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  • Commercial Property Claims Examiner

    CWA Recruiting

    Remote claims coordinator job

    Commercial Property Claims Examiner - Property & Casualty Insurance Remote but must be in NYC About the Role Handle commercial property claims by investigating losses; managing and controlling independent adjusters and experts; interpreting the policy to make proper coverage determinations; addressing reserves; writing coverage letter and reports; and providing good customer service. Assure timely reserving and handling of a claim from assignment to completion by investigating that claim and interpreting coverage. Manage independent adjusters and experts. Inside desk adjusting role - 100% Remote for now - NYC based. Responsibilities Investigate losses Manage and control independent adjusters and experts Interpret the policy to make proper coverage determinations Address reserves Write coverage letters and reports Provide good customer service Assure timely reserving and handling of a claim from assignment to completion Manage independent adjusters and experts Qualifications Bachelor's degree is required Required Skills 3-5 years of first party property claims handling is required Experience with Microsoft Office 365 is required Preferred Skills Experience with ImageRight is a plus Availability to work extended hours in a CAT situation
    $35k-65k yearly est. 2d ago
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  • Complex Claims Specialist - E&S (Remote)

    Selective Insurance 4.9company rating

    Remote claims coordinator job

    About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year. Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs. Overview Selective Insurance is seeking an E&S Complex Claims Specialist to handle the company's most complex and challenging claims. This is a fully remote position. Responsibilities of this position include coverage analysis, investigation, evaluation, negotiation and disposition of assigned claims. Candidate must possess strong litigation management skills to aggressively manage litigation activities, budgets and claim outcomes while considering the overall impact to the customer and company. The individual in this position will also ensure claims are processed within company policies, procedures, and within individual's prescribed authority with exceptional standards of performance. This individual should possess strategic though process skills to effectively and efficiently manage loss exposures. Job duties will include communication and collaboration with key stakeholders, training, development and providing thought leadership where requested. In addition, position may require travel to mediations, arbitrations, settlement conferences, trials or other proceedings which may account for up to 20% of the specialist time. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements. Responsibilities Effectively evaluate and resolve coverage issues for all lines of business and all liability claim types. Investigate the claims through telephone, written correspondence, and/or personal contact with claimants, attorneys, insureds, witnesses and others having pertinent information. Effectively and efficiently manage vendors and expenses. Timely analyze information in order to evaluate assigned claims to determine the extent of loss, taking into consideration contributory or comparative negligence. Assign medical or other experts to case and arrange for medical examinations when necessary. Effectively evaluate, negotiate and resolve claims within delegated authority (ranging from $100,000 to $400,000) utilizing the appropriate denials or releases. Provide required reports to claims, underwriting, reinsurance and actuarial on significant exposure cases. Report on all cases going to trial on a timely basis and attend portions of trials when warranted or where requested by management. Ensure proper referrals and timely updates to appropriate Reinsurer(s). Ability to handle or oversee Extra-Contractual, EPLI, Social Services and E&O claims against the Company. Must be able to drive an automobile to travel within territory. Car travel represents approximately 10-25% of employee's time and a valid driver's license. Qualifications Knowledge and Requirements Experience in complex coverage analysis and significant large loss evaluations. Experience with E&S claim preferred but not required. Superior communication and strategic negotiation and claim disposition skills along with proven problem-solving skills. Excellent presentation skills and moderate proficiency with standard business-related software (including Microsoft Outlook, Work Excel, and PowerPoint). Sufficient keyboarding proficiency to enter data accurately and efficiently. Multi-State licensing with strong understanding of Medicare reporting & compliance preferred. Must have valid state-issued driver's license in good standing and be able to drive an automobile. Education and Experience College degree preferred. 8+ Casualty claims handling experience A minimum of 5 years handling cases of a complex nature with a primary P&C carrier. New York Labor Law experience required. Habitability, assault and battery and Coverage B experience preferred. Carrier experience preferred. Ability to write coverage letters is required. Total Rewards Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs. Pay Range USD $108,000.00 - USD $163,000.00 /Yr. Additional Information Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions. For Massachusetts Applicants It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
    $72k-104k yearly est. 1d ago
  • Claims Examiner

