WC Complex Med/Maint Adj- Charlotte, NC (Hybrid)
Charlotte, NC jobs
About Us At Selective, we don't just insure uniquely, we employ uniqueness. Selective is a midsized U.S. domestic property and casualty insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective's unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in Forbes Best Midsize Employers in 2025 and certification as a Great Place to Work in 2025 for the sixth consecutive year.
Employees are empowered and encouraged to Be Uniquely You by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our customers responsibly by helping to mitigate loss, keep them safe, and restore their lives and businesses after an insured loss occurs.
Overview
Selective Insurance is seeking a Workers Compensation Med/Maintenance Adjuster for our Charlott, NC office. This is a hybrid role, 2 days in the office and 3 days remote.
Responsibility includes effective and timely communication with employer, employee, and medical provider. Manage lifetime indemnity and medical benefits. Continuous review and analysis of these claims to ensure that the reserves are appropriate. Manage administration of benefits and claim resolution. Investigates claims to determine coverage and compensability based on jurisdictional guidelines. Obtain relevant information necessary for a thorough investigation. Freeze facts of claims and make timely decisions. Provide compelling customer service. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.
Responsibilities
* Handles assigned claims from the return-to-work units with lifetime indemnity awards, lifetime medical awards, and claim petitions. Collaborate with Workers Compensation Analyst from Strategic Case Unit as these claims tend to carry high exposure (upwards of $1M).
* Handles non-indemnity claims (no lost time within waiting period), medical causality, denied claims (not compensable and not covered), and medical claim petitions. Establishes initial and subsequent reserves on medical only claims with a general exposure of less than $25,000.
* Processes claims which include the following activities: Making contacts, setting reserves, evaluating claims for exposure, establishing timely reserve adjustments during the life of the file, making timely payments, and resolution. May adjust reserves accordingly with a general exposure of $75,000.
* Documents claims files and maintain control of work through documentation or diary system.
* Perform timely live-well checks on claimant and dependents.
* File state forms timely in accordance with statutory guidelines.
* Ensures compliance with company, state, and federal regulations.
* Handle disputed facts, benefits, compensability, coverage, medical causality, and relatedness.
* Receives assigned claims from the medical only unit with treatment beyond 60 days.
Qualifications
Knowledge and Requirements
* Knowledge of workers compensation statutes, coverage, and case law.
* Excellent written and verbal communication skills.
* Working knowledge of medical treatment and terms as related to medical only workers compensation claims.
* Critical thinking skills to assess compensability of WC claim as it relates to the facts and law.
Education and Experience
* College degree preferred.
* 1-3 years claims experience preferred.
Total Rewards
Selective Insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life. These benefits include comprehensive health care plans, retirement savings plan with company match, discounted Employee Stock Purchase Program, tuition assistance and reimbursement programs, and 20 days of paid time off. Additional details about our total rewards package can be found by visiting our benefits page.
The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout Selective's footprint. Additional considerations include relevant education, qualifications, experience, skills, performance, and business needs.
Pay Range
USD $55,000.00 - USD $75,000.00 /Yr.
Additional Information
Selective is an Equal Employment Opportunity employer. That means we respect and value every individual's unique opinions, beliefs, abilities, and perspectives. We are committed to promoting a welcoming culture that celebrates diverse talent, individual identity, different points of view and experiences - and empowers employees to contribute new ideas that support our continued and growing success. Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity, equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance; address biases; and foster diversity of viewpoints and opinions.
For Massachusetts Applicants
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Medication Access Specialist
Saint Paul, MN jobs
ABOUT VISANTE We are a specialized consulting firm focused on helping hospitals and health systems accelerate strong clinical, operational, and financial performance through pharmacy. Our team of professionals brings deep, contemporary expertise and innovation to optimizing all aspects of a fully integrated health system pharmacy program, driving significant value quickly.
Our mission is to transform healthcare through pharmacy, and our vision is to reimagine pharmacy to improve lives.
Visante is looking to add a Medication Specialist to our Specialty Pharmacy Services line. This individual will be responsible for
providing medication access and affordability services to Visante clients and their patients.
