Entry Level Representative (Recent grads needed)
Telephone claims representative job in Columbus, OH
Job Title: Customer Support Representative
Pay Rate: $19/hour
Schedule
Start remotely with 4-5 weeks of training, then transition to full in-office work for hands-on experience and team collaboration. After 6 months, enjoy a hybrid schedule (3 days in-office, 2 days remote).
Responsibilities:
Handle a high volume of inbound calls.
Assist clients with Cash Management products, online/mobile access, and general inquiries.
Deliver top-tier customer service while meeting performance metrics.
Learn and adapt quickly to new tools and processes.
Work collaboratively with teammates to ensure client satisfaction.
Benefits Info
Russell Tobin offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.
Commercial Trucking Liability Claim Adjuster - Remote (Multi-Line)
Remote telephone claims representative job
Overview Multi-Line Claim Representative I or II - Remote (Commercial Trucking)
Schedule: Monday-Friday, 8:00 AM-4:30 PM (local time) Salary Range: $60,000 to $75,000 annually, depending on experience Reports To: Claim Supervisor
Caseload: Approximately 100 active files
Client: Single, dedicated commercial trucking account
Build Your Career With Purpose at CCMSI
At CCMSI, we don't just process claims-we support people. As a leading Third Party Administrator and a certified
Great Place to Work
, we offer manageable caseloads, employee ownership, and a collaborative culture. Our employee-owners are empowered to grow, contribute, and make a meaningful impact every day.
Job Summary
We are seeking an experienced Multi-Line Claim Representative II to manage commercial trucking liability claims for a single, dedicated client. This remote position is ideal for a self-motivated professional who takes pride in thorough investigation, clear communication, and delivering high-quality service. You will handle claims from start to finish, ensuring fair and timely resolutions while adhering to CCMSI's corporate claim standards and client-specific service expectations.
Responsibilities
Investigate, evaluate, and adjust commercial trucking liability claims in accordance with established guidelines and jurisdictional regulations.
Review claim documentation, legal correspondence, and invoices to determine coverage, liability, and damages.
Authorize and process claim payments within settlement authority.
Negotiate settlements with claimants, attorneys, and other parties as appropriate.
Oversee litigation strategy and collaborate with defense counsel.
Identify and pursue subrogation opportunities.
Prepare detailed claim summaries, reserve updates, and client reports.
Maintain accurate and timely documentation in the claim management system.
Ensure compliance with service commitments, quality standards, and client-specific requirements.
Qualifications Required:
5+ years of experience handling commercial trucking or multi-line liability claims.
Active adjuster's license (in applicable jurisdictions).
Strong written and verbal communication skills.
Ability to work independently, prioritize effectively, and maintain confidentiality.
Proficiency with Microsoft Office (Word, Excel, Outlook).
Nice to Have:
Experience managing claims for national commercial trucking clients.
Knowledge of federal transportation regulations and industry best practices.
Performance Metrics
Performance is evaluated through annual reviews based on claim quality, timeliness, communication, and adherence to CCMSI's corporate and client standards.
What We Offer
• 4 weeks PTO + 10 paid holidays in your first year
• Medical, Dental, Vision, Life, and Disability Insurance
• 401(k) and Employee Stock Ownership Plan (ESOP)
• Internal training and advancement opportunities
• A supportive, team-based work environment
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.
ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.
Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.
Our Core Values
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
• Act with integrity
• Deliver service with passion and accountability
• Embrace collaboration and change
• Seek better ways to serve
• Build up others through respect, trust, and communication
• Lead by example-no matter their title
We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
#NowHiring #ClaimsJobs #InsuranceCareers #TruckingIndustry #LiabilityClaims #ClaimsAdjuster #RemoteJobs #CareerGrowth #HiringNow #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #LI-Remote
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Auto-ApplyMedical Claims Representative - Office/Hybrid position
Remote telephone claims representative job
GEMCORE's continued success has earned us national recognition with Inc. Magazine's list of
America's Fastest-Growing Companies
and with the Cleveland Plain Dealer as a
Top Workplace six years running!
GEMCORE is a rapidly growing multi-state family of companies headquartered in Hudson, OH.
Are you looking to begin or further your career in the medical supply industry where you are able to contribute to the success of the business, and build lasting relationships? All while allowing for personal time every evening, weekend, and holiday? Edwards Health Care Services (EHCS),
a division of GEMCORE
, is a well-established and growing national direct-to home medical supply provider. We are seeking a highly motivated Medical Claims Representative to join our high energy team. The Medical Claims Representative's primary role is to determine the root cause of denials and payment delays.
We are a fast-growing company with advancement opportunities!
This position offers the ability to work unique problems and to apply complex problem solving skills.
This is a full-time, non-exempt, position.
Once training is complete, this position will potentially be part of a hybrid remote work schedule. This position is located in Hudson, OH.
Schedule is 8:00 am - 4:45 pm, Monday through Friday.
Employer paid vacation.
Benefits available include medical/dental/vision, life, short and long-term disability insurances, and 401K Retirement Savings Plan.
Key Responsibilities
Analyze reports on insurance payment differences, appeals and rebills.
Work claim denials.
Identify denial trends and suggest process improvements.
Collaborate with claims team and communicate effectively with all other department managers in solving issues and implementing new procedures.
Proficient in the knowledge of healthcare products, deductibles, co-payments and third-party reimbursement for customer education and employee training purposes.
Job requirements
Key requirements:
Self-starter with the ability to work independently to achieve desired results.
Clinical background or medical terminology knowledge helpful but not necessary.
Demonstrated proficiency in Microsoft Outlook and Excel with 30 WPM typing skills.
Strong organizational skills and multitasking ability.
Excellent telephone skills required.
Good cognitive reasoning ability.
Detailed and thorough work orientation.
Minimum 1-2 years of experience in a consumer service organization or healthcare environment.
Education/Experience
High School Diploma or GED Equivalent
About Edwards Health Care Services, Inc.