    Firstsource 4.0company rating

    Remote claims coordinator job

    Job Title:Medical Claims Examiner-Work From Home Job Type:Full Time FLSA Status:Non-Exempt/Hourly Grade:H Function/Department:Health Plan and Healthcare Services Reporting to:Team Lead/Supervisor - Operations Pay Range:$16 Role Description:The Claims Examiner evaluates insurance claims to determine whether their validity and how much compensation should be paid to the policyholder. The Claims Examiner is responsible for reviewing all aspects of the claim, including reviewing policy coverage, damages, and supporting documentation provided by the policyholder. Roles & Responsibilities * Review insurance claims to assess their validity, completeness, and adherence to policy terms and conditions. * Collect, organize, and analyze relevant documentation, such as medical records, accident reports, and policy information. * Ensure that claims processing aligns with the company's insurance policies and relevant regulatory requirements. * Conduct investigations, when necessary, which may include speaking with claimants, witnesses, and collaborating with field experts. * Analyze policy coverage to determine the extent of liability and benefits payable to claimants. * Evaluate the extent of loss or damage and determine the appropriate settlement amount. * Communicate with claimants, policyholders, and other stakeholders to explain the claims process, request additional information, and provide status updates. * Make recommendations for claims approval, denial, or negotiation of settlements, and ensure timely processing. * Maintain accurate and organized claim files and records. * Stay updated on industry regulations and maintain compliance with legal requirements. * Provide excellent customer service, addressing inquiries and concerns from claimants and policyholders. * Strive for high efficiency and accuracy in claims processing, minimizing errors and delays. * Stay informed about industry trends, insurance products, and evolving claims management best practices. * Generate and submit regular reports on claims processing status and trends. * Perform other duties as assigned. Top of Form Qualifications The qualifications listed below are representative of the background, knowledge, skill, and/or ability required to perform their duties and responsibilities satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. Top of Form Top of FormEducation * High School diploma or equivalent required Work Experience * Medical claims processing experience required, including use of claims processing software and related tools Competencies & Skills * Highly-motivated and success-driven * Exceptional verbal and written communication and interpersonal skills, including negotiation and active-listening skills * Exceptional analytical and problem-solving skills * Strong attention to detail with a commitment to accuracy * Ability to adapt to change in a dynamic fast-paced environment with fluctuating workloads * Basic mathematical skills * Intermediate typing skills * Basic computer skills * Knowledge of medical terminology, ICD-9/ICS-10, CPT, and HCPCS coding, and HIPAA regulations preferred * Knowledge of insurance policies, regulations, and best practices preferred Additional Qualifications * Ability to download 2-factor authentication application(s) on personal device, in accordance with company and/or client requirements * Ability to pass the required pre-employment background investigation, including but not limited to, criminal history, work authorization verification and drug test Work Environment The work environment characteristics described here are representative of those an employee encounters while performing this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position may work onsite or remotely from home. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to regularly or frequently talk and hear, sit for prolonged periods, use hands and fingers to type, and use close vision to view and read from a computer screen and/or electronic device. Must be able to occasionally stand and walk, climb stairs, and lift equipment up to 25 pounds. Firstsource is an Equal Employment Opportunity employer. All employment decisions are based on valid job requirements, without regard to race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, age, disability, genetic information, veteran status, or any other characteristic protected under federal, state or local law. Firstsource also takes Affirmative Action to ensure that minority group individuals, females, protected veterans, and qualified disabled persons are introduced into our workforce and considered for employment and advancement opportunities. About Firstsource Firstsource Solutions is a leading provider of customized Business Process Management (BPM) services. Firstsource specialises in helping customers stay ahead of the curve through transformational solutions to reimagine business processes and deliver increased efficiency, deeper insights, and superior outcomes. We are trusted brand custodians and long-term partners to 100+ leading brands with presence in the US, UK, Philippines, India and Mexico. Our 'rightshore' delivery model offers solutions covering complete customer lifecycle across Healthcare, Telecommunications & Media and Banking, Financial Services & Insurance verticals. Our clientele includes Fortune 500 and FTSE 100 companies. Job Type: Full-time Benefits: 401(k) 401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Referral program Vision insurance Work Location: Remote
    $16 hourly 4d ago
  • Viral - Content Claiming Specialist

    Create Music Group 3.7company rating

    Remote claims coordinator job

    Create Music Group is currently looking for self-described viral internet culture enthusiasts to join our Viral Department. Viral Content Claiming Specialist perform administrative tasks such as YouTube copyright claiming and asset onboarding, as well as scope out trending memes and social media videos on a daily basis. This position requires a regular workload of data entry/administration in order to carry out the most basic functions of our department but there are plenty of opportunities for more creative and ambitious pursuits if you are so inclined. This is a full time position which may be done remotely, however our office is located in Hollywood, California, and we are currently only looking for job candidates who are located in California. In the future, you may be encouraged to come into our office for meetings or company functions, so it is best if you are located in the Los Angeles/Southern California area. Through our Viral team, we collaborate with some of the most prominent viral talent from the TikTok and meme world including Supa Hot Fire (Deshawn Raw), Welven Da Great (Deez Nuts), Verbalase, KWEY B, Hoodnews, presidentofugly1, 10k Caash, dimetrees, Zackass, Supreme Patty, The Man with the Hardest Name in Africa, ViralSnare, Adin Ross, and more. YouTube monetization provides an alternative consulting and revenue-generating resource for our clients to grow their audience and earnings. We have helped our clients monetize and collected millions in previously unclaimed revenue for content creators, artists and labels. REQUIREMENTS: 1-3 years work experience Excellent communication skills, both written and verbal Internet culture and social media platforms, especially YouTube Conducting basic level research Organizing large amounts of data efficiently Proficiency with Mac OSX, Microsoft Office, and Google Apps PLUSES: Strong understanding of the online video market (YouTube, Instagram, TikTok) Bilingual - any language, although Spanish, Mandarin, and Russian is preferred RESPONSIBILITIES: We work directly with our clients and their team to help them break down the data and find potential opportunities to build their career. Daily responsibilities include but are not limited to the following. Watching YouTube videos for several hours daily Content claiming Uploading and defining intellectual assets Administrative metadata tasks Researching potential clients Staying on top of accounts for current client roster As this is a remote position, you are required to have your own computer and reliable internet connection. This position may require you to download a great deal of video files (files which may be deleted once onboarding tasks are completed) so please make sure that you have a computer that is up to the task. Laptops are preferable if you would like to come into our office to work (snacks, soft drinks, and Starbucks coffee are provided at our physical office). BENEFITS: Paid company holidays, paid time off, and health benefits (medical, dental, vision, and supplementary policies) are included. TO APPLY: Send us your resume and cover letter (in one file). After you apply, you will be redirected to take our Culture Index survey here. Otherwise, copy and paste the link to your web browser: ********************************************************* Info.php?cfilter=1&COMPANY_CODE=cYEX5Omste Applications without a cover letter and Culture Index survey will not be considered. OPTIONAL: Link relevant social media campaigns and/or writing samples from your portfolio.
    $45k-75k yearly est. Auto-Apply 60d+ ago
  • Claims Manager - Professional Liability

    Counterpart International 4.3company rating

    Remote claims coordinator job

    Claims Manager (Professional Liability) Counterpart is an insurtech platform reimagining management and professional liability for the modern workplace. We believe that when businesses lead with clarity and confidence, they become more resilient, more innovative, and better prepared for what's ahead. That's why we built the first Agentic Insurance™ system - where advanced AI and deep insurance expertise come together to proactively assess, mitigate, and manage risk. Backed by A-rated carriers and trusted by brokers nationwide, our platform helps small businesses grow with confidence. Join us in shaping a smarter future, helping businesses Do More With Less Risk . As a Claims Manager (Professional Liability), you will be responsible for managing a large and diverse caseload of professional liability claims. In this role, you will apply and further develop your expertise by investigating, evaluating, and resolving claims in a way that reinforces our brand and values. You will also play a vital part in supporting the advancement of our systems and processes through ongoing feedback and collaboration with internal partners. In addition, you will be a key feedback provider for our active claims management processes and systems. Your input will help to shape and improve how we fulfill our mission of providing world-class service through tightly managing legal costs, making data-driven decisions when analyzing a claim's value, and ensuring that other potentially responsible parties pay their fair share. YOU WILL Achieve or exceed claims management case load and goals, applying sound judgment and legal knowledge to produce efficient and fair outcomes. Complete accurate and timely investigations into the coverage, liability, and damages for each claim assigned to you. Actively manage each claim assigned to you in a way that produces the most timely and cost-effective resolution. Build and maintain positive and productive working relationships with internal and external customers, including policyholders, brokers, carrier partners, and Risk Engineers (underwriters). Direct and monitor assignments to experts and outside counsel, and hold those vendors accountable for meeting or exceeding our service standards. Support our data collection efforts and models by effectively using our Agentic Claim Experience (ACE) system to fully and accurately capture critical details about each claim assigned to you. Identify and escalate insights into emerging claims trends across industries, geographies, and key business segments. Offer user-level feedback and insights to support the continuous improvement of our claim handling processes, guidelines, and systems. Ensure that every touchpoint with our insureds and brokers is representative of our brand, mission, and vision. YOU HAVE At least 10 years of professional experience, with at least 5 years of experience litigating or managing professional liability claims. Previous carrier experience is a plus. Bachelor's degree required; law degree (J.D.) and professional designations (RPLU, AIC, etc.) highly preferred. Must possess all required state claim adjuster licenses, or be able to obtain them within 90 days of hire. Proven ability to work both independently on complex matters and collaboratively as a team player to assist others as needed. High level of personal initiative and leadership skills. Exceptional time management, problem solving and organizational skills. Comfort and skill operating in a paperless claims environment. Familiarity with Google Workplace is preferred, but not required. Willingness to quickly adapt to change and use creative thinking and data-driven insights to overcome obstacles to resolution. Strong communication skills, both verbal and written. Ability to succeed in a full remote workplace environment, and travel as necessary (approximately 10-15%). WHO YOU WILL WORK WITH Eric Marler, Head of Claims: An industry veteran, Eric has more than 20 years of experience working with or for insurers offering management liability solutions. He is a licensed attorney who began his career in private practice before transitioning in-house. Prior to joining Counterpart, Eric held leadership roles at Great American Insurance Group and The Hanover Insurance Group. Jaclyn Vogt, Senior Claims Manager: Jaclyn is a licensed adjuster with over 15 years of experience handling Employment Practices Liability, Management Liability and Workers Compensation claims. Jaclyn received her bachelor's degree from Centre College. Katherine Dowling, Claims Manager: Katherine is a licensed attorney, mediator and adjuster with over a decade of experience handling professional liability and management liability litigation and claims. Katherine practiced law for several years with two of Atlanta's largest insurance defense firms prior to joining a wholesale specialty insurance carrier where she managed complex Professional Liability and Commercial General Liability claims. WHAT WE OFFER Stock Options: Every employee is able to participate in the value that they create at Counterpart through our employee stock option plan. Health, Dental, and Vision Coverage: We care about your health and that of your loved ones. We cover up to 100% of your monthly contributions for health, dental, and vision insurance and up to 80% coverage for family members. 401(k) Retirement Plan: We value your financial health and offer a 401(k) option to help you save for retirement. Parental Leave: Birthing parents may take up to 12 weeks of parental leave at 100% of their regular pay following the birth of the employee's child, and can choose to take an additional 4 unpaid weeks. Non-birthing parents will receive 8 weeks of parental leave at 100% of their regular pay. Unlimited Vacation: We offer flexible time off, allowing you to take time when you need it. Work from Anywhere: Counterpart is a fully distributed company, meaning there is no office. We allow employees to work from wherever they do their best work, and invite the team to meet in person a couple times per year. Home Office Allowance: As a new employee, you will receive a $300 allowance to set up your home office with the necessary equipment and accessories. Wellness stipend: $100 per month to spend toward an item or service that supports your wellness (i.e. massage or gym membership, meditation app subscription, etc.) Book stipend: To support your intellectual development, we offer a book stipend that allows you to purchase books, e-books, or educational materials relevant to your role or professional interests. Professional Development Reimbursement: We provide up to $500 annually for you to invest in relevant courses, workshops, conferences, or certifications that will enhance your skills and expertise. No working birthdays: Take your birthday off, giving you the opportunity to relax, enjoy your special day, and spend time with loved ones. Charitable Contribution Matching: For every charitable donation you make, we will match it dollar for dollar, up to a maximum of $150 per year. This allows you to amplify your charitable efforts and support causes close to your heart. COUNTERPART'S VALUES Conjoin Expectations - it is the cornerstone of autonomy. Ensure you are aware of what is expected of you and clearly articulate what you expect of others. Speak Boldly & Honestly - the only failure is not learning from mistakes. Don't cheat yourself and your colleagues of the feedback needed when expectations aren't being met. Be Entrepreneurial - control your own destiny. Embrace action over perfection while navigating any obstacles that stand in the way of your ultimate goal. Practice Omotenashi (“selfless hospitality”) - trust will follow. Consider every interaction with internal and external partners an opportunity to develop trust by going above and beyond what is expected. Hold Nothing As Sacred - create routines but modify them routinely. Take the time to reflect on where the business is today, where it needs to go, and what you have to change in order to get there. Prioritize Wellness - some things should never be sacrificed. We create an environment that stretches everyone to grow and improve, which is fulfilling, but is only one part of a meaningful life. Our estimated pay range for this role is $150,000 to $180,000. Base salary is determined by a variety of factors, including but not limited to, market data, location, internal equitability, and experience. We are committed to being a welcoming and inclusive workplace for everyone, and we are intentional about making sure people feel respected, supported and connected at work-regardless of who you are or where you come from. We value and celebrate our differences and we believe being open about who we are allows us to do the best work of our lives. We are an Equal Opportunity Employer. We do not discriminate against qualified applicants or employees on the basis of race, color, religion, gender identity, sex, sexual preference, sexual identity, pregnancy, national origin, ancestry, citizenship, age, marital status, physical disability, mental disability, medical condition, military status, or any other characteristic protected by federal, state, or local law, rule, or regulation.
    $150k-180k yearly Auto-Apply 60d+ ago
  • Patient Claims Specialist - Bilingual Only

    Modmed 4.5company rating

    Remote claims coordinator job

    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 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 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.
    $66k-101k yearly est. Auto-Apply 19d ago
  • Automotive Claims Representative

    Alpha Automotive 4.3company rating

    Claims coordinator job in Columbus, OH

    Alpha Automotive is looking for an Automotive Claims Representative to join our rapidly growing team! Here at Alpha Automotive, we pride ourselves on providing the best service possible for our customers by being an alternative to large, impersonal dealerships and providing them with an elevated level of personalized service each and every time. We are now hiring for ALL of our locations: Stealth Auto Recovery, Excite Towing, Wayne's Auto Powell, Wayne's Auto Schrock, Wayne's Auto Westerville, Mann's Expedite Service, H.I.N.T., Excite Collision Repair, and Ernie's Auto Repair! As an Automotive Claims Representative, a typical day may include the following: Acting as a liaison between insurance companies and customers, to assure claims are being paid in a timely manner so repairs can begin Working in harmony with the service writers in getting repair estimates sent to insurance companies, and following up to confirm they have been received and submitted correctly Keeping customers in the loop with any updates from the insurance company, and communicate when there are changes or any additional information is needed from them This career may be for you if: You enjoy helping people and problem solving You love the automotive industry and are ready to make the transition to an office environment You thrive in a fast paced environment Benefits include: Training & competitive pay Dental, vision, life & disability insurance Paid time off after a year of service View all jobs at this company
    $29k-36k yearly est. 10d ago
  • Claims Manager II, Hospital Professional Liability

    Liberty Mutual 4.5company rating

    Remote claims coordinator job

    Ready to lead and shape Hospital Professional Liability claims strategy? Apply to this senior-level claims leader position, Claims Manager II. Join a high-performing team leading the Hospital Professional Liability claims unit for IronHealth/NAS Claims. We're looking for a seasoned Claims Manager with deep Hospital Professional Liability experience who wants to lead a technical team, shape claims strategy, and drive measurable improvements across a portfolio of complex and high-severity matters consistent with the standards of Liberty International Underwriters. *This position may have in-office requirements and other travel needs depending on candidate location. You will be required to go into an office twice a month if you reside within 50-miles of one of the following offices: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; or Westborough, MA. This policy is subject to change. The salary range reflects the varying pay scale that encompasses each of the Liberty Mutual regions, and the overall cost of labor for that region, and based on you location you may not qualify for the top salary listed in the range. Responsibilities Responsible for performance, development and coaching of staff (including hiring, terminating, performance and salary management). Serve as technical resource not only for claims staff, but also cross-functional partners, including Underwriting (UW), Actuarial, Finance and Operations. Work with claims team and external attorneys to review coverages, investigate claims, analyze liability and damages, establish adequate indemnity and expense reserves, develop strategies and resolve claims, including, but not limited to direct participation in mediation and arbitration and active participation in settlement discussions. Perform quality assurance reviews/observations and provide feedback to team as well as action plan for development of team, where necessary. Actively pursue all avenues of recovery including, but not limited to timely recovery of deductibles from insureds and manage subrogation activities. Provide regular reports to claims management regarding losses either exceeding or likely to exceed the authority level in accordance with best practices. Must be able to present effectively, produce appropriate reports and develop team and train team in these skills Partner with underwriting managers/team to provide excellent customer service and to market and meet with brokers, risk managers and reinsurers. Serve as external face claims leader for product line and demonstrate ability to forge and maintain relationships with external customers, effectively resolving concerns where necessary. Ability to effectively articulate the claims value proposition in claims advocacy meetings, account renewals and new business prospecting. Present at industry conferences or publishes external industry content. Lead short to medium-term strategic claims activities/priorities for the product line, with alignment with the strategic priorities of IronHealth and NAS Claims. Oversee projects assigned by the department head. Direct and manage the Claims participation and content for multidisciplinary reviews, monthly UW connectivity meetings, and quarterly actuarial meetings. Ensure timely feedback to senior management, underwriting and actuaries regarding relevant losses, account issues, and trends. Assist and coordinate with underwriting team regarding new policy forms, product development and/or product rollouts and provide timely feedback to senior management and underwriting regarding recommendations. Ability to achieve fluency in Loss Triangle interpretation and Product Level Profitability Understanding/Awareness. Other duties as assigned, including delivery on established operational goals and objectives. Qualifications Qualifications - what will make you successful! Bachelors' degree or equivalent training; advanced degrees or certifications preferred. A minimum of 8+ years of relevant and progressively more responsible work experience required, including at least 2 years of supervisory experience. At least 5 years claims handling within a technical specialty. Requires advanced knowledge of claims handling concepts, practices, procedures and techniques, including, but not limited to coverage issues, product lines, marketing, computers and product competition within the marketplace. Requires advanced knowledge of a technical specialty. Knowledge of law and insurance regulations in various jurisdictions. The ability to effectively interact with brokers and internal departments is also required. Strong verbal and written communications and organizational skills. Strong negotiation, analytical and decision-making skills also required. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.
    $86k-132k yearly est. Auto-Apply 3d ago
  • Claims Clerk

