Claims representative full time jobs

Job Description The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a Hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers' Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests Participate in customer claim reviews and presentations Ability to travel overnight and attend meetings if required Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to assist team members to develop knowledge and understanding of claims practice Effective quantitative, analytical and interpretive skills Strong leadership, management and motivational skills Demonstrated, strong customer service skills Maintains composure under pressure and communicates diplomatically across various channels, including telephone, email, and written correspondence Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to work both independently and within a team environment Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Demonstrated public speaking skills Minimum of 5 years' claims handling experience Knowledge of WC required Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel Self-Insured Certificate preferred State Certification as an experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $71, 696 - $110,701 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid

JOB RESPONSIBILITIES * Financial Support - May perform duties of FSR I & II. May have specialized areas of responsibility (e.g. government & non-government billing, appeal processing, review & approval of refunds, etc.). * Systems Support - Identify system and technology needs. Participate in advancing use of technology. Ensures systems meet all regulatory and compliance requirements. * Quality - May perform research and analysis. Participate in departmental/division performance improvement and quality assurance controls. May develop and execute corrective actions plans. * Billing - Compile and prepare patient charges. Prepare invoices billings, UB-04 and 1500 claim forms to be sent to 3rd party payers for payment indicating individual line items for services and total costs. Review charges. Obtain and evaluate family, third party payers and agency resources for payment of charges. Managing patient billing and ensure procedures are billed according to contracts, transmit or mail all paper and claims, and review correspondence and follow up as needed. * Collaboration - Act as a preceptor and/or lead for new employees. Perform specialty services functions. Act as a resource within the department/division. Provide instruction for performing non-routine functions. Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patent Financial Services and other Cincinnati Children's departments. May have supervisory responsibilities. JOB QUALIFICATIONS * High school diploma or equivalent * 3+ years of work experience in a related job discipline Primary Location South Campus Schedule Full time Shift Day (United States of America) Department Professional Billing Operation Employee Status Regular FTE 1 Weekly Hours 40 * Expected Starting Pay Range * Annualized pay may vary based on FTE status $20.57 - $25.72 Market Leading Benefits Including*: * Medical coverage starting day one of employment. View employee benefits here. * Competitive retirement plans * Tuition reimbursement for continuing education * Expansive employee discount programs through our many community partners * Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions * Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group * Physical and mental health wellness programs * Relocation assistance available for qualified positions * Benefits may vary based on FTE Status and Position Type About Us At Cincinnati Children's, we come to work with one goal: to make children's health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children's. Cincinnati Children's is: * Recognized by U.S. News & World Report as a top 10 best Children's Hospitals in the nation for more than 15 years * Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding * Recognized as one of America's Best Large Employers (2025), America's Best Employers for New Grads (2025) * One of the nation's America's Most Innovative Companies as noted by Fortune * Consistently certified as great place to work * A Leading Disability Employer as noted by the National Organization on Disability * Magnet designated for the fourth consecutive time by the American Nurses Credentialing Center (ANCC) We Embrace Innovation-Together. We believe in empowering our teams with the tools that help us work smarter and care better. That's why we support the responsible use of artificial intelligence. By encouraging innovation, we're creating space for new ideas, better outcomes, and a stronger future-for all of us. Comprehensive job description provided upon request. Cincinnati Children's is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability

Our Claims team is currently seeking a Senior Litigation Adjuster for either Commercial General Liability (CGL) or Auto Bodily Injury (ABI). This is a full-time, exempt role with a hybrid work schedule (two days in the office) or fully remotely for those not near a Hanover office. POSITION OVERVIEW: This position requires daily telephone contacts with the policyholders, risk managers, and agents. Fully responsible for the analysis, investigation, evaluation, negotiation and resolution of complex claims requiring thorough investigations including telephone contacts with the involved parties; technical expertise and complex analysis. Claim assignments are multi-state and involve customers. IN THIS ROLE, YOU WILL: Must have or secure and maintain appropriate states adjuster license (s) and continuing education credits. Responsible for the settlement of litigated cases, involving disputes over coverage, liability, and damages issues. Gather the facts and analyze the statements/testimony and declaration of damages to develop claims resolution strategies. Work in partnership with defense counsel and all other parties/vendors to bring about a timely cost effective conclusion. Identifies possibly suspicious claims Claims handled are transferred existing losses or first notice lawsuits over disputed issues of great complexity where the policyholder's coverage is in question. These claims require the highest level of investigation, analysis, evaluation, and negotiation. Responsible for all aspects of each claim, including informal hearings, arbitrations and claims litigation and maintaining a high level of productivity, confidentiality and customer service. Will be utilized as a technical resource by adjusters. Will represent the company at mediation, arbitration and trials. Review and analyze contracts, leases, and identify risk transfer opportunities Demonstrate ability to write positional coverage letters. Manage litigation expenses. Reports into Unit Manager WHAT YOU NEED TO APPLY: Typically has 5 + years of litigation experience with insurance carrier. (TPA experience will not be considered) Bachelor's degree or equivalent experience, industry designation preferred. Dedicated to meeting the expectations and requirements of internal and external customers Makes decisions in an informed, confident and timely manner Maintains constructive working relationships despite differing perspectives Considers the perspectives of others and gives them credibility Strong organizational and time management skills Ability to negotiate skillfully in difficult situations with both internal and external groups. Demonstrates ability to win concessions without damaging relationships. Demonstrates strong written and verbal communication skills. Promotes and facilitates free and open communication. Understanding of applicable statutes, regulations and case law Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a timely manner. Easily adapts to new or different changing situations, requirements or priorities. Cultivates an environment of teamwork and collaboration Operates with latitude for un-reviewed action or decision. Computer experience (MS Office, excel, word, etc) Ability to work in a paperless environment. This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. The Crop Division of Great American has been helping generations of farmers take control of their risks since 1915. The Division is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI policies. With six regional offices throughout the U.S., the teams provide tremendous expertise in the specific needs of farmers and crops. ********************************** Great American is currently seeking Seasonal Crop Adjusters. These positions are seasonal and may not be eligible for full-time or part-time benefits. Qualified candidates will cover territory in one of the following states: * Alabama * Arkansas * California * Colorado * Florida * Georgia * Idaho * Illinois * Indiana * Iowa * Kansas * Kentucky * Louisiana * Michigan * Minnesota * Mississippi * Missouri * Montana * Nebraska * New York * North Carolina * North Dakota * Ohio * Oklahoma * Oregon * Pennsylvania * South Carolina * South Dakota * Tennessee * Texas * Washington * Wisconsin * Wyoming Schedule: Seasonal part-time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, you will: * Understand and can work claims for all major crops, policy/plan types, in all stages of growth. * Complete field inspections, reviews, and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company Crop insurance policies. * Review and evaluates coverage and/or liability. * Secure and analyze necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims. * Ensure compliant and cost effective application of Crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory requirements. * Accurately document, process and transmit loss information to determine potential. * Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions, or trials as necessary. * May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority. * Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. * Ensures that claims handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed. * Follow regulatory and company rules, policies, and procedures. * Performs other duties as assigned. Physical Requirements for employees in the Crop Business Unit/Crop Claims General Adjuster * Requires continuous and prolonged walking and standing. * Requires frequent lifting, carrying, pushing and pulling of objects up to 50 lbs. * Requires frequent climbing grain bins, bending, twisting, stooping, kneeling and crawling. * Requires overhead reaching and grabbing. * Requires regular and predictable attendance. * Requires ability to conduct visual inspections. * Requires work outdoors, in inclement weather conditions. * Requires frequent travel. * May require ability to operate a motor vehicle. Business Unit: Crop Salary Range: $0.00 -$0.00 Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.

Title: Claims Representative I (Health & Dental) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Claims Representative I responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How you will make an impact: * Learning the activities/tasks associated with his/her role. * Works under direct supervision. * Relies on others for instruction, guidance, and direction. * Work is reviewed for technical accuracy and soundness. * Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. * Researches and analyzes claims issues. Minimum Requirements * HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences * Good oral and written communication skills, previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

122685 Zurich is currently looking for a RCIS Crop Claims Field Adjuster I to join our Rural Community Insurance Services (RCIS) team. RCIS is one of the leading crop insurance providers in the U.S. RCIS offers insurance protection in all 50 states through a national network of about 3,600 licensed agents. RCIS offers a wide range of private product coverages, including a diverse selection of named-peril options, supplemental and stand-alone insurance products as well as federal crop insurance plans through the United States Department of Agriculture's Risk Management Agency. Together with RCIS agents, we protect America's farmers and ranchers. Zurich/RCIS is currently looking for a Crop Adjuster to work out of the state of Ohio. This incumbent will work from a home-based office. This position is scheduled to work 40 hours per week. Approximately 50% travel is expected to cover the territory. **The ideal candidate will need to live and service within the following counties in Ohio:** + **Pickaway** + **Fayette** + **Ross** + **Adams** RCIS provides insurance and superior services through leading agents to protect America's farmers and ranchers. It's been an innovator in crop insurance since the crop insurance business was privatized by the federal government in 1980. Today it's one of the nation's largest crop insurance providers, offering risk management protection in all 50 states through a national network of about 4,000 professionally trained and licensed agents. This is a great opportunity to serve the agricultural community. As a Crop Adjuster, your primary responsibilities will include: + With minimal supervision, completes field inspections and related responsibilities such as reading maps and aerial photos, measuring fields, storage bins, and discussing findings of crop loss with farmers on the most complex non-routine, problematic claims including controversial claims. + Ability to convey complex regulations and interpretations to claimants, agents, and industry people on claim situations. + Performs fact finding regarding crop damage, records information and transmits loss information to accurately determine potential indemnities. + Gather relevant facts, utilizing applicable law and establishing basic principles of negligence. + Complete claim reviews and audits on lower-level adjusters as assigned. + Ensure legal compliance by maintaining a strong working knowledge of regulatory and company policies and procedures. + Contribute to the team effort by accomplishing related results and participating on projects as needed. Basic Qualifications: + High School Diploma or Equivalent and 6 or more months of experience in the agricultural area + Crop Adjuster Proficiency Program Certification (CAPP) must be obtained with 180 days of hire date + Reliable personal transportation and travel within territory + Valid Driver's License + RCIS Crop Adjuster Physical Requirements: walk in agricultural fields up to 3 miles, climb agricultural storage bins up to 25 feet, lift 25 lbs. to 50 lbs., work outdoors in varying temperatures/weather conditions Preferred Qualifications: + Excellent verbal, written and interpersonal communication skills + Strong organization and prioritization skills + Experience as a Crop Claims Field Adjuster + Intermediate Microsoft Office skills At Zurich, compensation for roles is influenced by a variety of factors, including but not limited to the specific office location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a fair and reasonable compensation range for each role. For more information about our Total Rewards, please click here (****************************************** . Additional rewards may encompass short-term incentive bonuses and merit increases. We encourage candidates with salary expectations beyond the provided range to apply as they will be considered based on their experience, skills, and education. The proposed Salary range for this position is $22.02 - $30.24, with short-term incentive bonus eligibility set at 5%. As an insurance company, Zurich is subject to 18 U.S. Code § 1033. A future with Zurich. What can go right when you apply at Zurich? Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500 . Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please clickhere (********************************* to learn more. Zurich in North America is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission. Location(s): AM - Ohio Virtual Office Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MM1 EOE Disability / Veterans

Come to work with us at Community Health Services! We offer full-time benefits, 10 paid holidays, no weekend hours and so much more! We are looking for a full-time Claims Specialist to work in our Fremont office. CHS employs those who are eager to grow professionally, gain great experience, and work with a terrific team. The Claims Specialist will be responsible for performing general finance functions, entering encounters, processing and recording claims and all other duties as assigned. Hours for this position are: Mondays 7am-7pm, Tuesdays through Thursdays 8am-5pm, Fridays 8am-1pm Qualified candidates must have the following to be considered for employment: * Associate's degree from an accredited college or university * Experience in accounting/bookkeeping * Demonstrates ability to organize and implement general accounting and bookkeeping procedures for a healthcare organization * Ability to work with clinic personnel and patients in a courteous, cooperative manner * Ability to function as part of a team * Must have excellent customer service skills * Must have excellent multi-tasking, problem solving, and decision-making skills * Ability to follow instructions with attention to detail * Demonstrates professional relationship skills, and a strong work ethic * Prioritizes responsibilities, takes initiative, and possesses excellent organizational skills * Demonstrates effective communication skills * Ability to work with a culturally diverse group of people At CHS, we value our team and the critical role they play in patient care. If you're dependable, detail-oriented, and passionate about making a difference in your community, we'd love to hear from you. CHS is a drug-free/nicotine free organization. Candidates must pass a drug and nicotine screening upon employment offer.

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Claims Management Shift/schedule: Full Time (40 hrs/wk) Works under the supervision of the Assistant Manager of Claims Management and Lead Insurance Claim Specialists. The Insurance Claim Specialist's primary job functions is to analyze, process, submit, and follow up on inpatient and outpatient medical claims. Is responsible for safeguarding the public relations and confidentiality of the organization and its records by consistent professional conduct. QUALIFICATIONS Education: * High School Diploma or successful completion of an equivalent High School Exam Required Licensure: * None Experience: * Three to six months of related work experience in medical billing preferred JOB SPECIFIC DUTIES AND PERFORMANCE EXPECTATIONS The following is a summary of the major job duties of this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. * Reviews all claims for complete and accurate information. * Contacts other SOMC departments, physician offices, and insurance companies to obtain necessary information to file complete, accurate, and timely claims. * Processes, edits, and submits all claims for the organization. * Follows up on Commercial, Worker's Comp, VA, and Governmental claims by phone calls to the insurance companies, websites, or any online resources available. * Works with the patient/guarantor by phone to assist with any questions regarding unpaid claims. Obtains information from the patient/guarantor with which to submit the claim for payment (i.e., claim forms, Medicare Secondary Payer (MSP) Questionnaire, etc.) * Processes administrative appeals, reinstatements, and rejections of insurance claims. * Completes account follow up daily, maintaining established goals, and notifies the Lead Specialist, when necessary, of issues preventing achievement of such goals. * Analyzes daily correspondence (denials, underpayments) to appropriately resolve issues. * Adheres to HIPPA regulations by verifying pertinent information to determine caller authorization level receiving information on account. * Identifies billing and coding issues with individual claims, notifying medical billers for correction. * Makes determinations through on-line systems of patient eligibility, coverage, and reviews status of claims. * Performs other duties as assigned. Thank you for your interest in Southern Ohio Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status Southern Ohio Medical Center is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability, ethnicity, gender identity, or expression, genetic information, military status, national origin, race, religion, sex, gender, sexual orientation, pregnancy, protected veteran status or any other basis under the law.

Seeking experienced Full-Time to Part-Time Private Investigators to conduct SURVEILLANCE as it relates to the investigation of suspect insurance claims. We are seeking individuals who possess proven investigative skill sets within the industry. Honesty, integrity, self-reliance, resourcefulness, independence, discipline, and a calm intensity are a few characteristics of our Investigators and staff. Investigators with Scene Investigation and Recorded Statement experience are encouraged to apply. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** Requirements: 1+ years of experience as an Surveillance Investigator Must be licensed as a Private Investigator in your state (if required) Flexibility to work varied/irregular hours and days including weekends and holidays Valid state issued driver's license The Surveillance Investigator should demonstrate proficiency in the following areas: Obtaining quality surveillance video evidence Writing accurate and detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook email Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment

Top 100 Agency for 2025 Best Agencies to Work for in 2024 by the Insurance Journal Big “I” Best Practices Agency in 2023 Annual bonus eligibility No weekends required - great work/life balance 3+ weeks of Paid Time Off 8 Paid Company Holidays We are looking for someone who will Manage the claims reporting process for agency clients. Report claims to the appropriate carrier and maintain records in the agency management system by documenting claim actions in accordance with established procedures. Follow up on claim to obtain the specific adjuster and claim number relevant to the reported loss. Notify appropriate parties when a claim is processed with carrier, providing accurate and timely claim information. Continuously monitor claims until claims are closed by the insurance carrier. Report any potential issues with a claim to the client's Account Manager and Producer, escalating to management as needed. Prepare reports by collecting and summarizing information as requested by management. Why Join AAA Club Alliance and the Energy Insurance team? A base rate of $20.00 to $25.00/hour, depending on experience and geographic location. Annual bonus potential Do you have what it takes? Minimum of 2 years experience handling claims for Commercial Insurance - general liability, workers compensation, commercial auto, etc. Strong communication skills (both verbal and written) and attention to detail Strong time management skills Ability to obtain property and casualty license within 60 days of hire Full time Associates are offered a comprehensive benefits package that includes: Medical, Dental, and Vision plan options Up to 2 weeks Paid parental leave 401k plan with company match up to 7% 2+ weeks of PTO within your first year Paid company holidays Company provided volunteer opportunities + 1 volunteer day per year Free AAA Membership Continual learning reimbursement up to $5,250 per year And MORE! Check out our Benefits Page for more information ACA is an equal opportunity employer and complies with all applicable federal, state, and local employment practices laws. At ACA, we are committed to cultivating a welcoming and inclusive workplace of team members with diverse backgrounds and experiences to enable us to meet our goals and support our values while serving our Members and customers. We strive to attract and retain candidates with a passion for their work and we encourage all qualified individuals to apply. It is ACA's policy to employ the best qualified individuals available for all positions. Hiring decisions are based upon ACA's operating needs, and applicant qualifications including, but not limited to, experience, skills, ability, availability, cooperation, and job performance. Job Category: Insurance

* Top 100 Agency for 2025 * Best Agencies to Work for in 2024 by the Insurance Journal * Big "I" Best Practices Agency in 2023 * Annual bonus eligibility * No weekends required - great work/life balance * 3+ weeks of Paid Time Off * 8 Paid Company Holidays We are looking for someone who will * Manage the claims reporting process for agency clients. * Report claims to the appropriate carrier and maintain records in the agency management system by documenting claim actions in accordance with established procedures. * Follow up on claim to obtain the specific adjuster and claim number relevant to the reported loss. Notify appropriate parties when a claim is processed with carrier, providing accurate and timely claim information. * Continuously monitor claims until claims are closed by the insurance carrier. Report any potential issues with a claim to the client's Account Manager and Producer, escalating to management as needed. * Prepare reports by collecting and summarizing information as requested by management. Why Join AAA Club Alliance and the Energy Insurance team? * A base rate of $20.00 to $25.00/hour, depending on experience and geographic location. * Annual bonus potential Do you have what it takes? * Minimum of 2 years experience handling claims for Commercial Insurance - general liability, workers compensation, commercial auto, etc. * Strong communication skills (both verbal and written) and attention to detail * Strong time management skills * Ability to obtain property and casualty license within 60 days of hire Full time Associates are offered a comprehensive benefits package that includes: * Medical, Dental, and Vision plan options * Up to 2 weeks Paid parental leave * 401k plan with company match up to 7% * 2+ weeks of PTO within your first year * Paid company holidays * Company provided volunteer opportunities + 1 volunteer day per year * Free AAA Membership * Continual learning reimbursement up to $5,250 per year * And MORE! Check out our Benefits Page for more information ACA is an equal opportunity employer and complies with all applicable federal, state, and local employment practices laws. At ACA, we are committed to cultivating a welcoming and inclusive workplace of team members with diverse backgrounds and experiences to enable us to meet our goals and support our values while serving our Members and customers. We strive to attract and retain candidates with a passion for their work and we encourage all qualified individuals to apply. It is ACA's policy to employ the best qualified individuals available for all positions. Hiring decisions are based upon ACA's operating needs, and applicant qualifications including, but not limited to, experience, skills, ability, availability, cooperation, and job performance. Job Category: Insurance

Water Claims Coordinator/Accounts Receiveable We are currently searching for a full-time Water Claims Coordinator related to water mitigation insurance claims for our Southeast Region. The pay range for this position will be $19.00-$21.00, depending on experience. This on-site position will be located in downtown Cincinnati, OH. You will also receive company-paid parking at a nearby garage. The primary role of the Water Claims Coordinator is to bill, collect payments, and maintain accounts for the Water Restoration Department. The Water Claims Coordinator will keep precise records of all insurance/homeowner payments. Founded in 1935, Roto-Rooter is North America's largest plumbing, drain cleaning, and water cleanup services provider. Roto-Rooter operates businesses in over 100 company-owned branches, independent contractor territories, and approximately 400 independent franchise operations, serving approximately 90% of the U.S. population and parts of Canada. The ideal candidate will have 1-3 years of experience in the collection industry. In addition, the ideal candidate should possess strong communication skills, both with customers and within the insurance industry, and have a good working knowledge and/or experience in water restoration collections. Responsibilities Working knowledge of restoration billing and collections procedures 1-3 years of collections experience, preferably in the water restoration industry Administrative experience in the restoration (preferred) or service industry Highly motivated, detail-oriented, and able to work independently Outstanding organizational, time management, and follow-up skills Self-starter who thrives in a fast-paced environment Able to handle multiple projects at once Strong communication skills and ability to work professionally with customers and the insurance industry Bilingual a plus Requirements Highschool diploma or equivlant is required. 1-2 years of collections experience, preferably in the water restoration industry. Must be able to speak and write in English Basic computer skills, including Microsoft Office AS400 experience is preferred Benefits At Roto-Rooter we believe our greatest investment is in our employees. We prioritize the health and well-being of our team and their families. That's why we offer an extensive employee benefit package including: Medical insurance with a Prescription Drug Card Accident and Critical Illness Insurance Dental Insurance Vision Insurance Paid Vacation Paid Training Life Insurance Matching 401K Retirement Savings Plan Tuition Reimbursement Profit Sharing Roto-Rooter offers excellent career paths for military veterans and personnel transitioning to civilian professions. Throughout our 86 years in business, we've found that military training and structure are a great fit at our company. EEO Statement We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, religion, color, sex, gender, age, national origin, veteran status, military status, disability, gender identity, sexual orientation, genetic information, or any other characteristic protected by law.

FHA Mortgage Origination RepresentativeEmployment Type: Full Time , Entry LevelDepartment: Customer Service CGS is seeking an FHA Mortgage Origination Representative to join our team supporting a wide-ranging customer support initiative for a large Federal agency. CGS brings motivated, highly skilled, and creative people together to solve the government's most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success:- Provide excellent customer service, answering a variety of calls and emails from the mortgage lending industry and the public on FHA guidelines and procedures.- Use your knowledge of the mortgage industry to locate answers in a knowledge database to acknowledge client's requests.- Follow standard operating procedures for various topics, systems, and contact channels.- Document all of your contacts in a database- Keep up to date on FHA mortgage processes and procedures Qualifications:- The capability to navigate multiple computer systems and applications and utilize search tools to provide information to our clients.- Excellent time management skills and dependability.- Strong verbal and written communication skills.- High School diploma or GED.- At least two years working with FHA loans ( e.g. loan originator, loan processor, junior underwriter, loan officer) plus an additional year of customer service or contact center background, or at least three years of loan origination working with conventional loans and/or other government-backed loans ( e.g. FHA, USDA, VA)- Will be able to obtain a Public Trust Security clearance, which includes a credit check and background investigation. Ideally, you will also have:- Contact Center experience (omnichannel).- Bilingual (Spanish/English), verbal and written.- FHA knowledge/experience Our Commitment:Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client's specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years, we've been growing our government-contracting portfolio, and along the way, we've created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package.- Health, Dental, and Vision- Life Insurance- 401k- Flexible Spending Account (Health, Dependent Care, and Commuter)- Paid Time Off and Observance of State/Federal Holidays Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Join our team and become part of government innovation! Explore additional job opportunities with CGS on our Job Board: ************************************* For more information about CGS please visit: ************************** or contact: Phone: *****************Email: [email protected]$37,000 - $42,000 a year We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

SummaCare - 1200 E Market St, Akron, OH Full-Time / 40 Hours / Days * Hybrid after training As a regional, provider-owned health plan, SummaCare values the relationship between the members and their doctors. SummaCare is a part of Summa Health, an integrated healthcare delivery system that includes Summa Health System hospitals, its community-based health centers, dedicated clinicians and SummaCare. Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits. Summary: Accurately and efficiently handles claims in accordance with regulatory and contractual guidelines. Reviews claims related to coordination of benefits, medical coding, and authorization allocation while ensuring compliance with established policies. Applies cost-containment strategies in collaboration with vendor partners to minimize claim expenses while adhering to plan-specific processing rules. are essential for success in this position. 1. Formal Education Required: a. High School Diploma or equivalent 2. Experience & Training Required: a. One (1) year experience to include any combination of the following: i. Health insurance claims processing ii. Health claims data entry including Document Management Services (DMS) iii. Customer service experience in a managed care environment iv. Physician or hospital billing v. Patient accounts Essential Functions: 1. Requires close attention to detail with independent judgment, decision making and problem solving skills necessary to complete the task being performed 2. Organizes reference materials for easy access; manages time to accurately complete tasks within time frames in a fast paced environment 3. Processes all types of claims, promptly and accurately, as assigned via the document management system, and ensures self-funded service standards, prompt pay standards, and regulatory requirements are met. 4. Maintains a working knowledge of the claims processing system, imaging system, key-stroke emulation system, code editing application, claims processing policies & procedures, and unique benefits/processing rules for self-funded, Medicare, MEWA, Marketplace and fully-insured plans. 5. Escalates questions or concerns to their mentor for evaluation and potential referral to the Claims Management staff for action plan and resolution 6. Meets or exceeds claims production and quality standards as established/communicated by Claims Management staff 7. Coordinates information and resolves service forms and other assignments promptly, in accordance with experience/capabilities. Handles special projects within timeframes established/assigned by supervisor 3. Other Skills, Competencies and Qualifications: a. Strong independent judgment and decision-making skills b. MS-windows based computer environment c. Medical terminology, CPT, HCPCs and ICD-10 knowledge d. Familiar with professional (CMS1500) and institutional (UB-04) claim types 4. Level of Physical Demands: a. Sit for prolonged periods of time b. Bend, stop and stretch c. Lift up to 20 pounds d. Manual dexterity to operate computer, phone and standard office machines Equal Opportunity Employer/Veterans/Disabled $19.23/hr - $23.08/hr The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical. Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits. * Basic Life and Accidental Death & Dismemberment (AD&D) * Supplemental Life and AD&D * Dependent Life Insurance * Short-Term and Long-Term Disability * Accident Insurance, Hospital Indemnity, and Critical Illness * Retirement Savings Plan * Flexible Spending Accounts - Healthcare and Dependent Care * Employee Assistance Program (EAP) * Identity Theft Protection * Pet Insurance * Education Assistance * Daily Pay

Planet Fitness CareersTeam Member Are you somebody that would love to work in a fun, positive, and energetic work environment? Do you like personal development? Do you want to better yourself? Is growing yourself each day important to you?Then this is the job for you. We take pride in providing a unique culture that truly cares about our people! We will give you the tools for success in and out of Planet Fitness!Role SummaryThe Team Member will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective members and guests.Essential Duties and Responsibilities Greet members, prospective members and guests, providing exceptional customer service. Handle all front desk related activities including: Answer phones in a friendly manner and assist callers with a variety of questions. Check members into the system. New member sign-up. Take prospective members on tours. Facilitate needed updates to member's accounts. Respond to member questions and concerns in a timely and professional manner and elevate to Assistant Manager or Manager as needed. Assist in maintaining the neatness and cleanliness of the club. Qualifications/Requirements Customer service background preferred. Basic computer proficiency. A passion for fitness and health. Upbeat and positive attitude! Punctuality and reliability is a must. Exceptional customer service skills; able to interact in a positive and professional way with members and co-workers, exceeding the member's expectations. Strong listener with the ability to empathize and problem solve. Demonstrate diplomacy in all interactions while using appropriate behavior and language. High School diploma/GED equivalent required. Must be 18 years of age or older. Team Member Benefits Free black card membership Mentorship Opportunities for advancement Ongoing leadership training Full time employee health insurance Physical Demands Continual standing and walking during shift. Continual talking in person or on the phone during shift. Must be able to occasionally lift up to 50 lbs. Will occasionally encounter toxic chemicals during shift. Compensation: $12.50 per hour JOIN THE CLUB. Enhancing people's lives with an affordable, high-quality fitness experience requires a team of inspiring, motivated and fun-loving go-getters. As one of the largest and fastest-growing franchisors and operators of fitness centers in the United States, Planet Fitness is just getting warmed up. We're continuously seeking top talent to join us in cultivating the Judgement Free Zone and shaping the future of our brand. With more than 2,000 locations in all 50 states, the District of Columbia, Puerto Rico, Canada, the Dominican Republic, Panama, Mexico and Australia, there's plenty of opportunity on our Planet and we are always looking for talented individuals to join our team! Our member mission says it best: our product is a tool, a means to an end; not a brand name or a mold maker, but a tool that can be used by anyone. To use our product, members need to feel inspired and motivated. That's where you come in. If you're looking for a place where you can make a difference in a customer's life, you've found it. Come to add your mojo to the Judgement Free Zone, but stay for the feeling that you're making a difference on our Planet. TO FIND YOUR PERFECT FIT, SEARCH FOR A CLUB OPPORTUNITY NEAR YOU. Employees at a franchise location are employed by the Franchisee and are not employees of PFHQ (the Franchisor). PFHQ neither dictates nor controls labor or employment matters for franchisees or their employees, and does not retain any reserved authority to control the terms and conditions of employment for franchisees or their employees. Each franchisee is responsible for ensuring compliance with local, state and federal law.

Transmission Construction Representative - $5K Sign-On Bonus - Electric Utilities - Transmission Line & Substation We are looking for a highly skilled and knowledgeable Transmission Construction Representative to oversee contractor performance and ensure compliance with contract terms for construction projects related to the owner's electric transmission system. This role will involve ensuring work is completed safely, on schedule, and design specifications, across a range of projects, from simple upgrades to the construction of new substations. Ensure contractors adhere to all contract requirements while performing construction on the electric transmission system. Monitor the safe completion of work, ensuring alignment with design specifications and safety standards. Manage a wide scope of projects, including substation upgrades and the construction of new substations. Proactively identify potential issues that could impact project success, such as design flaws, material shortages, contractor performance, access challenges, and customer concerns. Assist in resolving issues to maintain project timelines, quality, and safety standards. Apply expert knowledge of line, substation, and civil construction requirements, with a broad understanding of other transmission and distribution areas. Interpret engineering drawings and provide guidance for their application in construction. Ensure compliance with Owner construction standards and safety terms. Perform all duties independently, while demonstrating leadership and a high level of expertise. Mentor and train lower-level Transmission Construction Representatives (TCR), sharing best practices and ensuring the application of correct methods and processes. The successful candidate will demonstrate excellent problem-solving, communication, and leadership skills, making them an invaluable asset to our team and ensuring the smooth, compliant execution of key construction projects. Physical Demands and Work Environment 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 accommodation may be made to enable qualified individuals with disabilities to perform the essential functions. · The employee may be required to stand; reach with hands and arms, stoop and kneel · The employee may be subject to rough terrain and inclement weather · The employee may be required to sit or stand for long periods of time · The employee may be required to lift, carry, push, pull or move up to 50 pounds · The employee may be required to travel · The employee is frequently exposed to outside weather conditions including wet and/or humid conditions · This position may require working more than 40 hours per week Requirements Requirements Associate's degree in construction management or engineering is a plus 6+ years of relevant transmission line and substation work experience required Experience working in the utility industry is highly preferred Compliance management experience is a plus Proficient at using a computer, iPad and Microsoft Office products Good communication skills, both verbal and written Must have a valid driver's license Must currently be eligible to work in the United States without sponsorship About Think Power Solutions Think Power Solutions is a certified Great Place to Work company! This credential was earned based on extensive ratings provided by our employees in anonymous surveys conducted by the Great Place to Work organization - the global authority on workplace culture since 1992. Think Power Solutions is a leading tech-enabled infrastructure management solutions provider with highly skilled and dedicated consultants who clients entrust to manage their mission-critical infrastructure. Think Power Solutions was founded with the vision of providing exceptional client service influenced by modern technology to positively impact the utilities, telecom, and construction industries. Think Power Solutions exists to serve its clients, making every effort to understand their needs to produce a high-quality deliverable specifically tailored to meet custom requirements. Our client-centric philosophy, creative thinking, and innovative solutions, combined with stellar project execution attracts top industry talent. Think Power Solutions' culture enables its people to deliver industry leading services and products. Benefits · 401(k) with 3.5% company match · 100% employer paid employee-only medical plan · 100% company paid basic life insurance · 100% company-paid long-term disability · Optional vision and dental insurance · Optional short-term disability · 6 company-paid holidays · 10 days PTO · 5 days paid family leave · 6-weeks maternity leave paid at 100% · 1-week paternity leave paid at 100% · Infertility benefits up to $10,000 · Adoption assistance up to $5,000 Note to Recruiters, Placement Agencies, and Similar Organizations Think Power Solutions does not accept unsolicited resumes from agencies. Please do not forward unsolicited agency resumes to our jobs alias, website, or to any Think Power Solutions employee. Think Power Solutions will not pay fees to any third-party agency or firm and will not be responsible for any agency fees associated with unsolicited resumes. Unsolicited resumes received will be considered the property of Think Power Solutions and will be processed accordingly. EEO Statement Think Power Solutions provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, pregnancy or maternity, national origin, citizenship, genetic information, disability, protected veteran, gender identity, age or any other status protected by law. This policy applies to recruiting, hiring, transfers, promotions, terminations, compensation, benefits, and all other terms and conditions of employment. Think Power Solutions will not tolerate any unlawful discrimination towards, or harassment of applicants or employees, by anyone at Think Power Solutions, or anyone working on behalf of Think Power Solutions.

We are looking for an enthusiastic BDC representative to join our growing dealership's sales team. You will be responsible for coordinating all incoming requests made via telephone or online, searching for potential sales leads, booking appointments for the showroom, and acting as a first point of contact for our customers. This is a in-person position here at the dealership only. We offer training for qualified candidates. Experience is a plus, but not necessary. Responsibilities Include Answering incoming phone calls and online inquiries Documenting customers details and comments in our system Scheduling appointments for our sales staff and following up with any "no show" appointments Providing up to date product knowledge Maintaining contact with our customers via outbound texts, phone calls and emails Making customers aware of promotions BDC Requirements Maintain excellent attendance and work ethic Great verbal communication skills Highly organized and able to learn quickly Proficient with Windows, internet applications, and general computer skills Professional and personable demeanor We Offer 401k with employer match Paid vacation (full time only) Health insurance (full time only) Dental Insurance (full time only) Very casual dress code Hourly pay with bonus

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAs a Product Liability Litigation Adjuster, Risk Management, you will be responsible for managing lawsuits and overseeing outside counsel defending CVS in high exposure, product liability mass tort litigations and general liability cases filed throughout the United States. Responsibilities include:Developing relationships with internal colleagues for fact-finding and key litigation activities. Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. Managing all aspects of product liability mass tort litigations and complex general liability cases. Working with outside national counsel and sr. management to develop consistent litigation strategies applicable to mass tort cases filed across the country. Providing reporting to key internal stake holders on case developments and litigation trends for product liability mass torts and other cases. Managing large scale discovery investigations by working with internal custodians, outside counsel and vendors to develop comprehensive procedures for identifying, locating, preserving and producing corporate records. Analyzing case and internal materials and utilizing resources across CVS to discern key issues and identify the litigation strategy in every case assigned. Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working with and overseeing outside counsel. Participating in meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. Required Qualifications2+ years of legal experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. Juris Doctor degree from an ABA accredited university. Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. Preferred QualificationsExperience overseeing or defending product liability claims and litigation. Familiarity or experience with insurance and coverage issues related to litigated claims. Strong attention to detail and project management skills. Experience overseeing and answering written discovery. Ability to work independently and in an environment requiring teamwork and collaboration. Strong written and verbal communication skills. Demonstrated negotiation skills and ability. Ability to articulate and summarize cases with management in a concise, cogent manner. Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. 3-5 years of legal or claims experience. Familiarity with the rules and procedures applicable to mass tort litigations, class actions, and/or multidistrict litigations. Knowledge and experience navigating attorney-client privilege issues, corporate litigation holds, corporate witness depositions, and e-discovery. Ability to influence and work collaboratively with senior leaders, CVS' in-house legal counsel and outside counsel. Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new software programs and systems. Ability to positively and aggressively represent the company at mediation, arbitration and trial. Ability to navigate difficult situations and communicate effectively with both internal and external groups. Excellent organizational and time management skills and ability to handle a high volume of litigated claims. Experience with and understanding of legal documents (pleadings, discovery, motions and briefs). EducationVerifiable Juris Doctor degree Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/03/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

JOB RESPONSIBILITIES * Billing - Compile and prepare patient charges. Prepare invoices billings, UB-04 and 1500 claim forms to be sent to 3rd party payers for payment indicating individual line items for services and total costs. Review charges. Obtain and evaluate family, third party payers and agency resources for payment of charges. Managing patient billing and ensure procedures are billed according to contracts, transmit or mail all paper and claims, and review correspondence and follow up as needed. * Systems Support - Maintain and update departmental system, including templates, and payer and physician information. * Collaboration - Act as a preceptor for new employees. Perform specialty services functions. Act as a resource within the department/division. Provide instruction for performing non-routine functions. Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patent Financial Services and other Cincinnati Children's departments. * Financial Support - Obtain and evaluate family, third party payers and agency resources for payment of charges. Counsel patient on third party coverage and present financial aspects. Determine eligibility for State Medicaid, Social Security and other outside funding. Complete necessary paperwork for eligible patients, including medical and financial applications. Coordinate inpatient and outpatient admissions. Coordinate information with the inpatient and outpatient charge systems. Input charges and relative information. Manage accounts receivable data and collection information, ensure timeliness and accuracy. Research third party payers and community physician charges in order to maintain usual and customary as will as competitive charges. Check and update charge master. Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Children's Utilization Review department. Process, post, and balance payments to accounts timely, accurately, and in the correct period. * Quality - Provide Quality Assurance reports for the division. JOB QUALIFICATIONS * High school diploma or equivalent * 2+ years of work experience in a related job discipline Primary Location South Campus Schedule Full time Shift Day (United States of America) Department Professional Billing Operation Employee Status Regular FTE 1 Weekly Hours 40 * Expected Starting Pay Range * Annualized pay may vary based on FTE status $18.16 - $22.25 Market Leading Benefits Including*: * Medical coverage starting day one of employment. View employee benefits here. * Competitive retirement plans * Tuition reimbursement for continuing education * Expansive employee discount programs through our many community partners * Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions * Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group * Physical and mental health wellness programs * Relocation assistance available for qualified positions * Benefits may vary based on FTE Status and Position Type About Us At Cincinnati Children's, we come to work with one goal: to make children's health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children's. Cincinnati Children's is: * Recognized by U.S. News & World Report as a top 10 best Children's Hospitals in the nation for more than 15 years * Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding * Recognized as one of America's Best Large Employers (2025), America's Best Employers for New Grads (2025) * One of the nation's America's Most Innovative Companies as noted by Fortune * Consistently certified as great place to work * A Leading Disability Employer as noted by the National Organization on Disability * Magnet designated for the fourth consecutive time by the American Nurses Credentialing Center (ANCC) We Embrace Innovation-Together. We believe in empowering our teams with the tools that help us work smarter and care better. That's why we support the responsible use of artificial intelligence. By encouraging innovation, we're creating space for new ideas, better outcomes, and a stronger future-for all of us. Comprehensive job description provided upon request. Cincinnati Children's is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability