Claims Representative
Claims representative job in Tulsa, OK
Claims Representative
Pay: $45,000 - $75,000/year
Experience: At least 5 years handling Commercial General Liability, Claims-Made, and/or Commercial Auto claims; litigation exposure; ability to travel.
Education: Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
Type: Full-time; Direct Hire
Schedule: Monday - Friday, 8:00 AM to 5:00 PM
ProRecruiters is seeking a Claims Representative to join a growing and dynamic team!
Job Description:
Manage an inventory of Pollution Liability and General Liability claims.
Investigate claims and secure necessary documentation and reports.
Evaluate coverage, liability, and claim resolution options.
Attend mediations, arbitrations, depositions, or trials when required.
Settle claims within authority limits and escalate when necessary.
Ensure compliance with all state, legal, and regulatory requirements.
Communicate claim decisions and complex information to all parties professionally.
Position Requirements:
Strong analytical and problem-solving abilities.
Excellent written and verbal communication skills.
Strong organizational and time-management abilities.
Ability to maintain professionalism in complex or high-pressure situations.
Ability to collaborate with internal teams and leadership.
ProRecruiters is part of Array Corporation, the leading technology-enabled workforce solutions company whose mission is to fix how work is bought, sold and delivered to enable access to the American Dream.
We are proud to be an Equal Employment Opportunity and Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
Workers Compensation Claims Representative
Claims representative job in Bartlesville, OK
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Workers Compensation Claims Representative
**PRIMARY PURPOSE** : To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
+ Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
+ Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
+ Administers subrogation of claims and negotiates settlements.
+ Communicates claim action with claimant and client.
+ Ensures claim files are properly documented and claims coding is correct.
+ May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
+ Maintains professional client relationships.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred.
**Experience**
Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
**Skills & Knowledge**
+ Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
+ Excellent oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Analytical and interpretive skills
+ Strong organizational skills
+ Good interpersonal skills
+ Ability to work in a team environment
+ Ability to meet or exceed Service Expectations
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical:** Computer keyboarding, travel as required
**Auditory/Visual:** Hearing, vision and talking
_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $45,000 - $68,000/yr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Claims Follow-Up Representative
Claims representative job in Tulsa, OK
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!
Epic Resolute PB Claims Analyst
Claims representative job in Tulsa, OK
Are you an experienced, passionate pioneer in technology who wants to work in a collaborative environment? As an experienced Epic Resolute PB Claims Analyst you will have the ability to share new ideas and collaborate on projects as a consultant without the extensive demands of travel. If so, consider an opportunity with Deloitte under our Project Delivery Talent Model. Project Delivery Model (PDM) is a talent model that is tailored specifically for long-term, onsite client service delivery.
Work you'll do/Responsibilities
As a Project Delivery Senior Analyst (PDSA) at Deloitte, you will work within an engagement team and be responsible for supporting the overall project goals and objectives. In this role, you will interact with stakeholders and cross-functional teams. It is expected that you will be able to perform independent tasks as well as provide technical guidance to team members, as needed.
* Work with the implementation team to plan and complete build, implement end-to-end Epic.
* Work command center shifts to investigate during go-live, document, and resolve break-fix tickets.
* Conduct and document root cause analysis and complete any assigned system maintenance.
* Assist in low level design, operational discussions, build, test, and migrate Epic build, provide go-live support following migration of new build.
* Communicate regularly with Engagement Managers (Directors), project team members, and representatives from various functional and / or technical teams, including escalating any matters that require additional attention and consideration from engagement management.
The Team
Join our AI & Engineering team in transforming technology platforms, driving innovation, and helping make a significant impact on our clients' success. You'll work alongside talented professionals reimagining and re-engineering operations and processes that are critical to businesses. Your contributions can help clients improve financial performance, accelerate new digital ventures, and fuel growth through innovation.
AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements.
Our Industry Solutions offering provides verticalized solutions that transform how clients sell products, deliver services, generate growth, and execute mission-critical operations. We deliver integrated business expertise with scalable, repeatable technology solutions specifically engineered for each sector.
Qualifications
Required
* Current Epic Certification in Epic Professional Billing
* 3+ years' experience in Epic Professional Billing
* Experience in Epic implementation or enhancement processes
* Experience in application design, workflows, build, troubleshooting, testing, and support.