Edwards Health Care Services, Inc. (EHCS) is a national direct-to home medical supply provider of high quality medical and diabetes products that support the needs of individuals with diabetes and other conditions. For over 25 years, EHCS have been lighting the way to better health by providing customers an easier way to have products delivered directly to their door. By partnering with healthcare professionals, product manufacturers, and a large network of government and private insurers, EHCS prides itself on personalized customer service and a simplified, seamless order process for every customer…every time! For more information, visit ***************
About GEMCORE
GEMCORE, a family of companies headquartered in Hudson, Ohio -
Edwards Health Care Services, GEMCO Medical, GemCare Wellness, and GEM Edwards Pharmacy
- offers a core set of healthcare solutions by partnering with manufacturers, providers, employer groups, insurance groups, and patients to deliver high quality healthcare products and innovative services to proactively better lives. For more information, visit **********************
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Your application has been successfully submitted!
Other jobs
Workers Compensation- Subrogation Claims Rep I
Remote telephone claims representative job
The Workers Comp Legal Claims department is looking for a Worker's Compensation Subrogation Representative I. Reporting to the Supervisor, Workers' Compensation Legal Subrogation, the Worker's Compensation Subrogation Representative is responsible for the daily management and resolution of Workers' Compensation Subrogation Claims in New Jersey. Leveraging technical expertise, the Worker's Compensation Subrogation Representative will be tasked with efficient handling of negotiations and resolution of Workers' Compensation liens while collaborating with other departments and policyholders to proactively share knowledge and expertise. Demonstrate flexibility and pursue challenging tasks.
Schedule: Monday through Friday, with work from home opportunities after training is complete.
Specific hours are subject to selected start time between 8am-9am pending supervisory approval
Essential Duties and Responsibilities: Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and predictable onsite attendance is an essential function of the job.
Manage the negotiation and resolution of New Jersey Workers' Compensation liens;
Interface with internal and external stakeholders, including policyholders, attorneys and insurance carriers;
Produce lien correspondences, review of policy and litigation documents relative to third party actions, ensure quality claim documentation;
Evaluate New Jersey Workers' Compensation claims and identify subrogation potential;
Assist in onboarding and training of subrogation team members;
Support Workers' Compensation Claims as needed
Required Qualifications: Knowledge, skills & abilities, experience, minimum & desired education, certification and/or license requirements.
Experience in Workers' Compensation Claims;
Demonstrated skills in MS Word, Excel and other applications;
Ability to accurately organize and examine legal and claims documents;
Strong verbal and written communication skills with strong attention to detail and customer service;
Strong organizational skills with the ability to manage competing priorities;
Ability to work independently and collaboratively;
Must have the ability to prioritize and proactively manage a large case load;
Preferred Qualifications:
Workers' Compensation claims or legal experience preferred;
Subrogation experience preferred
Compensation: Salary is commensurate with experience and credentials.
Pay Range: $49,871-$57,881
Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses.
Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
Auto-ApplySr Associate, Claim Representative - Operations
Remote telephone claims representative job
This role ensures timely and accurate processing of claims, supports internal and external audits, and contributes to operational efficiency. The Sr. Associate works cross-functionally to resolve issues and maintain high standards of data integrity and client service.
BA/BS degree in business administration with an emphasis in accounting/finance or equivalent work experience
Advanced degree or industry certification preferred
3 years of experience in life claims administration and adjudication
Understanding of claim treaty provisions, adjudication thresholds, and regulatory compliance.
Strong analytical and decision-making skills with attention to detail and accuracy.
Strong problem-solving skills and the ability to navigate and resolve complex issues.
Strong analytical and organizational skills.
Proficiency in claims systems and reporting tools.
Ability to work independently and collaboratively across teams.
Excellent communication and problem-solving skills.
Pay Range for roles performed in NC: $72,000-$88,000 base salary per year. Actual salaries may vary based on various factors including but not limited to location,
experience, role and performance. The range listed is just one component of SCOR's total compensation
package for employees. Other rewards may include annual bonuses, short- and long-term incentives. In addition, we provide a variety of benefits to employees, including health insurance
coverage, life and disability insurance, a retirement saving plan, paid holidays and paid time off.
Perform adjudication of life claims for assigned clients, including standard and contestable cases.
Review claim documentation such as death certificates, claimant statements, and policy records to verify eligibility.
Assess claim validity based on treaty terms, policy provisions, and underwriting guidelines.
Assist with performance of client adjudication audits for assigned clients to ensure compliance with treaty terms and adjudication standards.
Serve as liaison to clients for claim-related inquiries
Review and approve claims in accordance with claim payment approval hierarchy.
Review, enhance, and sign settlements to ensure timely client payments
Process claim refunds appropriately and timely.
Monitor workflow and identify potential claims processing issues.
Work cross-functionally to resolve system impediments to claim payment processing.
Identify opportunities for improvement and contribute to process enhancements.
Assist with internal and external audits and ensure all ICS controls are properly documented.
Establish requirements for system enhancements and log tickets for tracking, testing, and implementation.
Creation and maintenance of reports allowing for analysis of claim workflow and data fields to ensure accuracy of claim data.
Analyze client trending data to understand financial results and identify potential future impact.
Produce ad-hoc reports and claims metrics for management and other stakeholders.
Perform monthly and quarterly reporting requirements for performance measurement and to meet quarter end deliverables.
May perform other duties as required.
Auto-ApplyCasualty Claims Representative
Remote telephone claims representative job
Job Description
Casualty Claims Representative
Harrison Gray Search has been engaged by a mission-driven insurance organization to identify a skilled Claims Representative to join their team in East Lansing, MI.
This is a meaningful opportunity to work with a trusted organization that protects Michigan public schools. As a Casualty Claims Representative, you'll handle the full lifecycle of general and professional liability claims-investigating,
evaluating, and resolving cases while working closely with school districts and legal partners.
Why You'll Want This Role:
Purposeful Work: Help safeguard Michigan public schools and support their staff through claims resolution.
Top-Tier Benefits: 100% employer-paid medical, dental, and vision, generous PTO, and paid parental leave.
Respected Workplace: Recognized as one of Business Insurance's Best Places to Work.
What You'll Do:
Manage and resolve assigned casualty claims, including investigation, analysis, negotiation, and settlement.
Monitor and collaborate with external investigators, attorneys, and medical/legal vendors.
Evaluate liability, coverage, and damages; set and adjust reserves accordingly.