ABOUT THE ROLE (Remote, work from home)
The Medication Specialist's responsibilities include the following:
Reviewing medication authorizations submitted by clients
Performing appropriate actions based on client and patient needs, including:
Identifying the process to submit authorizations
Reviewing documentation in the client's medical record that is required for authorization submissions
Performing benefits investigation reviews to determine patient coverage and out-of-pocket costs
Identifying patient assistance programs, copay cards, grants, or funds that could be utilized to reduce patient financial burdens
Communicating with the clinic to obtain additional information or guidance related to prior authorization submission
Assisting clinics with submitting appeals related to coverage denials
Communicates determinations and relevant follow-up with patients on behalf of clients, including:
Sharing information related to medication coverage and financial assistance options
Providing pharmacy options for where prescriptions can be filled
Ensuring timely and accurate documentation related to services provided to clients and their patients by appropriately documenting information in clients' EMR systems based on the agreed-upon Visante-client workflow and documenting information in Visante systems for tracking prior authorization volumes and associated fees
Supporting clients with onboarding and training of client-employed medication access specialists, when directed and supporting Visante with continual process improvement and client-specific workflow and process development
Collaborating with Visante team members and leaders to provide insight and constructive feedback into day-to-day operations
Supporting clients with improving clinical staff and client pharmacy workflows and communications
Completing other duties as assigned by the supervisor
Requirements
Education
Required: High school diploma or equivalent
Experience
Required: 3 years of experience working within healthcare or with pharmacy providers on medication access
Preferred: Previous consulting and/or client-facing experience; Experience with electronic medical record documentation and prior authorization workflows; Experience with performing retail pharmacy PBM adjudication; Experience in utilizing CoverMyMeds to submit prior authorizations; Two (2) years of experience in healthcare revenue cycle that includes medication authorizations; Knowledge of CPT and ICD coding is highly desired; Knowledge of Medicare and third-party payer regulations and guidelines is highly desired; Two (2) years of experience in preadmission/precertification
Skills and Abilities
Demonstration of good judgment, multi-tasking and meeting deadlines with a sense of urgency, and being able to prioritize competing demands; Strong client relationship, interpersonal, and team skills; Proven ability to diagnose and resolve issues, demonstrating strong analytical and creative skills; Ability to make sound and timely decisions based on analysis, experience, and judgment; Clear and concise verbal and written communication skills and the ability to advise clients professionally and positively; Maintains confidentiality of all patient-related information; Excellent knowledge of medication reimbursement and healthcare prior authorization/coding; Excellent knowledge and proficiency in MS Word, Outlook, PowerPoint, and Excel
Compensation and Benefits:
We offer competitive salary and benefits for this full-time salaried role.
Equal Opportunity Statement: Visante is an equal opportunity employer. Visante's people are its greatest asset and provide the resources that have made the company what it is today. Visante is, therefore, committed to maintaining an environment free of discrimination, harassment, and violence. This means there can be no deference because of age, religion or creed, gender, gender identity or expression, race, color, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by applicable laws and regulations
Service Technician
Marietta, OH jobs
Job Details Ohio Office - Marietta, OH Full Time Not Specified Road Warrior Any Skilled Labor - TradesDescription
Job Purpose: - The Drilling Side Service Technician is responsible for the installation and maintenance of Iron Horse Tools' rental equipment. This equipment includes chokes, auto chokes, mud/gas separators, flare stacks, and various other tools and equipment provided by the company.
Key Responsibilities:
- Install and maintain Iron Horse Tools' rental equipment, ensuring all components such as chokes, auto chokes, mud/gas separators, and flare stacks are functioning properly.
- Conduct routine inspections and maintenance on equipment to ensure optimal performance and safety standards are met.
- Troubleshoot and resolve any technical issues that arise with the equipment, using mechanical knowledge and problem-solving skills.
- Collaborate with team members to ensure efficient and timely completion of installations and maintenance tasks.
- Adhere to all safety protocols and company guidelines while performing job duties.
- Maintain accurate records of service and maintenance activities, including any repairs or replacements made.
- Provide exceptional customer service by addressing client inquiries and concerns regarding equipment functionality and maintenance.
- Continuously update knowledge of industry trends and advancements in equipment technology to enhance service quality.
Qualifications
Required Education:
- High School Diploma or equivalent GED
Required Experience:
- Experience in the installation and maintenance of equipment such as chokes, auto chokes, mud/gas separators, and flare stacks
- Familiarity with handling various tools and equipment
Preferred Experience:
- Previous service-related experience
- Mechanical or construction knowledge
Required Skills and Abilities:
- Strong problem-solving skills to address equipment issues efficiently
- Ability to work independently and as part of a team
- Excellent communication skills for effective interaction with clients and team members
- Proficiency in using hand and power tools
- Ability to read and interpret technical manuals and diagrams
- Strong attention to detail and commitment to safety standards
Medical Technologist, 40 Hours/4-10 hour shifts; Days (Microbiology)
Cuyahoga Falls, OH jobs
Performs a variety of routine and complex laboratory procedures under supervision using standard and specialized techniques, instrumentation and equipment on a wide variety of biological specimens to assist the physician in the diagnosis and treatment of patients. Exercises professional judgment in order to recognize, prioritize, and facilitate varying test requests and workload in an efficient manner. Assumes responsibility and accountability for accuracy of procedures performed.
Bachelor's degree in related field OR Associate's degree in related field with 4 years of laboratory experience required
This applicant must be ASCP or AMT certified (MLS or MT - may consider a MLT)
Schedule:
4-10 Hour Shifts
6:30 - 4:30 pm
Works every 4th weekend plus holiday rotation
OR Technician, Full-Time, 40 hours, 7a-5:30p
Cuyahoga Falls, OH jobs
Provides surgical scrub technical services under supervision and assists in operating room as assigned and directed by the RN.
Requirements
Education and Training
High school graduate or equivalent.
Completion of course for surgical technicians.
BLS certification required.
Experience
One (1) year Surgical Technician experience in Operating Room preferred.
Technology & Innovation (T&I) Technician II
Elmore, OH jobs
At Materion, everyone is included, respected and offered opportunity to grow.
Join us!
The Technology & Innovation (T&I) Technician II within Materion's Materials (PM) business will support engineering projects for new product and process development. The Technician II performs duties with other team and project members as assigned by the Laboratory Supervisor. Operating independently or in a team environment, the incumbent will set up and operate experimental equipment.
You will have the opportunity to:
Assist in the design of work requests aimed at product and process development and quality improvement.
Execute work requests and trials within defined goals, operating laboratory and manufacturing equipment, including sample preparation, melting and casting, fabricating equipment, heat treating, SEM/EDS, surface analysis, testing equipment and metallographic methods.
Monitor trials and documents required data and observations. Contribute to the preparation of written reports.
Participate in the development and documentation of safe working practices and standard operating procedures for Laboratory and Manufacturing equipment
Participate in the effective training of Technician I's and participates in training themselves
Be responsible for general housekeeping in area of work
Work in a safe, honest, and ethical manner at all times.
Handle and processes Be and Be-containing powders and solids. Identifies any areas where safety can be improved.
Safely handles hazardous materials such as chemicals, either providing proper safety protocols or requesting protocols from the responsible engineer or Supervisor when there is uncertainty.
REQUIREMENTS:
Education -
Preferred: Associate's degree in a related field
Experience -
Required: Maintenance and operation of complex mechanical and electrical machinery
Preferred:
Experience with metallographic preparation, including metallurgical mounting, polishing and etching, and metallurgical testing
Preferred: Experienced with metallographic SEM / TEM operation
Experience with experimental design and preparation
Experience with chemical or powder metal handling, heat treatment, welding, machining, metal manufacturing techniques (casting, extrusion, hot/cold rolling, HIP, CIP)
Years of Experience: 2+ years' experience participating in engineering and product development projects
Minimal travel. Up to 15% travel may be required based on business need or training
Knowledge, Skills and Abilities -
Required: Basic computer skills
Preferred: Changed wording to reflect on duties rather than requirements.
HP
The selection of the person to be hired for this position is contingent on the candidate having export compliance eligibility for access to U.S. controlled technology which comes under the licensing jurisdiction of the U.S. Department of State, International Traffic in Arms Regulations (ITAR) and the U.S. Department of Commerce, Export Administration Regulations (EAR).
The candidate selected will have to qualify as either a U.S. citizen, a U.S. National, a lawful permanent resident of the U.S., a Person Admitted into the U.S. as an Asylee or Refugee., a National of a country that is not prohibited from having access to U.S. controlled technology (via a letter of assurance), or a Person to be approved for an export license by the governing agency whose technology comes under its jurisdiction. Please understand that any job offer that requires approval of an export license will be conditional on Materion's determination that it will be able to obtain an export license in a time frame consistent with Materion's business requirements.