* Bachelor's degree, preferably in Computer Science, Information Technology, Computer Engineering, or related IT discipline; or equivalent experience
* Limited immigration sponsorship may be available.
* Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve
Preferred
* Hospital or Clinic operations experience
* Additional Epic Certifications
* ITIL process knowledge
* Analytical/ Decision Making Responsibilities
* Analytical ability to manage multiple projects and prioritize tasks into manageable work products
* Can operate independently or with minimum supervision
* Excellent Written and Communication Skills
* Ability to deliver technical demonstrations
Additional Requirements
Information for applicants with a need for accommodation: ************************************************************************************************************
Recruiting tips
From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. Check out recruiting tips from Deloitte recruiters.
Benefits
At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. Learn more about what working at Deloitte can mean for you.
Our people and culture
Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our clients' most complex challenges. This makes Deloitte one of the most rewarding places to work.
Our purpose
Deloitte's purpose is to make an impact that matters for our people, clients, and communities. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. Learn more.
Professional development
From entry-level employees to senior leaders, we believe there's always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.
As used in this posting, "Deloitte" means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see ********************************* for a detailed description of the legal structure of Deloitte LLP and its subsidiaries.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.
Requisition code: 316852
Job ID 316852
Claims Representative/Senior Claims Representative
Claims representative job in Tulsa, OK
Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other industries. Mid-Continent Group provides a broad selection of General Liability, Commercial Auto, Inland Marine and Umbrella products.
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group, a Fortune 500 company, combines “small company” culture with “big company” expertise. Here, your ideas will be heard, and you'll have the support to succeed. With over 35 specialty and property and casualty operations, there are always opportunities 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.
Mid-Continent Group is looking for a Claims Representative/Senior Claims Representative to join our Multi-Peril Claims team. This individual will work a hybrid schedule from one of our downtown corporate locations in Tulsa, Oklahoma or Cincinnati, Ohio.
Essential Job Functions and Responsibilities
Manage an inventory of Pollution Liability and General Liability claims with some litigation.
Investigate and maintain claims:
Evaluate coverage and liability.
Secure necessary information (i.e.: reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims.
Actively work toward the resolution of claim files.
Attend arbitrations, mediations, depositions, or trials as necessary.
Affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority.
Convey the complex information (coverage, decisions, outcomes, negotiations, etc.) to all appropriate parties while maintaining a professional demeanor in all situations.
Ensure compliance of claims handling pursuant to all state, legal, statutory, and regulatory bodies to comply with all company procedures and requirements.
Evaluate and make recommendations to executive management on internal and external issues of strategic importance to a product(s) and/or line of business.
Job Requirements
Generally, 6 months to 5 years of experience handling Commercial General Liability claims, Claims-Made coverage, and/or Commercial Auto claims.
Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
A successful candidate will be able to demonstrate strong writing, analytical, communication, and organizational skills.
Professional designations (e.g., CPCU) are a plus.
Ability to travel as needed.
Company:
MCC Mid-Continent Casualty Company
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.
Auto-ApplyField Claims Adjuster
Claims representative job in Tulsa, OK
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.
Independent Insurance Claims Adjuster in Tulsa, Oklahoma
Claims representative job in Tulsa, OK
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.
Auto-ApplyClaims Specialist/Senior Claims Specialist
Claims representative job in Tulsa, OK
Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other industries. Mid-Continent Group provides a broad selection of General Liability, Commercial Auto, Inland Marine and Umbrella products.
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group, a Fortune 500 company, combines "small company" culture with "big company" expertise. Here, your ideas will be heard, and you'll have the support to succeed. With over 35 specialty and property and casualty operations, there are always opportunities 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.
Mid-Continent Group is currently seeking a Claims Specialist/Senior Claims Specialist to join our Claims Team. The position will work a hybrid schedule from downtown Tulsa, OK, or downtown Cincinnati, OH.
Essential Job Functions and Responsibilities
* Manage a portfolio of complex, high-value commercial general liability and auto claims across the U.S.
* Lead investigations, evaluate coverage and liability, and drive resolution strategies.
* Represent the company in mediations, depositions, and trials.
* Collaborate with underwriting and marketing teams to identify trends and improve outcomes.
* Serve as a technical expert and strategic advisor within your line of business.