Represent the organization in mediations, facilitate strategy sessions, and document case activity thoroughly.
Ensure timely movement of claims via an internal diary system and claim handling standards.
What You Bring:
Bachelor's degree plus 2+ years handling general liability and professional liability claims (or equivalent experience).
Strong knowledge of complex claims handling, coverage analysis, and liability assessment.
Skilled communicator with high emotional intelligence and professionalism.
Comfortable working in a fast-paced, collaborative environment with school district representatives, legal professionals, and internal teams.
Willingness to travel occasionally and work remotely as needed.
If you're looking for meaningful claims work that supports the greater good-and you're ready to join a high-performing, purpose-driven team - apply today!
Casualty Claims Representative
Remote telephone claims representative job
Title: Casualty Claims Representative Reports To: Claims Manager Department: Property/Casualty and Workers' Compensation (PC/WC) SET SEG is looking for a Casualty Claims Representative who will be responsible for the investigation, negotiation, adjustment, and resolution of designated PC claims. This position reports to the Claims Manager.
WHO WE ARE
School Employers Trust (SET) is a non-profit company that was created after a monumental shift in school funding happened in 1965. SET, which began in 1971, served as an employee benefits association focused on offering comprehensive and affordable employee benefit solutions to Michigan public schools and their employees. Two years later, its partner organization School Employers Group (SEG) was formed to administer compensation and fringe benefits for SET. As schools were faced with more challenges related to insurance, SEG evolved and grew into a company that provides workers' compensation and property/casualty services for Michigan public schools.
Today, SET SEG continues to expand and find creative ways to meet the specialized needs of its members. This, coupled with a superior member experience, is why SET SEG has maintained its position as an industry leader in the school insurance market.
We value those who proactively solve challenges, simplify the complex, thrive in a fast-paced setting, have a customer-first mentality, and seek a collaborative and inclusive work environment. We are also listed on the Business Insurance Best Places to Work. We offer 100% employer paid insurance (medical, dental, and vision), Paid Time off (PTO), and paid parental leave.
Our passion is delivering peace of mind to Michigan public schools and we look for team members who are motivated by our cause. To learn more, visit: *******************
WHO YOU ARE
You are energized by working with a collaborative team and industry peers to support Michigan public schools through their challenges. You seek understanding and are motivated to tackle projects and problems with the customer in mind. You anticipate needs and preempt challenges and concerns, delivering increasingly relevant customer experiences over time. You value a culture that is rooted in mutual respect, where you can learn from different perspectives and roles.
Primary Responsibilities:
Manages, investigates, evaluates, negotiates, and adjusts assigned claims in adherence to guidelines within authority
Ensures adequacy of reserves and recommends reserve increases on cases in excess of authority
Monitors outside investigators and performs outside investigations when assigned.
Provides oversight of medical, legal damage estimates, and miscellaneous invoices to determine if they are reasonable and related to designated claims
Negotiates any disputed bills or invoices for resolution
Assigns litigated claims to approved law firms and/or individual attorneys and monitors progress
Follows a uniform system of reserving by reviewing incoming litigation, establishing initial reserves and completing reserve reports
Negotiates settlements in accordance with claim handling standards while also considering member preferences when appropriate
Attends facilitations/mediations as assigned
Manages diary system to move losses to conclusion in a timely manner
Participates in strategy sessions with internal business units such as Underwriting and Loss Control
Other duties as assigned by the Claims Manager
Required Qualifications:
Bachelor's Degree plus two years of experience adjusting general liability and professional liability claims or an equivalent combination of education and experience
Must have knowledge of coverage, liability, and complex claims handling procedures
Ability to handle complex case-related tasks in a fast-paced and changing environment
Excellent interpersonal skills and the ability to work in a strong team environment
Must be highly organized and detail oriented
Must be dependable, reliable, and able to achieve high levels of professionalism when handling cases and interacting with school district representatives and their employees, attorneys, families of injured and fellow employees
Must be able to create and maintain high levels of confidentiality when dealing with proprietary information and sensitive situations
Must have strong cognitive and analytical skills
Ability to initiate, receive, understand, and reply to written and oral communication (verbal, written, telephone, e-mail, etc.)
Ability to travel and work remotely on a periodic basis
Physical Demands / Work Environment
Several hours per day at a sit/stand desk, average mobility to move around an office environment; able to spend several hours per day at a computer. Occasional in-state travel may be required. Punctual, regular, and consistent attendance is required.
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.
Auto-ApplyClaims Adjuster
Remote telephone claims representative job
Fetch Pet Insurance, a tech-enabled pet wellness company, has consistently been an innovative leader in the pet insurance industry, offering the most extensive and all-inclusive pet insurance and health advice.
Put simply, Fetch makes vet bills affordable. We offer a comprehensive product that does not have any restrictions based on breed, age, or size. We are believers in helping pets get through their bad days but also focus on extending the good days. How do we do that? - through a wide portfolio of products + offerings, which include Fetch Health Forecast, our pet health and lifestyle blog, The Dig, and our partnerships with Project Street Vet and animal no-kill shelters across North America.
Our business is growing and we are looking for compassionate professionals that want to join a team that works hard and celebrates success! You will have an opportunity to hone your skills and develop new skills as you learn the ins-and-outs of Fetch pet insurance and support our pet parents. Your success is our success!
RESPONSIBILITIES.
Adjudicate assigned claims in accordance with the Terms & Conditions of the individual pet's policy
Review medical records, lab results, invoices, and claims forms for complete and thorough assessment
Process claims determinations to include assessment and payment for submitted claims
Verify claims coverage through in-depth knowledge of policy Terms & Conditions
Consult with treating veterinary practices regarding medical records evaluation and necessary documentation
Maintain an average quality assurance score above department minimums
Complete assigned tasks within compliance deadlines
Maintain an average productivity rate above department minimums
Provide feedback on process opportunities to further strengthen SOPs
REQUIRED SKILLS.
Comprehensive understanding of disease processes and veterinary medical terminology
Ability to read and interpret veterinary medical records and invoices
Ability to identify chronic and acute medical conditions
Adapt quickly in a fast-paced, ever-changing environment and operate multiple computer systems simultaneously
Work independently in a remote capacity, while also fostering teamwork and collaborating with others
Superior communication skills for collaboration with team members and support from managers
Demonstrated problem solving skills and ability to work through complex medical/vet-related scenarios affecting a pet's diagnosis and/or treatment plan
QUALIFICATIONS.
Minimum of five years experience as a veterinary technician
Bachelor's degree in veterinary science OR CVT or equivalent preferred
Property and Casualty Adjuster license in good standing preferred
Complete and pass state adjuster licensing
Be reliable with good attendance
Able to work a minimum of 42 hours per week, with occasional weekends and extra hours as needed
WORK-FROM-HOME SET-UP.
Subscription to reliable high-speed internet connection (minimum of 100 Mbps download and 30 Mbps upload speed)
A quiet, dedicated place to work in your home that is not easily disrupted by background noises or distractions
Office workspace must be large enough to accommodate two 19” dual monitors, laptop, mouse, keyboard, and headset
Ability to set up and connect (with instructions and remote IT team assistance) equipment that is shipped to your home
-ABOUT FETCH-
Fetch is a high-growth, Warburg-Pincus portfolio company. We are a passionate group of 200+ employees and partners across the U.S. and Canada dedicated to helping pets live their best lives. We have two offices (New York City, NY, and Winnipeg, Canada), and we currently provide security to over 360,000 pet parents.
We don't just accept differences - we celebrate it, we support it, and we thrive on it for the benefit of our employees, our products, and our community. We are proud to be an equal opportunity employer. We recruit, hire, pay, grow and promote no matter of gender, race, color, sexual orientation, religion, age, protected veteran status, physical and mental abilities, or any other identities protected by law.
Claims Representative
Remote telephone claims representative job
Company Details
Berkley Small Business Solutions (BSB) is committed to providing small business customers with the next generation of small business solutions, including offering operational, underwriting, and marketing opportunities. We offer insurance products to Small Business Owners for transportation and other main street businesses. We leverage underwriting expertise, data, and analytics, and automation for risk assessment, selection, pricing retention. We champion our customers, distribution always seeking a smarter way to provide a more efficient and better user experience.
We are a proud member of W. R. Berkley Corporation, one of the largest commercial lines property casualty insurance holding companies in the United States. With the resources of a large Fortune 500 corporation and the flexibility of a small company, we exclusively work with select independent agents to bring technology solutions that help them build their business.
Responsibilities
The position is responsible for handling low-complexity claims involving physical damage, property damage, total loss, fuel spills, medical payments, and cargo damage resulting from commercial auto claims. This position will work closely with insureds and stakeholders to ensure timely and accurate claims resolution and provide exceptional customer service.
Customer Service
Act with urgency in establishing initial and subsequent contact with all parties and key stakeholders.
Update appropriate parties as needed, providing new facts as they become available and explaining impact of those facts upon the liability analysis and settlement options.
Collaborate with vendors to ensure timely appraisal and evaluation of damages.
Coverage
Analyze coverage by applying policy information to facts or allegations of each loss.
Communicate coverage decisions to insured and stakeholders and update coverage analysis as new facts warrant it.
Ensure compliance with jurisdictional requirements, including timeliness of communicating coverage disposition.
Data Integrity
Maintain discipline in securing and updating information throughout the life of the claim.
Ensure data is complete and comply with statutory requirements for reporting.
Reserving
Establish and maintain appropriate initial, subsequent loss, and expense reserves. Ensure supporting rationale for each reserve is documented within the electronic claim file.
Act with urgency in collaborating with internal stakeholders regarding significant changes within claim reserving.
Investigation
Directly investigate each claim through prompt and strategic contact with appropriate parties including policyholders, witnesses, claimants, law enforcement agencies, agents, medical providers, and technical experts to determine the extent of liability, damages, and contribution potential.
Interview witnesses and stakeholders. Take recorded and/or written statements when appropriate.
Evaluate all claims for recovery potential. Directly handle recovery efforts and/or engage and direct Company resources for recovery efforts.
Evaluation and Resolution
Utilize diary management system to ensure all claims are handled timely and in compliance with jurisdictional requirements and Company guidelines.
Collaborate with external vendors, e.g., appraisers and independent adjusters.
Manage total loss claims process including vehicle appraisal procedures, diminished value, vendor networks, subrogation demands, salvage procedures and heavy equipment appraisals.
May perform other functions as assigned.
Remote work arrangements may be considered for qualified candidates who are open to travel as needed.
Qualifications
1+ years of casualty claim handling experience; trucking experience preferred.
Excellent interpersonal and communication skills.
Strong problem-solving and organizational skills.
Computer proficiency, including working knowledge of Microsoft Office products.
Previous experience in customer service role, or a related field, is preferred but not required.
Willingness to learn and expand knowledge.
Position will require that Claims Representative obtain independent adjuster's licenses for all states that have requirement, including but not limited to: AL, CT, GA, FL, ME, MS, NY, NC, SC, TN, TX. Licenses must be obtained within 90 days of hire and require course work, testing, and background checks that may include fingerprinting
Education
College degree preferred or equivalent work experience.
Additional Company Details ****************************
The Company is an equal employment opportunity employer
We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
• Salary Range: 75k - 90k
• Eligible for annual discretionary bonus
• Benefits: Health, Dental, Annual Bonus Potential, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Auto-ApplyRemote - Claims Adjuster - Automotive
Remote telephone claims representative job
":"* This is a full-time, remote position working from 9:45am to 6:15pm CST American Guardian Warranty Services, Inc. (AGWS), an affiliate of Reynolds and Reynolds, is seeking Claims Adjuster - Automotive for our growing team. In this role you will work remotely and be responsible for investigating, evaluating and negotiating minor to complex vehicle repair costs to accurately determine coverage and liability.
You will take inbound calls to determine coverage based on contracts in order to appropriately resolve customer issues.
Responsibilities will include, but are not limited to: -\tAnswering inbound calls -\tProvide information about claim processing and explain the different levels of contract coverage and terms -\tAccurately establish, review and authorize claims -\tEntering claim and contract information into the AGWS' system A home office package will be provided for this position.
