Claims representative jobs in El Paso, TX

ERISA Recovery are experts in collecting complex and aged claims through the Federal ERISA appeals process. We are a fast-growing organization located in Plano, TX. If you would like to join a friendly, passionate team with limitless potential, we'd love to meet you. This extraordinary opportunity to advance your career and make a difference is now. We are searching for a Legal Hospital Claims Analyst - someone who works well in a fast-paced setting. In this position, you'll provide support in analyzing comprehensive claims and identifying key metrics. You will be a subject matter expert in legal claims. You must be able to work both independently and as part of a team. Key attributes for the ideal candidate include working with intensity, focus, and being detail oriented. Essential responsibilities and duties Conducts legal research and investigation of claims Drafting legal documents Keeping track of changes in legal framework and providing timely updates on these changes Utilizes ERISA law enforcement Utilizes knowledge of health care standards appropriate to specific claim Ability to understand and apply medical reimbursement policies, procedures, and standards Ensures eligibility for claims is reasonable and correct by analyzing claims and providing supporting documentation Utilize a variety of EHR systems Thrives in a fast-paced environment Collaborates effectively with other team members Ability to adapt to changing needs Consistently applies knowledge relevant to claims Work intensely at a fast-paced rate Ability to communicate effectively with third party administrators Determine the status of medical claims through research Meet the standards of the department and quality standards Strong organizational skills Desired skills and Qualifications Bachelor's degree 3+ years working in the legal field 2+ years working with healthcare insurance claims (preferred) Strong Communication skills Working knowledge utilizing Microsoft software (Word, Excel, Outlook) Ability to work in a fast-paced environment Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance Paid lunches Bonus ERISA Recovery is an Equal Opportunity Employer

Duration:6 Months+ Roles & Responsibilities Maximize customer satisfaction by providing prompt actions to customer's need and obtain quality photos/data to determine root cause of claim to defend or accommodate customer's claim Provide efficient solutions to customer-facing agents by developing and operating guide and contents Use various tools/dashboard/systems to quantify the agent's performance of customer care and develop appropriate actions to improve performance and quality Spanish speaking agent recommended but not a requirement. [Customer Experience Management] Analyze end-to-end processes that customers experience and participate in providing suitable resolutions accordingly and in controlled & monitored turnaround time for each action of customer claim process [Quality Management] Monitor and review customer calls/tickets for customer care quality control, carry out activities to secure quality competitiveness of our company and customers Maintains and improves operational quality by monitoring system performance; identifying and resolving problems; preparing and completing action plans. Qualifications & Experience College Graduate 3~5 Years in customer experience Case management for MX/CE claims CE Tender management Pending Management (KPI, LTP) Case Tracker Management for special issue CPSC claim management (Customer care/tracker) (CE) Monitoring FCCM report quality (ACQ/OS Reports) Special Projects Customer Care Resolution EnR Submission/Management Work to de-escalate customer situations while finding an appropriate solution; involve upper management as needed Skills Customer Care Experience (Call Center) Claims Management Experience Insurance Claims or Adjuster background beneficial About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name: P Praveen Chary Email: **************************** Internal Id: 25-54476

At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. Join a team where your expertise truly matters!Our Casualty Claims department is seeking a highly motivated and experienced Claims Supervisor (Bodily Injury). As a key leader within our Casualty organization, you will be responsible for empowering a team that handles attorney-represented automotive liability claims. Your team will manage: complex investigations coverage determinations liability assessments bodily injury claim resolutions-through both settlement and litigation. This role requires advanced knowledge of litigation processes and the ability to strategically support litigated and attorney-represented claims. If you're passionate about developing talent, driving results, and making an impact in the automotive liability space, we'd love to hear from you.Success in this role is built on the foundation of GEICO's core leadership behaviors: Ownership: You take responsibility for outcomes in all scenarios. Adaptability: You navigate dynamic environments with creativity and resilience. Leading People: You empower individuals and teams to achieve their best. Collaboration: You build and strengthen partnerships across organizational lines. Driving Value: You use data-driven insights to align actions with strategic goals. What You'll Do: Lead, mentor, and inspire a team of associates to deliver exceptional customer service while building trust. Leverage your property and casualty insurance expertise to guide team members in resolving complex customer inquiries and claims. Provide authority on evaluations that exceed your adjusters personal, assigned authority and work with others on claims that exceed your authority Personalize your leadership approach to develop team members' skills, fostering their growth and ensuring they consistently exceed customer expectations. Monitor and evaluate team performance using key performance indicators (KPIs) to enhance efficiency, customer satisfaction, and retention. Hold your team accountable for achieving results, maintaining compliance with insurance regulations, and delivering outstanding service. Address escalated customer concerns with professionalism and empathy, modeling GEICO's dedication to service excellence. Collaborate with leadership and cross-functional teams to identify and implement process improvements. Serve as a resource for team members on insurance-related questions providing mentorship and training to build their industry knowledge. What We're Looking For: Minimum of 2 years of leadership experience in Bodily Injury claims, including direct oversight of litigated cases. Active Adjuster license (required) Expertise in Casualty claims, including knowledge of industry regulations and best practices Strong ability to assess needs and guide associates in negotiating claim settlements as needed Experienced in the use of various claims tools with ability to assist associates Strong adherence to compliance and regulatory requirements Proven ability to motivate, inspire, and develop high-performing teams in a customer-centric environment Strong results orientation, with a history of meeting or exceeding performance goals Excellent interpersonal and communication skills, with the ability to adapt leadership styles to diverse individuals and situations Ability to analyze data and metrics to inform decision-making and improve customer outcomes Collaborative mindset with a commitment to fostering a culture of inclusivity and excellence Why Join GEICO? Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Inclusive Culture: Join a company that values diversity, collaboration, and innovation. Workplace Flexibility: This is a M-F, 8:00am - 4:30pm position offering a Hybrid work model based in Richardson, TX. GEICO reserves the right to adjust in-office requirements as needed to support the needs of the business unit. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Licensing and continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Increased Earnings Potential: Pay Transparency: The starting salary for this position is between $97,735 annually and $151,700 annually. Incentives and Recognition: Corporate wide bonus programs are in place to reward top performers. Beware of scams! As a recruiter, I will only contact you through ************ email address and will never ask you for financial information during the hiring process. If you think you are being scammed or suspect suspicious activity during the hiring process, please contact us at ...@geico.com. keywords: litigation, auto liability, liability claims#geico300#LI-AL2 At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.