* Ensure compliance with all legal and regulatory standards.
* Offer expert advice to other members of your team on complex claim file management and demonstrate leadership across the organization.
Job Requirements
* 9+ years of experience handling general liability and/or commercial auto claims.
* Strong analytical skills and deep understanding of policy coverage.
* Excellent communication, negotiation, and organizational abilities.
* Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
* Professional designations (e.g., CPCU) are a plus.
Ready to Make a Difference?
Join a team where your expertise is valued, your voice is heard, and your career can flourish. Apply today and be part of something great.
Company:
MCC Mid-Continent Casualty Company
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.
Auto-ApplyLiability Field Adjuster - Tulsa, OK
Claims representative job in Tulsa, OK
Job Description
CCMS & Associates is looking for 1099 Field Liability Adjusters. We are answering a call to action to add to our existing roster. The time is now to get on with our innovative team! We are seeking auto/homeowners/general liability field adjusters with at least 5 years of field experience.
Requirements:
Minimum 5 years auto and/or premise liability adjusting experience
Working computer/laptop - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
State adjusters license (where applicable)
Must have a valid drivers license
Responsibilities:
Conduct in-depth investigations into liability claims to gather facts regarding the loss
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses, and by interviewing fire, police, or other government officials as well as inspecting claimed damages
Inspect damage to property and obtain personal injury information to assist in determining liability
Maintain acceptable product quality through compliance with established best practices
Knowledge and Skills:
In-depth knowledge of property and liability insurance coverage and industry standards
Ability to prepare full-captioned reports by collecting and summarizing required information
Strong verbal and written communication skills
Prompt, reliable, and friendly
Detail-oriented individual to accurately gather and analyze information to avoid errors
Preferred but Not Required:
College degree
Professional designations and certifications
All candidates must pass a full background check (void in states where prohibited)
Powered by JazzHR
bZnXAn6FZ9
Claims HMO - Claims Examiner 140-1031
Claims representative job in Tulsa, OK
The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or adjust the claim. Examiners are expected to meet performance expectations in accuracy and efficiency.
KEY RESPONSIBILITIES:
Examining and adjudicating claims that have pended for review utilizing resources, tools, knowledge and decision-making in determining appropriate actions.
Identify claims requiring additional resources and route to the team lead, supervisor or other departments as needed.
Enter claims information using the processing software to compute payments, allowable amounts, limitations, exclusions and denials.
Identify and communicate trends or problems identified during adjudication process.
Contribute to the creation of a pleasant working environment with peers and other departments.
Assist in investigating and solving claims that require additional research.
Consistently learn and adapt to changes related to claims processing, benefits, limits and regulations.
Perform other duties as assigned.
QUALIFICATIONS:
Self-motivated and able to work with minimal direction.
Ability to read and understand claims processing manuals, medical terminology, CPT codes, and perform basic processing procedures.
Ability to read and understand health benefit booklets.
Demonstrated learning agility.
Successful completion of Health Care Sanctions background check.
Knowledge in the contracted managed care plan terms and rates.
General understanding of unbundling methods, COB, and other over-billing methodologies.
Must have high attention to detail.
Proficient in Microsoft applications.
Ability to perform basic mathematical calculations.
Possess strong oral and written communication skills.
EDUCATION/EXPERIENCE:
High School Diploma or Equivalent required.
Two years related work experience in claims processing, claims data entry or medical billing OR medical related education to meet minimum two years required.
Claims ExaminerTulsa, OK
Claims representative job in Tulsa, OK
At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100 TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly.
Job Description
Kelly Services is currently working with our client in Tulsa, OK to hire Claims Examiners.
This is a temporary to hire opportunity that will be starting with a 16 week training program on August 14th.
· A Claims Examiner is responsible for processing insurance claims that have been flagged by the automated system and need manual intervention in order to process accurately.
· This position will work in an office setting, where you will be working on a computer majority of the day.
· There are times this position requires phone work to place outbound calls but it is not a call center position.
· The training offered for this position is very fast paced and it makes it unlikely for those who miss days to succeed.
· During this period of time, attendance is critical.
· You would be working full time hours, Monday through Friday from 8AM to 5PM for roughly the first 16 weeks.
