Level I Florida Claims Adjuster
Claims adjuster job in Sunrise, FL
Amwins Specialty Auto is seeking career-oriented candidates to join a claims team within our rapidly growing company. As a Level I Claims Adjuster, you will investigate straightforward 1st party and non-injury related liability 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 an in office position based out of our Sunrise, FL location!
Responsibilities:
Establish timely contact with all applicable parties to a claim (insureds, drivers, witnesses, etc), gathers facts of the loss and clearly explains the claims process
Assess coverage, identifying and addressing potential coverage issues
Determine liability and document the claim file with details of the claim investigation
Communicate to applicable parties the rationale behind coverage or liability decisions
Document information obtained regarding damages and resolve within assigned authority limits
Manage the assignment of claims to material damage handling units for inspection or repairs
Maintain file notes and correspondence while performing multiple tasks associated with a fast-paced environment
Manage reserve adequacy throughout the life of the claim
Alert claims supervisor in the event of potential fraud, recovery, or severity escalation in the claim
Ensure timely and cost-effective claim resolution
Qualifications:
1-3 years of P&C adjusting experience
Must be fluent in English, fluent in Spanish is preferred
Associates degree or above preferred
Must obtain Florida adjuster license prior to start date
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:
Medical, dental & vision coverage
401K with Company match
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.
Field Claims Adjuster
Claims adjuster job in Miami, 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.
Independent Insurance Claims Adjuster in Miami, Florida
Claims adjuster job in Miami, FL
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
Auto-ApplyPIP Claims Adjuster (On-site)
Claims adjuster job in Coral Springs, FL
Job DescriptionDescription:
The ideal candidate is an experienced, all-lines adjuster, with at least one year of PIP handling experience for Florida PIP claims, specifically with experience clearing coverage and qualifying claimants for benefits under the policy. The candidate has a strong background in insurance claims processing, excellent communication skills, and the ability to handle complex situations with empathy and professionalism. Adjusters are responsible for assigned files within their department matched to their expertise in claims handling. They must follow protocols set forth by department supervisors/managers and operate within their stated authority and handle claims in accordance with the Florida adjuster code of ethics.
Essential Duties and Functions
The essential functions include, but are not limited to the following:
· Evaluate auto insurance claims promptly and accurately to determine coverage, liability, and settlement options.
· Conduct thorough investigations into the circumstances surrounding each claim, including obtaining statements, collecting evidence, and analyzing policy provisions.
· Maintain detailed and organized claim files, documenting all relevant information, correspondence, and decisions made throughout the claims process.
· Communicate effectively with policyholders, claimants, witnesses, and other involved parties to gather information, explain coverage, and provide updates on claim status.
· Negotiate settlements within authorized limits, considering factors such as liability, damages, and policy coverage.
· Provide exceptional customer service to policyholders and claimants, addressing inquiries, concerns, and complaints in a timely and professional manner.
· Ensure compliance with insurance regulations, company policies, and industry standards in all aspects of claims handling.
· Collaborate with internal teams, including underwriters, legal counsel, and other claims professionals, to resolve complex claims and mitigate risk effectively.
· Identify opportunities for process improvement and contribute to the development of best practices within the claims department.
· Perform quality reviews of claim files to ensure accuracy, consistency, and adherence to company guidelines.
· Ensure timecards are reviewed daily for accurate hours worked.
Requirements:
Minimum Qualifications (Knowledge, Skills, and Responsibilities)
· Strong knowledge of insurance principles, regulations, and industry standards.
· Excellent analytical skills with the ability to assess liability and evaluate damages.
· Exceptional communication and interpersonal skills, both written and verbal.
· Proficiency in insurance claims software, preferably Microsoft Office suite.
· Demonstrated ability to manage multiple priorities and meet deadlines in a fast-paced environment.
· Commitment to providing outstanding customer service and maintaining professionalism in challenging situations.
Required Education and Experience:
· High School Diploma or equivalent experience in auto claims insurance, business administration, or a related field; Bachelor's or Associates degree preferred.
· Minimum of 1+ years of PIP handling experience for Florida PIP claims
· Florida Adjuster License.
Public Adjuster
Claims adjuster job in Miami, FL
Department
Insurance & Financial Services
Employment Type
Full Time
Location
Florida
Workplace type
Hybrid
Compensation
$90,000 - $170,000 / year
Key Responsibilities Skills, Knowledge and Expertise Benefits About The Misch Group Stone Hendricks Group is a direct-hire search firm that brings together years of experience and a diverse range of talent to connect businesses with exceptional job candidates. With a focus on timely and effective recruitment, we understand the power of a well-formed employee base in helping businesses achieve their goals. We offer our services to businesses of all sizes, providing qualified candidates for blue- and grey-collar roles, as well as white-collar and executive positions. The success of our direct-hire search process is driven by our advanced training, proprietary technology, and extensive network across industries. At Stone Hendricks Group, we value integrity and prioritize connectedness, commitment, and candor in our interactions with both employers and job seekers. Our clients consider us trusted advisors, relying on the highly personalized service we provide and our ability to find candidates that are an ideal fit for their unique needs. Choose Stone Hendricks Group for unsurpassed direct-hire search services that match successful organizations with talented job candidates.
Patient Claims Specialist
Claims adjuster job in Boca Raton, FL
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 a plus (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
Auto-ApplyClaims Adjuster (Bodily Injury)
Claims adjuster job in Oakland Park, FL
Job Description
CLAIMS ADJUSTOR (remote - East Coast) ARC Group seeks a Bodily Injury Claims Adjuster to work in a remote hybrid role for our direct client based in FL. The Claims Adjustor will investigate, evaluate, and negotiate bodily injury claims, ensuring compliance with legal standards and company policies while also coordinating with counsel on the defense of claims. There is a preference for someone in FL but Claims Adjusters from surrounding gulf and eastern seaboard states will be considered.
The Claims Adjustor must have experience with bodily injury, liability, and preferably with liability, property damage, and commercial auto. But bodily injury is required.
Our client is a leading insurance underwriter, and this is a great opportunity for a Claims Adjustor to join a well-established firm (45+ years) that is on a multi-year growth plan. You would join a company that offers competitive salary and comprehensive benefits package including PTO, Paid Holidays, health, vision, detail, Life & Voluntary/ADD, STD & LTD, 401K contributions and business casual dress
Claims Adjustor Responsibilities:
Correspond and interview with agents, witnesses, or claimants to compile information
Take accurate and detailed statements from all involved parties
Calculate and approve payment of claims within a certain monetary limit
Negotiate and settle property losses with little oversight
Coordinate with legal counsel in handling cases correctly
Negotiation and Settlement:
Negotiate settlements with claimants, attorneys, and other involved parties in a fair and cost-effective manner.
Collaborate with internal teams, such as underwriters and claims specialists, to facilitate efficient claims resolution.
Documentation and Reporting:
Prepare detailed and accurate documentation of claim investigations, legal actions, and settlement agreements.
Provide regular reports to management on claim status, legal developments, and financial implications.
Compliance and Best Practices:
Ensure compliance with state and federal regulations, as well as company policies and procedures.
Stay informed about changes in legislation and industry trends affecting commercial auto insurance.
Claims Adjustor Qualifications:
3+ years of previous bodily injury insurance experience, investigations or other related fields with liability, and property damage, and commercial auto (preferred)
Experience in conflict resolution
Strong negotiation skills
Excellent written and verbal communication skills
Deadline and detail-oriented
Would you like to know more about our new opportunity? You can apply online while viewing all open jobs at *******************
ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed.
We are proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse workforce.
We are a no-fee agency for candidates.
Field Claims Investigator
Claims adjuster job in Miami, FL
Job Description
Job Type: Contract Workplace Type: Hybrid (50% remote, 50% fieldwork) Compensation: $25/hr plus $.50/mi
Phoenix Loss Control (PLC) is a US-based business services provider in the cable, telecom, and utilities sector. PLC's core service is outside plant damage investigation, recovery, and prevention. Across the US and parts of Canada, we help our clients recover the costs of third-party damage to their infrastructure, such as underground fiber optic or gas lines. PLC currently employs over 140 people, servicing some of the largest cable and telecoms operators (e.g., Comcast, Spectrum, AT&T, and Google). PLC is currently aggressively expanding its business and looking for talented and energetic people to bring onboard to help drive growth.
POSITION SUMMARY
Outside Plant Damage (OPD) costs our clients over 30 million annually. Field investigators are needed to collect, access, and report these damages. This is a part-time, on-call contract job to help support our clients with damage recovery. For our field investigators, each day and every investigation is different. We need inquisitive, self-driven individuals who are comfortable rolling up their sleeves and working in a constantly changing, dynamic environment.
Duties
Conduct on-site field investigations
Write detailed but concise investigation reports using diverse sources of information, types of evidence, witness statements, and costing estimates
Develop and maintain comprehensive knowledge of local and state statutes, laws, and regulations for underground and aerial cables and utility service lines
Remain prepared and willing to respond to damage calls within a timely manner
Complete damage investigations within 7 days and then work with and support our claims managers to complete the investigation and begin the recovery process
Respond to damages same day if received during business hours (if not, first response following day)
Accurately record all time, mileage, and other associated specific items
Requirements
Interpersonal skills to gather information and conduct field interviews with involved parties including contractors and technicians, witnesses, law enforcement, and possible damagers
Smartphone to gather photos, videos, and other information while conducting investigations
Computer, with high-speed internet access, to upload and download reports, research cases, and to interact with our claims system and other databases and portals
Exceptional attention to detail and strong written and verbal communication skills
Proven ability to operate independently and prioritize while adhering to timelines
Strong and objective analytical skills
Valid driver's license, current insurance, and reliable vehicle with ability to respond to damages at any time
Safety vest, work boots, and hard-hat
Preferred Qualifications and Skills
Current or previous telecommunication or utility experience
Knowledge of underground utility locating procedures and systems
Investigation, inspection, or claims/field adjusting
Criminal justice, legal, or military training or work experience
Engineering, infrastructure construction, or maintenance background
Remote location determined at discretion of investigations manager
This is a contract position. There are no benefits offered with this position.
Claims Investigator - Part-Time
Claims adjuster job in Miami, FL
Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.
Job Description
Allied Universal is hiring a Claims Investigator. Claim Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation.
Florida applicants must either hold a C Private Investigators' License
OR
Independently complete the 40-hour course necessary to successfully apply for a CC Private Investigator's license (apprenticeship) before applying.
Must possess a valid driver's license with at least one year of driving experience
RESPONSIBILITIES:
Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability
Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations
Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation
Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters
Run appropriate database indices if necessary and verify the accuracy of results found
QUALIFICATIONS (MUST HAVE):
Must possess one or more of the following:
Bachelor's degree in Criminal Justice
Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims
High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims
Ability to be properly licensed as a Private Investigator as required by the states in which you work
Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course
Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims
Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country
Special Investigative Unit (SIU) Compliance knowledge
Ability to type 40+ words per minute with minimum error
Flexibility to work varied and irregular hours and days including weekends and holidays
Proficient in utilizing laptop computers and cell phones
PREFERRED QUALIFICATIONS (NICE TO HAVE):
Military experience
Law enforcement
Insurance administration experience
One or more of the following professional industry certifications
Certified Fraud Investigator (CFE)
Certified Insurance Fraud Investigator (CIFI)
Fraud Claim Law Associate (FCLA)
Fraud Claim Law Specialist (FCLS)
Certified Protection Professional (CPP)
Associate in Claims (AIC)
Chartered Property Casualty Underwriter (CPCU)
BENEFITS:
Medical, dental, vision, basic life, AD&D, and disability insurance
Enrollment in our company's 401(k)plan, subject to eligibility requirements
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.
Closing
Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: ***********
If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices.
Requisition ID 2025-1488482
Auto-ApplyPublic Adjuster
Claims adjuster job in Plantation, FL
Title: Public Field Adjuster - Exciting Opportunity in Multiple Cities
Are you a talented Public Insurance Adjuster tired of the endless cycle of selling and looking for a more fulfilling adjusting role? Join us in a dynamic joint venture position, and be a part of our expanding 'boots on the ground' teams across multiple cities in the country!
Company Overview:
We are an innovative insurance adjusting firm rapidly expanding across various cities. Our focus is on delivering exceptional claim handling services with a personal touch. We specialize in providing comprehensive claim adjustment solutions, ensuring our clients receive just and fair settlements.
Position Overview:
As a Public Field Adjuster, you'll be at the forefront of our field operations, handling the adjusting aspect of the claim process in your assigned territory. This role is perfect for those who excel in claim adjusting and seek to move away from sales-driven positions.
Key Responsibilities:
- Conduct thorough adjuster inspections and assess claims within your designated territory.
- Maintain consistent and effective communication with clients throughout the claim process.
- Analyze insurance policies, evaluate damages, and advocate for the best interest of our clients.
- Work collaboratively with our team to manage and negotiate settlements efficiently.
- Ensure compliance with industry standards and regulations.
What We Offer:
- A joint venture role, providing the freedom of independent work while being part of a supportive team.
- A defined territory, allowing for focused and effective claim management.
- Hassle-free case management and financial handling. We provide you with fully signed and verified claim files, so you can dive straight into the adjusting process without the preliminary steps of client acquisition or file verification.
- We handle all financial aspects, including invoicing and payment collection, allowing you to concentrate fully on claim adjustment and client advocacy. This streamlined approach ensures that you can focus on what you do best, with the assurance that the administrative and financial details are expertly managed by our team.
- A dynamic and supportive work environment with opportunities for professional growth.
Requirements:
- Proven experience as a Public Insurance Adjuster.
- Strong understanding of insurance policies and claim settlement processes.
- Exceptional communication and negotiation skills.
- Detail-oriented with strong analytical abilities.
- Self-motivated and capable of managing multiple claims independently.
- Valid insurance adjuster license.
Join Us:
If you're ready to step into a role that values your adjusting expertise over sales tactics, we'd love to hear from you. Embrace this exciting opportunity to grow with us and make a real impact in the lives of our clients. Apply now to be part of our journey in revolutionizing insurance claim adjusting!
Claims Investigator - Part-Time
Claims adjuster job in Hialeah, FL
Overview
Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.
Job Description
Allied Universal is hiring a Claims Investigator. Claim Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation.
Florida applicants must either hold a C Private Investigators' License
OR
Independently complete the 40-hour course necessary to successfully apply for a CC Private Investigator's license (apprenticeship) before applying.
Must possess a valid driver's license with at least one year of driving experience
RESPONSIBILITIES:
Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability
Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations
Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation
Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters
Run appropriate database indices if necessary and verify the accuracy of results found
QUALIFICATIONS (MUST HAVE):
Must possess one or more of the following:
Bachelor's degree in Criminal Justice
Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims
High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims
Ability to be properly licensed as a Private Investigator as required by the states in which you work
Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course
Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims
Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country
Special Investigative Unit (SIU) Compliance knowledge
Ability to type 40+ words per minute with minimum error
Flexibility to work varied and irregular hours and days including weekends and holidays
Proficient in utilizing laptop computers and cell phones
PREFERRED QUALIFICATIONS (NICE TO HAVE):
Military experience
Law enforcement
Insurance administration experience
One or more of the following professional industry certifications
Certified Fraud Investigator (CFE)
Certified Insurance Fraud Investigator (CIFI)
Fraud Claim Law Associate (FCLA)
Fraud Claim Law Specialist (FCLS)
Certified Protection Professional (CPP)
Associate in Claims (AIC)
Chartered Property Casualty Underwriter (CPCU)
BENEFITS:
Medical, dental, vision, basic life, AD&D, and disability insurance
Enrollment in our company's 401(k)plan, subject to eligibility requirements
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.