This includes two computer monitors, a laptop, keyboard and mouse.
","job_category":"Customer Service","job_state":"NV","job_title":"Remote - Claims Adjuster - Automotive","date":"2025-11-18","zip":"89101","position_type":"Full-Time","salary_max":"55,000.
00","salary_min":"50,000.
00","requirements":"2+ years of experience as an automotive mechanic within a service department, dealership, or independent shop~^~2+ years of experience adjusting automobile mechanical claims~^~ASE certification is a plus~^~Must have a quiet designated work space to work from home~^~Must have reliable internet with at least a download speed of 50mbps~^~Must be able to work effectively under pressure in a fast paced environment~^~Strong communication skills~^~Strong organizational and multi-tasking skills~^~High school diploma","training":"On the job","benefits":"We strive to offer an environment that provides our associates with the right balance between work and family.
We offer a comprehensive benefits package including: - Medical, dental, vision, life insurance, and a health savings account - 401(k) with up to 6% matching - Professional development and training - Promotion from within - Paid vacation and sick days - Eight paid holidays - Referral bonuses Reynolds and Reynolds promotes a healthy lifestyle by providing a non-smoking environment.
Reynolds and Reynolds is an equal opportunity employer.
","
Claims CL Casualty General Liability Representative (GLPD)- remote
Remote telephone claims representative job
If you're excited about this role but don't meet every qualification, we still encourage you to apply! At Grange, we value growth and are committed to supporting continuous learning and skill development as you advance in your career with us.
Summary: In this role you will be responsible for investigating, evaluating and negotiating settlement of assigned Commercial General Liability Property Damage claims in accordance with best practices to promote retention or purchase of insurance from Grange Enterprise.
What You'll Be Doing:
Pursuant to line of business strategies and good faith claim settlement practices, investigates, evaluates, negotiates, and resolves (within authorized limits) assigned claims.
Demonstrates technical proficiency, allowing for the handling of more complex claims with minimal supervision.
Establishes and maintains positive relationships with both internal and external customers, providing excellent customer service.
Assists in building business partner relationships with agents, insureds and Commercial Lines through regular and effective communications. May include face-to-face as needed.
Will be the “point person” (when required) for certain identified large customer accounts where specialized communication and handling are required.
Establishes and maintains proper reserving through proactive investigation and ongoing review.
Assist other departments (when required) with investigations. May be assigned general liability claims during high volume workload periods.
Demonstrates effectiveness and efficiencies in managing diary system and handling workload with limited supervision or direction.
What You'll Bring To The Company:
High school diploma or equivalent education plus five (5) years of claims experience. Bachelor's degree preferred. For property focused role, at least two (2) years handling commercial general liability property claims handling exposures or frontline property claims handling experience preferred. Preference to those candidates with Construction Defect experience. Must possess strong communication and organization skills, critical thinking competencies and be proficient with personal computer. Demonstrated ability to interact with customers and agents in a professional manner. State specific adjusters' license may be required.
About Us:
Grange Insurance Company, with $3.2 billion in assets and more than $1.5 billion in annual revenue, is an insurance provider founded in 1935 and based in Columbus, Ohio. Through its network of independent agents, Grange offers auto, home and business insurance protection. Grange Insurance Company and its affiliates serve policyholders in Georgia, Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and Wisconsin and holds an A.M. Best rating of "A" (Excellent).
Grange understands that life requires flexibility. We promote geographical diversity, allowing hybrid and remote options and flexibility in work hours (role dependent). In addition to competitive traditional benefits, Grange has also created unique benefits based on employee feedback, including a cultural appreciation holiday, family formation benefits, compassionate care leave, and expanded categories of bereavement leave.
Who We Are:
We are committed to an inclusive work environment that welcomes and values diversity, equity and inclusion. We hire great talent from various backgrounds, and our associates are our biggest strength.â¯We seek individuals that represent the diversity of our communities, including those of all abilities. A diverse workforce's collective ideas, opinions and creativity are necessary to deliver the innovative solutions and service our agency partners and customers need. Our core values: Be One Team, Deliver Excellence, Communicate Openly, Do the Right Thing, and Solve Creatively for Tomorrow.
Our Associate Resource Groups help us create a more diverse and inclusive mindset and workplace. They also offer professional and personal growth opportunities. These voluntary groups are open to all associates and have formed to celebrate similarities of ethnicity/race, nationality, generation, gender identity, and sexual orientation and include Multicultural Professional Network, Pride Partnership & Allies, Women's Group, and Young Professionals.
Our Inclusive Culture Council, created in 2016, is focused on professional development, networking, business value and community outreach, all of which encourage and facilitate an environment that fosters learning, innovation, and growth.â¯Together, we use our individual experiences to learn from one another and grow as professionals and as people.â¯
We are committed to maintaining a discrimination-free workplace in all aspects, terms and conditions of employment and welcome the unique contributions that you bring from education, opinions, culture, beliefs, race, color, religion, age, sex, national origin, handicap, disability, sexual orientation, gender identity or expression, ancestry, pregnancy, veteran status, and citizenship.
Claims Adjuster - Associate
Remote telephone claims representative job
Established in 2021, Independence Pet Holdings is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.
We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.
PetPartners, a subsidiary of IPH, is an ensemble of seasoned industry experts who are working to strip away all the complexities that don't add real value to pet insurance coverage. We're delivering solutions that make it easy for employers to offer this sought-after benefit in a way that's painless and worry-free - a truly one-of-a-kind approach to pet insurance.
Job Summary:
PetPartners is seeking a Claims Adjuster- Associate who will report to the Supervisor, Claims. The Claims Adjuster- Associate is responsible for investigating, evaluating, and settling insurance claims. This role also determines policy coverage for the claimed loss and appropriate compensation amount.
Job Location: Remote- USA
Main Responsibilities:
Works closely with veterinary hospitals, and policyholders to evaluate and review a pet's medical history to determine a baseline of health.
Investigates and processes assigned insurance claims, verifies coverage, and compensation amounts, per insurance policy.
Updates Explanation of Benefits (EOB), pays and closes claim.
May order medical records from providers.
May communicate with clients and providers during treatment.
Performs other duties and responsibilities as assigned.
