Claims representative jobs in Daytona Beach, FL

Commercial Auto - Multi Line Claim Specialist Hours: Monday - Friday, 8:00 AM to 4:30 PM ET Salary Range: $60,000-$85,000 NY License required At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. Reasons you should consider a career with CCMSI: Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10+ years multi-line claim experience is required. Bachelor's Degree is preferred. NY license required Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work requires the ability to sit or stand up to 7.5 or more hours at a time. Work requires sufficient auditory and visual acuity to interact with others. CORE VALUES & PRINCIPLES Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. #CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #ClaimsSpecialist #LiabilityClaims #HybridWork #FloridaJobs #InsuranceCareers #GeneralLiability #AutoClaims #MultiJurisdiction #FLAdjusters #CommercialAuto #NowHiring #InsuranceJobs #FLLiability #IND123 #LI-Hybrid

Remote Role - Live Anywhere in the United StatesBuild your best future with the Johnson Controls team As a global leader in smart, healthy and sustainable buildings, our mission is to reimagine the performance of buildings to serve people, places and the planet. Join a winning team that enables you to build your best future! Our teams are uniquely positioned to support a multitude of industries across the globe. You will have the opportunity to develop yourself through meaningful work projects and learning opportunities. We strive to provide our employees with an experience, focused on supporting their physical, financial, and emotional wellbeing. Become a member of the Johnson Controls family and thrive in an empowering company culture where your voice and ideas will be heard - your next great opportunity is just a few clicks away! What we offer Competitive salary Paid vacation/holidays/sick time Comprehensive benefits package Encouraging and collaborative team environment Dedication to safety through our Zero Harm policy JCI Employee discount programs (The Loop by Perk Spot) Check us Out: A Day in the Life of the Building of the Future ******************* ZMNrDJviY What you will do The Operations Claims Specialist is part of our Building Solutions business at Johnson Controls. Under general direction, works in concert with the Claims Consultants to ensure consistent delivery of services and assure customer expectations are being met as well as internal financial commitments. Responsible for Claim Status Reporting trend analysis along with recommendations on analysis of construction documents (i.e. certified payroll analysis, continuous improvement of process documentation, schedule collection and verification). Proactively track time horizons and claim deadlines to keep the Claims Consultants focused on client triage, recommending and implementing solutions where appropriate How you will do it Provides support for Claims Consultants and ensures completion of all phases of the Claim Identifies issues and recommends solutions to the appropriate processes. Participates in monthly Claims Status, Local Market Backlog Reviews, and Staff Meetings. Serve as Publisher and Editor of the team's affirmative and defensive claims. Initiates research and follow up on fact gathering, document retention and e-discovery. Provides feedback to Manager of Construction Claims and Claims Consultants as appropriate. Owns, maintains and ensures the integrity of the team's project data for purposes of forecasting, scheduling and staffing. Serves as the team's data historian. Prioritizes work activities based upon financial impact to desired business goals What we look for Required Bachelor's Degree in Construction Management, Business Administration, Finance, or equivalent directly related work experience plus two to three years' experience in the construction industry/contracting business performing similar contract and project management functions. Read copy or proof to detect and correct errors in spelling, punctuation, and syntax. Ability to effectively represent JCI and communicate with clients at varying levels. Demonstrated proficiency to simultaneously handle a large and diverse number of projects and issues with tact, cooperation, and persistence. Ability to prioritize work activities based upon financial impact to desired business goals. Innovative and conceptual thinker. High level of productivity and efficiency. HIRING SALARY RANGE: $85,000- 107,000(Salary to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, location and alignment with market data.) This position includes a competitive benefits package. For details, please visit the About Us tab on the Johnson Controls Careers site at ***************************************** #LI-MM1 #LI-Remote Johnson Controls International plc. is an equal employment opportunity and affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, genetic information, sexual orientation, gender identity, status as a qualified individual with a disability or any other characteristic protected by law. To view more information about your equal opportunity and non-discrimination rights as a candidate, visit EEO is the Law. If you are an individual with a disability and you require an accommodation during the application process, please visit here.