    All Care To You

    Remote claims coordinator job

    About Us All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 401k plan. Additional employee paid coverage options available. Job Purpose The Claims Clerk plays a vital role in supporting the claims team by handling daily administrative tasks, including reviewing and responding to claims portal messages, processing incoming faxes, and organizing documentation. This position ensures efficient communication and smooth workflow within the department, helping to maintain timely and accurate claims processing. Duties and responsibilities Monitor and respond to claims portal messages daily. Assist Customer Service department with portal registrations. Process and categorize incoming claims-related faxes. Assist with Claims related inquiries from other departments. Requesting and reviewing medical records as needed for basic information to validate billing information. Reviewing claims for required information, pending claims when necessary, maintaining a follow-up system, and updating and releasing pending claims when indicated. Serve as a primary point of contact for providers, members, and internal staff regarding claims status, documentation requirements, and resolution steps. Respond to inbound claims phone calls, emails, and portal inquiries in a professional and timely manner. Provide clear explanations of claim outcomes, payment decisions, and next steps while maintaining a high level of customer service. Research and resolve claim-related issues by gathering information, reviewing documentation, and escalating as needed. Document all interactions in the system to ensure accurate records of customer communications and resolutions. Must maintain an error accuracy of under 5%. Support claims examiners and workflow projects. Attend weekly or monthly departmental meetings and provide feedback when requested. Complies with all Company and Department Policies and Procedures. When needed assist in claims audit activities. Support other departments as needed. All other duties as assigned. Qualifications Experience in administrative support, claims processing, or a related field preferred. Excellent communication skills including reports, correspondence, and verbal communications. Experience with EZ-Cap and Encoder preferred. Proficiency using Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe Detail oriented and highly organized Strong ability to multi-task, project management, and work in a fast-paced environment Strong ability in problem-solving. Ability to self-manage, strong time management skills. Ability to work in an extremely confidential environment. Must work well under pressure and deadlines.
    $34k-42k yearly est. 60d+ ago
  • BCBS Claims Specialist II

    Healthcare Management Administrators 4.0company rating

    Remote claims coordinator job

    HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ***************** How YOU will make a Difference: As a Claims Specialist, you'll be at the heart of our mission to deliver exceptional service. Working alongside a dedicated team, you'll ensure the accurate and timely processing of medical, dental, vision, and short-term disability claims that HMA administers for our members. Your role goes beyond handling claims, you'll be a key player in shaping a positive healthcare experience for our members. Every claim you interact with helps someone navigate their healthcare journey with confidence, making your work both meaningful and impactful. What YOU will do: Research and process ITS claim adjustments, returned checks, refunds and stop payment in an accurate and timely manner Communicate with local Blue plans utilizing real time chat Process priority claims and general inquiries Respond to appeals and correspondence regarding claims functions Support team members and be open to providing assistance when and where neede Become a SME regarding BCBS network Requirements High school diploma required 3-5+ years of claims processing experience 2+ years of BCBS claims processing experience required Strong interpersonal and communication skills Strong attention to detail, with high degree of accuracy and urgency Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving Previous success in a fast-paced environment Benefits Compensation: The base salary range for this position in the greater Seattle area is $28/hr - $32/hr for a level II and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: *****************
    $28 hourly Auto-Apply 30d ago
  • Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)

    Holmes Murphy 4.1company rating

    Remote claims coordinator job

    We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $47k-81k yearly est. Auto-Apply 19d ago
  • Medical Claims Processor I

    Broadway Ventures 4.2company rating

    Remote claims coordinator job

    At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation. Become an integral part of a dedicated team supporting the World Trade Center Health Program. In this role, you will leverage your strong attention to detail and commitment to accuracy in processing complex medical claims. If you are eager to make a positive impact in the community through your administrative skills, we encourage you to apply. Work Schedule Remote Monday through Friday, 8:30 AM to 5:00 PM EST Must be able to work 8am - 5pm Eastern Standard Time Responsibilities Claims Review and Processing Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. Critical Analysis Adjudicate claims according to program guidelines, applying critical thinking skills to navigate complex scenarios. Timely Processing Ensure prompt claims processing to meet client standards and regulatory requirements. Identify and resolve any barriers using effective problem-solving strategies. Issue Resolution Collaborate with internal departments to proactively resolve discrepancies and issues. Use analytical skills to identify root causes and implement solutions. Confidentiality Maintenance Uphold confidentiality of patient records and company information in accordance with HIPAA regulations. Detailed Record Keeping Maintain thorough and accurate records of claims processed, denied, or requiring further investigation. Trend Monitoring Analyze and report trends in claim issues or irregularities to management. Assist Team Leads with reporting to contribute to continuous process improvements. Audit Participation Engage in audits and compliance reviews to ensure adherence to internal and external regulations. Critically evaluate and recommend process improvements when necessary. Mentoring Mentor and train new claims processors as needed. Requirements High school diploma or equivalent. Minimum of five years of experience in medical claims processing, including professional and facility claims, as well as complex and high-dollar claims. Billing experience doesn't count towards years of experience qualification Familiarity with ICD-10, CPT, and HCPCS coding systems. Understanding of medical terminology, healthcare services, and insurance procedures (experience with worker's compensation claims is a plus). Strong attention to detail and accuracy. Ability to interpret and apply insurance program policies and government regulations effectively. Excellent written and verbal communication skills. Proficiency in Microsoft Office Suite (Word, Excel, Outlook). Ability to work independently and collaboratively within a team environment. Commitment to ongoing education and staying current with industry standards and technology advancements. Experience with claim denial resolution and the appeals process. Ability to manage a high volume of claims efficiently. Strong problem-solving capabilities and a customer service-oriented mindset. Flexibility to adjust to the evolving needs of the client and program changes. Benefits 401(k) with employer matching Health insurance Dental insurance Vision insurance Life insurance Flexible Paid Time Off (PTO) Paid Holidays What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting. Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.
    $33k-43k yearly est. Auto-Apply 53d ago
  • Claims CL Casualty Large Loss Auto Injury Representative (remote)

    Grange Insurance Careers 4.4company rating

    Remote claims coordinator job

    Summary: This position is responsible for investigating, evaluating and negotiating settlement of assigned large loss Commercial Auto Body Injury Claims in accordance with best practices and to promote retention or purchase of insurance from Grange Enterprise. If you're excited about this role but don't meet every qualification, we still encourage you to apply! At Grange, we value growth and are committed to supporting continuous learning and skill development as you advance in your career with us. What You'll Be Doing: Pursuant to line of business strategies and good faith claim settlement practices, investigates, evaluates, negotiates, and resolves (within authorized limits) assigned claims. Demonstrates technical proficiency, routinely handling the most complex claims with minimal manager oversight. Establishes and maintains positive relationships with both internal and external customers, providing excellent customer service. Assists in building business relationships with agents, insureds and Commercial Lines partners through regular, effective and insightful communications. May include face-to-face as needed. Will be the “point person” (when required) for certain identified large customer accounts where specialized communication and handling are required. Regularly develops and mentors other associates. Assists leadership in advancing the technical acumen of the department through the development of formal and informal training and resources. Establishes and maintains proper reserving through proactive investigation and ongoing review. Assists other departments (when required) with investigations. May be assigned general liability claims during high volume workload periods. Demonstrates effectiveness and efficiencies in managing diary system and handling workload with limited supervision or direction. What You'll Bring To The Company: High school diploma or equivalent education plus five (5) years claims experience with at least three (3) years of Commercial Casualty experience. Experience in General Liability preferred. Bachelor's degree preferred. Must possess strong communication and organization skills, critical thinking competencies and be proficient with personal computer. Requires excellent decision-making ability, a broad depth of experience and technical competence and capacity to manage work to meet time sensitive deadlines. Demonstrated ability to interact with internal and external customers in a professional manner. State specific adjusters' license may be required. About Us: Grange Insurance Company, with $3.2 billion in assets and more than $1.5 billion in annual revenue, is an insurance provider founded in 1935 and based in Columbus, Ohio. Through its network of independent agents, Grange offers auto, home and business insurance protection. Grange Insurance Company and its affiliates serve policyholders in Georgia, Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and Wisconsin and holds an A.M. Best rating of "A" (Excellent). Grange understands that life requires flexibility. We promote geographical diversity, allowing hybrid and remote options and flexibility in work hours (role dependent). In addition to competitive traditional benefits, Grange has also created unique benefits based on employee feedback, including a cultural appreciation holiday, family formation benefits, compassionate care leave, and expanded categories of bereavement leave. Who We Are: We are committed to an inclusive work environment that welcomes and values diversity, equity and inclusion. We hire great talent from various backgrounds, and our associates are our biggest strength. We seek individuals that represent the diversity of our communities, including those of all abilities. A diverse workforce's collective ideas, opinions and creativity are necessary to deliver the innovative solutions and service our agency partners and customers need. Our core values: Be One Team, Deliver Excellence, Communicate Openly, Do the Right Thing, and Solve Creatively for Tomorrow. Our Associate Resource Groups help us create a more diverse and inclusive mindset and workplace. They also offer professional and personal growth opportunities. These voluntary groups are open to all associates and have formed to celebrate similarities of ethnicity/race, nationality, generation, gender identity, and sexual orientation and include Multicultural Professional Network, Pride Partnership & Allies, Women's Group, and Young Professionals. Our Inclusive Culture Council, created in 2016, is focused on professional development, networking, business value and community outreach, all of which encourage and facilitate an environment that fosters learning, innovation, and growth. Together, we use our individual experiences to learn from one another and grow as professionals and as people.  We are committed to maintaining a discrimination-free workplace in all aspects, terms and conditions of employment and welcome the unique contributions that you bring from education, opinions, culture, beliefs, race, color, religion, age, sex, national origin, handicap, disability, sexual orientation, gender identity or expression, ancestry, pregnancy, veteran status, and citizenship.
    $34k-45k yearly est. 11d ago
  • Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)

    HMA Group Holdings 3.7company rating

    Remote claims coordinator job

    We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
    $39k-68k yearly est. Auto-Apply 19d ago
  • Mortgage Claims Specialist II

