational risk management procedures. This role ensures that Patterson Companies operate within industry regulations while building strong partnerships with carriers and safeguarding our customers' freight.
Key Responsibilities
Claims & OS&D Management
Serve as the first point of contact for all OS&D and freight claims from shippers, carriers, and internal teams.
Investigate, document, and process claims in compliance with company policies, federal regulations, and industry best practices.
Communicate with carriers, customers, and internal stakeholders to resolve disputes promptly and fairly.
Maintain detailed claim files, documentation, and reporting for trend analysis and process improvement.
Carrier Vetting & Qualification
Conduct thorough vetting of new carriers, including verifying MC/DOT authority, safety ratings, insurance coverage, and operational capabilities.
Ensure carriers meet Patterson Companies' safety and compliance standards before onboarding.
Monitor ongoing carrier compliance, including insurance renewals, safety performance, and regulatory changes.
Manage the carrier onboarding process in collaboration with the operations team, utilizing TMS-integrated vetting tools (e.g., Highway).
Insurance & Compliance Management
Track and verify carrier insurance policies, ensuring timely renewals and appropriate coverage.
Coordinate with carriers and insurance providers to update coverage documents in company systems.
Monitor regulatory requirements and ensure company compliance with FMCSA, DOT, and other governing bodies.
Organizational Risk Management
Identify operational risks and recommend preventive strategies to mitigate exposure.
Develop and update company policies related to risk, claims, and carrier compliance.
Provide regular risk and claim trend reports to leadership to inform decision-making.
Collaborate with sales, operations, and leadership to ensure contractual agreements protect company interests.
Carrier Relations & Partnership Management
Serve as a primary point of contact for carriers regarding qualification requirements, insurance compliance, claims processes, and risk-related inquiries
Communicate Patterson's carrier standards, documentation requirements, and expectations clearly and professionally
Build and maintain respectful, solutions-oriented relationships with approved carriers while enforcing compliance and risk policies consistently
Support carrier onboarding and requalification by providing guidance on required documentation, timelines, and corrective actions
Manage carrier communications during claims, incidents, or service failures with a focus on transparency, resolution, and professionalism
Collaborate with Operations and Carrier Sales teams to balance carrier partnership, service reliability, and risk mitigation
Identify recurring carrier issues or trends and proactively recommend improvements to processes, standards, or communication
De-escalate disputes when necessary while protecting Patterson's interests and maintaining long-term carrier trust
Qualifications
Strong Analytical Skills for evaluating claims, problem-solving, and ensuring data accuracy
Excellent Communication and Customer Service abilities to effectively collaborate with clients and carriers
Ability to work in a fast-paced, detail-oriented environment
Proficiency in using standard office software and transportation management systems
Previous experience in logistics, supply chain, or transportation management is preferred
Minimum 3 years of experience in transportation, logistics, risk management, or claims processing
$41k-52k yearly est. 4d ago
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Claim Representative, Medical Only
Ccmsi 4.0
Claims adjuster job in Maitland, FL
Workers' Compensation ClaimAdjuster, Medical Only
Hours: Monday - Friday, 8:00 AM to 4:30 PM ET
Salary Range: $20/hr - $23/hr
CCMSI is Hiring! We're looking for a Workers' Compensation ClaimAdjuster, Medical Only to join our team. This role is hybrid, reporting to our Maitland, FL office.
At CCMSI, we are employee-owned and committed to providing exceptional service. We offer manageable caseloads, extensive career development, and industry-leading benefits.
Why Join CCMSI?
✅ Work-Life Balance - Enjoy 4 weeks of PTO in your first year + 10 paid holidays
✅ Comprehensive Benefits - Medical, Dental, Vision, 401K, ESOP & more
✅ Career Growth - Structured training programs with opportunities for advancement
✅ Supportive Culture - Work in an environment where your expertise is valued
The Medical Only Claim Representative is responsible for claims handling of designated medical only claims and provide support to claim staff. This position may be used as a training position for consideration of promotion to an intermediate level claim position. Is accountable for the quality of claim services as perceived by CCMSI clients and within the corporate claim standards.
Responsibilities
Set up and manage medical files only in accordance with corporate claim standards and law.
Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision.
Review and approve related medical and miscellaneous invoices on designated claims. Negotiate any disputed bills/invoices for resolution under direct supervision.
Request and monitor medical treatment of designated claims in accordance with corporate claim standards.
Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim.
Close claim files when appropriate.
Retrieve closed claim files and re-file in storage, as requested.
Provide support to claim staff on client service teams.
Compliance with Corporate Claim Standards and special client handling instructions as established.
Performs other duties as assigned.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required.
Education and/or Experience
Associate Degree or two (2) year's related business experience required
Knowledge of medical terminology preferred.
Jurisdictions Preferred: Fl, GA, SC, NC, WV, VA
Computer Skills
Proficient using Microsoft Office products such as Word, Excel, Outlook
Certificates, Licenses, Registrations
Adjusters license may be required based upon jurisdiction.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity
Work requires the ability to sit or stand up to 7.5 or more hours at a time
Work requires sufficient auditory and visual acuity to interact with others
CORE VALUES & PRINCIPLES
Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.
Visa Sponsorship:
CCMSI does not provide visa sponsorship for this position.
ADA Accommodations:
CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team.
Equal Opportunity Employer:
CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.
#CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #MedicalClaims #HybridWork #ClaimsAdjuster #MaitlandFL #WorkersCompensation #CustomerService #MedicalTerminology #ClaimsSupport #ProblemSolving #AttentionToDetail #NegotiationSkills #FastPacedEnvironment #IND456 #LI-Hybrid
$20 hourly Auto-Apply 56d ago
Independent Insurance Claims Adjuster in Orlando, Florida
Milehigh Adjusters Houston
Claims adjuster job in Orlando, FL
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMSADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance ClaimsAdjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed ClaimsAdjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed ClaimsAdjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed ClaimsAdjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claimsadjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claimsadjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claimsadjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed ClaimsAdjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
$42k-52k yearly est. Auto-Apply 60d+ ago
General Liability Claim Adjuster
Westgate Resorts
Claims adjuster job in Ocoee, FL
Westgate Resorts provides a diverse range of vacation experiences. From sandy beaches on the Atlantic Ocean to snow-covered Utah mountains, families can affordably experience the country's most desirable vacation destinations. A world leader in the timeshare and hospitality industry, Westgate has resorts in Florida, Tennessee, South Carolina, Missouri, Utah, Nevada, and Arizona. Westgate meets every vacation expectation, for every family, for every budget. As we continue growing, we will continue offering the best and most-affordable vacation options out there!
Job Description
Are you a seasoned General Liability ClaimsAdjuster with strong litigation experience? In this role, you'll manage a diverse portfolio ofof general liability claims, including claims in litigation, from first notice of loss through resolution. You'll work closely with defense counsel, the VP of Risk Management, and cross-functional teams to protect company interests, reduce exposure, and drive fair, strategic claim outcomes.
If you excel in investigation, litigation management, negotiation, and fast-paced decision-making, this is an opportunity to directly influence risk reduction and contribute to a culture of continuous improvement.
What You'll Do
* Manage litigated general liability claims, maintaining detailed documentation throughout each claim's lifecycle.
* Collaborate with defense counsel and leadership to develop litigation strategies, evaluate exposure, and negotiate settlements.
* Prepare files for mediations, hearings, trials, and settlement conferences; attend proceedings as the company representative.
* Analyze reserves, prepare settlement evaluations, and make recommendations for represented and litigated cases.
* Investigate incidents, review legal documents, and collect documentation from internal departments.
* Identify subrogation opportunities and implement strategies to mitigate future losses.
* Participate in Resort Safety meetings and support initiatives that improve safety and reduce claim frequency.
* Ensure compliance with policy language, ISO forms, internal programs, and industry standards.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Must have thorough understanding of claims handling practices, policy language, exclusions, and ISO forms. Prioritization, organization, effective time management, creativity and self-discipline are needed to successfully perform in this position. Setting and achieving goals set is essential, along with the ability to work closely with defense counsel, and effectively manage litigation. The requirements listed below are representative of the knowledge, skill, and/or ability required.
What We're Looking For
* Strong background in general liability claims handling, with proven experience managing litigated files.
* Thorough understanding of policy language, exclusions, claims practices, and ISO forms.
* Excellent analytical, negotiation, and communication skills.
* Strong prioritization, organization, and time-management abilities.
* Ability to work independently, collaborate with counsel, and drive cases to resolution.
* Alignment with our company values: Integrity, Passion, and Work Ethic.
* High school diploma or GED required.
* Minimum 5 years of liability claims handling experience, including litigation.
* Valid FloridaAdjuster's License required.
* Preference for candidates with:
* College degree
* AICPCU coursework (AIC, ARM, CPCU)
* Industry-specific continuing education
Additional Information
Why Westgate?
* Comprehensive health benefits - medical, dental and vision
* Paid Time Off (PTO) - vacation, sick, and personal
* Paid Holidays
* 401K with generous company match
* Get access to your pay as you need it with our Daily Pay benefit
* Family benefits including pregnancy, and parental leave and adoption assistance
* Wellness Programs
* Flexible Spending Accounts
* Tuition Assistance
* Military Leave
* Employee Assistance Program (EAP)
* Life, Disability, Accident, Critical Illness & Hospital Insurance
* Pet Insurance
* Exclusive discounts for Team Member (i.e., hotels, cruise, resorts, restaurants, entertainment, etc.)
* Advancement & development opportunities
* Community Involvement Programs
Westgate Resorts is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability status or any other protected status under federal, state or local law. If you have a disability and believe you need a reasonable accommodation in order to complete your application or any part of the recruiting process, please email WGAccommodations@wgresorts.com with the job title and the location of the position for which you are applying.
This job posting is intended to provide a general overview of the position and may not include every responsibility, duty, or qualification required. Duties, responsibilities, and activities may change at any time with or without notice.
$42k-52k yearly est. 6d ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claims adjuster job in Winter Garden, FL
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
$42k-52k yearly est. Auto-Apply 36d ago
Claims Adjuster Trainee
Frontline Homeowners Insurance
Claims adjuster job in Lake Mary, FL
Job Description
ClaimsAdjuster Trainee
Onsite in Lake Mary, FL
At Frontline Insurance, we are on a mission to Make Things Better, and our ClaimsAdjuster Trainee plays a pivotal role in achieving this vision. We strive to provide high quality service and proactive solutions to all our customers to ensure that we are making things better for each one.
What makes us different? At Frontline Insurance, our core values - Integrity, Patriotism, Family, and Creativity - are at the heart of everything we do. We're committed to making a difference and achieving remarkable things together. If you're looking for a role, as a ClaimsAdjuster Trainee, where you can make a meaningful impact and grow your career, your next adventure starts here!
Our ClaimsAdjuster Trainee enjoy robust benefits:
Health & Wellness: Company-sponsored Medical, Dental, Vision, Life, and Disability Insurance (Short-Term and Long-Term).
Financial Security: 401k Retirement Plan with a generous 9% match
Work-Life Balance: Four weeks of PTO and Pet Insurance for your furry family members.
What you can expect as a ClaimsAdjuster Trainee:
Orientation & Licensing - Complete onboarding and obtain required state licensing.
Policy Interpretation - Learn insurance policy provisions and coverage details.
Application & Assessment - Apply specific regulations and complete final evaluation.
Customer Service & Communication - Develop skills for effective client interaction and support.
Claims Lifecycle & Systems - Understand end-to-end claims process and system navigation.
Property Construction & Materials - Gain knowledge of building components and materials
Estimating- Learn fundamentals of property damage estimation.
Investigation & Evidence - Acquire techniques for gathering and evaluating claim evidence.
Coverage Evaluation - Assess policy coverage and determine claim applicability.
Subrogation & Liability - Understand recovery processes and liability principles.
Dispute Resolution - Learn strategies for resolving conflicts and claim disputes.
Field Operations - Participate in on-site inspections and fieldwork procedures.
Obtain the FloridaAdjuster's license within 60 days of hire
Obtain all other required state licenses within 90 days of hire.
As necessary, upon acquisition of required licensing:
Deliver empathetic, customer-focused service throughout the claim lifecycle: coverage analysis, investigation, evaluation, reserving, negotiation, and resolution.
Apply policy interpretation and coverage evaluation skills to ensure fair and transparent claim outcomes.
Conduct thorough claim investigations, including on-site inspections, recorded statements, and other evidence gathering.
Utilize estimating tools and systems to assess property damage accurately.
Collaborate with team members and stakeholders to resolve disputes and support subrogation and liability processes.
Maintain compliance with internal quality standards and state regulations.
Assist with catastrophe operations as required, including, but not limited to working extra hours during major events or deploying to affected areas to help policyholders.
What we are looking for as a ClaimsAdjuster Trainee:
Bachelor's degree is preferred or minimum one year of work or customer service experience.
Strong organizational, time management, and communication skills.
Proficiency in Microsoft Office (Word, Excel, Outlook)
Ability to work independently and collaboratively in a fast-paced, high-volume environment.
Why work for Frontline Insurance?
At Frontline Insurance, we're more than just a workplace - we're a community of innovators, problem solvers, and dedicated professionals committed to our core values: Integrity, Patriotism, Family, and Creativity. We provide a collaborative, inclusive, and growth-oriented work environment where every team member can thrive.
Frontline Insurance is an equal-opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
$42k-52k yearly est. 14d ago
Independent Adjuster Roofing
Stratus Roofing
Claims adjuster job in Winter Garden, FL
Stratus Roofing is leading the Residential and Commercial ROOFING industry by putting PEOPLE first and we are in search of hard-working professionals to join our Stratus Family! At Stratus Roofing, we operate with a high level of integrity and customer service; therefore, expect this from our vendors and employees alike. We are proud to say we have hand-picked our team to assure our customers work with the most professional roofing consultants in the industry. We are currently seeking experienced, professional Roofing ClaimsAdjusters to cover the GREATER FORT MYERS, SARASOTA AND TAMPA areas.
CORE RESPONSIBILITIES:
Communicate with insurance to get agreement on the scope of work and pricing.
Evaluate document and estimate storm damage to roofs.
REQUIREMENTS:
2+ years working as an insurance adjuster; specifically on storm damage claims for roofing, siding, windows, and gutters
Florida PPIA Licensing: All Lines Adjuster (We will pay for courses and designations if needed).
Xactimate experience a plus
Must have a valid state driver's license and an acceptable Motor Vehicle Driving Record
$39k-53k yearly est. Auto-Apply 60d+ ago
Insurance Claims Specialist
Mid Florida Finance 4.1
Claims adjuster job in Lakeland, FL
Mid Florida Financing is looking for an Insurance Specialist to join our team in Lakeland, FL. This position will provide insurance coverage to our new and existing clients. We are looking for someone who is self-motivated, organized, and has the ability to work independently.
Benefits:
401(k)
Dental insurance
Flexible schedule
Health insurance
Paid time off
Vision insurance
Responsibilities:
Provides exceptional customer service while investigating policy coverage, liability and damages in a timely manner
Gathers information and documents claim file to comply with company guidelines and state compliance and regulations
Negotiates timely and appropriate settlements with insurance companies
Manages pending claims to meet company quality criteria
Recognizes recovery opportunities in regards salvage vehicles
Performs other related duties as assigned or required.
Assists internal and external customers with problems or questions regarding claims by phone or through written correspondence while providing a high level of customer service.
Job Type:
Full-time
Pay:
$16.00 per hour
Expected hours:
40 per week
Schedule:
Monday to Friday
Work Location:
In person
We are an equal opportunity employer.
$16 hourly Auto-Apply 60d+ ago
Patient Claims Specialist - Bilingual Only
Modmed 4.5
Claims adjuster job in Orlando, FL
We are united in our mission to make a positive impact on healthcare. Join Us!
South Florida Business Journal, Best Places to Work 2024
Inc. 5000 Fastest-Growing Private Companies in America 2024
2024 Black Book Awards, ranked #1 EHR in 11 Specialties
2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold)
2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara)
Who we are:
We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany.
ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine!
Your Role:
Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections
Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates
Input and update patient account information and document calls into the Practice Management system
Special Projects: Other duties as required to support and enhance our customer/patient-facing activities
Skills & Requirements:
High School Diploma or GED required
Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST
Minimum of 1-2 years of previous healthcare administration or related experience required
Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs)
Manage/ field 60+ inbound calls per day
Bilingual required (Spanish & English)
Proficient knowledge of business software applications such as Excel, Word, and PowerPoint
Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone
Ability and openness to learn new things
Ability to work effectively within a team in order to create a positive environment
Ability to remain calm in a demanding call center environment
Professional demeanor required
Ability to effectively manage time and competing priorities
#LI-SM2
ModMed Benefits Highlight:
At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits:
India
Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk,
Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees,
Allowances: Annual wellness allowance to support your well-being and productivity,
Earned, casual, and sick leaves to maintain a healthy work-life balance,
Bereavement leave for difficult times and extended medical leave options,
Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave,
Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind.
United States
Comprehensive medical, dental, and vision benefits
401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
Generous Paid Time Off and Paid Parental Leave programs,
Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,
Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.
PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.
$78k-99k yearly est. Auto-Apply 38d ago
Inside Claims Rep- Maitland, FL
Sfbcic
Claims adjuster job in Maitland, FL
This job is with Florida Farm Bureau which is the Florida state office for Southern Farm Bureau Casualty Insurance Company, and we currently have an opening for an Inside Claims Representative to work in Maitland, FL. This position is responsible for resolving damage and injury claims caused by or incurred by insureds. Starting salary of $54,800. We offer many benefits including health, dental, vision, PTO, Extended Illness Leave, Pension and matching 401K.
ESSENTIAL DUTIES AND RESPONSIBILITES: Include the following. Other duties may be assigned.
Investigate, validate, evaluate, negotiate, and settle all claims as assigned.
Maintain claim files and follow departmental reporting procedures.
Submit reserve recommendations on assigned claims.
Communicate with customers and other Claims personnel regarding procedures, problems, and coverages.
Enroll in training and continuing education courses when and where required.
Negotiate fair settlements with individual claimants or attorneys.
Report risk reviews to Underwriting Department.
Regular and predictable attendance is required.
EDUCATION and/or EXPERIENCE:
Bachelor's degree from four-year college or university
Obtain Adjuster's license in 6 months
SKILLS/ABILITY
Strong Verbal communication & listening skills
Effective negotiation skills
Effective conflict management skills
Ability to simultaneously handle multiple priorities
Possesses strong product knowledge
PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally required to sit at a desk or table with some walking, standing, bending, stooping or carrying of light objects. The employee frequently is required to perform continuous operations of personal computer for four hours or more and use their hands to finger, handle, or feel objects, tools, or controls; and talk or hear. Specific vision abilities required by this job include close vision.
$54.8k yearly 37d ago
Licensed Public Adjuster Orlando
Rockwall National Public Adjusters
Claims adjuster job in Orlando, FL
Job DescriptionSalary:
About Us
Rockwall National Public Adjusters is one of the most established public adjusting firms in the region. For more than 15 years, we have successfully advocated for property owners, supported by leadership with over 20 years of experience in the insurance claims industry.
We pride ourselves on our longevity, high retention, and reputation for excellence. Many of our adjusters and office staff have been with us for over 10 years, reflecting our supportive culture and commitment to long-term careers.
At Rockwall, our mission is simple: level the playing field, fight for our clients rights, and secure the settlements they deserve. By joining our team, you will become part of a well-respected firm with proven processes, unmatched administrative support, and a collaborative environment that fosters professional growth.
The Role
We are seeking a motivated and Licensed Public Adjuster in the Orlando area to join our team in a hybrid, commission-based role.
As a Public Adjuster, you will represent policyholders throughout the insurance claims process, guiding them through stressful property damage losses and securing fair settlements. You will play a vital role in soliciting referral business, signing clients, evaluating damages, preparing and negotiating claims, and advocating for clients best interests.
This position is designed to support all levels of experience:
Newly licensed adjusters benefit from structured training, mentorship, and back-office support.
Experienced adjusters gain access to qualified leads, advanced systems, and a trusted brand with a long-standing reputation.
Key Responsibilities
Collaboratively solicit residential and commercial new claims and referral partners
Sign, inspect, evaluate, and document property damage for residential and commercial claims
Prepare, submit, and negotiate insurance claims on behalf of policyholders
Communicate with clients, insurance carriers, contractors, and stakeholders to advance claims efficiently
Advocate for clients best interests and ensure fair settlements are achieved
Maintain accurate records, reports, and claim documentation
Deliver exceptional customer service while educating clients on the claims process
Generate new business and efficiently close provided leads
Required Qualifications
Active Florida Public Adjuster license (or ability to obtain one)
Prior experience in insurance adjusting, construction, restoration, or a related field preferred, but not required
Strong negotiation and communication skills
Organized, detail-oriented, and able to manage multiple claims simultaneously
Professional demeanor with a client-focused mindset
Valid drivers license and reliable transportation for field inspections
Compensation & Benefits
Commission-based structure with unlimited earning potential
Training and ongoing professional development
Career growth opportunities within a supportive and collaborative team
Hybrid work flexibility (field + office)
Full administrative and office support (contracts, compliance, claims, invoicing, mortgage company payments)
The Rockwall Difference
At Rockwall, we provide unmatched support at every stage of the claims process, allowing our adjusters to focus on serving clients and building careers.
Key Advantages:
Comprehensive adjuster onboarding and mentorship programs
Professional ongoing sales training to close contracts faster and expand referral networks
Proprietary lead generation sources and affiliate networks
Automated client onboarding to reduce paperwork
Access to advanced claims management software for streamlined workflows
Hands-on field training for residential and commercial claims
Xactimate training and estimate reviews to ensure complete assessments
Seamless invoicing and fee collection support
Regular updates on case law, legislation, and industry trends
A collaborative team environment that promotes growth and shared knowledge
Why Join Rockwall NPA
20+ years of insurance industry expertise
15+ years as a trusted, established firm
Strong reputation and high staff retention
Proprietary lead generation sources and long-standing affiliate networks
Full support systems that empower adjusters to succeed
A company culture built on professionalism, advocacy, and results
$39k-53k yearly est. 7d ago
Claims Representative I
Florida League of Cities Inc. 4.4
Claims adjuster job in Orlando, FL
Investigates, determines liability, confirm coverage, establishes damages, and negotiates settlement of auto, property and light general liability claims for a Member based organization in accordance with approved policy & procedure and industry Best Practices. This position does not handle injury, complex or litigated claims.
RESPONSIBILITIES AND DUTIES:
Responsible for the investigation of assigned auto, non-complex general liability, and first-party property cases in compliance with prescribed industry best practices. This includes verifying coverage, determining liability, evaluating damages, establishing reserves, reporting status, and negotiating appropriate settlements for each claim.
Possesses a certain level of financial authority to settle independently.
Maintains an appropriate diary and documentation as to file activity.
Makes determination and handles files with subrogation potential.
Works with Independent Appraisers to estimate the cost of repair or replacement of damaged or stolen vehicles / damaged property.
Reports theft, fraud, and arson losses as required to state and industry agencies, as appropriate.
Performs most duties on an individual basis, and work has a direct bearing on Management results.
Represents the Company from a public relations standpoint and must conduct oneself appropriately at all times.
Personal contacts are a major part of activity and include Members, claimants, witnesses, vendors, repair facilities, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses and all other person's incident to the investigation and processing of claims.
Attends required or necessary training sessions, courses to maintain their license credits and to maintain up to date knowledge & skills.
Performs other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
Excellent negotiation, analytical and interpretive skills
Excellent oral, written communication and presentation skills
Strong organizational and interpersonal skills
Superior customer service skills
Able to multitask and set own priorities
Works well under pressure
Should be used to and able to function effectively in a fast-paced environment.
Able to establish and maintain effective working relationships with department heads, managers, employees, and vendors.
Government claims background is a plus.
Physical Requirements include: Bending, Pulling, Sorting, Carrying up to 20 lbs., Pushing, Speaking (English), Climbing, Reaching, Standing, Key entering, Reading (English), Walking, Kneeling, Seeing, Writing (English)
Should be able to type 35 WPM.
Spanish fluency is a plus.
TRAINING AND EXPERIENCE:
Position requires a degree from an accredited College/University in business or insurance preferred or equivalent experience in industry. One to three years of experience in insurance industry as a Customer Service Representative or Property or Auto Liability (no injury) adjuster. Knowledge of Microsoft Office products a must.
Must have an active FloridaAdjusters License.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.
**PLEASE DO NOT APPLY IF YOU ARE A SMOKER**
Classification: Exempt
Dept: Property & Liability
Reports to: Claims Supervisor
$26k-35k yearly est. Auto-Apply 8d ago
Claims Specialist - Auto
Philadelphia Insurance Companies 4.8
Claims adjuster job in Lake Mary, FL
Marketing Statement:
Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.
We are looking for a Claims Specialist - Auto to join our team.
JOB SUMMARY
Investigate, evaluate and settle more complex first and third party commercial insurance auto claims.
JOB RESPONSIBILITIES
Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner.
Communicates with all relevant parties and documents communication as well as results of investigation.
Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts.
Travel is required to attend customer service calls, mediations, and other legal proceedings.
JOB REQUIREMENTS
High School Diploma; Bachelor's degree from a four-year college or university preferred.
10 plus years related experience and/or training; or equivalent combination of education and experience.
• National Range : $82,800.00 - $97,300.00
• Ultimate salary offered will be based on factors such as applicant experience and geographic location.
EEO Statement:
Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.
Benefits:
We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.
Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
$82.8k-97.3k yearly Auto-Apply 60d+ ago
Claims Specialist
Mindlance 4.6
Claims adjuster job in Lake Mary, FL
My name is Pondsy Anthony, and I am Recruiting Specialist with Mindlance Inc. I have reviewed your resume and at a first glance find it to be a good fit for a Position that we are exclusively recruiting for. We are working very closely with our Client based in FL to fill this requirement urgently. This is a 4+ months of contract position with a possible extension depending on performance. You can get back to me at ************ to discuss in detail.
Job Description
Job Title: Claim Specialist
Client Location : 255 Technology Park, Lake Mary, FL 32746
Contract Duration : 4+ months (High possibility of Extension)
***Info about Schedules:
- Candidates being selected need to be open for the contractor shift of either
9a-6p or 10a-7p or 11-8.
- If contractors are hired on, they have to be available for shifts like 11a-8p
and 12p-9p. Please let candidates know this!
Looking for :-
Candidates must have reimbursement experience that is within the past 6 months
Prior authorization - submission, review, support, completion, verification
Appeal - submission, review, support, completion, verification, coordination
Reimbursement - investigation, verification
JOB SUMMARY:
The primary function/purpose of this job:-
Verify member submitted claims forms, member's eligibility and pharmacy
information is complete and accurate, updating system information as needed.
Superior data entry proficiency is expected in order to provide accurate and
timely processing of claims submitted by member, pharmacy or appropriate
agency. Moderate knowledge of drugs and drug terminology used daily. Process
claims according to client specific guidelines while identifying claims
requiring exception handling. Navigate daily through several platforms to
research and accurately finalize claim submissions. Oral or written
communication with internal departments, members, pharmacies or agencies to resolve
claim issues. Adhere to strict HIPAA regulations especially when communicating
to others outside of Express Scripts. Prioritize and coordinate influx of daily
workload for claims processing, returned mail and out-going correspondence and
e-mails to assure required turnaround time is met. Assess accuracy of system
adjudication and alert management of potential problems affecting the integrity
of claim processing. Analyze claims for potential fraud by member or pharmacy.
May be required to work on special projects for claims team.
SCOPE OF JOB
Reimbursement
verification of enrollments
MINIMUM QUALIFICATIONS TO ENTER THE JOB:
Formal Education and/or Training: High school diploma or equivalent required, some
college or technical training preferred
YEARS OF EXPERIENCE:
Two years' experience in P.B.M. environment is helpful but not required.
KNOWLEDGE AND ABILITIES:
• Strong data entry and 10-key skills
• Retail pharmacy, customer service experience helpful but not required
• PC and MS Office literate
• Strong attention to detail
• Excellent retention and judgment ability
• Proficient written and oral communication skills
• Ability to work in fast-paced, production environment
• Reliable, self-motivated with excellent attendance
• Team player who has the ability to stay on task with little supervision
Qualifications
•
Prior authorization - submission, review, support, completion, verification
• Appeal - submission, review, support, completion, verification, coordination
• Reimbursement - investigation, verification
Additional Information
All your information will be kept confidential according to EEO guidelines.
$37k-51k yearly est. 60d+ ago
Customer Claims Representative
Service Pros Auto Glass
Claims adjuster job in Orlando, FL
Job Description
Customer Claims Representative - Orlando
Join the Service Pros Auto Glass team inside our partnered dealerships! You'll engage customers, spot glass-replacement opportunities, and coordinate quick, professional service - all while building strong relationships and developing a personal team. This role is perfect for a teachable person who loves being part of a supportive, winning team.
What You'll Do:
Engage customers in the service drive and identify windshield replacement needs.
Educate and guide customers through their options and next steps.
Build strong relationships with service advisors, managers, and technicians.
Encourage dealership referrals and hit daily/weekly sales goals.
Schedule and coordinate on-site glass services.
Keep accurate records of leads, interactions, and completed jobs.
Represent the company with a professional, positive attitude.
What Makes You a Great Fit:
Experience in customer service or sales is a plus, but not required.
Strong communication and people skills.
A self-motivated, proactive approach - you enjoy taking the lead.
Team-oriented mindset with a friendly, professional appearance.
Valid driver's license and reliable transportation.
What We Offer:
A fun, energetic, team-first culture
Ability to earn $1000 - $2500 per week
You are
paid on a weekly basis
Promotion from within and clear growth paths
Ongoing training and development
Team events, company outings, and a culture that celebrates wins
$28k-40k yearly est. 7d ago
Claim Representative, Medical Only
Cannon Cochran Management 4.0
Claims adjuster job in Maitland, FL
Workers' Compensation ClaimAdjuster, Medical Only
Hours: Monday - Friday, 8:00 AM to 4:30 PM ET
Salary Range: $20/hr - $23/hr
CCMSI is Hiring! We're looking for a Workers' Compensation ClaimAdjuster, Medical Only to join our team. This role is hybrid, reporting to our Maitland, FL office.
At CCMSI, we are employee-owned and committed to providing exceptional service. We offer manageable caseloads, extensive career development, and industry-leading benefits.
Why Join CCMSI?
✅ Work-Life Balance - Enjoy 4 weeks of PTO in your first year + 10 paid holidays
✅ Comprehensive Benefits - Medical, Dental, Vision, 401K, ESOP & more
✅ Career Growth - Structured training programs with opportunities for advancement
✅ Supportive Culture - Work in an environment where your expertise is valued
The Medical Only Claim Representative is responsible for claims handling of designated medical only claims and provide support to claim staff. This position may be used as a training position for consideration of promotion to an intermediate level claim position. Is accountable for the quality of claim services as perceived by CCMSI clients and within the corporate claim standards.
Responsibilities
Set up and manage medical files only in accordance with corporate claim standards and law.
Establish reserves and/or provide reserve recommendations within established authority levels under direct supervision.
Review and approve related medical and miscellaneous invoices on designated claims. Negotiate any disputed bills/invoices for resolution under direct supervision.
Request and monitor medical treatment of designated claims in accordance with corporate claim standards.
Summarize all correspondence and medical records in claim log notes as well as file same in the appropriate claim.
Close claim files when appropriate.
Retrieve closed claim files and re-file in storage, as requested.
Provide support to claim staff on client service teams.
Compliance with Corporate Claim Standards and special client handling instructions as established.
Performs other duties as assigned.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required.
Education and/or Experience
Associate Degree or two (2) year's related business experience required
Knowledge of medical terminology preferred.
Jurisdictions Preferred: Fl, GA, SC, NC, WV, VA
Computer Skills
Proficient using Microsoft Office products such as Word, Excel, Outlook
Certificates, Licenses, Registrations
Adjusters license may be required based upon jurisdiction.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work requires the ability to stoop, bend, reach and grab with arms and hands, manual dexterity
Work requires the ability to sit or stand up to 7.5 or more hours at a time
Work requires sufficient auditory and visual acuity to interact with others
CORE VALUES & PRINCIPLES
Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits.
Visa Sponsorship:
CCMSI does not provide visa sponsorship for this position.
ADA Accommodations:
CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team.
Equal Opportunity Employer:
CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment.
#CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #MedicalClaims #HybridWork #ClaimsAdjuster #MaitlandFL #WorkersCompensation #CustomerService #MedicalTerminology #ClaimsSupport #ProblemSolving #AttentionToDetail #NegotiationSkills #FastPacedEnvironment #IND456 #LI-Hybrid
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$20 hourly Auto-Apply 57d ago
General Liability Claim Adjuster
Westgate Resorts
Claims adjuster job in Ocoee, FL
Westgate Resorts provides a diverse range of vacation experiences. From sandy beaches on the Atlantic Ocean to snow-covered Utah mountains, families can affordably experience the country's most desirable vacation destinations. A world leader in the timeshare and hospitality industry, Westgate has resorts in Florida, Tennessee, South Carolina, Missouri, Utah, Nevada, and Arizona. Westgate meets every vacation expectation, for every family, for every budget. As we continue growing, we will continue offering the best and most-affordable vacation options out there!
Job Description
Are you a seasoned General Liability ClaimsAdjuster with strong litigation experience? In this role, you'll manage a diverse portfolio ofof general liability claims, including claims in litigation, from first notice of loss through resolution. You'll work closely with defense counsel, the VP of Risk Management, and cross-functional teams to protect company interests, reduce exposure, and drive fair, strategic claim outcomes.
If you excel in investigation, litigation management, negotiation, and fast-paced decision-making, this is an opportunity to directly influence risk reduction and contribute to a culture of continuous improvement.
What You'll Do
Manage litigated general liability claims, maintaining detailed documentation throughout each claim's lifecycle.
Collaborate with defense counsel and leadership to develop litigation strategies, evaluate exposure, and negotiate settlements.
Prepare files for mediations, hearings, trials, and settlement conferences; attend proceedings as the company representative.
Analyze reserves, prepare settlement evaluations, and make recommendations for represented and litigated cases.
Investigate incidents, review legal documents, and collect documentation from internal departments.
Identify subrogation opportunities and implement strategies to mitigate future losses.
Participate in Resort Safety meetings and support initiatives that improve safety and reduce claim frequency.
Ensure compliance with policy language, ISO forms, internal programs, and industry standards.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Must have thorough understanding of claims handling practices, policy language, exclusions, and ISO forms. Prioritization, organization, effective time management, creativity and self-discipline are needed to successfully perform in this position. Setting and achieving goals set is essential, along with the ability to work closely with defense counsel, and effectively manage litigation. The requirements listed below are representative of the knowledge, skill, and/or ability required.
What We're Looking For
Strong background in general liability claims handling, with proven experience managing litigated files.
Thorough understanding of policy language, exclusions, claims practices, and ISO forms.
Excellent analytical, negotiation, and communication skills.
Strong prioritization, organization, and time-management abilities.
Ability to work independently, collaborate with counsel, and drive cases to resolution.
Alignment with our company values: Integrity, Passion, and Work Ethic.
High school diploma or GED required.
Minimum 5 years of liability claims handling experience, including litigation.
Valid FloridaAdjuster's License required.
Preference for candidates with:
College degree
AICPCU coursework (AIC, ARM, CPCU)
Industry-specific continuing education
Additional Information
Why Westgate?
Comprehensive health benefits - medical, dental and vision
Paid Time Off (PTO) - vacation, sick, and personal
Paid Holidays
401K with generous company match
Get access to your pay as you need it with our Daily Pay benefit
Family benefits including pregnancy, and parental leave and adoption assistance
Wellness Programs
Flexible Spending Accounts
Tuition Assistance
Military Leave
Employee Assistance Program (EAP)
Life, Disability, Accident, Critical Illness & Hospital Insurance
Pet Insurance
Exclusive discounts for Team Member (i.e., hotels, cruise, resorts, restaurants, entertainment, etc.)
Advancement & development opportunities
Community Involvement Programs
Westgate Resorts is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability status or any other protected status under federal, state or local law. If you have a disability and believe you need a reasonable accommodation in order to complete your application or any part of the recruiting process, please email [email protected] with the job title and the location of the position for which you are applying.
This job posting is intended to provide a general overview of the position and may not include every responsibility, duty, or qualification required. Duties, responsibilities, and activities may change at any time with or without notice.
$42k-52k yearly est. 5d ago
Claims Representative I
Florida League of Cities Inc. 4.4
Claims adjuster job in Orlando, FL
Job Description
CLAIMS REPRESENTATIVE I
Investigates, determines liability, confirm coverage, establishes damages, and negotiates settlement of auto, property and light general liability claims for a Member based organization in accordance with approved policy & procedure and industry Best Practices. This position does not handle injury, complex or litigated claims.
RESPONSIBILITIES AND DUTIES:
Responsible for the investigation of assigned auto, non-complex general liability, and first-party property cases in compliance with prescribed industry best practices. This includes verifying coverage, determining liability, evaluating damages, establishing reserves, reporting status, and negotiating appropriate settlements for each claim.
Possesses a certain level of financial authority to settle independently.
Maintains an appropriate diary and documentation as to file activity.
Makes determination and handles files with subrogation potential.
Works with Independent Appraisers to estimate the cost of repair or replacement of damaged or stolen vehicles / damaged property.
Reports theft, fraud, and arson losses as required to state and industry agencies, as appropriate.
Performs most duties on an individual basis, and work has a direct bearing on Management results.
Represents the Company from a public relations standpoint and must conduct oneself appropriately at all times.
Personal contacts are a major part of activity and include Members, claimants, witnesses, vendors, repair facilities, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses and all other person's incident to the investigation and processing of claims.
Attends required or necessary training sessions, courses to maintain their license credits and to maintain up to date knowledge & skills.
Performs other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
Excellent negotiation, analytical and interpretive skills
Excellent oral, written communication and presentation skills
Strong organizational and interpersonal skills
Superior customer service skills
Able to multitask and set own priorities
Works well under pressure
Should be used to and able to function effectively in a fast-paced environment.
Able to establish and maintain effective working relationships with department heads, managers, employees, and vendors.
Government claims background is a plus.
Physical Requirements include: Bending, Pulling, Sorting, Carrying up to 20 lbs., Pushing, Speaking (English), Climbing, Reaching, Standing, Key entering, Reading (English), Walking, Kneeling, Seeing, Writing (English)
Should be able to type 35 WPM.
Spanish fluency is a plus.
TRAINING AND EXPERIENCE:
Position requires a degree from an accredited College/University in business or insurance preferred or equivalent experience in industry. One to three years of experience in insurance industry as a Customer Service Representative or Property or Auto Liability (no injury) adjuster. Knowledge of Microsoft Office products a must.
Must have an active FloridaAdjusters License.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.
**PLEASE DO NOT APPLY IF YOU ARE A SMOKER**
Classification: Exempt
Dept: Property & Liability
Reports to: Claims Supervisor
$26k-35k yearly est. 10d ago
Customer Claims Representative
Service Pros Auto Glass
Claims adjuster job in Lakeland, FL
Job Description
Customer Claims Representative - Lakeland
Join the Service Pros Auto Glass team inside our partnered dealerships! You'll engage customers, spot glass-replacement opportunities, and coordinate quick, professional service - all while building strong relationships and developing a personal team. This role is perfect for a teachable person who loves being part of a supportive, winning team.
What You'll Do:
Engage customers in the service drive and identify windshield replacement needs.
Educate and guide customers through their options and next steps.
Build strong relationships with service advisors, managers, and technicians.
Encourage dealership referrals and hit daily/weekly sales goals.
Schedule and coordinate on-site glass services.
Keep accurate records of leads, interactions, and completed jobs.
Represent the company with a professional, positive attitude.
What Makes You a Great Fit:
Experience in customer service or sales is a plus, but not required.
Strong communication and people skills.
A self-motivated, proactive approach - you enjoy taking the lead.
Team-oriented mindset with a friendly, professional appearance.
Valid driver's license and reliable transportation.
What We Offer:
A fun, energetic, team-first culture
Ability to earn $1000 - $2500 per week
You are
paid on a weekly basis
Promotion from within and clear growth paths
Ongoing training and development
Team events, company outings, and a culture that celebrates wins
$28k-40k yearly est. 7d ago
Claim Specialist
Mindlance 4.6
Claims adjuster job in Lake Mary, FL
Business Claim Specialist Visa GC/Citizen Division Pharmaceutical Pay $16.00/hr. Contract 5 Month Timings Mon - Fri between 9.00AM - 6.00PM The primary function/purpose of this job. Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside the client. Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team.
ESSENTIAL FUNCTIONS:
The 6-10 major responsibility areas of the job. Weight: (%)
(Total = 100%)
1. Manage member and client expectations related to claim reimbursements. Input claim requests into adjudication platform maintaining compliance to performance guarantees, HIPAA guidelines and service standards, which include production and accuracy standards. Processing according to client guidelines making exceptions upon member appeal and client approval. Recognize and escalate appropriate system crises/problems and fraudulent claims to management. 40 %
2. Identify claims requiring additional research, navigate through appropriate system platforms to perform research and resolve issue or forward as appropriate 15 %
3. Research to define values for missing information not submitted with claim but required for processing. Identify drug form, type and strength to manually determine correct NDC number value which will allow claim to process. Continue researching values if system editing does not accept original assigned value. Utilize anchor platform, internet resources and/or contacting retail pharmacist as resources for missing values. 15 %
4. Initiate correspondence to members, pharmacies or other internal departments for missing information, claim denials or other claim issues. 15 %
5. Evaluate claim submission, ensure all required information is present and determine what action should be taken. Confirm patient eligibility and verify patient information matches system. Update member's address to match claim form if necessary. 5 %
6. Identify exception handling and process per client requirements. Monitor system to ensure client specific documentation related to claims processing and benefits is current and system editing is operating appropriately. 5 %
7. Variety of other miscellaneous duties as assigned 5 %
SCOPE OF JOB
Provide quantitative data reflecting the scope and impact of the job - such as budget managed, sales/revenues, profit, clients served, adjusted scripts, etc.
Maintain an average of 30 Commercial claims per hour (cph) or 35 Work Comp claims per hour (cph).
Qualifications
Formal Education and/or Training:
High school diploma or equivalent required, some college or technical training preferred
Years of Experience:
Two years' experience in P.B.M. environment is helpful but not required.
Computer or Other Skills:
Strong data entry, 10-key skills, general PC skills and MS Office experience
Knowledge and Abilities:
• Strong data entry and 10-key skills
• Retail pharmacy, customer service experience helpful but not required
• PC and MS Office literate
• Strong attention to detail
• Excellent retention and judgment ability
• Proficient written and oral communication skills
• Ability to work in fast-paced, production environment
• Reliable, self-motivated with excellent attendance
• Team player who has the ability to stay on task with little supervision
Additional Information
Thanks & Regards,
Ranadheer Murari
|
Recruitment Executive
|
Mindlance, Inc.
|
W
:
************
***************************
How much does a claims adjuster earn in Kissimmee, FL?
The average claims adjuster in Kissimmee, FL earns between $38,000 and $57,000 annually. This compares to the national average claims adjuster range of $40,000 to $64,000.
Average claims adjuster salary in Kissimmee, FL
$47,000
What are the biggest employers of Claims Adjusters in Kissimmee, FL?
The biggest employers of Claims Adjusters in Kissimmee, FL are: