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Customer Support Specialist
Brilliance Canada
Remote claims resolution specialist job
We are growing and hiring Customer Service Representatives to manage incoming customer queries and field questions regarding policy information. You will also process payments, modifications, and escalate complaints across a number of communication channels. A successful candidate would need to be high energy, customer centric, have a friendly demeanor, display empathy, patience and have experience working in the insurance industry, call center and proficient in computers. REMOTE OPPORTUNITY.
Job Description:
We Are: Covenir is a company with a startup attitude with the support of a corporation. In the last three years we have experienced tremendous growth and have quickly become one of the go to companies for business process outsourcing.
You Are: Someone with a few years of call center/customer service/office support experience or someone with a lot of experience looking to make a career change. You enjoy working a flexible schedule in a team environment around a lot of great people. You need a fast-paced environment where no two days are the same and you understand how to be the face/voice of a company.
Responsibilities Include:
Work with our insurance provider clients and deliver great overall customer service
Take in a high volume of calls, communicate via email and letters as appropriate
Document all client communication across several platforms
Be the point person for our clients as well as their customers
Qualifications:
2+ years of customer service experience in a call-center environment
Demonstrated communication, organizational and interpersonal skills
Intermediate proficiency in Microsoft Office
Strong independent problem solving and analytical skills
Preferred Qualifications:
4+ years of insurance experience (insurance agent license a plus!)
Bilingual (Spanish/English)
Associate's degree
Worker Type:
Number of Openings:
3
$44k-68k yearly est. 4d ago
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Online Customer Support Specialist (REMOTE)
Ao Globe Life
Remote claims resolution specialist job
Job Title: Online Customer Support Specialist - Remote Job Type: Full-Time / Part-Time About the Job Are you ready to kickstart your career in a fast-growing industry with no prior experience required? Join one of the nation's leading supplemental benefits providers, proudly serving families for over 65 years. We're actively hiring Entry-Level Benefits Representatives who are eager to learn, grow, and build a successful career-all from the comfort of their home.
This is a great opportunity for recent high school graduates, college students, career changers, or anyone seeking a remote entry-level job with real potential.
Key Responsibilities:
Provide friendly, helpful support to customers regarding their benefits
Educate clients on available supplemental health and life insurance options
Answer questions, schedule virtual consultations, and walk customers through coverage
Learn and stay up to date with our products, services, and training tools
Help clients choose the most effective and affordable benefit plans
Collaborate in a team environment while working independently
What You'll Need to Succeed:
No experience required - we'll train you!
A strong work ethic and eagerness to learn
Great communication and people skills
Basic computer literacy and ability to use video conferencing tools
Professional attitude with a positive mindset
Must be 18 years or older and eligible to work in the U.S.
We're Looking For Someone Who Is:
Looking to build a long-term career with advancement potential
Reliable, self-motivated, and goal-oriented
Comfortable speaking with people and enjoys helping others
A team player who takes pride in their work
Benefits & Perks:
Remote position - work from home anywhere in the U.S.
Weekly pay and performance-based bonuses
Residual income for long-term earnings
Paid company trips and travel incentives
Full training provided - no experience needed
Flexible schedule (full-time or part-time)
Opportunities to advance into leadership and management roles
Apply Today!
Start a rewarding career in customer service and sales from the ground up. We're hiring now-no degree or experience needed. If you're ready to learn, grow, and thrive in a remote, entry-level position, apply now and join a team that values your potential.
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$32k-46k yearly est. 2d ago
CUSTOMER RELATION SPECIALIST
Big Sandy Superstore 4.0
Claims resolution specialist job in Columbus, OH
Benefits:
Dental insurance
Employee discounts
Health insurance
Opportunity for advancement
Stock options plan
Vision insurance
Wellness resources
Customer Relation Specialist
Retail Customer Service Office Duties
Big Sandy Superstore was recently named One of America's Fastest Growing Home Furnishings Retailers!
Our customer relations specialists are an important piece of the overall success of Big Sandy Superstore! When customers are provided with an exceptional experience, they will not only return, they will refer us to their friends and family. Our customer service jobs are focused around helping customers with warranty issues, product concerns and processing their orders in a timely manner. The ultimate goal is to ensure a fully satisfied positive experience with their purchases and with our organization as a whole.
We have a great benefits package consisting of:
Health Insurance - Affordable health insurance with the 2 plan options: PPO 2000 or HSA 3000
Dental Insurance - Affordable dental insurance with NO waiting period.
Vision Insurance - Quality vision coverage for very little cost.
Life Insurance - $10,000 Life Insurance Policy paid in full by the company.
401K Plan - All administrative fees are paid by the company.
ESOP - Employee Stock Ownership Program
Paid Time Off - Competitive paid time off policies.
Employee Discount - Generous employee discount on ALL merchandise.
As a Customer Relations Specialist you will:
Verifies all information related to orders is accurate; identifies and corrects discrepancies.
Completes all documentation in an accurate and efficient manner and processes information regarding cash balances, deliveries, sales orders, account balances in compliance within corporate guidelines.
Provides customer service support by answering phones, managing counter inquiries, processing payments, solving customer complaints/questions.
Completes and processes credit applications, payments and financing paperwork.
Communicates with internal and external personnel in a professional and timely manner.
Maintains accurate files and processes in order to maximize productivity.
Performs clerical support for store staff as needed.
Other duties as assigned.
Qualities and skills we are looking for:
Excellent verbal and written communication, and listening skills
Basic reading and comprehension skills.
Basic numerical reasoning skills.
Ability to complete paperwork in an accurate, neat and efficient manner.
Demonstrated knowledge of software, including Microsoft Office
Excellent organizational skills
Outstanding customer service skills
Physical Demands:
Ability to sit, stand, bend, stoop, and reach regularly
Education and Experience:
High school diploma or equivalent combination of education and experience
Previous clerical experience preferred
Position Type
Full-Time/Regular
#BSSALES
This employment opportunity is available at the organization listed at the top of this page. Your application will go directly to them and all hiring decisions will be made by their management. All inquiries should be made directly with the organization that posted this employment opportunity.
$25k-36k yearly est. 2d ago
Client Experience Specialist (Licensed) - Arizona Time US Based Remote
Anywhere Real Estate
Remote claims resolution specialist job
**Client Experience Specialist (licensed)**
The **Client Experience Specialist** is a service minded professional who manages all non-licensed and limited licensed aspects of the transaction, from contract to close, to create a seamless experience for the agent, consumer and all deal parties. You are part of a collaborative team that is enhancing the way that Coldwell Banker is doing business by eliminating the friction and simplifying the transaction process.
The key to success in this role is the ability to multitask, solve problems and communicate effectively with agents, clients, third parties and internal operations. As a trusted professional, you provide our agents, homebuyers, and sellers, the confidence that their transaction is in reliable and skillful hands.
**This position is 100% remote and will support various markets, primarily** **_in Arizona_** **. The ideal candidate will be able to work on Arizona time.**
**Responsibilities:**
+ Perform non-licensed administrative tasks for real estate agents. Identify and manage the contractual dates and deadlines and ensure the transaction is closed in a timely, efficient, and accurate manner.
+ Ensure your real estate license remains in good standing to perform authorized licensed tasks, including drafting contract addendums and amendments.
+ Collaborate closely with agent services department, agents or other third parties to ensure all proper documentation has been received for compliance in the transaction file in the appropriate systems.
+ Organize all transaction details in applicable systems while providing continuous updates to the agent, client and third parties.
+ Serve as all deal stakeholder's point-of-contact for agents and their clients through closing, which includes obtaining documentation or information needed for clear to close.
+ Own and execute full end-to-end transaction processing by entering transaction-related expenses, verifying accuracy of details, preparing commission invoices, calculating and finalizing commission payments, and proactively resolving discrepancies to ensure timely and accurate agent payouts.
+ Regularly update and manage communication with all parties involved in the transaction.
+ Prioritize service to the agent and all parties with a positive and engaging attitude to create a seamless experience.
**Experience:**
+ Minimum of 2 years Real Estate/mortgage/title administration/transaction coordination experience required.
+ Active real estate license in good standing, preferably in AZ.
**Competencies:**
To perform the job successfully, an individual should demonstrate the following competencies:
+ **Self-motivated** - able to work independently with a sense of urgency in a fast-paced, high volume paperless environment.
+ **People first approach** - keeping the agent and consumer at the center of the transaction by anticipating their needs to provide exceptional customer service throughout the transaction process.
+ **Technical** - ability to learn and navigate multiple software systems with an elevated level of competency while demonstrating comfort with transaction management and financial tools.
+ **Analytical Thinking & Transaction Accuracy** - able to apply strong critical thinking and problem-solving skills to ensure precise management of financial details such as expenses, invoices, and commission calculations while analyzing data to identify discrepancies, resolve issues promptly, and maintain compliance and data integrity.
+ **Process Management** - able to effectively manage end-to-end workflows, prioritize tasks, and ensure timely completion of transaction processing.
+ **Partnership/Collaboration** -the individual remains open to others' ideas and exhibits willingness to try new things.
+ **Oral/Written Communication** -the individual speaks clearly and persuasively in positive or negative situations to clearly advise and resolve any issues.
+ **Quality Assurance** -demonstrates accuracy and thoroughness and monitors their own work to ensure quality.
+ **Adaptability** - the individual adapts to changes in the work environment, prioritizes and manages competing demands, and can deal with frequent changes or delays while remaining resilient.
+ **Building Collaborative Relationships** - the individual develops, maintains, and strengthens partnerships with agents and colleagues while providing information and support.
**Anywhere is proud to offer a comprehensive benefits package to our employees including:**
+ Medical, Dental, Vision, Short-term and Long-term disability benefits, AD&D
+ 401(k) savings plan with company match
+ Paid Time Off to Include Holidays, Vacation Time, and Sick Time
+ Paid Family & Paternity Leave
+ Life Insurance
+ Business Travel Accident Insurance
+ All employees receive access to LinkedIn Learning
+ Tuition reimbursement for approved programs
+ Employee Referral Program
+ Adoption Assistance Program
+ Employee Assistance Program
+ Health and Wellness Program and Incentives
+ Employee Discounts
+ Employee Resource Groups
Coldwell Banker (******************************** is one of the world's leading brands for the sale of million-dollar-plus homes and one of the largest residential real estate brokerage franchisors, with approximately 2,800 franchise and company owned offices and over 99,000 independent sales associates in the United States, Canada and 40 other countries. Coldwell Banker is a subsidiary of Anywhere Real Estate Inc.
Anywhere Real Estate Inc. (************************ **(NYSE: HOUS) is moving real estate to what's next.** Home to some of the most recognized brands in real estate Better Homes and Gardens Real Estate (*********************** , Century 21 (*************************** , Coldwell Banker (******************************** , Coldwell Banker Commercial (****************************** , Corcoran (************************** , ERA (********************* , and Sotheby's International Realty (*********************************** , we fulfill our purpose to empower everyone's next move through our leading integrated services, which include franchise, brokerage, relocation, and title and settlement businesses, as well as mortgage and title insurance underwriter minority owned joint ventures. Anywhere supports nearly 1 million home sale transactions annually and our portfolio of industry-leading brands turns houses into homes in more than 118 countries and territories across the world.
**At Anywhere, we are empowering everyone's next move - your career included.** What differentiates us is our scale, expertise, network, and unique business model that positions us as a trusted advisor throughout every stage of the real estate transaction. **We pursue talent** - strategic thinkers who are eager to always find a better way, relentlessly focus on talent, obsess about growth, and achieve exceptional results. **We value our people-first culture,** which thrives on empowerment, innovation, and cross-company collaboration as we keep moving the world forward, together. Read more about our company culture and values in our annual Impact Report (********************************************************************** .
We are proud of our award-winning culture and are consistently recognized as an employer of choice by various organizations including:
+ Great Place to Work
+ Forbes World's Best Employers
+ Newsweek World's Most Trustworthy Companies
+ Ethisphere World's Most Ethical Companies
EEO Statement: EOE including disability/veteran
$33k-59k yearly est. 2d ago
Senior Resolution Specialist
Arthur J Gallagher & Co 3.9
Remote claims resolution specialist job
Introduction
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people's lives. It takes empathy, precision, and a strong sense of partnership-and that's exactly what you'll find here. We're a team of fast-paced fixers, empathetic experts, and outcomes drivers - people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you'll play a vital role in helping businesses and individuals move forward with confidence. Here, you'll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you're here, you're part of something bigger. You're part of a team that shows up, stands together, and leads with purpose.
Overview
Salary: up to $165,000 per year, dependent upon experience
Jurisdictions: Open to Any
Licenses: must be willing to obtain all licenses stated by manager within specified timeframe
Location: This role is eligible for fully remote work.
Claims Background: Medical Malpractice - Long Term Care
How you'll make an impact
* Analyzes coverage and settles the most complex and challenging claims within Gallagher Bassett's specialty claims areas (excluding workers' compensation).
* Handles the full life cycle of all assigned claims files, from intake to resolution.
* Determines coverage applicability and defense obligations independently.
* Conducts thorough investigations and analysis to assess exposure and develop settlement strategies and action plans.
* Drafts and issues reservation of rights and coverage denial letters.
* Negotiates settlements with clients, client attorneys, and Public Adjusters.
* Engages with all parties involved in the claims process; may recommend retaining outside experts when appropriate.
* Prepares reserve and settlement authority requests for both client and carrier approval.
* May act as a client advocate with carriers to ensure proper handling of claims, including scoping, estimating, and addressing coverage issues.
* Possesses solid understanding of claims processing and the insurance brokerage business.
* Demonstrates deep knowledge of industry-specific terminology, case law, and specialized claims areas.
* Handles claims in alignment with client and corporate policies, best practices, and all regulatory and ethical standards.
* Provides guidance and mentorship to junior adjusters.
* Capable of handling a full caseload independently and effectively.
About You
Potential candidates should have the following:
Claims Background: Medical Malpractice - Long Term Care
Jurisdictional Experience: Any
Active Adjusters' licenses: must be willing to obtain all licenses stated by manager within specified timeframe
As a key member of our Claims Adjuster team, you will:
Investigate, evaluate, and resolve complex Medical Malpractice claims, applying your claims experience and analytical skills to make informed decisions and bring claims to resolution.
Work in partnership with our clients to deliver innovative solutions and improve the claims management process
Think critically, solve problems, plan, and prioritize activities to optimally serve clients
REQUIRED QUALIFICATIONS:
* High school diploma.
* Minimum of 5+ years of experience handling claims within the applicable specialty area (Medical Malpractice).
* Proven ability to handle complex and challenging claims issues at a senior adjuster level.
* Licensed and/or certified in all applicable states, or able to acquire necessary licenses per local requirements.
* Familiarity with accepted industry standards and practices.
* Proficient with relevant claims management and business software.
DESIRED:
Bachelor's Degree
Law Degree (JD)
Litigation Experience
10+years of prior experience adjusting claims in applicable specialty area
Experience in claims as well as the insurance legal and regulatory environment
#LI-TJ1
#GBTopJob
$33k-53k yearly est. 7d ago
Patient Scheduling Specialist
Medasource 4.2
Remote claims resolution specialist job
Medical Support Assistant
Duration: 1 year contract (strong possibility of extension!)
Onsite: Denver, CO
Full Time: M-F, Day Shift
Overview: We are seeking reliable and mission-driven Medical Support Assistants to support Veterans served by a large healthcare system. MSAs provide critical front-line administration support across outpatient clinics and virtual care services.
Responsibilities:
• Customer service, appointment scheduling, and records management
• Answer phones, greet Veteran patients, schedule appointments and consults
• Help determine a clinic's daily needs, and verify and update insurance information
Required Qualifications:
• Minimum 6+ months of customer service experience
• 1+ year of clerical, call center, or healthcare administrative experience
• High school diploma or GED required
• Proficient with medical terminology
• Typing speed of 50 words per minute or more
• Ability to pass a federal background check
• Reliable internet for a remote work environment
$35k-42k yearly est. 1d ago
Treasury Services Specialist
Allied 3.9
Remote claims resolution specialist job
This position is geared toward being the subject matter expert concerning the daily Treasury Services processes. This role will perform typical Analyst level tasks while supporting the Treasury Services team with any day-to-day issues and concerns. This position is responsible for building out processes and providing additional training to the Treasury Services team.
ESSENTIAL FUNCTIONS
Complete Monthly Reconciliations of client accounts through Great Plains
Process New business banking setup (BPO & ASO)
Make existing business banking changes (BPO & ASO)
Vendor maintenance for print fulfillment
VCC/EFT Implementation & support
Complete Check Tracer processes
Positive Pay submission
Create and implement new processes as needed
Lead new hire and existing team member training as needed
Other duties as assigned
EDUCATION
Bachelor's degree in accounting, or equivalent work experience required.
EXPERIENCE AND SKILLS
A minimum of 2 years' experience as a Treasury Analyst required
Must be detailed oriented
Excellent written and verbal communication skills required.
Excellent organizational and time management skills required.
Proficient with Microsoft Office Suite, Excel, Word, or similar software required
Experience with financial management systems, such as Great Plains or similar
Good computer skills with programs such as MS Excel, Access, and Power BI.