Closing
Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: ***********
If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices.
Requisition ID
2025-1488482
Claims Specialist
Claims adjuster job in Boca Raton, FL
Join our dynamic team at Quadrant Health Group! Quadrant Billing Solutions, a proud member of the Quadrant Health Group, is seeking a passionate and dedicated Claims Specialist to join our growing team. You will play a vital role focused on ensuring that healthcare services are delivered efficiently and effectively.
Why Join Quadrant Health Group?
Competitive salary commensurate with experience.
Comprehensive benefits package, including medical, dental, and vision insurance.
Paid time off, sick time and holidays.
Opportunities for professional development and growth.
A supportive and collaborative work environment.
A chance to make a meaningful impact on the lives of our clients.
Compensation: $18 - $24 per hour - Full-time
What You'll Do:
The ideal candidate is organized, persistent, and results-driven, with deep knowledge of out-of-network billing for Substance Use Disorder (SUD) and Mental Health (MH) services. You'll join a high-performing team focused on maximizing collections, reducing aging A/R, and ensuring every dollar is pursued.
Major Tasks, Duties and Responsibilities:
Proactively follow up on unpaid and underpaid claims for Detox, Residential, PHP, and IOP levels of care.
Manage 500-700 claims per week, prioritizing efficiency and accuracy.
Handle 4-5 hours of phone time per day with strong communication skills.
Communicate with payers via phone, portals, and written correspondence to resolve billing issues.
Identify trends in denials and underpayments and escalate systemic issues.
Dispute and overturn wrongly denied claims.
Update and track claims using CMD (CollaborateMD) and internal task systems.
Follow QBS workflows using Google Drive, Docs, Sheets, and Kipu EMR.
Maintain professional and timely communication with internal teams and facility partners.
Bonus Experience (Not Required):
Handling refund requests and appeals.
Preparing and submitting level 1-3 appeals (e.g., medical necessity, low pay, timely filing).
Gathering and submitting medical records for appeal support.
Working with utilization review (UR) or clinical teams.
Familiarity with ASAM and MCG medical necessity criteria.
Exposure to payment posting, authorization reviews, or credentialing.
What You'll Bring:
Minimum 1 year of SUD/MH billing and claims follow-up experience (required).
High School Diploma or equivalent, associate or bachelor's degree (preferred).
Strong understanding of insurance verification, EOBs, and RCM workflows.
Familiarity with major payers: BCBS, Cigna, Aetna, UHC, Optum, TriWest.
Experience overturning insurance denials is a strong plus.
Proficient in CMD (CollaborateMD) and Kipu EMR (strongly preferred).
Excellent written and verbal communication skills.
Highly organized, detail-oriented, and capable of managing multiple priorities.
Why Join Quadrant Billing Solutions?
Rapid career growth in a mission-driven, niche billing company.
Collaborate with clinical and billing experts who understand behavioral health.
Join a tight-knit, supportive team culture.
Gain opportunities for leadership advancement as the company scales.
#HP
Compensation details: 18-24 Hourly Wage
PI8f5f94a69303-26***********0
Easy ApplyClaims Specialist (Substance Abuse Billing)
Claims adjuster job in Fort Lauderdale, FL
Reports to: Claims Supervisor
Employment Status: Full-Time
FLSA Status: Non-Exempt
Job Summary:
We are searching for a diligent Claims Follow-Up Specialist to ensure a timely and accurate collection of medical claims. The specialist will work closely with insurance companies to rectify payment denials, settle disputes, and receive due reimbursements. The ideal candidate will possess strong communication skills, a deep understanding of medical billing and coding, and the determination to resolve outstanding claims.
Duties/Responsibilities:
· Reviews and works on unpaid claims, identifying and rectifying billing issues.
· Communicates with insurance companies regarding any discrepancy in payments if necessary.
· Conducts research and appeals denied claims timely.
· Reviews Explanation of Benefits (EOBs) to determine denials or partial payment reasons.
· Provides detailed notes on actions taken and next steps for unpaid claims.
· Collaborates with the billing team to ensure accurate claim submission.
· Maintains a comprehensive understanding of the insurance follow-up process, payer guidelines, and compliance requirements.
· Resubmits claims with necessary corrections or supporting documentation when needed.
· Tracks and documents trends related to denials and work towards a resolution with the billing team.
· Assists patients with inquiries related to their insurance claims, providing clear and accurate information.
· All other duties as assigned.
Required Skills/Abilities:
· Proficiency in healthcare billing software.
· Strong analytical, organizational, and multitasking skills.
· Excellent verbal and written communication abilities.
· Ability to navigate payer websites and use online resources to resolve outstanding claims.
Education and Experience:
· High school diploma or equivalent required.
· Experience in medical billing collections or a similar role in a Behavioral Health industry specializing in Substance abuse and Mental Health is strongly preferred.
· Knowledge of medical terminology, CPT and ICD-10 coding is a plus.
· Knowledge of HIPAA and other healthcare industry regulations.
Benefits
· Health Insurance
· Vision Insurance
· Dental Insurance
· 401(k) plan with matching contributions
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FNOL Adjuster
Claims adjuster job in Deerfield Beach, FL
The FNOL Adjuster is responsible for taking inbound calls and recording First Notice of Loss. The position provides excellent customer service to all internal and external PTIC customers by utilizing excellent, in-depth knowledge of company products and programs. 620 license required. ESSENTIAL DUTIES AND RESPONSIBILITIES
Provide timely and accurate information to incoming customer requests.
Take First Notice of Loss (FNOL).
Resolve customer concerns and answer question on existing claims.
Receives, investigates, and then responds to customer complaints.
Works under general supervision performing a variety of complicated tasks requiring a wide degree of latitude and creativity.
Must be knowledgeable of concepts, practices, and procedures within a particular field.
Performs other duties as assigned.
REQUIRED SKILLS 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, skill, and/or ability required.
Problem Solving: identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem-solving situations; uses reason even when dealing with emotional topics.
Teamwork: contributes to building a positive team spirit.
Oral / Written Communication: speaks and writes clearly and persuasively in positive and negative situations; listens and gets clarification.
Attendance/Punctuality is consistently at work and on time; ensures work responsibilities are covered when absent.
Analytical: understands situations by breaking them down into component parts and looking for interdependence; weigh options and proposals critically and thoroughly through the use of a variety of information sources and tools; provides rationale for and results of analysis to others.
Interpersonal Skills: refer to the measure of a person's ability to operate within business organizations through social communication and interactions. Interpersonal skills are how people relate to one another.
Creativity: ability to identify radical alternatives to current thinking. Ability to develop innovative solutions to problems.
QUALIFICATIONS
High school diploma or general education degree GED); at least three years (3 plus) related experience and/or training; or equivalent combination of education and experience
State of Florida 5-20 or 6-20 Insurance Adjusters license
Intermediate to advanced computer skills: Microsoft Office, Outlook
Field Claims Adjuster
Claims adjuster job in Hialeah, 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.
Independent Insurance Claims Adjuster in Fort Lauderdale, Florida
Claims adjuster job in Fort Lauderdale, FL
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
Auto-ApplyPatient Claims Specialist - Bilingual Only
Claims adjuster job in Boca Raton, 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.
Auto-ApplyClaims Adjustor (BI)
Claims adjuster job in Oakland Park, FL
Job DescriptionCLAIMS ADJUSTER (remote) ARC Group seeks two Bodily Injury Claims Adjuster to work in a remote contract role for our direct client based in Fort Lauderdale, FL. This is a 90 day contract to start and could possibly extend.
