Claims representative jobs in Toledo, OH

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Arch Insurance Group Inc., AIGI, has an opening in the Claims Division is seeking a Senior Claims Examiner to join the Casualty Team. In this role, the responsibilities include actively managing commercial accounts claims caseload throughout the United States. Primary Responsibilities Specific duties include but not limited to the below: * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement strategy to resolve matters of liability and damages of a particular case * Maintain contact with the business line leader, underwriter, defense counsel, program manager, and broker * Investigate claim and review the insureds' materials, pleadings, and other relevant documents * Identify and review of each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Qualifications * Proper adjuster licensing in all applicable states * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Ability to take part in active strategic discussions * Ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 20% * This role is hybrid with 2 days in office Education and Experience * Bachelor's degree; Juris Doctorate degree preferred * Five (5) years of working experience with a primary and / or excess carrier supporting commercial accounts for Casualty claims; Professional Liability claims #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. For Jersey City, Morristown, NYC: $123,400 - $166,633/year For Hartford, Chicago, Long Island: $111,100 - $149,970/year * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. For Colorado Applicants - The deadline to submit your application is: December 08, 2025 14400 Arch Insurance Group Inc.

... The Workers' Compensation Claim Supervisor, working under general direction, is responsible for supporting the administration of workers' compensation policies and procedures related to claim filing, claim fulfillment, incident investigations, etc., with fairness and consistency in a timely manner. Additionally, the role is responsible for staying updated on trends and industry practices within the workers' compensation domain, collaborating with teams to implement training programs, and ensuring compliance with policies. The role would also maintain accurate and confidential records and data related to workers' compensation matters. Responsibilities What you'll do... Implements the execution of the organization's workers' compensation policies and procedures, with fairness and consistency in a timely manner. Ensures compliance with employment laws, regulations, and company policies. Offers expert technical and jurisdictional guidance to claim staff regarding complex compensability, investigation and litigation issues. Supports handling the workers' compensation claims from initial report to resolution and investigates accidents involving company staff, vehicles, and equipment. Performs regular workers' compensation operations review with each plant location to ensure each case has an action plan in place. Ensures necessary documentation is obtained and provided to the claim adjusters. Determines the need to report claims and maintains regular communication/review with claim adjusters to ensure excellent management of claims. Represents the company at workers' compensation claim review meetings as required. Coordinates modified duty return-to-work efforts with the claim adjusters, HR, and plant operations. Participates in the delivery of workers' compensation special projects by representing the team as the prime contact, coordinating with senior internal and industry personnel, integrating data and information from multiple sources to identify trends, and innovating solutions to minimize the overall cost of workers' compensation claims through effective claims management and loss prevention strategies. Stays updated on workers' compensation laws and regulations to ensure program compliance. Monitors claims status, maintains files, and provides necessary support in defense of claims. May maintain occupational safety and health agency records if necessary. Supports the preparation of regular reports on workers' compensation program performance, trends, and metrics for management. Compiles and analyzes data related to workplace injuries, claims, and costs. Maintains important records related to claim processing such as medical bills, treatment plans, etc. Provides input on risk assessments, development of strategies, action plans, and associated recommendations to move claims to settlement or closure. Participates in the annual audit process for the company's workers' compensation programs including claims administration, cost analysis, injured employee communications, and return-to-work programs, and updates existing policies related to the workers' compensation function, whilst maintaining compliance and consistency with relevant laws and companywide policies. Supports the development of trainings to educate employees about the workers' compensation processes, their rights, and responsibilities. Demonstrates full knowledge of industry best practices in workers' compensation subjects such as loss prevention and rehabilitation management programs along with a strong understanding and application of related concepts and principles. Attends conferences, and other trainings to stay current on risk, claims, and safety developments. Coaches and guides managers and employees on matters related to workers' compensation. Qualifications You'll have... Bachelor's Degree in Human Resources, Risk Management, or any other related discipline or commensurate work experience in workers' compensation. Minimum 7 years of experience managing multi-state workers' compensation claims and navigating diverse regulatory environments. Work Requirements… Involves frequent (defined as one to two-thirds of the time) lifting of more than 10 to 25 pounds. Work performed requires a good deal of walking or standing and may include some sedentary work and working conditions that include moderate noise levels related to the use of office equipment or machinery. May involve exposure to varying outside temperatures. This description outlines the general nature and scope of work typically performed in this job. It is not intended to be an exhaustive list of all duties, responsibilities, knowledge, skills, work requirements, etc. It may vary slightly based on business or geographic needs and is subject to being reviewed and updated periodically. You may not check every box, or your experience may look a little different from what we've outlined, but if you think you can bring value to Ford Motor Company, we encourage you to apply! As an established global company, we offer the benefit of choice. You can choose what your Ford future will look like: will your story span the globe, or keep you close to home? Will your career be a deep dive into what you love, or a series of new teams and new skills? Will you be a leader, a changemaker, a technical expert, a culture builder…or all the above? No matter what you choose, we offer a work life that works for you, including: Immediate medical, dental, vision and prescription drug coverage Flexible family care days, paid parental leave, new parent ramp-up programs, subsidized back-up childcare and more Family building benefits including adoption and surrogacy expense reimbursement, fertility treatments, and more Vehicle discount program for employees and family members and management leases Tuition assistance Established and active employee resource groups Paid time off for individual and team community service A generous schedule of paid holidays, including the week between Christmas and New Year's Day Paid time off and the option to purchase additional vacation time. This position is a salary grade 7. For more information on salary and benefits, click here: New Hire Benefits Visa sponsorship is not available for this position. Candidates for positions with Ford Motor Company must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. In the United States, if you need a reasonable accommodation for the online application process due to a disability, please call **************. This position is hybrid (onsite four days per week) for candidates who are in commuting distance to a Ford hub location. #LI-Hybrid #LI-LP3

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAs a Product Liability Litigation Adjuster, Risk Management, you will be responsible for managing lawsuits and overseeing outside counsel defending CVS in high exposure, product liability mass tort litigations and general liability cases filed throughout the United States. Responsibilities include:Developing relationships with internal colleagues for fact-finding and key litigation activities. Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. Managing all aspects of product liability mass tort litigations and complex general liability cases. Working with outside national counsel and sr. management to develop consistent litigation strategies applicable to mass tort cases filed across the country. Providing reporting to key internal stake holders on case developments and litigation trends for product liability mass torts and other cases. Managing large scale discovery investigations by working with internal custodians, outside counsel and vendors to develop comprehensive procedures for identifying, locating, preserving and producing corporate records. Analyzing case and internal materials and utilizing resources across CVS to discern key issues and identify the litigation strategy in every case assigned. Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working with and overseeing outside counsel. Participating in meetings and attending mediation and trial as necessary to oversee and assist in the defense or resolution of cases. Required Qualifications2+ years of legal experience, ideally with a law firm or as a litigation adjuster with a large self-insured company or insurance carrier. Juris Doctor degree from an ABA accredited university. Ability to travel and participate in legal proceedings, arbitrations, depositions, etc. Preferred QualificationsExperience overseeing or defending product liability claims and litigation. Familiarity or experience with insurance and coverage issues related to litigated claims. Strong attention to detail and project management skills. Experience overseeing and answering written discovery. Ability to work independently and in an environment requiring teamwork and collaboration. Strong written and verbal communication skills. Demonstrated negotiation skills and ability. Ability to articulate and summarize cases with management in a concise, cogent manner. Litigation experience at a law firm, and/or significant experience overseeing litigated claims for an insurance carrier or corporation, including mediation experience and trial exposure. 3-5 years of legal or claims experience. Familiarity with the rules and procedures applicable to mass tort litigations, class actions, and/or multidistrict litigations. Knowledge and experience navigating attorney-client privilege issues, corporate litigation holds, corporate witness depositions, and e-discovery. Ability to influence and work collaboratively with senior leaders, CVS' in-house legal counsel and outside counsel. Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook) with a proven ability to learn new software programs and systems. Ability to positively and aggressively represent the company at mediation, arbitration and trial. Ability to navigate difficult situations and communicate effectively with both internal and external groups. Excellent organizational and time management skills and ability to handle a high volume of litigated claims. Experience with and understanding of legal documents (pleadings, discovery, motions and briefs). EducationVerifiable Juris Doctor degree Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$46,988. 00 - $122,400. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/03/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Job Details Ohio Location - Walbridge, OH Full Time Equivalent Work Experience $21.50 - $22.25 Hourly None Second ManufacturingDESCRIPTION SIGN ON BONUS up to $5,000.00! Shift Available: 2nd Shift: 2:30pm - 10:30pm Are you a hands-on problem solver? If you love tinkering with machinery and turning ideas into reality, this is your chance to shine in our climate-controlled facility. Do you have the mechanical ability but no chance for advancement, and no one will invest the time to train you? Are you looking for a Career and not just a job? APPLY with Western States, we will invest the time to train candidates for this role. We are looking for candidates with hands-on mechanical ability who have had experience setting up orders on machines AND hands-on troubleshooting machines in a production/manufacturing OR candidates with experience in an auto/fleet mechanic environment. We seek a skilled and detail-oriented Order Setup Operator (Adjuster) to join our production team at our Walbridge plant just minutes from Perrysburg! This role ensures efficient and smooth operations by setting up and configuring machinery for production runs. This role involves operating all machines in the department, setting up work orders to specifications, troubleshooting, and performing daily maintenance and minor repairs on envelope folding machines. Do you worry about stability? Western States has a history of over 117 years, where 48% of their current staff have been with the company for 10 years or more. (We did the math!). Check out our Western States Facebook page to see some of the fun things we have done in Western States over the past century! HERE'S WHAT MAKES WESTERN STATES A GREAT PLACE TO WORK: Competitive compensation: Comprehensive benefits package including 401k with company match. Work-life balance: 9 paid holidays to help you recharge and enjoy time with loved ones. Growth potential: Join a company with a long history and a commitment to employee development. Stability: Family-owned company since 1908! WHAT DOES MY WORKDAY LOOK LIKE IN THIS ROLE? As a key member of our Folding Department, you'll ensure the smooth and efficient operation of our machinery. Your responsibilities will include: Performing daily machine maintenance, changeovers, and set-ups. Inspecting products and making necessary mechanical adjustments to eliminate quality variations and address mechanical malfunctions. Troubleshooting minor operating difficulties using hand tools. Executing minor machine repairs. Operating all machines within the Folding Department. Examining work orders to determine production specifications. Inspecting product quality following established guidelines. Verifying order accuracy throughout production, including labeling, printing, and packaging. Performing machine wash-up and other general cleaning duties to maintain a tidy workspace. Accurately completing paperwork for labor, time, and quality tracking. Maintaining precise counts of envelopes for boxing, cartonizing, and palletizing. Neatly and uniformly packing envelopes into containers, keeping pace with machine speeds. Placing die-cut paper stacks into machine feeds and splicing paper rolls into web machine feeds. QUALIFICATIONS SUCCESSFUL PEOPLE IN THIS ROLE HAVE THE FOLLOWING SKILLS Demonstrated expertise as Set-Up Operator, Envelope Adjuster or Auto Mechanic. Industry on an RA and/or WD machine in a position of similar skill set and level of responsibility within the Envelope Industry preferred, but not required. 5 years machine set-up and/or repair experience preferred. Proven ability to set up orders on production manufacturing equipment, mechanic, automotive, fleet mechanic, or farm mechanic. Capacity to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Capable of speaking effectively with employees of the organization. Aptitude to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Proficiency in reading and interpreting ruler measurements. Ability to walk and stand frequently during an eight-hour shift. Ability to move up to 50 lbs. PREFERRED QUALIFICATIONS Prior Manufacturing experience in a similar role using hand tools to set up orders in a production environment. ESSENTIAL FUNCTIONS Ability to stand for the approximate duration of the scheduled shift (minus paid breaks), lift up to 20 lbs frequently and up to 50 lbs occasionally, repetitive grasping, frequent twisting, lifting above shoulder height, occasional bending, reaching, crouching, or stooping. Sensory requirements are tactile/touch with hands and digits, near and far visual acuity, color vision, peripheral vision, depth perception, and the ability to adjust focus. Reasoning, mechanical aptitude, and mathematical skills for the appropriate operations of the equipment.

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

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 Workers' Compensation Claim Supervisor, working under general direction, is responsible for supporting the administration of workers' compensation policies and procedures related to claim filing, claim fulfillment, incident investigations, etc., with fairness and consistency in a timely manner. Additionally, the role is responsible for staying updated on trends and industry practices within the workers' compensation domain, collaborating with teams to implement training programs, and ensuring compliance with policies. The role would also maintain accurate and confidential records and data related to workers' compensation matters. You'll have... Bachelor's Degree in Human Resources, Risk Management, or any other related discipline or commensurate work experience in workers' compensation. Minimum 7 years of experience managing multi-state workers' compensation claims and navigating diverse regulatory environments. Work Requirements… Involves frequent (defined as one to two-thirds of the time) lifting of more than 10 to 25 pounds. Work performed requires a good deal of walking or standing and may include some sedentary work and working conditions that include moderate noise levels related to the use of office equipment or machinery. May involve exposure to varying outside temperatures. This description outlines the general nature and scope of work typically performed in this job. It is not intended to be an exhaustive list of all duties, responsibilities, knowledge, skills, work requirements, etc. It may vary slightly based on business or geographic needs and is subject to being reviewed and updated periodically. You may not check every box, or your experience may look a little different from what we've outlined, but if you think you can bring value to Ford Motor Company, we encourage you to apply! As an established global company, we offer the benefit of choice. You can choose what your Ford future will look like: will your story span the globe, or keep you close to home? Will your career be a deep dive into what you love, or a series of new teams and new skills? Will you be a leader, a changemaker, a technical expert, a culture builder…or all the above? No matter what you choose, we offer a work life that works for you, including: Immediate medical, dental, vision and prescription drug coverage Flexible family care days, paid parental leave, new parent ramp-up programs, subsidized back-up childcare and more Family building benefits including adoption and surrogacy expense reimbursement, fertility treatments, and more Vehicle discount program for employees and family members and management leases Tuition assistance Established and active employee resource groups Paid time off for individual and team community service A generous schedule of paid holidays, including the week between Christmas and New Year's Day Paid time off and the option to purchase additional vacation time. This position is a salary grade 7. For more information on salary and benefits, click here: New Hire Benefits Visa sponsorship is not available for this position. Candidates for positions with Ford Motor Company must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. In the United States, if you need a reasonable accommodation for the online application process due to a disability, please call **************. This position is hybrid (onsite four days per week) for candidates who are in commuting distance to a Ford hub location. #LI-Hybrid #LI-LP3 What you'll do... Implements the execution of the organization's workers' compensation policies and procedures, with fairness and consistency in a timely manner. Ensures compliance with employment laws, regulations, and company policies. Offers expert technical and jurisdictional guidance to claim staff regarding complex compensability, investigation and litigation issues. Supports handling the workers' compensation claims from initial report to resolution and investigates accidents involving company staff, vehicles, and equipment. Performs regular workers' compensation operations review with each plant location to ensure each case has an action plan in place. Ensures necessary documentation is obtained and provided to the claim adjusters. Determines the need to report claims and maintains regular communication/review with claim adjusters to ensure excellent management of claims. Represents the company at workers' compensation claim review meetings as required. Coordinates modified duty return-to-work efforts with the claim adjusters, HR, and plant operations. Participates in the delivery of workers' compensation special projects by representing the team as the prime contact, coordinating with senior internal and industry personnel, integrating data and information from multiple sources to identify trends, and innovating solutions to minimize the overall cost of workers' compensation claims through effective claims management and loss prevention strategies. Stays updated on workers' compensation laws and regulations to ensure program compliance. Monitors claims status, maintains files, and provides necessary support in defense of claims. May maintain occupational safety and health agency records if necessary. Supports the preparation of regular reports on workers' compensation program performance, trends, and metrics for management. Compiles and analyzes data related to workplace injuries, claims, and costs. Maintains important records related to claim processing such as medical bills, treatment plans, etc. Provides input on risk assessments, development of strategies, action plans, and associated recommendations to move claims to settlement or closure. Participates in the annual audit process for the company's workers' compensation programs including claims administration, cost analysis, injured employee communications, and return-to-work programs, and updates existing policies related to the workers' compensation function, whilst maintaining compliance and consistency with relevant laws and companywide policies. Supports the development of trainings to educate employees about the workers' compensation processes, their rights, and responsibilities. Demonstrates full knowledge of industry best practices in workers' compensation subjects such as loss prevention and rehabilitation management programs along with a strong understanding and application of related concepts and principles. Attends conferences, and other trainings to stay current on risk, claims, and safety developments. Coaches and guides managers and employees on matters related to workers' compensation.

The Opportunity: The Claims Adjuster is responsible for providing partners with exceptional claims handling services. Partners include, but are not limited to, public entities, public schools, agents, reinsurers, and fellow employees. The ideal candidate will be able to apply prior claims handling knowledge from experience in the insurance industry as well as experience with claims for public entities and public schools. This position can be located in one of Hylant's Ohio office locations (Cincinnati, Cleveland, Columbus or Toledo) with remote work flexibility. In This Role You Will Execute On: Investigate to confirm coverage, determine liability, establish damages, report status, document activities, discern immunities/defenses available and negotiate settlement of all types of assigned claims in a supervised learning environment. Determines, reports on, and initiates subrogation and salvage recoveries. Settle and make payments on assigned claims within prescribed authority level. Effectively plan and schedule work needed to properly handle assigned claims. Performs most duties on an individual bases, with assistance of other senior staff or supervisor if needed. Make timely contact and interview customers, claimants, and witnesses while being responsive to messages, phone calls, emails and correspondence. In This Role You'll Need: A bachelor's degree (or work experience equivalent) and valid state driver's license are required. Claims experience required; public entity and/or public-school claims experience is preferred. A well-qualified applicant has exceptional attention to detail; communicates clearly and concisely, both verbally and in writing; is a team player; and is organized and efficient with his/her time. Why Hylant? A multi-year recipient of Best Places to Work in Insurance, Hylant is a full-service insurance brokerage with over 20 offices in seven states. And since the founding of our family-owned business over 90 years ago, we made a promise to strengthen and protect the businesses, employees and communities of our client family by embracing them as our own. We're more than an insurance brokerage firm and you're more than a client, employee or neighbor. You're family. And that's just the way we treat you. Hylant is proud to be an equal opportunity workplace. All qualified applicants will receive consideration for employment without regard to race, marital status, sex, age, color, religion, national origin, Veteran status, disability or any other characteristic protected by law. If you have a disability or special need that requires accommodation, please let us know. Hylant participates in E-Verify. #LI-Hybrid

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.

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. The Crop Division of Great American has been helping generations of farmers take control of their risks since 1915. The Division is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI policies. With six regional offices throughout the U.S., the teams provide tremendous expertise in the specific needs of farmers and crops. ********************************** Great American is currently seeking Seasonal Crop Adjusters. These positions are seasonal and may not be eligible for full-time or part-time benefits. Qualified candidates will cover territory in one of the following states: * Alabama * Arkansas * California * Colorado * Florida * Georgia * Idaho * Illinois * Indiana * Iowa * Kansas * Kentucky * Louisiana * Michigan * Minnesota * Mississippi * Missouri * Montana * Nebraska * New York * North Carolina * North Dakota * Ohio * Oklahoma * Oregon * Pennsylvania * South Carolina * South Dakota * Tennessee * Texas * Washington * Wisconsin * Wyoming Schedule: Seasonal part-time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, you will: * Understand and can work claims for all major crops, policy/plan types, in all stages of growth. * Complete field inspections, reviews, and adjustments by reading maps and aerial photos, measuring fields and storage bins, and appropriately administering company Crop insurance policies. * Review and evaluates coverage and/or liability. * Secure and analyze necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims. * Ensure compliant and cost effective application of Crop policies by leveraging knowledge of basic insurance statutes and regulations and complying with state and federal regulatory requirements. * Accurately document, process and transmit loss information to determine potential. * Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions, or trials as necessary. * May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority. * Conveys simple to moderately complex information (coverage, decision, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. * Ensures that claims handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed. * Follow regulatory and company rules, policies, and procedures. * Performs other duties as assigned. Physical Requirements for employees in the Crop Business Unit/Crop Claims General Adjuster * Requires continuous and prolonged walking and standing. * Requires frequent lifting, carrying, pushing and pulling of objects up to 50 lbs. * Requires frequent climbing grain bins, bending, twisting, stooping, kneeling and crawling. * Requires overhead reaching and grabbing. * Requires regular and predictable attendance. * Requires ability to conduct visual inspections. * Requires work outdoors, in inclement weather conditions. * Requires frequent travel. * May require ability to operate a motor vehicle. Business Unit: Crop Salary Range: $0.00 -$0.00 Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.

Job Details 00005 Plymouth Corporate - Plymouth, MIDescription The Cargo Claim Analyst will support the Risk Management Department in Cargo claims processing, analytical, reporting and record keeping functions. The primary responsibility of this position is to analyze each cargo claim based on investigation findings and documentation to determine claim validity and process for best resolution. The Cargo Claims Analyst aids the Cargo Claims Supervisor in achieving the department's goals and initiatives. Job Duties Manage cargo claims; gather all facts concerning a claim and provide direction to facilitate claim resolution by working directly with Customers, United Road Operational staff, Independent Contractors and 3 rd party carriers, claim adjusters, industry consultants and insurance companies to mitigate losses and ensure claims are resolved in a timely, cost effective manner Investigate the nature of the incident, collect all necessary documents, determine claim validity, determine and communicate resolution Track and report outstanding claims, determining equitable settlements and managing daily work queues. Maintain customer cargo claim aging on assigned accounts within customer guidelines Process rebuttals, negotiations, and declinations for claim settlement Accountable to achieve quotas and goals as assigned Optimize work processes by investigating and employing best practices with a focus on continuous improvement Data analytics with the use of Excel as the department requires Support CSI tasks as directed by the Cargo Claim Supervisor Qualifications Ability to succeed in a fast-paced environment and work under pressure Proficiency in web-based programs (OVISS, Origami or similar programs) Proficient use of Microsoft Products, with emphasis on Word, Excel, Teams and Outlook Strong analytical skills with the ability to collect, organize, analyze, and disseminate information arising from the Claim processing duties Adept at queries, report writing and presenting findings Ability to exercise good judgement in a variety of situations Ability to solve problems and think quickly under pressure Effective oral and written communication skills Process improvement catalyst Demonstrated poise, tact, and diplomacy Maintain a positive work atmosphere by acting and communicating in a manner which facilitates the success of business operations in order to meet company demands and expectations Two years of experience in trucking industry preferred Two-year college degree preferred United Road is proud to offer our full-time employees best-in-class benefits designed to support your health, well-being, and financial security. From comprehensive medical, dental, and vision coverage to generous retirement savings options and paid time off, we provide a benefits package that goes beyond the basics. We also offer unique perks like a zero-dollar-out-of-paycheck medical plan, telehealth, wellness discounts, and employee assistance resources, ensuring that our team is fully supported both at work and in life. These benefits reflect our commitment to attracting and retaining top talent while helping employees thrive every day. Health & Wellness BCBS PPO Medical with Telehealth Delta Dental NVA Vision Company Paid Life and AD&D Supplemental Life Dependent Life Short-Term Disability Employee Assistance Program (EAP) New Vehicle Supplier Discounts Financial Benefits 401(k) with Company Match Work-Life Balance PTO Program (Vacation, Sick, Personal, Jury, Bereavement) 6 Paid Holidays Hybrid Work Options Available for Select Positions

Eligible candidates for this role should reside within a commutable distance of Saginaw, Michigan. Job Title- Field Property Claim Specialist Reports to: Claim Manager II What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. * Review assigned claims, * Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. * Complete complex coverage analysis. * Ensure all possible policyholder benefits are identified. * Create additional sub-claims if needed. * Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. * Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. * Evaluate the financial value of the loss. * Approve payments for the appropriate parties accordingly. * Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). * Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. * Utilize strong negotiating skills. Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates. Supervisory Responsibilities: None How you will benefit: * A competitive annual salary between $65,700 - $82,000 * ACG offers excellent and comprehensive benefits packages, including: * Medical, dental and vision benefits * 401k Match * Paid parental leave and adoption assistance * Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays * Paid volunteer day annually * Tuition assistance program, professional certification reimbursement program and other professional development opportunities * AAA Membership * Discounts, perks, and rewards and much more We're looking for candidates who: Required Qualifications (these are the minimum requirements to qualify) Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent * CPCU coursework or designation * Xactware Training * Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience. * In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. * Must have a valid State Driver's License Ability to: * Lift up to 25 pounds * Climb ladders. * Walk on roofs. Experience: * Three years of experience or equivalent training in the following: * Negotiation of claim settlements * Securing and evaluating evidence * Preparing manual and electronic estimates * Subrogation claims * Resolving coverage questions * Taking statements * Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: * Fair Trade Practices Act as it relates to claims * Subrogation procedures and processes * Intercompany arbitration * Handling simple litigation * Advanced knowledge of building construction and repair techniques Ability to: * Handle claims to the line Claim Handling Standards * Follow and apply ACG Claim policies, procedures and guidelines * Work within assigned ACG Claim systems including basic PC software * Perform basic claim file review and investigations * Demonstrate effective communication skills (verbal and written) * Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns * Analyze and solve problems while demonstrating sound decision-making skills * Prioritize claim related functions * Process time sensitive data and information from multiple sources * Manage time, organize and plan workload and responsibilities * Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. * Research analyze and interpret subrogation laws in various states * May travel outside of assigned territory which may involve overnight stay Preferred Qualifications: Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent * CPCU coursework or designation * Xactware/Xactimate Training or equivalent Work Environment This position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

United Road is the most diversified finished vehicle logistics provider in North America. We employ approximately 1,800 professionals, operating out of nearly 75 locations strategically positioned in every region of the United States, creating a superior and efficient national service network. Our competitive advantage lies in our ability to provide timely, professional and dependable automobile transport delivery and logistics services. Leveraging our collective strengths, local operational control capitalizes on immediate and regional market knowledge, name recognition, and personal and customer relationships enjoyed by each division. At the same time, United Road's leadership experience, industry leading technology, national purchasing power, and investments in equipment, ensures that we excel in customer service, create an attractive, supportive environment for our employees and provide for the stability and growth of the company as a whole. Job Description The Claims Analyst will support the Risk Management/Quality Department in analytical, reporting and record keeping functions. The primary responsibility of this position is to analyze each cargo claim based on investigation findings and documentation to determine claim validity to for best resolution. The Claims Analyst aids the Cargo Claims Manager in achieving the department's goals and initiatives. Job Duties Manage cargo claims; gather all facts concerning a claim and provide direction to facilitate claim resolution by working directly with claim adjusters, internal/external legal counsel, industry consultants and insurance companies to mitigate losses and ensure claims are resolved in a timely, cost effective manner Investigate the nature of the incident, collect all necessary documents, determine claim validity, determine and communicate resolution Track and report outstanding claims, determining equitable settlements and managing daily work queues. Maintain customer cargo claim aging on assigned accounts within customer guidelines Process check requests Communicate and support recommendation for carriers to be placed on hold Generate, analyze and distribute weekly claim report Process rebuttals, negotiations, and declinations for claim settlement Quality support including but not limited to assisting with preparation, follow up and documentation for weekly calls Accountable to achieve quotas and goals as assigned Optimize work processes by investigating and employing best practices with a focus on continuous improvement Other duties assigned as business needs require Skills Required Ability to succeed in a fast-paced environment and work under pressure Proficiency in web-based programs (TCM, OVISS, etc.) Proficient use of Microsoft Products, with emphasis on Word, Excel, and Outlook Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy Adept at queries, report writing and presenting findings Ability to exercise good judgement in a variety of situations Ability to solve problems and think quickly under pressure Effective oral and written communication skills Process improvement catalyst Demonstrated poise, tact, and diplomacy Maintain a positive work atmosphere by acting and communicating in a manner which facilitates the success of business operations in order to meet company demands and expectations Qualifications Two years of claims handling experience in transportation industry preferred Two year college degree preferred Additional Information Please apply online at: ************************************************************************** All your information will be kept confidential according to EEO guidelines.

Medicaid Specialist at Cambridge Dental Group - Dearborn Heights, MI* Cambridge Dental Group is seeking a detail-oriented and experienced CBO Team Member to join our centralized business office team. This role is essential in ensuring accurate and timely submission and follow-up of Medicaid pre-authorizations and claims. The ideal candidate will bring a strong background in Medicaid billing and revenue cycle management (RCM), with a commitment to accuracy and efficiency. Responsibilities: Submit all Medicaid pre-authorizations and claims in a timely manner. Follow up consistently on pre-authorizations and claims to ensure proper resolution. Review and manage daily work logs to resolve outstanding claims. Appropriately document all account activities within the practice management system. Process EOB and R/A payments/denials accurately and promptly. Communicate effectively with leadership, co-workers, and dental offices regarding claim status. Maintain a high level of accuracy and attention to detail in all job functions. Provide backup support to other CBO team members as needed. Required Qualifications: 5+ years of Medicaid billing and RCM experience (preferred) Proven ability to manage pre-authorizations and claims efficiently High attention to detail and task-focused work style Strong organizational and follow-up skills Preferred Qualifications: Some dental clinical experience (helpful but not required) Why Join Us: Full-time position with comprehensive benefits including health insurance, life insurance, PTO, paid holidays, disability options, 401k with match Be part of a supportive and collaborative CBO team Play a key role in ensuring smooth financial operations for our office Competitive compensation and growth opportunities within a trusted dental group #indeedwavedp Requirements Education and Training High school diploma or equivalent required. Three years healthcare cash posting, billing, third party follow-up and collections experience required; OR a combination of education and/or experience in business or related field totaling three years. Knowledge of automated business applications, including word-processing, spreadsheet and data base management applications required. Data entry experience and knowledge of Medicare, Medicaid, and third-party insurance preferred. FLSA Status: Hourly, Non-Exempt Reports to: VP of Finance

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary The Claims Division is seeking a team member to join the Casualty Team as Senior Claims Examiner, New York Labor Law. In this role, the responsibilities include but not limited to actively manage a caseload and provide oversight to third-party administrator claims handlers for commercial New York Labor Law cover, liability, and damage claims. Responsibilities * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement strategy to resolve matters of liability and damages of a particular case * Maintain contact with the TPA claim staff, business line leader, underwriter, and defense counsel, program manager and broker * Investigate claim and review the insureds' materials, pleadings, and other relevant documents * Identify and review of each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze, and direct risk transfer, additional insured issues and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills * Three to five (3-5) years of working experience with commercial accounts supporting primary and/or excess claims experience handling New York Labor Law claims * Energy Casualty, Construction and/or Rail experience is a plus * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Ability to take part in active strategic discussions * Ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 25% * This position is a hybrid role with 2 days in office Education and Experience * Bachelor's degree required; Juris Doctorate degree preferred * Proper Adjuster Licensing in all applicable states #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. For NYC, Jersey City: $123,400 - $150,000/year * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. 14400 Arch Insurance Group Inc.

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. Essential Job Duties * Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. * Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. * Assists with reducing rework by identifying and remediating claims processing issues. * Locates and interprets claims-related regulatory and contractual requirements. * Tailors existing reports and/or available data to meet the needs of claims projects. * Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. * Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. * Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. * Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. * Works collaboratively with internal/external stakeholders to define claims requirements. * Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. * Fields claims questions from the operations team. * Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. * Appropriately conveys claims-related information and tailors communication based on targeted audiences. * Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. * Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. * Supports claims department initiatives to improve overall claims function efficiency. Required Qualifications * At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. * Medical claims processing experience across multiple states, markets, and claim types. * Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. * Data research and analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Ability to work cross-collaboratively in a highly matrixed organization. * Customer service skills. * Effective verbal and written communication skills. * Microsoft Office suite (including Excel), and applicable software programs proficiency. Preferred Qualifications * Health care claims analysis experience. * Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $46.42 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of 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. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI

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.

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.