Exceptional analytical and problem-solving skills.
Strong financial and mathematic abilities.
Excellent verbal and written communication skills.
Strong time management and organizational abilities
POSITION COMPENTENCIES
Communication
Customer Focus
Accountability
Functional/Technical Job Skills
PHYSICAL DEMANDS
This is an office environment requiring extended sitting and computer work
WORK ENVIRONMENT
Remote
Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.
Protect Yourself from Hiring Scams
Important Notice About Our Hiring Process
To keep your experience safe and transparent, please note:
All interviews are conducted via video.
No job offer will ever be made without a video interview with Human Resources and/or the Hiring Manager.
If someone contacts you claiming to represent us and offers a position without a video interview, it is not legitimate. We never ask for payment or personal financial information during the hiring process.
For your security, please verify all job opportunities through our official careers page: Current Career Opportunities at Allied Benefit Systems
Your security matters to us-thank you for helping us maintain a fair and trustworthy process!
$41k-60k yearly est. 2d ago
Viral - Content Claiming Specialist
Create Music Group 3.7
Remote claims resolution specialist job
Create Music Group is currently looking for self-described viral internet culture enthusiasts to join our Viral Department.
Viral Content ClaimingSpecialist perform administrative tasks such as YouTube copyright claiming and asset onboarding, as well as scope out trending memes and social media videos on a daily basis. This position requires a regular workload of data entry/administration in order to carry out the most basic functions of our department but there are plenty of opportunities for more creative and ambitious pursuits if you are so inclined.
This is a full time position which may be done remotely, however our office is located in Hollywood, California, and we are currently only looking for job candidates who are located in California. In the future, you may be encouraged to come into our office for meetings or company functions, so it is best if you are located in the Los Angeles/Southern California area.
Through our Viral team, we collaborate with some of the most prominent viral talent from the TikTok and meme world including Supa Hot Fire (Deshawn Raw), Welven Da Great (Deez Nuts), Verbalase, KWEY B, Hoodnews, presidentofugly1, 10k Caash, dimetrees, Zackass, Supreme Patty, The Man with the Hardest Name in Africa, ViralSnare, Adin Ross, and more.
YouTube monetization provides an alternative consulting and revenue-generating resource for our clients to grow their audience and earnings. We have helped our clients monetize and collected millions in previously unclaimed revenue for content creators, artists and labels.
REQUIREMENTS:
1-3 years work experience
Excellent communication skills, both written and verbal
Internet culture and social media platforms, especially YouTube
Conducting basic level research
Organizing large amounts of data efficiently
Proficiency with Mac OSX, Microsoft Office, and Google Apps
PLUSES:
Strong understanding of the online video market (YouTube, Instagram, TikTok)
Bilingual - any language, although Spanish, Mandarin, and Russian is preferred
RESPONSIBILITIES:
We work directly with our clients and their team to help them break down the data and find potential opportunities to build their career. Daily responsibilities include but are not limited to the following.
Watching YouTube videos for several hours daily
Content claiming
Uploading and defining intellectual assets
Administrative metadata tasks
Researching potential clients
Staying on top of accounts for current client roster
As this is a remote position, you are required to have your own computer and reliable internet connection.
This position may require you to download a great deal of video files (files which may be deleted once onboarding tasks are completed) so please make sure that you have a computer that is up to the task.
Laptops are preferable if you would like to come into our office to work (snacks, soft drinks, and Starbucks coffee are provided at our physical office).
BENEFITS:
Paid company holidays, paid time off, and health benefits (medical, dental, vision, and supplementary policies) are included.
TO APPLY:
Send us your resume and cover letter (in one file). After you apply, you will be redirected to take our Culture Index survey here. Otherwise, copy and paste the link to your web browser: ********************************************************* Info.php?cfilter=1&COMPANY_CODE=cYEX5Omste
Applications without a cover letter and Culture Index survey will not be considered. OPTIONAL: Link relevant social media campaigns and/or writing samples from your portfolio.
$45k-75k yearly est. Auto-Apply 60d+ ago
Post Payment Claims Specialist
Reliant 4.0
Remote claims resolution specialist job
Reliant Health Partners is an innovative medical claims repricing service provider, helping employers achieve maximum health plan savings with minimum noise. We tailor our services to each client's needs, providing everything from individual specialty claims repricing, to full plan replacement as a high-performance, open-access network alternative.
As a Medical Claims Appeal Specialist, you are responsible for contacting providers to educate on NSA process/payments, respond to appeals for various products, and negotiate these post pay appealed claims to resolve payment disputes.
Primary Responsibilities
Monitor and manage your post payment queues.
Conduct outreach, education, and negotiation calls to providers for post payment claims.
Effectively communicate with providers to verify/confirm understanding of NSA claims payments and regulations.
Effectively communicate with providers to explain claim payments for various pricing products.
Maintain compliance, including but not limited to Confidentiality and HIPAA requirements.
Maintain acceptable levels of production including but limited to turn around time standards as mandated by the regulation(s).
Document all conversations and record name, phone number, and email of contact person if available, payment rates offered on behalf of clients, and any counter offers by the provider.
Adhere to client specific and Reliant protocols, scripts, and other requirements.
Develop a comprehensive understanding of the state and federal regulations that will impact payments to providers.
Develop a comprehensive understanding of our various products.
Perform other job-related duties and special projects as required.
Qualifications
2-3 years of related job experience - appeals, negotiations, medical billing.
Experience conducting outreach to providers via phone calls or other communication means.
Experience understanding Reliant critical behaviors and compliance requirements.
Broad healthcare policy and payment understanding.
Experience with claims workflow tools or systems.
Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role.
Pay Transparency$50,000-$60,000 USDBenefits:
Comprehensive medical, dental, vision, and life insurance coverage
401(k) retirement plan with employer match
Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
Paid time off (PTO) and disability leave
Employee Assistance Program (EAP)
Equal Employment Opportunity: At Reliant, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business-and our society-stronger. Reliant Health Partners is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.
$50k-60k yearly Auto-Apply 3d ago
Patient Claims Specialist - Bilingual Only
Modmed 4.5
Remote claims resolution specialist job
We are united in our mission to make a positive impact on healthcare. Join Us!
South Florida Business Journal, Best Places to Work 2024
Inc. 5000 Fastest-Growing Private Companies in America 2024
2024 Black Book Awards, ranked #1 EHR in 11 Specialties
2024 Spring Digital Health Awards, “Web-based Digital Health” category for EMA Health Records (Gold)
2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara)
Who we are:
We Are Modernizing Medicine (WAMM)! We're a team of bright, passionate, and positive problem-solvers on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical practice success and improves patient outcomes. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed's global headquarters is based in Boca Raton, FL, with a growing office in Hyderabad, India, and a robust remote workforce across the US, Chile, and Germany.
ModMed is hiring a driven Patient ClaimSpecialist who will play a pivotal role in shaping a positive patient experience within our passionate, high-performing Revenue Cycle Management team. As a critical team member, you will support patients receiving care from ModMed BOOST service providers and doctors, ensuring their account needs are met excellently. This direct interaction with our customers' patients makes you an integral part of ModMed's business. It opens the door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company that is genuinely Modernizing Medicine!
Your Role:
Serve as primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections
Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates
Input and update patient account information and document calls into the Practice Management system
Special Projects: Other duties as required to support and enhance our customer/patient-facing activities
Skills & Requirements:
High School Diploma or GED required
Availability to work 9:30-5:30pm PST or 11:30am to 8:30 pm EST
Minimum of 1-2 years of previous healthcare administration or related experience required
Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs)
Manage/ field 60+ inbound calls per day
Bilingual is a requirement (Spanish & English)
Proficient knowledge of business software applications such as Excel, Word, and PowerPoint
Strong communication and interpersonal skills with an emphasis on the ability to work effectively over the telephone
Ability and openness to learn new things
Ability to work effectively within a team in order to create a positive environment
Ability to remain calm in a demanding call center environment
Professional demeanor required
Ability to effectively manage time and competing priorities
#LI-SM2
ModMed Benefits Highlight:
At ModMed, we believe it's important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits:
India
Meals & Snacks: Enjoy complimentary office lunches & dinners on select days and healthy snacks delivered to your desk,
Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members, all at no cost to employees,
Allowances: Annual wellness allowance to support your well-being and productivity,
Earned, casual, and sick leaves to maintain a healthy work-life balance,
Bereavement leave for difficult times and extended medical leave options,
Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave,
Celebration leave to make your special day even more memorable, and company-paid holidays to recharge and unwind.
United States
Comprehensive medical, dental, and vision benefits
401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
Generous Paid Time Off and Paid Parental Leave programs,
Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,
Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.
PHISHING SCAM WARNING: ModMed is among several companies recently made aware of a phishing scam involving imposters posing as hiring managers recruiting via email, text and social media. The imposters are creating misleading email accounts, conducting remote "interviews," and making fake job offers in order to collect personal and financial information from unsuspecting individuals. Please be aware that no job offers will be made from ModMed without a formal interview process, and valid communications from our hiring team will come from our employees with a ModMed email address (*************************). Please check senders' email addresses carefully. Additionally, ModMed will not ask you to purchase equipment or supplies as part of your onboarding process. If you are receiving communications as described above, please report them to the FTC website.
$66k-101k yearly est. Auto-Apply 30d ago
Scheduling Specialist Remote after training
Radiology Partners 4.3
Remote claims resolution specialist job
RAYUS now offers DailyPay! Work today, get paid today!
RAYUS Radiology is looking for a Scheduling Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As a Scheduling Specialist, you will be responsible for providing services to patients and referring professionals by answering phones, managing faxes and scheduling appointments. This is a full-time position working 9:00AM - 5:30PM CST Mon-Fri, Rotating Saturday 7am-1pm CST.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
(85%) Scheduling Activities
Answers phones and handles calls in a professional and timely manner
Maintains positive interactions at all times with patients, referring offices and team members
Schedules patient examinations according to existing company policy
Ensures all appropriate personal, financial and insurance information is obtained and recorded accurately
Ensures all patient data is entered into information systems completely and accurately
Ensures patients are advised of financial responsibilities, appropriate clothing, preparation kits, transportation and/or eating prior to appointment
Communicates to technologists any scheduling changes in order to ensure highest level of patient satisfaction
Maintains an up-to-date and accurate database on all current and potential referring physicians
Handles overflow calls for other centers within market to ensure uninterrupted exam scheduling for referring offices
Provides back up coverage for front office team members as requested by supervisor (i.e., rest breaks, meal breaks, vacations and sick leave)
Fields 1-800 number calls and routes to appropriate department or associate (St. Louis Park only
(10%) Insurance Activities
Pre-certifies all exams with patient's insurance company as required
Verifies insurance for same day add-ons
Uses knowledge of insurance carriers (example Medicare) and procedures that require waivers to obtain authorization if needed prior to appointment
(5%) Other Tasks and Projects as Assigned
$33k-39k yearly est. 38m ago
Claims Process Expert Sr. - Ohio MyCare
Elevance Health
Claims resolution specialist job in Columbus, OH
Location: Candidates are required to live in Ohio. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.
The Claims Process Expert Sr. oversees the administration of claims processing and operational support functions to ensure compliance with the regulatory standards of Anthem's Ohio Medicaid products. Works with Provider Experience to research provider inquiries for possible configuration and rate related claims errors, and responsible for ensuring claimsresolution success. Also responsible for adhering and reporting against State Prompt Pay and Claims Issue reporting requirements.
How you will make an impact
Primary duties may include, but are not limited to:
* Oversee the end-to-end claims process, including receipt, adjudication, payment, and performance reporting on claims timeliness, accuracy, backlog and provider payment compliance.
* Serve as the operational liaison with the state of Ohio, Provider Experience, and internal executive leadership.
* Researches operations workflow problems and system irregularities.
* Develops, tests, presents process improvement solutions for new systems, new accounts and other operational improvements.
* Develops and leads project plans and communicates project status,
* Provides process direction and decision making for all minor and major project work.
* Provides guidance to process experts.
* May perform duties as a lead when involved with enterprise wide initiatives/projects.
Minimum Qualifications:
* Requires a BA/BS and minimum of 8 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
* Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred.
* Experience with Dual Products: Medicaid and Medicare strongly preferred.
* Ohio state regulatory reporting experience preferred.
* Broad experience in claims Medicaid and/or Medicare within the state of Ohio is strongly preferred.
For candidates working in person or virtually in the below locations, the salary* range for this specific position is $81,760.00 to $122,640.00
Location(s): Columbus, OH.
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors
set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Job Level:
Non-Management Exempt
Workshift:
1st Shift (United States of America)
Job Family:
BSP > Process Improvement
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$28k-35k yearly est. 2d ago
(Remote) Claims Assistant
Military, Veterans and Diverse Job Seekers
Remote claims resolution specialist job
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Evaluates residential and commercial contents inventories obtained by or submitted to VeriClaim on both a Replacement Cost and Actual Cash Value (ACV) basis.
Applies limitations and/or exclusions on claims based on coverage afforded by the policy.
Tracks time and log file notes for daily field activity.
Assists with answering telephones.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS:
Education & Licensing
High school diploma or GED required. Resident Insurance Adjuster License (Fire and Other Hazards) preferred.
Experience
One (1) year customer service experience or equivalent combination of education and experience preferred. Accounting and insurance background preferred.
Skills & Knowledge
Oral and written communication skills
PC literate, including Microsoft Office products
Good comprehensive decision making skills
Ability to read and comprehend policy language
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
$35k-43k yearly est. 60d+ ago
Claims Assistant
Advocates 4.4
Remote claims resolution specialist job
OverviewAt Advocate, our mission is to empower Americans to obtain the government support they've earned. Advocate aims to reduce long wait times and bureaucratic obstacles of the current government benefits application process by developing a unified intake system for the Social Security Administration, utilizing cutting-edge technologies such as artificial intelligence and machine learning, crossed with the knowledge and experience of our small team of EDPNA's and case managers.
We are seeking a Claims Assistant to play a key role in ensuring smooth case management and operational support at Advocate. In this position, you will handle a variety of important administrative tasks, from managing incoming communication to scheduling appointments for case managers. You'll ensure that our administrative processes flow efficiently, contributing directly to the success of our mission. If you're organized, detail-oriented, and enjoy working in a fast-paced environment, this could be the perfect opportunity for you to make a meaningful impact.Job Responsibilities
Ensure the Social Security Administration (SSA) has processed representative forms and provided access to Electronic Records Express (ERE).
Manage a high volume of incoming mail as the company continues to grow.
Handle calls and texts to the client care team's dedicated 888 line.
Schedule appointments for case managers to keep operations on track.
Request medical source statements and assist with other administrative tasks to ensure smooth process flow.
Qualifications
Strong administrative and clerical skills are essential.
Prior experience with Social Security disability is preferred but not required.
Highly organized and capable of managing multiple tasks efficiently.
Strong attention to detail and task-oriented mindset.
Ability to thrive in a fast-paced and growing work environment.
This is a remote position and Advocate is currently a fully remote team. Advocate is an equal opportunity employer and values diversity in the workplace. We are assembling a well-rounded team of people passionate about helping others and building a great company for the long term.
$35k-39k yearly est. Auto-Apply 60d+ ago
Central Scheduling Specialist- Remote
HMC External
Remote claims resolution specialist job
The Central Scheduling Specialist coordinates the verification, scheduling, pre-registration, and authorization for medical services. Responsibilities include the accurate collection and entry of required financial and demographic patient information, scheduling management to maximize the efficiency of the visit, communicating preparatory instructions, and collection of payment. This role requires a high level of independent judgment in order to successfully coordinate and obtain authorization requests for governmental and complex managed care patients in a timely and efficient manner. Utilizing telecommunications and computer information systems, this individual will be responsible for handling inbound and outbound calls with a focus on exceptional service to patients, employees, and providers. In order to ensure an extraordinary patient experience, multitasking between different patient care areas will be required. The Central Scheduling Specialist is best defined as a highly independent and flexible resource that functions in alignment with the patient experience initiative. Performs all job duties and responsibilities in a courteous manner according to the Hurley Family Standards of Behavior.Works under the supervision of the department director or designee who assigns and reviews conformance with established procedures and standards.
High school graduate and/or GED equivalent.
Associate's degree in Business Administration or equivalent degree.
-OR-
Two (2) years of experience working in a call center or experience performing scheduling, registration, billing or front-desk responsibilities in a medical (hospital or physician office/clinic) setting
Knowledge of a call center environment and capable of handling a high call volume while maintaining high performance.
Knowledge of registration, scheduling, authorization, and referral policies and procedures relative to an outpatient clinic and surgical setting.
Demonstrates extensive knowledge of insurance plan pre-certification/referral requirements and processes.
Working knowledge of medical terminology, procedure and diagnosis coding, and billing procedures.
Proficient in business office information systems & software such as Google Suite & Microsoft Office containing spreadsheet and database applications.
Manage multiple, changing priorities in an effective and organized manner, under stressful demand while maintaining exceptional service. Maintain composure when dealing with difficult situations and responding professionally.
Independently recognize a high priority situation, taking appropriate and immediate action. Make decisions in accordance with established policies and procedures.
Knowledge of hospital operations and / or Ambulatory Clinic operations.
Excellent verbal and written communications skills and a pleasant and professional phone demeanor.
Ability to develop effective relationships with colleagues, physicians, providers, leaders, and other across the organization.
Demonstrates a genuine interest in helping our patients, providers, and other employees by using excellent communication skills, being polite, friendly, patient and calm under pressure.
PREFERRED QUALIFICATIONS: Working knowledge of Epic Revenue Cycle applications: Resolute Hospital Billing, Resolute Professional Billing, Single Business Office, Cadence, or Grand Central.
Schedules, cancels, reschedules appointments / services for designated departments. Manages scheduling to maximize the efficiency of the visit / provider. Monitors appointment schedules daily for cancellations, rescheduling, and no shows as well as other stats or changes; communicates timely with all departments impacted. Generates daily-weekly-monthly reports in order to manage schedules and distributes information as needed.
Performs pre-registration functions within designated time frame in advance of the patient appointment (including, but not limited to) obtaining and / or verifying demographic, clinical, financial, insurance information, and eligibility for scheduled service / procedure. Confirms Primary Care Provider making necessary updates as appropriate.
Identifies insurance companies requiring prior authorization and / or referrals for services and obtains authorization / referral for all services. Coordinates incoming / outgoing authorizations for procedures and testing requested by providers for all government and third-party payers, including emergent authorizations due to walk-in patients.
Informs the patient of their visit-specific preparatory instructions and ensures notification about their upcoming appointments. Schedules pre-admission testing when needed and assists in arranging necessary lab orders. Obtains all necessary information required by third-party payors for treatment authorization requests.
Courteously accepts and places telephone calls, and interacts with physicians and associates while providing services. Resolves or tactfully directs complaints, problems; obtains information and responds to inquiries within 24-48 hours. Frequently communicates with patients/family members/guarantors, physicians/office staff, medical center, and payors via telephone, email, enterprise EMR or other electronic services. Escalates issues that cannot be resolved in accordance with departmental guidelines.
Performs price estimates upon patient request in order to assist the patient in identifying their expected full patient liability and / or residual financial responsibility.
Educates the patient relative to their insurance policy / benefits. Collects patient / guarantor liabilities and refers patients who are uninsured / underinsured to Insurance Services Specialists for financial assistance or governmental program screening and application processes. Refers patients to the Financial Customer Service Specialist to resolve outstanding self-pay balances.
Maintains a log / guide with up-to-date information related to services in need of pre-certification or require referrals per insurance carrier. This includes compliance with regulatory requirements and ensuring all changes are incorporated into daily job functions.
Works with the coding department to validate the accuracy of the authorized service in comparison to the procedure performed. Discrepancies are addressed immediately within timelines set forth by the specific payer's guidelines for correction. Reports procedural updates to leadership.
Triages misrouted telephone and patient portal inquiries promoting an exceptional patient and provider experience. Makes follow-up calls to provider offices and / or testing sites to ensure receipt of all necessary information for the patient's visit.
Recommends modifications to existing policies or workflows that support the values of Hurley Medical Center and will increase efficiency and promote data integrity.
Maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully perform duties on a day-to-day basis. Able to work in a fast-paced call center environment while maintaining efficiency and accuracy.
Performs other related duties as required. Utilizes new improvements and/or technology that relate to job assignment. Involvement in special projects as needed.
$27k-41k yearly est. Auto-Apply 1d ago
Clinical Scheduling Specialist
Midi Health
Remote claims resolution specialist job
Master Clinical Scheduler @ Midi Health: 👩 ⚕️💻
Midi is seeking an experienced Master Scheduler to join our cutting edge healthcare start-up. This is a rare opportunity to start at the ground level of a fast-growing healthcare practice! We offer a flexible work schedule and 100% remote environment with a competitive salary, benefits and a kind, human-centered environment.
Business Impact 📈
Sole responsibility for creating every Midi clinician's schedule in Athena
Daily monitoring of clinician schedules
Management of patient waiting list to backfill patients as times become available
Rescheduling of patients as needed
Adjustment of clinician schedules as needed
Cross-coverage of Care Coordinator Team responsibilities as assigned
What you will need to succeed: 🌱
Availability! 5 days per week, 8 hour shift + 30 min unpaid lunch - 9:30 AM to 6 PM PST
Minimum of five (3) years as a Clinical Scheduler building clinician schedules (preferably in AthenaHealth)
Minimum of 1 year experience working for a digital healthcare company
Proficiency in scheduling across multiple time zones
Self-starter with strong attention to detail
What we offer:
Compensation: $30/hour, non-exempt
Full Time, 40-hour work-week
Fully remote, work from home opportunity!
Benefits (medical, dental, vision, 401k)
The interview process will include: 📚
Interview with Recruiter (30 min Zoom)
Interview with Scheduling Supervisor + Lead Scheduler (30 min Zoom)
Final Interview with Practice Manager (30 min Zoom)
***Scheduled Shift Time is M-F 9:30am-6pm PST***
Thanks for your interest in Midi 👋While you are waiting for us to review your resume, here is some fun content to check out! Check us out here and here. Trust that our patients love❣️us! #Menopauseishot
#LI-DS1
Please note that all official communication from Midi Health will come from **************** email address. We will never ask for payment of any kind during the application or hiring process. If you receive any suspicious communication claiming to be from Midi Health, please report it immediately by emailing us at ********************.
Midi Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Please find our CCPA Privacy Notice for California Candidates here.
$30 hourly Auto-Apply 13d ago
Booking & Scheduling Specialist
Traveling With McHaila
Remote claims resolution specialist job
We're seeking a reliable and detail-oriented Booking & Scheduling Planner to support clients by coordinating schedules, managing bookings, and ensuring a seamless experience from start to finish. This fully remote role is ideal for someone who enjoys organization, client communication, and keeping details running smoothly. This is perfect for individuals who can work independently while using the resources and tools provided.
What Youll Do:
Manage bookings, schedules, and confirmations
Communicate with clients to gather details and provide updates
Ensure accuracy and timely follow-ups
Deliver professional, friendly support throughout the process
What Were Looking For:
Strong organizational and communication skills
Customer service or administrative experience (preferred, not required)
Comfortable working independently in a remote setting
Detail-oriented, dependable, and tech-comfortable
Must be able to book, plan and create itineraries for clients and deliver quotes from start to finish
Must be a citizen of the US, UK, Australia, Mexico, Spain and LATAM
Why This Role Stands Out:
100% remote flexibility
Training and ongoing support provided
Opportunity for growth within a supportive team
$33k-48k yearly est. 7d ago
Claims Specialist - Auto
Philadelphia Insurance Companies 4.8
Claims resolution specialist job in Dublin, OH
Marketing Statement:
Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.
We are looking for a ClaimsSpecialist - Auto to join our team.
JOB SUMMARY
Investigate, evaluate and settle more complex first and third party commercial insurance auto claims.
JOB RESPONSIBILITIES
Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner.
Communicates with all relevant parties and documents communication as well as results of investigation.
Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts.
Travel is required to attend customer service calls, mediations, and other legal proceedings.
JOB REQUIREMENTS
High School Diploma; Bachelor's degree from a four-year college or university preferred.
10 plus years related experience and/or training; or equivalent combination of education and experience.
• National Range : $82,800.00 - $97,300.00
• Ultimate salary offered will be based on factors such as applicant experience and geographic location.
EEO Statement:
Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.
Benefits:
We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.
Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
$82.8k-97.3k yearly Auto-Apply 60d+ ago
V104 - Intake and Scheduling Specialist
Flywheel Software 4.3
Remote claims resolution specialist job
For ambitious, culturally diverse, curious minds seeking booming careers, Job Duck unlocks and nurtures your potential. We connect you with rewarding, remote job opportunities with US-based employers who recognize and appreciate your skills, allowing you to not just survive but thrive.
As a lifestyle company, we ensure that everybody working here has a fantastic time, which is why we've earned the Great Place to Work Certification every year since 2022!
Job Description:
This role at Job Duck offers the opportunity to support a fast‑paced professional environment where responsiveness and smooth communication truly make a daily impact. The position centers around assisting clients with care, managing incoming calls with a warm and engaging presence, and ensuring that follow‑ups and intakes are handled with clarity and consistency. You will contribute by preparing polished templates, maintaining accurate spreadsheets, and coordinating schedules so operations run seamlessly.
A candidate who thrives in this role enjoys interacting with others, communicates with confidence, and stays organized even when navigating multiple software tools at once. If you bring strong English skills and a naturally outgoing approach to your work, you will excel here.
• Salary Range: 1,150 USD to 1,220 USD
Responsibilities include, but are not limited to:
Client intake and follow-up.
Templates drafting.
Create and maintain spreadsheets
Support general administrative functions
Handle scheduling and calendar coordination
Answering phone calls (approximately 10/day), it can vary
Requirements:
Strong written and spoken English
Excellent grammar and communication skills
Responsive and detail‑oriented
Comfortable using multiple software platforms simultaneously
Outgoing communication style
Ability to stay organized while handling varied administrative tasks
CRM: Lawmatics
VoIP: RingCentral
Internal communication: Microsoft Teams Channel, Slack
Outlook
Work Shift:
9:00 AM - 6:00 PM [EST][EDT] (United States of America)
Languages:
English, Spanish
Ready to dive in? Apply now and make sure to follow all the instructions!
Our application process involves multiple stages, and submitting your application is just the first step. Every candidate must successfully pass each stage to move forward in the process.
Please keep an eye on your email and WhatsApp for the next steps. A recruiter will be assigned to guide you through the application process. Be sure to check your spam folder as well.
$30k-43k yearly est. Auto-Apply 8d ago
Medical Central Scheduling Specialist - Remote
Qualderm Partners 3.9
Remote claims resolution specialist job
Job Description
Candidates must reside within a reasonable driving distance of Lombard, IL.
Hours Scheduled: Mon-Thurs 9:30am-6pm/Fridays 8am-5pm
QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S., with over 150 locations across 17 states. Our commitment is to educate, protect, and care for your skin while delivering the highest quality dermatological services. We strive to make skin health accessible to all while fostering a rewarding work environment for both our patients and employees.
Position Summary:
The Remote Central Scheduling Specialist will be responsible for managing and coordinating the scheduling of patient appointments across our various practice locations. This role requires exceptional customer service skills and the ability to handle a high volume of calls while ensuring that each patient feels valued and supported throughout their scheduling experience.
Requirements
High School Diploma required; Associate's Degree preferred.
Minimum of 1 year customer service experience in a healthcare setting preferred.
Strong communication and interpersonal skills.
Ability to manage multiple tasks efficiently in a fast-paced environment.
Proficiency in scheduling software and Microsoft Office applications.
Understanding of HIPAA regulations is a plus.
Benefits
Competitive Pay
Medical, dental, and vision
401(k) - The company match is 100% of the first 3%; and 50% of the next 2%; immediately vested
Paid Time Off - accrual starts upon hire, plus 6 Paid Holidays and 2 floating days
Company paid life insurance and additional coverage available
Short-term and long-term disability, accident and critical illness, and identity theft protection plans
Employee Assistance Program (EAP)
Employee Discounts
Employee Referral Bonus Program
QualDerm Partners, LLC is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Compensation Range: $17.00 - 19.50 per hour. Final offer will be based on a combination of skills, experience, location, and internal equity.
$17-19.5 hourly 18d ago
Learn more about claims resolution specialist jobs