Insurance claims processor jobs near me - 125 jobs

5 Years Facets Claims Adjudication Experience The Claims Examiner must maintain production and inventory standards compliant with Claims Administration requirements High school diploma or equivalent required Must have 5+ years of relevant claim processing experience in healthcare industry (managed care or TPA Company) to support our clients Possess high productivity and quality standards within a claims processing automation environment Knowledge of CPT, HCPC, ICD-10 codes Knowledge of HMO, PPO, Medicare and Medicaid plans Knowledge of Medical terminology Computer with 2 Monitors High Speed Internet Connection Ability to work remote 8 hour day, Mon-Fri. Responsibilities: The claims examiner is responsible for accurate and timely adjudication of claims for the Health Plans lines of business Primary duties include analysis and resolution of claims, including reviewing pended claims and manually resolving based on client specified direction and criteria, including third-party liability claims The claims examiner must be able to work independently, effectively prioritizing work in a production environment that frequently changes to meet production standards and contractual requirements Success in this position will be based on the individual's ability to effectively prioritize work, identify, and resolve complex concerns in a professional manner, and work in a team environment to achieve and maintain production and audit standards Timely and accurate processing and adjudication of all types of claims from assigned workflow queues Compliance with state, federal and contractual requirements to Claims Administration Demonstrate a thorough knowledge of the Plan's claims processing procedures as provided in training materials and proficiency with the core and ancillary system applications Demonstrates the ability to think analytically to resolve complicated claim issues and identify appropriately when to escalate issues for review Ability to review and apply Plan directives and desktop procedures to claims, following step by step guidelines Claim analysis of coding and billing compliance, potential third-party liability, accurate coordination of benefits (COB), benefit application including limitations and restrictions, pre-existing conditions, subrogation, medical necessity and other claim investigation as appropriate Complete all mandatory claims training/refresher courses Actively participates and supports department and organization-wide efforts to improve efficiencies while supporting departmental goals and objectives Complete all mandatory compliance and corporate training Must be able to adapt to a changing work priorities and requirements and perform other duties as directed to support the overall functions of Claims Administration and support of staff without boundaries within the Plan

Title: Claims Processor 3 Department: Claims Union: UFCW 3000 Bothell Grade: 7 The Claims Processor 3 provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by /Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned. Minimum Qualifications High school diploma or GED. One year of experience as Level 2 Claims Processor. Intermediate knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10 and CPT-4 codes. Possesses a strong work ethic and team player mentality. Highly developed sense of integrity and commitment to customer satisfaction. Ability to communicate clearly and professionally, both verbally and in writing. Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations. Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages. Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion Computer proficiency including Microsoft Office tools and applications. Preferred Qualifications Experience working in a third-party administrator. *Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice. Working Conditions/Physical Effort Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. Disability Accommodation Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at ******************************, and we would be happy to assist you. Please note that in compliance with certain state law, we are displaying salary. This rate is intended for hires into this location. Compensation: $28.81/hr Zenith American Solutions Real People. Real Solutions. National Reach. Local Expertise. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before. We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American! We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation. Become an integral part of a dedicated team supporting the World Trade Center Health Program. In this role, you will leverage your strong attention to detail and commitment to accuracy in processing complex medical claims. If you are eager to make a positive impact in the community through your administrative skills, we encourage you to apply. Work Schedule Remote Monday through Friday, 8:30 AM to 5:00 PM EST Must be able to work 8am - 5pm Eastern Standard Time Responsibilities Claims Review and Processing Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. Critical Analysis Adjudicate claims according to program guidelines, applying critical thinking skills to navigate complex scenarios. Timely Processing Ensure prompt claims processing to meet client standards and regulatory requirements. Identify and resolve any barriers using effective problem-solving strategies. Issue Resolution Collaborate with internal departments to proactively resolve discrepancies and issues. Use analytical skills to identify root causes and implement solutions. Confidentiality Maintenance Uphold confidentiality of patient records and company information in accordance with HIPAA regulations. Detailed Record Keeping Maintain thorough and accurate records of claims processed, denied, or requiring further investigation. Trend Monitoring Analyze and report trends in claim issues or irregularities to management. Assist Team Leads with reporting to contribute to continuous process improvements. Audit Participation Engage in audits and compliance reviews to ensure adherence to internal and external regulations. Critically evaluate and recommend process improvements when necessary. Mentoring Mentor and train new claims processors as needed. Requirements High school diploma or equivalent. Minimum of five years of experience in medical claims processing, including professional and facility claims, as well as complex and high-dollar claims. Billing experience doesn't count towards years of experience qualification Familiarity with ICD-10, CPT, and HCPCS coding systems. Understanding of medical terminology, healthcare services, and insurance procedures (experience with worker's compensation claims is a plus). Strong attention to detail and accuracy. Ability to interpret and apply insurance program policies and government regulations effectively. Excellent written and verbal communication skills. Proficiency in Microsoft Office Suite (Word, Excel, Outlook). Ability to work independently and collaboratively within a team environment. Commitment to ongoing education and staying current with industry standards and technology advancements. Experience with claim denial resolution and the appeals process. Ability to manage a high volume of claims efficiently. Strong problem-solving capabilities and a customer service-oriented mindset. Flexibility to adjust to the evolving needs of the client and program changes. Benefits 401(k) with employer matching Health insurance Dental insurance Vision insurance Life insurance Flexible Paid Time Off (PTO) Paid Holidays What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting. Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.

