Claims adjuster jobs in Miramar, FL - 112 jobs

Assurant is looking for Financial Services Claims Adjusters to join our growing team! If you are motivated, solution-oriented and have a passion for providing great customer service, come grow a fulfilling career with us! As an Adjuster, you'll provide be working directly with policyholders when they have a claim. You'll advocate for the policyholder by listening, analyzing problems, and guide them through the claims process. You'll use your expertise to proactively make recommendations that will help customers avoid future issues. This role follows a Hybrid Model, which will require going into the Miami office location: 701 Waterford Way, Miami, FL 33126 * This job posting is for future openings * What makes us different? Medical benefits begin on your first day Tuition reimbursement available after 6 months, up to $5000/annually Competitive paid time off, including holidays We deliver exceptional paid time off What will be my duties and responsibilities? Educate clients/customers on card benefit insurance programs and procedures. Provide accurate, professional service and maintain a customer-focused approach. Review claim information and enter data using standard procedures. Review submitted documentation for accuracy and completeness. Investigate questionable claims in collaboration with management. Adjudicate claims and provide settlements in accordance with laws and policy provisions. Make claim approval/denial decisions within authority limits or escalate as needed. Document all actions and outcomes in the system. Strive for high performance in customer satisfaction, efficiency, and quality. Maintain positive working relationships with internal and external stakeholders. Support multiple client product lines and stay current with industry changes. What are the requirements needed for this position? 2+ years of prior Claims Adjuster experience Active All-Lines (Independent/Company) license and required continuing education hours up to date Relentless drive to provide exceptional customer service Excellent verbal and written communications skills and ability to draft business-level communications when responding to customers Strong listening, problem solving, and negotiating skills Strong analytical skills Proven organizational and multi-tasking ability with an ability to adapt quickly in a fast-paced work environment Detail oriented with a commitment to excellence Strong attention to detail and problem-solving skills Minimum high school diploma or GED Proven ability to work independently with minimal supervision to manage schedules and meet deadlines This role follows a Hybrid Model, which will require going into the Miami office location: 701 Waterford Way, Miami, FL 33126 * This job posting is for future openings * Pay Range: $19.08 - $30.53 Any posted pay range considers a wide range of compensation factors, including candidate background, experience and work location, while also allowing for salary growth within the position. If there is no posting end date listed then this is a pipeline requisition, and we will continue to collect applications on an ongoing basis. Helping People Thrive in a Connected World Connect with us. Bring us your best work and your brightest ideas. And we'll bring you a place where you can thrive. Learn more at jobs.assurant.com. For U.S. benefit information, visit myassurantbenefits.com. For benefit information outside the U.S., please speak with your recruiter. What's the culture like at Assurant? Our unique culture is a big reason why talented people choose Assurant. Named a Best/Great Place to Work in 15 countries and awarded the Fortune America's Most Innovative Companies recognition, we bring together top talent around the world. Although we have a wide variety of skills and experiences, we share common characteristics that are uniquely Assurant. A passion for service. An ability to innovate in practical ways. And a willingness to take chances. We call our culture The Assurant Way. Company Overview Assurant is a leading global business services company that supports, protects, and connects major consumer purchases. A Fortune 500 company with a presence in 21 countries, Assurant supports the advancement of the connected world by partnering with the world's leading brands to develop innovative solutions and deliver an enhanced customer experience through mobile device solutions, extended service contracts, vehicle protection services, renters insurance, lender-placed insurance products, and other specialty products. Equal Opportunity Statement Assurant is an Equal Employment Opportunity employer and does not use or consider race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state, or local law in employment decisions. Job Scam Alert Please be aware that during Assurant's application process, we will never ask for personal information such as your Social Security number, bank account details, or passwords. Learn more about what to look out for and how to report a scam here.

Job DescriptionAmwins 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.

at Seaboard Marine Long-term employment with opportunities for growth. Discover more about our organization, culture, and employee benefits by visiting this page. Explore life at Seaboard Marine: ************************************************* We offer excellent benefits including: 401(K) Retirement Saving Plan w/ Employer Match Low-Cost Health, Dental & Vision insurance (Starting DAY ONE) Tuition & Certification Reimbursement Paid Time Off - (15 Days; prorated before 1st year) Parental Leave Paid holidays POSITION SUMMARY: In this function, an individual performs within operational procedures that have been developed and has the authority and the ability to interpret and apply laws and regulations to case scenarios and maintain working relationships with customers, attorneys, insurance companies and local authorities. Assignments are generally broad in scope with frequent opportunity for exercising independent judgment in making claims management decisions subject to final review and approval by Claims Supervisor and Claims Manager. 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. GEOGRAPHIC REGION:Please note applicants out of the geographic region for position applied will not be considered. QUALIFICATIONS: Required Minimum one (1) year of recent experience as a claim's adjuster working with handling cargo, property, casualty, contents or auto claims. Must possess a general understanding of the usage of a diary-based system to move claims along towards completion. Knowledge of insurance and claims legal vocabulary in order to understand the nature of cargo claims. Knowledge of techniques of investigation, adjustment, negotiation and settlement. Must have intermediate computer skills in programs such as MS Word, Excel & Outlook, etc. Must have advanced communication skills (reading, writing & speaking) both in English and Spanish in order to communicate at different levels throughout the organization, exterior organizations, out port offices, attorneys, etc. Possess strong analytical skills. Possess organizational and time management skills with ability to prioritize and be detail oriented. Ability to conduct effective negotiations with claimants, attorneys and insurance carriers. Ability to express ideas clearly and concisely, verbally and in writing. Ability to analyze define problems, collect data, establish facts, and exercise sound judgment in drawing valid conclusions. Ability to prepare a variety of reports and meet consistent deadlines. Ability to work independently with limited supervision, multitask and possess strong initiative. Ability to establish and maintain effective working relationships with customers, vendors and fellow employees. Ability to think logically, establish and follow procedures, instructions and make sound decisions. Ability to exercise independent judgment within established systems and procedures. Ability to work a flexible schedule, extended hours, holidays, and/or weekends as needed. Possess high energy level, comfortable performing multifaceted projects in conjunction with normal activities. Must have or be able to obtain a TWIC card within 30 days of employment. Preferred Experience handling marine cargo claims Knowledge of Carriage of Goods by Sea Act (COGSA). Bachelor's degree in Business Administration or related field. DUTIES AND RESPONSIBILITIES: Primary Plan, organizes and reviews the investigation, negotiation and preparation of settlement recommendations of a variety of insurance claims; reviews accident reports, losses and litigation claims, reefer claims; and provides intra-company personnel with technical advice and assistance. Manages highly complex investigation of claims, including coverage issues liability, compensability and damages Manages all types investigative activity or litigation or litigation on major claims, including the posting of appropriate reserves in a timely manner Monitoring claims to ensure file handling is compliant with established standards. Analyzes claims activities; prepare and present reports to management and other internal business partners and clients. Miscellaneous tasks to include assignment of survey inspections and provide support in a collaborative effort as needed to department manager as well as co-workers. Attend seminars and workshops to ascertain new development and/or further skills relating to required duties. Provides guidance and assistance to less experienced claims staff and other functional areas. Handling of the duty phone on a rotational basis Performs other job-related duties as assigned. PHYSICAL REQUIREMENTS: While performing the duties of this job, the employee is regularly required to sit and use his/her fingers. The employee frequently is required to talk and/or hear. The employee is continuously required to sit. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. SAFETY REQUIREMENTS: Report safety hazards. Immediately report incidents involving injury, illness, or property damage. Wear appropriate PPE as instructed by immediate supervisor. Comply with all company safety policies, procedures, and rules. Refuse any unsafe task or operation. Participate in safety meetings and training. Be constantly aware of their personal safety and that of their coworkers. SUPERVISION RECEIVED AND EXERCISED: Receives direct supervision from the Insurance and Claims Manager and the Insurance and Claims Supervisor. Does not exercise supervision over any position. CONDITIONS: Indoors office, controlled temperature environment. The noise level in the work environment is usually quiet. DISCLAIMER: We are an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other protected characteristic as outlined by federal, state, or local laws. If an applicant with a disability is unable or limited in their ability to use or access our online application center as a result of their disability, they can request reasonable accommodations by sending an email to [email protected] The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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.

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.

**Become a part of our caring community and help us put health first** The Claims Processing Representative reviews and adjudicates complex or specialty claims, submitted either via paper or electronically while performing basic administrative/clerical/operational/customer support/computational tasks. The Claims Processing Representative determines whether to return, deny, or pay claims following organizational policies and procedures. Accurately enters claims information into the company's database and maintain up-to-date records. Communicates effectively with policyholders, healthcare providers, and other stakeholders to gather necessary information and provide updates on claim status. Ensures all claims are processed in accordance with company policies, industry regulations, and legal requirements. Investigates and resolves discrepancies or issues related to claims, working collaboratively with other departments as needed. Provides exceptional service to clients, addressing inquiries and concerns promptly and courteously. **Use your skills to make an impact** **Required Qualifications** + Medical Claims experience and/or knowledge of medical claims processes + Knowledge of CPT, ICD-10, and HCPCS coding + Medical terminology + Ability to manage multiple or competing priorities, work in a fast-paced environment and adapt quickly to change + Aptitude for quickly learning and navigating new technology systems and applications + Ability to think analytically + Strong focus on accuracy and detail + Proficiency in all Microsoft Office Programs, including Word, PowerPoint, and Excel **Preferred Qualifications** + Billing experience + Coding Certification + Previous inbound call center or related customer service experience + Knowledge of HIPAA 837 and 835 electronic claims transactions + Knowledge of Medicare Risk Adjustment and/or Medicaid processes **Additional Information** + Onsite (Location: 3351 Executive Way Miramar, FL 33025) + Required shifts: 8:00a - 5:00p (ET) **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $39,000 - $49,400 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About Us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************

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.

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.

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

Salary: Commensurate based on experience and qualifications This is an excellent opportunity for recent college graduates looking to build long-term careers in a fast-paced industry. Apply today. Would it surprise you to find an employer that... …pays 100% of employees' medical insurance premiums …offers Paid Time Off starting on Day One. …contributes to a Health Savings Account (HSA) to help cover deductibles …offers a 401(k) savings match …has doubled in size in the past 3 years …and...is a car insurance company! We invite top candidates to learn more. About Responsive Founded in 2007 and headquartered in Plantation, Florida, Responsive is a leading provider of personal auto insurance in Florida. We collaborate with thousands of agents from the most respected insurance agencies to deliver world-class service and claims experiences-all while continuing to rapidly grow and expand into new territories. Our mission to make auto insurance simple, affordable, and hassle-free; something we deliver on through innovation, feedback, analysis, and a commitment to excellence. Why Join Responsive? Responsive is more than just our name; it's how we do business. It's an idea that extends to our culture too-one that values collaboration along with plenty of fun. We support our employees with a competitive and comprehensive benefits package that pays 100% of employee premiums for medical, dental, and vision coverage, contributes to your Health Savings Account to offset health plan deductibles, matches a percentage of your 401(k) contributions, and offers worry-free paid time off. We also provide top-notch training through our proprietary Claims University program, an accessible executive team, and plenty of opportunities for growth. What You'll Do As an Associate Claims Adjuster, you'll develop the skills needed to effectively manage the claims process through hands-on training and mentorship. Specifically, you'll: Learn the fundamentals of claims adjusting Assist experienced adjusters with processing medical bills Communicate with medical providers, claimants, attorneys, and other parties in both English and Spanish Support the adjustment and administration of claims Maintain accurate and timely claim documentation Other duties as assigned Requirements Qualifications College degree (required) Bilingual in English and Spanish (required) Strong organizational and analytical skills Ability to manage multiple tasks and meet deadlines Professional communication skills (written and verbal) Florida 6-20 Adjuster License preferred, but not required Responsive provides equal employment opportunities (EEO) to all employees and applicants, fostering a diverse and inclusive workplace.

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 is a requirement (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

At Morgan & Morgan, the work we do matters. For millions of Americans, we're their last line of defense against insurance companies, large corporations or defective goods. From attorneys in all 50 states, to client support staff, creative marketing to operations teams, every member of our firm has a key role to play in the winning fight for consumer rights. Our over 6,000 employees are all united by one mission: For the People. Summary We are seeking a Case Manager to join our team. As a Case Manager you must be highly organized and able to work on a varied caseload. The Case Manager will assist the attorney in developing settlements, preparing documents and correspondence as needed. The ideal candidate is customer focused and empathetic. Responsibilities Daily interaction with existing and potential clients, via telephone and in person. Order medical records from providers and communicate with clients and providers during the course of treatment. Obtain documents necessary to support injury and/or liability positions Interact with insurance carriers and healthcare providers to secure records and account balances Work directly with multiple coworkers involved in the management and support of case files Maintain organized case files. Prepare comprehensive demands and assemble support for submission to carriers under the direct supervision of an attorney Interact with attorneys and present case synopsis when required Manage case files from intake to closing under the direction of an attorney Performs other related duties as assigned to meet the needs of the business. Qualification Bachelor's degree (preferred) Prior experience as a Personal Injury Case Manager preferred. At least 2 years of working in a legal position or insurance adjuster experience preferred. Ability to be a team player and follow procedures. Proactive interaction with clients, insurance companies and medical providers. Must possess the ability to multi-task, prioritize, and manage workload with a positive attitude and minimal supervision. Highly organized with the ability to juggle multiple deadlines in a fast-paced environment Strong writing and communication skills along with attention to detail Extensive computer and database expertise, Microsoft Word, Excel, Outlook, and type no less than 35 wpm. Not remote eligible. #LI-MP1 Benefits Morgan & Morgan is a leading personal injury law firm dedicated to protecting the people, not the powerful. This success starts with our staff. For full-time employees, we offer an excellent benefits package including medical and dental insurance, 401(k) plan, paid time off and paid holidays. Equal Opportunity Statement Morgan & Morgan provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. E-Verify This employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the I-9 Form. Privacy Policy Here is a link to Morgan & Morgan's privacy policy.

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.

CCMS & Associates is looking for 1099 Field Liability Adjusters. We are answering a call to action to add to our existing roster. The time is now to get on with our innovative team! We are seeking auto/homeowners/general liability field adjusters with at least 5 years of field experience. Requirements: Minimum 5 years auto and/or premise liability adjusting experience Working computer/laptop - internet access and Microsoft Word required Must demonstrate strong time management and customer service skills State adjusters license (where applicable) Must have a valid drivers license Responsibilities: Conduct in-depth investigations into liability claims to gather facts regarding the loss Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses, and by interviewing fire, police, or other government officials as well as inspecting claimed damages Inspect damage to property and obtain personal injury information to assist in determining liability Maintain acceptable product quality through compliance with established best practices Knowledge and Skills: In-depth knowledge of property and liability insurance coverage and industry standards Ability to prepare full-captioned reports by collecting and summarizing required information Strong verbal and written communication skills Prompt, reliable, and friendly Detail-oriented individual to accurately gather and analyze information to avoid errors Preferred but Not Required: College degree Professional designations and certifications All candidates must pass a full background check (void in states where prohibited)

will include, but are not limited to: Responsible for directing the planning, design, development, implementation and evaluation of policies and procedures that assure accurate, timely claims and encounter processing and provider inquiries (written or verbal). Assure timely and accurate processing of Medicare claims and encounters, and respond to provider telephone calls, written inquiries, and appeals. The compilation of all information and documents required for claims and encounter processing and related inquiries to assure compliance with all applicable rules, regulations, and external and internal policies and procedures The review of provider contracts and configuration of these contracts within the claims processing system to assure accurate payments to our providers Collaboration and communication with other SHP departments on claims and encounter issues, related projects and inter-departmental operations issues Development and maintenance of well-defined processes to enter, adjust, manage and report claims and encounters data Preparation and timely submission of management and regulatory reports Generation of configuration requests to assure accurate, timely administration of providers claims and processing and reporting of encounters Maintain a full comprehensive understanding of the covered benefits, coding and reimbursement policies and contracts Production and submission of reports as required Analyze, track and trend claims and encounters data; identify any potential service or systems issues;implement interventions and determine success of interventions Qualifications Requirements: BA/BS degree preferred with at least 5 years of relevant professional experience, and the following OR any combination of education and experience which would provide an equivalent background: Minimum of 2 years of managerial experience at the department manager level preferred. Minimum of 5 years of Medicare/Medicaid claims experience that demonstrates progressive growth within claims operations. Extensive knowledge of claims policies and procedures, including industry standards from Medicaid, CMS, and CCI Edits. Excellent oral and writing skills. Highly developed quantitative and qualitative analytical skills. Highly developed project management skills. Additional Information All your information will be kept confidential according to EEO guidelines.

Field Property Adjuster, Ft. Lauderdale, FL Scope We are currently looking for a Senior Claims Specialist to handle property claims in the West Palm, Florida area. Responsibilities • Complete onsite inspection of properties to include investigating facts, evaluating damages and writing estimates • Effectively evaluate contract language and identify coverage issues • Promptly and appropriately develop the file to provide accurate and timely investigation and loss analysis • Maintain an active file diary to more file toward resolution • Recognize and pursue recovery • Adhere to all statutory and regulatory fair claims practices • Recognize and identify potential fraudulent claims • Effectively control the use, work product, and expenses of outside vendors • Effectively evaluate claim facts and negotiate claim settlements • Develop and maintain strong business relationships with internal and external customers • Successfully contribute to the development and delivery of the team's goals, objectives and results • Supports workload surges and/or Catastrophe Operations as needed to include working overtime during designated CATs. • Establish and maintain rapport with business partners including insureds, agents, and underwriters • Provide excellent customer service skills to a diverse client base that results in more than satisfied clients. Qualifications • Full knowledge of personal and commercial insurance contracts, investigation techniques, legal requirements, and insurance regulations a plus. Experience in commercial claims handling would be preferred • Symbility or similar estimating platform experience required • An aptitude for evaluating, analyzing, and interpreting information • Excellent verbal and written communication skills • Innovative thinker with ability to multi-task • Strong customer service skills • Working knowledge in Microsoft Office • Prior experience handling complex claims with large exposures • Ability to work in multiple systems and utilize provided technology to estimate damages in the field • Ability to work both independently and team supportive environment • Empowerment to make decisions within your authority and execute company mission • Must have the ability to secure the Property and Casualty Adjusters license within 6 months of employment

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.

Summary/Objective Assists the Claims Manager with clerical and administrative duties in the Claims Department. Essential Functions • Handle cargo claims from intake to final resolution • Investigate claims using bills of lading, survey reports, photos, and other evidence • Determine liability and negotiate fair settlements with customers, carriers, and insurers • Coordinate directly with our cargo insurance providers for filing and recovery • Communicate clearly and professionally in English and Spanish with customers, agents, and internal teams across the Americas • Maintain an accurate claims log and prepare management reports • Identify ways to reduce claim frequency and improve recovery rates Qualifications: • Fully bilingual in English and Spanish (written & spoken) - required • 2+ years of experience in cargo claims, insurance adjusting, or logistics coordination • Strong analytical and negotiation skills with a sharp eye for detail • Ability to remain calm, focused, and solution-oriented in a high-expectation, direct-feedback environment • Comfortable managing multiple claims at once in a fast-paced environment • Proficient in Microsoft Office (Excel, Word, Outlook) • Knowledge of maritime law, cargo liability, or container shipping is a big plus • Associate's or Bachelor's degree preferred What We Offer • Salary: $48,000 - $70,000 per year (depending on experience and bilingual fluency) • Medical, dental, and vision insurance • 401(k) • Generous paid time off • On-site role in Sweetwater, FL with remote work option at management discretion • Opportunity to grow within a stable, expanding company Location On-site at our Sweetwater, Florida headquarters (remote work option available at management discretion) How to Apply Please email your resume and a brief note explaining why you're a great fit to: ****************************** Subject line: Claims Coordinator - [Your Name] We are reviewing applications immediately and will contact qualified candidates for interviews. Equal Opportunity Employer | No agencies please Work Environment This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. 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. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. Great analytical skills are required to perform the job successfully. Employee needs to be able to work independently or with minimal supervision. Position Type/Expected Hours of Work This is a full-time position. Days and core hours of work are Monday through Friday, 8:30 a.m. to 5:30 p.m. Overtime may be required at times. Flexibility to work from home or the office is also required. Required Education and Experience One to three years of industry experience required Work Authorization/Security Clearance Employee must be authorized to work in the United States. AAP/EEO Statement King Ocean Agency provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law.

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 View all jobs at this company View all jobs at this company