· After training, this position allows a flex schedule, which means you are able to work an 8 hour shift of your choosing between the hours of 6AM and 6PM, Monday through Friday.
· Typically, Claims Examiners have the opportunity work overtime once they're trained.
· The pay rate is a range between $11.77 and $12.77 and will be determined by our client based on your experience.
· The position is a temporary to hire opportunity, which means our client has indicated they will hire on Kelly Temporary employees that qualify in performance and attendance.
· Usually we see our employees go full time between 6 and 12 months.
· This is a great way to get your foot in the door if you are seeking permanent employment with our client; however, it does start temporarily though Kelly Services.
Job Specific Qualifications:
• High School Diploma or GED
• Data Entry and/or typing experience
• Clear and concise written and verbal communication skills
• Ability to multi task and prioritize is required
• Social, verbal and written communication skills
• Ability to sit for long periods of time
• Strong problem-solving and analytical skills
• Dependable and flexible
Qualifications
Job Specific Qualifications:
• High School Diploma or GED
• Data Entry and/or typing experience
• Clear and concise written and verbal communication skills
• Ability to multi task and prioritize is required
• Social, verbal and written communication skills
• Ability to sit for long periods of time
• Strong problem-solving and analytical skills
• Dependable and flexible
Additional Information
Kelly Services is a U.S.-based Fortune 500 company. With our global network of branch locations, we are uniquely positioned to provide our customers with international staffing support and our employees with diverse assignments around the world.
We invite you to bookmark our Web site and encourage you to review it regularly for new opportunities worldwide: www.kellyservices.com.
Claims Specialist
Claims representative job in Tulsa, OK
Claims Specialist
Pay: $60,000 - $85,000/year
Experience: At least 9 years handling general liability and/or commercial auto claims; experience with high-value, complex files; strong analytical and coverage evaluation skills.
Education: Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
Type: Full-time; Direct Hire
Schedule: Monday - Friday, 8:00 AM to 5:00 PM
ProRecruiters is seeking a Claims Specialist to join a growing and dynamic team!
Job Description:
Manage a portfolio of complex commercial general liability and auto claims.
Lead investigations and evaluate coverage, liability, and exposure.
Represent the company during mediations, depositions, and trials.
Develop and execute resolution strategies for complex claims.
Collaborate with underwriting and marketing teams to identify trends.
Serve as a technical expert and advisor within the business.
Ensure compliance with all legal and regulatory standards.
Position Requirements:
Strong strategic thinking and analytical ability.
Excellent written and verbal communication skills.
Strong negotiation and problem-solving skills.
Ability to guide and support teammates on complex claim matters.
Strong organizational and time-management abilities.
ProRecruiters is part of Array Corporation, the leading technology-enabled workforce solutions company whose mission is to fix how work is bought, sold and delivered to enable access to the American Dream.
We are proud to be an Equal Employment Opportunity and Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
Workers Compensation Claims Representative
Claims representative job in Tulsa, OK
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Workers Compensation Claims Representative
**PRIMARY PURPOSE** : To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
+ Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
+ Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
+ Administers subrogation of claims and negotiates settlements.
+ Communicates claim action with claimant and client.
+ Ensures claim files are properly documented and claims coding is correct.
+ May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
+ Maintains professional client relationships.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred.
**Experience**
Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
**Skills & Knowledge**
+ Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
+ Excellent oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Analytical and interpretive skills
+ Strong organizational skills
+ Good interpersonal skills
+ Ability to work in a team environment
+ Ability to meet or exceed Service Expectations
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical:** Computer keyboarding, travel as required
**Auditory/Visual:** Hearing, vision and talking
_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $45,000 - $68,000/yr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Claims Specialist/Senior Claims Specialist
Claims representative job in Tulsa, OK
Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other industries. Mid-Continent Group provides a broad selection of General Liability, Commercial Auto, Inland Marine and Umbrella products.
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group, a Fortune 500 company, combines “small company” culture with “big company” expertise. Here, your ideas will be heard, and you'll have the support to succeed. With over 35 specialty and property and casualty operations, there are always opportunities 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.
Mid-Continent Group is currently seeking a Claims Specialist/Senior Claims Specialist to join our Claims Team. The position will work a hybrid schedule from downtown Tulsa, OK, or downtown Cincinnati, OH.
Essential Job Functions and Responsibilities
Manage a portfolio of complex, high-value commercial general liability and auto claims across the U.S.