Materion Corporation and its subsidiaries (the “Company”) is an equal employment opportunity employer. It is the Company's policy to not unlawfully discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin or ancestry, sex, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, gender identity, marital status, or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. The Company also prohibits harassment of applicants and employees based on any of these protected categories. It is also the Company's policy to comply with all applicable federal, state and local laws respecting consideration of unemployment status in making hiring decisions. The information collected by this application is solely to determine suitability for employment, verify identity and maintain employment statistics on applicants.
Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on the Company. Please inform the Company's personnel representative if you need assistance completing any forms or to otherwise participate in the application process.
Materion's Veteran Employee Resource group supports veterans and promotes the benefits of hiring veterans in the workplace. We honor all those who have served and are a military friendly company. Veterans are encouraged to apply and military experience and skills are transferrable to Materion careers.
Please provide complete information. An incomplete application may affect your consideration for employment.
Auto-ApplyTensile-Metallographic Technician
Elmore, OH jobs
At Materion, everyone is included, respected and offered opportunity to grow.
Join us!
This Metallurgical Technician position prepares test samples, performs metallurgical testing, completes analysis and reports results on a variety of materials using defined processes and techniques. Depending on the area assigned, the position may include the use of Optical Microscopy, Tensile Testers, Hardness Testers, and CTE equipment.
You will have the opportunity to:
Proficient and able to train Technician B operators in the basic skills required.
Guides, assigns work, and checks results for Tech B.
Assists in the development of new or modified procedures.
Able to work independently for more advanced Metallurgical Laboratory techniques, for example:
Preparation of Precision Elastic Limit (PEL) test bars by etching, measuring, and installing strain gages and performing testing of the prepared bars.
Making precision measurements with micrometers, microscope, stage micrometers, and electrical temperature instruments while conducting tensile property testing.
Evaluating metallurgical samples for cleanliness, heat-treated condition, and grain size, using any of a number of different methods.
Performing CTE, and Magnetic Permeability Testing.
Reports analytical results directly to those requesting laboratory service within the limitations established by the Supervisor.
Maintain Quality Systems in the laboratory and assist in writing Procedures as requested.
REQUIREMENTS:
Requires a minimum of 3 years of experience in the metals or materials field with experience as a metallurgical technician strongly preferred.
Alternatively, we will consider 1 year of technical laboratory experience coupled with at least 2 years of college-level laboratory experience, specifically including proficiency in any two of the following areas: metal sample preparation, mechanical testing, tensile testing, or metallography.
Requires working knowledge of SAP and Microsoft products.
Strong verbal and written communication skills required.
Self-motivated and able to initiate action without direction required.
Ability to multi-task and prioritize required.
HP
The selection of the person to be hired for this position is contingent on the candidate having export compliance eligibility for access to U.S. controlled technology which comes under the licensing jurisdiction of the U.S. Department of State, International Traffic in Arms Regulations (ITAR) and the U.S. Department of Commerce, Export Administration Regulations (EAR).
The candidate selected will have to qualify as either a U.S. citizen, a U.S. National, a lawful permanent resident of the U.S., a Person Admitted into the U.S. as an Asylee or Refugee., a National of a country that is not prohibited from having access to U.S. controlled technology (via a letter of assurance), or a Person to be approved for an export license by the governing agency whose technology comes under its jurisdiction. Please understand that any job offer that requires approval of an export license will be conditional on Materion's determination that it will be able to obtain an export license in a time frame consistent with Materion's business requirements.
Materion Corporation and its subsidiaries (the “Company”) is an equal employment opportunity employer. It is the Company's policy to not unlawfully discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin or ancestry, sex, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, gender identity, marital status, or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. The Company also prohibits harassment of applicants and employees based on any of these protected categories. It is also the Company's policy to comply with all applicable federal, state and local laws respecting consideration of unemployment status in making hiring decisions. The information collected by this application is solely to determine suitability for employment, verify identity and maintain employment statistics on applicants.
Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on the Company. Please inform the Company's personnel representative if you need assistance completing any forms or to otherwise participate in the application process.
Materion's Veteran Employee Resource group supports veterans and promotes the benefits of hiring veterans in the workplace. We honor all those who have served and are a military friendly company. Veterans are encouraged to apply and military experience and skills are transferrable to Materion careers.
Please provide complete information. An incomplete application may affect your consideration for employment.
Auto-Apply