    Loancare 3.9company rating

    Remote claims coordinator job

    Looking for a career with purpose and reward? At LoanCare we help customers every day with what is for many their largest and most personal financial transaction: the purchase of their home. With the mission to simplify the complex with empathy and insight, we are constantly innovating and are a top provider in the mortgage services industry as a result. We are actively seeking to fill the role of Claims Specialist II. Our ideal candidate enjoys working with clients, both internal and external, eager to learn and maximize results, is detail oriented and driven to meet tight deadlines in a fast-paced environment. Background in the mortgage or real estate industry is a plus. If this sounds like you, and you are ready for a career and not just your next job, apply today! Responsibilities • Prepare mortgage insurance claims for two or more agencies- or investor-acquired properties. • Complete reconciliation of all advances to be included in the claim. • Assist in conducting internal department quality control audits of post claim activity. • Validate all the necessary supporting documents needed for the claim. • Maintain clear records and reports for management regarding daily production. • Assist with updating appropriate workstations for claim payments. • Follow up and track payment of filed claims. • Conduct miscellaneous research to complete daily tasks. • Conduct research for post-claim activities such as “missing documents and/or agency inquiries”. • Complete tasks queue and notate internal system accordingly. • All other duties as assigned. Qualifications 2-4 years of experience in default mortgage servicing and/or mortgage insurance claim and/or the legal field. Knowledge of accepted business practices in the mortgage industry and understanding of claims process. Proficient knowledge of foreclosure process and appropriate guidelines (FHD). LPS-MSP (Mortgage Servicing Platform) experience. Ability to manage time and priorities wisely. Ability to make sound decisions and resolve issues. Ability to work independently and effectively meet deadlines. Ability to communicate effectively in writing, in person, and by telephone. Ability to use Microsoft Office applications, specifically, Excel and Word. Ability to maintain strict confidentiality. Total Rewards LoanCare's Total Rewards Package offers a comprehensive blend of health and welfare, financial, lifestyle and learning benefits to support employee well-being and engagement. Highlights include: Health & Welfare Coverage: Optional medical, dental, vision, life, and disability insurance Time Off: Paid holidays, vacation, and sick leave Retirement & Investment: Matching 401(k) plan and employee stock purchase plan Wellness Programs: Access to mental health resources, including free Calm memberships, and initiatives that promote physical and emotional well-being Employee Recognition: Programs that celebrate achievements and milestones Lifestyle & Learning Perks: Enjoy discounts on gym memberships, pet insurance, and employee purchasing programs, plus access to a tuition reimbursement program that supports your continued education and professional growth. Compensation Range: $17.88 - $26.73 hourly. Actual compensation may vary within the range provided, depending on a number of factors, including qualifications, skills and experience. Build Your Future with LoanCare At LoanCare, we don't just service mortgage loans-we serve people. As a leading full-service mortgage loan subservicer, we deliver excellence to banks, credit unions, independent mortgage companies, investors, and the homeowners they support. Backed by the strength and stability of Fidelity National Financial (NYSE: FNF), a Fortune 500 company, we offer a career foundation built on integrity, innovation, and collaboration. Here, you'll find: A culture that helps you thrive, with resources and support to fuel your growth Flexibility to work remotely, while staying connected through virtual engagement Opportunities to make a real impact in an industry that touches millions of lives If you're ready to grow your career in a place that values your contributions and empowers your success, we invite you to join our team. About Remote Employment We provide the necessary equipment; all you need is a quiet, private place in your home and a high-speed internet connection with a minimum network download speed of 25 megabits per second (MBPS) and a minimum network upload speed of 10 MBPS. Work Conditions Able to attend work and be productive during normal business hours and to work early, late or weekend hours as needed for successful job performance. Overtime required as necessary. Physical Demands Sitting up to 90% of the time Walking and standing up to 10% of the time Occasional lifting, stooping, kneeling, crouching, and reaching Equal Employment Opportunity LoanCare, its affiliates and subsidiaries, is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, protected veteran status, national origin, sexual orientation, gender identity or expression (including transgender status), genetic information or any other characteristic protected by applicable law.
    $17.9-26.7 hourly Auto-Apply 37d ago
  • Process Expert II - Claims

    Paragoncommunity

    Claims coordinator job in Columbus, OH

    Location: Ohio. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. The Process Expert II supports the claims issue research and resolution for Home & Community Based Services (HCBS) by participating in project and process work. How you will make an impact Primary duties may include, but are not limited to: Researches operations workflow problems and system irregularities. Develops tests, presents process improvement solutions for new systems, new accounts and other operational improvements. Develops and leads project plans and communicates project status. Minimum Qualifications: Requires a BA/BS and minimum of 5 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred. Claims issue research and resolution for Home & Community Based Services (HCBS) highly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $66,880.00 to $100,320.00. Location(s): Columbus, OH. In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: BSP > Process Improvement Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $28k-35k yearly est. Auto-Apply 13d ago
  • Process Expert II - Claims

    Elevance Health

    Claims coordinator job in Columbus, OH

    Location: Ohio. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. The Process Expert II supports the claims issue research and resolution for Home & Community Based Services (HCBS) by participating in project and process work. How you will make an impact Primary duties may include, but are not limited to: * Researches operations workflow problems and system irregularities. * Develops tests, presents process improvement solutions for new systems, new accounts and other operational improvements. * Develops and leads project plans and communicates project status. Minimum Qualifications: * Requires a BA/BS and minimum of 5 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: * Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred. * Claims issue research and resolution for Home & Community Based Services (HCBS) highly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $66,880.00 to $100,320.00. Location(s): Columbus, OH. In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: BSP > Process Improvement Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $28k-35k yearly est. 12d ago
  • Claims Specialist - Life Global Claims

