Claims representative jobs in Portland, ME - 264 jobs

Auto Claims Representative to $47K - Lauch Your Career! Our client, a leading insurance organization, is seeking an Auto Claims Representative to manage automobile property damage claims while delivering exceptional customer service. As part of a growth-oriented training program, you'll investigate claims, assess liability, and ensure timely resolution. Position Details: Location: Boston, MA Work Model: Hybrid Degree: Preferred Responsibilities include analyzing policy provisions to determine coverage; investigating auto accidents and gathering documentation; negotiating and settling claims within authority limits; maintaining accurate records and follow-up systems; coordinating with vendors and internal teams to resolve disputes; initiating subrogation processes when applicable; and managing phone and email communications to ensure timely updates. The ideal candidate possesses strong organizational and multitasking skills; excellent verbal and written communication abilities; proficiency in Microsoft Office Suite; ability to handle sensitive situations with professionalism; and a customer-focused mindset with adaptability to manage multiple priorities. Enjoy a role that offers comprehensive benefits, long-term career growth, and a supportive team environment committed to your success! Beacon Hill is an equal opportunity employer and individuals with disabilities and/or protected veterans are encouraged to apply. California residents: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: ***************************************** Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records. Company Profile: Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement. Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs. Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting ************* Benefits Information: Beacon Hill offers a robust benefit package including, but not limited to, medical, dental, vision, and federal and state leave programs as required by applicable agency regulations to those that meet eligibility. Upon successfully being hired, details will be provided related to our benefit offerings. We look forward to working with you. Beacon Hill. Employing the Future (TM)

At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include: Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support. Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team. What You Bring Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You'll Thrive Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions. Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment. Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.

Granite delivers advanced communications and technology solutions to businesses and government agencies throughout the United States and Canada. We provide exceptional customized service with an emphasis on reliability and outstanding customer support and our customers include over 85 of the Fortune 100. Granite has over $1.85 Billion in revenue with more than 2,100 employees and is headquartered in Quincy, MA. Our mission is to be the leading telecommunications company wherever we offer services as well as provide an environment where the value of each individual is recognized and where each person has the opportunity to further their growth and achieve success. Granite has been recognized by the Boston Business Journal as one of the "Healthiest Companies" in Massachusetts for the past 15 consecutive years. Our offices have onsite fully equipped state of the art gyms for employees at zero cost. Granite's philanthropy is unparalleled with over $300 million in donations to organizations such as Dana Farber Cancer Institute, The ALS Foundation and the Alzheimer's Association to name a few. We have been consistently rated a "Fastest Growing Company" by Inc. Magazine. Granite was named to Forbes List of America's Best Employers 2022, 2023 and 2024. Granite was recently named One of Forbes Best Employers for Diversity. Our company's insurance package includes health, dental, vision, life, disability coverage, 401K retirement with company match, childcare benefits, tuition assistance, and more. If you are a highly motivated individual who wants to grow your career with a fast paced and progressive company, Granite has countless opportunities for you. EOE/M/F/Vets/Disabled General Summary of Position: Granite is currently seeking applicants for our Voice Activations team to support our voice related products and services (HPBX, SIP, ePOTS, RCFs, Epik). This individual will be responsible for contributing to the technical implementation of our IP voice services at customer locations, from strategic planning and order configurations through to turning up and troubleshooting IP voice services. We are looking for representatives preferably with experience in the VoIP technology space or relevant technical background willing to learn and excel in the field. Duties and Responsibilities: Use internal system to run through activation queue Assist technicians and customers on the phone Handle escalation support for voice product activations both internally and to customers Troubleshoot services and devices in the field with customers and technicians Update configurations and/or order details to create successful turn up of services for customer Reconfigure Routers or equipment Required Qualifications: Technical background or desire to grow in technical field Strong organizational skills Ability to work independently and make judgement calls to resolve issues Ability to take direction and act upon it Demonstrative critical thinking and analytical problem-solving skills Strong verbal and written communication skills, ability to multitask Collaborative, Can-Do attitude Willingness to obtain government security clearance Solid work ethic Preferred Qualifications: Understanding of Networking, TCP/IP, Routing, Switching Experience in customer facing technical support roles Ability to refine and improve personal technical capabilities in enterprise networking, network security, and unified voice application support to contribute to the company mission at a higher level of expertise. 1-2 years in a technical support related role, or equivalent experience Understanding of Networking, TCP/IP, Routing, Switching, SD-WAN Prior public trust P2 security clearance Bachelor's Degree in Computer Science, Network Design, Network Security, or related field Experience with coding and automation platforms such as Python, Javascript or similar #LI-JH1

Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more. Position Summary Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days. Applicants must be currently authorized to work in the United States on a full-time basis. Principle Duties and Responsibilities: Claims Management * Manage caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations. * Monitor and ensure timely execution of all statutory deadlines or legal filings as needed. * Analyze facts of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines. * Identify fraud indicators and actively pursue subrogation opportunities. * Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks. * Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers. Financial Impact Administration * Manage book of claims business (up to $ 2million) with authority to settle/negotiate a single claim within their authority of up to $25,000. * Communicate ongoing causes of incidents to Safety and Brands. * Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications. Basic Qualifications: * Licensed adjuster (as appropriate by jurisdiction) * Bachelor's degree or experience handling General Liability claims or equivalent expertise. * Thorough knowledge of rules, regulations, statutes, and procedures pertaining to general liability claims. * Knowledge of medical terminology involved in complex claims * Negotiates resolution of claims of various exposure and complexity Skills and Abilities: * Demonstrates relationship building and communication skills, both written and verbal. * Highly self-motivated, goal oriented, and works well under pressure. * Customer focused solid understanding of legal procedures, processes, practices and standards in the handling of general liability claims * Ability to identify problems and effectuate solutions * Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail * Able to apply critical thinking when solving problems and making decisions. ME/NC/PA/SC Salary Range: $63,440-$95,160 IL/MA/MD/NY Salary Range: $72,880 - $109,320 Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws. #LI-SM1 #LI-Hybrid At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent. Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies. Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work. We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $67,000.00 - $110,600.00 Target Openings 1 What Is the Opportunity? Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. This position services a territory in Southeastern, South Shore and Cape Cod areas of Massachusetts . The selected candidate must either reside in or be willing to relocate at his or her own expense to the assigned territory. What Will You Do? * Handles 1st party property claims of moderate severity and complexity as assigned. * Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. * Broad scale use of innovative technologies. * Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate. * Establishes timely and accurate claim and expense reserves. * Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. * Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits. * Writes denial letters, Reservation of Rights and other complex correspondence. * Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. * Meets all quality standards and expectations in accordance with the Knowledge Guides. * Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. * Manages file inventory to ensure timely resolution of cases. * Handles files in compliance with state regulations, where applicable. * Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. * Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. * Identifies and refers claims with Major Case Unit exposure to the manager. * Performs administrative functions such as expense accounts, time off reporting, etc. as required. * Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. * May provides mentoring and coaching to less experienced claim professionals. * May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. * CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. * Must secure and maintain company credit card required. * In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. * On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. * This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position. * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Bachelor's Degree. * General knowledge of estimating system Xactimate. * Two or more years of previous outside property claim handling experience. * Interpersonal and customer service skills - Advanced. * Organizational and time management skills- Advanced. * Ability to work independently - Intermediate. * Judgment, analytical and decision making skills - Intermediate. * Negotiation skills - Intermediate. * Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate. * Investigative skills - Intermediate. * Ability to analyze and determine coverage - Intermediate. * Analyze, and evaluate damages -Intermediate. * Resolve claims within settlement authority - Intermediate. * Valid passport. What is a Must Have? * High School Diploma or GED. * One year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program. * Valid driver's license. What Is in It for You? * Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. * Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. * Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. * Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. * Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: * Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim * The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions * Maintain claim block and meet departmental production and quality metrics * An awareness of industry claim practices * Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records * Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. * Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process * Establish cooperative and productive relationships with professional resources What you will bring with you: * Bachelor's degree preferred * A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing * Demonstrated ability to work as part of a cohesive team * Strong written and verbal communication skills * Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in negotiation, persuasion, and solutions-based underwriting * Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism * Overall knowledge of health care industry * Proficiency using the Microsoft Office suite of products * Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026

Job Description Our role as a Field Claims Representative will be responsible for the investigation, evaluation and settlement of assigned claims involving 1st Party Homeowner and Commercial Property claims. This role is a field-based position and will require travel to loss sites to evaluate the damages. This also includes special investigation activities with an emphasis on investigating possible fraudulent activity. This is a field based position, travel will be required within Southern Maine, with occasional travel to other areas as required. Responsibilities Field appraise losses of all types for both personal lines and commercial lines claims Take loss reports directly from insureds and/or claimants and/or their representatives. Appropriately handle incoming correspondence on assigned claim files. Investigate assigned claims - confirm coverage - verify damages. Effectively handle portions of claim investigations principally through on-site investigations, as warranted. Evaluate and settle assigned claims based upon the results of the investigation. A strong ability to work independently. Other related duties as assigned by supervisor including but not limited to aiding during CATs or other unusual spikes in claim volume. Requirements Bachelor's degree preferred or several years of direct experience 5-7 years of experience handling Property Claims; Commercial Lines experience a plus. Strong understanding of personal and commercial lines policy forms and coverage analysis. Multi-line adjuster's license as required in our operating territories. Demonstrated proficiency in writing detailed structural cost of repair/replacement estimates in Xactimate estimating system and proficient in PC Windows environment. Demonstrated proficiency in investigating, evaluating and settling contents claims. Excellent understanding and skill level of claim handling and customer service. Possess or has ability to timely secure and maintain required multiline adjuster licenses. Knowledge of policy contracts, insurance laws, regulations, and the legal environment in which we operate. Outside/Field Adjusters - ability to view damages and prepare estimates based on their inspection of the damaged property. Benefits At The Concord Group, we're proud to offer a comprehensive benefits package designed to support the wellbeing of our associates. This includes medical, vision, dental, life insurance, disability insurance, and a generous paid time off program for vacation, personal, sick time, and holiday pay. Additional benefits include parental leave, adoption assistance, fertility treatment assistance, a competitive 401(k) plan with company match, gym member/fitness class reimbursement, and additional resources and programs that encourage professional growth and overall wellness. Why Concord Group Insurance Since 1928, The Concord Group has been protecting families and small businesses across New England with trusted, personal insurance solutions. The Concord Group is a member of The Auto Owners Group of Companies and is recognized as a leading insurance provider through the independent agency system. Rated A+ (Superior) by AM Best, the company is represented by more than 550 of the best local independent agents throughout Maine, Massachusetts, New Hampshire, and Vermont. At Concord Group, we believe in more than just insurance, we believe in our people. Our associates thrive in a supportive, collaborative workplace where community involvement, professional growth, and shared values drives everything we do. Starting your career with The Concord Group means joining a team that values people first and gives you the opportunity to grow, give back, and make a lasting difference in the lives of those we serve. Compensation We are dedicated to fair and competitive total compensation package that supports the wellbeing and success of our associates. In addition to this, we offer other components like bonus opportunities. Equal Employment Opportunity The Concord Group is an equal opportunity employer and hires, transfers, and promotes based on ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state, or local law. The Concord Group participates in E-Verify

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: * Award-winning culture * Inclusion and diversity as a priority * Performance Based Incentive Plans * Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability * Generous PTO (including paid time to volunteer!) * Up to 9.5% 401(k) employer contribution * Mental health support * Career advancement opportunities * Student loan repayment options * Tuition reimbursement * Flexible work environments * All the benefits listed above are subject to the terms of their individual Plans. And that's just the beginning… With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! General Summary: Minimum starting hourly rate is $22.60 This is an entry level position within the Voluntary Benefits Claims Organization. This position is responsible for the thorough, fair, objective, and timely adjudication of voluntary benefits claims in conjunction with providing technical expertise regarding applicable regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, health care providers and other specialized internal resources. Incumbents in this role are considered trainees and are assigned a formal mentor for 6-12 months until they are assessed as capable of independent work. Incumbents are primarily responsible for learning and developing the skills, knowledge, and behaviors necessary to successfully adjudicate assigned claims, in accordance with our claims philosophy and policies and procedures. Incumbent must demonstrate the ability to effectively manage an assigned caseload, exercise discretion and independent judgment, and appropriately render timely claim decisions while demonstrating strong customer service prior to movement to the exempt level claims specialist role. Principal Duties and Responsibilities: * Maintain organizational service standards on all assigned claims demonstrating success in developing and implementing effective strategies to manage a caseload of varying size and complexity. * Develop an understanding and working knowledge of Voluntary Benefits for Unum and Colonial Life, including products, policies, procedures, and contracts. * Develop an understanding of the applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders, and waivers, as well as regulatory and statutory requirements for claim products administered. * Develop skill set to determine appropriate risk management strategies through analyzing and applying technical and complex contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions, and benefits payee. * Develop problem solving skills by demonstrating analytical and logical thinking resulting in the timely and accurate adjudication of a variety of simple to complex voluntary benefits claims. * Develop a working knowledge of systems needed for claims adjudication. * Provide excellent customer service and independently respond to all inquiries within service guidelines. * Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and referrals/notifications to other areas (i.e., medical assessments, billing, etc.) as appropriate. * Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively communicate determinations while ensuring compliance with Voluntary Benefits procedures and all legal requirements including state regulations. * Partner and coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation, when appropriate. * Ensure a timely and well communicated transfer process when transitioning integrated claims across lines of business, ensuring a coordinated and continuous claims experience for customers. * Be familiar with specialized workflow requirements and performance standards for any assigned customers. * May perform other duties as assigned. Job Specifications: * 4-year degree preferred or equivalent work experience * Ability to develop Voluntary Benefits product knowledge and apply a best-in-class service experience * Medical background, voluntary benefits claims and/or disability management experience preferred * Possess strong analytical, critical thinking, and problem-solving skills * Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions, including initial decision and ongoing medical management. * Able to effectively utilize a broad spectrum of resources, materials, and tools needed to assist with the decision-making process * Strong service and quality orientation. * Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc. * Demonstrated ability to operate with a sense of urgency and make balanced decisions with the highest degree of integrity and fairness. * Excellent communication skills, written and verbal * Meets the standards for this position, as defined in the Talent Management framework ~IN3 #LI-LM2022 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $40,000.00-$75,600.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

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.

The Claim Specialist III investigates, evaluates, negotiates, and resolves lost time claims within settlement and reserving authority up to stated maximum. (Supervisor will determine actual individual authority up to the stated maximum). Conducts training classes (including research and position papers) for less experienced Claim Department Representatives. Based on experience and proven ability, an expanded and more difficult caseload will be expected, requiring a lesser degree of supervision. Principal Duties and Responsibilities: Communicates with insureds, injured workers, agents, brokers, witnesses, attorneys, loss prevention, and underwriters to obtain and relate necessary information to determine coverage/compensability, facts of loss, and degree of liability/exposure. Maintains contact throughout the life of the file as needed. Administers the delivery of timely, appropriate and accurate indemnity and medical benefits. Evaluates claim exposure, negotiate and resolve claims. Works closely with defense counsel on litigated cases and attend mediation, arbitration, and hearings, as necessary. Develops litigation plan with defense counsel and tracks adherence to plan in order to control legal expenses and assure effective resolution. Works closely with insureds and employees making visitations and presentations as needed to facilitate partnership approach to claims handling. Maintains quality claim files in accordance with appropriate best practices, and other company procedures. Implements Managed Care strategies, coordinate rehabilitation or medical management, process bills, review all mail through Image Right, and monitor progress as appropriate. Interacts with State and Federal Boards and Commissions, while establishing and maintaining proper reserves, as appropriate. Serves as a mentor and helps prepare/train the less experienced Claim Department representatives. Keeps up-to-date on State laws and Company procedures relating to various claims; educates injured worker and/or insured on same. Prepares and presents files for Agent/Broker Reviews and Insured File Review. Understands medical terminology and standard medical procedures as they pertain to worker's compensation, U.S. Longshoreman's and Jones Act claims. Participates in in-house and outside training programs to keep up-to-date on relevant issues/topics. Maintains a working knowledge of all computer systems currently in use. Continues education in claims through Associate in Claims or Claims Law (AEI) courses. Requirements: Three years of workers' compensation lost time claim handling experience required. Bachelor's degree preferred. Computer skills, Word, Excel and Image Right preferred. Must have valid driver's license. Strong attention to detail and strong communication skills both verbal and written. Adaptable/flexible and self-directed with the ability to manage time and other resources wisely. Must have the ability to work effectively with other organizational team members. Our comprehensive benefits package includes all traditional offerings such as: Health Insurance options, Dental Insurance options and Vision Insurance Employee Life Insurance/AD&D and Dependent Life Insurance options Short-term & Long-term Disability Health Savings Account with potential employer match Flexible Medical and Dependent Care Account Accident Insurance Critical Illness Insurance Employee Assistance Program Legal/Identify Theft Insurance options Long Term Care Insurance Pet Insurance 401 (k) Retirement Plan with match up to 5%, plus profit sharing & discretionary contributions (subject to vesting) 5 weeks of Paid Time Off (PTO) 11 paid holidays We also offer other benefits to help foster a healthy, balance lifestyle such as: Flextime schedules Paid Parental Leave Student loan paydown and refinancing assistance Educational assistance for job related courses, seminars, certifications or degrees One paid day every year to volunteer for your non-profit of choice On-site fitness center (Maine only) or fitness reimbursement Subsidized parking Sit-Stand desks & daily stretch breaks MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law. #IND2022

Under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Assists in providing service to policyholders/customers on mid-sized and/or large commercial accounts. This is a hybrid position requiring twice a month in-office with preference on candidates residing within 50 miles of Suwanee, GA office. Please note this is subject to change. Responsibilities Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly. Establishes action plans based on case facts, best practices, protocols, jurisdictional issues and available resources. Manages an inventory of property/casualty and disability claims (e.g. workers` compensation, general liability, commercial automobile, property, group benefits), evaluates compensability/liability and losses, and negotiates settlements within prescribed limits. Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols. Confirms or denies coverage based on facts obtained during the investigation and advises policyholders as to proper course of action. Makes effective use of loss management techniques (e.g. Immediate Contact Plan, L9 check, Disability Management, open end release, first call settlements) and other resources. Updates files and provides comprehensive reports as required. Qualifications Effective interpersonal, analytical and negotiation abilities required. Ability to provide information in a clear, concise manner with an appropriate level of detail. Demonstrated ability to build and maintain effective relationships. Demonstrated success in a professional environment; success in a customer service/retail environment preferred. Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent. Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory. Licensing may be required in some states. 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.

Department Insurance & Financial Services Employment Type Full Time Location Maine Workplace type Hybrid Compensation $90,000 - $170,000 / year Key Responsibilities Skills, Knowledge and Expertise Benefits About The Misch Group Stone Hendricks Group is a direct-hire search firm that brings together years of experience and a diverse range of talent to connect businesses with exceptional job candidates. With a focus on timely and effective recruitment, we understand the power of a well-formed employee base in helping businesses achieve their goals. We offer our services to businesses of all sizes, providing qualified candidates for blue- and grey-collar roles, as well as white-collar and executive positions. The success of our direct-hire search process is driven by our advanced training, proprietary technology, and extensive network across industries. At Stone Hendricks Group, we value integrity and prioritize connectedness, commitment, and candor in our interactions with both employers and job seekers. Our clients consider us trusted advisors, relying on the highly personalized service we provide and our ability to find candidates that are an ideal fit for their unique needs. Choose Stone Hendricks Group for unsurpassed direct-hire search services that match successful organizations with talented job candidates.

At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together. Come be a part of this journey with us as we champion lives! Job Summary The Manager Claims Admin is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our customers and the Claims department. This individual will focus on meeting all key financial business objectives and enhance customer service levels for assigned team; effectively managing the performance of all individuals to achieve optimal productivity; maintaining clear and ongoing communications with other business partners, inside and outside of the Claims department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc. Primary duties may include, but are not limited to: KEY RESPONSIBILITIES: * Consistently adhere to the documented workflow guidelines and established procedures. * Assure consistent, quality claims handling by review of pending claim, diary and Change of Definition reports. * Respond to and track all Insurance Department complaints. * Actively participate in review of claims for approvals/denials. * Conduct one-on-one meetings with all claims staff on a monthly basis to assess performance. * Document and address all performance management issues and communicate those to the Director of Claims. * Monitor caseloads to maintain consistency within team. * Analyze claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc. * Ensure the team provides excellent customer service by appropriately adjudicating claims within established service protocols. * Respond to and document customer complaints from claimants/their representatives, clients, and policyholders. * Ensure quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings. * Participate in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims. * Reach or exceed approved quality rating requirements. * Display a high level of leadership through employee development, coaching and performance management. * Strive to timely utilize appropriate resources across the benefits organization. * Participate in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims Job Requirements Required Education and/or Certifications * B.S. degree or a combination of equivalent related work experience and education. * Or any combination of education and experience which would provide an equivalent background Recommended Education and/or Certifications * Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc. Required Work Experience * Leadership experience strongly preferred * A minimum of 5 years' experience managing disability claims. * Or any combination of education and experience which would provide an equivalent background Salary Band: 06A #LI-SC1 This selected candidate will be expected to work hybrid in Indianapolis, In or Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

Job Type: Permanent Build a brilliant future with Hiscox Individual contributor role responsible for the handling of Miscellaneous Professional Liability claims for the organization from inception to resolution. This involves the negotiation and settlement of Miscellaneous Professional Liability insurance claims. May be responsible for single or multi-country claims and will be responsible for all aspects of the claims, including liaise with external and internal business partners (e.g., outside experts and/or or legal counsel; underwriting) as required. Bring your Passion and Enthusiasm to our Team! We are a fun, innovative and growing Claims team where you'll get the opportunity to learn multiple insurance products and interact with business leaders across the organization. Please note that this position is hybrid and requires two (2) days in office weekly. Position can be based in the following locations: * Manhattan, NY * West Hartford, CT * Atlanta, GA * Chicago, IL * Boston, MA The Role: The Complex Claims Specialist is a high-level adjuster role that adjudicates assigned claims within given authority and provides operational support to the claims team. This person also: * Adjusts and resolves complex to severe claims that includes all phases of litigation * With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters * Reviews and analyses claim documentation and legal filings * Drives litigation best practices to lead defense strategy on litigated files * Mentors Claim Examiners * Uses superior knowledge and experience to affect positive claim outcome via investigation, negotiation and utilization of alternative dispute resolutions * Identifies emerging exposures and claims trends * Identifies suspected fraudulent claims and tracks with special investigations unit * Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities * Develops content and conducts training for claims team and underwriters as requested The Team: The US Claims team at Hiscox is a growing group of professionals working together to provide superior customer service and claims handling expertise. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker partners. With strong growth across the US business, the Claims team is focused on delivering profitability while reinforcing Hiscox's strong brand built on a long history of outstanding claims handling. Requirements: * 8+ years of claims handling experience or 7-8 years litigation experience. (A JD from an ABA accredited law school may be considered as a supplement to claims handling experience.) * Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation * Advanced knowledge of coverage within the team's specialty or focus * Advanced knowledge of litigation process and negotiation skills * Experience in mentoring and training other claims examiners * Excellent verbal and written communication skills * Advanced analytical skills * B.A./B.S degree from an accredited College or University preferred Additional Factors Considered: * Ability to act a subject matter expert within team * Demonstrated ability to work with minimal oversight * Experience attending and leading mediations, arbitrations and trials * Demonstrated ability to advance product innovation or develop a greater understanding of other aspects of the business through training or other relevant projects * Demonstrates courage in addressing and solving difficult or complex matters with insureds, attorneys and brokers * Demonstrated steps taken toward additional certifications by an approved authority such as a CPCU, ARMS or AINS designation * Commitment to professional development and learning demonstrated by at least 5 hours of continuing education related to insurance topics through Success Factory, Hiscox in-person or video conference training sessions, or other in-person seminars or webinars. What Hiscox USA offers: * 401(k) with competitive company matching * Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care) * Company paid group term life, short- term disability and long-term disability coverage * 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days * Paid parental leave * 4-week paid sabbatical after every 5 years of service * Financial Adoption Assistance and Medical Travel Reimbursement Programs * Annual reimbursement up to $600 for health club membership or fees associated with any fitness program * Company paid subscription to Headspace to support employees' mental health and wellbeing * 2023 Gold level recipient of Cigna's Healthy Workforce Designation for having a best-in-class health and wellness program * Dynamic, creative and values-driven culture * Modern and open office spaces, complimentary drinks * Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. Diversity and flexible working at Hiscox: At Hiscox we care about our people. We hire the best people for the job and we're committed to diversity and creating a truly inclusive culture, which we believe drives success. We also understand that working life doesn't always have to be 'nine to five' and we support flexible working wherever we can. No promises, but please chat to our resourcing team about the flexibility we could offer for this role. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary range: $125,000-$155,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture

Equal Opportunity Employer/Disability/Veterans Reliable Respiratory is a Durable Medical Equipment (DME) company that provides the highest quality level of service for patients in need of respiratory, diabetes, urology, and maternity support. Equipment provided includes, CPAPs, BiPAPs, AutoPAPs, nebulizers, oxygen equipment, ventilators, CGM devices, insulin pumps, and breast pumps. Each patient is treated with professionalism, understanding, and attentive service. We care about our customers, work closely with the medical community, and have highly skilled staff ready to assist customers in receiving the best care possible. The Billing C laims Specialist focuses on claims and procurement of authorizations and medical documentation to ensure Reliable is reimbursed in accordance with the procedures provided. This position reports to the Billing Manager, but will perform duties that pertain to customer service, documentation retrieval, medical billing and coding, and reimbursement. The primary purpose of this position is to identify reasons for claim denials and take all corrective action to resubmit the claim and obtain full reimbursement for the services rendered. Additional duties include: Review claims for denied procedures, identify issues, and take appropriate action to correct issue, resubmit claim, and procure maximum reimbursement for specific service. Duties include obtaining authorization, collecting medical documentation directly from facilities, and working with payers and provider services. Organize and report back denial trends to Management to implement measures to improve claim health and reduce payer AR times. Create and/or update written material and documentation related to insurance procedures and programs (i.e., insurance guidelines and processes and procedures). Assist in reviewing and analyzing relevant organizational and payer data (i.e., reviews payments and denials of insurance and communicates when changes need to be made for payment and profit margins) Develop and implement a system for working denials, ranging from dollar value to payor specialization, to age of invoice Issue invoices and bills and send them to customers through various channels (mail, e-mail etc.) Receive payments through various methods (cash, online payments etc.) and check for credibility. Answer questions and handle complaints from customers and payors regarding claims Reconcile deposits and invoices posted. Basic Qualifications 18 years of age or older Must be eligible to work in the United States and not require work authorization from us now or in the future Bachelor's Degree required At least 2 years of medical billing, coding, reimbursement or health insurance experience preferred Required Skills Strong health insurance knowledge of New England payers and Massachusetts ACO plans Proficient in obtaining authorizations in the most efficient manner (portal, fax form, phone in submission) Ability to learn Billing functions and be adaptable to the needs of the position. Strong interdepartmental communication Effective and professional verbal and written communication abilities Professional computer experience (especially Microsoft Office Suite) Ability to investigate problems and make decisions independently. Strong analytical skills Competencies Computer skills Interpersonal skills Product expertise Communication skills Results driven Conflict management Customer service Organizational skills Work Environment & Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate and convey information with the appropriate parties. The job requires assuming a stationary position for long periods of time This role routinely uses standard office equipment such as computers, phones, and printers/scanners The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. This job operates in a professional office environment The noise level in the work environment is usually moderate to loud Direct Reports - None Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Reliable Respiratory, INC participates in E-Verify. E-Verify is a web-based system that allows an employer to determine an employee's eligibility to work in the US using information reported on an employee's Form I-9. The E-Verify system confirms eligibility with both the Social Security Administration (SSA) and Department of Homeland Security (DHS). For more information, please go to the USCIS E-Verify website.

Job Description At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together. Come be a part of this journey with us as we champion lives! Job Summary The Manager Claims Admin is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our customers and the Claims department. This individual will focus on meeting all key financial business objectives and enhance customer service levels for assigned team; effectively managing the performance of all individuals to achieve optimal productivity; maintaining clear and ongoing communications with other business partners, inside and outside of the Claims department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc. Primary duties may include, but are not limited to: KEY RESPONSIBILITIES: Consistently adhere to the documented workflow guidelines and established procedures. Assure consistent, quality claims handling by review of pending claim, diary and Change of Definition reports. Respond to and track all Insurance Department complaints. Actively participate in review of claims for approvals/denials. Conduct one-on-one meetings with all claims staff on a monthly basis to assess performance. Document and address all performance management issues and communicate those to the Director of Claims. Monitor caseloads to maintain consistency within team. Analyze claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc. Ensure the team provides excellent customer service by appropriately adjudicating claims within established service protocols. Respond to and document customer complaints from claimants/their representatives, clients, and policyholders. Ensure quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings. Participate in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims. Reach or exceed approved quality rating requirements. Display a high level of leadership through employee development, coaching and performance management. Strive to timely utilize appropriate resources across the benefits organization. Participate in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims Job Requirements Required Education and/or Certifications B.S. degree or a combination of equivalent related work experience and education. Or any combination of education and experience which would provide an equivalent background Recommended Education and/or Certifications Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc. Required Work Experience Leadership experience strongly preferred A minimum of 5 years' experience managing disability claims. Or any combination of education and experience which would provide an equivalent background Salary Band: 06A #LI-SC1 This selected candidate will be expected to work hybrid in Indianapolis, In or Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together. Come be a part of this journey with us as we champion lives! Job Summary The Manager Claims Admin is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our customers and the Claims department. This individual will focus on meeting all key financial business objectives and enhance customer service levels for assigned team; effectively managing the performance of all individuals to achieve optimal productivity; maintaining clear and ongoing communications with other business partners, inside and outside of the Claims department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc. Primary duties may include, but are not limited to: KEY RESPONSIBILITIES: Consistently adhere to the documented workflow guidelines and established procedures. Assure consistent, quality claims handling by review of pending claim, diary and Change of Definition reports. Respond to and track all Insurance Department complaints. Actively participate in review of claims for approvals/denials. Conduct one-on-one meetings with all claims staff on a monthly basis to assess performance. Document and address all performance management issues and communicate those to the Director of Claims. Monitor caseloads to maintain consistency within team. Analyze claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc. Ensure the team provides excellent customer service by appropriately adjudicating claims within established service protocols. Respond to and document customer complaints from claimants/their representatives, clients, and policyholders. Ensure quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings. Participate in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims. Reach or exceed approved quality rating requirements. Display a high level of leadership through employee development, coaching and performance management. Strive to timely utilize appropriate resources across the benefits organization. Participate in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims Job Requirements Required Education and/or Certifications B.S. degree or a combination of equivalent related work experience and education. Or any combination of education and experience which would provide an equivalent background Recommended Education and/or Certifications Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc. Required Work Experience Leadership experience strongly preferred A minimum of 5 years' experience managing disability claims. Or any combination of education and experience which would provide an equivalent background Salary Band: 06A #LI-SC1 This selected candidate will be expected to work hybrid in Indianapolis, In or Portland, ME. The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration. If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York. Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual's race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

Part-time Description Do you have experience with medical billing and coding? Do you have a keen eye for detail and a passion for accuracy? Consider joining our small office team as a Provider Practice Billing & Claims Specialist and play a vital role in ensuring smooth, efficient billing processes that directly impact patient care. This is your chance to combine your expertise with a mission-driven environment where your work will make a positive impact on the lives of over 600 Maine seniors. Hiring immediately! Composed of ten companies across the great state of Maine, Woodlands Senior Living provides a residence for more than 700 seniors to age gracefully, happily, and comfortably surrounded by compassionate caregivers. All ten of those companies have become the first in Maine to receive Joint Commission accreditation! On a mission to make each day the best day possible for every resident served, we have embarked on yet another ground-breaking concept - a senior living provider practice. What you will do as a Provider Practice Billing & Claims Specialist: Utilizes clinical and coding knowledge to ensure accurate and compliant diagnostic and procedural assignments are captured to optimize reimbursement for professional charges, utilizing ICD-10-CM, CPT-4 and sequencing best-practices. Submits accurate and timely claims to payors. Receives payments from payors and performs data entry of payments and account adjustments. Informs Accounting Supervisor of accounting discrepancies. Performs error analysis for denied claims and provides recommendations for process improvements and claim reimbursement resolution. Escalates concerns to Accounting Supervisor. Acts as liaison and subject matter expert to internal and external stakeholders, delivering expert guidance and training related to coding systems, required documentation, payer requirements, and industry standards. This is a 20 - 24 hour position. The benefits to join the team: Vacation and holiday pay because you deserve time to relax and recharge Tuition assistance because we believe in the investment of your growth and success Health, dental, vision and supplemental benefits to support your health 401(k) savings and investment plan to prepare for your future Requirements What you'll bring to the role: Two or more years of previous experience as a medical biller/coder preferred Proficient with Microsoft Office products preferred. Must provide proof of immunization/immunity to MMR, Varicella and Influenza A current, valid license to operate a vehicle in the state of Maine and a driving record that is satisfactory to the company may be required Strong command of the English language with the ability to follow oral and written instructions with precision Salary Description $21 - $29 / hour

Working as part of the Claims Department, the Litigated Claims Specialist lends expertise in the laws, regulations, and jurisdictional statutes to identify or resolve disputed claims, assuring effective reimbursement. What You'll Do Investigate/rectify partial payments from claims in litigation Secure payment on outstanding invoices Investigate claim that are in litigation Assess current and ongoing risk of continued medications service in relation to ongoing litigation Research and act upon information obtained Interact and communicate daily with other departments Communicate with external sources such as attorneys and adjusters Obtain medical documentation to facilitate/warrant collections Analyze information and data for resolution Participate and develop special processes/procedures to better the Litigated Claims Team Special projects as designated by manager What You'll Need to Succeed 2+ years Workers Compensation knowledge Bachelor's Degree or equivalent related experience Familiar with medical terminology Knowledge of databases and MS Office (Excel & Word) Knowledge of IWP reimbursement process and procedures Make A Difference With IWP Injured Workers Pharmacy (IWP) is proud to be THE Patient Advocate Pharmacy, helping injured workers around the country access their prescription medications with ease. As a specialized workers' compensation home delivery pharmacy, we collaborate with the legal, medical, and insurance communities to help injured workers return to a productive life. At IWP we believe in our service, but it's the people who make it a great place to work. We value our employees and strive for a culture of teambuilding, open mindedness, and fun. If that sounds like something you'd like to be part of, we'd love to hear from you! Your compensation will include a competitive salary, generous benefits, and opportunities for growth and development. IWP is an Equal Opportunity Employer. IWP does not discriminate on the basis of race, creed, color, religion, national origin, sex, sexual orientation, gender identity, age, physical or mental disability, or any other basis covered by appropriate law. All employment decisions are made on the basis of qualifications, merit, and business need. IWP is committed to providing reasonable accommodations for qualified individuals with physical and mental disabilities in our job application procedures. If you need assistance or an accommodation due to a disability, you may contact us at humanresources@IWPharmacy.com We will make a determination on your request for reasonable accommodation on a case-by-case basis. We are dedicated to attracting and retaining top talent with competitive and fair compensation. The salary range for this role is $23/hr - $25/hr.