Basic Qualifications:
1 year relevant experience working in a veterinary clinic
Education: Must meet one of the following requirements:
Associate's Degree or equivalent work experience (One-year relevant experience is equivalent to one year college); or
Certified Veterinary Technician (CVT)
Registered Veterinary Technician (RVT)
Licenses/Certifications
Must have and maintain Adjusters license or must obtain within 90 days of hire
Only United States residents will be considered for this role
Expected Hours of Work:
This is a full-time position: Days and hours to be determined by needs of business. Hours to be determined between employee and director.
#li-Remote
#PPI
All of our jobs come with great benefits including healthcare, parental leave and opportunities for career advancements. Some offerings are dependent upon the location of where you work and can include the following:
Comprehensive full medical, dental and vision Insurance
Basic Life Insurance at no cost to the employee
Company paid short-term and long-term disability
12 weeks of 100% paid Parental Leave
Health Savings Account (HSA)
Flexible Spending Accounts (FSA)
Retirement savings plan
Personal Paid Time Off
Paid holidays and company-wide Wellness Day off
Paid time off to volunteer at nonprofit organizations
Pet friendly office environment
Commuter Benefits
Group Pet Insurance
On the job training and skills development
Employee Assistance Program (EAP)
Auto-ApplyGeneral Liability Claims Adjuster
Remote telephone claims representative job
Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike.
We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can't wait to meet you.
About the role
We are seeking highly organized and customer-focused General Liability Adjuster to join our team. The successful candidate will be responsible for speaking to customers on the phone, educating and helping the customer work through their claim to the best possible outcome. Your role will also be responsible for handling an inventory of claims, triaging critical claims, and delivering service to all constituents of the claim.
The ideal candidate has a willingness to work through and design process that supports the quickest claim resolution with the best outcome. In addition, you will collaborate closely with our product and engineering teams to give feedback and identify technology and process improvements.
Who you are
Highly motivated and growth-oriented. You're excited by the prospect of building a tech-driven claims org.
Passionate adjuster who cares about the customer and their experience.
Empathetic. You exercise empathy and patience towards everyone you interact with.
Sense of urgency - at all times. That does not mean working at all hours.
Creative. You can find the right exit ramp (pun intended) for the resolution of the claim that is in the insured's best interest.
Conflict-enjoyer. Conflict does not have to be adversarial, but it HAS to be conversational.
Curious. You have to want to know the whole story so you can make the right decisions early and action them to a prompt resolution.
Anti-status quo. You don't just
wish
things were done differently, you
action
on it.
Communicative. (we'd love to know what this means to you)
And did we mention, you have a sense of humor. Claims are hard enough as it is.
What we need
Provide prompt, courteous and high-quality customer service to all policyholders and claimants by answering customer calls, filing claims, and resolving customer requests.
Gather necessary information from customers to initiate the claim and explain policy,coverage, and appropriate course of action.
Manage an inventory of claims, establish initial reserves for all potential exposures, and adjust as appropriate throughout the claim.
Coordinate the repair of damaged vehicles and assist with rental reimbursement.
Recognize recovery opportunities in regards to subrogation and salvage, as well as total loss.
Ensure compliance with specific state regulations, policy provisions, and standard operating procedures.
Communicate with involved parties and negotiate appropriate settlements with claimants, insureds, and attorneys within approved payment authority.
Provide input for continuous development of claims guidelines, best practices, and process improvements.
Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to resolve the claim.
Engage in learning opportunities to build knowledge of personal lines claims, court decisions impacting the claims function, current guidelines in claims function, and policy changes and modifications.
Requirements
Bachelor's degree. JD, Professional insurance designations strongly preferred.
Active adjuster license required: resident state license if available, otherwise a Designated Home State (DHS) license
Minimum of 5 years of experience ideally with;
General Liability (Premise, Habitational, Auto, Garagekeepers, BOP's, Dwelling)
Construction Liability.
Employers Liability.
Liquor Liability/Dram Shop.
Complex claims involving litigation.
Policy interpretation. Drafting Reservation of Rights letters, coverage declinations.
Third-party bodily injury.
Third-party litigated bodily injury/property damage.
Willing to obtain all licenses within 45 days, including completing state required testing
Knowledge of state regulations, policy provisions, and standard operating procedures
Ability to analyze and evaluate complex data and make sound decisions based on established guidelines, policies, and procedures
Curious and motivated by problem solving and questioning the status quo
Desire to engage in learning opportunities and continuous professional development
Ability to collaborate with colleagues within and outside your department
Willingness to travel for client and claims needs
Benefits
Generous health-insurance package with nationwide coverage, vision, & dental
401(k) retirement plan with employer matching
Competitive PTO policy - we want our employees fresh, healthy, happy, and energized!
Generous family leave policy
Work from anywhere to facilitate your work life balance paired with frequent, regular corporate retreats to build team cohesion, reinforce culture, and have fun
Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!
At Reserv, we value diversity and believe that a variety of perspectives leads to innovation and success. We are actively seeking candidates who will bring unique perspectives and experiences to our team and welcome applicants from all backgrounds. If you believe you are a good fit for this role, we would love to hear from you!
Auto-ApplyMedical Only Claims Adjuster (Workers' Compensation) | GA, SC, NC, VA
Remote telephone claims representative job
Medical Only Claims Adjuster (Workers' Compensation) | 100% Remote Opportunity (covering the states of - GA, SC, NC, and VA)
Must have experience in one or more of the following states: Georgia, South Carolina, North Carolina, Virginia
General Summary
Using claims system automation and capabilities, the Medical Only Claims Adjuster is responsible for timely and accurate management of a high volume of workers' compensation claims requiring minor or simple medical treatment and escalating them or moving them efficiently to closure.
Essential Duties and Responsibilities
Receives and reviews information related to new claims involving no or minimal lost time from work.
Under direct supervision, may handle a small number of fast-track indemnity claims that have low exposure or complexity.
Communicate with injured workers, employers, and medical providers to obtain necessary additional information and evaluate claims for exceptions or escalations.
Confirms or determines coverage and compensability as needed within state statutes and claims best practices.
Reviews and responds to mail, emails, telephone calls and faxes from employers, providers, and injured workers within 24 hours.