Staffing Now is looking for a detail-oriented and customer-focused contract to hire Specialty Claims Examiner to join our clients team in the Austin area. In this role, you'll be responsible for accurately processing and adjudicating GAP and Anti-Theft claims while delivering an exceptional service experience. What You'll Do Review loan, insurance, and contract documents to confirm claim eligibility Process claims submitted through phone, email, and chat Document all claim interactions in our system with accuracy and clarity Provide timely updates on open and pending claims Manage your assigned queue to ensure efficient claim resolution Interpret insurance and dealership documents, including payment histories Maintain strong product knowledge and deliver high-quality customer service Support administrative tasks and assist with special projects as needed What You Bring High school diploma or equivalent 2+ years of claims experience in a call center or insurance setting Working knowledge of GAP and Anti-Theft claims Strong communication skills, critical thinking, and the ability to read and interpret contracts Ability to manage high contact volume (40+ calls/emails/chats daily) Preferred Qualifications Active Claims Adjuster License Previous experience in the insurance industry If you're driven, organized, and ready to make an impact, this could be the perfect next step in your career.

Company Details Berkley Oil & Gas, (a W.R. Berkley Company) is an insurance underwriting manager providing unique property and casualty products and risk services to customers engaged in the energy sector. Our customers recognize the importance of the expertise we provide and appreciate the opportunity to work with professionals who understand their business. We are in turn committed to delivering innovative products and exceptional service to them, our valued agents and brokers, Berkley Oil & Gas is dedicated in its efforts to be well-informed of the changing dynamics of the industry; support industry efforts to minimize and mitigate risks and hazards in the ‘oil patch', and to constantly seek ways to improve our products and services to meet customer needs. Company URL: *************************** The company is an equal opportunity employer. Responsibilities The Technical Claims Specialist position will be responsible for handling, negotiating and resolving first and third party commercial general liability, property, Inland Marine and automobile bodily injury and property damage claims to conclusion. This position may also handle worker's compensation claims. This would include coverage verification, policy interpretation, contract interpretation, liability investigation and evaluation and negotiation of claims consistent with company policies and state regulations. Conduct and manage the investigative process, while demonstrating ongoing communication with the customer and relevant internal and external parties. Documenting files to include all key activities, contacts made, statements taken, including a full outline covering all aspect of the claim requirements for resolution. Demonstrate understanding of medical terms, medical treatment and injury descriptions. Recognition and evaluation of potential damages related to injuries. Manage the claim authorization process. Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence. Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction. Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements. Verify, analyze, and correctly apply coverage. Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures. Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law. Keep policyholders, underwriting and agents advised of file status and other matters as required. Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues. Successfully complete relevant continuing education as required. Qualifications Minimum of 7 years of multi-line experience Must possess a current Texas claims adjuster licenses; additional licenses a plus. Multi-jurisdictional experience preferred. Familiarity with Contractual Risk Transfer concepts and anti-indemnity laws Ability to follow detailed procedures and ensure accuracy in documentation and data. Excellent written and verbal communications; with ability to listen well. Recognizes differences in opinions and misunderstandings and encourages open discussion while working towards resolution. Accepts individual responsibility for all actions taken. Holds self and others accountable to the organization and stakeholders. Excellent organizational skills; ability to prioritize workload Ability to think critically and solve problems, including the ability to interpret related documentation Strong negotiation skills leading to best claim outcomes Demonstrate proficiency in computer programs, such as Microsoft Word, Outlook and Excel Education Requirement Bachelor's Degree required or equivalent work experience. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $90,000 - $140,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. The application window for this role is estimated to be open through January 30, 2026, but may be extended, if necessary, please submit your application as soon as possible prior to January 30, 2026. Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.

The Claims Specialist will be responsible for assisting with the management of the Fleet Vehicle Safety & Operations Policy for DPR (and DPR related entities) across the US, as well as first and third-party auto physical damage and low severity property damage claims as requested by, and under the supervision of, DPR's Insured Claims Manager. Specific Duties include: Claims & Incident Management: Initial processing of first and third-party auto and low severity property damage incidents involving DPR (and DPR related entities), including but not limited to: Input and/or review all incidents reported in DPR's RMIS system. Maintain incident records in Insurance Team's document management system. Ensure all necessary information is compiled to properly manage the claims, including working with the internal teams to identify culpable parties, potential risk transfer to the culpable trade partner, if applicable, collecting documents such as incident reports, root cause analyses, if any, and vehicle lease or rental agreements. Report, with all appropriate documents and information, all claims for DPR (and DPR related entities) to all potentially triggered insurance policies for various types of programs (traditional, CCIP, OCIP), including analyzing contractual risk transfer opportunities. Assess potential risk transfer opportunities and ensure additional insured tenders or deductible responsibility letters are sent, where applicable. Liaison with the carriers in evaluating whether claims reported directly to the carriers are appropriate. Manage all auto and low severity property damage claims, as assigned, in the DPR RMIS system for DPR (and DPR related entities), including ensuring that all information is kept up to date. Provide in-network aluminum certified repair shop information to drivers following an incident. Act as a liaison between our carriers, auto repair shops, Operations, Fleet and EHS teams related to claim progress, strategy, expenses and settlement. When required, notify the applicable State's Department of Motor Vehicles office of motor vehicle accidents by preparing and mailing the specific State form. Work with Insurance Controller on auto program claim reports Liaison with Operations, Fleet and EHS teams on new incident reporting processes, as needed. Fleet Vehicle Safety & Operations Policy Management: Manage the Fleet Risk Index scores for authorized drivers, ensuring its accurate and up to date based on incidents and MVRs Assign training to authorized drivers based on MVA incidents, MVRs and citations, as well as managing completion of the training Ensure authorized driver list is kept current Liaison with internal HR, Fleet, EHS and Business Unit Leaders, where appropriate, on suspending vehicle usage permissions Responsible for working with internal teams on implementing appropriate updates to the Fleet Vehicle Safety & Operations Policy Key Skills: Strategic thinking Ability to mentor and inspire others Integrity Team player Strong writing and communication skills Self-Starter Highly organized and responsive - ability to meet deadlines Detail Oriented Basic working knowledge in all of the following coverages/programs: auto insurance, commercial general liability, property insurance, and controlled insurance programs. Risk and dispute management - insured claims Qualifications: A minimum of five years relevant insurance industry experience Previous experience in auto claims management highly desired DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************

Job Description Key Responsibilities: Customer Claims: • Manage Customer Injury and Liability Claims: Oversee the investigation, documentation, and resolution of customer claims related to personal injury, property damage, or any other incidents occurring on organization premises. • Coordinate with Insurance Providers: Liaise with insurance companies to ensure proper claims filing and coordinate the resolution of claims involving external parties. • Customer Support: Handle escalated customer claims and provide appropriate resolutions while ensuring the store's best interests are maintained. • Documentation & Compliance: Ensure that all claims are properly documented in compliance with company policies and legal requirements. Keep detailed records of each customer-related claim. • Risk Prevention: Identify trends or recurring incidents that may contribute to customer claims and work with store management to implement safety measures or preventive actions. Employee Claims: • Workers' Compensation Claims: Oversee and manage all workers' compensation claims, ensuring compliance with state and federal regulations, and ensuring employees receive appropriate benefits. • Workplace Injury Claims: Manage the investigation of employee injury claims, including gathering evidence, interviewing witnesses, and ensuring all necessary forms are completed and submitted on time. • Fleet Claims Management: Manage the investigation of employee fleet claims, support employee's injuries if any, gather witness statements • Support and Guidance: Provide support to injured employees, ensuring they are informed throughout the claims process and are aware of their rights and available benefits. • Collaboration with HR and Legal: Work with HR and legal teams to ensure employee-related claims are handled correctly and in compliance with labor laws, insurance regulations, and company policies. • Collaboration with Safety Team: Work with the Safety Team to consistently do store visits, conduct safety audits, checklists and investigations as needed. Development: • Process Improvement: Identify opportunities to improve the claims process, whether through more efficient systems, better documentation, or enhanced communication strategies. Risk Management and Reporting: • Claims Analysis and Reporting: Review and analyze the data on claims to identify trends, recurring issues, or areas for improvement. Prepare detailed reports for management regarding claim frequency, costs, and risk mitigation efforts. • Collaboration with Risk and Safety Teams: Work closely with the Risk Management and Safety teams to address underlying causes of incidents that may lead to claims and develop preventive strategies. • Compliance: Ensure that all claims are processed in line with company policies, industry standards, and legal requirements, including managing documentation for audits or regulatory reviews. • Invoices: Reconcile and verify all invoices generated from claims. • Safety Monitor Report: Complete Safety Monitor report and communicate all parties involved to resolve an issue related to an investigation. Qualifications: • Bachelor's degree in Business, Risk Management, Insurance, or a related field (or equivalent experience). • 3-5 years of experience in claims management, risk management, or a specialist role, preferably in a retail or supermarket environment. • Strong understanding of risk management principles, insurance claims processes, and workers' compensation regulations. • Strong problem-solving and analytical abilities to investigate and resolve complex claims efficiently. • Excellent communication skills, both written and verbal, with the ability to manage sensitive issues with customers and employees. • Attention to detail and ability to maintain accurate records and reports. • Proficient in Microsoft Office and experience with claims management software or risk management tools. Physical Requirements: • Ability to stand for extended periods • Ability to lift up to 50 lbs as needed Work Environment: • Fast-paced, high-volume environment • Occasional evening, weekend, or holiday work may be required • Occasional travel to different company locations Physical Demands: Some lifting, carrying, pushing, and/or pulling; some stooping, kneeling, crouching, and/or crawling; and significant fine finger dexterity. Generally, the job requires 70% sitting, 20% walking, and 10% standing. This job is performed in a generally clean and healthy office environment.

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

JOIN THE ASSURANCEAMERICA TEAM Do you want to be part of an organization where you are valued, and your ideas and opinions have an impact? Join the AssuranceAmerica team. For more than 25 years, AssuranceAmerica has provided superior property and casualty insurance products through contracted independent agents and directly to customers. Our team succeeds through diversity of thought, experiences, skills, and backgrounds. Liability Adjuster II The Liability Adjuster II is responsible for managing a caseload of complex liability and coverage claims, including those involving minor bodily injuries. This role requires the execution of thorough investigations to gather all necessary facts, along with a strong understanding of policy language to ensure accurate and timely coverage and liability determinations. While working with a degree of autonomy, the Adjuster will collaborate with their supervisor for guidance on more nuanced or high-exposure cases. About the ROLE Each day at AssuranceAmerica is different, but as a Liability Adjuster II you will: Conduct thorough investigations and evaluations of coverage, liability, and damages across all lines of personal automobile insurance/. Accurately assess exposure and evaluate injury claims in a fair, consistent, and equitable manner based on the facts and extent of damages. Negotiate timely and appropriate settlements, ensuring all required documentation is obtained to support proper claim resolution and closure. Manage low-complexity, attorney-represented injury claims with sound judgement and attention detail, maintaining compliance with internal guidelines and industry standards. Control expenses and adhere to company reserving philosophy by maintaining proper reserves on all pending claims/potential exposures. Meet and maintain general file handling goals and procedures as outlined by the company including maintaining a 1:1 closing ratio and status on diary reviews. Properly utilize underwriting and policy systems and understand its features and functionality, as needed. Attend any available seminars and classes applicable to this position and the skills required to meet the job duties and responsibilities. Continually ask questions and have a desire to develop additional skills to better investigate and evaluate claims. About YOU Excellent communication skills with demonstrative ease with both verbal and written formats. Attention to detail and ability to multi-task. A high degree of motivation and team orientation. Direct, results driven, and dedicated to the success of the business and each other. Required Minimum three years of experience handling auto claims. Minimum of two years of experience handling complex liability and coverage issues and unrepresented bodily injury cases. Preferred Bachelor's degree or equivalent. Non-standard experience. Adjuster's license in relevant state or the ability to obtain one quickly. Bilingual (English-Spanish). Physical Requirements Prolonged periods sitting at a desk and working on a computer. Must be able to lift 15 pounds at times. Must be able to navigate various departments of the organization's physical premises. About US We are direct, results-driven, and dedicated to the success of our business and each other. We are a diverse group of thinkers and doers. We offer many opportunities to grow in your professional skills and career. We fight homelessness by directing 5% of our earnings from each policy we sell to organizations that help those in need. We call it our Generous Policy. WHAT WE OFFER AssuranceAmerica provides these benefits to Associates: Premium healthcare plans: All full-time Associates and part-time Associates working a regular schedule of 30 hours, or more, are eligible for benefits including Medical, Dental, Vision, Voluntary Life, Flexible Spending Accounts, and a Health Savings Account. Employer Paid Benefits: We enroll all eligible Associates in Group Life and AD&D Insurance, Short- and Long-Term Disability Plans, Employee Assistance Program, Travel Assist, and the Benefit Resource Card which includes Teladoc™, Pet Insurance and Health Advocate. Additional Benefits: 401(k) Employer Match: We want to help you prepare for the future, now. All full-time and part-time Associates over age 21 are eligible to participate in the 401(k) Savings Plan. AssuranceAmerica will match 100% of the first 4% of an Associate's contributions. Engagement Events. We make time for fun activities that strengthen Associate relationships in all our locations. Annual Learning Credit: Want to learn something new? We'll reimburse you for approved educational assistance. Time Off: Paid Time Off (PTO), Parental Leave Pay, Volunteer Time Off (VTO), Bereavement Pay, Military Leave Pay, and Jury Duty Pay.

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.

Job DescriptionSalary: About Us Rockwall National Public Adjusters is one of the most established public adjusting firms in the region. For more than 15 years, we have successfully advocated for property owners, supported by leadership with over 20 years of experience in the insurance claims industry. We pride ourselves on our longevity, high retention, and reputation for excellence. Many of our adjusters and office staff have been with us for over 10 years, reflecting our supportive culture and commitment to long-term careers. At Rockwall, our mission is simple: level the playing field, fight for our clients rights, and secure the settlements they deserve. By joining our team, you will become part of a well-respected firm with proven processes, unmatched administrative support, and a collaborative environment that fosters professional growth. The Role We are seeking a motivated and Licensed Public Adjuster in Texas to join our team in a hybrid, commission-based role. As a Public Adjuster, you will represent policyholders throughout the insurance claims process, guiding them through stressful property damage losses and securing fair settlements. You will play a vital role in soliciting referral business, signing clients, evaluating damages, preparing and negotiating claims, and advocating for clients best interests. This position is designed to support all levels of experience: Newly licensed adjusters benefit from structured training, mentorship, and back-office support. Experienced adjusters gain access to qualified leads, advanced systems, and a trusted brand with a long-standing reputation. Key Responsibilities Collaboratively solicit residential and commercial new claims and referral partners Sign, inspect, evaluate, and document property damage for residential and commercial claims Prepare, submit, and negotiate insurance claims on behalf of policyholders Communicate with clients, insurance carriers, contractors, and stakeholders to advance claims efficiently Advocate for clients best interests and ensure fair settlements are achieved Maintain accurate records, reports, and claim documentation Deliver exceptional customer service while educating clients on the claims process Generate new business and efficiently close provided leads Required Qualifications Active Texas Public Adjuster license (or ability to obtain one) Prior experience in insurance adjusting, construction, restoration, or a related field preferred, but not required Strong negotiation and communication skills Organized, detail-oriented, and able to manage multiple claims simultaneously Professional demeanor with a client-focused mindset Valid drivers license and reliable transportation for field inspections Compensation & Benefits Commission-based structure with unlimited earning potential Training and ongoing professional development Career growth opportunities within a supportive and collaborative team Hybrid work flexibility (field + office) Full administrative and office support (contracts, compliance, claims, invoicing, mortgage company payments) The Rockwall Difference At Rockwall, we provide unmatched support at every stage of the claims process, allowing our adjusters to focus on serving clients and building careers. Key Advantages: Comprehensive adjuster onboarding and mentorship programs Professional ongoing sales training to close contracts faster and expand referral networks Proprietary lead generation sources and affiliate networks Automated client onboarding to reduce paperwork Access to advanced claims management software for streamlined workflows Hands-on field training for residential and commercial claims Xactimate training and estimate reviews to ensure complete assessments Seamless invoicing and fee collection support Regular updates on case law, legislation, and industry trends A collaborative team environment that promotes growth and shared knowledge Why Join Rockwall NPA 20+ years of insurance industry expertise 15+ years as a trusted, established firm Strong reputation and high staff retention Proprietary lead generation sources and long-standing affiliate networks Full support systems that empower adjusters to succeed A company culture built on professionalism, advocacy, and results

Why Texas Association of School Boards (TASB) TASB comes from humble beginnings - picture a one-person organization created in 1949 to advocate for excellence in public education on behalf of Texas school board members. Flash forward to today, and we have over 500 employees working together to provide 1,024 school districts with purposeful resources and services so they can focus on what matters most - excellent education for over 5 million Texas students. Our employees work alongside talented team members who are passionate about supporting public education and enjoy learning from new and different perspectives. TASB believes the rich variety of expertise our employees collectively bring to the workplace makes our organization highly successful. And TASB's passion for education and learning doesn't end there. Our culture has always encouraged employees to grow and become their best selves, professionally and personally, through a variety of innovative and collaborative development opportunities. You're likely beginning to see why we'd been regularly named by the Austin Business Journal as one of the Top Ten Best Places to Work! TASB offers competitive pay, rich benefits (including retirement matching of 2:1 up to 5% after one year, which means that if you contribute 5% to the plan, TASB will contribute 10%), family-friendly paid leave, onsite daycare, onsite gym, wellness program, tuition reimbursement, hybrid work options, and more. Every role at TASB thoughtfully complements our mission and its impact on school districts across Texas. These roles include work in TASB's Risk Management Services division, which provides administrative services to the TASB Risk Management Fund - a multi-line self-insurance pool (or “risk pool”) of Texas schools. If you consider your work exceptional, have a passion for risk management or risk pools, and want to help drive our mission forward, keep reading! About You As the Medical Only Adjuster, you will bring strong analytical skills, attention to detail, and a commitment to delivering excellent service to our member districts and injured employees. You will investigate and manage workers' compensation claims, ensuring compliance with Texas statutes and internal best practices, while communicating effectively with stakeholders. Whether you are early in your claims career or have advanced experience, your expertise in claims handling, problem-solving, and customer service will add value to our collaborative team environment. A Typical Day Investigate and manage a caseload of workers' compensation medical-only claims, ensuring timely and accurate benefit payments in compliance with Texas statutes and internal guidelines. Communicate with injured employees, member districts, and vendors to gather information, resolve issues, and provide updates throughout the claims process. Collaborate with your team during meetings or case reviews to share insights, discuss complex claims, and contribute to continuous improvement initiatives. If you're still reading, we'd love to meet you! How You'll Make an Impact Investigate, evaluate, and manage workers' compensation medical-only claims to ensure timely and accurate benefit delivery. Maintain thorough documentation, proper reserves, and compliance with all regulatory and departmental requirements. Communicate proactively with injured employees, member districts, and vendors to resolve questions and provide updates. Apply knowledge of Texas workers' compensation statutes, best practices, and claims handling procedures to every case. Contribute to a positive team environment by sharing insights and supporting continuous improvement efforts. Skills for Success High school diploma required. Bachelor's degree or some college preferred. Experienced candidates should have a Type 03 or 08 Texas adjuster license. Candidates without adjusting experience will be considered for an Adjuster 1 role and required to obtain a license within one year of hire. Must demonstrate good organizational, analytical, and communication skills (oral and written). The TASB Difference Enjoy competitive pay and rich benefit offerings. Be a part of a collaborative environment where every contribution impacts Texas public schools. Thrive in a culture that promotes bringing your whole self to work every day and emphasizes healthy boundaries and work-life balance. Learn and grow individually and together through frequent professional development, wellness seminars, and more. Work alongside transparent leaders with an open and consistent feedback approach. Celebrate as a team with meaningful (and fun) events throughout the year. Posting Notices The health and safety of our employees and members, is our top priority. The Association is an equal opportunity employer and will not discriminate against an individual based on any of the following personal characteristics protected by law: race, color, national origin, religion, sex (including in relation to marital status, pregnancy, pay, sexual orientation or gender identity), age, disability, genetics or veteran status. This position does not qualify for visa sponsorship. Any job offer is contingent upon receipt of results of a satisfactory background check. #LI-Hybrid

As a 100% employee-owned contractor, when you work at Sundt, you're not just hiring on at a company, you're joining a culture. Because everyone at Sundt is part owner, you'll join a team of people who are deeply invested in their work. From apprentices to managers, we're passionate about the details and deliberate in everything we do. At Sundt we focus on building long-term prosperity for our clients, communities, and employee-owners. We offer competitive pay, industry-leading benefits including a 401k and employee stock ownership plan, incentive programs for craft and administrative employees as well as training that focuses on your personal and professional growth. We're driven by skill, grit and purpose. Join us as we strive to be the most skilled builder in America. Job Summary The Paralegal / Claims Specialist supports the company's Legal and Risk Management functions by assisting attorneys and insurance professionals in the investigation, evaluation, and resolution of claims and lawsuits. The role involves direct collaboration with outside counsel, insurance adjusters, and internal Safety and Operations teams. The Paralegal/Claims Specialist will independently manage the day-to-day handling of routine litigation and claims matters, including discovery, documentation, and coordination with defense counsel. Key Responsibilities 1. Assists attorneys with trial preparation, exhibits, witness coordination, and logistics. 2. Assists company attorneys with responding to non-party subpoenas and regulatory inquiries. 3. Attends mediations, depositions, and hearings as appropriate to support counsel, our internal personnel and maintain awareness of case progress. 4. Communicates directly with claimants, witnesses, experts, and internal personnel to obtain and analyze relevant information, including managing internal electronic data preservation in coordination with IT team, and oversee transfer of preserved data for discovery. 5. Coordinates with Safety personnel regarding incident intake, documentation, and potential claims escalation. 6. Drafts and edits legal documents including correspondence, discovery requests and responses, routine pleadings, affidavits, and case summaries. 7. In conjunction with attorneys, manages litigation, including coordinating discovery and e-discovery, tracking deadlines, managing document production, approving and processing legal invoices and maintaining organized case files. 8. Maintains accurate and up-to-date records in Risk Information Management Systems {RIMS) or other claims databases. 9. Reviews and analyzes claims in coordination with legal and risk management professionals determine liability, damages, and insurance coverage. 10. Works closely with company attorneys, outside counsel, and insurance adjusters to investigate, evaluate, and resolve claims and lawsuits. Minimum Job Requirements 1. 5-10 Years of Experience 2. Bachelor's degree 3. Knowledge working for a law firm or an insurance company representing clients in responding to claims and lawsuit preferred. 4. Paralegal certification Note: is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 50Ibs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Note: Job Description is subject to change at any time and may include other duties as assigned. Physical Requirements 1. May stoop, kneel, or bend, on an occasional basis 2. Must be able to comply with all safety standards and procedures 3. Required to use hands to grasp, lift, handle, carry or feel objects on a frequent basis 4. Will interact with people and technology frequently during a shift/work day 5. Will lift, push or pull objects up to 501bs on an occasional basis. 6. Will sit, stand or walk short distances for up to the entire duration of a shift/work day. 7. Will use telephone, computer system, email, and other electronic devices on a frequent basis to communicate with internal and external customers or vendors Equal Opportunity Employer Statement: Sundt is committed to the equal treatment of all employees, and/or applicants for employment, and prohibits discrimination based on race, religion, sex (including pregnancy), sexual orientation, gender identity, color, age, disability, national origin, covered veteran status, genetic information; or any other classification protected by applicable Federal, state, or local laws. Benefit list: Market Competitive Salary (paid weekly) Bonus Eligibility based on company, group, and individual performance Employee Stock Ownership Plan & 401K Industry Leading Health Coverage Starting Your First Day Flexible Time Off (FTO) Medical, Health Savings, and Wellness credits Flexible Spending Accounts Employee Assistance Program Workplace Wellness Programs Mental Health Program Life and Disability Insurance Employee-Owner Perks Educational Assistance Sundt Foundation - Charitable Employee-Owner's program #LI-KA1

Job DescriptionBenefits: Life Insurance Dental insurance Health insurance Paid time off Vision insurance The Subrogation Adjuster will be responsible for identifying subrogation opportunities, investigating liability, and pursuing recoveries from at-fault parties or their insurers. The ideal candidate has hands-on experience with non-standard auto claims, understands complex liability scenarios, and is comfortable negotiating to maximize recoveries. Key Responsibilities Review claim files to identify subrogation potential and establish recovery strategies Investigate liability by obtaining police reports, witness statements, and other relevant evidence Communicate with policyholders, claimants, other insurers, and attorneys to pursue recoveries Negotiate settlements with adverse carriers and uninsured parties Document all activity accurately and in a timely manner within claim systems Collaborate with litigation teams when legal action is required to support recovery efforts Handle deductible reimbursements in accordance with company policy and state regulations Maintain productivity and recovery goals in alignment with department metrics Qualifications 2+ years of subrogation or claims adjusting experience, preferably within non-standard auto insurance Solid understanding of auto liability, comparative negligence, and subrogation principles Excellent negotiation, communication, and investigative skills Strong organizational skills and attention to detail Ability to manage a high-volume caseload efficiently Familiarity with arbitration forums (e.g., AF) and relevant state regulations is a plus Proficiency in claims management systems and Microsoft Office Pay Pay is negotiable based on experience THIS IS AN IN PERSON POSITION

Lockton is currently seeking a Clinical Claims Specialist within our Specialty Practice unit. The objective of this role is to improve and reduce the severity of complex and catastrophic claims, reduce the cost of risk while improving the health of our employer client's employee health plan. * Provide explanation of disease states and associated costs to internal and external stakeholders. * Provide cost-of-care estimates used in the risk assessment of stop loss underwriting. * Consult with and advise underwriting on medical/clinical care approaches, standards of care and research of data for new business and renewals. * Serve as a resource regarding medical necessity issues, standards of care and analysis for the reimbursement of submitted stop loss claims. * Review claims and clinical documents to identify and monitor opportunities to increase member quality of care and overall cost reduction. * Collaborate with various key stake holders to strategize clinical and cost savings strategies and assist on execution of plan. * Coordinate implementation of claims savings solutions with Lockton Client Service Teams, TPAs, and stop loss carriers including regular tracking to measure savings and plan performance. * Manage and organize task lists and open items and cases. * Attend team clinical rounds to discuss cases and strategy solutions.

SafeRide Health is looking for a hands-on Claims Specialist to scale SafeRide. We are looking for a leader with deep experience managing Medicare and Medicaid programs as we scale past $100M in annual revenue. The Billing Specialist is responsible for elevating SafeRide's billing function and continuously enhancing the effectiveness of the organization. Strong business and financial orientation as well as a passion for growth and development are critical for this role. Responsibilities: Facilitates data processing and processes claims for NEMT and GMR rides. Performs reconciliation of billing data to encounter data. Works closely with the operations team to resolve issues. Work with internal operations and project teams to solve claims-related problems, benefit plans research and provider contract interpretation and configurations. Communicate and work with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines. Receive incoming calls from providers, customers, vendors, and internal groups, to successfully analyze the caller's needs, research information, answer questions, and resolved issues and/or disputes in a timely and accurate manner. Identify issues negatively impacting the provider community including but not limited to system set up, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules. Develops and implements policies, processes and procedures that incorporate industry best practices, and reinforces high quality standards within the Billing team. Served as the Billing team's subject matter expert and primary contact for claims related projects and critical activities. Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues. Implement: Scalable and accurate billing operations systems leveraging best in class technology. This includes financial reporting for management, clients and designated state and federal agencies (e.g., HHSC in Texas). Champion and reinforce SafeRide's culture. Required Education/Experience: Minimum 1 years of experience in billing/claims management Must be bilingual Spanish Speaking Preferred NEMT/transportation background preferred Knowledge of CMS/HHSC regulations preferred Skills Strong data skills in Excel/Sheets, including pivot tables, v-lookups, etc. Self-starter, ability to work independently and in a team environment. Strength in problem solving, applying hard data and qualitative insight to frame problems and develop novel solutions Ability to adapt to unforeseen circumstances quickly Keen attention to detail Ability to work with a variety of stakeholders What we offer you An inclusive, encouraging and collaborative company culture Strong support for career growth, including access to our investor communities Competitive compensation with upside for growth (including stock options and performance grants) Competitive benefits including health/vision/dental insurance, 401k match and 18 day's PTO About SafeRide Health: SafeRide's mission is to restore access and dignity to care. SafeRide is transforming access to care for the nations sick, poor and underserved. We are a high growth, tech enabled services firm that's growing past 400 employees. SafeRide is backed by premier investors like NEA and clients like Fresenius. We operate nationally and now deliver over 5M rides per year. Learn more at ***********************

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. The Appearance Claims Adjuster is responsible for evaluating and processing insurance claims related to property damage and personal injury. This role involves conducting thorough investigations, assessing damages, and determining liability based on policy coverage. The adjuster will collaborate with policyholders, service providers, and legal teams to ensure timely and accurate claim resolution. How You Will Contribute • Handles claims from initial contact through to conclusion. • Thoroughly investigates claims and verifies eligibility • Responsible for maintaining positive customer relationships seeking to enhance organizational skills. • Manages a high call volume with exception communication and customer service skills • Successfully works independently and in a team atmosphere. • Skillfully adapts and uses critical thinking and problem-solving issues. Skills & Experience to Be Successful · Excellent written and verbal communication skills · Proficient with Microsoft Office Suite and industry standard web applications · Ability to maintain a high level of confidentiality Preferred · Bilingual is a plus, not required · Service Advisor, Warranty, or Service Drive experience a plus · Basic mechanical knowledge of automotive systems. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services; Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.

We're thrilled that you are interested in joining us here at the Amynta Group! The WARRANTY CLAIMS ADJUSTER is responsible for interactions with customers, inspectors, repair facilities, and part vendors to support our auto warranty call center. The Warranty Claims Adjuster will be responsible for providing our innovative extended service plans and warranty programs to retailers, dealers, distributors and manufacturers in numerous consumer and automotive markets. ESSENTIAL JOB DUTIES AND RESPONSIBILITIES* Handle claims on a daily basis Work in a call center environment focused on handling calls daily with expected performance metrics, handle times, and volume Probe and troubleshoot mechanical breakdown claims to determine whether customer complaint, repair facility diagnosis, and failed parts meets the criteria for approval based on the terms and conditions of the extended service contract. Review and verify repair costs using standard “national labor guides” (including labor rates and time) to ensure estimates are within approval guidelines. Use other resources such as, technical bulletins, recalls and system comments, and other requirements during the adjudication process. Verify repair information to determine if coverage is within the guidelines of the service contract. Determine if a field inspection is necessary based on cause of failure and cost estimates submitted by repair facility. Document all interactions, research, verification and other claim-related information in the database system. Interface with customers, agents, dealers, and other relevant parties to complete all investigations of claims. Review claims using the adjudication process established by department. Partner with other departments, claim adjusters, and management staff to identify options that support claims resolution and approval. Maintain a continual working knowledge of our client's products, services and promotions. Retrieve information from company systems and communicate information back to the customers, dealers, repair facilities, and vendors in a clear and concise manner. BASIC AND PREFERRED QUALIFICATIONS (EDUCATION AND EXPERIENCE) 2+ year's minimum experience (Required) High School Diploma or GED (Required) Some college (Preferred) Proficient knowledge of Microsoft Office (Required) ASE Certification (Preferred) MINIMUM QUALIFICATIONS, JOB SKILLS, ABILITIES Mastery of the English language, both written and verbal. Strong attention to detail, is dependable and follows through. Ability to read and interpret information. High level of maturity to handle sensitive and confidential situations. Strong work ethic and excellent time management skills. Strong interpersonal skills and ability to work well with people throughout the organization. Willingness to maintain a professional appearance and provide a positive company image. Willingness to work non-traditional shifts which meet the needs of the team and company. Ability to think independently and make decisions. Ability to assist peers. The Amynta Group (the “Company”) is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of any ground of discrimination protected by applicable human rights legislation. The information collected is solely used to determine suitability for employment, verify identity and maintain employment statistics on applicants. Applicants with disabilities may be entitled to reasonable accommodation throughout the recruitment process in accordance with applicable human rights and accessibility legislation. A reasonable accommodation is an adjustment to processes, procedures, methods of conveying information and/or the physical environment, which may include the provision of additional support, in order to remove barriers a candidate may face during recruitment such that each candidate has an equal employment opportunity. The Company will accommodate a candidate to the point of undue hardship. Please inform the Company's personnel representative if you require any accommodation in the application process.

Lantern is the specialty care platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation's top specialists for surgery, cancer care, infusions and more, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation's largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com. About You: You use LOGIC in your decision making and understand that progress is critical to making change. You focus on the execution of your content while balancing a fast-paced environment and you take the time to celebrate both the small & big wins. INCLUSION is a core tenant of your personal beliefs. A diverse and inclusive environment is incredibly important to you. You understand and desire to be a part of a diverse team with different experiences and perspectives & you cherish the differences in each individual that you interact with. You have the GRIT, drive and ambition to tackle big problems. Big problems require big ideas and a team that supports new ideas. You care deeply for your customers are driven to keep HUMANITY in all decisions. Your customers aren't just the individuals using your product. They are the driving factor in your motivation to make a change. Integrity guides you in life. Focusing on the TRUTH vs. giving people the answers they want to hear. You thrive in a Team Environment. Collaboration is key in innovation and creating change. These pillars of LIGHT are a reminder to our team that we are making a difference by providing guidance and support in navigating the often complex and confusing landscape of healthcare. We hope that through this LIGHT, individuals can find their way to the best care, resources, and support they need to get back to life. If this sounds like you, we would love to connect to speak further about career opportunities at Lantern. Please apply to our role & someone from our Talent Acquisition Team will reach out to help you navigate our interview process. Job Overview Our Reimbursement Specialists are a central points of contact for our provider network. The primary responsibility of the role is to deliver effective, accurate payment and communication to our providers. The day-to-day responsibilities of our Reimbursement Specialists include payment processing, researching, accurate billing/payment disbursement, and ensuring payment data accuracy and integrity. The desired candidate is articulate, empathetic, pragmatic, self-starting and ambitious. In addition, our Reimbursement Specialists are horizontal thinkers, analytical, organized and detail oriented. Key Responsibilities: Processes provider payments in accordance with company policies and procedures. Serves as primary contact to Finance Department regarding payment, determinations and payment processing activities. Assist in the final determination on claim disposition and payment determination. Serves as liaison to internal departments regarding provider related inquiries on claims related content. Processes adjustments or provider disputes providing timely follow-up. Coordinates research and responds to system inquiries from providers regarding payment, reimbursement determination, provider contact information and claims billing procedures. Communicates with supervisor on a daily and/or weekly basis regarding any outstanding claims issues related to system, authorizations, reimbursement/payment errors or internal approvals. Works with provider contracting staff when new/modified reimbursement contracts are needed Performs pre-adjudication claims reviews to ensure proper terms and schedules were used. Initiate necessary actions regarding pending claims or payment documentation. Follow up on open items reports to timely and accurate resolution. Respond proactively to provider issues and concerns and give feedback to management. Provide feedback to the manager regarding proper claims billing procedures in accordance with company policy and procedures. Assist in training new Payment Specialists. Initiate change requests to resolve system issues impacting claims/payment processing or issue resolution Runs and analyzes daily activity reports. Analyze, develop and deliver claims resolutions quickly and accurately according to company policies and procedures. Requirements: Minimum Bachelor's degree in healthcare, business, marketing or related field; or HS Diploma (or GED) and 4 years' applicable experience Minimum 2 years of experience in previous claims, health insurance or healthcare practice Knowledge of medical coding systems (i.e., CPT, ICD-9/10, revenue codes) preferred Knowledge of commonly used medical data resources preferred Knowledge of payor contracts and interpretation Knowledge of general office operations and/or experience with standard medical insurance claim forms preferred Strong communication (verbal, written and listening), teamwork, negotiation and organizational skills Ability to commit to providing a level of customer service within established standards Ability to provide attention to detail to ensure accuracy including mathematical calculations Ability to organize workload to meet deadlines and participate in department/team meetings Ability to analyze data and arrive at a logical conclusion Ability to identify issues and determine appropriate course of action for resolution Ability to display professionalism by having a positive demeanor, proper telephone etiquette and use of proper language and tone Ability to use software and hardware related to job responsibilities, including MS Office Suite and database software Ability to work with accuracy in a fast-paced environment Ability to work independently and handle PHI and confidential information Ability to process detailed verbal and written instructions Benefits Medical Insurance Dental Insurance Vision Insurance Short & Long Term Disability Life Insurance 401k with company match Paid Time Off Paid Parental Leave Lantern does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.