Claims representative jobs in Mesa, AZ

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

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

Advance your career at Liberty Mutual - A Fortune 100 Company! Manages, investigates and resolves claims assigned and assists in providing service to policyholders. Responsibilities: * Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. * Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. * Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports. * Ensures adequacy of reserves. * Accountable for security of financial processing of claims, as well as security information contained in claims files. * Makes effective use of loss management techniques. Negotiates settlements with attorneys, claimants, and/or co-defendants. Arranges for expert inspections involving third party or potential fraud actions as needed. * Updates files and provides comprehensive reports as required Qualifications Qualifications: * Strong written and oral communications skills required. * Good interpersonal, analytical, investigative, and negotiation skills required. * Customer service experience preferred. * Basic knowledge of legal liability, general insurance policy coverage and State Tort Law. * Bachelor's degree is required. * Ability to obtain proper licensing as required. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

Company Details Berkley One is a modern insurance provider for a modern generation of affluence. We serve clients who live dynamic, adventurous lives and expect their insurance experience to match. Our mission is to deliver highly personalized risk and claims management through a blend of expert independent agents, cutting-edge digital tools, and the strength of the Berkley brand. Why Join Us? At Berkley One, you'll be part of a forward-thinking team that's reimagining personal insurance. We're building solutions that are as sophisticated and agile as the clients we serve-individuals and families who value innovation, simplicity, and exceptional service. You'll collaborate with passionate professionals, leverage modern technology, and help shape the future of our industry. What We Value A client-first mindset with a passion for delivering exceptional experiences Curiosity, creativity, and a drive to challenge the status quo Collaboration across disciplines to build smarter, more intuitive solutions Integrity, expertise, and a commitment to excellence Join us in creating a new standard in personal insurance-where protection meets possibility. This role will be based in our Phoenix, AZ or Wilmington, DE office. We offer a hybrid work schedule with 4 days in the office; and 1 day remote where it makes sense to do so. #LI-AV1 #LI-HYBRID The Company is an equal employment opportunity employer. Responsibilities The Casualty Claims Adjuster is a key contributor to the Berkley One brand. The position requires Liability, Injury and Auto Physical Damage claim technical, organizational and time management skills, along with self-direction and exceptional customer service. This position is responsible for quality, timely handling and resolution of moderately complex claims in a professional manner. What you can expect: Culture of innovation, teamwork, supportive colleagues and leaders willing to invest in talent Internal mobility opportunities Visibility to senior leaders and partnership with cross functional teams Opportunity to impact change Benefits - competitive compensation, paid time off, comprehensive wellness benefits and programs, employer funded health savings account, profit sharing, 401k, paid parental leave, employee stock purchase plan, tuition assistance and professional continuing education We'll count on you to: Handle first and third-party personal lines auto, homeowner liability, bodily injury, first party medical/PIP, and auto physical damage claims of moderate complexity. Appropriately manage claims through coverage analysis, investigation, reserving and resolution Identify and address coverage issues, complete investigation to determine cause & exposure, set timely reserves and develop detailed action plans Negotiate claim settlements with attorneys and unrepresented claimants Establish validity of claims submitted for payment through coverage research and contact with policyholders, claimants and outside parties Research and locate additional information and documentation to investigate, evaluate and properly resolve claims Write denial letters, reservation of rights, coverage disclaimers and other correspondence Work with defense counsel and coverage counsel as needed. Maintain an effective diary system and document claim file activities in accordance with established procedures Pro-actively manage file inventory to ensure timely resolution of cases Deliver exceptional customer service to meet the needs of the insured, agent and all internal and external customers Perform administrative functions such as expense accounts and time off reporting as required Qualifications Bachelors degree or equivalent work experience Minimum 3 years of experience handling injury insurance claims with an emphasis in working with High Net Worth customers and experience with automated claims systems You will also actively participate on CAT duty when needed Broad knowledge of auto, bodily injury, UM/UIM, and first party injury claims. Agile learner who can quickly absorb information and apply it to current business situations. Incredible empathy and understanding of the needs of customers, both insureds and their agents alike. You will be an excellent, pro-active advocate for Berkley One customers and are passionate about their brand experience Exceptional oral and written communication skills. Your communication style is flexible to the situation. You communicate clearly and with a purpose Calm under pressure. You have excellent organizational and negotiation skills, integrity, and great follow-through on tasks. You are comfortable challenging norms while working collaboratively with colleagues at all levels of the organization You have a strong sense of accountability, fun and adventure Natural curiosity. You love learning how things work and you are always looking for innovative improvements Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details Sponsorship not Offered for this Role

Requirements What You Bring to the Team by Way of Skills and Experience: Bachelor's degree required in Business, Risk Management, or related field. Minimum 5+ years of experience in auto estimating and claims management. Valid driver's license and current auto insurance preferred. Professional appraisal or adjuster licenses preferred. Strong knowledge of auto damage estimating, freight/cargo claims processes, and insurance policy structures. Knowledge of FMCSA/DOT regulations, multi-jurisdictional claims practices, Carmack Amendment principles, and carrier liability standards. Exceptional interpersonal, negotiation, communication, and organizational skills. Proven ability to work independently, prioritize competing demands, and resolve complex issues within deadlines. Strong business acumen and collaborative approach to working cross-functionally with internal teams and external vendors. Experience managing full claims lifecycle, coordinating with insurers and TPAs, and analyzing claims trends. Strong communication skills, integrity, and sound judgment with experience handling sensitive information and conducting investigations. Proficient in Microsoft Office Suite (Word, Excel, Outlook) and claims management systems/tools. Service-oriented mindset with a positive, proactive attitude. Travel Requirements: Occasional travel ( What is in it for You and Why you Should Apply: Market-competitive pay based on education, experience, and location. Highly competitive medical, dental, vision, Life w/ AD&D, Short-Term Disability insurance, Long-Term Disability insurance, pet insurance, identity theft protection, and a 401(k) retirement savings plan. Employee wellness program. Employee rewards, discounts, and recognition programs. Generous company-paid holidays (12 per year), vacation, and sick time. Paid paternity/maternity leave. Monthly connectivity/home office stipend if working from home 5 days a week. A supportive and positive space for you to grow and expand your career. Pay Range Disclosure: The advertised range represents the expected pay range for this position at the time of posting based on education, experience, skills, location, and other factors. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. RunBuggy is an equal-opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination, harassment, and retaliation on the basis of race, color, religion, sex (including gender identity and sexual orientation), pregnancy, parental status, national origin, age, disability, genetic information, or any other status protected under federal, state, or local law. Salary Description $65k - $85k, DOE and location

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

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

At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.

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.

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

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

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

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

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

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

The Claims department within IAT has an immediate opening for a Homeowner's Claims Specialist that can be located in one of the following locations: Raleigh, North Carolina Scottsdale, Arizona Alpharetta, Georgia Spring, Texas Virginia Beach, Virginia Omaha, Nebraska This role works a hybrid schedule from an IAT Office in Scottsdale, AZ, or Alpharetta, GA, or Raleigh, NC, or Spring, Texas or Virginia Beach, Virginia, or Omaha, NE. The hybrid schedule reflects our values (thinking and acting like an owner, collaboration, and teamwork) as it requires working from the office with colleagues and other disciplines Monday through Wednesday, with the option of working Thursday and Friday remotely. Responsibilities: Handles claims, moderate to severe in scope, relative to homeowner's property based on Claim Guidelines. Perform CAT duty as needed that will require occasionally working weekend hours, overnight hours, holiday hours (Federal and religious), etc. Follows standard practices and procedures in analyzing situations or data where answers can be readily obtained. Verifies/analyzes applicable coverage for the reported loss. Establishes 24-hour contact and maintain appropriate contact with all involved stakeholders throughout the life of the claim file. Investigates each claim by gathering information, conducting interviews, taking statements, conducting website research as needed, reviewing and analyzing reports and related bills. Identifies and addresses subrogation/contribution/SIU opportunities. Sets accurate/timely loss/expense reserves in compliance with Claim Guidelines. Evaluates, negotiates, and authorizes settlements with all stakeholders within designated authority. Selects, directs and manages Vendors/Counsel including approval of defense budgets. Negotiates directly with claimants and claimant attorneys upon receipt of critical information. Drafts correspondence, including but not limited to, coverage letters to stakeholders as required. Maintains resident/nonresident adjuster licenses as required. Works on problems of limited scope. Follows standard practices and procedures in analyzing situations or data from which answers can be readily obtained. Perform other duties as needed Qualifications: Must-Have: HS degree/GED with 5+ years of relevant claims experience. Must be able to understand fire loss. Must be able to identify and investigate subrogation potential of a claims. Must have the ability draft appropriate and professional correspondence. Must have good estimating skills and be proficient with Xactimate. Must have or be able to obtain licensure as required by respective state(s). Excellent oral and written communication skills. Ability to analyze date, utilize sound judgment to draw conclusion and make supported decisions. Knowledge of various property insurance coverages and forms. To qualify, applicants must be authorized to work in the United States and must not require VISA sponsorship, now or in the future, for employment purposes. Preferred to Have: Associate/Bachelors Degree CPCU and other insurance related studies Field adjusting experience Proficiency Cotality platform Our Culture IAT is the largest private, family-owned property and casualty insurer in the U.S. I nsurance A nswers T ogether is how we define IAT, in letter and in spirit. We work together to provide solutions for people and businesses. We collaborate internally and with our partners to provide the best possible insurance and surety options for our customers. At IAT, we're committed to driving and building an open and supportive culture for all. Our employees propel IAT forward - driving innovation, stable partnerships and growth. That's why we continue to build an engaging workplace culture to attract and retain the best talent. We offer comprehensive benefits like: 26 PTO Days (Entry Level) + 12 Company Holidays = 38 Paid Days Off 7% 401(k) Company Match and additional Profit Sharing Hybrid work environment Numerous training and development opportunities to assist you in furthering your career Healthcare and Wellness Programs Opportunity to earn performance-based bonuses College Loan Assistance Support Plan Educational Assistance Program Mentorship Program Dress for Your Day Policy All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We maintain a drug-free workplace and participate in E-Verify.

Established in 2021, Independence Pet Holdings is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America. We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands. Job Summary: Pets Best is seeking a Claims Processing Specialist who will report to the Manager, Claims. Claims Processing Specialists are responsible for reviewing invoices and pet medical documents and determining coverage in compliance with the current Underwriter's policy. Job Location: Remote - USA Main Responsibilities: Review individual policies to make an eligibility determination with high degree of accuracy Contact with internal departments as well as veterinarians and clinic staff Ensure compliance guidelines are met with both internal policies and procedures and contractual commitments Work independently and with others on a virtual team Drive a “Great Place to Work” culture, attend and participate in team meetings as well as engagement events Use PC based programs to enter data into claims system, communicate with leaders and teammates, and organize information Create and issue claim decisions to pet parents using proper spelling, grammar, and punctuation in line with the policy terms Calculate invoice totals, discounts, and tax rates Perform other duties and/or special projects as assigned Basic Qualifications: High school diploma or equivalent 3+ years recent clinical veterinary experience (dog and cat) as a veterinary assistant, veterinary technician or veterinarian Knowledge of veterinary terms, abbreviations and conditions. Knowledge of medical conditions and associated symptoms, procedures, treatments, secondary conditions and pharmaceuticals used in veterinary medicine Knowledge of canine and feline breeds, anatomy and associated predispositions to illness. Ability to read and interpret medical diagnoses via medical records review both written and digital. Ability to work cross functionally with our internal and external resources Ability to handle multiple projects concurrently Ability to navigate Windows OS, Google Chrome, and corresponding applications Demonstrable Microsoft Office proficiency: Word, PowerPoint, Excel, Outlook, Teams Strong writing skills: organization, spelling, grammar and punctuation Strong mathematical and problem-solving skills #LI-Remote #LI-PetsBest All of our jobs come with great benefits including healthcare, parental leave and opportunities for career advancements. Some offerings are dependent upon the location of where you work and can include the following: Comprehensive full medical, dental and vision Insurance Basic Life Insurance at no cost to the employee Company paid short-term and long-term disability 12 weeks of 100% paid Parental Leave Health Savings Account (HSA) Flexible Spending Accounts (FSA) Retirement savings plan Personal Paid Time Off Paid holidays and company-wide Wellness Day off Paid time off to volunteer at nonprofit organizations Pet friendly office environment Commuter Benefits Group Pet Insurance On the job training and skills development Employee Assistance Program (EAP)

What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be an acknowledged technical expert and be responsible for the resolution of high complexity and high exposure Public Company D&O and Financial Institutions D&O and E&O claims. The position will have significant responsibility for decision making and work autonomously within their authority. Job Duties: * Confirms coverage of claims by reviewing policies and documents submitted in support of claims * Analyzes coverage and communicates coverage positions * Conducts, coordinates, and directs investigation into loss facts and extent of damages * Directs and monitors assignments to experts and outside counsel * Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure * Sets timely reserves within authority or makes claim recommendations concerning reserve changes to supervisor * Negotiates and settles claims either directly or indirectly * Prepares reports by collecting and summarizing information * Adheres to Fair Claims Practices regulations and internal Claims Quality Performance Objectives * Assists in training and mentoring of examiners * Serves as technical resource to subordinates and others in the organization. * Reviews and approves correspondence,s reports and authority requests as directed by supervisor * Participates in special projects or assists other team members as requested * Travel to meditations, trials, and conferences as required Education * Bachelor's degree or equivalent work experience * JD , advanced degree, or focused technical degree a plus Certification * Must have or be eligible to receive claims adjuster license. * Successful achievement of industry designations (INS, IEA, AIC, ARM, SCLA, CPCU, RPLU) or * I-Lead or other Management Training Work Experience * Public Company D&O, Financial Institutions D&O and E&O, Financial Advisors, and/or Management Liability Claims handling experience preferred. * Minimum of 10 years of claims handling experience or equivalent combination of education and experience Skill Sets * Excellent written and oral communication skills * Strong analytical and problem solving skills * Strong organization and time management skills * Ability to deliver outstanding customer service * Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word) * Ability to work in a team environment * Strong desire for continuous improvement US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The national average salary for the Executive Claims Specialist - Executive Liability is $97,520 - $134,090 with 25% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. * We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. * All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. * We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose 'Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: * All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. * All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.

Established in 2021, Independence Pet Holdings is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America. We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands. Pets Best, a subsidiary of IPH, is building a digital first pet e-commerce platform with the aim of connecting key market services such as adoption, lost pet and insurance to make pet care easy. Job Summary: Pets Best is seeking a Claims Processing Specialist who will report to the Supervisor, Claims. Claims Processing Specialists are responsible for reviewing invoices and pet medical documents and determining coverage in compliance with the current Underwriter's policy. Job Location: Remote - USA Main Responsibilities: Review individual policies to make an eligibility determination with high degree of accuracy Contact with internal departments as well as veterinarians and clinic staff Ensure compliance guidelines are met with both internal policies and procedures and contractual commitments Work independently and with others on a virtual team Drive a “Great Place to Work” culture, attend and participate in team meetings as well as engagement events Use PC based programs to enter data into claims system, communicate with leaders and teammates, and organize information Create and issue claim decisions to pet parents using proper spelling, grammar, and punctuation in line with the policy terms Calculate invoice totals, discounts, and tax rates Perform other duties and/or special projects as assigned Qualifications: High school diploma or equivalent 3+ years recent clinical veterinary experience (dog and cat) as a veterinary assistant, veterinary technician or veterinarian Knowledge of veterinary terms, abbreviations and conditions. Knowledge of medical conditions and associated symptoms, procedures, treatments, secondary conditions and pharmaceuticals used in veterinary medicine Knowledge of canine and feline breeds, anatomy and associated predispositions to illness. Ability to read and interpret medical diagnoses via medical records review both written and digital. Ability to work cross functionally with our internal and external resources Ability to handle multiple projects concurrently Ability to navigate Windows OS, Google Chrome, and corresponding applications Demonstrable Microsoft Office proficiency: Word, PowerPoint, Excel, Outlook, Teams Strong writing skills: organization, spelling, grammar and punctuation Strong mathematical and problem-solving skills #LI-Remote #petsbest All of our jobs come with great benefits including healthcare, parental leave and opportunities for career advancements. Some offerings are dependent upon the location of where you work and can include the following: Comprehensive full medical, dental and vision Insurance Basic Life Insurance at no cost to the employee Company paid short-term and long-term disability 12 weeks of 100% paid Parental Leave Health Savings Account (HSA) Flexible Spending Accounts (FSA) Retirement savings plan Personal Paid Time Off Paid holidays and company-wide Wellness Day off Paid time off to volunteer at nonprofit organizations Pet friendly office environment Commuter Benefits Group Pet Insurance On the job training and skills development Employee Assistance Program (EAP)