About Us All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 401k plan. Additional employee paid coverage options available. Job purpose The Claims Examiner III is responsible for the processing and/or adjusting and the releasing of hospital or medical claims according to established policies and procedures. Must identify procedural and system inefficiencies and work with the appropriate entities to resolve issues. Examiners also perform research, analysis, reporting and special projects as assigned. Examiners must be able to meet production requirements and quality standards. Must be able to successfully perform all the duties of the Claims Examiner II. Duties and responsibilities Participate in claims workflow projects. Create and run Crystal /SQL reports for distribution to claims examiners, other department as needed to maintain claims turnaround time compliance. Processing claims for all lines of business including complex claims. Complies with all Company and Department Policies and Procedures. When needed assist in claims audit preparation/activities. Responsible for the processing of claims that are either the financial responsibility of the assigned IPA or capitated Hospital. Must meet quantitative production standard of 100 - 150 claims per day. Must maintain an error accuracy of under 5%. Responsible for validating the diagnosis and procedure codes against the authorized services on Inpatient claims. Responsible for the resolution of Provider Disputes (PDR's) and their documentation (code driven) for required Acknowledgement and Resolution Letters to send to providers. Responsible for requesting additional information required to adjudicate claims, by correctly coding claims notes to generate Development Letters and or Notifications to providers. Responsible for accurately coding claims notes to generate Denial Letters for claims denied as member liability. Ability to resolve claims issues on identified processing errors and make recommendations for improvements to avoid error. Identify any overpayment/underpayment in a review and or history search. Follow department protocol for reporting and following up. Adjusts voids and reopens claims within guidelines to ensure proper adjudication. Resolve any grievances and complaints received through Customer Services, responds when needed to portal/email inquiries and initiates steps to assist regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims. Support the Claims Department as business needs require. May have customer/client contact. May assist with training of team members. Works without significant guidance. Identify claims payment errors and/or system configuration flaws during day-to-day operation, report to department manager to correct/resolve them. Able to assist with check run preparation as needed. All other duties as assigned. Qualifications Must have experience with EZ-Cap 10+ years or more experience in processing HMO claims in a managed care environment. Familiar with all regulatory requirements including CMS, DMHC and DHS. Proficient with all Federal and state requirements in claim processing. Knowledge of medical terminology and coding. Proficient in rate application for outpatient PPS & Inpatient DRG facility, ASC, APC, Interim Rate Payment methods to applicable lines of business. (Medicare, Commercial, Medi-Cal). Recognize the difference between Shared Risk and Full Risk claims. Proficient in and knows how to use and apply Health Plan Benefit Matrix and Division of Financial Responsibility. Proficient understanding of AB1324. Proficient understanding of AB1455 Claims Settlement Practice & Dispute and Resolution regulations. Proficiency using Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe Detail oriented and highly organized Strong ability to multi-task, project management, and work in a fast-paced environment Strong ability in problem-solving Ability to self-manage, strong time management skills. Ability to work in an extremely confidential environment. Strong written and verbal communication skills

Our client is seeking to add a Commercial Auto Claims Examiner to their team. This individual will be responsible for handling commercial auto liability and physical damage claims from initial intake through resolution. The position involves evaluating coverage, investigating losses, and negotiating settlements across various jurisdictions. This person will have the ability to work fully remote. Key Responsibilities: Investigate, evaluate, and resolve Commercial Auto and Trucking claims from first notice of loss through closure. Review liability, assess damages, and determine appropriate claim strategies. Establish timely and accurate reserves based on claim investigation and exposure. Collaborate with insureds, claimants, attorneys, and vendors to move claims toward resolution. Handle coverage analysis and issue coverage position letters as required. Maintain consistent communication with policyholders and stakeholders throughout the claim lifecycle. Ensure proper file documentation and compliance with company and regulatory standards. Negotiate settlements within authority and in accordance with company/client expectations. Stay current on state-specific laws and regulations related to commercial auto claims. Requirements: 3 - 5+ years of Commercial Auto/Trucking claims handling experience. Active Adjuster's License required. Strong analytical, negotiation, and communication skills. Ability to draft detailed claim reports and correspond professionally with stakeholders. Highly organized, proactive, and able to manage workload independently. Proficient in Microsoft Office and relevant claims management systems. Salary & Benefits: $65,000 - $75,000 annually (depending on experience) Comprehensive Medical, Dental, and Vision coverage 401(k) with company match Paid Time Off and holiday benefits Professional development and career growth opportunities

Why MSI? We thrive on solving challenges. As a leading MGA, MSI combines deep underwriting expertise with insurer and reinsurer risk capacity to create specialized insurance solutions that empower distribution partners to meet customers' unique needs. We have a passion for crafting solutions for the important risks facing individuals and businesses. We offer an expanding suite of products - from fully-digital embedded renters coverage to high-value homeowners insurance to sophisticated commercial coverages, such as cyber liability and habitational property - delivered through agents, brokers, wholesalers and other brand partners. Our partners and customers count on us to deliver exceptional service through a dedicated team that makes rapid resolutions a priority. We simplify the insurance experience through our advanced technology platform that supports every phase of the policy lifecycle. Bring on your challenges and let us show you how we build insurance better. The Claims Examiner is considered an expert in managing insurance claims for our policyholders. The Claims Examiner must have technical knowledge in insurance claims handling and the skills needed to provide superior service for our customers. The ability to develop relationships and effectively communicate with a diverse range of clients, carriers and colleagues is a key success factor in this role. Strategic vision coupled with tactical execution to achieve results in accordance with goals and objectives is also critical to the overall success of this position. PRIMARY RESPONSIBILITIES: • Maintains compliance with all state-specific timelines and MSI best practices, including timely initial contact, acknowledgments, diary management, and thorough claim documentation. • Provides professional, proactive communication to insureds, agents, vendors, public adjusters, and attorneys. • Applies policy language accurately to make fair, well-supported coverage decisions. • Participates in team trainings, process improvement initiatives, and ongoing development. • Meets performance expectations related to responsiveness, claim cycle times, reserve accuracy, and timely claim closure. • Investigates and analyzes claim information to determine extent of liability. • Handles claims 1st Party Property Claims. • Assist in suits, mediations and arbitrations. Works with Counsel in the defense of litigation. • Sets timely, adequate reserves in compliance with the company's reserving philosophy. • Engages experts to assist in the evaluation of the claim. • Monitors vendor performance and controls expense costs. • Evaluates, negotiates and determines settlement values. • Communicates with all interested parties throughout the life of the claim. Proactively discusses coverage decisions, the need for additional information, and settlement amounts with interested parties. • Handles all claims in accordance with Best Practices. • Responsible for monitoring and completing assigned claims inventory. • Acquire and maintain a state adjuster's license and meet state continuing education requirements. • Provides Best-In-Class customer service for insureds and agents. • Updates and maintains the claim file. • Identifies opportunities for subrogation and ensures recovery interests are protected. • Identifies fraud indicators and refers files to SIU for further investigation. • Participates in claims audits, internal and external. • Provides oversight of TPAs KNOWLEDGE, SKILLS & ABILITIES: EDUCATION & EXPERIENCE: High School/GED 2-3 years' experience in claims Must have Property & Casualty Insurance License #LI-JW2 #LI-REMOTE Click here for some insight into our culture! The Baldwin Group will not accept unsolicited resumes from any source other than directly from a candidate who applies on our career site. Any unsolicited resumes sent to The Baldwin Group, including unsolicited resumes sent via any source from an Agency, will not be considered and are not subject to any fees for any placement resulting from the receipt of an unsolicited resume.

Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.

