Liability claims examiner full time jobs - 38 jobs

Become a part of our caring community and help us put health first The Claims Processing Representative reviews and adjudicates complex or specialty claims, submitted either via paper or electronically while performing basic administrative/clerical/operational/customer support/computational tasks. The Claims Processing Representative determines whether to return, deny, or pay claims following organizational policies and procedures. Accurately enters claims information into the company's database and maintain up-to-date records. Communicates effectively with policyholders, healthcare providers, and other stakeholders to gather necessary information and provide updates on claim status. Ensures all claims are processed in accordance with company policies, industry regulations, and legal requirements. Investigates and resolves discrepancies or issues related to claims, working collaboratively with other departments as needed. Provides exceptional service to clients, addressing inquiries and concerns promptly and courteously. Use your skills to make an impact Required Qualifications Medical Claims experience and/or knowledge of medical claims processes Knowledge of CPT, ICD-10, and HCPCS coding Medical terminology Ability to manage multiple or competing priorities, work in a fast-paced environment and adapt quickly to change Aptitude for quickly learning and navigating new technology systems and applications Ability to think analytically Strong focus on accuracy and detail Proficiency in all Microsoft Office Programs, including Word, PowerPoint, and Excel Preferred Qualifications Billing experience Coding Certification Previous inbound call center or related customer service experience Knowledge of HIPAA 837 and 835 electronic claims transactions Knowledge of Medicare Risk Adjustment and/or Medicaid processes Additional Information Onsite (Location: 3351 Executive Way Miramar, FL 33025) Required shifts: 8:00a - 5:00p (ET) Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $39,000 - $49,400 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Job Description The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a Hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers' Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests Participate in customer claim reviews and presentations Ability to travel overnight and attend meetings if required Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to assist team members to develop knowledge and understanding of claims practice Effective quantitative, analytical and interpretive skills Strong leadership, management and motivational skills Demonstrated, strong customer service skills Maintains composure under pressure and communicates diplomatically across various channels, including telephone, email, and written correspondence Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to work both independently and within a team environment Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Demonstrated public speaking skills Minimum of 5 years' claims handling experience Knowledge of WC required Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel Self-Insured Certificate preferred State Certification as an experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $71, 696 - $110,701 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Great American is one of the few carriers with a dedicated Property & Inland Marine Division and, in the industry segments it covers, with expertise second to none. From the underwriters to claims representatives, the focus is strictly on property and inland marine coverages. They are dedicated to writing only these coverages, which include Commercial Property Coverage, Inland Marine Coverage, Builder's Risk, Contractor's Equipment and Motor Truck Cargo. They specialize in the construction, energy & renewables, and transportation industries. **************************************************************************************************** Essential Job Functions and Responsibilities Investigates and maintains claims: Reviews and evaluates coverage and/or liability. Secures and analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, reports, or other documents) in the investigation of claims. Works toward the resolution of claims files, and may attend arbitrations, mediations, depositions or trials as necessary. May affect settlements/reserves within prescribed limits and submit recommendations to supervisor on cases exceeding personal authority. Conveys moderately complex information (coverage, decisions, outcomes, etc.) to all appropriate parties, maintaining a professional demeanor in all situations. Ensures that claims payments are issued in a timely and accurate manner. Ensures that claims handling is conducted in compliance with applicable statutes, regulations and other legal requirements, and that all applicable company procedures and policies are followed. May provide guidance and assistance to lower level positions and other functional areas. Performs other duties as assigned. Job Requirements Education: Bachelor's Degree or equivalent experience. Field of Study: Liberal Arts, Business or a related discipline. Experience: Generally, 1 to 5 years of related experience. Great American's culture is built on connection, shared learning, and strong relationships. To support this, employees in this role are expected to be on-site four days a week, with the flexibility to work one day remotely. Core in‑office days are Tuesday-Thursday, with the fourth day determined by business needs. Business Unit: Property Inland Marine Benefits: We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits. Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at **************************** *Excludes seasonal employees and interns.

