Claims representative jobs in Hawaii

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division on the Mid Corp Property Team as a Senior Claims Examiner, Property. In this role, the responsibilities include actively managing complex First Party Commercial Property claims focused in Hawaii and other jurisdictions throughout the United States. This candidate will need to be local to Hawaii. Responsibilities * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy related to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures * Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary * Investigate claims and review the insureds' materials, pleadings, and other relevant documents * Identify and review each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Demonstrated ability to take part in active strategic discussions * Demonstrated ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 10% Education * Bachelor's degree required. * 5-7+ years of work experience at an insurance company and/or insurance claims loss adjustment service provider managing property claims process supporting commercial accounts * Proper & active adjuster licensing in all applicable states, Hawaii #LI-SW1 #LI-REMOTE For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $97,000 - $115,000/year * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Representative (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements. **ESSENTIAL RESPONSIBILITIES** + Coordinate, analyze, and interpret the benefits and claims processes for the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties. + Investigate benefit/claim information and provide technical guidance to clinical and claims staff regarding the final adjudication of complex claims. Research and investigate conflicting benefit structures in multi-payor situations. + Provide prompt, thorough and courteous replies to written, electronic and telephonic inquiries from internal/external customers (e.g., clinical, sales/marketing, providers, vendors, etc.) Follow-up on all inquiries in accordance with corporate and regulatory standards and timeframes. + Must have the ability to apply knowledge about the business operations of the area within the defined scope of the job. Assess benefit limitations in accordance with Medical Policy Guidelines. + Monitor and identify claim processing inaccuracies. Bring trends to the attention of management. + Assist with handling inbound calls and strive to resolve customer concerns received via telephone or written communication. + Work independently of support, frequently utilizing resources to resolve customer inquiries. + Collaborate with Clinical Strategy, Sales/Client Management and other areas across the enterprise to respond to client questions and concerns about care/case management and high-cost claimants. + Gather information and develop presentation/training materials for support and education. + Other duties as assigned or requested. **EDUCATION** **Required** + High School or GED **Substitutions** + None **Preferred** + Associate's degree in or equivalent training in Business or a related field **EXPERIENCE** **Required** + 3 years of customer service, health insurance benefits and claims experience. + Working knowledge of Highmark products, systems (e.g., customer service and clinical platforms, knowledge resources, etc.), operations and medical policies + PC Proficiency including Microsoft Office Products + Ability to communicate effectively in both verbal and written form with all levels of employees **Preferred** + Working knowledge of medical procedures and terminology. + Complex claim workflow analysis and adjudication. + ICD9, CPT, HPCPS coding knowledge/experience. + Knowledge of Medicare and Medicaid policies **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services + Knowledge of administrative and clerical procedures and systems such as managing files and records, designing forms and other office procedures + The ability to take direction, to navigate through multiple systems simultaneously + The ability to interact well with peers, supervisors and customers + Understanding the implications of new information for both current and future problem-solving and decision-making + Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate and not interrupting at inappropriate times + Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems + Ability to solve complex issues on multiple levels. + Ability to solve problems independently and creatively. + Ability to handle many tasks simultaneously and respond to customers and their issues promptly. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $21.53 **Pay Range Maximum:** $32.30 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273827

Under minimal to no supervision, handles claims from first notice to final disposition. Duties include, but are not limited to, coverage analysis, investigation, litigation management, and negotiation of a variety of claims assigned, including the more complex and severe damage and/or injury cases. Duties: * Claim Handling and Investigation * Receive claim loss information from agencies, insured, and claimants or other involved parties via telephone, facsimile, mail, or computer; and establish a claim on the appropriate computer claim handling system. * Review limited assignments as well as assigned claims for applicable coverage, liability, and exposures. * Handle those losses or litigated claims involving the greatest complexity. * Must have thorough knowledge of all lines of business written by the company, including, but not limited to auto, homeowners, dwelling fire, commercial general liability, and umbrella. * Review applicable policy forms, determine and explain available coverage/benefits, resolve conflicts. * Contact insured and other involved parties within the specified time frame, as outlined by department procedure. * Determine/confirm facts of loss/cause of loss, identify parties involved, and extent of injuries or damages, as applicable. * Obtain written or recorded statement(s) as needed. * Inspect, photograph, and diagram damages and the scene of loss. Ensure the investigation is thorough and complete, and documentation in the file supports the claim. Secure and preserve evidence. * Obtain other documentation, as appropriate, including but not limited to police and fire investigative reports, applicable contracts, plans and specifications, diagrams and photographs, repair proposals and appraisals, and medical records and bills. * Determine liability based on facts developed and thorough knowledge of the applicable Hawaii Revised Statutes and other applicable laws. * Provide clear and concise analysis of liability based on the facts and the applicable Hawaii Revised Statutes and other applicable laws. * Provide analysis of alleged damages and injuries. * Initiate deductible recovery procedures where applicable. * Communication and Customer Service * Review questionable claims and all coverage issues with the Claim Manager. * Communicate status to insureds, claimants, and their attorneys, if any, as required by the Hawaii Revised Statutes or per department policy. * Stay abreast of statute, case law decisions, as well as policy and coverage changes. * Possess a positive, service-oriented attitude toward agencies, insureds, and employees within the company. * Provide quality claims handling and superior customer service on a regular basis. * Serve as a mentor to other claims professionals in a technical capacity. * Assist other claim professionals with claims handling, evaluations, negotiations, and litigation issues. * Provide technical advice/direction to department personnel on more complex claims. * Assist with the assignment of claim assignments as needed, reviewing first notices of loss, providing direction, and support to the assigned individual. * Financial and Administrative Responsibilities * Perform appropriate and timely processing of financial transactions, including establishing reserves, adjusting reserves, and making payments on the applicable claim system, as authorized. * Prepare and submit written requests for authority, as well as other reports, as required. * Evaluate damages and injuries considering applicable coverage, liability determination, and other pertinent information developed. * Negotiate settlements within authority granted. * Enter timely, clear, and concise notes on the applicable computer claim handling system to document all activities - investigations, evaluations, recommendations, negotiations, and resolution. * Diary all assigned claim files for timely follow-up and review them within the specified time frame as outlined by department procedure. * Manage all outside vendors (e.g., independent adjusters, appraisers, contractors, investigators, experts, and attorneys) to minimize the length of time to resolution of the claim, and the allocated loss expenses. * Follow prescribed litigation guidelines and procedures including reporting requirements and attorney fee review program. * Attend and participate in mediations, arbitrations, settlement conferences as required. * Perform accurate and timely preparation and submission of data and reports, as required by the department procedure or management. Qualifications: * High school diploma or general education degree (GED); and 5-7 years multi-line Claims Specialist required. * College degree with credits in insurance related subjects preferred. * Equivalent combination of education and job-related experience will be considered. * Continuing education in insurance and job related issues and subjects required. * State of Hawaii general adjusting license preferred. * Valid Hawaii Driver's license and use of own vehicle required. * Enrollment or completion of IIA, AIC or other insurance industry courses preferred.

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

Investigates, adjusts, and negotiates for settlement of claims of real and personal property damage for and against the County of Hawai'i; conducts investigative work in contemplation of litigation and anticipated cases; handles personal injury cases not covered by insurance carried by the County of Hawai'i; and performs other related duties as required. There is one (1) immediate temporary full-time not-to-exceed 11/30/2028 vacancy with the Office of the Corporation Counsel - Litigation Division in Hilo. The eligible list may be used for other permanent and temporary vacancies as they arise during the life of the list. Temporary appointment may lead to conversion to permanent appointment. Examples of Duties * Determines, evaluates, and verifies the facts set forth in any claim or lawsuit filed against and by the County. * Locates, interviews, and interrogates the principals involved and/or the witnesses. * Inspects the physical evidence of damages; gathers and verifies the value of damages by asking for expert opinions when necessary; arrives at judgments of the worth of statements given by individuals. * Obtains additional, clarifying, or substantiating information, evidence, and facts. * Prepares reports on findings with recommendations. * Negotiates for the settlement of claims to the satisfaction of the principals involved. * Recommends to the Corporation Counsel the acceptance or rejection of liability by the County or action to be taken against individuals who owe the County. * Checks with the appropriate agencies to determine the assets of individuals against whom the County has claim. * Follows up on delinquent accounts by personal interview and recommends new terms or enforcement of terms based on findings. * Assists the County attorneys in the presentation of cases. * Testifies and presents supporting information in court, arbitrations, mediations, hearings, administrative hearings or any other quasi-judicial proceedings. * Assists the County attorneys in presenting evidence and producing witnesses. * As directed, works with County commissions, boards, administrators, and others in judicial or quasi-judicial hearings. * Monitors and evaluates all requests for No-Fault benefits, including medical treatment plans for compliance with appropriate laws and guidelines; recommends the approval or disapproval of payments, treatment plans, or modifications to plans. * Notifies claimant or authorized representative when No-Fault benefits are about to be or have been exhausted. * Locates missing persons. * Investigates complaints against County of Hawai'i employees. * Prepares detailed reports of investigations, analyses, findings, and recommendations; prepares other administrative reports as required. * Serves complaints, counter and/or cross claims, warrants, subpoenas, summonses, or other documents for the Office of the Corporation Counsel. * Investigates hardship cases in condemnation proceedings and workers' compensation cases. * Performs other related duties as assigned. Minimum Qualification Requirements Training and Experience: A combination of education and experience substantially equivalent to: * graduation from an accredited college or university with a baccalaureate degree (scan and attach a copy of your official transcript to your application), and * three (3) years of investigational or law enforcement work, of which * one (1) year shall have involved the investigation or the adjustment of claims relating to personal, medical, and property damages, and * possession of a valid State of Hawai`i driver's license (Class 3) or any other valid comparable driver's license at time of filing. (You will be required to submit your valid driver's license at time of hire.) Note: Foreign transcripts must be accompanied by an official credential evaluation report to determine U.S. equivalency. (Scan and attach a copy of your official credential evaluation report to your application.) Examination: All applicants who meet the minimum qualification requirements will be assigned a score of 70 points. An education and experience evaluation will be conducted based on the applicant's training, education and experience as presented in the application. Please read the minimum qualification requirements carefully. Be certain to list all pertinent training and experience, as this may be important in determining your examination score. It is essential that the applicant describe fully the duties and responsibilities of each position held, specify the date of each position held (from and to, month and year), and indicate the number of hours worked per week. Attach all required documentation (e.g. official transcript, professional license(s)/certification(s), DD-214, etc.) at the time of submitting your application. Note: In-person interviews and/or further testing in Hawai'i County may be required at the discretion of the hiring department/agency. If in-person interviews and/or further testing are required, applicants who are referred to the hiring department/agency must be available to participate in person and at their own expense at that phase of the selection process. Knowledge of: principles and practices of investigation; interviewing and interrogating methods and techniques; rules of evidence; elementary law of real property, insurance, and torts; court procedures; human relations and behavior. Ability to: interpret and apply laws and regulations; gather, analyze, and evaluate facts and settle liabilities; make sound observations and mature judgments; deal tactfully and effectively with the public and representatives of other government agencies; write accurate, clear, and concise reports. Physical Requirements: Persons seeking appointment to positions in this class must meet the health and physical condition standards deemed necessary and proper to perform the essential functions of the position with or without reasonable accommodations. Physical Effort Grouping: Light Benefits of County employment: The County of Hawai'i offers a competitive compensation package. Your total compensation is comprised of your salary and a generous range of valuable benefits, subject to eligibility requirements. * Flexible Working Arrangements: Options may include alternate work schedules (4-10) and flexible working hours. (Not all Departments/Agencies participate and not all positions are eligible.) * Vacation: Start accruing paid vacation time immediately upon hire - up to 21 days per year. * Sick Leave: Start accruing paid sick leave time immediately upon hire - up to 21 days per year. * Holidays: The County provides 13 paid holidays per year (plus General Election Day when applicable). * Training and Development: The County has a variety of training and development opportunities for employees. * County Tuition Reimbursement Program: This scholarship program rewards employees who take the initiative to advance their education and learning. * Public Service Loan Forgiveness (PSLF) Program: You may be eligible for this federal program which forgives portions of federal student loans for individuals working in public service. * Retirement Plan: The Employees' Retirement System is a qualified defined benefit public pension plan that provides retirement, disability, survivor and other benefits to all eligible full-time and part-time county employees in the State of Hawaii as well as their beneficiaries. * Deferred Compensation: Save additional money for retirement - this voluntary supplemental retirement savings plan allows for the investment of tax-deferred contributions. * Flexible Spending Plan: Use pre-tax dollars to pay for qualified dependent care and/or medical expenses, as well as insurance premiums. * Health Benefit Plans: The County of Hawai'i offers a variety of health benefit plans for eligible employees. * Employee Assistance Program (EAP): This voluntary assistance program provides employees and their family members with free professional and confidential assistance in overcoming personal and work-related problems. * Group Life Insurance: Free life insurance policy for active employees. * Credit Union Membership * Other Leaves: You may be eligible for other leaves, including Family Leave, Funeral Leave, Leave Sharing, Military Leave, Donor Leave, Victims Protection Leave, as well as leave for Parent-Teacher Conferences, Disaster Relief, Blood Bank Donations, and Jury Duty. All benefits are subject to eligibility requirements and change due to legislative actions and/or changes negotiated through collective bargaining. Please check out the benefits tab for additional information. Supplemental Information Please scan and attach these supporting documents to your on-line application, if required: * an official college transcript, * a valid driver's license, * a temporary assignment verification, * professional licenses, and/or * certificates. Veterans applying for veteran's preference points shall also scan and attach their DD-214 form and as needed, their VA claim letter to the on-line application. PLEASE APPLY IMMEDIATELY AS THIS RECRUITMENT MAY CLOSE AT ANY TIME. ELECTRONIC NOTIFICATION TO APPLICANTS: Please ensure that the email address and mobile phone number you provide is current, secure, and readily accessible to you. We will not be responsible in any way if you do not receive our emails and text messages or fail to check your email box or NEOGOV account INBOX in a timely manner. Checking your NEOGOV account INBOX daily is recommended and is the most secure method to check on notices sent to you. This is a new feature created by our vendor, NEOGOV. Please add *********************** to your contact list. Open your NEOGOV account using your user name and password. In the upper right hand corner of the account is your name, and under your name, click on INBOX to view all notices sent you. The notices will appear here in the INBOX even in the event you don't receive it on your cell phone, computer, or other electronic device. This is the best way to check and view all notices sent to you. You will receive a confirmation email upon successfully submitting your application. Failure to receive this confirmation email, indicates that your application was not submitted. APPLICATIONS MUST BE FILED ONLINE AT: *************************************************** E-mail: *********************

**NOW HIRING: Temp-to-Hire Claims Specialist - Dental Agency (Honolulu, HI)** **Now Hiring: Claims Specialist** **Pay Rate:** $19/hr **Schedule:** Monday - Friday, 8 AM - 5 PM **Type:** Temp to Hire Opportunity Join a reputable dental agency in Honolulu as a Claims Specialist! Under the supervision of the Claims Supervisor, you'll perform essential functions related to dental claims processing. This role requires adherence to claims processing rules, guidelines, and policies, while consistently meeting departmental standards for productivity and quality. **Essential Duties and Responsibilities** + Complete all aspects of claims data entry, including documentation verification + Digitally image hardcopy claims, x-rays, and related attachments + Adjudicate dental claims in accordance with HDS rules and guidelines + Process coordination of benefit claims **Other Duties and Responsibilities** + Assist the Claims department with adherence to established document policies and procedures + Provide back-up support for Customer Service and other departments as needed **Minimum Qualifications and Experience** + **Education:** High School Diploma required; post-high school training in data processing, office management, business, or a related field preferred + **Experience:** 1-2 years of related clerical, data entry, accounting, or claims processing experience, or an equivalent combination of education, experience, and training; dental office or dental claims processing experience preferred **Skills and Knowledge** + Working knowledge of PC applications (word processing and spreadsheets highly desirable) + Demonstrated customer service skills and sales ability + Strong attention to detail and ability to maintain focus + Ability to multitask despite distractions + Effective oral and written communication skills for all levels of staff, customers, and vendors + Ability to maintain confidentiality and comply with laws and regulations (e.g., HIPAA, PHI) **How to Apply** Once you apply, you'll proceed to the next steps if your skills and experience match the role. Even if this position isn't a fit, you remain in our network-giving other recruiters access to your profile and expanding your opportunities. We are committed to helping you discover what's next in your career. **Apply today!** We look forward to meeting you and helping you take the next step in your career journey! As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here (********************************************************************* for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community. Trust the office staffing pioneer. Finding the right job isn't always easy. Kelly Professional & Industrial takes the guesswork out of your job search by connecting you with great opportunities that work for you. That means your schedule, your interests, and your career plan. In fact, our company created the staffing industry with the goal of connecting people with great office jobs-so you could say we're pretty good at it! About Kelly Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life-just ask the 300,000 people we employ each year. Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly's Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment.

** At Western Digital, our vision is to power global innovation and push the boundaries of technology to make what you thought was once impossible, possible. At our core, Western Digital is a company of problem solvers. People achieve extraordinary things given the right technology. For decades, we've been doing just that-our technology helped people put a man on the moon and capture the first-ever picture of a black hole. We offer an expansive portfolio of technologies, HDDs, and platforms for business, creative professionals, and consumers alike under our Western Digital , WD and WD_BLACK Professional brands. We are a key partner to some of the largest and highest-growth organizations in the world. From enabling systems to make cities safer and more connected, to powering the data centers behind many of the world's biggest companies and hyperscale cloud providers, to meeting the massive and ever-growing data storage needs of the AI era, Western Digital is fueling a brighter, smarter future. Today's exceptional challenges require your unique skills. Together, we can build the future of data storage. **Job Description** ESSENTIAL DUTIES AND RESPONSIBILITIES + Work cross-functionally between Technical Support, Supply Chain, Pricing, Legal, and Product Marketing organizations within company to meet customers' needs + Manage the relationship with the account - including contract manufacturers, distributors, and end customer + Drive customer revenue and shipments to the goals of the account and company + Manage the internal and external communication regarding the account, making sure there is alignment and consistency within WD and externally to the customer Is available, responsive, and timely to customer inquiries, requests for information and/or quotations, problem resolution, etc - even if after normal business hours. + Coordinate customer pricing and rebate communication, and ensure correct rebates are paid on time to the customers + Manage the product lifecycle by account: product list, product roadmap, product launch, qualification, End of Life Schedule and host various technology and business meetings on weekly & quarterly basis + Manage meeting preparation, including creating pre-meeting document and scheduling pre-meeting for internal review and alignment prior to facing the customer + Manage meeting logistics including travel for customer engagements Map customer relationships and identify areas for improvement Manage historical and current revenue, PB, and unit shipment data for the account **Qualifications** REQUIRED + Bachelor's degree in a related field + 5-7 years of account management experience or equivalent experience. + Understand market conditions and how they affect WD and the customer + Understand the customer legal contracts and terms in place + Understand the supply chain process from WD to the end customer, identify areas of concern as they arise, and escalate when necessary SKILLS + Exceptional customer service and communication skills, with the ability to explain complex technical concepts to all levels of users. + Strong problem-solving and analytical skills. + Proven troubleshooting skills in customer-facing environments. + Strong desire and ability to learn new products and technologies. **Additional Information** Western Digital is committed to providing equal opportunities to all applicants and employees and will not discriminate against any applicant or employee based on their race, color, ancestry, religion (including religious dress and grooming standards), sex (including pregnancy, childbirth or related medical conditions, breastfeeding or related medical conditions), gender (including a person's gender identity, gender expression, and gender-related appearance and behavior, whether or not stereotypically associated with the person's assigned sex at birth), age, national origin, sexual orientation, medical condition, marital status (including domestic partnership status), physical disability, mental disability, medical condition, genetic information, protected medical and family care leave, Civil Air Patrol status, military and veteran status, or other legally protected characteristics. We also prohibit harassment of any individual on any of the characteristics listed above. Our non-discrimination policy applies to all aspects of employment. We comply with the laws and regulations set forth in the "Know Your Rights: Workplace Discrimination is Illegal (************************************************************************************** " poster. Our pay transparency policy is available here (*********************************************************************************************** . Western Digital thrives on the power and potential of diversity. As a global company, we believe the most effective way to embrace the diversity of our customers and communities is to mirror it from within. We believe the fusion of various perspectives results in the best outcomes for our employees, our company, our customers, and the world around us. We are committed to an inclusive environment where every individual can thrive through a sense of belonging, respect and contribution. Western Digital is committed to offering opportunities to applicants with disabilities and ensuring all candidates can successfully navigate our careers website and our hiring process. Please contact us at jobs.accommodations@wdc.com to advise us of your accommodation request. In your email, please include a description of the specific accommodation you are requesting as well as the job title and requisition number of the position for which you are applying. Based on our experience, we anticipate that the application deadline will be 1/16/2025 (3 months from posting), although we reserve the right to close the application process sooner if we hire an applicant for this position before the application deadline. If we are not able to hire someone from this role before the application deadline, we will update this posting with a new anticipated application deadline. \#LI-VV1 **Compensation & Benefits Details** + An employee's pay position within the salary range may be based on several factors including but not limited to (1) relevant education; qualifications; certifications; and experience; (2) skills, ability, knowledge of the job; (3) performance, contribution and results; (4) geographic location; (5) shift; (6) internal and external equity; and (7) business and organizational needs. + The salary range is what we believe to be the range of possible compensation for this role at the time of this posting. We may ultimately pay more or less than the posted range and this range is only applicable for jobs to be performed in California, Colorado, New York or remote jobs that can be performed in California, Colorado and New York. This range may be modified in the future. + If your position is non-exempt, you are eligible for overtime pay pursuant to company policy and applicable laws. You may also be eligible for shift differential pay, depending on the shift to which you are assigned. + You will be eligible to be considered for bonuses under **either** Western Digital's Short Term Incentive Plan ("STI Plan") or the Sales Incentive Plan ("SIP") which provides incentive awards based on Company and individual performance, depending on your role and your performance. You may be eligible to participate in our annual Long-Term Incentive (LTI) program, which consists of restricted stock units (RSUs) or cash equivalents, pursuant to the terms of the LTI plan. Please note that not all roles are eligible to participate in the LTI program, and not all roles are eligible for equity under the LTI plan. RSU awards are also available to eligible new hires, subject to Western Digital's Standard Terms and Conditions for Restricted Stock Unit Awards. + We offer a comprehensive package of benefits including paid vacation time; paid sick leave; medical/dental/vision insurance; life, accident and disability insurance; tax-advantaged flexible spending and health savings accounts; employee assistance program; other voluntary benefit programs such as supplemental life and AD&D, legal plan, pet insurance, critical illness, accident and hospital indemnity; tuition reimbursement; transit; the Applause Program; employee stock purchase plan; and the Western Digital Savings 401(k) Plan. + **Note:** No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. **Notice To Candidates:** Please be aware that Western Digital and its subsidiaries will never request payment as a condition for applying for a position or receiving an offer of employment. Should you encounter any such requests, please report it immediately to Western Digital Ethics Helpline (******************************************************************** or email ****************** .

Manage and lead a claims team by providing training, mentorship, and best practice solutions. Manage daily operations of the claims team, including inventory analysis, tracking and resolution of claims Serve as the escalation point for complex or disputed claims and drive resolution within defined SLA. Monitor and analyze key performance indicators (KPIs) and take corrective actions to improve efficiency, accuracy, and customer satisfaction Collaborate with key stakeholders to include underwriting, LOB, legal, servicing teams to ensure a consistent and integrated approach to accurate and timely claims processing. Maintain documentation, audit trails, and reporting in line with internal controls and external compliance requirements. Contribute to the development and implementation of new policies, procedures, and systems to improve claims operations. #LI-Hybrid

Exemption Status:United States of America (Non-Exempt)$17.92 - $22.85 - $27.78 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.” This position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job Description Summary The successful candidate will work as a member of the Claims Processing team, ensuring accurate and timely processing of Physician, Facility, Dental, and Vision claims for multiple plan designs, including traditional PPO plans, Reference Based Pricing (RBP) plans, and Minimal Essential Coverage (MEC) plans. Interprets schedules of benefits and plan documents to apply accurate benefits to claims according to the plan design. Applies internal policy and procedures for claims adjudication, identifies and resolves claim processing errors, adjusts previously processed claims, and logs refunds for claim overpayments. Performs data entry of CMS 1500, UB 04, and dental claims, research claim issues, and assists in audit projects. Works under general supervision, relying on instructions, work process guidelines, policies & procedures, and company knowledge/experience to perform job functions, with supervision ranging from close to minimal oversight based on demonstrated skill and performance levels. Essential Duties and Responsibilities include the following. Other duties may be assigned. Accurate and timely processing of Physician, Facility, Dental and Vision claims for multiple plan designs, including traditional PPO plans, Reference Based Pricing (RBP) plans and Minimal Essential Coverage (MEC) plans. Adhere to Corporate and Departmental standards including production and quality goals. Interpret schedule of benefits and plan documents to apply accurate benefits to claims according to the plan design. Identify potential system or plan design issues that would impact the correct adjudication of a claim. Effectively communicate with the Management team on claim processing questions and issues. Interpretation and application of internal policy and procedures for claims adjudication. Identify and resolve the root cause of a claim processing and/or data entry error. Adjust previously processed claims. Identify claim over payments and log refunds. Data entry of CMS 1500, UB 04, and dental claims. Research complex claim issues. Assist in audit projects Supervisory Responsibilities No supervisory responsibilities Client Responsibilities This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience GED/HS Diploma and 1+ year experience or equivalent combination of education and experience Computer Skills Intermediate knowledge of MS Office/Word, Excel, PowerPoint and Outlook. Experience with Windows based database programs is preferred. Strong aptitude for new programs. Certificates, Licenses, Registrations Certified Claims Professional (CCP), Medical Billing and Coding Certificate, or Certified Professional Coder (CPC) not required but highly preferred. Other Skills and Abilities Demonstrated ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment. Reasoning Ability Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Mathematical Skills Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance. Language Skills Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. Competencies To perform the job successfully, an individual should demonstrate the following competencies: Composure Decision Quality Organizational Agility Problem Solving Customer Focus Drive for Results Peer Relations Time Management Dealing with Ambiguity Learning on the Fly Political Savvy Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic). Work Location This position must work on-site at the Honolulu, Hawaii location for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders. Remote work is not an option for these purposes. Working Hours This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm. Travel This position requires no travel however attendance may be required at various local conferences and meetings. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to ************************* MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA: To perform this job successfully, the successful candidate 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. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Manage and lead a claims team by providing training, mentorship, and best practice solutions. Manage daily operations of the claims team, including inventory analysis, tracking and resolution of claims Serve as the escalation point for complex or disputed claims and drive resolution within defined SLA. Monitor and analyze key performance indicators (KPIs) and take corrective actions to improve efficiency, accuracy, and customer satisfaction Collaborate with key stakeholders to include underwriting, LOB, legal, servicing teams to ensure a consistent and integrated approach to accurate and timely claims processing. Maintain documentation, audit trails, and reporting in line with internal controls and external compliance requirements. Contribute to the development and implementation of new policies, procedures, and systems to improve claims operations. #LI-Hybrid

Under the supervision of Claims Supervisor, performs accurately all functions related to dental claims processing. Follows processing rules, guidelines, and policies. Meets department productivity, quality, and accountability standards. ESSENTIAL DUTIES AND RESPONSIBILITIES Key Responsibilities Electronically images hardcopy claims batch as OCR, Non-OCR, and x-ray attachments. Batch image paper attachments, POAs and adjustments, and back-end imaging of claims documentation. Inputs rejected and RFI claims notices. Performs all aspects of claims data entry, including verification of required documentations. Processes Levels 1, 2 and 3 claims consisting of single, COB-S, Dual, Pre-authorizations and out of state type claims. Reviews all levels of suspended electronic claims including opening and sorting of ECS mails. Processes requests to pay pre-authorizations. Other Duties and Responsibilities Assists the Claims department in adhering to established document policies and procedures. Provides back-up support and assistance in Customer Service and other departments as necessary. Accomplishes special projects as assigned. Determines and follows through with a plan to meet annual goals set up with the supervisor. Takes responsibility for relationships with others in the department and company. Works as a team player and assists wherever there is a need. Maintains a customer advocate attitude, understanding the importance that timely and accurate claims processing has on customer satisfaction. Other miscellaneous duties and responsibilities as assigned. MINIMUM QUALIFICATIONS AND EXPERIENCE Education High School Diploma or its equivalent required. Experience Minimum two years of clerical experience, customer service, sales, or any combination of education and experience which would provide the necessary knowledge, skills, and abilities to meet the minimum qualifications to perform the essential functions of this position. Skills and Knowledge Working knowledge of PC applications (i.e., word processing and spreadsheets) highly desirable. Requires demonstrated customer service skills and sales ability. Ability to maintain focus and attention to detail. Ability to handle multiple tasks with some distractions. Ability to communicate orally and in writing with all levels of staff, customers and vendors. Ability to handle all information in a confidential manner and in compliance with federal and state laws/regulations (i.e., HIPAA, PHI). Note : The above information in this description has been designed to indicate the general nature and level of work performed by an employee in this classification. It is not to be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications of employees assigned to this job. Hawaii Dental Service has the right to add to, revise, or delete information in this description. Reasonable accommodation will be made to enable qualified individuals with disabilities to perform the essential functions of this position.

RESPONSIBILITIES I. JOB SUMMARY/RESPONSIBILITIES: - Responsible for scheduling patients for one (1) type of outpatient scheduling, i.e. primary care, specialty care or hospital outpatient departments (HOD). Performs authorization, pre-registration, and insurance verification functions, as assigned. - Provides general and specific information to hospital users, patients, families and physician offices. - Ensures that patients meet financial requirements. - Fosters positive relationships with patients to provide quality service in a pleasant, professional, and timely manner, while being sensitive to guest services. - Communicates effectively to service delivery areas to maximize patient flow and customer service. II. TYPICAL PHYSICAL DEMANDS: - Essential: standing, sitting, walking, stooping/bending, walking on uneven ground, squatting, twisting body, finger dexterity, seeing, hearing, speaking, lifting and carrying up to 20 lbs, pushing/pulling usual weight of 15 to 20 pounds, reaching at and below shoulder level, repetitive arm/hand motions and gripping of an object. - Occasional: kneeling, crawling, climbing stairs, reaching above shoulder level. - Operates various office equipment such as computers, copiers, facsimiles, telephone, typewriter, pneumatic tube system, credit card swipe. III. TYPICAL WORKING CONDITIONS: - Not substantially subjected to adverse environmental conditions. - Work pace varies and is frequently stressful. IV. MINIMUM QUALIFICATIONS: A. EDUCATION/CERTIFICATION AND LICENSURE: - High school diploma or equivalent. B. EXPERIENCE: - One (1) year patient access experience in a hospital or physician office setting. - Prior experience in insurance verification and registration. - Knowledge and understanding of different payor types (i.e. Medicare, Medicaid, Commercial, HMO, Workers' Compensation, Capitation, TPL, etc.). - Knowledge of medical terminology. - Strong time management, organizational, and interpersonal skills. - Ability to communicate effectively in English, both orally and in writing. - Proficiency with automated systems and computer applications. Equal Opportunity Employer/Disability/Vet

Job Functions: * At sites where no other ATI support exists be prepared to conduct/oversee the overhaul, maintenance, and repair of airframe components, powerplants, aircraft communication equipment and associated components in accordance with Company manuals, manufacturer's manuals, including policies, Procedures Bulletins and Orders in order to return the aircraft to service and continue the mission. * Maintenance Representatives will be required to sign for work accomplished and must be prepared to oversee other non-ATI individuals/contractors working on ATI aircraft at remote locations and to "buy-back" the work of these individuals if required. Maintenance Representatives are directly responsible for the safety of the aircraft while at the remote sites and must insure that all work is accomplished in accordance with FAA and Company procedures in order to insure the safety of Company property, personnel and customers. * The mechanic in performing his/her duties is required to be constantly alert for defective, worn or failed parts as well as Unsafe working conditions and to bring these immediately to the attention of the flight crew to which he/she is assigned. Additionally, the Maintenance Representative is required to insure that the aircraft's assigned Spares Parts Kit (SPK) is fully stocked and that the required materials and parts are available to support the scheduled mission to the fullest extent possible. * During the course of normal operations, the Maintenance Representative must be prepared to work with various Company hired agents at sites throughout the world to procure maintenance services and support, as needed to repair/fix the aircraft. Should no Company agent be available, the Maintenance Representative working in conjunction with the flight crew must be prepared to act as Company agent and procure the support/equipment necessary to facilitate the repair/servicing of the aircraft as required. * As part of normal remote location operations, the Maintenance Representative is specifically charged and responsible to keep Maintenance Control fully apprized of the status of the aircraft and to provide copies of all completed log pages directly to Maintenance Control. Additionally, the Maintenance Representative must be fully capable of working with minimal supervision during the normal course of events, but should the need arise to solicit and follow directions from Maintenance Control and higher management despite the thousands of miles separating him/her from senior leadership. * The Maintenance Representative is also specifically responsible and required to conduct such housekeeping duties as required to keep his/her assigned aircraft clean and presentable. This may require the use of third parties, but the responsibility to insure the cleanliness and appearance/upkeep of the assigned aircraft rests specifically with the Maintenance Representative flying on that aircraft during the course of the currently on-going mission. * At any location where mechanics are utilized, assume the duties, responsibilities, and authority of the Maintenance Supervisor, and work for the Line Maintenance Supervisor responsible for that station. * When the Maintenance Representative is exercising his/her authority under the RII provisions of this manual, he/she will be directly responsible to the Director of Quality Control. * Attend all Company training classes as assigned by the Director of Maintenance. What you will need: * Minimum of three (3) years, proven line maintenance experience on 767/757 aircraft * High School Diploma or equivalent * Must successfully complete a DOT/FAA pre-employment drug screen and a DOT/FAA compliant background check. * Ability to clearly communicate with customers and co-workers; stand, bend, and reach in order to maintain files; sit for extended periods of time; and comply with ATI attendance requirements. * Shall hold a valid Airframe and Powerplant license (FAR 121.378a) * Shall have a valid passport, and Driver's License. * Ability to travel as the needs of the airline dictates. (may require travel up to 3 weeks per month) Preferred: * B 757/767 aircraft; Parts 121, 125, 145; Heavy transport category aircraft experience Physical Requirements: Must be able to lift up to 50 lbs., climb up to 3 flights of stairs. Must be able to work at heights up to 80 feet and from ladders up to 10 feet. This job will require the following abilities: * Hearing/Speaking * Near/Far Sight Acuity * Depth perception/Field of vision * Hand/Eye Coordination * Color Vision * Effective Oral/Written communication Air Transport International is an equal employment/affirmative action employer. It is the Company's policy not to discriminate against any applicant or employee based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status and prohibits discharging or in any other manner discriminating against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. The Company further does not discriminate on any other basis protected by applicable federal, state or local laws.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Specialty Loss Adjuster **Embark on an Exciting Career Journey with Sedgwick Specialty** **Job Location** **: USA, Mexico, Brazil and strategic locations globally** **Job Type** **: Permanent** **Remuneration** **: Salaries can range from** **_$40,000.00USD to $250,000.00USD_** **taking into account skills, experience and qualifications.** **We have a number of fantastic opportunities for Specialty Loss Adjusters across the US, Mexico and Brazil and a number of key locations** We are looking for a variety of skill sets at all levels. Whether you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your skills and grow with a company that values innovation, excellence, and employee satisfaction. Are you ready to be a part of providing a differentiated and best of class proposition to clients whilst working with like-minded colleagues? Sedgwick Specialty is thrilled to announce that we are investing in growth across Natural Resources, Property, Casualty, Technical and Special Risks and Marine. As we expand our operations, we are seeking individuals who are passionate about making a difference to the Adjusting industry. **As a member of the Specialty platform, you will have the opportunity to:** + Work with a wide range of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team of professionals who are dedicated to delivering exceptional results + Utilise state-of-the-art technology and resources to streamline processes and enhance efficiency + Receive ongoing training and development opportunities to further enhance your skills and knowledge in the marine industry + Enjoy a flexible work arrangement that allows you to maintain a healthy work-life balance while contributing to our global success **The skills you will have when you apply:** + **Qualified** : it is important to us that you are either accredited, on your way to be accredited or qualified by experience + **Insurance claims experience:** it is imperative that you have experience working on insurance claims within you respective field. Full claims life cycle experience is a must + **Great communicator:** you will be constantly working with policy holders, brokers, carriers and various third parties, so being able to communicate accurately important. Providing an excellent customer service with our clients in mind. Able to approach issues empathetically + **Commercially minded:** An understanding of how the industry operates and where the role of a Loss Adjuster fits in. Being able to negotiate. Understanding how to market your services is a big advantage **What we'll give you for this role:** As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the annual salaries can range from _$40,000.00 to $250,000.00USD._ Bonus eligible role. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always Accepting Applications. **This isn't just a position, it's a pivotal role in shaping our industry** At Sedgwick, you won't just build your career; you'll cultivate a team of experts. Our Sedgwick University offering empowers you to excel as well as your team members, with the most comprehensive training program in the industry which includes more than 15,000 courses on demand, training specific to roles, and opportunities to continue formal education. Together, we're not only reshaping the insurance landscape, we're building a legacy of talent. Come and be a catalyst for change within our industry. **Next steps for you:** **Think we'd be a great match? Apply now -** ** we want to hear from you.** As part of our commitment to you, we are proud to have a zero tolerance policy towards discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex or sexual orientation. After the closing date we will review all applications and may select some applicants for an interview (which may be virtual, or in-person). \#LI-HYBRID Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

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

Under minimal to no supervision, reviews, investigates, evaluates, negotiates and resolves a variety of multi-line casualty claims including but not limited to disputed liability, personal injury, coverage disputes, and contract based losses, and specialty claims of a complex nature. Independently handles all aspects of assigned claim inventory in line with department standards, procedures, and appropriate claims practices. Duties: * Claim Intake and Initial Processing * Receives claim loss information from agencies, insured, and claimants or other involved parties via telephone, facsimile, mail, or computer; and establish a claim on the appropriate computer claim handling system. * Reviews limited assignments, as well as assigned claims for applicable coverage, liability, and exposures. * Posesses working knowledge of all lines of business written by the company, including, but not limited to auto, homeowners, dwelling fire, commercial general liability, and umbrella. * Makes initial contact with insured and any other involved parties within the specified time frame, as outlined within department procedure. * Determines/confirms facts of loss, cause of loss, the identification of parties involved, and the existence of/extent of injuries and/or damages involved. * Reviews applicable policy forms/coverage documents, determine and explain available coverage and benefits, and address/resolve conflicts. * Establishes appropriate initial reserves on the computer claims-handling system within the specified time frame outlined within department procedures. * Investigates and handles losses in an appropriate, adequate, and thorough manner. * Obtains written or recorded statements as needed. * Investigation and Documentation * Ensures that damages, scenes, etc. are inspected, photographed, diagramed, and properly documented. Secures and protects evidence, as required. * Obtains other documents and records, such as police and fire reports, contracts and legal agreements, medical bills and reports, etc. * Prepares and submits any required data and reports (such as injury index, Medicare), per department procedure * Determines liability based upon the facts and a working knowledge of the applicable Hawaii Revised Statutes and any other applicable laws. * Stays abreast of statute changes, case law decisions, as well as policy and coverage changes. * Evaluates damages and/or injuries considering applicable coverage, liability determination, and any other pertinent information developed within the investigation. * Negotiates settlements within the authority granted. * Recognizes subrogation opportunity and complete the appropriate investigation in support of the pursuit of financial recovery on the claim. Assist the Subrogation unit, or complete arbitration filings as required. * Recognizes third party liability and contribution, and the handling and resolve of loss accordingly. * Initiates deductible recoveries with an insured per policy/coverage. * Communication and Reporting * Reviews questionable claims and all coverage issues with department management. * Communicates loss status to insured, claimant, or an attorney, as required by law or by department procedure. * Accurately processes financial transactions upon the applicable computer claims handling system, to include establishing or adjusting reserves and making payments within granted authority. * Prepares and submits requests and required reports, for increased financial authority, as required by department procedure. * Maintains a diary on all active claims with diary date established and addressed in line with department procedure. * Enters timely, clear, concise notes within the applicable computer claims handling system(s) related to investigation, handling, assessments, evaluations, and negotiations and settlements on all assigned claims. * Manages and directs any/all outside vendors (such as independent adjusters, contractors, repair shops, experts, or attorneys). * Litigation and Legal Compliance * Handles claims and/or litigation cases, as assigned. * Follows prescribed litigation guidelines and procedures, including reporting requirements and legal fee review program. * Attends and participates in mediations, arbitrations, settlement conferences as directed. * Travels to the neighbor islands as required for inspections and client visits. * Informs Claim Supervisor of any/all oral or written complaints, and any coverage dispute. * Prepares and timely submits required reports as may be required by procedure, department management, the company, or a vendor of the company. Education/Experience: * High school diploma or general education degree (GED); and 3 to 5 years multi-line claims and litigation management experience as a Claim Service Representative required. * College degree with credits in insurance related subjects preferred. * Equivalent combination of education and job-related experience will be considered. * Continuing education in insurance and job-related issues and subjects required Certificates, Licenses, Registrations: * Valid Hawaii Driver license and use of own vehicle required. * State of Hawaii general adjusting license preferred. An Equal Opportunity Employer Committed to an Inclusive Workplace.

HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve **Duties Note: The following is not intended to be an exhaustive list of all duties required of this position.** ADA E1. Maintains the funding for self-insured clients. (35%) E2. Responsible for communicating with external client contacts and internal departments. (30%) E3. Prepares and sends reports and bills to clients daily, weekly or monthly. (35%) N4. Performs other duties as assigned. **Education/Experience/Skills Requirements** **Required Education:** HS/GED: **Required Experience:** Some college preferred. Prior experience in billing and eligibility preferred. **Required Knowledge/Skills:** 1. Proficient in Microsoft Office Suite 2. Ability to meet deadline requirements 3. Must be detail oriented and a team player 4. Must be able to work in a fast paced environment 5. Excellent communication and organizational skills 6. Problem Solving 7. Ability to identify problems and issues and work within the Department for resolution or with other Department for resolution. **Required Licenses/Certifications:** None **Managerial/Supervisory Responsibilities** Does this Position have Supervisory Responsibility? No **Pay Range Minimum:** $19.27 **Pay Range Maximum:** $26.88 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273332

Under the supervision of Claims Supervisor, performs accurately all functions related to dental claims processing. Follows processing rules, guidelines, and policies. Meets department productivity, quality, and accountability standards. ESSENTIAL DUTIES AND RESPONSIBILITIES Key Responsibilities * Electronically images hardcopy claims batch as OCR, Non-OCR, and x-ray attachments. Batch image paper attachments, POAs and adjustments, and back-end imaging of claims documentation. Inputs rejected and RFI claims notices. * Performs all aspects of claims data entry, including verification of required documentations. * Processes Levels 1, 2 and 3 claims consisting of single, COB-S, Dual, Pre-authorizations and out of state type claims. Reviews all levels of suspended electronic claims including opening and sorting of ECS mails. Processes requests to pay pre-authorizations. Other Duties and Responsibilities * Assists the Claims department in adhering to established document policies and procedures. * Provides back-up support and assistance in Customer Service and other departments as necessary. * Accomplishes special projects as assigned. * Determines and follows through with a plan to meet annual goals set up with the supervisor. * Takes responsibility for relationships with others in the department and company. * Works as a team player and assists wherever there is a need. * Maintains a customer advocate attitude, understanding the importance that timely and accurate claims processing has on customer satisfaction. * Other miscellaneous duties and responsibilities as assigned. MINIMUM QUALIFICATIONS AND EXPERIENCE Education High School Diploma or its equivalent required. Experience Minimum two years of clerical experience, customer service, sales, or any combination of education and experience which would provide the necessary knowledge, skills, and abilities to meet the minimum qualifications to perform the essential functions of this position. Skills and Knowledge * Working knowledge of PC applications (i.e., word processing and spreadsheets) highly desirable. * Requires demonstrated customer service skills and sales ability. * Ability to maintain focus and attention to detail. * Ability to handle multiple tasks with some distractions. * Ability to communicate orally and in writing with all levels of staff, customers and vendors. * Ability to handle all information in a confidential manner and in compliance with federal and state laws/regulations (i.e., HIPAA, PHI). Note: The above information in this description has been designed to indicate the general nature and level of work performed by an employee in this classification. It is not to be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications of employees assigned to this job. Hawaii Dental Service has the right to add to, revise, or delete information in this description. Reasonable accommodation will be made to enable qualified individuals with disabilities to perform the essential functions of this position.