Reviews and responds to mail, emails, telephone calls and faxes from employers, providers and injured workers.
Takes action to handle communication within established best practices and statutory requirements.
Maintains ongoing professional communications with all internal and external customers.
Accurately evaluates and pays benefits in compliance with statutory and company procedures and guidelines.
Files appropriate state forms, as needed.
Manages or coordinates medical treatment and communicates with providers in a timely manner to continue to move the claim forward.
Reviews medical bills and makes appropriate determinations.
Reviews case facts to identify and report fraud or abuse throughout the course of the claim.
Reviews claims for closure and proactively takes action to guide claims in that direction.
Other duties as assigned.
Requirements
Minimum of 1 year general office experience or equivalent combination of education and experience.
Minimum 6 months experience working in workers' compensation insurance environment or an equivalent combination of education and qualifying experience. Experience in one or more of the following states: - GA, SC, NC, and VA
Working knowledge of medical terminology
Excellent written and oral communication, customer service and telephone skills.
Knowledge of MS Office software and an imaged environment.
Demonstrated ability to understand and adhere to statutes, regulations, and company policies and practices.
Demonstrated skills in multi-tasking and prioritizing, adhering to deadlines and completing assignments.
Always conduct business with the highest standards of personal, professional and ethical conduct. Ability to maintain confidentiality.
Claims Insurance industry experience preferred.
Education / Certifications
If State Certification is required, must meet certification within the state mandated time frame.
AIC, ARM, or CPCU certification Preferred, not required
Must have High School Diploma or GED equivalent.
Work Environment:
Remote: This role is a remote (work from home (WFH)) opportunity, and only open to candidates currently located in the United States and able to work without sponsorship.
It requires a suitable space that provides a private and quiet workplace.
Expected Work Hours: Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.
Travel: May be required to travel to off-site location(s) to attend meetings, as necessary
Hourly Pay Rate: $20.00 - $26.00 and a comprehensive benefits package, please follow the link to our benefits page for details! *********************************************************
About EMPLOYERS
As a dynamic, fast-growing provider of workers' compensation insurance and services, we are seeking a goal-oriented individual willing to put their ideas to work!
We offer a positive, challenging work environment, combined with an opportunity to build your career as you help us grow our business, in innovative and imaginative ways that are uniquely EMPLOYERS!
Headquartered in Nevada, EMPLOYERS attributes its long-standing success to its most valuable resource, our employees across the United States. EMPLOYERS is known for the quality service and expertise we provide to our clients, and the exemplary work environment we provide for our employees.
We live and breathe our core values: Integrity, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment. These are the pillars that support how we do business with our clients as well as how we treat each other!
At EMPLOYERS, you'll discover an energetic environment that inspires top achievement. As “America's small business insurance specialist”, we have the resources, a solid reputation, and an expanding nationwide identity to enrich your work/life and enhance your career. #LI-Remote
Medical Only Claims Adjuster | California
Remote telephone claims representative job
Medical Only Workers' Compensation Claims Adjuster | 100% Remote Opportunity - California Must have experience in California Using claims system automation and capabilities, the Medical Only workers' compensation Claims Adjuster is responsible for timely and accurate management of a high volume of workers' compensation claims requiring minor or simple medical treatment and escalating them or moving them efficiently to closure.
Essential Duties and Responsibilities
* Receives and reviews information related to new work comp insurance claims involving no or minimal lost time from work. Under direct supervision, may handle a small amount of fast-track indemnity claims that have low exposure or complexity.
* Communicates with injured workers, employers, and medical providers to obtain necessary additional information and evaluate claims for exceptions or escalations.
* Confirms or determines coverage and compensability as needed within state statutes and claims best practices.
* Reviews and responds to mail, emails, telephone calls and faxes from employers, providers, and injured workers within 24 hours.
* Reviews and responds to mail, emails, telephone calls and faxes from employers, providers and injured workers. Takes action to handle communication within established best practices and statutory requirements. Maintains ongoing professional communications with all internal and external customers.
* Accurately evaluates and pays benefits in compliance with statutory and company procedures and guidelines. Files appropriate state forms, as needed.
* Manages or coordinates medical treatment and communicates with providers in a timely manner to continue to move the claim forward. Reviews medical bills and makes appropriate determinations.
* Reviews case facts to identify and report possible fraud or abuse throughout course of claim.
* Reviews claims for closure and proactively takes action to guide claims in that direction.
Requirements
* Minimum of 1 year general office experience or equivalent combination of education and experience.
* Excellent written and oral communication, customer service and telephone skills.
* Knowledge of MS Office software and an imaged environment.
* Demonstrated ability to understand and adhere to statutes, regulations and company policies and practices.
* Demonstrated skills in multi-tasking and prioritizing, adhering to deadlines and completing assignments.
* Conducts business at all times with the highest standards of personal, professional and ethical conduct. Ability to maintain confidentiality.
* Claims industry experience preferred.
* Working knowledge of medical or insurance terminology preferred.
Education:
* High school diploma or equivalent required.
Certification
* If State certification or license is required, must meet certification within
Work Environment:
* Remote: This role is a remote (work from home (WFH) opportunity, and only open to candidates currently located in the United States and able to work without sponsorship.
* It requires a suitable space that provides a private and quiet workplace.
* Expected Work Hours: Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.
* Travel: May be required to travel to off-site location(s) to attend meetings, as necessary
Salary Range: $20.00 - $26.00/hr and a comprehensive benefits package, please follow the link to our benefits page for details! *********************************************************
About EMPLOYERS
As a dynamic, fast-growing provider of workers' compensation insurance and services, we are seeking a goal-oriented individual willing to put their ideas to work!
We offer a positive, challenging work environment, combined with an opportunity to build your career as you help us grow our business, in innovative and imaginative ways that are uniquely EMPLOYERS!
Headquartered in Nevada, EMPLOYERS attributes its long-standing success to its most valuable resource, our employees across the United States. EMPLOYERS is known for the quality service and expertise we provide to our clients, and the exemplary work environment we provide for our employees.
We live and breathe our core values: Integrity, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment. These are the pillars that support how we do business with our clients as well as how we treat each other!