The Director Claims directs activities within the General and Auto Liability Claims, Physical Damage Repairs and Property and Cargo Claims including the management of loss control activities and third-party provider relationships (including consultants, legal counsel, insurers, and external claims administrators). The Director manages and oversees the physical damage team and handling individual liability, property, and cargo claim. This position reports to the Senior Director of Claims and requires little supervision and is considered a liability, property and physical damage expert within the company. This position has responsibility to handle and manage the aforementioned claims in the US, Canada and Puerto Rico. The Director position leads an internal staff of approximately 40; this consists of professional Claims Managers, Supervisors, Senior Office Manager, Claims Analysts, and clerical staff support. **Essential Functions** + Provides strategic direction to the claims team to establish defined and impacting goals, improve processes, create an inclusive work environment, and motivate staff to reach goals that increase claim quality, costs and improve employee and customer satisfaction. + Ensures consistent identification of exposures, recommends solutions, promotes loss prevention, updates and monitors compliance with procedures and manages documented safety/risk management programs. + Develop and implements processes to ensure physical damage repairs are completed timely and properly partnering with vendor, operations and all business units. + Partners with and gives direction to Operations, Sales, Central Support and Safety in various liability, property and cargo, and physical damage repair matters. + Ensures correct coverage to avoid major exposure while keeping costs at a minimum. + Manages team to ensure the claim process supports proper invoicing and reduce credits to improve customer satisfaction. + Responsible for continuous improvement, developing and implementing new processes to improve overall financial results including the Process Integrity Program. + Significant interaction with field and senior management, internal legal counsel, safety directors, Sales, Ryder Security, and members of corporate risk management. Informs field and senior management on all claims issues. + Primary backup for the Senior Director assisting with all aspects of the operations + Leads and directs claims managers, office manager, and supervisors as well as a team of 40+ claims analysts and administrative staff charging them with continuous development, training sessions, and individual development plans **Additional Responsibilities** + Performs other duties as assigned. + Provides direction on high exposure claims and business process + Routinely updates senior management on trends, compliance issues on specific claims to assist in timely and well-informed business decisions; understand root cause of claim frequency and severity + Establish positive relationships with operations, sales, central support, leadership, and customers. Ensure superior customer service and assist with renewal business + Leads and direct special projects and performs other duties as assigned. **Skills and Abilities** + Demonstrated ability to manage and develop a sizeable staff, Required + Foster collaborative relationships and increase customer satisfaction, Required + Superior ability drives favorable outcomes through strategic negotiations, Required + Demonstrates exceptional interpersonal skills and ability to communicate clearly in verbal and written interactions, Required + Ability to effectively interact and influence Executive, Field management and other business units within Ryder, Required + Create a collaborative environment that drives engagement and results, Required **Qualifications** + Bachelor's degree in business, Economics, Finance or related field or equivalent claims work experience, Required + 10 years or more in in the Casualty Claim field, Required + 5 years or more experience in Vehicle Rental/Leasing Business or Commercial Trucking Insurance, Preferred + 5 years or more in Management or administrative experience, Required + Working knowledge of state laws to include ownership, joint and several liabilities Advanced, Required + Strong understanding of insurance law and policy languages as well as interpreting contracts Advanced, Required + Strong knowledge of the principles of Total Quality Management Advanced, Required + Adjuster Insurance Licenses-Insurance related courses such as I.I.A. or C.P.C.U, Preferred **Job Category:** Risk Management **Compensation Information** : The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. The position may also be eligible to receive an annual bonus, commission, and/or long-term incentive plan based on the level and/or type. Compensation ranges for the position are below: **Pay Type** : Salaried Minimum Pay Range: 150,000 Maximum Pay Range: 200,000 **Benefits Information** : **For all Full-time positions only** : Ryder offers comprehensive health and welfare benefits, to include medical, prescription, dental, vision, life insurance and disability insurance options, as well as paid time off for vacation, illness, bereavement, family and parental leave, and a tax-advantaged 401(k) retirement savings plan. For more information about benefits, click here (********************************************************************************************************** to download the comprehensive benefits summary. Ryder is proud to be an Equal Opportunity Employer and Drug Free workplace. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability. **Important Note** **:** Some positions require additional screening that may include employment and education verification; motor vehicle records check and a road test; and/or badging or background requirements of the customer to which you are assigned. Security Notice for Applicants: Ryder will only communicate with an applicant directly from a [@ryder.com] email address and will never conduct an interview online through a chat type forum, messaging app (such as WhatsApp or Telegram), or via an online questionnaire. During an interview, Ryder will never ask for any form of payment or banking details and will never solicit personal information outside of the formal submitted application through ********************* . Should you have any questions regarding the application process or to verify the legitimacy of an interview or Ryder representative, please contact Ryder at ***************** or ************. **Current Employees** **:** If you are a current employee at Ryder, please click here (*************************************************** to log in to Workday to apply using the internal application process. _Job Seekers can review the Job Applicant Privacy Policy by clicking here (********************************************** ._ \#wd