This position is responsible for the oversight of complex and large exposure losses and will report to the National Casualty Claims Manager. The Casualty Claims Examiner will work alongside claims management, providing direction and oversight ensuring that compliance with best practices and state/local guidelines is achieved. In addition, this position will report findings and make recommendations on current practices including the claim department's performance on meeting regulatory standards. Job Responsibilities · Review home office casualty files, provide direction as required to ensure that handling is within best practice guidelines and local jurisdiction regulations. · Responsible for providing guidance and direction to claims staff in order to ensure proper handling and risk mitigation. · Provide authority and guidance on all bodily injury claims regarding coverage, liability and damages, as required. · Provide feedback to leadership and adjusting staff as required for continually improved file handling. · Responsible for collaboration with claims staff, front line claims management, senior claims management and legal counsel. · Available to answer questions and participate in roundtable discussions with claims staff and management to provide feedback and guidance on claim handling procedures. · Complete research pertaining to complex coverage issues, industry trends, and related topics. · May assist with targeted audits of a particular process or function (e.g. total loss handling, BI evaluations, cycle times, regulatory reviews, customer service skills, etc.) and/or management re-audits to verify calibration and accuracy of the first level reviews completed. · Assist in designing and delivering casualty training as needed to ensure compliance and proper claim handling Job Qualifications Formal Education & Certification Bachelor's degree or equivalent work experience Knowledge & Experience · A minimum of five years of adjusting claims. At least two years adjusting/overseeing casualty claims with high complexity. · Prior claims management experience and/or auditing preferred. Skills & Competencies · Communication and analytical ability at a level to interact with associates, managers, agents and vendors. · Demonstrated team building and coordination skills. · Must possess strong interpersonal skills and the ability to present critical information to Senior Management. · Ability to manage multiple priorities and work independently. · Leadership abilities are necessary, with the ability to make autonomous decisions based on multiple facts. · Must be able to work in a fast-paced automated production environment and possess solid planning and organizational skills including time management, prioritization, and attention to detail. · Must meet company guidelines for attendance and punctuality and professional appearance/decorum. This indicates the essential responsibilities of the job. The duties described are not to be interpreted as being all-inclusive to any specific associate. Management reserves the right to add to, modify, or change the work assignments of the position as business needs dictate. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. This job description does not represent a contract of employment. Employment with AssuranceAmerica is at-will. The at-will relationship can be terminated at any time, with or without reason or notice by either the employer or the associate. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike. We have ambitious (but attainable!) goals and need adjusters who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can't wait to meet you. About the role We are seeking a skilled BI-LIT Claims Examiner to manage litigated files and attend trials, conferences, mediations, and arbitrations. The successful candidate will: Investigate and gather all necessary information and documentation related to claims Evaluate liability and damages Negotiate and settle claims Manage litigation cases related to auto claims disputes The BI-LIT Claims Examiner will also be responsible for maintaining electronic files, analyzing defense counsel's performance, and regularly reporting to the Claims Manager. In addition, you will collaborate closely with our product and engineering teams to give feedback and identify technology and process improvements. Who you are Highly motivated and growth-oriented. You're excited by the prospect of building a tech-driven claims org. Passionate adjuster who cares about the customer and their experience. Empathetic. You exercise empathy and patience towards everyone you interact with. Sense of urgency - at all times. That does not mean working at all hours. Creative. You can find the right exit ramp (pun intended) for the resolution of the claim that is in the insured's best interest. Conflict-enjoyer. Conflict does not have to be adversarial, but it HAS to be conversational. Curious. You have to want to know the whole story so you can make the right decisions early and action them to a prompt resolution. Anti-status quo. You don't just wish things were done differently, you action on it. Communicative. (we'd love to know what this means to you) And did we mention, a sense of humor. Claims are hard enough as it is. What we need We need you to do all the things typical to the role: Managing legal aspects of litigated cases, including evaluation of legal process and expenses Analyzing and reviewing auto insurance claims to identify areas of dispute, investigating and gathering all necessary information and documentation related to the claim, evaluating liability and damages related to the claim, and negotiating and settling claims with opposing parties or their insurance providers Managing litigation cases related to auto claims disputes, attending mediations, arbitrations, and court hearings as necessary, and communicating regularly with clients, claims adjusters, attorneys, and other stakeholders Collaborating with defense counsel, claims counsel, and litigation claims management for strategic planning, including developing and maintaining positive working relationships with approved defense firms and other vendors in the industry Reviewing legal documents and ensuring compliance with initial suit-handling plan of action Serving as corporate representative for discovery review and depositions, and appearing as Corporate Representative at depositions and trials when needed Analyzing policy language and reaching appropriate coverage decisions, drafting frequent and complex coverage correspondence, and proactively managing primarily litigated claim files from inception to closure Directing and controlling the activities and costs of numerous outside vendors including defense counsel and coverage counsel, experts and independent adjusters Maintaining adjuster licenses and continuing education requirements Requirements Bachelor's degree (lack of one should not stop you from applying if you possess all the other qualifications) 10+ years of claim handling experience, with 5+ of those years handling a pending of >60% in litigation Transportation litigation (rideshare, auto, trucking, etc) is preferred but those with personal lines experience should still apply if they meet all other requirements. You are not intimidated by an attorney, even if you are not one! You are the driver of the litigation strategy for any particular claim. You manage the discovery in the order and timing of events and hold attorney accountable Understand transportation coverages. Understand contractual risk transfer and additional insured forms You have strong medical knowledge You have a sense of urgency and understanding of how to manage time-sensitive demands Ability and willingness to communicate both on the phone and in written form in a prompt, courteous, and professional manner Strong analytical and negotiation skills. You will conduct your own negotiations directly with opposing counsel Knowledge of multiple state statutes, including good faith claim handling practices, regulations, and guidelines Ability to professionally collaborate with all stakeholders in a claim Have active adjuster license(s) and be willing to obtain all licenses within 45 days, including completing state required testing Attention to detail, time management, and the ability to work independently in a fast-paced, remote environment Curious and motivated by problem solving and questioning the status quo Desire to engage in learning opportunities and continuous professional development Willingness to travel for client and claims needs Benefits Generous health-insurance package with nationwide coverage, vision, & dental 401(k) retirement plan with employer matching Competitive PTO policy - we want our employees fresh, healthy, happy, and energized! Generous family leave policy Work from anywhere to facilitate your work life balance Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder! Additionally, we will Provide a manageable pending for you to deliver the service in a way you've always wanted and a dedicated account Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster Work toward reducing and eliminating all the administrative work from an adjuster role Foster a culture of empathy, transparency, and empowerment in a remote-first environment At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!

SUMMARY DESCRIPTION: The Residential Claims Examiner is responsible for approving and settling residential property claims from the field where an estimate of damage has been prepared, or for preparing and settling estimates, or documenting claims decisions and settling those claims with the policyholder and claimants. The role's primary duties include phone scoping, reviewing coverage, determining settlement amounts, communicating with the policyholder or their representative, and documenting the claim file as outlined by the client or RENFROE. They are also responsible for documenting all activity, submitting required claims documentation, issuing settlement payments, settling and closing the claim using fair claims settlement practices, and ensuring compliance with legal and contractual obligations. REPORTS TO: Assigned RENFROE Manager ESSENTIAL JOB FUNCTIONS: · Follows RENFROE and clients' policies and procedures to handle all assigned property claims · Works with the RENFROE Manager and other adjusters to share knowledge and experience and to gain new skills · Assigns task work for property inspections and interacts with field adjusters and estimators to determine the scope of loss · Oversees claims files for assigned claims and updates claims as new information becomes available using the client's proprietary software · Manages the progression of claims/tasks and claim inventories assigned to them · Contacts and interacts with the policyholder or their representative to obtain documents such as purchase receipts, bills, photographs, or other documents to establish the existence, ownership, and value of the items claimed damaged · Determines coverage and amounts for additional living expenses such as rental housing, travel, meals, etc. · Sets claim reserves following the client's guidelines · Calculates settlement amounts and, within their settlement authority or after receiving requested authority from the client's designee, issues settlement checks with supporting claim documentation · Writes closing reports, including recommendations for the pursuit of subrogation or the disposal of salvage · Reviews the claim file to support and draft coverage decision letters · Maintains required jurisdictional adjusting licenses as required by the client and/or RENFROE · Does not handle claims for which they do not have client authorization or for which they are not licensed · Participates and communicates in client team meetings to discuss claim handling trends, team production, and any claim handling concerns or changes · Makes suggestions on ways to improve process efficiency · Participates in special projects and completes other duties as assigned Non-Authorized Activities: Claims Examiners should not: · Communicate training requirements to client staff adjusters and non-affiliated firms · Communicate training requirements to any claim handler who is not deployed with RENFROE · Discuss Human Resource issues with any client staff adjusters in any segment or any claim handler that is not deployed with RENFROE · Discuss any of the following topics with a client staff adjuster or any claim handler that is not deployed with RENFROE: job openings, termination, prior work history, attendance, absence requests, daily work schedule, claim volume or workload, meal and rest break schedule, promotions, development, compensation, or mentoring of any kind EXPERIENCE/QUALIFICATIONS: · Minimum of 1 year of property claims experience is preferred · Participation in technical insurance coursework is preferred, such as CPCU · Experience using various claims processing systems is preferred · Appropriate licenses, depending on state requirements, and successful completion of required/applicable claims certification training classes · Effective problem resolution and decision-making skills to include analyzing insurance policies and information, demonstrating sound judgment, and utilizing one's own experience and the experience of others · Strong analytical skills and consistent attention to detail · Knowledge of ISO forms, and client policy coverage, procedures, and systems · Communicates clearly and effectively, both verbally and in writing · Strong customer service orientation and good rapport with the insured · Well-organized and hard-working, with the ability to thrive in a fast-paced work environment · Strong interpersonal skills and proven ability to establish good relationships with clients, RENFROE management, employees, and others with whom they interact · Computer skills, including but not limited to practical knowledge of Word and Excel PHYSICAL DEMANDS: · Sitting in a chair for extended periods of time · Ability to operate a telephone, computer, mouse, keyboard, and other similar equipment for extended periods of time · Extended and varying work schedules, which may include work from home or work from a centralized office · Regular attendance required, working up to 12 hours a day, 7 days a week, for extended periods of time, including weekends and holidays · Ability to work in a fast-paced, changing, and multi-tasking environment

Workers' Compensation Claims Assistant - 20068665 (250009KD) Organization: Workers' CompensationAgency Contact Name and Information: a85603@bwc. state. oh. us Unposting Date: Dec 30, 2025, 11:59:00 PMWork Location: William Green Building 30 West Spring Street Columbus 43215-2256Primary Location: United States of America-OHIO-Franklin County-Columbus Compensation: $22. 96/hr. Schedule: Full-time Work Hours: 8:00 am-5:00 pm Classified Indicator: ClassifiedUnion: OCSEA Primary Job Skill: Claims ExaminationTechnical Skills: Claims Examination, InsuranceProfessional Skills: Attention to Detail, Customer Focus, Listening, Teamwork Agency OverviewA Little About Us:With roughly 1,500 employees in seven offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers. For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries. Our Culture:BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC strives to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee work groups, participate in on-line forums and learn about how different perspectives can improve leadership skills. Our Vision:To transform BWC into an agile organization driven by customer success. Our Mission:To deliver consistently excellent experiences for each BWC customer every day. Our Core Values:One Agency, Personal Connection, Innovative Leadership, Relentless Excellence. What our employees have to say:BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work. I have worked at several state agencies and BWC is the best place to work. Best place to work in the state and with a sense of family and support. I love the work culture, helpfulness, and acceptance I've been embraced with at BWC. I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC. If you are interested in helping BWC grow, please click this link to read more, and then come back to this job posting to submit your application!Job DescriptionBWC's core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC's seven offices across the state. BWC offers flextime work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval. What You'll Be Doing:Provides assistance to the Workers' Compensation Medical Claims Specialists and supervisors in the Medical Billing and Adjustments unit;Reviews and cross-references data on bills, adjustments, Medicare correspondence, and other documents with data in BWC's claims management system and other ancillary systems;Scans, indexes and track bills, adjustments, Medicare documents, and correspondences into claim file; other tracking databases Reviews incoming claims and billing documents to obtain missing information and determine required action;Performs specialized clerical tasks and handling of all departmental incoming, outgoing, and misdirected mail, and other documents. QualificationsTo Qualify, You Must Clearly Demonstrate:Required Experience and/or Education:2 courses or 6 mos. exp. in English composition or grammar AND 2 courses or 6 mos. exp. in accounting, bookkeeping or general math AND 2 courses or 6 mos. exp. in communication or public speaking or 6 mos. exp. in a position involving receiving & responding to public inquiries or complaints or involving contact with injured workers, employers, legislators, providers or their representatives & public AND successful completion of one typing course or demonstrate ability to type 35 words per minute. Or equivalent of Minimum Class Qualifications For Employment noted above. Note: Classification may require use of proficiency demonstration to determine minimum class qualifications for employment. Job Skills: Claims Examination, InsuranceMAJOR WORKER CHARACTERISTICS: Knowledge of addition, subtraction, multiplication, division, fractions, decimals & percentages; ICD/CPT codes, BWC/IC policies & procedures & ORC rules & regulations*; applicable state &/or federal regulations governing documents processed, reviewed &/or prepared*; public relations. Skill in operation of pc to efficiently log & enter data. Ability to solve practical, everyday problems; gather, collate & classify information about data, people or things; handle routine inquiries from & contacts with injured workers, employers, legislators, providers or their representatives & public; complete routine forms & prepare standard reports. (*) Developed after employment. Supplemental InformationEEO & ADA Statement:The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order. The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request reasonable accommodations related to disability, pregnancy, or religion, please contact the ADA mailbox bwcada@bwc. ohio. gov. BWC OCSEA Selection Rights:This position shall be filled in accordance with the provisions of the OCSEA Collective Bargaining Agreement. BWC bargaining unit members have selection rights before non-bargaining unit members. All other applications will only be considered if an internal bargaining unit applicant is not selected for this position. Salary Information:Hourly wage is expected to be paid at step 1 of the pay range associated with the position for candidates who are new employees of the state. Current employees of the state will be placed in the appropriate step based on any applicable union contract and/or requirements of the Ohio Revised Code. Movement to the next step of the pay range (a roughly 4% increase) will occur after six months, assuming job performance is acceptable. Thereafter, an employee will advance one step in the pay range every year until the highest step of the pay range is reached. There may also be possible cost of living adjustments (COLA) and longevity supplements begin after five (5) years of state service. Educational Transcripts:For any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed. All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted. Background Check:Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market - to do more for clients - and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company. Point C is looking for a detail-oriented and motivated Claims Examiner to join our team. In this role, you'll be responsible for accurately processing medical claims while ensuring compliance with plan documents, policies, and industry regulations. The ideal candidate is analytical, organized, and experienced in self-funded or third-party administration environments. Primary Responsibilities Adjudicate new claims and process adjustments, including denials upon receipt of additional information Review and resolve appeals and subrogation/third-party liability cases Manage individual inventory to ensure timely turnaround and production goals are met Ensure claims are processed in accordance with stop loss contract terms Respond to internal and external inquiries via email and other channels within established timeframes Follow up on missing or incomplete information to ensure claims can be accurately processed Maintain minimum production, financial, and procedural accuracy standards on a monthly basis Minimum Qualifications Associate's degree preferred Experience with Third Party Administrator (TPA) or self-funded claims administration preferred At least 1+ year of experience in insurance claims processing Working knowledge of CPT and ICD-10 coding Basic understanding of medical terminology Strong communication and customer service skills Proficiency in Microsoft Office and general computer applications Ability to maintain confidentiality and comply with all company policies and procedures Able to work independently with minimal supervision Ability to prioritize, multitask, and work overtime as needed 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$38,000-$41,000 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 Point C Health, 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. Point C Health 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.

Through our dedicated associates, Arsenault delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. Remote Data Entry Associate Equipment Provided Temp with chance to convert to full time Salary: $15-$20 HR. Hours: 8:00 am to 4:30 pm EST, M-F Would you enjoy being part of a team that makes a difference in people's lives Do you love helping people solve complex problems and delivering solutions? About The Role As a member of the team, you will be processing FSA and HSA claims. You will review and research the claim and process them on a web-based application. It is essential to have a good understanding of EOBs, FSAs, how to read receipts, doctor bills, and basic medical paperwork.We have 3 different classes with the 1st one starting in early October. A successful candidate will be computer literate, maintain good attendance, and have the right attitude and discipline to work from home. You will take pride in being a contributing member of a busy team. Meet your quality and volume requirements consistently. This starts as temporary position. You will receive fully paid training of 4-6 weeks. Based on performance and attendance you may be converted to a permanent employee with benefits. What You Will Be Doing Review and research claims Determine if the claim is valid to approve Process claims on a web-based application Completes assignments using multiple source documents to verify data or use additional information to do the work. Follows up on pending documents involving analysis. Requirements Be computer literate able to set up equipment and operate with ease Have own highspeed internet connection: 25 download and 5 upload Must be at least 18 years of age or older. Must have a high school diploma or general education degree (GED). Must be eligible to work in the Los Angeles, CA. Must be able to clear a criminal background check and drug test. Arsenault is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

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.