At EMPLOYERS, you'll discover an energetic environment that inspires top achievement. As "America's small business insurance specialist", we have the resources, a solid reputation and an expanding nationwide identity to enrich your work/life and enhance your career. #LI-Remote
Claims Clerk
Remote telephone claims representative job
About Us
All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 401k plan. Additional employee paid coverage options available.
Job Purpose
The Claims Clerk plays a vital role in supporting the claims team by handling daily administrative tasks, including reviewing and responding to claims portal messages, processing incoming faxes, and organizing documentation. This position ensures efficient communication and smooth workflow within the department, helping to maintain timely and accurate claims processing.
Duties and responsibilities
Monitor and respond to claims portal messages daily. Assist Customer Service department with portal registrations.
Process and categorize incoming claims-related faxes.
Assist with Claims related inquiries from other departments.
Requesting and reviewing medical records as needed for basic information to validate billing information.
Reviewing claims for required information, pending claims when necessary, maintaining a follow-up system, and updating and releasing pending claims when indicated.
Serve as a primary point of contact for providers, members, and internal staff regarding claims status, documentation requirements, and resolution steps.
Respond to inbound claims phone calls, emails, and portal inquiries in a professional and timely manner.
Provide clear explanations of claim outcomes, payment decisions, and next steps while maintaining a high level of customer service.
Research and resolve claim-related issues by gathering information, reviewing documentation, and escalating as needed.
Document all interactions in the system to ensure accurate records of customer communications and resolutions.
Must maintain an error accuracy of under 5%.
Support claims examiners and workflow projects.
Attend weekly or monthly departmental meetings and provide feedback when requested.
Complies with all Company and Department Policies and Procedures.
When needed assist in claims audit activities.
Support other departments as needed.
All other duties as assigned.
Qualifications
Experience in administrative support, claims processing, or a related field preferred.
Excellent communication skills including reports, correspondence, and verbal communications.
Experience with EZ-Cap and Encoder preferred.
Proficiency using Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe
Detail oriented and highly organized
Strong ability to multi-task, project management, and work in a fast-paced environment
Strong ability in problem-solving.
Ability to self-manage, strong time management skills.
Ability to work in an extremely confidential environment.
Must work well under pressure and deadlines.
Field Claims Adjuster
Telephone claims representative job in Columbus, OH
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
Remote Medical Claims Representative
Remote telephone claims representative job
At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.
For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
NTT DATA currently seeks a Remote **Medical Claims Representative** to join our team in **for a remote position** .
This is a US based, W-2 project. All candidates will be paid through NTT DATA only.
**Role Responsibilities**
**- Pay rate is $18.00**
-Processing of Professional claim forms files by provider
-Reviewing the policies and benefits
-Comply with company regulations regarding HIPAA, confidentiality, and PHI
-Abide with the timelines to complete compliance training of NTT Data/Client
-Work independently to research, review and act on the claims
-Prioritize work and adjudicate claims as per turnaround time/SLAs
-Ensure claims are adjudicated as per clients defined workflows, guidelines
-Sustaining and meeting the client productivity/quality targets to avoid penalties
-Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
-Timely response and resolution of claims received via emails as priority work
-Correctly calculate claims payable amount using applicable methodology/ fee schedule
**-Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities**
**-Time management with the ability to cope in a complex, changing environment**
**-Ability to communicate (oral/written) effectively in a professional office setting**
**Required Skills/Experience**
+ 1+ year(s) hands-on experience in **Healthcare Claims Processing**
+ **Previously performing - in P&Q work environment; work from queue; remotely**
+ 2+ year(s) using a computer with Windows applications using a keyboard, **navigating multiple screens and computer systems, and learning new software tools**
+ Key board skills and computer familiarity -
+ **Toggling back and forth between screens** /can you navigate multiple systems.
+ Working knowledge of MS office products - Outlook, MS Word and **MS-Excel** .
**Preferences**
Amisys &/or Xcelys Preferred
About NTT DATA:
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com.
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is **$18.00/hourly** . This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.
Mechanical Claims Adjuster
Telephone claims representative job in Westerville, OH
At APCO Holdings, home to trusted brands like EasyCare, GWC Warranty, and National Auto Care, we're redefining the automotive protection industry through trusted products, exceptional service, and people who care deeply about doing what's right. Our Mechanical Claims Adjusters are the engine that keeps our promise of service excellence running. In this role, you'll combine your mechanical know-how and customer service skills to help drivers get back on the road quickly, delivering the peace of mind our partners and customers expect.
What You'll Do
* Review and verify automotive mechanical breakdown claims for coverage, service history, and eligibility.
* Collaborate with repair facilities to approve covered repairs and negotiate fair parts and labor costs.
* Apply contract terms and make accurate repair cost calculations.
* Communicate decisions clearly, ensuring every customer interaction is handled with care, empathy, and professionalism.
* Manage your call queue efficiently while maintaining detailed and accurate claim documentation.
What You'll Bring
* High school diploma or equivalent (ASE or Manufacturer Certification is a plus!).
* Solid understanding of vehicle mechanical systems, repairs, and diagnostics.
* Strong communication and problem-solving skills.
* Computer proficiency and comfort working in a fast-paced environment.
* A caring, authentic approach that puts the customer first, always.
Why You'll Love Working Here
At APCO, we move with velocity, passion, and purpose. Our team lives by our core values:
* Invested - We believe in our mission, our team, and your growth.
* Authentic - We bring honesty and transparency to every interaction.
* Principled - We do the right thing, even when no one's watching.
* Caring - We act with empathy and respect for our customers and each other.
* Open - We embrace change and value every voice.
When you join APCO Holdings, you're not just taking a job, you're starting a career where your expertise, integrity, and drive make a real impact.
What We Offer
* Competitive compensation and career advancement opportunities.
* Comprehensive benefits package.
* Supportive, team-oriented culture.
* The opportunity to work with industry-leading automotive protection brands.
Join us and help shape the future of automotive protection, one claim, one customer, and one trusted interaction at a time.
Apply today to start your journey with APCO Holdings.
Independent Insurance Claims Adjuster in Springfield, Ohio
Telephone claims representative job in Springfield, OH
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
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Auto-Apply