Come to work with us at Community Health Services! We offer full-time benefits, 10 paid holidays, no weekend hours and so much more! We are looking for a full-time Claims Specialist to work in our Fremont office. CHS employs those who are eager to grow professionally, gain great experience, and work with a terrific team. The Claims Specialist will be responsible for performing general finance functions, entering encounters, processing and recording claims and all other duties as assigned. Hours for this position are: Mondays 7am-7pm, Tuesdays through Thursdays 8am-5pm, Fridays 8am-1pm Qualified candidates must have the following to be considered for employment: * Associate's degree from an accredited college or university * Experience in accounting/bookkeeping * Demonstrates ability to organize and implement general accounting and bookkeeping procedures for a healthcare organization * Ability to work with clinic personnel and patients in a courteous, cooperative manner * Ability to function as part of a team * Must have excellent customer service skills * Must have excellent multi-tasking, problem solving, and decision-making skills * Ability to follow instructions with attention to detail * Demonstrates professional relationship skills, and a strong work ethic * Prioritizes responsibilities, takes initiative, and possesses excellent organizational skills * Demonstrates effective communication skills * Ability to work with a culturally diverse group of people At CHS, we value our team and the critical role they play in patient care. If you're dependable, detail-oriented, and passionate about making a difference in your community, we'd love to hear from you. CHS is a drug-free/nicotine free organization. Candidates must pass a drug and nicotine screening upon employment offer.

Come to work with us at Community Health Services! We offer full-time benefits, 10 paid holidays, no weekend hours and so much more! We are looking for a full-time Claims Specialist to work in our Fremont office. CHS employs those who are eager to grow professionally, gain great experience, and work with a terrific team. The Claims Specialist will be responsible for performing general finance functions, entering encounters, processing and recording claims and all other duties as assigned. Hours for this position are: Mondays 7am-7pm, Tuesdays through Thursdays 8am-5pm, Fridays 8am-1pm Qualified candidates must have the following to be considered for employment: Associate's degree from an accredited college or university Experience in accounting/bookkeeping Demonstrates ability to organize and implement general accounting and bookkeeping procedures for a healthcare organization Ability to work with clinic personnel and patients in a courteous, cooperative manner Ability to function as part of a team Must have excellent customer service skills Must have excellent multi-tasking, problem solving, and decision-making skills Ability to follow instructions with attention to detail Demonstrates professional relationship skills, and a strong work ethic Prioritizes responsibilities, takes initiative, and possesses excellent organizational skills Demonstrates effective communication skills Ability to work with a culturally diverse group of people At CHS, we value our team and the critical role they play in patient care. If you're dependable, detail-oriented, and passionate about making a difference in your community, we'd love to hear from you. CHS is a drug-free/nicotine free organization. Candidates must pass a drug and nicotine screening upon employment offer.

Title: Claims Representative I (Health & Dental) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. 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 Claims Representative I responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How you will make an impact: * Learning the activities/tasks associated with his/her role. * Works under direct supervision. * Relies on others for instruction, guidance, and direction. * Work is reviewed for technical accuracy and soundness. * Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. * Researches and analyzes claims issues. Minimum Requirements * HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences * Good oral and written communication skills, previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly preferred. 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.

JOB RESPONSIBILITIES * Billing - Compile and prepare patient charges. Prepare invoices billings, UB-04 and 1500 claim forms to be sent to 3rd party payers for payment indicating individual line items for services and total costs. Review charges. Obtain and evaluate family, third party payers and agency resources for payment of charges. Managing patient billing and ensure procedures are billed according to contracts, transmit or mail all paper and claims, and review correspondence and follow up as needed. * Systems Support - Maintain and update departmental system, including templates, and payer and physician information. * Collaboration - Act as a preceptor for new employees. Perform specialty services functions. Act as a resource within the department/division. Provide instruction for performing non-routine functions. Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patent Financial Services and other Cincinnati Children's departments. * Financial Support - Obtain and evaluate family, third party payers and agency resources for payment of charges. Counsel patient on third party coverage and present financial aspects. Determine eligibility for State Medicaid, Social Security and other outside funding. Complete necessary paperwork for eligible patients, including medical and financial applications. Coordinate inpatient and outpatient admissions. Coordinate information with the inpatient and outpatient charge systems. Input charges and relative information. Manage accounts receivable data and collection information, ensure timeliness and accuracy. Research third party payers and community physician charges in order to maintain usual and customary as will as competitive charges. Check and update charge master. Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Children's Utilization Review department. Process, post, and balance payments to accounts timely, accurately, and in the correct period. * Quality - Provide Quality Assurance reports for the division. JOB QUALIFICATIONS * High school diploma or equivalent * 2+ years of work experience in a related job discipline Primary Location South Campus Schedule Full time Shift Day (United States of America) Department Professional Billing Operation Employee Status Regular FTE 1 Weekly Hours 40 * Expected Starting Pay Range * Annualized pay may vary based on FTE status $18.16 - $22.25 Market Leading Benefits Including*: * Medical coverage starting day one of employment. View employee benefits here. * Competitive retirement plans * Tuition reimbursement for continuing education * Expansive employee discount programs through our many community partners * Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions * Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group * Physical and mental health wellness programs * Relocation assistance available for qualified positions * Benefits may vary based on FTE Status and Position Type About Us At Cincinnati Children's, we come to work with one goal: to make children's health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children's. Cincinnati Children's is: * Recognized by U.S. News & World Report as a top 10 best Children's Hospitals in the nation for more than 15 years * Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding * Recognized as one of America's Best Large Employers (2025), America's Best Employers for New Grads (2025) * One of the nation's America's Most Innovative Companies as noted by Fortune * Consistently certified as great place to work * A Leading Disability Employer as noted by the National Organization on Disability * Magnet designated for the fourth consecutive time by the American Nurses Credentialing Center (ANCC) We Embrace Innovation-Together. We believe in empowering our teams with the tools that help us work smarter and care better. That's why we support the responsible use of artificial intelligence. By encouraging innovation, we're creating space for new ideas, better outcomes, and a stronger future-for all of us. Comprehensive job description provided upon request. Cincinnati Children's is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryReviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. Additional Responsibilities: Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists. - Makes outbound calls to obtain required information for claim or reconsideration. Required Qualifications- New York Independent Adjuster License- Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. Preferred Qualifications- 18+ months of medical claim processing experience- Self-Funding experience- DG system knowledge Education- High School Diploma required- Preferred Associates degree or equivalent work experience. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$18. 50 - $42. 35This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/27/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

* Top 100 Agency for 2025 * Best Agencies to Work for in 2024 by the Insurance Journal * Big "I" Best Practices Agency in 2023 * Annual bonus eligibility * No weekends required - great work/life balance * 3+ weeks of Paid Time Off * 8 Paid Company Holidays We are looking for someone who will * Manage the claims reporting process for agency clients. * Report claims to the appropriate carrier and maintain records in the agency management system by documenting claim actions in accordance with established procedures. * Follow up on claim to obtain the specific adjuster and claim number relevant to the reported loss. Notify appropriate parties when a claim is processed with carrier, providing accurate and timely claim information. * Continuously monitor claims until claims are closed by the insurance carrier. Report any potential issues with a claim to the client's Account Manager and Producer, escalating to management as needed. * Prepare reports by collecting and summarizing information as requested by management. Why Join AAA Club Alliance and the Energy Insurance team? * A base rate of $20.00 to $25.00/hour, depending on experience and geographic location. * Annual bonus potential Do you have what it takes? * Minimum of 2 years experience handling claims for Commercial Insurance - general liability, workers compensation, commercial auto, etc. * Strong communication skills (both verbal and written) and attention to detail * Strong time management skills * Ability to obtain property and casualty license within 60 days of hire Full time Associates are offered a comprehensive benefits package that includes: * Medical, Dental, and Vision plan options * Up to 2 weeks Paid parental leave * 401k plan with company match up to 7% * 2+ weeks of PTO within your first year * Paid company holidays * Company provided volunteer opportunities + 1 volunteer day per year * Free AAA Membership * Continual learning reimbursement up to $5,250 per year * And MORE! Check out our Benefits Page for more information ACA is an equal opportunity employer and complies with all applicable federal, state, and local employment practices laws. At ACA, we are committed to cultivating a welcoming and inclusive workplace of team members with diverse backgrounds and experiences to enable us to meet our goals and support our values while serving our Members and customers. We strive to attract and retain candidates with a passion for their work and we encourage all qualified individuals to apply. It is ACA's policy to employ the best qualified individuals available for all positions. Hiring decisions are based upon ACA's operating needs, and applicant qualifications including, but not limited to, experience, skills, ability, availability, cooperation, and job performance. Job Category: Insurance

Top 100 Agency for 2025 Best Agencies to Work for in 2024 by the Insurance Journal Big “I” Best Practices Agency in 2023 Annual bonus eligibility No weekends required - great work/life balance 3+ weeks of Paid Time Off 8 Paid Company Holidays We are looking for someone who will Manage the claims reporting process for agency clients. Report claims to the appropriate carrier and maintain records in the agency management system by documenting claim actions in accordance with established procedures. Follow up on claim to obtain the specific adjuster and claim number relevant to the reported loss. Notify appropriate parties when a claim is processed with carrier, providing accurate and timely claim information. Continuously monitor claims until claims are closed by the insurance carrier. Report any potential issues with a claim to the client's Account Manager and Producer, escalating to management as needed. Prepare reports by collecting and summarizing information as requested by management. Why Join AAA Club Alliance and the Energy Insurance team? A base rate of $20.00 to $25.00/hour, depending on experience and geographic location. Annual bonus potential Do you have what it takes? Minimum of 2 years experience handling claims for Commercial Insurance - general liability, workers compensation, commercial auto, etc. Strong communication skills (both verbal and written) and attention to detail Strong time management skills Ability to obtain property and casualty license within 60 days of hire Full time Associates are offered a comprehensive benefits package that includes: Medical, Dental, and Vision plan options Up to 2 weeks Paid parental leave 401k plan with company match up to 7% 2+ weeks of PTO within your first year Paid company holidays Company provided volunteer opportunities + 1 volunteer day per year Free AAA Membership Continual learning reimbursement up to $5,250 per year And MORE! Check out our Benefits Page for more information ACA is an equal opportunity employer and complies with all applicable federal, state, and local employment practices laws. At ACA, we are committed to cultivating a welcoming and inclusive workplace of team members with diverse backgrounds and experiences to enable us to meet our goals and support our values while serving our Members and customers. We strive to attract and retain candidates with a passion for their work and we encourage all qualified individuals to apply. It is ACA's policy to employ the best qualified individuals available for all positions. Hiring decisions are based upon ACA's operating needs, and applicant qualifications including, but not limited to, experience, skills, ability, availability, cooperation, and job performance. Job Category: Insurance

Crop Insurance Adjuster At Farmers Mutual Hail (FMH), our mission is simple: protect the livelihoods and legacies of America's farmers through the complete farm insurance solutions we offer. As America's Crop Insurance Company™, we are headquartered in the U.S. and have been owned by the farmers we insure for over 125 years. As a full-time Crop Insurance Adjuster at FMH, you'll complete field inspections, read maps and aerial photos, measure fields, climb storage bins, and discuss findings of crop losses with producers to enable America's farmers to clothe, feed, and fuel the world. Due to the required travel, the potential candidate will need to be located in Northwest Ohio to be successful in this role. BENEFITS: Our employees appreciate our family-oriented culture, and we make sure their benefits reflect that. In addition to a competitive salary and bonuses, medical/dental/vision plan, 401(k) plan with a generous company match, you will be eligible for benefits such as: Paid Parental leave and Caregiver leave This position will receive a vehicle, cell phone, and paid expenses for travel Employee appreciation events Employee Assistance Program (EAP) for support when you and your family need it REQUIREMENTS: To be considered for this role, you will need the following: Experience: A minimum of 1 to 5 years of crop insurance adjusting experience or an agriculture background is preferred. Education: High school diploma or general education degree (GED) required; Associates and/or Bachelor's degree in business or an ag-related field preferred. Skills: Must possess basic computer skills: Ability to use a computer, printer, scanner, Internet and Microsoft Office Products. Additional Requirements: Must be available to attend all Company-mandated training events and conferences and be able to travel for work-related reasons for periods of time exceeding twenty-four (24) hours. Must be able to physically climb heights in excess or ten (10) feet, walk distances over ¼ mile over uneven terrain, and stand without rest for periods of time greater than one hour. Must maintain a valid driver's license, clean MVR, and own a vehicle. RESPONSIBILITIES: Understands and is able to work claims for all major crops, policy/plan types, in all stages of growth. Effectively and clearly communicates regulations and interpretations to producers, agents, and Company staff regarding claims processes. Stays current with RMA-requirements and maintains CAPP certification if working multi-peril crop insurance (MPCI) claims. Maintains a State Adjuster License where required. Does this sound like a good fit for you? Apply today through our website! This position is not eligible for sponsorship for work authorization by Farmers Mutual Hail Insurance Company of Iowa. Therefore, if you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. Farmers Mutual Hail Insurance Company does not discriminate in employment (EOE). All qualified applicants are encouraged to apply.