Lead investigations, evaluate coverage and liability, and drive resolution strategies.
Represent the company in mediations, depositions, and trials.
Collaborate with underwriting and marketing teams to identify trends and improve outcomes.
Serve as a technical expert and strategic advisor within your line of business.
Ensure compliance with all legal and regulatory standards.
Offer expert advice to other members of your team on complex claim file management and demonstrate leadership across the organization.
Job Requirements
9+ years of experience handling general liability and/or commercial auto claims.
Strong analytical skills and deep understanding of policy coverage.
Excellent communication, negotiation, and organizational abilities.
Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
Professional designations (e.g., CPCU) are a plus.
Ready to Make a Difference?
Join a team where your expertise is valued, your voice is heard, and your career can flourish. Apply today and be part of something great.
Company:
MCC Mid-Continent Casualty Company
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.
Auto-ApplyClaims Representative
Claims representative job in Tulsa, OK
Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other industries. Mid-Continent Group provides a broad selection of General Liability, Commercial Auto, Inland Marine and Umbrella products.
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group, a Fortune 500 company, combines “small company” culture with “big company” expertise. Here, your ideas will be heard, and you'll have the support to succeed. With over 35 specialty and property and casualty operations, there are always opportunities 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.
Mid-Continent Group is looking for a Claims Representative to join their Multi-Peril Claims team. This individual will work a hybrid schedule from one of our downtown corporate locations in Tulsa, Oklahoma or Cincinnati, Ohio. Remote opportunities will be considered.
Essential Job Functions and Responsibilities
Manage an inventory of General Liability claims with some litigation.
Investigate and maintain claims:
Evaluate coverage and liability.
Secure necessary information (i.e.: reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims.
Actively work toward the resolution of claim files.
Attend arbitrations, mediations, depositions, or trials as necessary.
Affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority.
Convey the complex information (coverage, decisions, outcomes, negotiations, etc.) to all appropriate parties while maintaining a professional demeanor in all situations.
Ensure compliance of claims handling pursuant to all state, legal, statutory, and regulatory bodies to comply with all company procedures and requirements.
Evaluate and make recommendations to executive management on internal and external issues of strategic importance to a product(s) and/or line of business.
Job Requirements
Generally, 2+ years of experience handling commercial General Liability claims and auto experience is required. Previous legal experience will be considered.
Bachelor's Degree or equivalent experience is required. A Juris Doctor degree is encouraged.
A successful candidate will be able to demonstrate strong writing, analytical, communication, and organizational skills.
Ability to travel as needed.
Company:
MCC Mid-Continent Casualty Company
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.
Auto-ApplyLiability Field Adjuster - Tulsa, OK
Claims representative job in Tulsa, OK
CCMS & Associates is looking for 1099 Field Liability Adjusters. We are answering a call to action to add to our existing roster. The time is now to get on with our innovative team! We are seeking auto/homeowners/general liability field adjusters with at least 5 years of field experience.
Requirements:
Minimum 5 years auto and/or premise liability adjusting experience
Working computer/laptop - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
State adjusters license (where applicable)
Must have a valid drivers license
Responsibilities:
Conduct in-depth investigations into liability claims to gather facts regarding the loss
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses, and by interviewing fire, police, or other government officials as well as inspecting claimed damages
Inspect damage to property and obtain personal injury information to assist in determining liability
Maintain acceptable product quality through compliance with established best practices
Knowledge and Skills:
In-depth knowledge of property and liability insurance coverage and industry standards
Ability to prepare full-captioned reports by collecting and summarizing required information
Strong verbal and written communication skills
Prompt, reliable, and friendly
Detail-oriented individual to accurately gather and analyze information to avoid errors
Preferred but Not Required:
College degree
Professional designations and certifications
All candidates must pass a full background check (void in states where prohibited)
Auto-ApplyField Claims Adjuster
Claims representative job in Broken Arrow, OK
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.
Claims Examiner
Claims representative job in Tulsa, OK
At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100 TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly.
Job Title: Claims Examiner
Pay Rate: $11.77/hour
Job Description Overview:
•Under supervision, this position is responsible for processing complex claims requiring further investigation, including coordination of benefits, and resolving pended claims
•Review and compare information in computer systems and apply proper codes/documentation
•May place outgoing calls to providers and/or pharmacies for further investigation before processing claims
Job Specific Qualifications:
•High school diploma or GED
•Data Entry and/or typing experience
•Clear and concise written and verbal communication skills
•Ability to multi task and prioritize is required
•Interpersonal, verbal and written communication skills
•Ability to sit for long periods of time
•Analytical and problem solving skills
•Must be dependable and flexible
Additional Information
Kelly Services is a U.S.-based Fortune 500 company. With our global network of branch locations, we are uniquely positioned to provide our customers with international staffing support and our employees with diverse assignments around the world.
We invite you to bookmark our Web site and encourage you to review it regularly for new opportunities worldwide: www.kellyservices.com.
Claims Representative (IAP) - Workers Compensation Training Program
Claims representative job in Bartlesville, OK
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Claims Representative (IAP) - Workers Compensation Training Program
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
A stable and consistent work environment in an office setting.
A training program to learn how to help employees and customers from some of the world's most reputable brands.
An assigned mentor and manager who will guide you on your career journey.
Career development and promotional growth opportunities through increasing responsibilities.
A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
PRIMARY PURPOSE OF THE ROLE: To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due.
ARE YOU AN IDEAL CANDIDATE? We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
Attendance and completion of designated classroom claims professional training program.
Performs on-the-job training activities including:
Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims.
Adjusting low and mid-level liability and/or physical damage claims under close supervision.
Processing disability claims of minimal disability duration under close supervision.
Documenting claims files and properly coding claim activity.
Communicating claim action/processing with claimant and client.
Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned.
Participates in rotational assignments to provide temporary support for office needs.
QUALIFICATIONS
Bachelor's or Associate's degree from an accredited college or university preferred.
EXPERIENCE
Prior education, experience, or knowledge of:
• Customer Service
• Data Entry
• Medical Terminology (preferred)
• Computer Recordkeeping programs (preferred)
• Prior claims experience (preferred)
Additional helpful experience:
• State license if required (SIP, Property and Liability, Disability, etc.)
• WCCA/WCCP or similar designations
• For internal colleagues, completion of the Sedgwick Claims Progression Program
TAKING CARE OF YOU
Entry-level colleagues are offered a world class training program with a comprehensive curriculum
An assigned mentor and manager that will support and guide you on your career journey
Career development and promotional growth opportunities
A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Auto-ApplyClaims Representative/Senior Claims Representative
Claims representative job in Tulsa, OK
Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other industries. Mid-Continent Group provides a broad selection of General Liability, Commercial Auto, Inland Marine and Umbrella products.
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group, a Fortune 500 company, combines “small company” culture with “big company” expertise. Here, your ideas will be heard, and you'll have the support to succeed. With over 35 specialty and property and casualty operations, there are always opportunities 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.
Mid-Continent Group is looking for a Claims Representative/Senior Claims Representative to join our Multi-Peril Claims team. This individual will work a hybrid schedule from one of our downtown corporate locations in Tulsa, Oklahoma or Cincinnati, Ohio.
Essential Job Functions and Responsibilities
Manage an inventory of Pollution Liability and General Liability claims with some litigation.
Investigate and maintain claims:
Evaluate coverage and liability.
Secure necessary information (i.e.: reports, policies, appraisals, releases, statements, records, or other documents) in the investigation of claims.
Actively work toward the resolution of claim files.
Attend arbitrations, mediations, depositions, or trials as necessary.
Affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority.
Convey the complex information (coverage, decisions, outcomes, negotiations, etc.) to all appropriate parties while maintaining a professional demeanor in all situations.
Ensure compliance of claims handling pursuant to all state, legal, statutory, and regulatory bodies to comply with all company procedures and requirements.
Evaluate and make recommendations to executive management on internal and external issues of strategic importance to a product(s) and/or line of business.
Job Requirements
Generally, 6 months to 5 years of experience handling Commercial General Liability claims, Claims-Made coverage, and/or Commercial Auto claims.
Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience).
A successful candidate will be able to demonstrate strong writing, analytical, communication, and organizational skills.
Professional designations (e.g., CPCU) are a plus.
Ability to travel as needed.
Company:
MCC Mid-Continent Casualty Company
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.
Auto-Apply