Claims representative jobs in Orem, UT

Job description Responsible for the investigation, negotiation and resolution of property loss claims. This includes assessing damages and writing the estimate of repairs or replacement using Xactimate. Responsible for documenting and organizing claim records to support payment. Must apply the appropriate policy coverage and legal analysis for payment of claims.As an exempt employee, this position is paid to get the job done, which may mean additional hours will need to be worked, depending on the circumstances.The employee customarily and regularly exercises independent judgment and discretion. Essential Job Functions and basic duties:1. Maintains high standards for customer service relations. This includes prompt contact and follow up to resolve claim issues as well as actively pursuing claim investigation to reach an expedient resolution.2. Conducts a thorough investigation of coverage, liability and damages. Must maintain supporting evidence for payment or denial.3. Inspection and documentation of damages. This may include photos, inventories, scope of damage, diagrams, etc.4. Coordinates repairs or replacement of damaged property, temporary housing, emergency restoration and contents replacement.5. Negotiates claim to a fair resolution.6. Responsible for conducting risk analysis for home safety standards in a report form.7. Prepares cost estimator to establish insurance to value.8. Maintains an adequate claim reserve for anticipated loss and claim expense payments.9. Responsible for managing costs in association with all aspects of recovery (subrogation, salvage and reinsurance), as well as loss adjustment expenses. Qualifications:Education/Certification: College degree or equivalent training.Required Knowledge:Working knowledge of auto & property damage estimating.Working knowledge of computer related applications.Working knowledge of Home & Auto construction.Understanding of Insurance policy contracts and coverage.Understanding of the Utah Unfair Claim Practices Act. Experience Required:3+ years prior claims handling or damage repair experience.2+ years prior property loss estimating. Skills/Abilities:Excellent communication and public relations skills.Well organized and attentive to detail.Excellent negotiation skills.Strong computer skills.Ability to resolve conflict amicably.Clean driving record.Job Type: Full-time Pay: $70,000.00 - $95,000.00 per year Benefits:Bear River Mutual offers impressive benefits including: 120 hours of PTO for first-year employees, profit sharing up to 8%, a pension after five years of employment, medical and dental plans, HSA employee contributions, company 401k match up to 4%, and a hybrid work schedule. Pays $50,000 - $70,000 based on experience. About Bear River MutualBear River Mutual, established in 1909, is Utah's oldest and largest personal lines property and casualty insurance company headquartered in Murray, Utah. The company's dedication to the Utah market and focus on high-level service have created loyal customers for over 100 years. Bear River Mutual has been recognized for its success and named one of Utah's Best Companies to Work for by Utah Business Magazine. E04JI802mmr3407b752

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

Looking for a skilled and motivated Commercial Property Claims Adjuster to join a growing team. This is an excellent opportunity for an experienced professional to handle large-loss commercial property claims while contributing to a collaborative and dynamic work environment. Compensation Package Salary Range: $80,000 - $115,000 annually Competitive benefits package, 401(k), paid time off, professional development opportunities, etc. Responsibilities Adjust large-loss commercial property claims, including those involving fires, hail, floods, and water damage. Estimate commercial property building damages using the Symbility estimating system (candidates with Xactimate experience will also be considered). Interpret and apply coverage policies to claims. Handle approximately 2-3 new claims per week. Collaborate with other departments to ensure efficient claims processing. Qualifications/Requirements Prior experience handling large-loss commercial property claims. Familiarity with coverage interpretation and claims settlement processes. Experience with Symbility or Xactimate estimating systems. Claims-related certifications are a plus. Strong analytical, communication, and organizational skills. Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion. #LI-MM10

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.

Extraordinary opportunity. Exceptional experience. Sometimes in life, you find yourself in the right place, at the right time, looking at an opportunity so extraordinary it cannot be ignored. At Trucordia, our company is built on wildly successful businesses in our communities across the country, and now we've come together to create the next great insurance brokerage. We offer an unrivaled combination of people, tools and solutions, and deliver exceptional experiences and opportunities for our employees, clients and stakeholders. We celebrate both individual successes and collective accomplishments, making sure the industry recognizes the remarkable company we're building together, as well as the impact we're having on our clients and communities. Ranked as one of the fastest-growing companies in the U.S. for three consecutive years, we have more than 5,000 team members across 200 offices across the country, who actively, genuinely care about our clients, each other and the quality of our work, and in every interaction, represent a company that people want to work for and do business with. Trucordia Values We actively, genuinely CARE about our clients, each other and the quality of our work, and in every interaction, represent a company that people want to work for and do business with. We COLLABORATE continuously because, together, we are more powerful and make amazing things happen for our clients and company. We LEAD with intelligence, hunger, curiosity, energy and a future-focused attitude of “what's next”? We are RESULT-ORIENTED , growth-focused and driven to out-perform expectations of what an insurance brokerage can achieve. We CELEBRATE both individual successes and collective accomplishments, making sure the industry recognizes the remarkable company we're building together, as well as the impact we're having on our clients and communities. Job Description We are seeking a detail-oriented and customer service driven individual to join our claims team. In this role, you will conduct coverage investigations, investigate the factual details of auto losses, evaluate and resolve physical damage claims and settle bodily injury claims by working closely with insureds, claimants, auto repair facilities, rental car agencies, other insurance carriers, legal teams, and other people incident to the investigation and processing of claims. The ideal candidate will bring optimism to our team, possess strong organization and customer service skills, have a strong desire to help others, have the ability to manage multiple concurrent tasks effectively, and have the desire and capability of complying with internal expectations and statutory mandates. Duties and Responsibilities: Manage a diverse inventory of commercial and personal lines auto claims. Analyze, review, and interpret policies to determine if coverage applies. Investigate, assess liability, and assign liability/fault. Negotiate physical damage settlements with insureds, claimants, attorneys, and repair facilities. Maintain accurate and detailed records of all communications, investigations, and decisions related to the claim. Ensure all physical damage and bodily injury claims are handled in accordance with company policies, industry standards, and regulatory requirements. Provide timely and professional updates to claimants and other stakeholders regarding the status of claims. Assist claimants with inquiries and guide them through the claims process. Investigate and evaluate bodily injury claims by reviewing medical records, police reports, statements, and other relevant documents. Qualifications Bachelors Degree is preferred At least one year of prior casualty claim handing is preferred At least 3 years of customer service experience is required Excellent organizational skills Ability to effectively communicate verbally and in written form Ability to work in an independent and team based environment Ability to learn quickly and work at a fast pace independently Technical proficiency in Microsoft suite tools, including data manipulation in Excel. Must be reliable Ability to fluently communicate in English and Spanish is a major plus Additional Information Please see our company Benefits: Medical, Dental, Vision Life and AD&D insurance FSA / HSA Commuter & Child Care FSA Cancer Support Benefits Pet Insurance Accident & Critical Illness Hospital Indemnity Employee Assistance Program (EAP) 11 Paid Holidays Flexible PTO 401K Trucordia is an equal opportunity employer. We believe that every employee has the right to work in an environment that is free from all forms of discrimination. It is our policy that all decisions involving any aspect of the employment relationship such as hiring, compensation and training, promotions, transfers, discipline, and termination will be based on merit, qualifications, and abilities. Such decisions will be made without regard to age, ancestry, color, race, national origin, disability, protected medical condition, genetic information, military service, veteran status, citizenship status, religion, creed, sex, gender, gender identity, sexual orientation, pregnancy, childbirth, marital status, or any other condition, characteristic or activity protected by law. Discrimination based on any of these factors is contrary to our operating philosophy. Attention Recruitment Agencies: Trucordia does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered property of Trucordia, and we will not be obligated to pay a referral fee. This includes resumes submitted directly to hiring managers without contacting Trucordia's Talent Acquisition Department.

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.

At Collective Health, we're transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design. The Analytics team is a data-driven team focused on unlocking insights that improve member outcomes and drive business performance. Our team sits at the intersection of data, strategy, and execution. The Analytics team reports directly to the Vice President, Data Engineering, Analytics, and AI in Product Development. In this role, you will help with standardizing and scaling all of the analytics deliverables which include reporting and self-serve dashboards leveraging data from claims, eligibility, population health, customer engagement, and digital platforms. You will collaborate across departments, mentor junior analysts, and work directly with business stakeholders and present meaningful insights to clients. If you're passionate about using data to make a meaningful impact in healthcare, you'll find a home here. What you'll do: Design, build, and deliver sophisticated analyses focusing on core metrics from various domains such as claims, eligibility, customer experience, digital engagement, and the complete member journey. Translate business questions into analytic plans and communicate results in a clear, actionable manner to both technical and non-technical audiences. Design logical categorizations for dashboards and views, building scalable and automated reports in Looker and other BI tools to provide self-service insights to the business. Support internal stakeholders (e.g., Product, Customer Success, Marketing, etc.) by generating insights that inform strategy and operational improvements. Proactively identify and execute opportunities to build automated reports and analytical processes, reducing manual effort and increasing reliability. Provide technical mentorship and peer review, including refactoring and optimizing complex code for existing reports to improve performance and scalability. Work closely with the Data Architect and engineering teams to help build and refine the semantic layer, ensuring data models are optimized for analytical use. To be successful in this role, you'll need: A minimum of 5+ years in data analytics, ideally within a related healthcare or health tech field. Requires a track record of success in a high-velocity environment and a strong technical aptitude for simplifying and scaling complex data assets to support long-term standardization. Proven ability to work with complex, large-scale datasets from disparate silos, with a deep focus on healthcare data. Strong SQL skills with a track record of writing efficient, scalable queries for analysis and reporting. To be technically savvy with modern data tools. This includes advanced SQL, hands-on experience with cloud data platforms like Databricks, and expert-level proficiency in BI tools, especially Looker. Demonstrated project management skills, with the ability to prioritize tasks, manage timelines, and drive cross-functional collaboration. Strong communication skills, with the ability to translate technical findings into clear, actionable recommendations for non-technical stakeholders. To champion data governance and quality by conducting audits and validation. This includes the ability to pull and interpret data from EDI files to support claims audits and analysis. A strong functional understanding of the claims adjudication process, from submission to payment. To be self-sufficient, intellectually curious and take ownership for everything you do. Pay Transparency Statement This is a hybrid position based out of one of our offices: San Francisco, CA, Plano, TX, or Lehi, UT. Hybrid employees are expected to be in the office two days per week.#LI-hybrid The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the salary, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at ******************************************** San Francisco, CA Pay Range$120,000-$150,500 USDLehi, UT Pay Range$96,300-$120,500 USDPlano, TX Pay Range$105,575-$132,550 USDWhy Join Us? Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare Impactful projects that shape the future of our organization Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests Flexible work arrangements and a supportive work-life balance We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact recruiting-accommodations@collectivehealth.com. Privacy Notice For more information about why we need your data and how we use it, please see our privacy policy: *********************************************

About Specialty Program Group: Specialty Program Group (SPG) is the wholesale & MGA division of HUB International. SPG acts in a holding company capacity acquiring best-in-class underwriting businesses to operate independently under discrete brands (portfolio companies). About ANOVA Marine: ANOVA is a premier provider of first-class Cargo and Logistics Insurance, Liability Insurance, and Bonds for freight forwarders, NVOCC's, shipping lines, customs brokers, and international trading companies. Right from the outset in 2011, our aim was to create a smarter, more agile experience for our clients. That includes superior cargo insurance coverage designed by freight forwarders and transport-industry attorneys; technology that simplifies quotes and speeds up coverage; and experienced claims people who understand the challenges our clients face, with the authority to settle fast. About ANOVA Personal Effects: In addition to our core logistics offerings, ANOVA provides specialized Personal Effects and Household Goods insurance solutions, supporting storage partners, and individuals navigating domestic and international relocations. Our Personal Effects claims team plays a critical role in delivering compassionate, accurate, and efficient resolutions for customers during stressful transitions. Summary of the Role: The Personal Effects Claims Specialist is a key member of ANOVA's Claims Department, responsible for managing the full lifecycle of household-goods and personal-effects claims. This role requires a balance of technical coverage analysis, strong customer communication, and disciplined claim-handling practices. Responsibilities: Investigation & Evaluation: Conduct thorough investigations of claims arising from the transit or storage of household goods and personal effects, including domestic moves, international shipments, and storage. Coverage & Liability Analysis: Review and interpret applicable policy forms, apply provisions to factual scenarios, and determine coverage and liability. Valuation & Settlement: Assess the value of lost or damaged items and negotiate fair, accurate settlements consistent with ANOVA guidelines. Customer Advocacy & Communication: Communicate clearly, empathetically, and proactively with insureds. Documentation & Compliance: Maintain meticulous and timely claim documentation following internal controls and regulatory standards. Stakeholder Collaboration: Work closely with internal departments, surveyors, adjusters, and brokers. Qualifications: 5+ years of experience as a Claims Adjuster preferred. Experience in P&C, Inland Marine, or Household Goods/Moving claims preferred. Strong analytical and communication skills. Customer-focused mindset. Ability to manage high-volume claims. Proficiency with claims systems and Google Workspace. Adjuster license(s) or willingness to obtain. Salary Transparency: Disclosure required under applicable law in California, Colorado, Illinois, Maryland, Minnesota, New York, New Jersey, and Washington states: The expected salary range for this position is $70,000-$75,000 and will be impacted by factors such as the successful candidate's skills, experience and working location, as well as the specific position's business line, scope and level. HUB International is proud to offer comprehensive benefit and total compensation packages: health/dental/vision/life/disability insurance, FSA, HSA and 401(k) accounts, paid-time-off benefits such as vacation, sick, and personal days, and eligible bonuses, equity and commissions for some positions. Compensation may vary based on experience, skillset, and location. Eligible employees may also receive benefits including health/dental/vision/life/disability insurance, FSA/HSA, 401(k), PTO, and incentives. #SPG Department Claims ManagementRequired Experience: 5-7 years of relevant experience Required Travel: NegligibleRequired Education: High school or equivalent HUB International Limited is an equal opportunity employer that does not discriminate on the basis of race/ethnicity, national origin, religion, age, color, sex, sexual orientation, gender identity, disability or veteran's status, or any other characteristic protected by local, state or federal laws, rules or regulations. E-Verify Program We endeavor to make this website accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the recruiting team **********************************. This contact information is for accommodation requests only; do not use this contact information to inquire about the status of applications.

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. **Essential Job Duties** - Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. - Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. - Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. - Assists with reducing rework by identifying and remediating claims processing issues. - Locates and interprets claims-related regulatory and contractual requirements. - Tailors existing reports and/or available data to meet the needs of claims projects. - Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. - Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. - Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. - Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. - Works collaboratively with internal/external stakeholders to define claims requirements. - Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. - Fields claims questions from the operations team. - Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. - Appropriately conveys claims-related information and tailors communication based on targeted audiences. - Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. - Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. - Supports claims department initiatives to improve overall claims function efficiency. **Required Qualifications** - At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. - Medical claims processing experience across multiple states, markets, and claim types. - Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. - Data research and analysis skills. - Organizational skills and attention to detail. - Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Ability to work cross-collaboratively in a highly matrixed organization. - Customer service skills. - Effective verbal and written communication skills. - Microsoft Office suite (including Excel), and applicable software programs proficiency. **Preferred Qualifications** - Health care claims analysis experience. - Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $46.42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

AmTrust is actively seeking a skilled Resolution Examiner specializing in Workers' Compensation Claims. The primary focus will be on negotiating and settling claims efficiently and at a cost effective value. In this role, you will be entrusted with the independent review and resolution of workers' compensation claims; utilizing your expertise in negotiation and settlement strategies to bring claims to resolution posture. Your ability to effectively interact with insureds, claimants, and their legal representatives will be essential in driving timely settlements while adhering to AmTrust's mission, vision, and values. Responsibilities Proactively negotiate settlements for workers' compensation claims, ensuring fair and expedient resolutions that meet the needs of all parties involved. Conduct thorough investigations by engaging with insured representatives, claimants, and witnesses to gather critical information that supports settlement discussions. Analyze coverage issues and the applicability of benefits under relevant policies and statutes to facilitate informed negotiation outcomes. Establish and adjust reserves based on projected claim outcomes, ensuring alignment with corporate standards and settlement strategies. Collaborate closely with internal Managed Care and Medical resources to ensure that treatment plans and billing are managed effectively during the settlement process. Collect and evaluate essential documentation, including medical records and incident reports, to strengthen negotiation positions and expedite settlements. Utilize critical thinking and decision-making skills to assess claims and develop effective negotiation tactics aimed at achieving optimal settlement outcomes. Maintain clear, concise, and factual documentation in claims files and communications, supporting transparency throughout the settlement process. Manage time effectively, prioritizing negotiations and settlements in a fast-paced environment to meet deadlines and client expectations. Build and maintain strong relationships with customers, fostering their trust and confidence throughout the claims settlement process. Unique Responsibilities: Conduct compensability analysis based on AOE/COE investigations to identify valid claims and streamline settlement negotiations. Verify the nature and extent of injuries, adapting settlement strategies based on changes in claim exposure. Leverage a high level of technical knowledge in workers' compensation claims to facilitate effective and timely settlements. Exhibit exceptional communication skills, both written and oral, to professionally engage with all stakeholders involved in the claims process. Adapt to changing circumstances and priorities, demonstrating flexibility in negotiations to achieve the best outcomes. Qualifications Bachelor's degree or equivalent experience. Minimum of 3 years of experience in handling and settling workers' compensation claims. Preferred experience in negotiating litigated or complex claims. State licensure as required. Proficiency with MS Office Suite and claims management software. Strong negotiation, investigation, and evaluation skills specific to workers' compensation claims. In-depth knowledge of workers' compensation laws and insurance practices. Ability to travel, as required for some positions. Preferred Qualifications: Multijurisdictional experience may be required. CPCU, ARM, AIC, or other relevant claims certifications are preferred. Join Us: If you are a dedicated claims adjuster with a strong focus on settlements and a passion for achieving optimal resolutions in workers' compensation claims, we invite you to apply today. Become an integral part of AmTrust's commitment to excellence in claims management! The expected salary range for this role is $44/hr-$59.50/hr Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations What We Offer AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off. AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future. Not ready to apply? Connect with us for general consideration.

Are cars your obsession? Have you turned wrenches as a profession or as a hobby? Are you looking to get off the floor and into an office setting? If you know engines like the back of your hand - we need your expertise - Let's talk! We offer a fantastic company culture that will foster your professional training and growth - our people come before profits ! If that isn't enough, you'll also get: Competitive pay - Base of $20-$22.25/hr. (doe) + $1/hr. for bilingual Spanish/English language skills! Up to $4/hr. more for certain active ASE Certifications! Up to $400 monthly performance bonus! $500 sign-on bonus after 6-months! Full benefits package (Medical, Dental, Vision, 401k, etc) with generous company contributions Paid Time Off and Paid Holidays Tuition Assistance from day one Monday-Friday schedules - NO WEEKENDS A state-of-the-art office building with awesome perks Onsite fitness center Basketball court Game room with bowling alley Ergonomic Workstations Here's what you'll do: As Alpha Warranty's Claims Adjuster L1 Repair Specialist, you will use your automotive knowledge to work directly with repair shops across the United States throughout the mechanical repair claim process. You communicate with the shops by phone and email to ensure a complete understanding of the necessary car repair and if it can be covered under the customer's service contract, while accurately typing notes of the claim in our system. With every interaction we work to provide accurate and efficient claim decisions for our customers, regardless of how complicated the repair may be. Don't worry, we have Sr. Claims Adjusters to handle the complex and high-dollar repair claims. A veteran owned business since 2002, Alpha Warranty Services is a multi-award-winning, nationally recognized Vehicle Service Contract (VSC) provider. At Alpha Warranty, you'll have the opportunity to connect and collaborate with members of our awesome team for success in your job responsibilities, which, in addition to what we've described above, also include: Documenting all claim details and decisions using our internal systems, including requesting approved claim payments Collaborating with repair shops to address claim needs such as part orders, inspections, and communicating final claim decisions Providing meaningful and innovative solutions to challenging problems, whenever possible Other responsibilities and projects as assigned by your manager What you need for success: Vehicle repair experience, knowledge, and/or interest is a huge plus, but not required Some customer service experience is required Call center experience is strongly preferred, but not required Clear and professional verbal and written English communication skills - bilingual Spanish/English skills are highly valued and paid more, but not required Comfortable navigating current technology such as computers, phones, internet, and various software Accurate typing skills with a speed of at least 30+ WPM Ability to successfully collaborate, problem solve, and listen, with a great attention to details Capacity to embrace change and new opportunities as we continue to grow High school diploma or GED equivalent is required Here's a few more perks: An exceptionally supportive company culture that places people over profit. Fair and competitive compensation. Health insurance options with generous company contributions. Dental and Vision coverage. Life and Disability insurance (100% company paid + options for more!) Competitive 401K matching. Paid Time Off (PTO) and Paid Holidays. Paid Volunteerism Time Off (VTO) to support your community. Legal and Pet insurance options. Free Roadside Assistance for your personal vehicle. Tuition Assistance Program with immediate eligibility. Ongoing professional training and development. Employee incentive and recognition programs About Alpha Warranty Services: Alpha Warranty Services provides a full line of unique and useful vehicle protection products and services. Founded in 2002 on a value system of integrity, dependability, and providing the best service, Alpha Warranty has enjoyed consistent growth and helped forge long-term partnerships with industry-leading auto dealerships across the country. The company takes pride in creating quality product and service innovations and fostering employee development. Because of this, Alpha has received recognition from multiple organizations including the MWCN Utah 100 for Fastest Growing Company, the Salt Lake Tribune for being a Top Workplace, and the American Business Awards for Veteran-Owned Company of the Year. If you want a rewarding and challenging career where you can work hard and play hard, join the Alpha team today. Learn more about Alpha Warranty and our affiliated companies at ********************** *************** and ************************ U.S. EQUAL EMPLOYMENT OPPORTUNITY/AFFIRMATIVE ACTION INFORMATION Alpha Warranty Services is an equal opportunity employer. Individuals seeking employment are considered without regard to race, color, religion, national origin, age, sex/gender, sexual orientation, gender identity, ancestry, physical or mental disability, medical condition, genetic information/characteristics, military or veteran status and other basis protected by federal, state, or local law or ordinance or regulation. Reasonable accommodations will be provided to individuals with known disabilities in compliance with the Americans with Disabilities Act. For accommodation information or if you need special accommodations to complete the application process, contact the Human Resources Department at ************.

Join us as a Field Property Claims Adjuster where you'll be responsible for helping our customers navigate the claims process and get back on their feet following damage to the homeowner's property. This is a role where people who love every day to be new, different and exciting, can thrive - you'll be traveling on the road to meet customers in person, providing hands-on assessment of damage and empathetic support. The Field Property Claims Adjuster will be traveling locally to insured homes within Bountiful, UT (84010) and surrounding areas. To be successful within the role, candidates should live within or near this area. Sign-On Bonus Available! We're offering a sign-on bonus for experienced and actively licensed new hires. What you'll do * Investigate and evaluate onsite to resolve complex coverage and damage issues to include preparing complete estimates of repair for the covered damages. This may include accessing roofs by ladder, inspecting attics, crawl spaces and basements in search of damage. * Handle moderate to complex claims independently while managing your workload, from first notice of loss to final closure. * Be expected to work in a vehicle in the field daily while occasionally handling assignments from the desk. * Explain coverage of loss, assist policyholders with itemization of damages, emergency repairs and additional living arrangements. * Work with and coordinate a few vendor services such as contractors, emergency repair, cleaning services and various replacement services. * May be called upon for catastrophe duty. Position details * Territory-based work: Most workdays will be spent in the field within your assigned local territory, giving you the opportunity to work directly with customers and gain hands-on experience. * Training & support: To set you up for success, you'll participate in a comprehensive 5-month training program, which includes: * Primarily virtual and on-the-job learning. * Two short in-person training sessions (Weeks 4 and 7) at our Lewisville, TX office. * Limited overnight travel for training and team meetings (typically less than 10%). * Mileage Reimbursement: This role offers mileage reimbursement. You may qualify for a company-provided vehicle once mileage requirements are met. Additional details will be provided if you advance in the selection process. Qualifications * Working knowledge of claims handling procedures and operations. * Proven ability to provide exceptional customer service. * Effective negotiation skills. * Ability to effectively and independently manage workload while exhibiting good judgment. * Strong written/oral communication and interpersonal skills. * Computer skills with the ability to work with multi-faceted systems. * The capabilities, skills and knowledge required through a bachelor's degree or equivalent experience and at least 1 year of directly related experience. * Ability to obtain proper licensing as required. * The ability to handle multiple competing priorities and organize your day. * Strong time management and organizational skills. * Demonstrated understanding of building construction principles. 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

Job description Responsible for the investigation, negotiation and resolution of Property Loss claims. This includes review of written estimate of repairs or replacement using computerized estimating software. Responsible for documenting and organizing claim records to support payment. Must investigate and apply the appropriate policy coverage and legal analysis for payment of claims as well as third party liability. Projects the Company's professional image. As an exempt employee, this position is paid to get the job done, which may mean additional hours will need to be worked, depending on the circumstances. The employee customarily and regularly exercises independent judgment and discretion. Essential Job Functions and basic duties: Maintains high standards for customer service relations. This includes prompt contact and follow up to resolve claim issues as well as actively pursuing claim investigation to reach an expedient resolution. Conducts a thorough investigation of coverage, liability and damages. Must maintain supporting evidence for payment or denial. Audits mitigation and repair estimates with documentation of damages from the desk. This may include reviewing photos, inventories, scope of damage, diagrams, etc. Coordinates repairs or replacement of damaged property, temporary housing, emergency restoration and contents replacement. Negotiates claim to a fair resolution. Responsible for conducting risk analysis for home safety standards. Prepares cost estimator to establish insurance to value. Maintains an adequate claim reserve for anticipated loss and claim expense payments. Responsible for managing costs in association with all aspects of recovery (subro, salvage and reinsurance) as well as loss adjustment expenses. Understanding of and compliance with Utah Unfair Claim Practices Act. Manages claims involving Public Adjusters. Manages claims involving attorney repped clients and litigation. Manages claims of high complexity, involving high authority and loss costs. We will train candidates as needed. Other Job Functions: Occasional onsite damage assessment or accident scene investigations, including measurements, photographs and witness contact. Other duties as assigned. Qualifications: Education/Certification: College degree or equivalent training. Required Knowledge: Working knowledge of property damage estimating. Knowledge of computer related applications. Working knowledge of Home construction. Understanding of Insurance policy contracts and coverage. Understanding of the Utah Unfair Claim Practices Act. Experience Required: 5 years prior property claims handling experience. 2 years prior property loss estimating. Experience working with Public Adjusters and litigation experience is preferred. Skills/Abilities: Excellent communication and public relations skills. Well organized and attentive to detail. Excellent negotiation skills. Good computer skills. Ability to problem solve and resolve conflict amicably. Clean driving record. Benefits: Bear River Mutual offers impressive benefits including: 120 hours of PTO for first-year employees, profit sharing up to 8%, a pension after five years of employment, medical and dental plans, HSA employee contributions, company 401k match up to 4%, and a hybrid work schedule. Pays $45,000 - $70,000 based on experience. E04JI802mmr3407gy1t

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

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.

At Collective Health, we're transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design. Collective Health is growing its Member Services team in Lehi, Utah! As part of our Member Services team, each Member Claims Associate operates core processes to run our employer-sponsored medical plans and assists our members with some of their most complex claims issues. Member Claims Associates gain a comprehensive understanding of medical plan operations-processing medical claims, researching and responding to complicated member issues, and handling details related to regulatory requirements, our network partner relationships, and medical coding. Member Claims Associates do all this with the lens of continuing to delight our members as part of the Member Services Team. As a Member Claims Associate, you can expect to learn and become a professional in the payer-side of healthcare. With the support of our established and knowledgeable teams, you will be an important contributor to scaling our operations and collaborating on a growing team at the forefront of redefining the healthcare industry. Start Date and Training Hybrid Training (Tues/ Wed) and Hybrid Full Time work (2 days in office) Start date: February 9, 2026 You must be available for 4 weeks of required training beginning on the start date through Feb 9 - March 9. You will not be able to take time off during the training period. What you'll do: Execute the daily operations of a health plan, including processing medical claims, researching and responding to our members' most complicated questions, tracking your accuracy around core metrics, and troubleshooting the many operational challenges that affect our business Be part of the team that is continuously adapting to improve efficiency and scalability Think critically and strategically to continually boost teamwork and communication across offices Gain additional skills across different areas of our business over time Develop in-depth industry expertise in the healthcare economy Cultivate a culture that aligns with Collective Health values and incorporates the unique aspects of our team Reporting to the Manager of Member Claims, this is an essential role on our Customer Experience team To be successful in this role, you'll need: Above all, you are driven, curious, and take ownership for everything you do You can become proficient with a large volume of information quickly You are a committed team player You are excited to build and adapt to the adventures of working on a growing team You are passionate about being a part of a fast-growing company You have a passion for Collective Health's mission to transform the health insurance experience for employers and their employees Nice to have: Bachelor's degree or 1 or more years of work experience Pay Transparency Statement This is a hybrid position based out of our Lehi office, with the expectation of being in office at least two weekdays per week. #LI-hybrid The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the hourly rate, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at ******************************************** Lehi, UT Pay Range$21.50-$21.50 USDWhy Join Us? Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare Impactful projects that shape the future of our organization Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests Flexible work arrangements and a supportive work-life balance We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact recruiting-accommodations@collectivehealth.com. Privacy Notice For more information about why we need your data and how we use it, please see our privacy policy: *********************************************

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. **Essential Job Duties** - Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. - Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. - Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. - Assists with reducing rework by identifying and remediating claims processing issues. - Locates and interprets claims-related regulatory and contractual requirements. - Tailors existing reports and/or available data to meet the needs of claims projects. - Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. - Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. - Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. - Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. - Works collaboratively with internal/external stakeholders to define claims requirements. - Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. - Fields claims questions from the operations team. - Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. - Appropriately conveys claims-related information and tailors communication based on targeted audiences. - Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. - Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. - Supports claims department initiatives to improve overall claims function efficiency. **Required Qualifications** - At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. - Medical claims processing experience across multiple states, markets, and claim types. - Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. - Data research and analysis skills. - Organizational skills and attention to detail. - Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Ability to work cross-collaboratively in a highly matrixed organization. - Customer service skills. - Effective verbal and written communication skills. - Microsoft Office suite (including Excel), and applicable software programs proficiency. **Preferred Qualifications** - Health care claims analysis experience. - Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $46.42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Join us as a Field Property Claims Adjuster where you'll be responsible for helping our customers navigate the claims process and get back on their feet following damage to the homeowner's property. This is a role where people who love every day to be new, different and exciting, can thrive - you'll be traveling on the road to meet customers in person, providing hands-on assessment of damage and empathetic support. The Field Property Claims Adjuster will be traveling locally to insured homes within Bountiful, UT (84010) and surrounding areas. To be successful within the role, candidates should live within or near this area. Sign-On Bonus Available! We're offering a sign-on bonus for experienced and actively licensed new hires. What you'll do Investigate and evaluate onsite to resolve complex coverage and damage issues to include preparing complete estimates of repair for the covered damages. This may include accessing roofs by ladder, inspecting attics, crawl spaces and basements in search of damage. Handle moderate to complex claims independently while managing your workload, from first notice of loss to final closure. Be expected to work in a vehicle in the field daily while occasionally handling assignments from the desk. Explain coverage of loss, assist policyholders with itemization of damages, emergency repairs and additional living arrangements. Work with and coordinate a few vendor services such as contractors, emergency repair, cleaning services and various replacement services. May be called upon for catastrophe duty. Position details Territory-based work: Most workdays will be spent in the field within your assigned local territory, giving you the opportunity to work directly with customers and gain hands-on experience. Training & support: To set you up for success, you'll participate in a comprehensive 5-month training program, which includes: Primarily virtual and on-the-job learning. Two short in-person training sessions (Weeks 4 and 7) at our Lewisville, TX office. Limited overnight travel for training and team meetings (typically less than 10%). Mileage Reimbursement: This role offers mileage reimbursement. You may qualify for a company-provided vehicle once mileage requirements are met. Additional details will be provided if you advance in the selection process. Qualifications Working knowledge of claims handling procedures and operations. Proven ability to provide exceptional customer service. Effective negotiation skills. Ability to effectively and independently manage workload while exhibiting good judgment. Strong written/oral communication and interpersonal skills. Computer skills with the ability to work with multi-faceted systems. The capabilities, skills and knowledge required through a bachelor's degree or equivalent experience and at least 1 year of directly related experience. Ability to obtain proper licensing as required. The ability to handle multiple competing priorities and organize your day. Strong time management and organizational skills. Demonstrated understanding of building construction principles. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.