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

Job DescriptionSalary: $18.00 per hour Thank you for your interest in joining our team. If youre looking to be part of a team that values integrity, humility, excellence, challenge, and life-long learning, youve come to the right place. At First Bank we believe in offering opportunities to help individuals build a long and lasting career, and we are currently seeking aTitle Insurance Clerk. The Title Insurance Clerk helps Southern Illinois Title fulfill its vision by providing quality service and creating profitable trusted relationships. Duties and Responsibilities Answers telephone calls, answers inquiries and follows up on requests for information. Travels to closings and county courthouses. Processes quotes. Researches the proper legal description of properties. Researches and obtains records at courthouse. Examines documentation such as mortgages, liens, judgments, easements, plat books, maps, contracts, and agreements to verify factors such as properties legal descriptions, ownership, or restrictions. Evaluates information related to legal matters in public or personal records. Researches relevant legal materials to aid decision making. Prepares reports describing any title encumbrances encountered during searching activities, and outlining actions needed to clear titles. Prepares and issues Title Commitments and Title Insurance Policies based on information compiled from title search. Confers with realtors, lending institution personnel, buyers, sellers, contractors, surveyors, and courthouse personnel to exchange title-related information, resolve problems and schedule appointments. Accurately calculates and collects for closing costs. Prepares and reviews closing documents and settlement statement for loan or cash closings. Obtains funding approval, verification and disbursement of funds. Conducts insured closings with clients, realtors, and loan officers. Maintains a streamline approach to meet deadlines. Records all recordable documents. Conducts 1099 reporting. Helps scan files into System. Protects the company and clients by following company policies and procedures. Performs other duties as assigned. Qualifications Skill Requirements: Analytical skills Interpreting Researching Reporting Problem solving Computer usage Verbal and written communication Detail orientation Critical thinking Complaint resolution Knowledge: Title Insurance Work experience: 5 years of banking or title insurance Certifications: None required Management experience: None required Education: High school diploma Motivations: Desire to grow in career Work Environment Work Hours: Monday through Friday, 8:00-5:00 (Additional hours may be required for company meetings or training.) Job Arrangement: Full-time, permanent Travel Requirement: Frequent travel is required for closings and research. Additional travel may be required from time to time for client meetings, training, or other work-related duties. Remote Work: The job role is primarily in-person. A personal or work crisis could prompt the role to become temporarily remote. Physical Effort: May require sitting for prolonged periods. May occasionally require moving objects up to 30 pounds. Environmental Conditions: No adverse environmental conditions expected. Client Facing Role: Yes The position offers a competitive salary, medical insurance coverage, 401K-retirement plan, and other benefits. EO / M /F/ Vet / Disability.First Bank is an equal opportunity employer. It is our policy to provide opportunities to all qualified persons without regard to race, creed, color, religious belief, sex, sexual orientation, gender identification, age, national origin, ancestry, physical or mental handicap, or veteran's status. Equal access to programs, service, and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify human resources. This application will be given every consideration, but its receipt does not imply that the applicant will be employed. Applications will be considered for vacancies which arise during the 60-day period following submission. Applicants should complete an updated application if not contacted and/or hired during this 60-day evaluation period. Replies to all questions will be held in strictest confidence. In order to be considered for employment, this application must be completed in full. APPLICANT'S STATEMENT By submitting an application Iagree to the following statement: (A) In consideration for the Banks review of this application, I authorize investigation of all statements contained in this electronic application. My cooperation includes authorizing the Bank to conduct a pre-employment drug screen and, when requested by the Bank, a criminal or credit history investigation. (B) As a candidate for employment, I realize that the Bank requires information concerning my past work performance, background, and qualifications. Much of this information may only be supplied by my prior employers. In consideration for the Bank evaluating my application, I request that the previous employers referenced in my application provide information to the Banks human resource representatives concerning my work performance, my employment relationship, my qualifications, and my conduct while an employee of their organizations. Recognizing that this information is necessary for the Bank to consider me for employment, I release these prior employers and waive any claims which I may have against those employers for providing this information. (C) I understand that my employment, if hired, is not for a definite period and may be terminated with or without cause at my option or the option of the Bank at any time without any previous notice. (D) If hired,I will comply with all rules and regulations as set forth in the Banks policy manualand other communications distributed to employees. (E) If hired,I understand that I am obligated to advise the Bank if I am subject to or observe sexual harassment, or other forms of prohibited harassment or discrimination. (F) The information submitted in my application is true and complete to the best of my knowledge. I understand that any false or misleading statements or omissions, whether intentional or unintentional, are grounds for disqualification from further consideration of employment or dismissal from employment regardless of when the false or misleading information is discovered. (G) I hereby acknowledge that I have read the above statement and understand the same.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy. NTT DATA currently seeks a long term **Temporary Medical Claims Processor** to join our team **for a remote position** . Must be able to work **7am - 4 pm CST** **virtual/remote (training is required on-camera, 8 weeks. During training, no time off will be approved).** This is a US based, W-2 project. All candidates will be paid through NTT DATA only. **Role Responsibilities:** -Processing of Professional claim form files by provider -Reviewing the policies and benefits -Comply with company regulations regarding HIPAA, confidentiality, and PHI -Abide with the timelines to complete compliance training of NTT Data/Client -Work independently to research, review and act on the claims -Prioritize work and adjudicate claims as per turnaround time/SLAs -Ensure claims are adjudicated as per clients defined workflows, guidelines -Sustaining and meeting the client productivity/quality targets to avoid penalties -Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. -Timely response and resolution of claims received via emails as priority work -Correctly calculate claims payable amount using applicable methodology/ fee schedule -Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities -Time management with the ability to cope in a complex, changing environment -Ability to communicate (oral/written) effectively in a professional office setting **Required Skills/Experience** + 2+ year (s) hands-on experience in **Medicare, Medicaid or Commercial Insurance Claims Processing. Will consider medical billers.** + 2+ year(s) using a computer with Windows applications using a keyboard, **navigating multiple screens and computer systems, and learning new software tools** + **Previously performing - in P&Q work environment; work from queue; remotely** + Key board skills and computer familiarity - + **Toggling back and forth between screens** /can you navigate multiple systems. + Working knowledge of MS office products - Outlook, MS Word and **MS-Excel** . + Must be able to work **7am - 4 pm CST** online/remote (training is **required on-camera** ). + Effective **troubleshooting where you can leverage your research, analysis and problem-solving abilities** + **Time management with the ability to cope in a complex, changing environment** + **Ability to communicate (oral/written) effectively** in a professional office setting **Preferences** Amisys &/or Xcelys claims systems Preferred **Education:** + High school diploma or GED About NTT DATA: NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com. NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is **$18.00/hourly** . This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. + \#LI-NorthAmerica