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Claims Management Shift/schedule: Full Time (40 hrs/wk) Works under the supervision of the Assistant Manager of Claims Management and Lead Insurance Claim Specialists. The Insurance Claim Specialist's primary job functions is to analyze, process, submit, and follow up on inpatient and outpatient medical claims. Is responsible for safeguarding the public relations and confidentiality of the organization and its records by consistent professional conduct. QUALIFICATIONS Education: * High School Diploma or successful completion of an equivalent High School Exam Required Licensure: * None Experience: * Three to six months of related work experience in medical billing preferred JOB SPECIFIC DUTIES AND PERFORMANCE EXPECTATIONS The following is a summary of the major job duties of this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. * Reviews all claims for complete and accurate information. * Contacts other SOMC departments, physician offices, and insurance companies to obtain necessary information to file complete, accurate, and timely claims. * Processes, edits, and submits all claims for the organization. * Follows up on Commercial, Worker's Comp, VA, and Governmental claims by phone calls to the insurance companies, websites, or any online resources available. * Works with the patient/guarantor by phone to assist with any questions regarding unpaid claims. Obtains information from the patient/guarantor with which to submit the claim for payment (i.e., claim forms, Medicare Secondary Payer (MSP) Questionnaire, etc.) * Processes administrative appeals, reinstatements, and rejections of insurance claims. * Completes account follow up daily, maintaining established goals, and notifies the Lead Specialist, when necessary, of issues preventing achievement of such goals. * Analyzes daily correspondence (denials, underpayments) to appropriately resolve issues. * Adheres to HIPPA regulations by verifying pertinent information to determine caller authorization level receiving information on account. * Identifies billing and coding issues with individual claims, notifying medical billers for correction. * Makes determinations through on-line systems of patient eligibility, coverage, and reviews status of claims. * Performs other duties as assigned. Thank you for your interest in Southern Ohio Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status Southern Ohio Medical Center is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability, ethnicity, gender identity, or expression, genetic information, military status, national origin, race, religion, sex, gender, sexual orientation, pregnancy, protected veteran status or any other basis under the law.

Water Claims Coordinator/Accounts Receiveable We are currently searching for a full-time Water Claims Coordinator related to water mitigation insurance claims for our Southeast Region. The pay range for this position will be $19.00-$21.00, depending on experience. This on-site position will be located in downtown Cincinnati, OH. You will also receive company-paid parking at a nearby garage. The primary role of the Water Claims Coordinator is to bill, collect payments, and maintain accounts for the Water Restoration Department. The Water Claims Coordinator will keep precise records of all insurance/homeowner payments. Founded in 1935, Roto-Rooter is North America's largest plumbing, drain cleaning, and water cleanup services provider. Roto-Rooter operates businesses in over 100 company-owned branches, independent contractor territories, and approximately 400 independent franchise operations, serving approximately 90% of the U.S. population and parts of Canada. The ideal candidate will have 1-3 years of experience in the collection industry. In addition, the ideal candidate should possess strong communication skills, both with customers and within the insurance industry, and have a good working knowledge and/or experience in water restoration collections. Responsibilities Working knowledge of restoration billing and collections procedures 1-3 years of collections experience, preferably in the water restoration industry Administrative experience in the restoration (preferred) or service industry Highly motivated, detail-oriented, and able to work independently Outstanding organizational, time management, and follow-up skills Self-starter who thrives in a fast-paced environment Able to handle multiple projects at once Strong communication skills and ability to work professionally with customers and the insurance industry Bilingual a plus Requirements Highschool diploma or equivlant is required. 1-2 years of collections experience, preferably in the water restoration industry. Must be able to speak and write in English Basic computer skills, including Microsoft Office AS400 experience is preferred Benefits At Roto-Rooter we believe our greatest investment is in our employees. We prioritize the health and well-being of our team and their families. That's why we offer an extensive employee benefit package including: Medical insurance with a Prescription Drug Card Accident and Critical Illness Insurance Dental Insurance Vision Insurance Paid Vacation Paid Training Life Insurance Matching 401K Retirement Savings Plan Tuition Reimbursement Profit Sharing Roto-Rooter offers excellent career paths for military veterans and personnel transitioning to civilian professions. Throughout our 86 years in business, we've found that military training and structure are a great fit at our company. EEO Statement We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, religion, color, sex, gender, age, national origin, veteran status, military status, disability, gender identity, sexual orientation, genetic information, or any other characteristic protected by law.