    Gen Re Corporation 4.8company rating

    Remote claims coordinator job

    Shape Your Future With UsGeneral Re Corporation, a subsidiary of Berkshire Hathaway Inc., is a holding company for global reinsurance and related operations, with more than 2,000 employees worldwide. It owns General Reinsurance Corporation and General Reinsurance AG, which conducts business as Gen Re. Gen Re delivers reinsurance solutions to the Life/Health and Property/Casualty insurance industries. Represented in all major reinsurance markets through a network of 38 offices, we have earned superior financial strength ratings from each of the major rating agencies. Gen Re currently offers an excellent opportunity for a Claims Specialist in our Life Health Global Claims unit to work remotely based out of our Stamford, CT office. Role Description The Claim Specialist is responsible for the delivery of the reinsurance claim risk management on multiple lines of business to both internal and external Gen Re clients. This includes, but is not limited to, the risk assessment of reinsurance liability and may include client training development and delivery, audit activities as well as representing the company and/or speaking at various industry conferences, as requested. Responsibilities: Responsible timely decision making and accuracy of reinsurance determinations on multiple lines of claim submissions. Incumbent contributes to the accurate and efficient adjudication of claims by supporting the department and client's investigation or coaching/mentoring on claims in all ranges of complexity to ensure compliance with policy provisions, state/federal regulations and reinsurance treaties in effect. Maintains a working knowledge of state and federal regulatory issues and keeps on the cutting edge of changes within the incumbent's area of expertise. Deliver high levels of customer service to internal and external customers in a professional, reliable and responsive manner. The incumbent works with claims management to develop, prioritize and execute a claim management strategy for each assigned client. Responsible for influencing a variety of constituents at various levels and not within one's direct employ. Thus, being accountable for the effective development, ongoing maintenance and consistent application of client communications and relationships. As an expert claim resource within a specific line of business, the Claim Specialist monitors national verdict/settlement trends and legal developments pertaining to their particular line of business. The incumbent researches, drafts and publishes articles and training oriented to educating clients on best practices gleaned. Responds to ad hoc reporting /projects from manager. Timely and accurate reporting of statistical information to management. Provides a broad range of regular (monthly/quarterly) management information in support of the Claims Department. Responsible for synthesizing a large amount of information from a variety of sources. May participate in client / TPA due diligence activities such as supporting audit activity, identifying emerging trends and themes not only in the client's inventory but within the industry; supporting manager with industry gleaned best practices via building and delivering customer specific training programs and seminars; emphasizing and implementing technical solutions to business needs to achieve desired improvements when asked. May participate in client meetings or with prospective accounts. Role Qualifications and Experience Prior claims experience in insurance and/or reinsurance operations. Prior experience managing claims (preferably LTC or Income Protection) thereby equipping the incumbent with the ability to assess reinsurer responsibility in its broadest sense (e.g. reviewing and offering risk management insights and recommendations on facultative and consultative claim submissions). Experience auditing claim files. Audit work of reinsured claims remotely or in client locations is an expectation. The audit process requires the ability to quickly adapt to the multitude of imaged systems in use by clients. The audit process may involve analyzing and verifying coverage and/or corresponding payments issued. The audit process may consist of managing internal and external communication with client executives in various areas such as claims, financial and legal resources, actuarial resources, etc. Thus, demonstrating an ability to emphasize and implement solutions to help clients manage risk and developing an in-depth knowledge of the management and organization of each assigned account. Holds insurance adjuster's license or a willingness to secure same within 1 year of hire Strong working knowledge of key coverage lines especially health (Long Term Care, Individual Disability) type claims Strong written and verbal communication skills Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously or as an effective member of a team Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to detail Flexibility to travel for business purposes, approximately less than 10 trips per year Strong client relationship, influencing and interpersonal skills Proven initiative, prioritization, presentation, and training abilities. Experience with and proficiency in Microsoft Suite of Products (WORD, EXCEL, PowerPoint), Visio, Power BI, developing and running queries etc. Salary Range 91,000.00 - 152,000.00 USD The annual base salary range posted represents a broad range of salaries around the US and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training. Our Corporate Headquarters Address General Reinsurance Corporation 400 Atlantic Street, 9th Floor Stamford, CT 06901 (US) At General Re Corporation, we celebrate diversity and are committed to creating an inclusive environment for all employees. It is the General Re Corporation's continuing policy to afford equal employment opportunity to all employees and applicants for employment without regard to race, color, sex (including childbirth or related medical conditions), religion, national origin or ancestry, age, past or present disability , marital status, liability for service in the armed forces, veterans' status, citizenship, sexual orientation, gender identity, or any other characteristic protected by applicable law. In addition, Gen Re provides reasonable accommodation for qualified individuals with disabilities in accordance with the Americans with Disabilities Act.
    $53k-73k yearly est. 25d ago
  • Claims Specialist - Auto

    Philadelphia Insurance Companies 4.8company rating

    Claims coordinator job in Dublin, OH

    Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
    $82.8k-97.3k yearly Auto-Apply 60d+ ago
  • Medical Claims Processor - Remote

    NTT Data North America 4.7company rating

    Remote claims coordinator job

    At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy. NTT DATA currently seeks a long term **Temporary Medical Claims Processor** to join our team **for a remote position** . Must be able to work **7am - 4 pm CST** **virtual/remote (training is required on-camera, 8 weeks. During training, no time off will be approved).** This is a US based, W-2 project. All candidates will be paid through NTT DATA only. **Role Responsibilities:** -Processing of Professional claim form files by provider -Reviewing the policies and benefits -Comply with company regulations regarding HIPAA, confidentiality, and PHI -Abide with the timelines to complete compliance training of NTT Data/Client -Work independently to research, review and act on the claims -Prioritize work and adjudicate claims as per turnaround time/SLAs -Ensure claims are adjudicated as per clients defined workflows, guidelines -Sustaining and meeting the client productivity/quality targets to avoid penalties -Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. -Timely response and resolution of claims received via emails as priority work -Correctly calculate claims payable amount using applicable methodology/ fee schedule -Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities -Time management with the ability to cope in a complex, changing environment -Ability to communicate (oral/written) effectively in a professional office setting **Required Skills/Experience** + 2+ year (s) hands-on experience in **Medicare, Medicaid or Commercial Insurance Claims Processing. Will consider medical billers.** + 2+ year(s) using a computer with Windows applications using a keyboard, **navigating multiple screens and computer systems, and learning new software tools** + **Previously performing - in P&Q work environment; work from queue; remotely** + Key board skills and computer familiarity - + **Toggling back and forth between screens** /can you navigate multiple systems. + Working knowledge of MS office products - Outlook, MS Word and **MS-Excel** . + Must be able to work **7am - 4 pm CST** online/remote (training is **required on-camera** ). + Effective **troubleshooting where you can leverage your research, analysis and problem-solving abilities** + **Time management with the ability to cope in a complex, changing environment** + **Ability to communicate (oral/written) effectively** in a professional office setting **Preferences** Amisys &/or Xcelys claims systems Preferred **Education:** + High school diploma or GED About NTT DATA: NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com. NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is **$18.00/hourly** . This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. + \#LI-NorthAmerica
    $18 hourly 60d+ ago

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