We are recruiting 100 entry level Remote Insurance Verification Representatives in FL, NV, SD, TX, and WY. If you are looking for steady work from home with consistent pay then this is the opportunity for you. To make sure this is a fit for you, please understand: You will be on the phone the entire shift. You will need to overcome simple objections and maintain a positive attitude. You will need to purchase a USB Headset (if you don't already have one). True W2 pay check and direct deposit company (not gimmick 1099 pay) No phone line needed No cellphone needed No driving required No people to meet No packaging materials No shipping No ebay accounts No phone experience needed (but a serious advantage) Company Culture This compant prides itself on empowering their team to be responsible, "show up" on time for their shift(s), and stay focused on their task(s) the whole time. Working from home is a blessing, but it can also be the biggest distraction. That's why they their staff with the utmost respect and expect the same from them. This is a serious opportunity from one of the most modern work from home companies on the planet. They are literally a bunch of people spread out around the country with a common goal of helping select customers complete their car insurance quotes. They skype together all day and everyone supports eachother as a team even though 95% all work from REMOTE locations. This company has been in the online and insurance marketing business for over 3 years now, and the founder has been in this industry for over 10 years now. Compensation $8.25/hr starting or 3$ per lead depending on which is more. Focused and aggressive verifiers make $15-$19 an hour. Scheduling The shifts that are available are 9am-1pm / 1pm-5pm / 5pm-9pm M-F. (Eastern Time). Depending on your location and availability you will be assigned (1) of these shifts temporarily until you are well trained and established. You will start as PART TIME. Once you are established Full time is possible and many reps choose full time. Full on-going success training is provided. (You are NOT required to purchase training materials or anything from them or us.) Again all you need is your own computer, high speed internet, 5 MBPS Download Speeds and 1 MBPS Upload Speeds USB headset.

Established in 2021, Independence Pet Holdings is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America. We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands. Pets Best, a subsidiary of IPH, is building a digital first pet e-commerce platform with the aim of connecting key market services such as adoption, lost pet and insurance to make pet care easy. Job Summary: Pets Best is seeking a Claims Processing Specialist who will report to the Supervisor, Claims. Claims Processing Specialists are responsible for reviewing invoices and pet medical documents and determining coverage in compliance with the current Underwriter's policy. Job Location: Remote - USA Main Responsibilities: Review individual policies to make an eligibility determination with high degree of accuracy Contact with internal departments as well as veterinarians and clinic staff Ensure compliance guidelines are met with both internal policies and procedures and contractual commitments Work independently and with others on a virtual team Drive a “Great Place to Work” culture, attend and participate in team meetings as well as engagement events Use PC based programs to enter data into claims system, communicate with leaders and teammates, and organize information Create and issue claim decisions to pet parents using proper spelling, grammar, and punctuation in line with the policy terms Calculate invoice totals, discounts, and tax rates Perform other duties and/or special projects as assigned Qualifications: High school diploma or equivalent 3+ years recent clinical veterinary experience (dog and cat) as a veterinary assistant, veterinary technician or veterinarian Knowledge of veterinary terms, abbreviations and conditions. Knowledge of medical conditions and associated symptoms, procedures, treatments, secondary conditions and pharmaceuticals used in veterinary medicine Knowledge of canine and feline breeds, anatomy and associated predispositions to illness. Ability to read and interpret medical diagnoses via medical records review both written and digital. Ability to work cross functionally with our internal and external resources Ability to handle multiple projects concurrently Ability to navigate Windows OS, Google Chrome, and corresponding applications Demonstrable Microsoft Office proficiency: Word, PowerPoint, Excel, Outlook, Teams Strong writing skills: organization, spelling, grammar and punctuation Strong mathematical and problem-solving skills #LI-Remote #petsbest All of our jobs come with great benefits including healthcare, parental leave and opportunities for career advancements. Some offerings are dependent upon the location of where you work and can include the following: Comprehensive full medical, dental and vision Insurance Basic Life Insurance at no cost to the employee Company paid short-term and long-term disability 12 weeks of 100% paid Parental Leave Health Savings Account (HSA) Flexible Spending Accounts (FSA) Retirement savings plan Personal Paid Time Off Paid holidays and company-wide Wellness Day off Paid time off to volunteer at nonprofit organizations Pet friendly office environment Commuter Benefits Group Pet Insurance On the job training and skills development Employee Assistance Program (EAP)