Are you an experienced, passionate pioneer in technology who wants to work in a collaborative environment? As an experienced Epic Resolute PB Claims Analyst you will have the ability to share new ideas and collaborate on projects as a consultant without the extensive demands of travel. If so, consider an opportunity with Deloitte under our Project Delivery Talent Model. Project Delivery Model (PDM) is a talent model that is tailored specifically for long-term, onsite client service delivery. Work you'll do/Responsibilities As a Project Delivery Senior Analyst (PDSA) at Deloitte, you will work within an engagement team and be responsible for supporting the overall project goals and objectives. In this role, you will interact with stakeholders and cross-functional teams. It is expected that you will be able to perform independent tasks as well as provide technical guidance to team members, as needed. * Work with the implementation team to plan and complete build, implement end-to-end Epic. * Work command center shifts to investigate during go-live, document, and resolve break-fix tickets. * Conduct and document root cause analysis and complete any assigned system maintenance. * Assist in low level design, operational discussions, build, test, and migrate Epic build, provide go-live support following migration of new build. * Communicate regularly with Engagement Managers (Directors), project team members, and representatives from various functional and / or technical teams, including escalating any matters that require additional attention and consideration from engagement management. The Team Join our AI & Engineering team in transforming technology platforms, driving innovation, and helping make a significant impact on our clients' success. You'll work alongside talented professionals reimagining and re-engineering operations and processes that are critical to businesses. Your contributions can help clients improve financial performance, accelerate new digital ventures, and fuel growth through innovation. AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements. Our Industry Solutions offering provides verticalized solutions that transform how clients sell products, deliver services, generate growth, and execute mission-critical operations. We deliver integrated business expertise with scalable, repeatable technology solutions specifically engineered for each sector. Qualifications Required * Current Epic Certification in Epic Professional Billing * 3+ years' experience in Epic Professional Billing * Experience in Epic implementation or enhancement processes * Experience in application design, workflows, build, troubleshooting, testing, and support. * Bachelor's degree, preferably in Computer Science, Information Technology, Computer Engineering, or related IT discipline; or equivalent experience * Limited immigration sponsorship may be available. * Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve Preferred * Hospital or Clinic operations experience * Additional Epic Certifications * ITIL process knowledge * Analytical/ Decision Making Responsibilities * Analytical ability to manage multiple projects and prioritize tasks into manageable work products * Can operate independently or with minimum supervision * Excellent Written and Communication Skills * Ability to deliver technical demonstrations Additional Requirements Information for applicants with a need for accommodation: ************************************************************************************************************ Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. Check out recruiting tips from Deloitte recruiters. Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. Learn more about what working at Deloitte can mean for you. Our people and culture Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our clients' most complex challenges. This makes Deloitte one of the most rewarding places to work. Our purpose Deloitte's purpose is to make an impact that matters for our people, clients, and communities. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. Learn more. Professional development From entry-level employees to senior leaders, we believe there's always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career. As used in this posting, "Deloitte" means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see ********************************* for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law. Requisition code: 316852 Job ID 316852

Remote Role - Live Anywhere in the United StatesBuild your best future with the Johnson Controls team As a global leader in smart, healthy and sustainable buildings, our mission is to reimagine the performance of buildings to serve people, places and the planet. Join a winning team that enables you to build your best future! Our teams are uniquely positioned to support a multitude of industries across the globe. You will have the opportunity to develop yourself through meaningful work projects and learning opportunities. We strive to provide our employees with an experience, focused on supporting their physical, financial, and emotional wellbeing. Become a member of the Johnson Controls family and thrive in an empowering company culture where your voice and ideas will be heard - your next great opportunity is just a few clicks away! What we offer Competitive salary Paid vacation/holidays/sick time Comprehensive benefits package Encouraging and collaborative team environment Dedication to safety through our Zero Harm policy JCI Employee discount programs (The Loop by Perk Spot) Check us Out: A Day in the Life of the Building of the Future ******************* ZMNrDJviY What you will do The Operations Claims Specialist is part of our Building Solutions business at Johnson Controls. Under general direction, works in concert with the Claims Consultants to ensure consistent delivery of services and assure customer expectations are being met as well as internal financial commitments. Responsible for Claim Status Reporting trend analysis along with recommendations on analysis of construction documents (i.e. certified payroll analysis, continuous improvement of process documentation, schedule collection and verification). Proactively track time horizons and claim deadlines to keep the Claims Consultants focused on client triage, recommending and implementing solutions where appropriate How you will do it Provides support for Claims Consultants and ensures completion of all phases of the Claim Identifies issues and recommends solutions to the appropriate processes. Participates in monthly Claims Status, Local Market Backlog Reviews, and Staff Meetings. Serve as Publisher and Editor of the team's affirmative and defensive claims. Initiates research and follow up on fact gathering, document retention and e-discovery. Provides feedback to Manager of Construction Claims and Claims Consultants as appropriate. Owns, maintains and ensures the integrity of the team's project data for purposes of forecasting, scheduling and staffing. Serves as the team's data historian. Prioritizes work activities based upon financial impact to desired business goals What we look for Required Bachelor's Degree in Construction Management, Business Administration, Finance, or equivalent directly related work experience plus two to three years' experience in the construction industry/contracting business performing similar contract and project management functions. Read copy or proof to detect and correct errors in spelling, punctuation, and syntax. Ability to effectively represent JCI and communicate with clients at varying levels. Demonstrated proficiency to simultaneously handle a large and diverse number of projects and issues with tact, cooperation, and persistence. Ability to prioritize work activities based upon financial impact to desired business goals. Innovative and conceptual thinker. High level of productivity and efficiency. HIRING SALARY RANGE: $85,000- 107,000(Salary to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, location and alignment with market data.) This position includes a competitive benefits package. For details, please visit the About Us tab on the Johnson Controls Careers site at ***************************************** #LI-MM1 #LI-Remote Johnson Controls International plc. is an equal employment opportunity and affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, genetic information, sexual orientation, gender identity, status as a qualified individual with a disability or any other characteristic protected by law. To view more information about your equal opportunity and non-discrimination rights as a candidate, visit EEO is the Law. If you are an individual with a disability and you require an accommodation during the application process, please visit here.

126205 Zurich is seeking an individual interested in growing their claims career with our General Liability team. As a General Liability (GL) Senior Claims Specialist on our IPZ (international Program) team you will work with a team of claims professionals with diverse experiences and backgrounds. This environment will support your development as you hone your technical skill set in GL policy interpretation and coverage analysis to resolve your claims effectively. At this level, you will handle single and multi-party personal or commercial line claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled most efficiently and effectively while delivering a customer-centric claims service. You will be expected to collaborate and develop partnerships with internal and external points of contact including customers, vendors, suppliers, and brokers to provide a quality claims experience. Additionally, you will learn and develop knowledge of established protocols and industry best practices to ensure that claims are handled in the most efficient, effective way while delivering a quality customer-centric claims experience. This position will work from one of the following office locations: Parsippany, NJ; Rocky Hill, CT, Atlanta, GA; Schaumburg, IL; Maitland, FL; or New York, NY Basic Qualifications: + Bachelor's Degree and 6 or more years of experience in the Claims and/ or Litigation Management area OR + High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area OR + Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area OR + Zurich Certified Insurance Apprentice, including an associate degree with 6 or more years of experience in the Claims and/ or Litigation Management area OR + Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area AND + Must obtain and maintain required adjuster license(s) + Microsoft Office experience + Knowledge of insurance regulations, markets, and products Preferred Qualifications: + 8+ years of experience handling commercial general liability claims within the area that includes litigated and severity ibodily njury and PD claims + 8+ years of experince with litigation management + 8+ construction expereince handling Bodily Injury and Property Damage OCIP/CCIP wrap up policies + Currently hold an active adjusters license + Experience collaborating across work groups ability to develop and maintain strong relationships + Understands claims adjustment process and possesses the ability to determine scope/exposure for losses + Understands the use of vendors and how litigation strategies are developed + Understands and applies financial and actuarial/reserving concepts. + Familiarity with negotiation strategies and experience in suggesting alternative approaches + Negotiation skills + Organizational and time management skills + MS Office + Customer service experience + Strong analytical, critical thinking, and problem-solving skills + Strong verbal and written communication skills Compensation for roles at Zurich varies depending on a wide array of factors including but not limited to the specific office location, role, skill set, and level of experience. As required by local law, Zurich provides in good faith a reasonable range of compensation for roles. For additional information about our Total Rewards, Click here (****************************************** . Other rewards may include short term incentive bonuses and merit increases. **C** andidates with salary expectations outside of the range are encouraged to apply, and will be considered based on experience, skill, and education. The salary provided is a nationwide market range and has not been adjusted for the applicable geographic differential associated with the location where the position may be filled. The starting salary range for this position is $72,800.00 - $119,200.00. As an insurance company, Zurich is subject to 18 U.S. Code § 1033. As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time ( ************************************ ). A future with Zurich. What can go right when you apply at Zurich? Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500 . Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please click here (********************************* to learn more. As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers' expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission. Location(s): AM - Rocky Hill, AM - Addison, AM - Atlanta, AM - Maitland, AM - New York, AM - Parsippany Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims. Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation. Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. May serve as a mentor/coach to less experienced claim professionals May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices. Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed. Demonstrated ability to develop collaborative business relationships with internal and external work partners. Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions. Demonstrated investigative experience with an analytical mindset and critical thinking skills. Strong work ethic, with demonstrated time management and organizational skills. Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. Developing ability to negotiate low to moderately complex settlements. Adaptable to a changing environment. Knowledge of Microsoft Office Suite and ability to learn business-related software. Demonstrated ability to value diverse opinions and ideas Education & Experience: Bachelor's Degree or equivalent experience. Typically a minimum four years of relevant experience, preferably in claim handling. Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Professional designations are a plus (e.g. CPCU) #LI-AR1 #Li-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois , Maryland, Massachusetts , New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

Join a Leading Team - Direct Hire | Sign-On Bonus | Hybrid Opportunity! We're hiring detail-oriented and customer-focused Claims Representatives for a reputable client located in Daytona Beach. In this role, you'll be responsible for efficiently reviewing, processing, and resolving insurance claims while ensuring full compliance with internal policies and industry regulations. What's In It for You? Direct hire opportunity with a stable organization Sign-on bonus available Hybrid schedule available after training Comprehensive benefits package: medical, dental, and vision insurance Ongoing professional development and training opportunities Work Schedule Training: Monday-Friday, 8:00 AM - 4:30 PM Post-Training: Flexible shifts available between 6:00 AM - 8:00 PM Key Responsibilities Accurately review and process insurance claims within specified timeframes Communicate with policyholders, claimants, and other involved parties to gather information and provide claim updates Maintain thorough and accurate records in internal claims systems Ensure adherence to regulatory guidelines and company policies Keep current with industry standards and procedural updates Qualifications & Skills High school diploma or equivalent required Experience in claims processing, insurance, or customer service is a plus Strong problem-solving and analytical abilities Clear and professional verbal and written communication skills Ability to handle multiple tasks and prioritize effectively in a fast-paced environment Proficiency in Microsoft Office Suite; experience with claims management software is a bonus Familiarity with insurance procedures and compliance regulations is preferred Ready to bring your attention to detail and customer service skills to a growing team? Apply today! All qualified applicants will receive consideration for employment without regard to race, color, religion, ethnicity, national origin, sex, gender identity, sexual orientation, disability status, protected veteran status or any other protected status under the law. EverStaff is an equal opportunity employer (M/F/D/V/SO/GI).

IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.