SummaCare - 1200 E Market St, Akron, OH Full-Time / 40 Hours / Days * Hybrid after training As a regional, provider-owned health plan, SummaCare values the relationship between the members and their doctors. SummaCare is a part of Summa Health, an integrated healthcare delivery system that includes Summa Health System hospitals, its community-based health centers, dedicated clinicians and SummaCare. Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits. Summary: Accurately and efficiently handles claims in accordance with regulatory and contractual guidelines. Reviews claims related to coordination of benefits, medical coding, and authorization allocation while ensuring compliance with established policies. Applies cost-containment strategies in collaboration with vendor partners to minimize claim expenses while adhering to plan-specific processing rules. are essential for success in this position. 1. Formal Education Required: a. High School Diploma or equivalent 2. Experience & Training Required: a. One (1) year experience to include any combination of the following: i. Health insurance claims processing ii. Health claims data entry including Document Management Services (DMS) iii. Customer service experience in a managed care environment iv. Physician or hospital billing v. Patient accounts Essential Functions: 1. Requires close attention to detail with independent judgment, decision making and problem solving skills necessary to complete the task being performed 2. Organizes reference materials for easy access; manages time to accurately complete tasks within time frames in a fast paced environment 3. Processes all types of claims, promptly and accurately, as assigned via the document management system, and ensures self-funded service standards, prompt pay standards, and regulatory requirements are met. 4. Maintains a working knowledge of the claims processing system, imaging system, key-stroke emulation system, code editing application, claims processing policies & procedures, and unique benefits/processing rules for self-funded, Medicare, MEWA, Marketplace and fully-insured plans. 5. Escalates questions or concerns to their mentor for evaluation and potential referral to the Claims Management staff for action plan and resolution 6. Meets or exceeds claims production and quality standards as established/communicated by Claims Management staff 7. Coordinates information and resolves service forms and other assignments promptly, in accordance with experience/capabilities. Handles special projects within timeframes established/assigned by supervisor 3. Other Skills, Competencies and Qualifications: a. Strong independent judgment and decision-making skills b. MS-windows based computer environment c. Medical terminology, CPT, HCPCs and ICD-10 knowledge d. Familiar with professional (CMS1500) and institutional (UB-04) claim types 4. Level of Physical Demands: a. Sit for prolonged periods of time b. Bend, stop and stretch c. Lift up to 20 pounds d. Manual dexterity to operate computer, phone and standard office machines Equal Opportunity Employer/Veterans/Disabled $19.23/hr - $23.08/hr The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical. Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits. * Basic Life and Accidental Death & Dismemberment (AD&D) * Supplemental Life and AD&D * Dependent Life Insurance * Short-Term and Long-Term Disability * Accident Insurance, Hospital Indemnity, and Critical Illness * Retirement Savings Plan * Flexible Spending Accounts - Healthcare and Dependent Care * Employee Assistance Program (EAP) * Identity Theft Protection * Pet Insurance * Education Assistance * Daily Pay

