Claim Specialist jobs at The Independent Traveler - 1603 jobs

To be considered, please apply through the link here. We are seeking an experienced and independent Insurance Claims Specialist with 7+ years of multi-line claims experience to manage and resolve claims across Marine Cargo, Property & Casualty, Automobile, Workers' Compensation, and Liability/Litigation. The role also supports contract reviews by assessing insurance-related provisions to ensure alignment with policy coverage and claims protocols. The ideal candidate will also provide support to the Insurance Manager and General Manager on special insurance projects as needed, contributing to broader departmental goals and demonstrating flexibility beyond core claims duties. ESSENTIAL JOB DUTIES: Manage the end-to-end claims process for: -Marine cargo/inland transit -Commercial property and general liability -Automobile (fleet and HNOA) -Workers' Compensation (“WC”) -Litigated liability claims, including bodily injury and third-party property damage Handle end-to-end claims for marine, property, liability, auto (fleet/HNOA), WC, and litigated matters including bodily injury and third-party property damage. Review policies to assess coverage, exclusions, deductibles, and retentions Coordinate with brokers, carriers, adjusters, and Internal legal counsel Support contract review by evaluating insurance clauses (limits, AI, Waiver of Subrogation) and identifying potential risk/coverage gaps Draft claim notifications and ensure compliance with policy timelines Provide loss history, reserve, and claim summaries to assist with renewal preparation Collaborate with Legal, MGC, and MAC BU Operations to resolve claims Participate in claim reviews and strategic discussions in recovery efforts Support the GM and Insurance Manager with special insurance-related projects as needed, and demonstrate flexibility in cross-functional assignments. MINIMUM EDUCATION REQUIREMENTS: Bachelor's degree in insurance or business-related fields or equivalent experience. MINIMUM EXPERIENCE AND CAPABILITY REQUIREMENTS: 7+ years of insurance claims experience across multiple P&C lines, including marine and litigated claims. Strong working knowledge of insurance policy language, ISO forms, and manuscript policies. Familiarity with contractual risk transfer principles and ability to analyze insurance-related clauses. Experience coordinating with external counsel and adjusters on complex/litigated claims. Proficiency in claims systems, Microsoft Word and Excel, and document management platforms. Technically skilled in both claims handling and policy interpretation. Detail-oriented with excellent judgment and risk awareness. Confident in reviewing contract language from an insurance perspective. Collaborative and able to communicate effectively with both technical and non-technical stakeholders. Able to manage competing priorities and operate independently. Must have the ability to work with deadlines and work in a fast-paced and dynamic work environment. Requires excellent written and verbal communication skills. Must be able to work in a multi-cultural business environment. JOB-RELATED CERTIFICATION: CPCU, ARM, or AIC designation preferred

ORGANIZATION DESCRIPTION Founded in 1965, the Chinese-American Planning Council, Inc. (CPC) aims to promote the social and economic empowerment of Chinese American, immigrant, and low-income communities. Today, CPC is the nation's largest Asian American social services agency and offers more than 50 programs at over 35 sites throughout New York City, including early childhood education, school-age care, youth services, workforce development, community services, and senior services. CPC strives to be the premier social service and leadership development organization. In 2017, CPC launched Advancing Our CommUNITY, its organization-wide strategy to expand services to address persistent needs and emerging trends and to improve leadership skills among staff and community members. In 2022, our core programs and emergency services reached 200,000 people living in all five boroughs and all 51 city council districts. In the summer of 2022, CPC was recognized as the number one Chinese American organization in New York City to recommend to a Chinese immigrant looking for in-language and culturally competent resources according to a recent survey. This accomplishment is a testament to the incredible work and dedication of our staff. (For more information, please visit: ************************* PROGRAM SUMMARY Funded through the NYC Department of Youth and Community Development (DYCD), the CPC Beacon Community Center at John J. Pershing I.S. 220 serves youth, adults, and families in the Sunset Park neighborhood. The center's goal is to deliver a multitude of services for local community members by creating an inclusive atmosphere that promotes cultural awareness, active engagement, leadership, and advocacy skills acquisition, and empowers individuals to ultimately become self-sufficient. JOB SUMMARY Reporting to the Beacon Director, the part-time Dance Specialist will have a strong background in dance, excellent teaching skills, and a commitment to helping students achieve their full potential. This role involves teaching dance classes, creating engaging lesson plans, and contributing to a positive and inclusive atmosphere. This position is from September 2025 until the end of the school year in June 2026. ESSENTIAL RESPONSIBILITIES Instruct students of various ages and skill levels in different dance styles. Create and implement engaging and age-appropriate lesson plans and choreography. Provide constructive feedback and encouragement to help students develop their dance skills. Organize and rehearse routines for community shows and recitals. Ensure a safe, clean, and welcoming environment for students and staff. Work closely with other teaching artists and staff to support the program goals and initiatives. Communicate with parents on students' progress and address any concerns Update Director on unit progress and address any concerns or questions. Other program duties as determined by the Director QUALIFICATIONS Education and Experience: Relevant certifications or a degree in Dance Education, Performing Arts, or a related field is a plus. Extensive training and experience in one or more dance styles (ballet, jazz, hip-hop, contemporary, etc.). Experience teaching dance, preferably in a studio or educational setting. Experience as a performer in professional dance setting. Skills and Competencies: Passion for dance and a genuine interest in teaching and inspiring students. Strong organizational and time-management abilities. Innovative and creative approach to choreography and teaching. COMPENSATION & BENEFITS OVERVIEW $25.00 -$30.00 per hour; 10-16 hours per week with occasional evenings and weekends until June 2026 CPC offers eligible part-time staff members mandatory benefits, including paid New York State sick time HOW TO APPLY Interested individuals should submit their resume, along with a cover letter addressed to Omar Roberts, when applying online via CPC's website: **************************** or selected online job boards. All documents should be submitted as one single file. Applicants may reach out to ******************* with any questions or further inquiries. CPC is an Equal Opportunity Employer. CPC values a diverse, equitable, and inclusive workplace and strongly encourages women, BIPOC, immigrants, LGBTQ+, individuals with disabilities, and veterans to apply.

Summary/ObjectiveAssists in administrating and coordinating motor vehicle fleet operations. Understands OSHA, DOT, fleet-specific regulations, licensing, registration, and reporting requirements. Prepares and maintains accurate records of vehicles, insurance, and required regulatory filings and reporting. Coordinates repairs and preventative maintenance scheduling that support fleet vehicle availability requirements. May assist with safety training and communication programs. May require an associate degree or equivalent. Typically reports to a supervisor. Works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. Typically requires 1-3 years of related experience. Key Responsibilities/ Job Duties: Samsara System Installation & Maintenance Install, configure, and troubleshoot Samsara GPS, cameras, and telematics hardware on all leased/rental trucks and trailers. Ensure 100% system uptime for fleet tracking and compliance. Minor Truck Repairs Repair/replace mudflaps, headlights, taillights, wipers, mirrors, and other DOT-compliant components when necessary. Conduct pre-trip and post-trip inspections; document and escalate any repairs to Fleet Supervisor. Install secure, adjustable cell phone mounts in driver cabs of all company leased vehicles. Route charging cables neatly and ensure hands-free compliance. Hand Truck Maintenance Inspect, lubricate, repair, and replace wheels, axles, handles, and frames on all handtrucks. Ensure hand trucks are load-rated, safe, and ready for daily driver use. Occasional Stock Pickup & Customer Deliveries Use company vehicle (Class B required) to pick up stock from local warehouses or deliver time-sensitive customer orders when drivers are unavailable. Fleet Record-Keeping Log all repairs, PM services, Samsara installs, and cell phone mount installs into Fleet Master Log. Review daily DVIR using Samsara Fleet program and address unresolved concerns. Update DOT inspection reports, odometer readings, and inspection due list. Assist Fleet Supervisor with monthly compliance audits. Required, Education and Experience: Education High school diploma or G.E.D. required Experience Valid CDL with clean driving record. 2+ years of light/medium-duty truck repair experience (box trucks, reefers, straight trucks). Proficiency with basic hand tools. Experience installing Samsara telematics and cell phone mounts. Familiarity with fleet DOT and OSHA compliance. Physical Requirements:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee is occasionally required to sit; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 75 pounds and lift and/or move up to 50 pounds on an infrequent basis. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Language Skills:Ability to read, write and speak fluently in English. Reasoning Ability:Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form.Work EnvironmentWhile performing the duties of this job, the employee frequently works in outside weather conditions. The employee is occasionally exposed to wet and/or humid conditions, fumes or airborne particles, toxic or caustic chemicals and vibration. Position Type and Expected Hours of WorkThe employee must work 40 hours per week, including weekends and holidays. TravelNo travel is expected for this position. Other DutiesPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. #LI-CT1 #ZR #IND1

Eligible candidates for this role should reside within a commutable distance of Saginaw, Michigan. Saginaw Michigan Field Property Claim Specialist - AAA Auto Club Group Reports to: Claim Manager II What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates. Supervisory Responsibilities: None How you will benefit: A competitive annual salary between $65,700 - $82,000 ACG offers excellent and comprehensive benefits packages, including: Medical, dental and vision benefits 401k Match Paid parental leave and adoption assistance Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays Paid volunteer day annually Tuition assistance program, professional certification reimbursement program and other professional development opportunities AAA Membership Discounts, perks, and rewards and much more We're looking for candidates who: Required Qualifications (these are the minimum requirements to qualify) Education: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent CPCU coursework or designation Xactware Training Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience. In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. Must have a valid State Driver's License Ability to: Lift up to 25 pounds Climb ladders. Walk on roofs. Experience: Three years of experience or equivalent training in the following: Negotiation of claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Handling simple litigation Advanced knowledge of building construction and repair techniques Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG Claim policies, procedures and guidelines Work within assigned ACG Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision-making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. Research analyze and interpret subrogation laws in various states May travel outside of assigned territory which may involve overnight stay Preferred Qualifications:Education: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent CPCU coursework or designation Xactware/Xactimate Training or equivalent Work EnvironmentThis position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

As a Claims Specialist, you will facilitate communications between contract carriers, insurance, and customers. You'll also review property damage claims and resolve the claims. On our team, you'll have the support to excel at work and the resources to build a career you can be proud of. RESPONSIBILITIES * Facilitate Claims Communications between multiple stakeholders. * Ability to manage conflict scenarios effectively and professionally. * Review claims within prescribed limits of authority. * Examine claims forms and other records to confirm coverage for loss or damage * Issue payments in a timely manner, in accordance with policy conditions * Effectively negotiate settlements with contractors QUALIFICATIONS At a minimum, you'll need: * 1 year experience in Customer Service/Data Entry or other similar roles It'd be great if you also have: * Basic knowledge of Microsoft Office and Windows applications * Knowledge of transportation industry * Ability to confidently resolve issues. * Solid written communication skills with excellent attention to detail and accuracy Category Code: JN003 #LI-AD1

UNITE HERE HEALTH serves 200,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity! The Claims Supervisor will oversee the claims production team who is scanning, uploading and keying in UNITE HERE HEALTH's member's and dependent's medical, vision, dental and short-term disability claims related correspondence. This position is responsible for the accuracy and timeliness of handling of claims and member correspondence based on the guidelines set forth by the Department of Labor. The Claims Supervisor is responsible for partnering with internal and external parties to ensure that the turnaround times are met, which includes, but is not limited to the BlueCross and BlueShield incentive. This position is relied upon as a subject matter expert for creating and updating provider records, Coordination of Benefits provisions and eligibility-related inquiries within the Department; this includes providing support to the Legal Team as it relates to subrogation files. The Claims Supervisor supports the production team through functions in collaboration and coordination with other teams, including New Membership, Member Services and C&E teams. To provide daily support to the Claims Department through updates to members COB information and providers records in the claims processing system. This position provides development, training, and coaching to employees for guidance and direction to ensure that a high level of accountability and performance is delivered to our participants. ESSENTIAL JOB FUNCTIONS AND DUTIES * Provides leadership, motivates, advocates, coaches and develops team performance and promotes Fund culture/mission along with advocating for appropriate change with a positive attitude * Holds direct reports accountable for individual performance, which may result in disciplinary action * Promotes operational efficiency and quality by critically analyzing team processes with the intention of improving member experience and creating a high level of consistency in the team's quality and production results. * Manages and reports on team inventory to ensure that departmental metrics are met * Successfully investigates and responds to escalated inquiries from internal and external sources * Allocates and cross trains team resources to complete goals * Assists in training to other UHH operational areas * Collaborates and partners with other Claims Department Supervisors to ensure consistency in processing across all teams and to identify ways to be BETTER, more efficient, adaptable and participant focused * Ensures adherence to policies and procedures are consistently applied * Assists in the design and preparation of management reports * Collaborates with the Legal team to understand legal regulations and plan provisions * Demonstrates necessary competence in technical, industry standard and soft skills to effectively support and develop staff * Communicates with Executive Leadership through creation of the monthly Claims Department Dashboard. * Interacts with members and UHH operational areas to resolve complex issues * Interacts with members and UHH operational areas to educate regarding policies and procedures * Strictly adheres to all regulatory and legal requirements, including time deadlines * Ensures members Coordination of Benefits information is accurately and consistently updated and maintained * Oversees the creation and maintenance of provider records for accuracy and claim payments, as well as, annual 1099 reporting to IRS * Demonstrates personal accountability for personal actions as well as team and departmental results through ensuring claims and correspondence are handled in accordance with the guidelines set forth by the DOL and our internal Claims Policy Committee * Plans, analyzes, and evaluates programs and services, operational needs, and fiscal constraints * Supervises, leads, and delegates work and coaches, mentors, develops employees * Analyzes problems, identifies and develops alternative solutions, projects consequences of proposed actions and implements recommendation/solutions * Recommends hires and promotions, directs and evaluates employment decisions for all assigned positions * Assists with developing and coordinating policies and procedures * Responsible for the oversight of continued employee training requirements, safety and quality initiatives ESSENTIAL QUALIFICATIONS: * Bachelor's degree in related field or equivalent work experience required * 4 ~ 6 years of direct experience minimum * 3 ~ 5 years of supervisory experience required * Preferred fluency (speak and write) in Spanish * Intermediate level Microsoft Office and Excel skills * Professional level training that provides working knowledge of: * Administration of welfare plan benefits * High degree of Claims Processing Knowledge * Understanding of Medicare, Medicaid, ACA, DOL regulations, ERISA and HIPAA * Audit and billing procedures * Plan documents and summary plan descriptions * Vendor relations * Eligibility rules Salary range for this position: Salary $70,500- $88,200. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule: Monday~Friday, 7.5 hours per day (37.5 hours per week) as a flexible hybrid (mostly work from home) opportunity with quarterly (approx.) in-office time. We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Short- & Long-term Disability, Pension, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). #LI-REMOTE #LI-LY-3

U NITE HERE HEALTH serves 200,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity! The Claims Supervisor will oversee the claims production team who is scanning, uploading and keying in UNITE HERE HEALTH's member's and dependent's medical, vision, dental and short-term disability claims related correspondence. This position is responsible for the accuracy and timeliness of handling of claims and member correspondence based on the guidelines set forth by the Department of Labor. The Claims Supervisor is responsible for partnering with internal and external parties to ensure that the turnaround times are met, which includes, but is not limited to the BlueCross and BlueShield incentive. This position is relied upon as a subject matter expert for creating and updating provider records, Coordination of Benefits provisions and eligibility-related inquiries within the Department; this includes providing support to the Legal Team as it relates to subrogation files. The Claims Supervisor supports the production team through functions in collaboration and coordination with other teams, including New Membership, Member Services and C&E teams. To provide daily support to the Claims Department through updates to members COB information and providers records in the claims processing system. This position provides development, training, and coaching to employees for guidance and direction to ensure that a high level of accountability and performance is delivered to our participants. ESSENTIAL JOB FUNCTIONS AND DUTIES Provides leadership, motivates, advocates, coaches and develops team performance and promotes Fund culture/mission along with advocating for appropriate change with a positive attitude Holds direct reports accountable for individual performance, which may result in disciplinary action Promotes operational efficiency and quality by critically analyzing team processes with the intention of improving member experience and creating a high level of consistency in the team's quality and production results. Manages and reports on team inventory to ensure that departmental metrics are met Successfully investigates and responds to escalated inquiries from internal and external sources Allocates and cross trains team resources to complete goals Assists in training to other UHH operational areas Collaborates and partners with other Claims Department Supervisors to ensure consistency in processing across all teams and to identify ways to be BETTER, more efficient, adaptable and participant focused Ensures adherence to policies and procedures are consistently applied Assists in the design and preparation of management reports Collaborates with the Legal team to understand legal regulations and plan provisions Demonstrates necessary competence in technical, industry standard and soft skills to effectively support and develop staff Communicates with Executive Leadership through creation of the monthly Claims Department Dashboard. Interacts with members and UHH operational areas to resolve complex issues Interacts with members and UHH operational areas to educate regarding policies and procedures Strictly adheres to all regulatory and legal requirements, including time deadlines Ensures members Coordination of Benefits information is accurately and consistently updated and maintained Oversees the creation and maintenance of provider records for accuracy and claim payments, as well as, annual 1099 reporting to IRS Demonstrates personal accountability for personal actions as well as team and departmental results through ensuring claims and correspondence are handled in accordance with the guidelines set forth by the DOL and our internal Claims Policy Committee Plans, analyzes, and evaluates programs and services, operational needs, and fiscal constraints Supervises, leads, and delegates work and coaches, mentors, develops employees Analyzes problems, identifies and develops alternative solutions, projects consequences of proposed actions and implements recommendation/solutions Recommends hires and promotions, directs and evaluates employment decisions for all assigned positions Assists with developing and coordinating policies and procedures Responsible for the oversight of continued employee training requirements, safety and quality initiatives ESSENTIAL QUALIFICATIONS: Bachelor's degree in related field or equivalent work experience required 4 ~ 6 years of direct experience minimum 3 ~ 5 years of supervisory experience required Preferred fluency (speak and write) in Spanish Intermediate level Microsoft Office and Excel skills Professional level training that provides working knowledge of: Administration of welfare plan benefits High degree of Claims Processing Knowledge Understanding of Medicare, Medicaid, ACA, DOL regulations, ERISA and HIPAA Audit and billing procedures Plan documents and summary plan descriptions Vendor relations Eligibility rules Salary range for this position: Salary $70,500- $88,200. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule: Monday~Friday, 7.5 hours per day (37.5 hours per week) as a flexible hybrid (mostly work from home) opportunity with quarterly (approx.) in-office time. We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Short- & Long-term Disability, Pension, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). #LI-REMOTE #LI-LY-3

Job Description UNITE HERE HEALTH serves 200,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity! The Claims Supervisor will oversee the claims production team who is scanning, uploading and keying in UNITE HERE HEALTH's member's and dependent's medical, vision, dental and short-term disability claims related correspondence. This position is responsible for the accuracy and timeliness of handling of claims and member correspondence based on the guidelines set forth by the Department of Labor. The Claims Supervisor is responsible for partnering with internal and external parties to ensure that the turnaround times are met, which includes, but is not limited to the BlueCross and BlueShield incentive. This position is relied upon as a subject matter expert for creating and updating provider records, Coordination of Benefits provisions and eligibility-related inquiries within the Department; this includes providing support to the Legal Team as it relates to subrogation files. The Claims Supervisor supports the production team through functions in collaboration and coordination with other teams, including New Membership, Member Services and C&E teams. To provide daily support to the Claims Department through updates to members COB information and providers records in the claims processing system. This position provides development, training, and coaching to employees for guidance and direction to ensure that a high level of accountability and performance is delivered to our participants. ESSENTIAL JOB FUNCTIONS AND DUTIES Provides leadership, motivates, advocates, coaches and develops team performance and promotes Fund culture/mission along with advocating for appropriate change with a positive attitude Holds direct reports accountable for individual performance, which may result in disciplinary action Promotes operational efficiency and quality by critically analyzing team processes with the intention of improving member experience and creating a high level of consistency in the team's quality and production results. Manages and reports on team inventory to ensure that departmental metrics are met Successfully investigates and responds to escalated inquiries from internal and external sources Allocates and cross trains team resources to complete goals Assists in training to other UHH operational areas Collaborates and partners with other Claims Department Supervisors to ensure consistency in processing across all teams and to identify ways to be BETTER, more efficient, adaptable and participant focused Ensures adherence to policies and procedures are consistently applied Assists in the design and preparation of management reports Collaborates with the Legal team to understand legal regulations and plan provisions Demonstrates necessary competence in technical, industry standard and soft skills to effectively support and develop staff Communicates with Executive Leadership through creation of the monthly Claims Department Dashboard. Interacts with members and UHH operational areas to resolve complex issues Interacts with members and UHH operational areas to educate regarding policies and procedures Strictly adheres to all regulatory and legal requirements, including time deadlines Ensures members Coordination of Benefits information is accurately and consistently updated and maintained Oversees the creation and maintenance of provider records for accuracy and claim payments, as well as, annual 1099 reporting to IRS Demonstrates personal accountability for personal actions as well as team and departmental results through ensuring claims and correspondence are handled in accordance with the guidelines set forth by the DOL and our internal Claims Policy Committee Plans, analyzes, and evaluates programs and services, operational needs, and fiscal constraints Supervises, leads, and delegates work and coaches, mentors, develops employees Analyzes problems, identifies and develops alternative solutions, projects consequences of proposed actions and implements recommendation/solutions Recommends hires and promotions, directs and evaluates employment decisions for all assigned positions Assists with developing and coordinating policies and procedures Responsible for the oversight of continued employee training requirements, safety and quality initiatives ESSENTIAL QUALIFICATIONS: Bachelor's degree in related field or equivalent work experience required 4 ~ 6 years of direct experience minimum 3 ~ 5 years of supervisory experience required Preferred fluency (speak and write) in Spanish Intermediate level Microsoft Office and Excel skills Professional level training that provides working knowledge of: Administration of welfare plan benefits High degree of Claims Processing Knowledge Understanding of Medicare, Medicaid, ACA, DOL regulations, ERISA and HIPAA Audit and billing procedures Plan documents and summary plan descriptions Vendor relations Eligibility rules Salary range for this position: Salary $70,500- $88,200. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule: Monday~Friday, 7.5 hours per day (37.5 hours per week) as a flexible hybrid (mostly work from home) opportunity with quarterly (approx.) in-office time. We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Short- & Long-term Disability, Pension, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). #LI-REMOTE #LI-LY-3

UNITE HERE HEALTH serves 190,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity! The Claims Adjudicator II position will receive, examine, verify and input submitted claim data, determine eligibility status, and review and adjudicate claims within established timeframes. This position utilizes multiple systems in order to perform the day-to-day functions of processing medical, disability, vision and dental claims, as well as, provider and member driven inquiries. ESSENTIAL JOB FUNCTIONS AND DUTIES * Screens claims for completeness of necessary information * Verifies participant/dependent eligibility * Interprets the plan benefits from the Summary Plan Description (SPD)/Plan Documents * Codes basic information and selects codes to determine payment liability amount * Evaluates diagnoses, procedures, services, and other submitted data to determine the need for further investigation in relation to benefit requirements, accuracy of the claim filed, and the appropriateness or frequency of care rendered * Determines the need for additional information or documentation from participants, employers, providers and other insurance carriers * Handles the end to end process of Medicare Secondary Payer (MSP) files * Processes Personal Injury Protection (PIP) claims * Requests overpayment refunds, maintains corresponding files and performs follow-up actions * Handles verbal and written inquiries received from internal and external customers * Processes Short Term Disability claims * Adjudicates claims according to established productivity and quality goals * Achieve individual established goals in order to meet or exceed departmental metrics ESSENTIAL QUALIFICATIONS * 3 ~ 5 years of direct experience minimum in a medical claim adjudication environment * Working knowledge and experience in interpretation of benefit plans, including an understanding of limitations, exclusions, and schedule of benefits * Experience with eligibility verification, medical coding, coordination of benefits, and subrogation and it's related processes * Experience with medical terminology, ICD10 and Current Procedural Technology (CPT) codes * Fluency (speak and write) in Spanish, preferred Salary range for this position: Hourly $20.36 - $24.97. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) Fully Remote, after 1-week training onsite in Oak Brook, IL. (Travel and Lodging paid for by UHH) We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). #Remote

Job Description UNITE HERE HEALTH serves 190,000+ workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity! The Claims Adjudicator II position will receive, examine, verify and input submitted claim data, determine eligibility status, and review and adjudicate claims within established timeframes. This position utilizes multiple systems in order to perform the day-to-day functions of processing medical, disability, vision and dental claims, as well as, provider and member driven inquiries. ESSENTIAL JOB FUNCTIONS AND DUTIES Screens claims for completeness of necessary information Verifies participant/dependent eligibility Interprets the plan benefits from the Summary Plan Description (SPD)/Plan Documents Codes basic information and selects codes to determine payment liability amount Evaluates diagnoses, procedures, services, and other submitted data to determine the need for further investigation in relation to benefit requirements, accuracy of the claim filed, and the appropriateness or frequency of care rendered Determines the need for additional information or documentation from participants, employers, providers and other insurance carriers Handles the end to end process of Medicare Secondary Payer (MSP) files Processes Personal Injury Protection (PIP) claims Requests overpayment refunds, maintains corresponding files and performs follow-up actions Handles verbal and written inquiries received from internal and external customers Processes Short Term Disability claims Adjudicates claims according to established productivity and quality goals Achieve individual established goals in order to meet or exceed departmental metrics ESSENTIAL QUALIFICATIONS 3 ~ 5 years of direct experience minimum in a medical claim adjudication environment Working knowledge and experience in interpretation of benefit plans, including an understanding of limitations, exclusions, and schedule of benefits Experience with eligibility verification, medical coding, coordination of benefits, and subrogation and it's related processes Experience with medical terminology, ICD10 and Current Procedural Technology (CPT) codes Fluency (speak and write) in Spanish, preferred Salary range for this position: Hourly $20.36 - $24.97. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) Fully Remote, after 1-week training onsite in Oak Brook, IL. (Travel and Lodging paid for by UHH) We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). #Remote

***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. *** Claim Specialist - Bodily Injury - The Auto Club Group Reports to: APD Claim Manager I What you will do: (Primary Duties & Responsibilities) ACG is seeking a prospective Claim Specialist to work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims In this position, you will: Handle highly complex new and reassigned auto and homeowner bodily injury liability claims. Adhere to ACG claim handling procedures, processes and guidelines. Complete coverage and liability investigations, including obtaining statements from involved parties. Obtain required documents and reports to complete coverage and liability investigations. Set expectations, ensuring the claim process is explained and understood. Complete complex coverage analysis. Identify additional exposures, create appropriate referrals for additional claims and subclaims. Conduct thorough reviews of liability, damages, and the applicability of state law. Evaluate settlement range value, prepare documents related to reserve, settlement and settlement authority. Negotiate settlements with attorney represented and non-represented parties. Utilize strong negotiation skills. Prepare legal releases. Authorize expense and indemnity payments. Complete referrals, when required, to underwriting, recovery, CSIU, large loss unit and HRCC. Document claim file memos, upload documents to claim file, complete claim coding. Present claim matters during meetings. Collaborate with legal team. Provide peer mentoring. Assist Management with special reports, projects, task. Handling policies within the following States: Illinois, Indiana, Georgia and/or Tennessee With our powerful brand and the mentoring, we offer, you will find your position as a Claims Specialist can lead to a rewarding career at our growing organization. How you will benefit: Claim Specialist will earn a competitive salary of $ 75,000 - $95,000 annually with an annual bonus potential based on performance. Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include: 401k Match Medical Dental Vision PTO Paid Holidays Tuition Reimbursement We're looking for candidates who: (Preferred/Required Qualifications) Education: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent CPCU coursework or designation Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members Experience: Three years of experience or equivalent training in the following: negotiation of claim settlements securing and evaluating evidence preparing manual and electronic estimates subrogation claims resolving coverage questions taking statements establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims subrogation procedures and processes intercompany arbitration handling simple litigation Negligence Law No-Fault Law medical terminology and human anatomy Ability to: handle claims to the line Claim Handling Standards follow and apply ACG Claim policies, procedures and guidelines work within assigned ACG Claim systems including basic PC software perform basic claim file review and investigations demonstrate effective communication skills (verbal and written) demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns analyze and solve problems while demonstrating sound decision-making skills prioritize claim related functions process time sensitive data and information from multiple sources manage time, organize and plan workload and responsibilities safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. research analyze and interpret subrogation laws in various states travel outside of assigned territory which may involve overnight stay relocate, work evenings or weekends Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. *** Claim Specialist - Bodily Injury - The Auto Club Group Reports to: Casualty Claim Manager II What you will do: (Primary Duties & Responsibilities) ACG is seeking a prospective Claim Specialist to work under minimal supervision. In this position, you will: Handle highly complex new and reassigned auto and homeowner bodily injury liability claims. Adhere to ACG claim handling procedures, processes and guidelines. Complete coverage and liability investigations, including obtaining statements from involved parties. Obtain required documents and reports to complete coverage and liability investigations. Set expectations, ensuring the claim process is explained and understood. Complete complex coverage analysis. Identify additional exposures, create appropriate referrals for additional claims and subclaims. Conduct thorough reviews of liability, damages, and the applicability of state law. Evaluate settlement range value, prepare documents related to reserve, settlement and settlement authority. Negotiate settlements with attorney represented and non-represented parties. Utilize strong negotiation skills. Prepare legal releases. Authorize expense and indemnity payments. Complete referrals, when required, to underwriting, recovery, SCIU, large loss unit and HRCC. Document claim file memos, upload documents to claim file, complete claim coding. Present claim matters during meetings. Collaborate with legal team. Provide peer mentoring. Assist Management with special reports, projects, task. With our powerful brand and the mentoring, we offer, you will find your position as a Claims Specialist can lead to a rewarding career at our growing organization. How you will benefit: Claim Specialist will earn a competitive salary of $75,000 to $85,000 annually with an annual bonus potential based on performance. Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include: 401k Match Medical Dental Vision PTO Paid Holidays Tuition Reimbursement We're looking for candidates who: Education: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent CPCU coursework or designation Required Qualifications: Education: Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. Must have a valid State Driver's License Experience: Three years of experience or equivalent training in the following: negotiation of claim settlements securing and evaluating evidence subrogation claims resolving coverage questions taking statements establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims subrogation procedures and processes intercompany arbitration handling simple litigation Advanced knowledge of: Negligence Law No-Fault Law medical terminology and human anatomy Ability to: handle claims to the line Claim Handling Standards follow and apply ACG Claim policies, procedures and guidelines work within assigned ACG Claim systems including basic PC software perform basic claim file review and investigations demonstrate effective communication skills (verbal and written) demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns analyze and solve problems while demonstrating sound decision making skills prioritize claim related functions process time sensitive data and information from multiple sources manage time, organize and plan work load and responsibilities safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. research analyze and interpret subrogation laws in various states travel outside of assigned territory which may involve overnight stay relocate, work evenings or weekends Work Environment This is a hybrid work arrangement (time spent in office and remote). Depending on the employee's role and leadership's assessment, some employees will come in to an ACG facility on a weekly basis, a monthly basis, or on an "as needed" basis for key meetings and collaborative activities. Most employees will be required to come into the office, at a minimum, for important departmental meetings or teambuilding events. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

Crystal Stairs, Inc. Improving the Lives of Families through Child Care Services, Research, and Advocacy Crystal Stairs is committed to building and sustaining a diverse workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin, disability, marital status, sexual orientation, or military status, in any of activities or operations. Provider Services - Claims Processor 100% Onsite - Location: Los Angeles, CA 90056 What We're Looking For: We are seeking a qualified candidate for the Claims Processor position. The Claims Processor will provide excellent client service by accurately processing provider claims in a timely manner while adhering to the contractual requirements of the California Department of Education and LA County Department of Public Social Services as well as Crystal Stairs, Inc. policies and procedures. The selected qualified candidate will have the following responsibilities: RESPONSIBILITIES: * Process attendance records and provider payment requests in accordance with department quality standards based upon the funder's payment rules and regulations in addition to the agency's policies. * Effectively communicate with providers, parents, and CSI staff, as needed. * Assist parents, providers, and staff in completing attendance records and\/ or provider payment requests by responding to incoming inquiries regarding payment or claims submission. * Communicate with case managers to resolve payment authorization issues on pending claims. * Contribute to a team atmosphere by participating in monthly staff meetings, training, and assisting department co-workers as needed. * Other duties as assigned. EXPERIENCE, KNOWLEDGE, SKILLS AND ABILITIES YOU SHOULD POSSESS: * High School Diploma or GED Equivalent required. An AA\/AS Degree in Accounting, Business, or Human Services preferred\/or a minimum of two years of verifiable college coursework with a focus on accounting or business; verifiable work experience may be substituted for college level education * Minimum of two years experience processing claims, billing or adjustment payments required. Experience in an entry level accounting role preferred. * Experience with child care providers and parents receiving subsidized child or social support services preferred. * Must have Knowledge of the Department of Public Social Service Stage 1 Child Care Services Contract or CDE Alternative Payment Program or experience working with social support services preferred. * Must have strong customer service, organization, written and verbal communication skills. * Requires excellent data entry and processing skills within a fast paced environment. * Requires considerable accuracy, attention to details and ability to adhere to strict processing deadlines. * Must be flexible and possess a strong ability to multi-task while working in a collaborative, team environment. * Must have the ability to perform basic mathematical computations to verify and confirm payment calculations. * Must have ability to work with diverse groups. * Must have technical proficiencies working with Microsoft Excel and Microsoft Word * Ability to understand and master complex program requirements and processes as they relate to provider payment * Able to work flexible hours as needed to complete required tasks in a timely manner. Overtime may be required to assure timely and compliant processing of provider payments; and * Able to work under pressure and with time-sensitive deadlines. Total Package of Benefits * Medical\/ Dental\/ Vision - 95% paid by employer * Pet Insurance * Employee Assistance Program * Voluntary Life and AD&D for Employee, Spouse and Children * 401k Matching Options * Flex Spending (Health Care and Dependent Care) * Mutual of Omaha (STD, Accident, & Critical Illness) * Generous Sick and Vacation Time * Paid Holidays + Paid Winter Break from 12\/24 - 1\/1 (for select positions) * Opportunity for Growth and Development * Robust Learning Management System offering the following continuing education units: PDC, HRCI, CEU, CPE, PDU, SHRM Qualified applicants with arrest or conviction records will be considered for Employment in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Crystal Stairs, Inc. is committed to building and sustaining a fully vaccinated, diverse workforce and culture. As part of this commitment, Crystal Stairs, Inc. provides equal opportunity in all of our employment practices, including selection, hiring, promotion, transfer, and compensation, to all qualified applicants and employees without regard to race, color, medical condition as defined by state law, ancestry, religion, sex, national origin, age, marital status, sexual orientation, gender, ethnic group identification, mental or physical disability, pregnancy, childbirth and related medical conditions, or any other legally protected status. For more information about Crystal Stairs, please visit our website at: *******************************************************

Crystal Stairs, Inc. Improving the Lives of Families through Child Care Services, Research, and Advocacy Crystal Stairs is committed to building and sustaining a diverse workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin, disability, marital status, sexual orientation, or military status, in any of activities or operations. Provider Services - Claims Processor 100% Onsite - Location: Los Angeles, CA 90056 What We're Looking For: We are seeking a qualified candidate for the Claims Processor position. The Claims Processor will provide excellent client service by accurately processing provider claims in a timely manner while adhering to the contractual requirements of the California Department of Education and LA County Department of Public Social Services as well as Crystal Stairs, Inc. policies and procedures. The selected qualified candidate will have the following responsibilities: RESPONSIBILITIES: Process attendance records and provider payment requests in accordance with department quality standards based upon the funder's payment rules and regulations in addition to the agency's policies. Effectively communicate with providers, parents, and CSI staff, as needed. Assist parents, providers, and staff in completing attendance records and/ or provider payment requests by responding to incoming inquiries regarding payment or claims submission. Communicate with case managers to resolve payment authorization issues on pending claims. Contribute to a team atmosphere by participating in monthly staff meetings, training, and assisting department co-workers as needed. Other duties as assigned. EXPERIENCE, KNOWLEDGE, SKILLS AND ABILITIES YOU SHOULD POSSESS: High School Diploma or GED Equivalent required. An AA/AS Degree in Accounting, Business, or Human Services preferred/or a minimum of two years of verifiable college coursework with a focus on accounting or business; verifiable work experience may be substituted for college level education Minimum of two years experience processing claims, billing or adjustment payments required. Experience in an entry level accounting role preferred. Experience with child care providers and parents receiving subsidized child or social support services preferred. Must have Knowledge of the Department of Public Social Service Stage 1 Child Care Services Contract or CDE Alternative Payment Program or experience working with social support services preferred. Must have strong customer service, organization, written and verbal communication skills. Requires excellent data entry and processing skills within a fast paced environment. Requires considerable accuracy, attention to details and ability to adhere to strict processing deadlines. Must be flexible and possess a strong ability to multi-task while working in a collaborative, team environment. Must have the ability to perform basic mathematical computations to verify and confirm payment calculations. Must have ability to work with diverse groups. Must have technical proficiencies working with Microsoft Excel and Microsoft Word Ability to understand and master complex program requirements and processes as they relate to provider payment Able to work flexible hours as needed to complete required tasks in a timely manner. Overtime may be required to assure timely and compliant processing of provider payments; and Able to work under pressure and with time-sensitive deadlines. Total Package of Benefits Medical/ Dental/ Vision - 95% paid by employer Pet Insurance Employee Assistance Program Voluntary Life and AD&D for Employee, Spouse and Children 401k Matching Options Flex Spending (Health Care and Dependent Care) Mutual of Omaha (STD, Accident, & Critical Illness) Generous Sick and Vacation Time Paid Holidays + Paid Winter Break from 12/24 - 1/1 (for select positions) Opportunity for Growth and Development Robust Learning Management System offering the following continuing education units: PDC, HRCI, CEU, CPE, PDU, SHRM Qualified applicants with arrest or conviction records will be considered for Employment in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Crystal Stairs, Inc. is committed to building and sustaining a fully vaccinated, diverse workforce and culture. As part of this commitment, Crystal Stairs, Inc. provides equal opportunity in all of our employment practices, including selection, hiring, promotion, transfer, and compensation, to all qualified applicants and employees without regard to race, color, medical condition as defined by state law, ancestry, religion, sex, national origin, age, marital status, sexual orientation, gender, ethnic group identification, mental or physical disability, pregnancy, childbirth and related medical conditions, or any other legally protected status. For more information about Crystal Stairs, please visit our website at: *********************

Job Description Crystal Stairs, Inc. Improving the Lives of Families through Child Care Services, Research, and Advocacy Crystal Stairs is committed to building and sustaining a diverse workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin, disability, marital status, sexual orientation, or military status, in any of activities or operations. Provider Services - Claims Processor 100% Onsite - Location: Los Angeles, CA 90056 What We're Looking For: We are seeking a qualified candidate for the Claims Processor position. The Claims Processor will provide excellent client service by accurately processing provider claims in a timely manner while adhering to the contractual requirements of the California Department of Education and LA County Department of Public Social Services as well as Crystal Stairs, Inc. policies and procedures. The selected qualified candidate will have the following responsibilities: RESPONSIBILITIES: Process attendance records and provider payment requests in accordance with department quality standards based upon the funder's payment rules and regulations in addition to the agency's policies. Effectively communicate with providers, parents, and CSI staff, as needed. Assist parents, providers, and staff in completing attendance records and/ or provider payment requests by responding to incoming inquiries regarding payment or claims submission. Communicate with case managers to resolve payment authorization issues on pending claims. Contribute to a team atmosphere by participating in monthly staff meetings, training, and assisting department co-workers as needed. Other duties as assigned. EXPERIENCE, KNOWLEDGE, SKILLS AND ABILITIES YOU SHOULD POSSESS: High School Diploma or GED Equivalent required. An AA/AS Degree in Accounting, Business, or Human Services preferred/or a minimum of two years of verifiable college coursework with a focus on accounting or business; verifiable work experience may be substituted for college level education Minimum of two years experience processing claims, billing or adjustment payments required. Experience in an entry level accounting role preferred. Experience with child care providers and parents receiving subsidized child or social support services preferred. Must have Knowledge of the Department of Public Social Service Stage 1 Child Care Services Contract or CDE Alternative Payment Program or experience working with social support services preferred. Must have strong customer service, organization, written and verbal communication skills. Requires excellent data entry and processing skills within a fast paced environment. Requires considerable accuracy, attention to details and ability to adhere to strict processing deadlines. Must be flexible and possess a strong ability to multi-task while working in a collaborative, team environment. Must have the ability to perform basic mathematical computations to verify and confirm payment calculations. Must have ability to work with diverse groups. Must have technical proficiencies working with Microsoft Excel and Microsoft Word Ability to understand and master complex program requirements and processes as they relate to provider payment Able to work flexible hours as needed to complete required tasks in a timely manner. Overtime may be required to assure timely and compliant processing of provider payments; and Able to work under pressure and with time-sensitive deadlines. Total Package of Benefits Medical/ Dental/ Vision - 95% paid by employer Pet Insurance Employee Assistance Program Voluntary Life and AD&D for Employee, Spouse and Children 401k Matching Options Flex Spending (Health Care and Dependent Care) Mutual of Omaha (STD, Accident, & Critical Illness) Generous Sick and Vacation Time Paid Holidays + Paid Winter Break from 12/24 - 1/1 (for select positions) Opportunity for Growth and Development Robust Learning Management System offering the following continuing education units: PDC, HRCI, CEU, CPE, PDU, SHRM Qualified applicants with arrest or conviction records will be considered for Employment in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Crystal Stairs, Inc. is committed to building and sustaining a fully vaccinated, diverse workforce and culture. As part of this commitment, Crystal Stairs, Inc. provides equal opportunity in all of our employment practices, including selection, hiring, promotion, transfer, and compensation, to all qualified applicants and employees without regard to race, color, medical condition as defined by state law, ancestry, religion, sex, national origin, age, marital status, sexual orientation, gender, ethnic group identification, mental or physical disability, pregnancy, childbirth and related medical conditions, or any other legally protected status. For more information about Crystal Stairs, please visit our website at: ********************* Job Posted by ApplicantPro

The Claims Specialist position is an on-site role based at our corporate headquarters in Savannah, Georgia. This role will play a key part in supporting and managing the claims process, working closely with cross-functional teams across the organization to help reduce and prevent accidents, injuries, and property damage involving both employees and customers, while promoting a proactive, safety-focused culture company-wide. ESSENTIAL DUTIES AND RESPONSIBILITIES Responsibilities: Will assist with the management process of claims for all lines of insurance to include property, general liability, auto, unemployment, and workers' compensation. Utilizes skills and trend-tracking to assist in reducing accidents, and occupational injuries. Coordinates claim notification with the insurance carriers and serves as a point of contact for all assigned claims with the insurance carriers. Contacts employees and customers with potential claims to assist in mitigating potential loss and further injuries. Assist with all Parker's Workers' Compensation (WC) Claims, Unemployment Claims, General Liability Claims, and all other from initial notification through to claim closure, including reviewing, analyzing, and approving authority amounts. Case management can include scheduling of appointments, obtaining current medical information, assisting managers with the transition of injured employees back to work, and assisting the injured employee. Ensure continued communication with injured parties to include customers, workers and leaders of the injured worker. May act as Parker's representative for depositions, informal conferences, mediations, and/or hearings pertaining to claims, working with assigned attorneys as necessary. Prepares Parker's written responses to unemployment claims based upon a summary of facts compiled from files, personnel records and interviews. May prepare cases for and represents Parker's at unemployment claim appeal hearings. Provides personnel employment information and verification, questions witnesses and claimant to ascertain facts of separation and presents a closing summary statement of the employer's position to the hearing officer. Prepares client witnesses for hearing appearances. Case preparation for hearings involves document gathering and organization, unemployment law research, and defense strategies. Maintains frequent telephone contact with management and leaders, gathering facts necessary to determine if unemployment claims are disputable and explaining unemployment rules, regulations, decisions and options. Refers information ascertained during investigations to the Claims team, Operations, and/or Human Resources, as necessary, when possible EEOC charges, wrongful discharge, or threatened litigation facts may have been uncovered. Other similar duties as required. Knowledge, Skills, and Abilities: Strong attention to detail Advanced skills in the use of Windows-based office software: Microsoft Office, Word, Excel, and PowerPoint and G-Suite products Must possess strong analytical and problem-solving skills Able to manage multiple priorities Able to research, collect, and analyze data and prepare written and oral reports Knowledge of claims processing techniques Able to analyze, classify, and rate risks, exposure, and loss expectancies Knowledge of workers' compensation laws and requirements, safety, loss control, and risk management principles Principles, practices, and procedures of general business including knowledge of the unemployment compensation system, filing appropriate unemployment responses, and personnel administration including legal aspects of hiring and firing; and the relationship of the Federal Unemployment Tax Act and the various state acts; knowledge of state and federal unemployment laws, rules and regulations. Highly organized and able to track a project from initial contact through the end of the project Ability to effectively communicate information and ideas in written and verbal format EDUCATION AND REQUIREMENTS Required: Associate or Bachelor's degree or equivalent experience 1-2 years' experience processing workers' compensation, general liability, and/or unemployment claims Experience in creating reports Preferred: ARM, CRM or similar designation 4+ years' experience processing workers' compensation, general liability, and/or unemployment claims TRAVEL As required PHYSICAL REQUIREMENTS Prolonged periods sitting/standing at a desk and working on a computer

Risk employees reduce accident, illness, and injury occurring on Church property or during Church-sponsored activities to protect people and to minimize the loss of sacred funds (donated confidentially in obedience to God's commandments) used for the Church's religious mission under the direction of senior ecclesiastical leaders. To manage and resolve general liability, property loss, and bodily injury claims and litigation of Church departments, ecclesiastical leaders and Church affiliate organizations in an honest, effective, fair and appropriate manner. * Direct handling assigned property/liability claims of increasing size and complexity asserted against the Church and affiliate entities * Retain, supervise and coordinate services of 3rd party vendors, insurance carriers, attorneys and other service providers * Conduct on-site investigations and interviews * Prepare loss evaluations, case plans, and strategic reports; * Proficiency with and capable of directing Litigation Risk Analysis, which is the analytical process whereby the claims manager (with the assistance of Kirton & McConkie, experts, third party administrators, and local counsel) obtains relevant facts through investigation, identifies outcome-determinative legal and factual issues, determines the complex probabilities associated with those legal and factual issues, and establishes case values by predicting what a judge or jury in the relevant jurisdiction will award as damages. The process requires organizing these issues using decision tree software modeling as needed, directing and educating Kirton & McConkie and local counsel regarding the logic of the analytical process. This is the process whereby we identify the financial risk to the Church. * Participate as the Church's representative in alternative dispute resolution * 4 yr degree from accredited university required (business, law, insurance, accounting or related field preferred) * Professional claims designations and certifications preferred (e.g., AIC, SCLA) * 8 yrs multi-line claims or equivalent experience (advanced degree/certification or JD constitutes 2 years experience) * Proficiency in Litigation Risk Analysis (decision tree software) * Proficiency in computer systems * Strong verbal and written communication proficiency * Strong analytical and problem-solving capabilities and skills * Capable of effective interface w/ claimants and attorneys * Institutional knowledge of the Church * At least one year in Claims Specialist II position

Risk employees reduce accident, illness, and injury occurring on Church property or during Church-sponsored activities to protect people and to minimize the loss of sacred funds (donated confidentially in obedience to God's commandments) used for the Church's religious mission under the direction of senior ecclesiastical leaders. To manage and resolve general liability, property loss, and bodily injury claims and litigation of Church departments, ecclesiastical leaders and Church affiliate organizations in an honest, effective, fair and appropriate manner. 4 yr degree from accredited university required (business, law, insurance, accounting or related field preferred) Professional claims designations and certifications preferred (e.g., AIC, SCLA) 8 yrs multi-line claims or equivalent experience (advanced degree/certification or JD constitutes 2 years experience) Proficiency in Litigation Risk Analysis (decision tree software) Proficiency in computer systems Strong verbal and written communication proficiency Strong analytical and problem-solving capabilities and skills Capable of effective interface w/ claimants and attorneys Institutional knowledge of the Church At least one year in Claims Specialist II position Direct handling assigned property/liability claims of increasing size and complexity asserted against the Church and affiliate entities Retain, supervise and coordinate services of 3rd party vendors, insurance carriers, attorneys and other service providers Conduct on-site investigations and interviews Prepare loss evaluations, case plans, and strategic reports; Proficiency with and capable of directing Litigation Risk Analysis, which is the analytical process whereby the claims manager (with the assistance of Kirton & McConkie, experts, third party administrators, and local counsel) obtains relevant facts through investigation, identifies outcome-determinative legal and factual issues, determines the complex probabilities associated with those legal and factual issues, and establishes case values by predicting what a judge or jury in the relevant jurisdiction will award as damages. The process requires organizing these issues using decision tree software modeling as needed, directing and educating Kirton & McConkie and local counsel regarding the logic of the analytical process. This is the process whereby we identify the financial risk to the Church. Participate as the Church's representative in alternative dispute resolution

at Community Options, Inc. Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states. We are now hiring a Full-Time Electronic Visit Verification (EVV) Specialist to provide support in Newtown, PA or Princeton, NJ. The Electronic Visit Verification (EVV) Specialist is the subject-matter expert responsible for ensuring accurate Electronic Visit Verification (EVV) compliance and successful EVV-based claim submission across multiple states. This role owns the identification, prevention, correction, and education related to EVV denials and is accountable for improving clean-claim rates and reducing EVV-related revenue loss. The EVV Specialist partners closely with state-level operational staff, billing teams, and leadership to document state-specific EVV rules, proactively correct issues before claim submission, and drive consistent, compliant EVV practices across the organization. Starting Salary: $65,000 per year Responsibilities Serve as the organization's EVV subject-matter expert for assigned states Learn, maintain, and document state-specific EVV requirements Monitor regulatory changes and payer updates impacting EVV compliance Identify the top EVV denial reasons by payer and state Develop and enforce pre-submission EVV validation processes to prevent denials Ensure EVV visits are properly matched to claims prior to billing Collaborate with billing teams to ensure EVV data flows correctly into claim systems Support resubmission and correction of EVV denied claims when appropriate Analyze EVV denials and trends across all states Determine root causes (system, workflow, staff, authorization, or compliance) Create standard correction workflows for common EVV denial types Track resolution outcomes and recovery rates Escalate systemic issues and recommend process improvements Develop standardized job aids, checklists, and reference guides Continuously improve EVV workflows based on performance data Train state-level staff on EVV best practices Coach and support staff to achieve higher EVV compliance and clean-claim rates Provide regular reporting and insights to leadership Additional tasks and responsibilities may be assigned Minimum Requirements 3+ years of hands on experience with EVV systems and EVV-based claim submission Strong understanding of Medicaid EVV requirements Proven experience resolving EVV denials and improving claim acceptance Experience working across multiple states and payers Ability to interpret payer manuals, state guidance, and denial codes Strong documentation and process-mapping skills Excellent communication and training skills High attention to detail and strong analytical ability Experience supporting large multi-state provider organizations Familiarity with common EVV vendors (e.g., Sandata, AuthentiCare, AHCCCS, HHAeXchange, Tellus, CareBridge, etc.) Revenue cycle or billing background Experience working with Managed Care Organizations (MCOs) Knowledge of home care, personal care, or waiver services Why Community Options? Competitive Insurance Benefits (Medical, Dental, Vision) Paid Holidays-Including a Birthday Holiday Generous PTO Employee Incentive & Discount Programs 403b Retirement Plan Incredible career growth opportunities University partnerships that include tuition reduction Please Visit Our Website to Complete an Online Application! Careers.comop.org Community Options is an Equal Opportunity Employer M/F/D/V #IND-NA