My name is Pondsy Anthony , and I am Recruiting Specialist with Mindlance Inc . I have reviewed your resume and at a first glance find it to be a good fit for a Position that we are exclusively recruiting for. We are working very closely with our Client based in FL to fill this requirement urgently. This is a 4+ months of contract position with a possible extension depending on performance. You can get back to me at ************ to discuss in detail. Job Description Job Title: Claim Specialist Client Location : 255 Technology Park, Lake Mary, FL 32746 Contract Duration : 4+ months (High possibility of Extension) ***Info about Schedules: - Candidates being selected need to be open for the contractor shift of either 9a-6p or 10a-7p or 11-8. - If contractors are hired on, they have to be available for shifts like 11a-8p and 12p-9p. Please let candidates know this! Looking for :- Candidates must have reimbursement experience that is within the past 6 months Prior authorization - submission, review, support, completion, verification Appeal - submission, review, support, completion, verification, coordination Reimbursement - investigation, verification JOB SUMMARY: The primary function/purpose of this job:- Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside of Express Scripts. Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. SCOPE OF JOB Reimbursement verification of enrollments MINIMUM QUALIFICATIONS TO ENTER THE JOB: Formal Education and/or Training: High school diploma or equivalent required, some college or technical training preferred YEARS OF EXPERIENCE: Two years' experience in P.B.M. environment is helpful but not required. KNOWLEDGE AND ABILITIES: • Strong data entry and 10-key skills • Retail pharmacy, customer service experience helpful but not required • PC and MS Office literate • Strong attention to detail • Excellent retention and judgment ability • Proficient written and oral communication skills • Ability to work in fast-paced, production environment • Reliable, self-motivated with excellent attendance • Team player who has the ability to stay on task with little supervision Qualifications • Prior authorization - submission, review, support, completion, verification • Appeal - submission, review, support, completion, verification, coordination • Reimbursement - investigation, verification Additional Information All your information will be kept confidential according to EEO guidelines.

Full-time Description Please Note: This is an in-person role based at our Altamonte Springs, FL office and handles moderate-to-complex bodily injury and property damage claims. Prior experience with BI/PD investigations, detailed analysis, evaluations, and settlements is required. Why Everstory At Everstory Partners, our mission is to create supportive spaces where individuals and families can find solace, meaning, and hope in the midst of loss. At the heart of our mission is a deep understanding of the profound and complex nature of grief. Every person's journey through loss is unique, and we are committed to providing compassionate and personalized support. We also believe that grief is not a problem to be solved or a burden to manage alone, but rather a natural and beautiful part of the human experience. Backed by our national strength and our local partners' role is to be a steady presence, a source of comfort and guidance, and a partner in celebrating the life and legacy of the person who has passed. The Impact You Will Make The Claims Specialist at Everstory will handle insurance claims for the Company, including general liability, auto and property damage claims, and assist with worker's compensation claims. The role reports to the Senior Litigation Counsel and works closely with the Legal Operations Manager. Essential Duties and Responsibilities: Investigate reported incidents to determine exposure and provide recommended action plans to manage incident or report the claim to Company's insurance carrier. Responsible for communicating with brokers and adjusters, facilitating contact with employees involved in a claim, gathering, and securing all needed information to effectively evaluate, investigate and resolve a claim. Making recommendations to members of the Everstory legal department with respect to reserves and excess authority. Responsible for evaluating claims, reviewing reserves, identifying and acting upon claims resolution opportunities within an assigned level of authority. Ensuring claims are properly documented and audited regularly. Work closely with internal counsel on General Liability claims by serving as the primary liaison between Everstory and the insurance carrier. The Claims Specialist will report incidents to the insurance carrier as directed by internal counsel and serve as the day-to-day point of contact with adjusters. Independently investigate and document claims by gathering statements, photos, and other evidence; coordinate with site operations to obtain necessary documentation; and provide detailed updates to internal counsel and Risk Management. Prepare and deliver written status reports on open General Liability claims; meet one-on-one with internal counsel to review strategy and progress; and participate in quarterly claim reviews with the insurance carrier and regular meetings with the broker. Analyze data from current incidents and claim trends to identify patterns, recommend corrective actions, and develop strategies to reduce losses and mitigate future risk exposure. Monitoring and reporting on trends in claims. The ideal candidate must have the ability and confidence to present on data, trends and recommendations to Everstory leadership team. Reviewing and evaluating claims-related expenses for reasonableness and necessity, and tracking/organizing broker and carrier invoices. Assisting with new vendor approvals by reviewing Certificates of Insurance (COI) for compliance with Everstory's coverage requirements. Providing administrative support to Legal Operations Manager on Workers' Compensation claims. Annually, working with departments to gather and secure all needed information to renew Everstory's insurance program, serving as the primary point of contact for Everstory's insurance broker. Adhering to Everstory's incident and claims reporting processes and procedures. Providing feedback and support to other departments. Requirements Bachelor's degree in a related field, such as business, finance, law, or health. 5 to 10 years of multi-line/multi-state insurance claims adjusting experience. 5+ years of experience in claims management, either with a corporate risk management department or with an insurance company. Must possess a valid Driver's License. Knowledge of property damage issues. Knowledge of relevant laws, regulations, and standards. Excellent research and communication skills. Able to handle complex claims. All-Lines License, preferred, but not required. Experience with multi-state, worker's compensation issues, including monopolistic states, preferred, but not required. Core Competencies: Compassion - Genuinely cares about people; is concerned about their work and non-work problems; is available and ready to help; is sympathetic to the plight of others not as fortunate; demonstrates real empathy with the joys and pains of others. Customer Focus - Is dedicated to meeting the expectations and requirements of internal and external customers; gets first-hand customer information and uses it for improvements in products and services; acts with customers in mind; establishes and maintains effective relationships with customers and gains their trust and respect. Ethics and Values - Adheres to appropriate (for the setting) and effective set of core values and beliefs during both good and bad times; acts in line with those values; rewards the right values and disapproves of others; practices what he/she preaches. Role Competencies: Organizing - Can marshal resources (people, funding, material, support) to get things done. Can orchestrate multiple activities at once to accomplish a goal. Uses resources effectively and efficiently. Arranges information and files in a useful manner. Functional/Technical Skills - has the functional and technical knowledge and skills to do the job at a high level of accomplishment. Problem Solving: uses rigorous logic and methods to solve difficult problems with effective solutions. Probes all fruitful sources for answer. Can see hidden problems. Excellent at honest analysis. Looks beyond the obvious and doesn't stop at the first answers. Presentation Skills - effective in a variety of formal presentation settings, one-on-one, small and large groups, with peers, direct reports, and bosses. Is effective both inside and outside the organization, on both data based and controversial topics. Commands attention and can manage group process during the presentation. Can change tactics midstream when something isn't working. Work Environment: On-Site M-F at our Altamonte Springs, FL Support Center. Our Investment in You Everstory Partners is proud to provide our employees with a quality work environment and opportunity for both personal and professional growth. As part of our ongoing commitment, we offer a competitive benefits package for our Full-Time Employees including: Medical, Dental, Vision, Life, AD&D and STD Insurance Tuition Reimbursement Career Advancement and Training Funeral and Cemetery Benefits Employee Referral Bonus 401k with Company Match Everstory Partners is an Equal Opportunity Employer and is committed to employing a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, national origin, age, sex, religion, disability, sexual orientation, marital status, military or veteran status, gender identity or expression, or any other basis protected by local, state, or federal law. The pay range for this role is based on a wide range of factors that are considered in making compensation decisions regardless of race, gender, age, religion, or any other protected characteristic. They include skill set, experience and training, licensure and certification, and other business and organizational needs. This range estimate has been adjusted for the applicable geographic differential associated with the location at which the position may be filled. Compensation decisions are dependent on the circumstances of each hire. Salary Description $80,000 - $85,000 per year

Description Advance your career at Liberty Mutual - A Fortune 100 Company! Manages, investigates and resolves claims assigned and assists in providing service to policyholders. Responsibilities: Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports. Ensures adequacy of reserves. Accountable for security of financial processing of claims, as well as security information contained in claims files. Makes effective use of loss management techniques. Negotiates settlements with attorneys, claimants, and/or co-defendants. Arranges for expert inspections involving third party or potential fraud actions as needed. Updates files and provides comprehensive reports as required Qualifications Qualifications: Strong written and oral communications skills required. Good interpersonal, analytical, investigative, and negotiation skills required. Customer service experience preferred. Basic knowledge of legal liability, general insurance policy coverage and State Tort Law. Bachelor's degree is required. Ability to obtain proper licensing as required. We can recommend jobs specifically for you! Click here to get started.

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly. Job Description Kelly Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location. In addition to working with the world's most recognized and trusted name in staffing, Kelly employees can expect: Competitive pay Paid holidays Year-end bonus program Recognition and incentive programs Access to continuing education via the Kelly Learning Center Pay $15 - $16 per hour Schedule: Monday through Friday - 9:00am - 6:00pm Duration: 4 months possible extension (Possible temp - perm) Anticipated start date: 10/31/2016 to 03/31/2017 SUMMARY Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved. MAJOR JOB DUTIES AND RESPONSIBILITIES Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. EDUCATION/EXPERIENCE High School Diploma or GED Required 1-3 years of Call Center and Reimbursement experience required Knowledge of completed benefits verifications, submitted test claims, completed or reviewed prior authorizations required Strong data entry and 10-key skills Proficient in MS Word and Excel Additional Information Why Kelly? As a Kelly Services candidate you will have access to numerous perks, including: Exposure to a variety of career opportunities as a result of our expansive network of client companies Career guides, information and tools to help you successfully position yourself throughout every stage of your career Access to more than 3,000 online training courses through our Kelly Learning Center Group-rate insurance options available immediately upon hire* Weekly pay and service bonus plans

Description We are looking for a detail-oriented Claims Admin Support Specialist to join our team in Maitland, Florida. In this long-term contract role, you will perform a variety of administrative and clerical tasks to ensure smooth office operations. This position requires excellent organizational skills, the ability to manage multiple responsibilities, and a commitment to providing exceptional support. Responsibilities: - Maintain and replenish office supplies to ensure seamless daily operations. - Operate and perform routine maintenance on office equipment, including printers, fax machines, and copiers. - Coordinate document shredding services with external vendors to ensure secure disposal. - Manage document handling tasks such as creating, retrieving, copying, and delivering files. - Draft standard correspondence and respond to routine inquiries as needed. - Welcome and direct visitors, providing assistance with general inquiries. - Sort, open, and distribute incoming mail and deliveries from FedEx and other carriers. - Organize and schedule meetings, as well as manage record retention activities. - Conduct research and create reports as requested by leadership. - Occasionally travel to fulfill job-related duties or attend meetings. Requirements - High school diploma or equivalent is required. - Proficiency in operating office equipment such as printers, fax machines, and copiers. - Strong customer service skills with the ability to follow up effectively. - Ability to lift items weighing less than 50 pounds and perform repetitive tasks for extended periods. - Basic knowledge of document handling and administrative procedures. - Effective communication skills to interact with visitors and resolve inquiries. - Strong organizational skills to manage multiple tasks and responsibilities. - Familiarity with standard office practices and procedures. TalentMatch Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking "Apply Now," you're agreeing to Robert Half's Terms of Use (https://www.roberthalf.com/us/en/terms) .

DETAILS Claims Supervisor III - Property & Casualty Department: Property & Casualty Reports To: Claims Manager Property & Casualty FLSA Status: Exempt Job Grade: 16 ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Supervisor III to support our Property & Casualty department. Management that lives less than 36 miles from our local office AND have a direct report in the office, are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee lives in a state we operate in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. Employees work a 37.5-hour work week. Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. The Claims Supervisor is responsible for supervising, directing, and coordinating the activities of a team handling complex liability claims within assigned authority limits and consistent with good faith handling practices. These claims are typically mid to high exposure. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Responsible for handling a unit of senior and complex examiners handling claims of a severe and complex nature involving bodily injury, property damage, occurrence or claims made and complex coverage. Exposures are typically valued at levels of 100K or higher Able to handle multiple coverage lines with specific concentration on high exposure Auto, GL, PL (E&O) involving varying program segments Plans, schedules, and supervises the work activities of the unit's personnel in reviewing, analyzing, investigating, negotiating, and settling claims in compliance with established standards and expectations Reviews claim loss reports, assesses complexity of submitted claims and assures claims are assigned to appropriate personnel (based on licensure, knowledge, skills, and abilities) to ensure optimal claims handling within team; serves as a technical resource for staff as necessary Reviews and approves, within assigned authority limits, claim expenses and settlements that exceed the claim adjusters granted authority; appropriately refers claim expenses and settlements that exceed personal authority limits for approval Oversight of complex and reportable litigation and coverage cases. Serves as the primary liaison between the examiners and clients on case conferences and referrals Must be able to interpret coverage, provide guidance on coverage matters and review reservation of rights and disclaimers for carrier approval Monitors and evaluates reserves for claims within the unit to ensure that they are adequate and that reserve adjustments are made, when necessary, consistent with established time frames Conducts regular reviews of pending and closed files to determine whether claims are handled appropriately; identifies areas for improvement and discusses individual training and development needs as necessary Prepares monthly reports on quality control, pending and closed file reviews and reserve activity to track and communicate unit performance relating to production, opportunity areas and significant achievements Maintains awareness of existing and proposed legislation, court decisions and emerging trends in claims litigation to monitor the company's compliance with the Unfair Claims Practices Act and to recommend process and/or procedure changes Participate in special projects such as analyzing reserves, leakage, methods for pending reduction and acquisition candidates Review and approve direct report monthly expense reports and related operating expenses for their assigned unit. Works closely with all levels of management to ensure compliance with budget targets for compensation, expense control and profitability. Assists in the selection of and monitors the performance of external vendors Works closely with the claims management team to identify needs of the unit and assist with hiring, training, motivating, and retaining staff, evaluating staff performance, encouraging staff development, recommending salary actions, and, as necessary, developing performance improvement plans and recommending individual terminations of employment Works with Management to achieve company initiatives and performance goals Works with clients to address issues regarding policies, and procedures to fulfill the service requirements of the account. Reviews and evaluates performance of staff in accordance with company performance guidelines Resolves employee/workflow problems Leads staff unit meetings Attends client and company meetings, as required, either in-person or remotely Conducts claim reviews with clients and other stakeholders Assures consistent and accurate claims coding throughout the unit ACCOUNTABILITIES Supervisory Responsibilities Supervising, scheduling, assigning, monitoring, and evaluating work of assigned staff are responsibilities for supervisor positions. Provide direct supervision to examiners, adjusters, claims assistants and all liability claims staff Review and approve direct report's monthly expense reports ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Possesses a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL preferred Additional State Adjuster License(s), may be required within 180 days Maintain licenses and continuing education requirements in all states. 8+ years' experience in a claims lead or supervisor position required High exposure Auto, GL and Professional Liability claims experience Relies on extensive experience and judgment to plan and accomplish goals with a minimum 8-10 years' complex/major claims experience including proficiency in investigation and resolution of mid to severe to major casualty claims In-depth understanding of company operating structure Thorough knowledge of claims procedures, litigation management, client reporting requirements and Multi-line coverage exposures Proficiency in determining case value, negotiating settlements, and understanding CA jurisdictional statutes and regulatory requirements that drive exposure Comprehensive knowledge of claims handling systems Maintain confidentiality of information Thorough knowledge in coverage and claims investigation techniques. People management skills including interviewing skills, training, team building, and performance management. Proficiency at applying business and technical acumen by understanding how the business works and how technology supports business initiatives. Leverages technology for self and staff to improve efficiency. Handles stressful situations and deadline pressures well Thinks strategically and creatively about business (pricing, products, and outcomes) Partnering with team to ensure on time task completion; done through delegation and leading by example, executing tasks rather than just instructing to execute tasks Embrace the leadership role and can be counted on to help senior management drive towards the desired results and to exceed goals successfully. Command of company and department policies, practices and procedures including supervision, training, and performance evaluation. Able to track claims activity and properly document all actions Advanced verbal, interpersonal and written communication skills Skilled at presenting in small and large group settings unique to self-insured districts. Effectively influence people to achieve unit and organizational objectives Skilled at developing and maintaining effective relationships with others (co-workers, customers, vendors, management, and other key stakeholders) to achieve organizational goals Mathematical calculating skills Exercise independent judgment and analytic ability in solving complex and sensitive problems Computer processing skills, including the ability to leverage technology for self and staff to improve efficiency Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Able to plan, prioritize and organize claims workload for a unit Ability to work independently and in a group setting Strong attention to detail and the ability to research and resolve problems Advanced organizational skills to meet multiple deadlines and to plan and effectuate short- and long-range Company and department objectives. Must be flexible, adaptable, and positive. Exhibit passion and energy for ensuring that all employees are respected and treated in a manner consistent with Athens Values. Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position Availability for extended and long distance, overnight travel, when required APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here

Commercial Auto - Multi Line Claim Specialist Hours: Monday - Friday, 8:00 AM to 4:30 PM ET Salary Range: $60,000-$85,000 NY License required At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. Reasons you should consider a career with CCMSI: Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10+ years multi-line claim experience is required. Bachelor's Degree is preferred. NY license required Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work requires the ability to sit or stand up to 7.5 or more hours at a time. Work requires sufficient auditory and visual acuity to interact with others. CORE VALUES & PRINCIPLES Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. #CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #ClaimsSpecialist #LiabilityClaims #HybridWork #FloridaJobs #InsuranceCareers #GeneralLiability #AutoClaims #MultiJurisdiction #FLAdjusters #CommercialAuto #NowHiring #InsuranceJobs #FLLiability #IND123 #LI-Hybrid We can recommend jobs specifically for you! Click here to get started.

127295 Zurich is seeking an individual interested in growing their claims career with our General Liability team. As a General Liability (GL) Senior Claims Specialist on our IPZ (international Program) team you will work with a team of claims professionals with diverse experiences and backgrounds. This environment will support your development as you hone your technical skill set in GL policy interpretation and coverage analysis to resolve your claims effectively. At this level, you will handle single and multi-party personal or commercial line claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled most efficiently and effectively while delivering a customer-centric claims service. You will be expected to collaborate and develop partnerships with internal and external points of contact including customers, vendors, suppliers, and brokers to provide a quality claims experience. Additionally, you will learn and develop knowledge of established protocols and industry best practices to ensure that claims are handled in the most efficient, effective way while delivering a quality customer-centric claims experience. This position will work from one of the following office locations:Rocky Hill, CT, Atlanta, GA, Schaumburg, IL, Maitland, FL, Parsippany, NJ, OR New York Basic Qualifications: + Bachelor's Degree and 6 or more years of experience in the Claims and/ or Litigation Management area OR + High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area OR + Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area OR + Zurich Certified Insurance Apprentice, including an associate degree with 6 or more years of experience in the Claims and/ or Litigation Management area OR + Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area AND + Must obtain and maintain required adjuster license(s) + Microsoft Office experience + Knowledge of insurance regulations, markets, and products Preferred Qualifications: + Commercial General Liability claims handling experience within the area that includes litigated and severity injury claims + Extensive litigation experience + Construction expereince handling Bodily Injury and Property Damage wrap up policies + Currently hold an active adjusters license + Experience collaborating across work groups ability to develop and maintain strong relationships + Understands claims adjustment process and possesses the ability to determine scope/exposure for losses + Understands the use of vendors and how litigation strategies are developed + Understands and applies financial and actuarial/reserving concepts. + Familiarity with negotiation strategies and experience in suggesting alternative approaches + Negotiation skills + Organizational and time management skills + MS Office + Customer service experience + Strong analytical, critical thinking, and problem-solving skills + Strong verbal and written communication skills Compensation for roles at Zurich varies depending on a wide array of factors including but not limited to the specific office location, role, skill set, and level of experience. As required by local law, Zurich provides in good faith a reasonable range of compensation for roles. For additional information about our Total Rewards, Click here (****************************************** . Other rewards may include short term incentive bonuses and merit increases. **C** andidates with salary expectations outside of the range are encouraged to apply, and will be considered based on experience, skill, and education. The salary provided is a nationwide market range and has not been adjusted for the applicable geographic differential associated with the location where the position may be filled. The starting salary range for this position is $72,800.00 - $119,200.00. As an insurance company, Zurich is subject to 18 U.S. Code § 1033. As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time ( ************************************ ). A future with Zurich. What can go right when you apply at Zurich? Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500 . Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please click here (********************************* to learn more. As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers' expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission. Location(s): AM - Parsippany, AM - Atlanta, AM - Maitland, AM - New York, AM - Rocky Hill, AM - Schaumburg Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: * Manages an inventory of low to moderate complexity and exposure commercial claims by following company protocols to verify policy coverage, gather necessary information, maintain appropriate file documentation and authorize disbursements within authority limit. * Contributes to customer satisfaction by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information. * Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language, estimating potential claim valuation, and following company's claim handling protocols. * Exercises judgement to determine liability and compensability by conducting investigations to gather pertinent information, taking recorded statements from insureds, witnesses and working with experts to verify the facts of the claim. * Works with appropriate internal and external partners, suppliers and experts by identifying and effectively collaborating with necessary resources to facilitate best claim outcomes. * Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. * Developing ability to manage expenses by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. * Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation. * Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements. * Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. May perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities * Developing basic knowledge of the commercial insurance industry, products and claim practices. * Good verbal and written communication skills with the ability to demonstrate empathy while providing exceptional customer service. * Ability to develop collaborative business relationships with both internal and external work partners. * Able to exercise independent judgement, solve basic problems and make sound business decisions. * Analytical mindset with critical thinking skills. * Strong work ethic, with demonstrated time management and organizational skills. * Ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. * Knowledge of Microsoft Office Suite and ability to learn business-related software. * Adaptable to a changing environment * Ability to value diverse opinions and ideas Education & Experience: * High school Diploma required. Associates or Bachelor's Degree preferred. * Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. * Prior claim handling, or business experience in the insurance industry and/or customer service is preferred. #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $47,000 to $78,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

Business Claim Specialist Visa GC/Citizen Division Pharmaceutical Pay $16.00/hr. Contract 5 Month Timings Mon - Fri between 9.00AM - 6.00PM The primary function/purpose of this job. Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside the client. Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. ESSENTIAL FUNCTIONS: The 6-10 major responsibility areas of the job. Weight: (%) (Total = 100%) 1. Manage member and client expectations related to claim reimbursements. Input claim requests into adjudication platform maintaining compliance to performance guarantees, HIPAA guidelines and service standards, which include production and accuracy standards. Processing according to client guidelines making exceptions upon member appeal and client approval. Recognize and escalate appropriate system crises/problems and fraudulent claims to management. 40 % 2. Identify claims requiring additional research, navigate through appropriate system platforms to perform research and resolve issue or forward as appropriate 15 % 3. Research to define values for missing information not submitted with claim but required for processing. Identify drug form, type and strength to manually determine correct NDC number value which will allow claim to process. Continue researching values if system editing does not accept original assigned value. Utilize anchor platform, internet resources and/or contacting retail pharmacist as resources for missing values. 15 % 4. Initiate correspondence to members, pharmacies or other internal departments for missing information, claim denials or other claim issues. 15 % 5. Evaluate claim submission, ensure all required information is present and determine what action should be taken. Confirm patient eligibility and verify patient information matches system. Update member's address to match claim form if necessary. 5 % 6. Identify exception handling and process per client requirements. Monitor system to ensure client specific documentation related to claims processing and benefits is current and system editing is operating appropriately. 5 % 7. Variety of other miscellaneous duties as assigned 5 % SCOPE OF JOB Provide quantitative data reflecting the scope and impact of the job - such as budget managed, sales/revenues, profit, clients served, adjusted scripts, etc. Maintain an average of 30 Commercial claims per hour (cph) or 35 Work Comp claims per hour (cph). Qualifications Formal Education and/or Training: High school diploma or equivalent required, some college or technical training preferred Years of Experience: Two years' experience in P.B.M. environment is helpful but not required. Computer or Other Skills: Strong data entry, 10-key skills, general PC skills and MS Office experience Knowledge and Abilities: • Strong data entry and 10-key skills • Retail pharmacy, customer service experience helpful but not required • PC and MS Office literate • Strong attention to detail • Excellent retention and judgment ability • Proficient written and oral communication skills • Ability to work in fast-paced, production environment • Reliable, self-motivated with excellent attendance • Team player who has the ability to stay on task with little supervision Additional Information Thanks & Regards, Ranadheer Murari | Recruitment Executive | Mindlance, Inc. | W : ************ ***************************

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly. Job Description Kelly Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location. In addition to working with the world's most recognized and trusted name in staffing, Kelly employees can expect: Competitive pay Paid holidays Year-end bonus program Recognition and incentive programs Access to continuing education via the Kelly Learning Center Pay $15 - $16 per hour Schedule: Monday through Friday - 9:00am - 6:00pm Duration: 4 months possible extension (Possible temp - perm) Anticipated start date: 10/31/2016 to 03/31/2017 SUMMARY Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved. MAJOR JOB DUTIES AND RESPONSIBILITIES Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. EDUCATION/EXPERIENCE High School Diploma or GED Required 1-3 years of Call Center and Reimbursement experience required Knowledge of completed benefits verifications, submitted test claims, completed or reviewed prior authorizations required Strong data entry and 10-key skills Proficient in MS Word and Excel Additional Information Why Kelly? As a Kelly Services candidate you will have access to numerous perks, including: Exposure to a variety of career opportunities as a result of our expansive network of client companies Career guides, information and tools to help you successfully position yourself throughout every stage of your career Access to more than 3,000 online training courses through our Kelly Learning Center Group-rate insurance options available immediately upon hire* Weekly pay and service bonus plans