Insurance Examiner/Analyst Supervisor (260000KM) Organization: InsuranceAgency Contact Name and Information: Kim Lowry ************Unposting Date: Jan 31, 2026, 4:59:00 AMWork Location: 50 W Town St 50 West Town Street Suite 300 Columbus 43215Primary Location: United States of America-OHIO-Franklin County Compensation: 77.25Schedule: Full-time Work Hours: 40Classified Indicator: ClassifiedUnion: Exempt from Union Primary Job Skill: AuditingTechnical Skills: Interpreting Financial Statements, Regulatory Compliance, Accounting and Finance, Auditing, InsuranceProfessional Skills: Analyzation, Attention to Detail, Leading Others, Results Oriented, Written Communication Agency Overview About Us:The Ohio Department of Insurance (ODI) was established in 1872 as an agency charged with overseeing insurance regulations, enforcing statutes mandating consumer protections, educating consumers, and fostering the stability of insurance markets in Ohio.Today, the mission of the Ohio Department of Insurance is to provide consumer protection through education and fair but vigilant regulation while promoting a stable and competitive environment for insurers.Please visit our website Department of Insurance and also find us on LinkedIn.Job DutiesThis position is only open to current Ohio Department of Insurance employees.The Office of Risk Assessment is seeking a highly motivated and experienced accounting/financial professional to manage a staff of Insurance examiner/analysts. The individual will have excellent communication, problem solving, and organizational skills.If this sounds interesting to you, continue reading below to learn more about this career opportunity with the Office of Risk Assessment.Your Key Responsibilities include but are not limited to the following:Supervises team of insurance examiner/analysts in conducting in-house analysis of insurance companies (e.g., life, property & casualty, health insuring corporations, multiple employer welfare arrangements, title, fraternal benefit societies & mutual protective associations) licensed to do business in Ohio.Schedules meetings with insurers (e.g., to discuss business plans, mergers, acquisitions, types of business written, material reinsurance contracts, & investment policies).Reviews & evaluates insurance companies' documents (e.g., statutory financial statements; CPA audited financial statements; management & service agreements; actuarial opinions; holding company filings; statutory reports of examinations; complaint activity.Prepares & conducts performance evaluations, initiates disciplinary actions, recommends &/or provides training, approves or disapproves requests for leave, & travel expense reports.Conducts periodic staff meetings; assists in regulatory actions against insurers (e.g., supervisions, rehabilitation, & liquidations); prepares work papers &/or writes reports to document findings during limited-scope or target examinations.Reviews examination/analysis projects of examiner/analysts, determines analysis emphasis & establishes time-budgets & upon completion, reviews prepared files (e.g., permanent files, surveillance files, planning & administration files) to control consistency & quality, assesses progress of examination/analysis work to assure proper procedures are performed & documented (e.g., correct conclusions drawn, final reports accurate, concise & completed within established time budgets).Coordinates work & assesses progress, oversees issuance of periodic & special reports & develops, implements, & maintains procedure manuals & writes reports of examination, stating findings of material changes &/or issues of regulatory significance.Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsCertified Public Accountant (i.e., CPA) designation by state accountancy board; 5 yrs. exp. in accounting, marketing, internal auditing, finance, insurance or business administration; valid driver's license; must provide own transportation. -Or Certified Financial Examiner (i.e., CFE) designation by Society of Financial Examiners; 5 yrs. exp. in accounting, internal auditing, finance, marketing, insurance or business administration; valid driver's license; must provide own transportation. -Or equivalent of Minimum Class Qualifications For Employment noted above may be substituted for the experience required, but not for the mandated licensure/designation. Job Skills: AuditingSupplemental InformationApplication Procedures:When completing the different sections of this application, be sure to clearly describe how you meet the minimum qualifications outlined in this job posting. We cannot give you credit for your Work Experience and Education & Certifications if you do not provide that information in your online application. Information in attached resumes or cover letters must be entered into your application in the appropriate Work Experience or Education & Certification sections to be considered.Status of Posted Positions:You can check the status of your application online by signing into your profile. Jobs you applied for will be listed. The application status is shown to the right of the position title and application submission details. Questions about the position not pertaining to your application status can be directed to: Kim Lowry @ ************. Applicants must be currently authorized to work in the United States on a full-time basis.Reasonable Accommodation:ODI does not discriminate on the basis of disability in its hiring or employment practices and complies with the ADA employment regulations. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact the agency Human Resource Offices' ADA Coordinator, Andrew Skal, by emailing ****************************** or calling ************. Otherwise, you will be given specific instructions on requesting an accommodation if you are invited to participate in a structured interview.Background Check Information:The final candidate selected for this position will be required to undergo a criminal background check. Section 2961 of the Ohio Revised Code (ORC) prohibits individuals convicted of a felony involving fraud, deceit or theft from holding a position that has substantial management of control over property of a state agency.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.

The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a Hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Supervises claims staff in their day-to-day operations * Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions * Ensures staff compliance with Workers' Compensation laws and mandated regulatory reporting requirements * Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) * Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions * Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests * Participate in customer claim reviews and presentations * Ability to travel overnight and attend meetings if required * Additional duties as assigned KNOWLEDGE & SKILLS: * Excellent written and verbal communication skills * Ability to assist team members to develop knowledge and understanding of claims practice * Effective quantitative, analytical and interpretive skills * Strong leadership, management and motivational skills * Demonstrated, strong customer service skills * Maintains composure under pressure and communicates diplomatically across various channels, including telephone, email, and written correspondence * Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets * Strong interpersonal, time management and organizational skills * Ability to work both independently and within a team environment * Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation EDUCATION & EXPERIENCE: * Bachelor's degree or a combination of education and related experience * Demonstrated public speaking skills * Minimum of 5 years' claims handling experience * Knowledge of WC required * Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel * Self-Insured Certificate preferred * State Certification as an experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $71, 696 - $110,701 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid

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

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process. - Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals. - Ensures all compliance requirements are satisfied and all payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for claim or reconsideration. **Required Qualifications** - New York Independent Adjuster License - Experience in a production environment. - Demonstrated ability to handle multiple assignments competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience - DG system knowledge **Education** **-** High School Diploma required - Preferred Associates degree or equivalent work experience. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $18.50 - $42.35 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 02/27/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.