Claims representative jobs in Port Orange, FL - 68 jobs

Commercial Auto - Multi Line Claim Specialist Hours: Monday - Friday, 8:00 AM to 4:30 PM ET Salary Range: $83,000-$100,000 (commensurate based on experience) Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. Experience in commercial trucking with litigation and/or the ability to handle attorney represented settlements and some litigation. This role will be for a dedicated trucking client that will require consistent communication and trust building. Adjuster will need to be able to be available for calls but also provide reasoning and recommendation in a consultative manner. This role will join a small but mighty dedicated team. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10+ years multi-line claim experience is required. Bachelor's Degree is preferred. Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Nice to Have: • Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Why You'll Love Working Here • 4 weeks PTO (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) • Career growth: Internal training and advancement opportunities • Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions Compliance & audit performance - adherence to jurisdictional and client standards Timeliness & accuracy - purposeful file movement and dependable execution Client partnership - proactive communication and strong follow-through Professional judgment - owning outcomes and solving problems with integrity Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #ClaimsSpecialist #LiabilityClaims #HybridWork #FloridaJobs #InsuranceCareers #GeneralLiability #AutoClaims #MultiJurisdiction #FLAdjusters #CommercialAuto #NowHiring #InsuranceJobs #FLLiability #IND123 #LI-Hybrid We can recommend jobs specifically for you! Click here to get started.

This job is with Florida Farm Bureau which is the Florida state office for Southern Farm Bureau Casualty Insurance Company, and we currently have an opening for an Inside Claims Representative to work in Maitland, FL. This position is responsible for resolving damage and injury claims caused by or incurred by insureds. Starting salary of $54,800. We offer many benefits including health, dental, vision, PTO, Extended Illness Leave, Pension and matching 401K. ESSENTIAL DUTIES AND RESPONSIBILITES: Include the following. Other duties may be assigned. Investigate, validate, evaluate, negotiate, and settle all claims as assigned. Maintain claim files and follow departmental reporting procedures. Submit reserve recommendations on assigned claims. Communicate with customers and other Claims personnel regarding procedures, problems, and coverages. Enroll in training and continuing education courses when and where required. Negotiate fair settlements with individual claimants or attorneys. Report risk reviews to Underwriting Department. Regular and predictable attendance is required. EDUCATION and/or EXPERIENCE: Bachelor's degree from four-year college or university Obtain Adjuster's license in 6 months SKILLS/ABILITY Strong Verbal communication & listening skills Effective negotiation skills Effective conflict management skills Ability to simultaneously handle multiple priorities Possesses strong product knowledge PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally required to sit at a desk or table with some walking, standing, bending, stooping or carrying of light objects. The employee frequently is required to perform continuous operations of personal computer for four hours or more and use their hands to finger, handle, or feel objects, tools, or controls; and talk or hear. Specific vision abilities required by this job include close vision.

Investigates, determines liability, confirm coverage, establishes damages, and negotiates settlement of auto, property and light general liability claims for a Member based organization in accordance with approved policy & procedure and industry Best Practices. This position does not handle injury, complex or litigated claims. RESPONSIBILITIES AND DUTIES: Responsible for the investigation of assigned auto, non-complex general liability, and first-party property cases in compliance with prescribed industry best practices. This includes verifying coverage, determining liability, evaluating damages, establishing reserves, reporting status, and negotiating appropriate settlements for each claim. Possesses a certain level of financial authority to settle independently. Maintains an appropriate diary and documentation as to file activity. Makes determination and handles files with subrogation potential. Works with Independent Appraisers to estimate the cost of repair or replacement of damaged or stolen vehicles / damaged property. Reports theft, fraud, and arson losses as required to state and industry agencies, as appropriate. Performs most duties on an individual basis, and work has a direct bearing on Management results. Represents the Company from a public relations standpoint and must conduct oneself appropriately at all times. Personal contacts are a major part of activity and include Members, claimants, witnesses, vendors, repair facilities, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses and all other person's incident to the investigation and processing of claims. Attends required or necessary training sessions, courses to maintain their license credits and to maintain up to date knowledge & skills. Performs other duties as assigned. KNOWLEDGE, SKILLS AND ABILITIES: Excellent negotiation, analytical and interpretive skills Excellent oral, written communication and presentation skills Strong organizational and interpersonal skills Superior customer service skills Able to multitask and set own priorities Works well under pressure Should be used to and able to function effectively in a fast-paced environment. Able to establish and maintain effective working relationships with department heads, managers, employees, and vendors. Government claims background is a plus. Physical Requirements include: Bending, Pulling, Sorting, Carrying up to 20 lbs., Pushing, Speaking (English), Climbing, Reaching, Standing, Key entering, Reading (English), Walking, Kneeling, Seeing, Writing (English) Should be able to type 35 WPM. Spanish fluency is a plus. TRAINING AND EXPERIENCE: Position requires a degree from an accredited College/University in business or insurance preferred or equivalent experience in industry. One to three years of experience in insurance industry as a Customer Service Representative or Property or Auto Liability (no injury) adjuster. Knowledge of Microsoft Office products a must. Must have an active Florida Adjusters License. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. **PLEASE DO NOT APPLY IF YOU ARE A SMOKER** Classification: Exempt Dept: Property & Liability Reports to: Claims Supervisor

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 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.

This is a complex claims role responsible for end-to-end handling of small commercial Workers' Compensation claims, including high-severity and litigated matters. The position primarily supports CT, MA, NJ, PA, and RI and requires strong technical expertise and multi-jurisdiction experience. Key Responsibilities: * Investigate, evaluate, and resolve complex and litigated WC claims with accuracy and timeliness * Set and manage reserves; develop resolution strategies; negotiate settlements * Partner with defense counsel and vendors; manage litigation plans and outcomes * Ensure compliance with state statutes, regulations, and internal guidelines * Communicate effectively with insureds, brokers, medical providers, and internal stakeholders Strong Preference: * Required: Prior Workers' Compensation claims experience, including complex and litigated case handling * Proven negotiation, litigation management, and analytical skills * Excellent communication, organization, and decision-making abilities * May require state-specific claims adjuster licensing; candidates must hold (or be able to obtain and maintain) all necessary licenses for CT, MA, NJ, PA, and RI. Remote role. If you live within 50 miles of a USRM hub location, in-office presence is required twice per month. Qualifications * A Bachelors degree or equivalent business experience is required * In addition, the candidate will generally posses 5-7 years of related claims experience with 1-2 years of experience in complex claims * Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skill 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

The Insurance Claims Specialist will be responsible for assisting with the management of all aspects of complex Construction Defect and Property Damage incidents and claims for DPR (and DPR-related entities), as assigned. Reporting: Role reports to Insured Claims Manager and Insured Claims Leader Specific Duties Include: Claims & Incident Management (General): * Initial triage and processing of incidents received from project teams for DPR (and DPR-related entities). * Input and/or review all incidents reported in DPR's RMIS system. * Working with the incident triage group to ensure timely and appropriate review of all incidents * Ensure all necessary information is compiled to properly manage claims. This includes working with the DPR teams to collect relevant documents such as the Prime contract, Subcontracts, Certificates of Insurance, Owner Policy Documents, Project Documents and Project Specific Coverage information, etc. * Assess all potential risks, as well as identify all contractual risk transfer mechanisms. * Analyzing potential insurance coverage for all applicable lines of coverage and report, with all appropriate documents and information, potential claims for DPR (and DPR-related entities) to the broker for any applicable program (Traditional, CCIP, OCIP). * Assist with the development and training of other DPR Workgroups (and DPR-related entities) around CD/PD Best Practices. Construction Defect & Property Damage (CD/PD) Specific Claims Management: * Manage all assigned claims in DPR's RMIS system relating to Construction Defect and Property Damage matters for DPR (and DPR-related entities). This would include using all appropriate lines of coverage such as Commercial General Liability, Builder's Risk, Property, Contractor's Pollution Liability and Professional Liability, whether the policies are placed by DPR or our Clients. * Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements. * Management of and coordination with DPR's consultants and outside attorneys throughout the claim process. * Continuously analyze claim-specific details as the claim progresses to devise key strategies in conjunction with all internal stakeholders and outside consultants. * Proactive management and coordination of all phases of the DPR CD/PD Claims Workflow. Key Skills: * Basic working knowledge and familiarity of: * Commercial General Liability * Property Insurance (Including Inland Marine and Builder's Risk * Pollution Liability * Professional Liability * Controlled Insurance Programs (CCIP/OCIP) * RMIS Systems * Construction Industry Expertise * Strategic thinking * Strong written and oral communication skills * High level of EQ (Soft skills) * Self-Starter * Highly organized and responsive; ability to meet deadlines * Detail Oriented * Contractual risk assessment * Dispute management * Integrity * Ability to mentor and inspire others * Team player * Willingness to understand and advance the DPR Culture * Proactive Learner Qualifications: * 5-7 years relevant construction industry and/or insurance industry experience preferred. * Previous experience in construction company Risk Management highly desired. * Position location - TBD based on location of most qualified candidate. DPR Construction is a forward-thinking, self-performing general contractor specializing in technically complex and sustainable projects for the advanced technology, life sciences, healthcare, higher education and commercial markets. Founded in 1990, DPR is a great story of entrepreneurial success as a private, employee-owned company that has grown into a multi-billion-dollar family of companies with offices around the world. Working at DPR, you'll have the chance to try new things, explore unique paths and shape your future. Here, we build opportunity together-by harnessing our talents, enabling curiosity and pursuing our collective ambition to make the best ideas happen. We are proud to be recognized as a great place to work by our talented teammates and leading news organizations like U.S. News and World Report, Forbes, Fast Company and Newsweek. Explore our open opportunities at ********************

Job Description Customer Claims Representative - Orlando Join the Service Pros Auto Glass team inside our partnered dealerships! You'll engage customers, spot glass-replacement opportunities, and coordinate quick, professional service - all while building strong relationships and developing a personal team. This role is perfect for a teachable person who loves being part of a supportive, winning team. What You'll Do: Engage customers in the service drive and identify windshield replacement needs. Educate and guide customers through their options and next steps. Build strong relationships with service advisors, managers, and technicians. Encourage dealership referrals and hit daily/weekly sales goals. Schedule and coordinate on-site glass services. Keep accurate records of leads, interactions, and completed jobs. Represent the company with a professional, positive attitude. What Makes You a Great Fit: Experience in customer service or sales is a plus, but not required. Strong communication and people skills. A self-motivated, proactive approach - you enjoy taking the lead. Team-oriented mindset with a friendly, professional appearance. Valid driver's license and reliable transportation. What We Offer: A fun, energetic, team-first culture Ability to earn $1000 - $2500 per week You are paid on a weekly basis Promotion from within and clear growth paths Ongoing training and development Team events, company outings, and a culture that celebrates wins

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

Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best. We are looking for a Claims Specialist - Auto to join our team. JOB SUMMARY Investigate, evaluate and settle more complex first and third party commercial insurance auto claims. JOB RESPONSIBILITIES Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Communicates with all relevant parties and documents communication as well as results of investigation. Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. Travel is required to attend customer service calls, mediations, and other legal proceedings. JOB REQUIREMENTS High School Diploma; Bachelor's degree from a four-year college or university preferred. 10 plus years related experience and/or training; or equivalent combination of education and experience. • National Range : $82,800.00 - $97,300.00 • Ultimate salary offered will be based on factors such as applicant experience and geographic location. EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law. Benefits: We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************

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.

My name is Pondsy Anthony , and I am Recruiting Specialist with Mindlance Inc . I have reviewed your resume and at a first glance find it to be a good fit for a Position that we are exclusively recruiting for. We are working very closely with our Client based in FL to fill this requirement urgently. This is a 4+ months of contract position with a possible extension depending on performance. You can get back to me at ************ to discuss in detail. Job Description Job Title: Claim Specialist Client Location : 255 Technology Park, Lake Mary, FL 32746 Contract Duration : 4+ months (High possibility of Extension) ***Info about Schedules: - Candidates being selected need to be open for the contractor shift of either 9a-6p or 10a-7p or 11-8. - If contractors are hired on, they have to be available for shifts like 11a-8p and 12p-9p. Please let candidates know this! Looking for :- Candidates must have reimbursement experience that is within the past 6 months Prior authorization - submission, review, support, completion, verification Appeal - submission, review, support, completion, verification, coordination Reimbursement - investigation, verification JOB SUMMARY: The primary function/purpose of this job:- Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside of Express Scripts. Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. SCOPE OF JOB Reimbursement verification of enrollments MINIMUM QUALIFICATIONS TO ENTER THE JOB: Formal Education and/or Training: High school diploma or equivalent required, some college or technical training preferred YEARS OF EXPERIENCE: Two years' experience in P.B.M. environment is helpful but not required. KNOWLEDGE AND ABILITIES: • Strong data entry and 10-key skills • Retail pharmacy, customer service experience helpful but not required • PC and MS Office literate • Strong attention to detail • Excellent retention and judgment ability • Proficient written and oral communication skills • Ability to work in fast-paced, production environment • Reliable, self-motivated with excellent attendance • Team player who has the ability to stay on task with little supervision Qualifications • Prior authorization - submission, review, support, completion, verification • Appeal - submission, review, support, completion, verification, coordination • Reimbursement - investigation, verification Additional Information All your information will be kept confidential according to EEO guidelines.

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.

Job DescriptionSalary: About Us Rockwall National Public Adjusters is one of the most established public adjusting firms in the region. For more than 15 years, we have successfully advocated for property owners, supported by leadership with over 20 years of experience in the insurance claims industry. We pride ourselves on our longevity, high retention, and reputation for excellence. Many of our adjusters and office staff have been with us for over 10 years, reflecting our supportive culture and commitment to long-term careers. At Rockwall, our mission is simple: level the playing field, fight for our clients rights, and secure the settlements they deserve. By joining our team, you will become part of a well-respected firm with proven processes, unmatched administrative support, and a collaborative environment that fosters professional growth. The Role We are seeking a motivated and Licensed Public Adjuster in the Orlando area to join our team in a hybrid, commission-based role. As a Public Adjuster, you will represent policyholders throughout the insurance claims process, guiding them through stressful property damage losses and securing fair settlements. You will play a vital role in soliciting referral business, signing clients, evaluating damages, preparing and negotiating claims, and advocating for clients best interests. This position is designed to support all levels of experience: Newly licensed adjusters benefit from structured training, mentorship, and back-office support. Experienced adjusters gain access to qualified leads, advanced systems, and a trusted brand with a long-standing reputation. Key Responsibilities Collaboratively solicit residential and commercial new claims and referral partners Sign, inspect, evaluate, and document property damage for residential and commercial claims Prepare, submit, and negotiate insurance claims on behalf of policyholders Communicate with clients, insurance carriers, contractors, and stakeholders to advance claims efficiently Advocate for clients best interests and ensure fair settlements are achieved Maintain accurate records, reports, and claim documentation Deliver exceptional customer service while educating clients on the claims process Generate new business and efficiently close provided leads Required Qualifications Active Florida Public Adjuster license (or ability to obtain one) Prior experience in insurance adjusting, construction, restoration, or a related field preferred, but not required Strong negotiation and communication skills Organized, detail-oriented, and able to manage multiple claims simultaneously Professional demeanor with a client-focused mindset Valid drivers license and reliable transportation for field inspections Compensation & Benefits Commission-based structure with unlimited earning potential Training and ongoing professional development Career growth opportunities within a supportive and collaborative team Hybrid work flexibility (field + office) Full administrative and office support (contracts, compliance, claims, invoicing, mortgage company payments) The Rockwall Difference At Rockwall, we provide unmatched support at every stage of the claims process, allowing our adjusters to focus on serving clients and building careers. Key Advantages: Comprehensive adjuster onboarding and mentorship programs Professional ongoing sales training to close contracts faster and expand referral networks Proprietary lead generation sources and affiliate networks Automated client onboarding to reduce paperwork Access to advanced claims management software for streamlined workflows Hands-on field training for residential and commercial claims Xactimate training and estimate reviews to ensure complete assessments Seamless invoicing and fee collection support Regular updates on case law, legislation, and industry trends A collaborative team environment that promotes growth and shared knowledge Why Join Rockwall NPA 20+ years of insurance industry expertise 15+ years as a trusted, established firm Strong reputation and high staff retention Proprietary lead generation sources and long-standing affiliate networks Full support systems that empower adjusters to succeed A company culture built on professionalism, advocacy, and results

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly. Job Description Kelly Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location. In addition to working with the world's most recognized and trusted name in staffing, Kelly employees can expect: Competitive pay Paid holidays Year-end bonus program Recognition and incentive programs Access to continuing education via the Kelly Learning Center Pay $15 - $16 per hour Schedule: Monday through Friday - 9:00am - 6:00pm Duration: 4 months possible extension (Possible temp - perm) Anticipated start date: 10/31/2016 to 03/31/2017 SUMMARY Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved. MAJOR JOB DUTIES AND RESPONSIBILITIES Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. EDUCATION/EXPERIENCE High School Diploma or GED Required 1-3 years of Call Center and Reimbursement experience required Knowledge of completed benefits verifications, submitted test claims, completed or reviewed prior authorizations required Strong data entry and 10-key skills Proficient in MS Word and Excel Additional Information Why Kelly? As a Kelly Services candidate you will have access to numerous perks, including: Exposure to a variety of career opportunities as a result of our expansive network of client companies Career guides, information and tools to help you successfully position yourself throughout every stage of your career Access to more than 3,000 online training courses through our Kelly Learning Center Group-rate insurance options available immediately upon hire* Weekly pay and service bonus plans

Commercial Auto - Multi Line Claim Specialist Hours: Monday - Friday, 8:00 AM to 4:30 PM ET Salary Range: $83,000-$100,000 (commensurate based on experience) Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. Experience in commercial trucking with litigation and/or the ability to handle attorney represented settlements and some litigation. This role will be for a dedicated trucking client that will require consistent communication and trust building. Adjuster will need to be able to be available for calls but also provide reasoning and recommendation in a consultative manner. This role will join a small but mighty dedicated team. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 10+ years multi-line claim experience is required. Bachelor's Degree is preferred. Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Nice to Have: • Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Why You'll Love Working Here • 4 weeks PTO (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) • Career growth: Internal training and advancement opportunities • Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions Compliance & audit performance - adherence to jurisdictional and client standards Timeliness & accuracy - purposeful file movement and dependable execution Client partnership - proactive communication and strong follow-through Professional judgment - owning outcomes and solving problems with integrity Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers a comprehensive benefits package, which will be reviewed during the hiring process. Please contact our hiring team with any questions about compensation or benefits. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. If you need assistance or accommodation, please contact our team. Equal Opportunity Employer: CCMSI is an Affirmative Action / Equal Employment Opportunity employer. We comply with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks are conducted only after a conditional offer of employment. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #CCMSICareers #CCMSIMaitland #EmployeeOwned #ESOP #GreatPlaceToWorkCertified #ClaimsSpecialist #LiabilityClaims #HybridWork #FloridaJobs #InsuranceCareers #GeneralLiability #AutoClaims #MultiJurisdiction #FLAdjusters #CommercialAuto #NowHiring #InsuranceJobs #FLLiability #IND123 #LI-Hybrid

Job Description CLAIMS REPRESENTATIVE I Investigates, determines liability, confirm coverage, establishes damages, and negotiates settlement of auto, property and light general liability claims for a Member based organization in accordance with approved policy & procedure and industry Best Practices. This position does not handle injury, complex or litigated claims. RESPONSIBILITIES AND DUTIES: Responsible for the investigation of assigned auto, non-complex general liability, and first-party property cases in compliance with prescribed industry best practices. This includes verifying coverage, determining liability, evaluating damages, establishing reserves, reporting status, and negotiating appropriate settlements for each claim. Possesses a certain level of financial authority to settle independently. Maintains an appropriate diary and documentation as to file activity. Makes determination and handles files with subrogation potential. Works with Independent Appraisers to estimate the cost of repair or replacement of damaged or stolen vehicles / damaged property. Reports theft, fraud, and arson losses as required to state and industry agencies, as appropriate. Performs most duties on an individual basis, and work has a direct bearing on Management results. Represents the Company from a public relations standpoint and must conduct oneself appropriately at all times. Personal contacts are a major part of activity and include Members, claimants, witnesses, vendors, repair facilities, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses and all other person's incident to the investigation and processing of claims. Attends required or necessary training sessions, courses to maintain their license credits and to maintain up to date knowledge & skills. Performs other duties as assigned. KNOWLEDGE, SKILLS AND ABILITIES: Excellent negotiation, analytical and interpretive skills Excellent oral, written communication and presentation skills Strong organizational and interpersonal skills Superior customer service skills Able to multitask and set own priorities Works well under pressure Should be used to and able to function effectively in a fast-paced environment. Able to establish and maintain effective working relationships with department heads, managers, employees, and vendors. Government claims background is a plus. Physical Requirements include: Bending, Pulling, Sorting, Carrying up to 20 lbs., Pushing, Speaking (English), Climbing, Reaching, Standing, Key entering, Reading (English), Walking, Kneeling, Seeing, Writing (English) Should be able to type 35 WPM. Spanish fluency is a plus. TRAINING AND EXPERIENCE: Position requires a degree from an accredited College/University in business or insurance preferred or equivalent experience in industry. One to three years of experience in insurance industry as a Customer Service Representative or Property or Auto Liability (no injury) adjuster. Knowledge of Microsoft Office products a must. Must have an active Florida Adjusters License. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. **PLEASE DO NOT APPLY IF YOU ARE A SMOKER** Classification: Exempt Dept: Property & Liability Reports to: Claims Supervisor

Business Claim Specialist Visa GC/Citizen Division Pharmaceutical Pay $16.00/hr. Contract 5 Month Timings Mon - Fri between 9.00AM - 6.00PM The primary function/purpose of this job. Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside the client. Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. ESSENTIAL FUNCTIONS: The 6-10 major responsibility areas of the job. Weight: (%) (Total = 100%) 1. Manage member and client expectations related to claim reimbursements. Input claim requests into adjudication platform maintaining compliance to performance guarantees, HIPAA guidelines and service standards, which include production and accuracy standards. Processing according to client guidelines making exceptions upon member appeal and client approval. Recognize and escalate appropriate system crises/problems and fraudulent claims to management. 40 % 2. Identify claims requiring additional research, navigate through appropriate system platforms to perform research and resolve issue or forward as appropriate 15 % 3. Research to define values for missing information not submitted with claim but required for processing. Identify drug form, type and strength to manually determine correct NDC number value which will allow claim to process. Continue researching values if system editing does not accept original assigned value. Utilize anchor platform, internet resources and/or contacting retail pharmacist as resources for missing values. 15 % 4. Initiate correspondence to members, pharmacies or other internal departments for missing information, claim denials or other claim issues. 15 % 5. Evaluate claim submission, ensure all required information is present and determine what action should be taken. Confirm patient eligibility and verify patient information matches system. Update member's address to match claim form if necessary. 5 % 6. Identify exception handling and process per client requirements. Monitor system to ensure client specific documentation related to claims processing and benefits is current and system editing is operating appropriately. 5 % 7. Variety of other miscellaneous duties as assigned 5 % SCOPE OF JOB Provide quantitative data reflecting the scope and impact of the job - such as budget managed, sales/revenues, profit, clients served, adjusted scripts, etc. Maintain an average of 30 Commercial claims per hour (cph) or 35 Work Comp claims per hour (cph). Qualifications Formal Education and/or Training: High school diploma or equivalent required, some college or technical training preferred Years of Experience: Two years' experience in P.B.M. environment is helpful but not required. Computer or Other Skills: Strong data entry, 10-key skills, general PC skills and MS Office experience Knowledge and Abilities: • Strong data entry and 10-key skills • Retail pharmacy, customer service experience helpful but not required • PC and MS Office literate • Strong attention to detail • Excellent retention and judgment ability • Proficient written and oral communication skills • Ability to work in fast-paced, production environment • Reliable, self-motivated with excellent attendance • Team player who has the ability to stay on task with little supervision Additional Information Thanks & Regards, Ranadheer Murari | Recruitment Executive | Mindlance, Inc. | W : ************ ***************************

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly. Job Description Kelly Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location. In addition to working with the world's most recognized and trusted name in staffing, Kelly employees can expect: Competitive pay Paid holidays Year-end bonus program Recognition and incentive programs Access to continuing education via the Kelly Learning Center Pay $15 - $16 per hour Schedule: Monday through Friday - 9:00am - 6:00pm Duration: 4 months possible extension (Possible temp - perm) Anticipated start date: 10/31/2016 to 03/31/2017 SUMMARY Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved. MAJOR JOB DUTIES AND RESPONSIBILITIES Verify member submitted claims forms, member's eligibility and pharmacy information is complete and accurate, updating system information as needed. Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency. Moderate knowledge of drugs and drug terminology used daily. Process claims according to client specific guidelines while identifying claims requiring exception handling. Navigate daily through several platforms to research and accurately finalize claim submissions. Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. Adhere to strict HIPAA regulations especially when communicating to others outside Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met. Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing. Analyze claims for potential fraud by member or pharmacy. May be required to work on special projects for claims team. EDUCATION/EXPERIENCE High School Diploma or GED Required 1-3 years of Call Center and Reimbursement experience required Knowledge of completed benefits verifications, submitted test claims, completed or reviewed prior authorizations required Strong data entry and 10-key skills Proficient in MS Word and Excel Additional Information Why Kelly? As a Kelly Services candidate you will have access to numerous perks, including: Exposure to a variety of career opportunities as a result of our expansive network of client companies Career guides, information and tools to help you successfully position yourself throughout every stage of your career Access to more than 3,000 online training courses through our Kelly Learning Center Group-rate insurance options available immediately upon hire* Weekly pay and service bonus plans

Multi Line Claim Specialist (Property & Casualty) Schedule: 8:00 am-4:30 pm ET Salary Range: $80,000-$88,000 Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day The Multi-Line Claim Specialist position is responsible for the investigation and adjustment of assigned general liability claims. This desk will focus on Property & Casualty claims. Experience and/or active licensure in one or more of the following jurisdictions is required: GA, AL, MS, TN, CA, LA, SC, KY. Duties will include reviewing coverage, writing ROR's, coverage denials, experience handling BOP, CPP policies, litigation, GL, complex BI and Property claims, Inland Marine, commercial auto PD/BI, FPPC. This position may be used as an advanced training position for promotion consideration for supervisory/management positions. The position is also accountable for the quality of multi-line claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate, evaluate and adjust multi-line claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations within established reserve authority levels. Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated multi-line claims. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of multi-line claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. Assist in the selection, referral and supervision of designated multi-line claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Compute disability rates in accordance with state laws. Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the multi-line claim adjustment process. Provide notices of qualifying claims to excess/reinsurance carriers. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience 8+ years multi-line claim experience is required. Bachelor's Degree is preferred. Experience with Crime/Fidelity claims. Nice to Have: Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjusters license may be required based upon jursidiction. AIC, ARM or CPCU Designation preferred. Why You'll Love Working Here 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions Compliance & audit performance - adherence to jurisdictional and client standards Timeliness & accuracy - purposeful file movement and dependable execution Client partnership - proactive communication and strong follow-through Professional judgment - owning outcomes and solving problems with integrity Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents. CCMSI posts internal career opportunities in compliance with applicable state and local promotion transparency laws. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #CCMSICareers #ESOP #EmployeeOwned #FloridaJobs #IND123 #LI-Hybrid #MultiLine We can recommend jobs specifically for you! Click here to get started.