Claims representative jobs in Rogers, AR

Workers' Compensation Claim Representative I Work Arrangement: Hybrid after training Schedule: Monday-Friday, 8:00 AM to 4:30 PM Salary Range: $50,000-$60,000 annually At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. Reasons you should consider a career with CCMSI: Culture: Our Core Values are embedded into our culture of how we treat our employees as a valued partner-with integrity, passion and enthusiasm. Career development: CCMSI offers robust internships and internal training programs for advancement within our organization. Benefits: Not only do our benefits include 4 weeks paid time off in your first year, plus 10 paid holidays, but they also include Medical, Dental, Vision, Life Insurance, Critical Illness, Short and Long Term Disability, 401K, and ESOP. Work Environment: We believe in providing an environment where employees enjoy coming to work every day, are provided the resources needed to perform their job and claims staff are assigned manageable caseloads. The Workers' Compensation Claim Representative I is responsible for the investigation and adjustment of assigned workers compensation claims. This position may be used as an advanced training position for future consideration for promotion to a Work Comp Claim Rep II or more senior level claim position. Accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards. Responsibilities Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision. Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiate any disputed bills for resolution. Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority. Negotiate settlements with claimants and attorneys in accordance with client's authorization. Assist in selection and supervision of defense attorneys. Assess and monitor subrogation claims for resolution. Prepare reports detailing claims, payments and reserves. Provide reports and monitor files, as required by excess insurers. Compliance with Service Commitments as established by team. Delivery of quality claim service to clients. Performs other duties as assigned. 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. Individual must be a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, initiative, and the ability to work with a minimum of direct supervision a must. Discretion and confidentiality required. Ability to work as a team member in a rapidly changing environment. 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 3 or more years of workers compensation claim experience or other related industry experience is required. Associates degree is preferred. Computer Skills Proficient using Microsoft Office programs such as: Word, Excel, Outlook, etc. Certificates, Licenses, Registrations Adjuster's license may be required based upon jurisdiction. 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. Work requires the ability to sit or stand up to 7.5 or more hours at a time. Work requires sufficient auditory and visual acuity to interact with others. CORE VALUES & PRINCIPLES Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example. 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. 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. #WorkersCompCareers #AdjusterJobs #ClaimsProfessional #HybridJobs #InsuranceCareers #GreatPlaceToWorkCertified #EmployeeOwned #CCMSICareers #NowHiring #IND123 #LI-Hybrid We can recommend jobs specifically for you! Click here to get started.

Who is Federated Insurance? At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own. Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values. What Will You Do? Customer-focused, source of knowledge and comfort, desire to help, professional - Does that sound like you? We are seeking someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss. No previous insurance or claims experience needed! Federated provides an exceptional training program to teach you the fundamentals of claims and will prepare you to assist clients. This is an in-office position that will work out of our Overland Park, KS office, located at 6130 Sprint Parkway, Ste 200 Overland Park, KS. A work from home option is not available. Responsibilities Work with policyholders, physicians, attorneys, contractors and others to ensure claims are resolved in a prompt, fair and courteous way. Explain policy coverage to policyholders and third parties. Complete thorough investigations and document facts relating to claims. Determine the value of damaged items or accurately pay medical and wage loss benefits. Negotiate settlements with policyholders and third parties. Resolve claims, which may include paying, settling, or denying claims, defending policyholders in court, compromising or recovering outstanding dollars. Minimum Qualifications Current pursuing, or have obtained a four-year degree Experience in a customer service role in industries such as retail, hospitality, logistics, banking, automotive dealerships, vehicle rental, sales or similar fields Ability to make confident decisions based on available information Strong analytical, computer, and time management skills Excellent written and verbal communication skills Leadership experience is a plus Salary Range: $61,700 - $75,400 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information can be discussed with a with a member of the Recruiting team. What We Offer We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You. Employment Practices All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization. If California Resident, please review Federated's enhanced Privacy Policy.

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 $55,200.00 - $91,100.00 Target Openings 3 What Is the Opportunity? Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process. This role is eligible for a sign on bonus. What Will You Do? * Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. * Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. * Determine claim eligibility, coverage, liability, and settlement amounts. * Ensure accurate and complete documentation of claim files and transactions. * Identify and escalate potential fraud or complex claims for further investigation. * Coordinate with internal teams such as investigators, legal, and customer service, as needed. What Will Our Ideal Candidate Have? * Bachelor's Degree. * Three years of experience in insurance claims, preferably Auto claims. * Experience with claims management and software systems. * Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. * Strong analytical and problem-solving skills. * Proven ability to handle complex claims and negotiate settlements. * Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. What is a Must Have? * High School Diploma or GED required. * A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required. 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 *********************************************************

ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers . If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. 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. 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 $55,200.00 - $91,100.00 What Is the Opportunity? Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process. This role is eligible for a sign on bonus. What Will You Do? Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. Determine claim eligibility, coverage, liability, and settlement amounts. Ensure accurate and complete documentation of claim files and transactions. Identify and escalate potential fraud or complex claims for further investigation. Coordinate with internal teams such as investigators, legal, and customer service, as needed. Additional Qualifications/Responsibilities What Will Our Ideal Candidate Have? Bachelor's Degree. Three years of experience in insurance claims, preferably Auto claims. Experience with claims management and software systems. Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. Strong analytical and problem-solving skills. Proven ability to handle complex claims and negotiate settlements. Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. What is a Must Have? High School Diploma or GED required. A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required. 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.

Experience more with a career at COUNTRY Financial! We're excited you're interested in a career at COUNTRY as we strive toward our vision - to enrich lives in the communities we serve. Our footprint spans coast to coast. But more important than where we operate, is the people who do the work. Apply today to help our organization grow and make a difference for our clients. About the role Looking for a genuinely rewarding career where you know you're actually making a difference in people's lives? COUNTRY Financial is seeking a Sr. Property Claims Adjuster to join our field claims team. You'll be providing a consistent, positive, and satisfying claims experience for our clients through the proper investigation, evaluation, negotiation, and settlement of property claims. You'll learn how to use innovative technologies, i.e., drones for property inspections. In addition to on-site inspections, we also use virtual claim handling software to lead our clients safely and expertly through the claim process. This position allows full-time field work within the territory for this position which includes the Kansas City, Ks, Kansas City, MO. and surrounding areas How does this role make an impact?- Investigates claims by determining applicable policy coverage, evaluates, negotiates and settles assigned claims. - Initiates contact with insureds, claimants, and all relevant parties to gather basic information, obtain recorded statements (when necessary), and explain the overall claims process. - Completes physical and/or virtual inspections of damaged property (when necessary), evaluates damages, and prepares written estimates according to policy provisions and liability.Do you have what we're looking for? Typically requires 7+ years of relevant experience or a combination of related experience, education and training. -Maintains the appropriate adjuster's licensing as required by the states in which we do business. -For Property-Field representatives only, excluding representatives in the Large Property Loss Unit: Part 107 drone license required for roof inspections. License must be obtained within 5 months of start date; must pass exam within 3 attempts. - This job operates in a professional office or work from home environment and routinely uses standard office equipment such as computers, phones, scanners and copy machines. - Work may extend beyond normal business hours as business needs dictate. - May be called upon for catastrophic duty. Base Pay Range: $76,000-$104,500 The base pay range represents the typical range of potential salary offers for candidates hired. Factors used to determine your actual salary include your specific skills, qualifications and experience. Incentive Pay: In addition to base salary, this position is eligible for a Short-Term Incentive plan. Why work with us? Our employees and representatives serve nearly one million households with our diverse range of personal and business insurance products as well as retirement and investment services. We build relationships and work together to create a stronger, more secure future for our clients and our communities. We're a big company, yet small enough you can make an impact and won't get lost in the shuffle. You'll have the opportunity to learn and grow throughout your career, either within this role or by exploring other areas of our business. You'll be able to take advantage of our benefits package, which includes insurance benefits (medical, dental, vision, disability, and life), 401(k) with company match. COUNTRY Financial is committed to providing equal opportunity in all areas of employment, and in providing employees with a work environment free of discrimination and harassment. Employment decisions are made without regard to race, color, religion, age, gender, sexual orientation, veteran status, national origin, disability, or any other status protected by applicable laws or regulations. Come join our team at COUNTRY today!

Reliable, Local Company, Providing Full-Time Remote Job Opportunities. While this position is a full-time remote position, we are looking for candidates in the KC Metro. Play an integral role in driving success, being a part of a passionate team, working directly from the comfort of your own home. We value your expertise and passion, and aim to create a supportive atmosphere that encourages personal and professional growth. We pride ourselves on being a leading company in our industry, known for our stability, reliability, and commitment to excellence. At Traders Insurance, we value employee empowerment, open communication, and the ability to make a difference. Join us today to enjoy a multitude of opportunities for learning, development, and advancement. The Bodily Injury Claims Representative position is primarily responsible for the handling of bodily injury and associated property damage claims that result from an automobile accident. The role requires a basic level of technical expertise along with sufficient problem solving and organizational skills to gather details, investigate accidents, and manage the claims process. Every day is different as you work to resolve problems and we ask that you be willing to work hard in a fast-paced and ever-changing environment. It is also expected this person exhibit strong interpersonal skills with other team members, while providing strong contributions to overall company and claims department success. Responsibilities Primarily investigates and handles bodily injury claims along with associated property damage claims, including questions of coverage, liability, and damages, of moderate to high complexity. Ability to deliver superior customer service through strong verbal and written communication skills. Interviews customers, claimants, and witnesses. Helps determine coverage and liability (who's at fault for the damages). Partners with appraisers/estimators to manage vehicle repairs. Sets timely, adequate reserves in compliance with the company reserving philosophy. Negotiates with customers and other insurance carriers. Demonstrates ownership attitude with the ability to be analytical and make accurate decisions. Personal computer literate with proficiency in the use of Word and Excel. Ensures all operations are consistent with the stated mission and direction set forth by Traders. All other duties as assigned. Qualifications Bachelor's degree or four years related work experience. 1+ years of prior experience as an auto claims representative or equivalent experience AIC or CPCU degree or equivalent insurance course preferred. Ability to obtain and maintain adjuster license in required states. Compensation is commensurate with experience. Traders employees also benefit from: Group Medical/Dental/Vision Employee and Dependent Life Insurance Paid Time Off 401K Plan Training and Career Development Opportunities for Advancement Traders is an Equal Opportunity Employer.

Reliable, Local Company, Providing Full-Time Remote Job Opportunities. While this position is a full-time remote position, we are looking for candidates in the KC Metro. Play an integral role in driving success, being a part of a passionate team, working directly from the comfort of your own home. We value your expertise and passion, and aim to create a supportive atmosphere that encourages personal and professional growth. We pride ourselves on being a leading company in our industry, known for our stability, reliability, and commitment to excellence. At Traders Insurance, we value employee empowerment, open communication, and the ability to make a difference. Join us today to enjoy a multitude of opportunities for learning, development, and advancement. The Bodily Injury Claims Representative position is primarily responsible for the handling of bodily injury and associated property damage claims that result from an automobile accident. The role requires a basic level of technical expertise along with sufficient problem solving and organizational skills to gather details, investigate accidents, and manage the claims process. Every day is different as you work to resolve problems and we ask that you be willing to work hard in a fast-paced and ever-changing environment. It is also expected this person exhibit strong interpersonal skills with other team members, while providing strong contributions to overall company and claims department success. Responsibilities Primarily investigates and handles bodily injury claims along with associated property damage claims, including questions of coverage, liability, and damages, of moderate to high complexity. Ability to deliver superior customer service through strong verbal and written communication skills. Interviews customers, claimants, and witnesses. Helps determine coverage and liability (who's at fault for the damages). Partners with appraisers/estimators to manage vehicle repairs. Sets timely, adequate reserves in compliance with the company reserving philosophy. Negotiates with customers and other insurance carriers. Demonstrates ownership attitude with the ability to be analytical and make accurate decisions. Personal computer literate with proficiency in the use of Word and Excel. Ensures all operations are consistent with the stated mission and direction set forth by Traders. All other duties as assigned. Qualifications Bachelor's degree or four years related work experience. 1+ years of prior experience as an auto claims representative or equivalent experience AIC or CPCU degree or equivalent insurance course preferred. Ability to obtain and maintain adjuster license in required states. Compensation is commensurate with experience. Traders employees also benefit from: Group Medical/Dental/Vision Employee and Dependent Life Insurance Paid Time Off 401K Plan Training and Career Development Opportunities for Advancement Traders is an Equal Opportunity Employer.

Job Details Parkside Hospital - Tulsa, OK Full TimeClaims Follow-Up Representative Job Description Do you enjoy making a difference in a patient's life? Do you enjoy making a difference in your community? Come work at Parkside! Where healing happens. Every day. Parkside Psychiatric Hospital & Clinic is a comprehensive mental healthcare system providing acute in-patient care, residential treatment, and outpatient therapy. With a focus on society's most vulnerable population, Parkside provides world-class mental health services focused on children and young people, ages 5 to 26. For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, patient-centered care that propel families from hopeful to hope-filled. As a center of excellence, we cultivate talent and provide professional purpose. Together we facilitate healing, one patient at a time. The Claims Follow-Up Representative is responsible for monitoring and managing outstanding insurance claims to ensure timely and accurate reimbursement. This role involves investigating and resolving denied or delayed claims, communicating with insurance providers, and maintaining compliance with industry regulations. The ideal candidate has strong analytical skills, attention to detail, and a thorough understanding of healthcare billing processes. Key Responsibilities: • Claims Follow-Up: Track and follow up on outstanding insurance claims to ensure prompt payment. • Denial Management: Analyze claim denials, identify root causes, and take appropriate corrective actions to appeal or resubmit claims. • Insurance Communication: Contact insurance carriers via phone, email, or online portals to resolve claim issues and obtain payment status. • Documentation: Maintain accurate records of claim statuses, communications, and resolution efforts in the billing system. • Compliance: Ensure adherence to HIPAA regulations, payer policies, and industry guidelines. • Collaboration: Work closely with billing specialists, coders, and other revenue cycle team members to address claim discrepancies. • Reporting: Generate and review aging reports to prioritize follow-up efforts and track claim resolution progress. • Process Improvement: Identify trends in denials and delays, providing feedback to management for process enhancements. • Other duties as assigned. Claims Follow-Up Representative Qualifications • High school diploma or equivalent (Associate's or Bachelor's degree in healthcare administration or a related field is a plus). • 1-2 years of experience in healthcare claims follow-up, medical billing, or revenue cycle management. • Knowledge of insurance guidelines, claims processing, and medical terminology. • Familiarity with Electronic Health Records (EHR) and billing software. • Strong communication and problem-solving skills. • Ability to work independently and meet deadlines in a fast-paced environment. Benefits include: Medical, Dental, and Vision Generous Paid Time Off and Holidays 401K and match start immediately, and includes a generous match Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!

This role requires the ability to work lawfully in the U.S. without employment-based immigration sponsorship, now or in the future. The Damage Claims Rep I must have in-depth knowledge of multiple systems and have experience handling escalated situations. Responsible for handling damage claim escalations; becoming the point of contact between field management and the customer and accurately capturing claim details for reporting purposes. MAJOR DUTIES AND RESPONSIBILITIES Actively and consistently support all efforts to simplify and enhance the customer experience Provides customer support for service complaints; answer questions regarding services and products; receive telephone calls from internal and external customers through the resolution of the claim. Provides support and guidance to Field Operations to ensure timely resolutions to damage claims. Enters damage tickets into ticketing system and update systems as required. Creates investigation forms and other official documents; drafts and sends mail correspondence to external customers and field management. Completes required liability forms for submission to risk management. Performs basic troubleshooting for all damage claims internal process. Some of these issue may include problems with the ticketing system; email attachments; damage claim reporting or liability form submission. Interacts with the regional leadership, the field, other departments and customers to ensure timely resolutions to damage claim reports. Accesses multiple billing systems for account information; conducts research in multiple billing and online systems. Accurately and thoroughly documents customer interactions and claim detail. Reports and escalates Field Operations missed SLA's as needed. Generates reports for management as required. Performs multiple tasks simultaneously and follows direction with minimal supervision. Performs other duties as requested by supervisor. REQUIRED QUALIFICATIONS Required Skills/Abilities and Knowledge Ability to read, write, speak and understand English Ability to prioritize and organize effectively Ability to multitask at a high level Ability to use critical thinking in complex situations Ability to use personal computer & software applications Ability to work independently in group environment Ability to effectively address/resolve customer complaints and issues Ability to work while seated for prolonged periods of time Ability to communicate orally and in writing in a clear and straightforward and professional manner Demonstrated knowledge of all three lines of business (Cable, HSI, Telephone) Knowledge of office procedures and Company policies Knowledge of KMS and CSG Knowledge of service troubleshooting Knowledge of MS Office Suite Required Education High School Diploma or equivalent Required Related Work Experience and Number of Years Customer service experience - 3 Telephone, Video, High Speed Data experience - 2 Telecommunication experience or equivalent - 2 PREFERRED QUALIFICATIONS Preferred Skills/Abilities and Knowledge Preferred Education Preferred Related Work Experience and Number of Years WORKING CONDITIONS Office, team setting environment Exposure to moderate noise level CRP145 2025-65275 2025 Here, our employees don't just have jobs, they're building careers. That's why we offer a comprehensive pay and benefits package that rewards employees for their contributions to our success, supporting all aspects of their well-being at every stage of life. A qualified applicant's criminal history, if any, will be considered in a manner consistent with applicable laws, including local ordinances. Get to Know Us Charter Communications provides superior communication and entertainment products for residential and business customers through the Spectrum brand. Our offerings include Spectrum Internet, TV, Mobile and Voice. Beyond our connectivity solutions, we also provide local news, programming and regional sports via Spectrum Networks and multiscreen advertising solutions via Spectrum Reach. When you join our team, you'll be keeping our customers connected to what matters most in 41 states across the U.S. Watch this video to learn more. Grow Your Career Here We're committed to growing a workforce that reflects the customers and communities we serve - providing opportunities for employment and advancement to all team members. Spectrum is an Equal Opportunity Employer, including job seekers with disabilities and veterans. Learn about Life at Spectrum.

Job DescriptionDescriptionPosition: Production Public Adjuster (Licensed) Location: Primary Locations: KS City, Des Moines IA, State of CO, State of CA, St. Louis, State of IL with emphasis on ChicagoCompensation: $75,000 - $100,000 compensation + Performance-based bonuses QUICK FACTS: Must have Public Adjuster License Must have experience with Xactimate Must have network of Condo, Apartment, Property Management partners Must be able to physically examine all buildings top to bottom (roofs as well) About the Company:A well-established, industry-leading public adjusting firm is seeking motivated and driven Outside Sales Representatives to join our growing team. We specialize in advocating for policyholders, ensuring they receive fair settlements for property damage claims. Our sales team plays a critical role in developing strong client relationships and driving company growth. Position Overview:We are looking for a results-oriented Outside Sales Representative with a strong background in direct-to-consumer (D2C) or business-to-business (B2B) sales. This role requires a motivated self-starter who thrives in building and maintaining client relationships while working in a fast-paced, competitive environment. Key ResponsibilitiesKey Responsibilities: Identify and pursue new business opportunities with homeowners, contractors, and referral partners. Educate prospective clients on our services and guide them through the insurance claims process. Develop and maintain a pipeline of leads through prospecting and networking efforts. Conduct presentations and training sessions to build brand awareness and establish partnerships. Provide exceptional customer service to existing clients, ensuring their satisfaction and retention. Work closely with internal teams to optimize the sales process and improve closing rates. Maintain accurate records of sales activities and client interactions. Skills, Knowledge and ExpertiseQualifications & Experience: 3+ years of proven sales experience as a licensed Public Adjuster Strong ability to generate leads, manage relationships, and close deals. Bachelor's degree in Business, Marketing, Communications, or equivalent experience. Familiarity with CRM tools, Microsoft Office Suite, and digital communication platforms. Highly organized with strong follow-through skills in a fast-paced environment. Public Adjuster license BenefitsWhat We Offer: Extensive training and support to help you succeed. Flexible work environment with opportunities for growth and career advancement. A team-oriented culture with strong leadership and professional development opportunities. If you're a highly motivated sales professional looking for a rewarding career with a company that makes a difference, apply today!

The Medical Review Claims Analyst is responsible and accountable for timely and accurate non-clinical reviews of Blue Cross and Blue Shield, National & Special, State, Federal, ITS claims and CSC inquiries to support corporate timeline goals. Responsible for accurate and timely responses to internal and external inquiries involving requests for explanation of contract coverage, coding, and claims payment. Responsible for identifying aberrant provider activity and opportunities for provider education and refer for appropriate intervention. "This position is eligible to work onsite, remote or hybrid (9 or more days a month on site) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment." Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas. Why Join Us * Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans. * Family Comes First: Total rewards package that promotes the idea of family first for all employees. * Professional Growth Opportunities: Advance your career with ongoing training and development programs. * Dynamic Work Environment: Collaborate with a team of passionate and driven individuals. * Flexibility: options to work onsite, hybrid or remote available * Balance: paid vacation and sick leave with paid maternity and paternity available immediately upon hire Compensation $23.58 - $29.40 hourly Non-Exempt 12 * Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts. What you'll do * Responsible for independent non-clinical review of claims and inquiries using contracts, medical policies, internal guides, and desk process. * Ensure claims and inquiries are processed timely and accurately according to contract, corporate, and federal guidelines. * Responsible for identifying when a non-clinical review should be elevated to a higher level of review, i.e., nurse consultant, management, consultants. * Responsible for researching history, identifying appropriate guidelines, and formatting clear concise question(s) for claims needing nurse, management, or outside consultant review. * Responsible for providing support to internal staff (i.e., Marketing, Hotline, CSC), regarding questions about coding, claim processing, and pricing issues. * Responsible for maintaining current knowledge regarding coding, contract language, system editing, and pricing guidelines. * Responsible for identifying areas of aberrant utilization for provider education, guideline, and system changes. * Participates in department and cross-divisional teams. * Must follow URAC standards as required for essential job functions. What you need Knowledge/Skills/Abilities * Must be able to comply with and implement corporate information security policies, standards, and guidelines relative to access control. * Must be self-directed with the ability to make independent decisions and prioritize personal and employee production activities. * Must have strong computer skills in order to operate effectively with company systems and programs. * Proficient in Excel, WORD, OneNote, and other department used systems. * Must be able to maintain a productive and professional relationship with multiple cross departmental and divisional teams. * Must be able to maintain an excellent record of attendance. * Must have a strong analytical background. * Must be able to use medical terminology/medical diagnostic and procedure information, ICD-10, CPT, HCPCS coding to accurately review and complete claims activity. Education and Experience * High school graduate or equivalent - required. * At least three years of BCBSKS Claims or CSC experience AND/OR American Academy of Professional Coders certification with at least 2 years of coding experience or at least 3 years of medical coding experience - required. * Thorough knowledge of multiple product lines, contracts, and related operating policies with preference to FEP, Blue Choice, State of Kansas, and Interplan Teleprocessing System (ITS) - Preferred. * Thorough knowledge of CSI, Reimbursement Schedules, Ask Oz, ACEs, Claims XTen, Imaging, BlueConnect, and Outlook - preferred. * CPC certified or obtain certification by American Academy of Professional Coders within three years of hire. Physical Requirements * 90-100% sedentary work setting using a computer. Benefits & Perks * Base pay is only one component of your competitive Total Rewards package * Incentive pay program (EPIP) * Health/Vision/Dental insurance * 6 weeks paid parental leave for new mothers and fathers * Fertility/Adoption assistance * 2 weeks paid caregiver leave * 5% 401(k) plan matching * Tuition reimbursement * Health & fitness benefits, discounts and resources Our Commitment to Connection and Belonging At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of connection and belonging, where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law. Blue Cross and Blue Shield of Kansas conducts pre-employment drug screening, criminal conviction check, employment verifications and education as part of a conditional offer of employment.

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 Title: Nights Casualty Claims Intake Representative I Department: Insurance Country: United States of America State/Province: Arkansas City: Lowell Full/Part Time: Full time Under general supervision, this position is responsible for the recording and triage process of all safety-related events pertaining to Casualty, Workers' Compensation, and Final Mile. The role serves as the initial point of contact for all parties involved in an event, gathering and verifying claim details, initiating appropriate actions, and ensuring accurate documentation in alignment with company policies and regulatory requirements. The incumbent supports timely claim resolution, collaborates with internal and external stakeholders, and contributes to risk mitigation efforts through early identification of claims potential exposure. : Schedule: Monday-Friday 11:30 PM-7:30 AM CST Key Responsibilities: Utilize experience and established procedure to field and process all incoming calls, email, and other various notification methods related to safety events to create an accurate record of the event and assess initial financial exposure to the company; maintain an organized workflow, coordinate initial claim assessments, and prioritize cases based on urgency and severity Utilize independent knowledge to assess all collected information, as well as identify missing, incorrect, or updated claim information, to determine appropriate course of action, support timely mitigation of financial exposure, and ensure compliance with company policy and local/state/federal laws; actions include, but are not limited to, providing information to the claimant, retaining independent field adjusters, determining the need for and coordinating drug test, and escalating complex issues to the appropriate internal parties Ensure accurate, timely, and complete documentation of safety events with attention to the direct effects on business units' financial performance, the company's overall DOT safety rating, driver coaching, establishment of training programs, analysis of trends, and resolution or defense of litigated matters Leverage strong verbal and written communication skills to coordinate effectively with claimants, internal and external stakeholders, law enforcement and legal representatives. Facilitate the verification of claims by ensuring timely and accurate information exchange, resolving discrepancies, and advancing incident resolution Utilize independent knowledge and experience to identify events with potential exposure after a short investigative period and pursue early resolution of claims through established financial authority levels or escalation to senior team members for the extension of increased authority with the goal of avoiding or reducing financial exposure from protracted claims and litigation. Actively provide continued investigative support to claims examiners At the direction of counsel, actively begin the litigation preservation process through the location, assessment and storage of collision mitigation and GPS data, onboard video data, and other documentation on all events which meet pre-defined criteria. This will often include detailed searches of media and social media reports, law enforcement websites, and other public databases, as well as reviewing additional videos to confirm involvement in alleged events Participate in training and development to stay updated on industry changes, company policy updates, and improvement of processing techniques Serve as a liaison between claimants, adjusters, and legal teams to support collaborative decision-making and maintain transparency throughout the claims process; utilize strong interpersonal, professional, and empathetic skills to de-escalate emotional and sometimes complex situations and provide timely solutions and resolutions for involved parties Provide process or system feedback to assist with improvement of information capture, ensuring program issues are addressed in a timely manner, and assist others with workarounds and alternative solutions Qualifications: Minimum Qualifications: High School Diploma/GED with up to 1 year of experience in Human Resources, Claims, Insurance, Customer Service, or related field Preferred Qualifications: Experience in a call center, particularly within the Insurance industry Ability to uphold a professional demeanor in all customer interactions, demonstrating empathy and patience in the face of challenging situations Knowledge of problem reporting and escalation practices Ability to accurately analyze situations and reach productive decisions based on informed judgment Ability to maintain composure under pressure Ability to adapt to a dynamic work environment and shifting priorities and directives Ability to effectively transmit, receive, and accurately interpret ideas through various mediums Ability to work with a variety of individuals and groups in a constructive and collaborative manner Ability to capture and document relevant business information in an auditable, organized, and easily retrievable manner Ability to process information with high levels of accuracy with attention to detail. Ability to type at least 40 words-per-minute Applicants can be considered for I, II, or Sr. Level depending on verified availability. This position is not eligible for employment-based sponsorship. Compensation: Factors which may affect starting pay within this range may include skills, education, experience, geography, and other qualifications of the successful candidate. This position may be eligible for annual bonus and incentives based on profitability or volumes in accordance with the terms of the Company's bonus and incentive plans, as applicable and in effect from time to time. Benefits: The Company offers the following benefits for full-time positions, subject to applicable eligibility requirements, as may be in effect from time to time: medical benefit, dental benefit, vision benefit, 401(k) retirement plan, life insurance, short-term and long-term disability coverage, paid time off commensurate with tenure (includes vacation and sick time), six weeks of paid maternity leave along with two weeks of paid parental leave, and six paid holidays annually. Education: GED (Required), High School (Required) Work Experience: Customer Service/Account Manager, Human Resources Job Opening ID: 00607006 Nights Casualty Claims Intake Representative I (Open) “This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.” J.B. Hunt Transport, Inc. is committed to basing employment decisions on the principles of equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, persons with disabilities, protected veterans or other bases by applicable law.

Job Details AR North Little Rock TLI - North Little Rock, AR TransportationDescription The responsibility of this position is to be available for accident and incident reporting and be proactive in the claims management process. Essential job duties include: Managing the day to day activities involved with accident and incident documentation. Report all claims to the appropriate insurance company in a timely manner. Correspond with public on accident claims as needed. Request and approve payments below insurance deductibles. Elevate any claims disputes to the appropriate parties. Manage a reporting database used to run reports and pass along information to other departments. Prepare reports for bi-weekly claims meetings with management. Collect all documentation needed for catastrophic accidents as required. Assist other safety coordinators in day to day activates to include driver phone calls, e-log corrections, employment verifications, etc. Training other employees in all the above as assigned. Various projects as needed. Qualifications Education: HS diploma or equivalent required. Preferred knowledge, skills and abilities: High school or equivalent Claims management experience 2+ years preferred. 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 stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee is frequently required to climb or balance; stoop, kneel, crouch, or crawl and talk or hear. The employee is occasionally required to sit. The employee must frequently lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, peripheral vision and depth perception. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Rapidly growing Insurance Restoration Company seeking qualified candidates for the position of Sales Representative. The Sales Representative will sell roofing product lines / systems and generate new growth and profitability through business networking, contacts, telephoning, door knocking, and the like to obtain inspections for potential weather related structural property damage and consultations for cosmetic/structural replacements, upgrades and remodels. You will also be provided with occasional company generated leads. Our ideal candidates will have in-home sales experience or come from the residential real estate, window/siding/roofing, home inspection, or home improvement industries. You MUST have verifiable and STABLE sales experience. Construction experience and knowledge is a definite plus. The ideal candidate must also have strong listening, follow-up, and closing skills. You must be proficient working with computer software and be detail oriented, focused, and a team player. Most importantly, you MUST have strong ethics and high integrity and be committed to ALWAYS putting the customer first. We also ask that you are outgoing, with a positive personality, have a professional and respectable demeanor, clean cut and professional appearance, are self-motivated, eager to succeed, possess excellent communication skills, have the ability to multitask and manage time effectively, are positive and energetic, have the ability & willingness to learn and implement today's top marketing and selling techniques, and be willing to work some weekends to go above and beyond. Team Players will thrive in our environment. We build our jobs promptly! Requires ability to climb on roofs and transport a ladder. W2 & 1099 Positions. If interested please call ************ to schedule your interview today! Qualifications Would prefer prior sales experience Additional Information All your information will be kept confidential according to EEO guidelines.

Job Description Researches insurance claim denials, determines the validity of the claim and when appropriate is responsible for adjusting and resubmitting the claims via multiple methods. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES Researches denial of claims, evaluates and rebills as necessary in an effort to ensure the maximum accurate payment and reduce the number of A/R days Communicates with Business Office or clinical staff regarding coverage and denials, if appropriate Sustains aged A/R of less than 120 days Maintains a high level of integrity and commitment to accurate claims processing Performs other duties as required QUALIFICATIONS One year of experience with insurance billing and claims research preferred High school or equivalent with emphasis on business related courses Ten key, computer/data entry, spreadsheets, and word processing Communication, analytical and problem solving skills Ability to multi-task and meet deadlines Detail oriented and organizational skills Excellent verbal and written communication skills Ability to work independently and collaboratively within a team environment Commitment to the mission of Red Rock BHS PHYSICAL REQUIREMENTS Must have the ability to stand or sit for long periods of time Must have the ability to lift, push, or pull a minimum of 25 pounds Ability to travel approximately 10% of the time Ability to use telephone, PC, fax machine, copy machine, and printer HOW WE TAKE CARE OF YOU! We pay a generous portion of your Health Insurance Low-cost Dental and Vision Insurance Retirement Plan with employer contributions equal to 5% of annual salary Student Loan Repayment options No cost Employee Assistance Plan 3 Weeks Paid Time-Off (increases annually between years 2-10) 9 Paid Holidays 1 Floating Holiday to use at your discretion. 4 Rest and Relaxation days 3 days of Education Leave 4 hours of Volunteer Leave Eligible for Pay Increases and Bonuses annually Employer Paid Long-Term Disability and Life Insurance Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities Red Rock Behavioral Health Services does not discriminate based on race, color, national origin, religion, gender, gender identity, age, marital/familial status, sexual orientation, or disability.

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.

Pay:$50K Full time Benefits available Primary Purpose: Investigate insurance claims; obtain all necessary information to evaluate claims and expedite settlement. Candidate must reside in one of the following counties: Garvin, Murray, Carter, Jefferson, Love, Johnston. Marshall and Bryan. Essential Duties and Responsibilities include the following. Other duties may be assigned. Investigate all lines insurance claims within assigned territory and limits of authority; responsible for the accurate and efficient completion of all phases of claims processing from inception to settlement. Investigate personally and/or in conjunction with Specialist major losses, complex liability/fire damage claims, catastrophe, multiple bodily injury claims and litigation cases. Obtain (via telephone, correspondence or personal visit) loss reports, insured/witness/claimant statements, medical/police reports, appraisals, repair estimates, etc., as required; take photos as indicated. Confirm coverage for new claims and set reserves amounts; follow up on necessary information; and record diaries for scheduled review of files; issue payment & correspondence as needed. Analyze all accumulated data, reports, photos, etc. and evaluate claims; determine coverage and extent of loss/liability; prepare corresponding claims summaries. Settle claim within limits of authority; issue drafts/checks for claim payment and obtain required liability releases upon settlement; close claims files. Confer with District Claims Manager regarding complex claims or when potential exposure exceeds settlement authority. Periodically review all open claims files assigned to adjuster, obtain any necessary information and adjusting reserve amounts as needed. Travel to county offices as needed. Travel to serve on storm teams to assist with any other catastrophe losses as required. Maintain company car in serviceable condition; prepare/submit weekly expense account. Competencies To perform the job successfully, an individual should demonstrate the following competencies: Analytical - Synthesize complex or diverse information; Collect and research data; Uses intuition and experience to complement data. Customer Service - Manage difficult or emotional customer situations; Respond promptly to customer needs; Respond to requests for service and assistance; Meet commitments. Interpersonal Skills - Maintain confidentiality; Keep emotions under control. Oral Communication - Speak clearly and persuasively in positive or negative situations; Listen and obtain clarification; Respond well to questions; Demonstrate group presentation skills; Participate in meetings. Written Communication - Write clearly and informatively; Edit work for spelling and grammar; Change writing style to meet needs; Present numerical data effectively; Read and interpret written information. Business Acumen - Understand business implications of decisions; Display orientation to profitability. Ethics - Treat people with respect; Keep commitments; Inspire the trust of others; Work ethically and with integrity; Uphold organizational values. Organizational Support - Follow policies and procedures; Support organization's goals and values. Judgment - Display willingness to make decisions; Exhibit sound and accurate judgment; Support and explain reasoning for decisions; Include appropriate people in decision-making process; Make timely decisions. Planning/Organization - Prioritize and plan work activities; Use time efficiently. Professionalism - Approach others in a tactful manner; React well under pressure; Accept responsibility for own actions. Quality - Demonstrate accuracy and thoroughness; Look for ways to improve and promote quality; Monitor own work to ensure quality. Quantity - Meet productivity standards; Complete work in timely manner; Work quickly & accurately. Safety and Security - Observe safety and security procedures. Adaptability - Adapt to changes in the work environment; Deal with frequent changes, delays, or unexpected events. Attendance/Punctuality - Is consistently at work and on time; Ensure work responsibilities are covered when absent; Arrive at meetings and appointments on time. Dependability - Follow instructions, responds to management direction; Commit to long hours of work when necessary to reach goals. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience Bachelor's degree from four-year college or university, and/or two to four years related experience and/or training or equivalent combination of education and experience. Employee is expected to participate in continuing education program(s). Skills and Knowledge Language Skills Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or government regulations, insurance policies and contracts. Ability to write reports and business correspondence. Ability to effectively present information and respond to common inquiries or complaints from groups including but not limited to managers and supervisors, company departments, insureds, third parties, witnesses, doctors, attorneys, agents, county offices and other insurance companies. Mathematical Skills Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent and to draw and interpret bar graphs. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Computer Skills To perform this job successfully, an individual should have knowledge of computers and computer systems. Certificates, Licenses, Registrations Valid driver's license or obtainment of valid Oklahoma driver's license is required. Satisfactory driving record is a condition of employment. Current Oklahoma adjuster license or obtainment of valid Oklahoma adjuster's license is required. Other Skills and Abilities Must have investigative skills and a proven ability to work with people and solve problems. Ability to manage stress due to high volumes of work, long hours, and dealing with discontented insureds and/or third parties. Employee is expected to maintain regular attendance. Other Qualifications Work unscheduled hours and some travel. 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 stand; walk; sit; use hands to finger, handle or feel; reach with hands and arms and talk or hear. The employee is frequently required to climb or balance and stoop, kneel, crouch or crawl. The employee is occasionally required to taste or smell. The employee must regularly lift and/or move their assigned equipment of a minimum of 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. This is not a remote position. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is frequently exposed to outside weather conditions. The employee is occasionally exposed to wet and/or humid conditions; moving mechanical parts; high, precarious places; fumes and airborne particles; extreme cold; extreme heat and risk of electrical shock. The noise level in the work environment is usually moderate. WE ARE AN EQUAL OPPORTUNITY EMPLOYEROklahoma Farm Bureau & Affiliated Companies does not discriminate on the basis of race, color, religion, national origin, sex, age or disability. It is our intention that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors.

The Claims Denial Specialist works within the organization's revenue cycle to investigate, resolve, and appeal denied insurance claims. By identifying the root causes of denials, correcting errors, and communicating with insurance companies, they help prevent revenue loss and secure proper reimbursement for services. Core responsibilities Denial analysis and resolution: Research denied or rejected claims by reviewing insurance correspondence, billing and coding documentation, and patient medical records. Appeals processing: Prepare and submit detailed, well-argued appeals to insurance payers, often citing clinical documentation, payer-specific policies, and contractual language. Investigative follow-up: Follow up on appeals and resubmitted claims with insurance companies, typically by phone or through payer portals, to resolve outstanding issues and ensure timely reimbursement. Process improvement: Identify trends and patterns in claim denials to help prevent future errors. This often involves collaborating with other departments, such as billing and coding, to improve processes. Documentation and reporting: Accurately document all communication and actions taken on a claim within the patient accounting system. Create and deliver reports to management on denial trends and recovery efforts. Compliance monitoring: Stay up-to-date with changing regulations, payer guidelines, and billing rules for government programs (like Medicare and Medicaid) and commercial insurance. Essential qualifications and skills Healthcare knowledge: A strong understanding of the healthcare revenue cycle, medical terminology, and medical coding systems. Experience with electronic health record (EHR) systems and billing software. The ability to conduct root-cause analysis, recognize patterns in denial data, and use critical thinking to build effective appeal strategies. Excellent written communication for drafting persuasive appeal letters and verbal communication for interacting with payers, providers, and patients. Professional certifications such as Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) are often preferred or required. Meticulous attention to detail is necessary to review complex documentation, catch errors, and ensure all resubmissions are accurate and compliant.