The Claims Adjuster must have experience with bodily injury, liability, and preferably with liability, property damage, and commercial auto. But bodily injury is required.
The Claims Adjuster will investigate, evaluate, and negotiate bodily injury claims. The Claims Adjuster will ensure compliance with legal standards and company policies while also coordinating with counsel on the defense of claims. There is a preference for someone on the east coast or central time zones.
Our client is a leading insurance underwriter, and this is a great opportunity for a Claims Adjustor to work with a well-established firm (45+ years) that values their employees and life-work balance.
Claims Adjuster Responsibilities:
Correspond and interview with agents, witnesses, or claimants to compile information
Take accurate and detailed statements from all involved parties
Calculate and approve payment of claims within a certain monetary limit
Negotiate and settle property losses with little oversight
Coordinate with legal counsel in handling cases correctly
Negotiation and Settlement:
Negotiate settlements with claimants, attorneys, and other involved parties in a fair and cost-effective manner.
Collaborate with internal teams, such as underwriters and claims specialists, to facilitate efficient claims resolution.
Documentation and Reporting:
Prepare detailed and accurate documentation of claim investigations, legal actions, and settlement agreements.
Provide regular reports to management on claim status, legal developments, and financial implications.
Compliance and Best Practices:
Ensure compliance with state and federal regulations, as well as company policies and procedures.
Stay informed about changes in legislation and industry trends affecting commercial auto insurance.
Claims AdjustEr Qualifications:
3+ years of previous bodily injury insurance experience, investigations or other related fields with liability, and property damage, and commercial auto (preferred)
MUST HAVE recent / current work with Bodily Injury/BI claims along with property damage.
Experience in conflict resolution
Strong negotiation skills
Excellent written and verbal communication skills
Deadline and detail-oriented
Would you like to know more about our new opportunity? For immediate consideration, please send your resume directly to Jon Meredith at ******************* or call him at ************. You can also apply directly and view all our open positions at *******************
ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed.
We are proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse workforce.
We are a no-fee agency for candidates.
Easy ApplyClaims Investigator - Part-Time
Claims adjuster job in Fort Lauderdale, FL
Overview
Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services. Allied Universal Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.
Job Description
Allied Universal is hiring a Claims Investigator. Claim Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation.
Florida applicants must either hold a C Private Investigators' License
OR
Independently complete the 40-hour course necessary to successfully apply for a CC Private Investigator's license (apprenticeship) before applying.
Must possess a valid driver's license with at least one year of driving experience
RESPONSIBILITIES:
Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability
Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations
Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation
Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters
Run appropriate database indices if necessary and verify the accuracy of results found
QUALIFICATIONS (MUST HAVE):
Must possess one or more of the following:
Bachelor's degree in Criminal Justice
Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims
High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims
Ability to be properly licensed as a Private Investigator as required by the states in which you work
Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course
Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims
Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country
Special Investigative Unit (SIU) Compliance knowledge
Ability to type 40+ words per minute with minimum error
Flexibility to work varied and irregular hours and days including weekends and holidays
Proficient in utilizing laptop computers and cell phones
PREFERRED QUALIFICATIONS (NICE TO HAVE):
Military experience
Law enforcement
Insurance administration experience
One or more of the following professional industry certifications
Certified Fraud Investigator (CFE)
Certified Insurance Fraud Investigator (CIFI)
Fraud Claim Law Associate (FCLA)
Fraud Claim Law Specialist (FCLS)
Certified Protection Professional (CPP)
Associate in Claims (AIC)
Chartered Property Casualty Underwriter (CPCU)
BENEFITS:
Medical, dental, vision, basic life, AD&D, and disability insurance
Enrollment in our company's 401(k)plan, subject to eligibility requirements
Seven paid holidays annually, sick days available where required by law
Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.
Closing
Allied Universal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: ***********
If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: ***********/offices.
Requisition ID
2025-1488482
Field Claims Adjuster
Claims adjuster job in Fort Lauderdale, 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.