Claims representative jobs in Glendale, AZ - 132 jobs

Phoenix Regional 2075 W Pinnacle Peak Rd, Suite 110, Phoenix, AZ 85027 Thank you for considering Amica as part of your career journey, where your future is our business. Ready to Join Us? Are you a detail-oriented professional with a passion for resolving complex issues and supporting customers in a time of need? We're looking for a Claims Representative who thrives in a fast-paced environment and is committed to delivering exceptional service. As an Associate Auto Physical Damage (APD) Claims Representative in our Phoenix Regional office, you will play a vital role in handling automobile insurance claims. At Amica, we recruit the best talent and believe that an investment in our people is an investment in us. Our frontline customer service representatives carry out our guiding philosophy - that empathy is our best policy - to our valued customers every day. We believe in promoting from within and providing our employees with opportunities for growth and advancement. This entry-level position offers a high level of growth potential, including the possibility to advance to team lead and supervisory roles. We are committed to helping our employees build long-term careers with us. As a key member of our claims team, you will: * Own your caseload: Manage a backlog of claims using a diary system to ensure timely communication, monitoring, and reporting. * Investigate: Conduct in-depth research to evaluate coverage and determine claim outcomes. * Communicate effectively: Monitor claim-related communications and respond to customer's needs. * Collaborate and contribute: Build strong relationships across departments and help foster a culture of teamwork. * Stay informed: Develop a working knowledge of laws and regulations impacting claims handling. * Stay compliant: Maintain active licenses in designated states and complete continuing education as required. * Adapt and support: Take on additional responsibilities as needed to support team success. What We're Looking For: * A high school diploma or equivalent - college coursework or additional training is a plus! * Willingness to obtain required state insurance licenses (Don't worry - we'll provide study materials, paid time to study and cover the exam costs!) * Prior experience in insurance or claims handling is helpful, but not required * Prior experience providing support to customers or clients is valued and can contribute to success in this role * Strong decision-making skills * A calm, empathetic communicator who can confidently support people during tough situations * Excellent written and verbal communication skills * Comfortable using Microsoft Word and Outlook Compensation and Schedule: * Starting annual salary of $43,105, overtime is paid for any excess hours subject to manager approval * Annual Success Sharing Plan - Paid to eligible employees if the company meets or exceeds the combined ratio, growth and/or service goals. * 37.5-hour schedule, Monday through Friday, 8:45 a.m. to 5 p.m. * Potential to work holidays for additional pay * Work from home up to two days per week once trained to work independently We've Got the Whole Package: * Medical, dental, vision coverage, short- and long-term disability, and life insurance * Paid Vacation - you will receive at least 13 vacation days in the first 12 months; amounts could be greater depending on the role. While able to use prior to accrual, vacation time will accrue monthly. * Holidays - 14 paid holidays observed * Sick time - 6 days sick time at hire, 6 additional days sick time at 90 days of employment * Generous 401k with company match and immediate vesting. Additionally, annual 3% non-elective employer contribution * Annual Success Sharing Plan - Paid to eligible employees if the company meets or exceeds combined ratio, growth and/or service goals * Generous leave programs, including paid parental bonding leave * Student Loan Repayment and Tuition Reimbursement programs * Generous fitness and wellness reimbursement * Employee community involvement * Strong relationships, lifelong friendships * Opportunities for advancement in a successful and growing company Why Amica? * Our People Are Our Priority: We're a mutual company where people come first, including empathetic employees who represent the diversity of our policyholders. That's why we welcome employees who represent differences in opinion, life experience and perspectives, who enrich a culture where everyone can contribute and grow. * The Opportunities Are Wide Open: We know growth isn't always linear. We encourage our employees to be curious about their career at Amica and explore the options available to them. We believe that what's best for our employees is best for the company. * Commitment Goes Both Ways: What employees get in return for what they bring to Amica includes compensation and benefits of a Total Rewards package. But it goes further to include flexible work environments and opportunities to advance their careers. The support we offer is designed to help you build a stable and fulfilling career that's uniquely Amica. Our dedication to diversity, equity, and inclusion ensures that every employee feels a true sense of belonging. Want to learn more about our commitment to diversity, equity, and inclusion? Visit our DEI page to read about it! Amica conducts background checks which includes a review of criminal, educational, employment and social media histories, and if the role involves use of a company vehicle, a motor vehicle or driving history report. The background check will not be initiated until after a conditional offer of employment is made and the candidate accepts the offer. Qualified applicants with arrest or conviction records will be considered for employment. The safety and security of our employees and our customers is a top priority. Employees may have access to employees' and customers' personal and financial information in order to perform their job duties. Candidates with a criminal history that imposes a direct or indirect threat to our employees' or customers' physical, mental or financial well-being may result in the withdrawal of the conditional offer of employment. About Amica Amica Mutual Insurance Company is America's oldest mutual insurer of automobiles. A direct national writer, Amica also offers home, marine and umbrella insurance. Amica Life Insurance Company, a wholly owned subsidiary, provides life insurance and retirement solutions. Amica was founded on the principles of creating peace of mind and building enduring relationships for and with our exceptionally loyal policyholders, a mission that thousands of employees in offices nationwide share and support Equal Opportunity Policy: All qualified applicants who are authorized to work in the United States will receive consideration for employment without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, family status, ethnicity, age, national origin, ancestry, physical and/or mental disability, mental condition, military status, genetic information or any other class protected by law. The Age Discrimination in Employment Act prohibits discrimination on the basis of age with respect to individuals who are 40 years of age or older. Employees are subject to the provisions of the Workers' Compensation Act. Amica Mutual Insurance Company is committed to protecting job seekers from recruitment fraud. We never request sensitive personal information or payment during the interview process. All legitimate job opportunities are listed on our official careers site: ************************** Learn more in the "Is Amica hiring?" section of our FAQ. rp

DEPT OF REVENUE Funding Arizona's future through excellence in innovation, exceptional customer service and public servant-led continuous improvement. All Arizona State employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government. Our goal is for every ADOR team member to reflect on individual and team performance, reduce waste, and commit to continuous improvement with sustainable progress. Through AMS, every ADOR team member seeks to understand customer needs, identify problems, improve processes, and measure results. Claims Specialist 2 Job Location: Address: 1600 W Monroe St., Phoenix AZ 85007 Posting Details: Salary: $19.71 an hour ($41,000 annualized) Grade: 17 Closing Date: Open until filled Job Summary: The Claims Review Specialist 2, is responsible for reviewing, investigating, and processing unclaimed property claims. This role researches and analyzes applicable State laws, statutes, rules, regulations, policies, and procedures, in addition to utilizing investigative tools of miscellaneous records, to advise the Unclaimed Property Specialist 3's and management on the determination and outcome of claims. This position is hybrid role which works onsite two days/week.. The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State's Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance. Job Duties: Claims Review and Investigations Completes unclaimed property claims reviews and investigations and to advise Unclaimed Property Specialist 3's and management on claims determinations and outcomes Researches and analyzes applicable State laws, statutes, rules, regulations, policies, and procedures regarding unclaimed property, probate, and domestic relations matters Utilizes investigative tools to review public, court, real property, vital statistic, corporate, and other miscellaneous records Service Delivery Communicates information to claimants and property holders of the determined ownership of unclaimed property in and accurate and professional manner Writes correspondences, including requests for evidence, formal decision notices, and explanations of policies, procedures, and practices to claimants Conducts initial and follow-up claimant interviews and investigations, primarily through phone but sometimes in-person, to elicit information to assist with claim determinations Resolves routine issues and complaints from claimants Agency/Department Compliance & Continuous Improvement Remains current on all laws, regulations, policies, and best practices related to taxation through regular engagement in activities such as: self-directed research, conferring with other practitioners and technical experts; subscriptions to regulatory/legal/industry newsletters and briefs; membership industry associations and attendance at meetings/events; and or participation in training and others continuing education opportunities. Actively contributes to team and individual effectiveness through the following: Attends staff meetings and huddles of work unit or district; and may cascade and track information as indicated Completes all required training in a timely manner. Participates in assigned work teams as appropriate. May complete periodic metrics, projects, huddle boards and reports as requested. Prepares for and actively participates in 1:1 coaching with supervisor Maximizes work processes and deliverables through lean principles within the Arizona Management System (AMS); and provides recommendations for process improvement, and engages in continuous improvement efforts as assigned. Knowledge, Skills & Abilities (KSAs): Education & Experience Any combination that meets the knowledge, skills and abilities (KSA); typical ways KSAs are obtained may include but are not limited to: a relevant degree from an accredited college or university such as Associate's Degree (e.g., A.A.), training, coursework, and work experience relevant to the assignment. Minimum of one year experience with unclaimed property and/or claims/audit related work Knowledge/Understanding Basic knowledge of Federal and State laws, statutes, rules, regulations, policies, and procedures regarding unclaimed property, probate, and domestic relations matters Basic knowledge of Federal and State laws, statutes, rules, regulations, policies, and procedures regulating confidentiality requirements Basic knowledge of investigative and research techniques Basic knowledge of all required supporting documentation necessary to make unclaimed property claims determinations Skills Effective verbal, written, and active listening skills Strong customer service skills to service taxpayers in a courteous and professional manner Effective interpersonal skills and demeanor Effective organization and time management skills with the ability to make measurable progress on several tasks simultaneously and work in high-pressure situations Strong mathematical skills such as addition, subtraction, multiplication, division, percentage, and averages Proficient in the use of a PC in a Windows environment; in the use of the Internet; in the use of MS Office Applications such as Outlook, Word and Excel; and in the use of Google Suite applications such as Gmail, Sheets, Docs, and Drive Abilities Ability to clear a comprehensive background and clearance process that includes an Arizona tax compliance verification, and a criminal background check through the FBI via level one fingerprint clearance through the Arizona Department of Public Safety Ability to work with a high degree of autonomy and also participate collaboratively as part of a team Ability to work in a confidential manner, ensuring information is shared with internal and external individuals in an appropriate manner Ability to convey unclaimed property related terminology and information in layman's terms Ability to understand and solve problems by applying intermediate analytical skills to include collecting all the relevant information and data needed to address the problem; organizing, classifying and synthesizing the data into fundamental issues; from the information, identifying the most probable causes of the problem; reducing the information down into manageable components; identifying the logical outcomes from the analyses of the data collected; and, identifying the options and solutions for addressing the problems analyzed Ability to learn and apply LEAN concepts, principles, and tools Willingness and ability to embody ADOR's core values of Do the Right Thing, Commit to Excellence, and Care About One Another Additional Job Demands In the course of performing the essential duties one must be able to exert up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. No substantial exposure to adverse environmental conditions (such as in typical office or administrative work.) Selective Preference(s): Associate's Degree in Business, Public Administration, or a related field Pre-Employment Requirements: The final candidate will be required to abide by the the following pre-employment checks: -Employment Verification and Reference Checks -State and Federal Criminal Background Check, including fingerprinting -Arizona Tax Filing Records Check If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver's License Requirements. All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify). Benefits: The State of Arizona provides a world class comprehensive benefits package including: -Paid time off for holidays, sick days, annual leave, military leave, bereavement leave, and civic duty leave -Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program). -A robust and affordable insurance plan that includes medical, dental, vision, life insurance, short-term, and long-term disability options. -Higher education discounts for State employees and tuition reimbursement up to $5,250 per fiscal year, available to seek further career advancement or certification in Continuing Professional Education. -Work-life balance and additional options for life betterment such as the Infant at Work Program, State Wellness Program, Public Transit Discounts, Alternate Work Schedules, and Telework opportunities. By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion. Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page Retirement: Top ranked Arizona State Retirement System (ASRS) provides 100% employer matched contributions (enrollment eligibility will be effective after 27 weeks of State employment). ASRS provides a lifelong benefit based on years of service earned, or worked, and your ending salary. Learn more about ASRS at: *********************************************************** Contact Us: If you have any questions, need assistance, or would like to request a reasonable accommodation, please contact the ADOR Talent Team at *********************. *The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.

We are united in our mission to make a positive impact on healthcare. Join Us! South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2024 2024 Black Book Awards, ranked #1 EHR in 11 Specialties 2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold) 2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara) Who we are: We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany. ModMed is hiring a driven Patient Claim Specialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine! Your Role: Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates Input and update patient account information and document calls into the Practice Management system Special Projects: Other duties as required to support and enhance our customer/patient-facing activities Skills & Requirements: High School Diploma or GED required Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST Minimum of 1-2 years of previous healthcare administration or related experience required Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs) Manage/ field 60+ inbound calls per day Bilingual is required (Spanish & English) Proficient knowledge of business software applications such as Excel, Word, and PowerPoint Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone Ability and openness to learn new things Ability to work effectively within a team in order to create a positive environment Ability to remain calm in a demanding call center environment Professional demeanor required Ability to effectively manage time and competing priorities #LI-SM2 ModMed Benefits Highlight: At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits: India Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk, Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees, Allowances: Annual wellness allowance to support your well-being and productivity, Earned, casual, and sick leaves to maintain a healthy work-life balance, Bereavement leave for difficult times and extended medical leave options, Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave, Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind. United States Comprehensive medical, dental, and vision benefits 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep. Generous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.

Must be able to work: Monday - Friday, 2:30pm to 11pm EST plus every fourth weekend Essential Functions Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent's performance objectives as outlined by the incumbent's immediate supervisor or manager. 1. Assist pharmacies with real-time and retrospective claims adjudication. Adjust and correct authorizations in dispensing and PBM systems to ensure timely claims submission. Research and resolve rejected claims by contacting hospices for approvals or updated authorizations. 2. Maintain accuracy of patient profiles, involving authorization status and relatedness indicators. 3. Evaluate and process compound medication claims, ensuring accuracy in ingredients, quantities, and pricing. 4. Research pharmacy invoices and hospice billing issues, reconciling discrepancies as needed. 5. Collaborate with the Customer Service team on complex claims research and resolution. 6. Understand Enclara Pharmacia's standard and custom formularies and differentiate between Per Diem (PD) and Fee-for-Service (FFS) billing models across hospice partners. 7. Contact facilities and pharmacies to verify and collect necessary information for onboarding spreadsheets. Coordinate PBM and billing system verification with facility pharmacies. Maintain and update facility-pharmacy tracking spreadsheets and communicate status with implementation teams. 8. Educate facility pharmacies on billing procedures and contacts for rejected claims. 9. Collect and verify missing or incomplete facility information reported by the Call Center team. Ensure all facilities are correctly linked to their respective hospices in internal systems. Assist with Confirmation Fax reports to validate and update facility-pharmacy relationships and demographics. 10. Complete tasks and special projects assigned by Pharmacy Claims Team Leaders on Pharmacy Claims (Support Services) Manager. 11. Support Call Center leadership in initiatives to streamline processes and improve service outcomes. Marginal or Additional Functions 1. Performs other duties as assigned or apparent. Supervisory and Managerial Responsibility • Supervisory/managerial responsibility is not applicable Knowledge, Skills & Abilities Education, Licensure or Certification: • High school diploma or equivalent required • CPhT or EXCPT preferred Work Experience or Related Experience: • Minimum of six (6) months of pharmacy technician experience. • Experience with pharmacy claims adjudication is required. Specialized Knowledge, Skills & Abilities: • PBM or billing platform experience preferred • Proficient in Microsoft Office Suite, especially Excel, Word, Outlook, and Access • Comfortable navigating multiple software systems, including pharmacy dispensing and PBM platforms • Excellent verbal and written communication skills • Ability to learn proprietary systems used for claims management and facility tracking. Equipment • Working knowledge of a PC, business and communications software (MS Office) and web-based tools are required Travel Requirements and Conditions • Travel is not required Work Environment, Conditions and Demands • Work is generally performed in a climate-controlled, smoke-free office environment. Physical Requirements and Demands • May sit, stand, walk, stoop, or bend intermittently throughout the day. • May be required to sit for extended periods (7-10 hours/day). • Occasional lifting of up to 25 pounds may be required. • Requires manual dexterity to operate office equipment. • Visual acuity to read fine print and digital screens; must be able to hear and respond to verbal communication. Additional Position Information • No additional information is applicable

The Insurance Claims Specialist will be responsible for assisting with the management of all aspects of complex Construction Defect and Property Damage incidents and claims for DPR (and DPR-related entities), as assigned. Reporting: Role reports to Insured Claims Manager and Insured Claims Leader Specific Duties Include: Claims & Incident Management (General): * Initial triage and processing of incidents received from project teams for DPR (and DPR-related entities). * Input and/or review all incidents reported in DPR's RMIS system. * Working with the incident triage group to ensure timely and appropriate review of all incidents * Ensure all necessary information is compiled to properly manage claims. This includes working with the DPR teams to collect relevant documents such as the Prime contract, Subcontracts, Certificates of Insurance, Owner Policy Documents, Project Documents and Project Specific Coverage information, etc. * Assess all potential risks, as well as identify all contractual risk transfer mechanisms. * Analyzing potential insurance coverage for all applicable lines of coverage and report, with all appropriate documents and information, potential claims for DPR (and DPR-related entities) to the broker for any applicable program (Traditional, CCIP, OCIP). * Assist with the development and training of other DPR Workgroups (and DPR-related entities) around CD/PD Best Practices. Construction Defect & Property Damage (CD/PD) Specific Claims Management: * Manage all assigned claims in DPR's RMIS system relating to Construction Defect and Property Damage matters for DPR (and DPR-related entities). This would include using all appropriate lines of coverage such as Commercial General Liability, Builder's Risk, Property, Contractor's Pollution Liability and Professional Liability, whether the policies are placed by DPR or our Clients. * Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements. * Management of and coordination with DPR's consultants and outside attorneys throughout the claim process. * Continuously analyze claim-specific details as the claim progresses to devise key strategies in conjunction with all internal stakeholders and outside consultants. * Proactive management and coordination of all phases of the DPR CD/PD Claims Workflow. Key Skills: * Basic working knowledge and familiarity of: * Commercial General Liability * Property Insurance (Including Inland Marine and Builder's Risk * Pollution Liability * Professional Liability * Controlled Insurance Programs (CCIP/OCIP) * RMIS Systems * Construction Industry Expertise * Strategic thinking * Strong written and oral communication skills * High level of EQ (Soft skills) * Self-Starter * Highly organized and responsive; ability to meet deadlines * Detail Oriented * Contractual risk assessment * Dispute management * Integrity * Ability to mentor and inspire others * Team player * Willingness to understand and advance the DPR Culture * Proactive Learner Qualifications: * 5-7 years relevant construction industry and/or insurance industry experience preferred. * Previous experience in construction company Risk Management highly desired. * Position location - TBD based on location of most qualified candidate. 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 ********************

The Copay Support/Claims Processing Specialist is a critical role within the organization and is responsible for servicing inbound calls, EOB faxes, and mail (emails, USMail) from pharmacies, patients, Sites of Care, Health Care Providers, copay vendors (PDMI, FHA and Merchant Card processors) and other sources. Required engagement is with pharmacy claim adjudicators, third party medical claim administrators, merchant vendors, finance for manual claim reimbursement, Sites of Care and Health Care Providers. The Copay Support/Claims Processing Specialist will adjudication, troubleshoot claim rejections, claim reversals, allocation deficiencies, identifying group accumulator and maximizers, provide alternate payment processing method, handle paperwork related to medical procedures, treatments and services submitted by the site of care or health care providers that meet the program business rules for determination of approval, denial, or pending for submission of required information for final determination as well as claim appeal handling. Quality control of commercial copay programs. Collaborate with internal HUB teams on enrollment discrepancies (missing info and duplicates) Partners with claim adjudication vendors ensure proper claims processing and data integrity. Monitor and remediate medical and pharmacy manual data entry errors Serve as Subject Matter Expert for internal and external stakeholders on medical and pharmacy Copay claim adjudication issues and platform logic variations. Provide ongoing insights on specific program trends and system/process opportunities. Patient and Prescriber Support: Act as the primary point of contact for handling inquiries from prescribers, patients, external clients, and internal program team members. Subject Matter Expert on reviewing and processing of medical claims submitted for copay programs where the therapy is primarily processed through a medical benefit Thorough understanding of copay program design and elements eligible for payment processing Ensure proper CMS form and EOB is provided for each eligible item Validate required elements for payment approval are present If not partner with HUB to secure missing information Create manual medical reimbursement record for submission to finance Review Directive Analytics against Net-Suite and make necessary corrections Identify applicable programs and guide stakeholders through next steps for patient support. Accept inbound calls, team chats, and emails. Ensure one-call resolution for patients and providers. Communicate status updates across all patient support activities in a holistic, clear, and professional manner. Liaise with program-specific AssistRx resources to secure outcomes and resolve escalations. Maintain accurate documentation and ensure protection of patient and prescriber information. Requirements High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience. Associate's Degree (AA) or equivalent from a two-year college or technical school, or six months to one year related experience and/or training, or equivalent combination of education and experience. Computer skills required: Contract Management Systems; Microsoft Office Other skills required: Pharmacy Data Management (PDMI), PNC Card Platform COMPETENCIES: Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce. Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values. Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan. Initiative - Volunteers readily; Undertakes self-development activities; Seeks increased responsibilities; Takes independent actions and calculated risks; Looks for and takes advantage of opportunities; Asks for and offers help when needed. Innovation - Displays original thinking and creativity; Meets challenges with resourcefulness; Generates suggestions for improving work; Develops innovative approaches and ideas; Presents ideas and information in a manner that gets others' attention. Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. Project Management - Develops project plans; Coordinates projects; Communicates changes and progress; Completes projects on time and budget; Manages project team activities. Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness. Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. Benefits Supportive, progressive, fast-paced environment Competitive pay structure Matching 401(k) with immediate vesting Medical, dental, vision, life, & short-term disability insurance Why Choose AssistRx: Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary. Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary. Impactful Work: Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications. Flexible Culture: Many associates earn the opportunity to work from home after 120 days. Enjoy a flexible and inclusive work culture that values work-life balance and diverse perspectives. Career Growth: We prioritize a “promote from within mentality”. We invest in our employees' growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization. Innovation: Contribute to the development of groundbreaking solutions that address complex challenges in the healthcare industry. Collaborative Environment: Work alongside talented professionals who are dedicated to collaboration, learning, and pushing the boundaries of what's possible. Tell your friends about us! If hired, receive a $750 referral bonus! Wondering how we recognize our employees for delivering best in class results? Here are some of the awards that our employees receive throughout the year! #TransformingLives Honor: This quarterly award program is a peer to peer honor that recognizes and highlights some of the amazing ways that our team members are transforming lives for patients on a daily basis. Values Award: This quarterly award program recognizes individuals who exhibit one, or many, of our core company values; Excellence, Winning, Respect, Inspiration, and Teamwork. Vision Award: This annual award program recognizes an individual who has gone above and beyond to support the AssistRx vision to transform lives through access to therapy. AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws. All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position. AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire.

CENCO is a leading provider of property claims solutions, collaborating with top insurance carriers to deliver accurate, timely, and dependable adjusting services. We are currently seeking experienced Daily Property Claims Adjusters to manage residential and commercial claims throughout Phoenix and the surrounding areas of Arizona. This role is perfect for adjusters looking for consistent assignments and the flexibility of independent fieldwork. Key Responsibilities: Conduct thorough inspections of property damage caused by wind, hail, fire, water, and other covered perils. Document damages with detailed reports and clear, high-quality photos. Prepare accurate repair estimates using Xactimate or Symbility. Maintain professional communication with policyholders, contractors, and insurance carriers. Manage claims efficiently to meet all deadlines and carrier requirements. Requirements: Licensing: Active Arizona adjuster license required. Software: Experience with Xactimate or Symbility preferred. Equipment: Reliable vehicle, ladder, laptop, and standard inspection tools. Work Style: Self-motivated, organized, and able to work independently. Availability: Able to accept assignments promptly and complete reports on schedule. Why Work with CENCO? Steady claim volume in Phoenix and surrounding communities Competitive pay with reliable, on-time compensation Supportive team and streamlined workflows If you're a skilled adjuster seeking steady daily work and the opportunity to grow with a trusted industry partner, we want to hear from you!

Requirements What You Bring to the Team by Way of Skills and Experience: Bachelor's degree required in Business, Risk Management, or related field. Minimum 5+ years of experience in auto estimating and claims management. Valid driver's license and current auto insurance preferred. Professional appraisal or adjuster licenses preferred. Strong knowledge of auto damage estimating, freight/cargo claims processes, and insurance policy structures. Knowledge of FMCSA/DOT regulations, multi-jurisdictional claims practices, Carmack Amendment principles, and carrier liability standards. Exceptional interpersonal, negotiation, communication, and organizational skills. Proven ability to work independently, prioritize competing demands, and resolve complex issues within deadlines. Strong business acumen and collaborative approach to working cross-functionally with internal teams and external vendors. Experience managing full claims lifecycle, coordinating with insurers and TPAs, and analyzing claims trends. Strong communication skills, integrity, and sound judgment with experience handling sensitive information and conducting investigations. Proficient in Microsoft Office Suite (Word, Excel, Outlook) and claims management systems/tools. Service-oriented mindset with a positive, proactive attitude. Travel Requirements: Occasional travel ( What is in it for You and Why you Should Apply: Market-competitive pay based on education, experience, and location. Highly competitive medical, dental, vision, Life w/ AD&D, Short-Term Disability insurance, Long-Term Disability insurance, pet insurance, identity theft protection, and a 401(k) retirement savings plan. Employee wellness program. Employee rewards, discounts, and recognition programs. Generous company-paid holidays (12 per year), vacation, and sick time. Paid paternity/maternity leave. Monthly connectivity/home office stipend if working from home 5 days a week. A supportive and positive space for you to grow and expand your career. Pay Range Disclosure: The advertised range represents the expected pay range for this position at the time of posting based on education, experience, skills, location, and other factors. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. RunBuggy is an equal-opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination, harassment, and retaliation on the basis of race, color, religion, sex (including gender identity and sexual orientation), pregnancy, parental status, national origin, age, disability, genetic information, or any other status protected under federal, state, or local law. Salary Description $65k to $80k, DOE

Join Our Team as a Claims Processing Expert! Are you a data-driven marketer who thrives on turning insights into impactful strategies? We are looking for a Claims Processing Expert to analyze key performance metrics, optimize marketing campaigns, and drive data-backed decision-making. Why You'll Love This Role: 📊 Data-Driven Impact - Play a critical role in shaping marketing strategies through analytics. 🚀 Career Growth - Access professional development and leadership opportunities. ⏰ Work-Life Balance - Enjoy a flexible schedule with full-time opportunities. 💰 Competitive Compensation - Earn a stable income with performance-based incentives. Your Responsibilities: Analyze marketing campaign performance, customer behavior, and market trends. Develop and track key performance indicators (KPIs) to measure marketing effectiveness. Provide data-driven insights and recommendations to optimize marketing strategies. Work with cross-functional teams to ensure data accuracy and consistency. Utilize analytics tools (Google Analytics, Tableau, etc.) to generate reports and dashboards. A/B test campaigns and refine strategies based on data insights. What We're Looking For: Proven experience in marketing analytics, data analysis, or a related field. Proficiency in analytics tools such as Google Analytics, Tableau, or SQL. Strong analytical and problem-solving skills. Ability to translate complex data into actionable marketing strategies. Experience with digital marketing metrics, reporting, and performance optimization. Perks & Benefits: Professional development and continuous learning opportunities. Health insurance and retirement plans. Performance-based bonuses and recognition programs. Leadership growth and career advancement opportunities. 🚀 Ready to Turn Data into Growth? If you're passionate about leveraging data to drive marketing success, apply today! Join us and help shape data-driven marketing strategies that make an impact. Your journey as a Claims Processing Expert starts here-let's optimize for success together!

Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level of knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Candidates should be based in California with California Self-Insured Certification or based in West Region with experience in handling Alaska Workers Compensation claims. The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region. Responsibilities Investigates claims to determine whether coverage is provided, establish compensability and verify exposure. Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure. Establishes and maintains accurate reserves on all assigned files. Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority. Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds. Demonstrates the ability to understand new and unique exposures and coverages. Demonstrates the ability to understand key data elements and claims related data analysis. Confers directly with policyholders on coverage and resolution strategy issues. Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff. Qualifications A bachelor's degree or equivalent business experience is required In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skills required About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $16.59 - $24.86/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto. That's where you come in. We're looking for an Auto Claims Specialist I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details! Benefits * We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox and flexible time-off policies. * We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. * How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program. * 10 days of free child or senior care through your complimentary Care.com membership. * Generous 401(k) retirement plans with up to 6% company match. * Employee discounts on hundreds of items, from cars to computers to continuing education. * Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance. * Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so. * We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well. At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits. What You'll Do From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include: * Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. * Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making. * Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. * Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. * Uses appropriate levels/limits of financial approval authority to resolve cases. * Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information. * Prepares and facilitates communication for resolution via telephone, email, and in-person discussion. * Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. * Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements. * Engages with supervisor/manager to determine if escalation is required. * Performs other duties as assigned. Who You Are You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications: Minimum * A high school diploma or GED and less than 2 years of related experience. * Accuracy and attention to detail. * Organizational and time management skills. * The ability to adapt in a fluid and changing environment. Preferred * 1+ years of automotive or body shop experience. * Claims adjuster experience. Cox is a great place to be, wouldn't you agree? Apply today! Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.

Job DescriptionSalary: $23-25 per hour Rapidly growing healthcare technology company is looking for outgoing, energetic, and motivated individuals to join our team of Claim Analysts. If you possess these qualities and want to be part of a passionate team on a mission to drive change in healthcare, then Green Light could be a great fit for you. Ideal candidates will share our core values, be a team player, possess a strong work ethic, be a problem solver, have professional integrity and a sense of humor! JOB SUMMARY: The Claims Analyst position is responsible for collaborating with out-of-network healthcare providers (telephonically, in most cases) to finalize allowed amounts on out-of-network claims. Our health plan clients have implemented various controls to establish out-of-network allowances and to ensure that non-contracted providers are paid fairly according to market data, for services provided to their health plan members. The Claims Analyst role facilitates any exceptions for higher out-of-network allowances on behalf of the health plan, in cases where patient balance billing can be eliminated, while also ensuring that out-of-network allowances adhere to the overall provisions of the health plan. RESPONSIBILITIES: Foster and maintain relationships with the Provider community to facilitate current and future claim settlements with professionalism. Verbally and accurately communicate the various out-of-network pricing methodologies used by our health plan clients for establishing allowances on out-of-network claims. Generate settlement agreements based on written and verbal communication with the Provider, throughout the settlement process. Work with internal stakeholders, such as Client Services, to coordinate the necessary flow of information required to successfully obtain settlement of out-of-network healthcare claims. Meet and maintain individual and departmental performance metrics. Manage high volume of claims in a queue; keep current with all claim actions and meet client deadlines for working and settling claims. Initiate provider telephone calls with respect to settlement proposals, mediate objections and apply effective telephone communication skills to reach successful resolution on out-of-network claims. Address any counter offers and present proposals for resolution while adhering to client guidelines and department goals. Collaborate, coordinate, and communicate across the organization, as is necessary to obtain successful settlement of claims. Ensure compliance with HIPAA protocol. QUALIFICATIONS: 3-5 years customer service experience High school diploma or equivalent Excellent verbal and written skills Ability to multi-task and thrive in fast paced work environment Willingness to perform high volume of outbound calls to healthcare providers General knowledge of healthcare claims processing and medical terminology Healthcare billing and/or coding background is a PLUS

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities The Professional Liability Adjuster is responsible for conducting office investigations and adjusting Professional Liability and Error & Omission (E&O), Employment Practices Liability Insurance (EPLI), and Directors & Officers (D&O) Liability claims. The Adjuster is also responsible for, but not limited to: Investigating losses and identifying coverage issues across Professional Liability, E&O, EPLO, and D&O lines Obtaining and reviewing evidence, reports, and medical records Establishing damages and reserves Processing payments Taking statements from insured's, claimants, and witnesses Participating in Mediations Qualifications Active attorney license with at least 5 years of professional liability experience Prior experience adjusting Professional Liability, E&O, EPLI, and D&O claims Experience with Legal Malpractice preferred Active Adjuster license is preferred Strong understanding of employment law and corporate governance as it relates to EPLI and D&O exposures Excellent written and verbal communication skills Strong organizational and computer skills Excellent time management skills with the ability to prioritize

Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $16.59 - $24.86/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto. That's where you come in. We're looking for an Auto Claims Specialist I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details! Benefits We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox and flexible time-off policies. We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program. 10 days of free child or senior care through your complimentary Care.com membership. Generous 401(k) retirement plans with up to 6% company match. Employee discounts on hundreds of items, from cars to computers to continuing education. Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance. Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so. We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well. At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits. What You'll Do From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include: Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making. Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. Uses appropriate levels/limits of financial approval authority to resolve cases. Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information. Prepares and facilitates communication for resolution via telephone, email, and in-person discussion. Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements. Engages with supervisor/manager to determine if escalation is required. Performs other duties as assigned. Who You Are You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications: Minimum A high school diploma or GED and less than 2 years of related experience. Accuracy and attention to detail. Organizational and time management skills. The ability to adapt in a fluid and changing environment. Preferred 1+ years of automotive or body shop experience. Claims adjuster experience. Cox is a great place to be, wouldn't you agree? Apply today! Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! * Competitive compensation * Healthcare benefits package that begins on first day of employment * 401K retirement plan with company match * Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays * Up to 6 weeks of parental and bonding leave * Hybrid work schedule (3 days in the office, 2 days from home) * Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) * Tuition reimbursement after 6 months of employment * Numerous opportunities for continued training and career advancement * And much more! Responsibilities Are you an experienced professional with a sharp eye for detail and a strong background in litigation? Join our team as a Complex Liability Adjuster, where you'll play a crucial role in managing Commercial General Liability (CGL) and Business Owners Policy (BOP) claims with precision and expertise. We're looking for someone who thrives in high-stakes environments, communicates with confidence, and knows how to navigate the legal landscape with precision. Key Responsibilities: * Conduct thorough investigations of losses, identifying coverage issues and ensuring accurate assessments. * Review and analyze evidence, reports, and medical records to establish damages and reserves. * Interview insureds, claimants, and witnesses to gather essential information and build strong cases. * Collaborate with legal teams to navigate complex litigation processes and defend our insureds effectively. * Manage litigated claims involving CGL and BOP policies, including coordination with defense counsel, litigation strategy development, and resolution planning. * Process payments efficiently, ensuring timely resolution of claims. Qualifications * Prior experience adjusting Commercial General Liability claims with a proven track record in litigation is required. * Juris Doctorate (JD) preferred, reflecting the value we place on strong legal acumen in managing complex liability claims. * Licensing: Active TX All Lines License, or willingness to obtain one at company's expense. * Exceptional written and verbal communication skills. * Strong organizational and computer skills. * Excellent time management skills with the ability to prioritize tasks effectively.

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Scottsdale, AZ. This will be a Full-Time position. This is a remote hybrid opportunity, after onsite training period. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Starting salary from $23.00 an hour and up Sign-On Bonus: $5,000 for employees starting before February 28, 2026. We offer a variety of benefits including: Medical; Dental; Vision 401k with a match Paid Time Off and Paid Holidays Tuition Reimbursement Company paid benefits - life; and short and long-term disability Pharmacy Adjudication Specialist Major Responsibilities: The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360... Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests. Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding active claims information.. Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information. Adjudicates pharmacy claims for prescriptions in active workflow for primary, secondary, and tertiary pharmacy plans and reviews claim responses for accuracy before accepting the claim. Contacts insurance companies to resolve third-party rejections and ensures pharmacy claim rejections are resolved to allow for timely shipping of medications. Performs outreach calls to patients or providers to reschedule their medication deliveries if claim resolution cannot be completed by ship date and causes shipment delays Ensures copay cards are only applied to claims for eligible patients based on set criteria such as insurance type (Government beneficiaries not eligible) Manages all funding related adjudications and works as a liaison to Onco360 Advocate team. Assists pharmacy team with all management of electronically adjudicated claims to ensure all prescription delivery assessments are reconciled and copay payments are charged prior to shipment. Serves as customer service liaison to patients regarding financial responsibility prior to shipments, contacts patients to communicate any copay discrepancy between quoted amount and claim and collects payment if applicable. Document and submit requests for Patient Refunds when appropriate. Pharmacy Adjudication Specialist Qualifications and Responsibilities... Education/Learning Experience Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification, Pharmacy Claims Adjudication Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician, Specialty pharmacy experience Work Experience Required: 1+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Desired: 3+ years experience in Pharmacy/Healthcare Setting or pharmacy claims experience Skills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills Desired: Knowledge of Foundation Funding, Specialty pharmacy experience Licenses/Certifications Required: Registration with Board of Pharmacy as required by state law Desired: Certified Pharmacy Technician (PTCB) Behavior Competencies Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills #Company Values: Teamwork, Respect, Integrity, Passion

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: West Hartford, CT (preferred) Atlanta, GA Boston, MA Chicago, IL Los Angeles, CA Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The Role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for tech E&O, first and third party cyber claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our Must-Haves: 5+ years of professional lines claims handling experience A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers: Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional PTO days Paid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary Range: $125,000- $160,000 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. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you! Modivcare is looking for a Claims Specialist I to join our team. This position is responsible for processing and managing claims submitted by providers, including verifying the accuracy and completeness of documentation and attachments. This role… Reviews incoming claims and related documentation to ensure accuracy and completeness. Inputs claim data and pertinent information into the claims processing system. Reviews company policies to determine coverage and assess the validity of claims. Uses standard scripts or form letters to request missing information. Applies established guidelines and policies to determine claim eligibility and process accordingly. Communicates with providers when necessary to obtain additional information or clarify claim details. Adheres to departmental policies, deadlines, and procedures for claim handling. Reports suspected fraudulent claims to the Fraud, Waste, and Abuse (FWA) department. May participate in special projects or perform other duties as assigned. We are interested in speaking with individuals with the following… High School Diploma required. Zero (0) plus years of experience. Or equivalent combination of education and/or experience. Strong attention to detail and data entry skills to ensure claim accuracy. Basic computer proficiency, including Microsoft Word, Excel, and Outlook. Analytical mindset with the ability to interpret claim data and follow established procedures. Effective verbal and written communication skills with a superior customer-focused demeanor. Problem-solving skills to address claim discrepancies and issues. Ability to work both independently and as part of a collaborative team. Salary: Starting at $16/hr Modivcare's positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings. We value our team members and realize the importance of benefits for you and your family. Modivcare offers a comprehensive benefits package to include the following: Medical, Dental, and Vision insurance Employer Paid Basic Life Insurance and AD&D Voluntary Life Insurance (Employee/Spouse/Child) Health Care and Dependent Care Flexible Spending Accounts Pre-Tax and Post --Tax Commuter and Parking Benefits 401(k) Retirement Savings Plan with Company Match Paid Time Off Paid Parental Leave Short-Term and Long-Term Disability Tuition Reimbursement Employee Discounts (retail, hotel, food, restaurants, car rental and much more!) Modivcare is an Equal Opportunity Employer. EEO is The Law - click here for more information Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at ***************************

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: * West Hartford, CT (preferred) * Atlanta, GA * Boston, MA * Chicago, IL * Los Angeles, CA * Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The Role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: * Reviewing and analyzing claim documentation and legal filings * Drafting coverage analyses for tech E&O, first and third party cyber claims * Strategizing and maximizing early resolution opportunities * Monitoring litigation and managing local defense and breach counsel * Attending mediations and/or settlement conferences, either in person or by phone as appropriate * Smartly managing and tracking third-party vendor and service provider spend * Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager * Liaising directly on daily basis with insureds and brokers * Maintaining timely and accurate file documentation/information in our claims management system Our Must-Haves: * 5+ years of professional lines claims handling experience * A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience * A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required * Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation * Advanced knowledge of coverage within the team's specialty or focus * Advanced knowledge of litigation process and negotiation skills * Excellent verbal and written communication skills * Advanced analytical skills * B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers: * Competitive salary and bonus (based on personal & company performance) * Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) * Company paid group term life, short-term disability and long-term disability coverage * 401(k) with competitive company matching * 24 Paid time off days with 2 Hiscox Days * 10 Paid Holidays plus 1 paid floating holiday * Ability to purchase 5 additional PTO days * Paid parental leave * 4 week paid sabbatical after every 5 years of service * Financial Adoption Assistance and Medical Travel Reimbursement Programs * Annual reimbursement up to $600 for health club membership or fees associated with any fitness program * Company paid subscription to Headspace to support employees' mental health and wellbeing * Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program * Dynamic, creative and values-driven culture * Modern and open office spaces, complimentary drinks * Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary Range: $125,000- $160,000 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. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture