UnitedHealthcare of Ohio Inc jobs - 741 jobs

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Primary Care Plus is looking for well qualified Internal Medicine and Family Practice physicians to join our growing practice in Louisiana. PCPlus clinics are part of a clinically integrated network designed to provide enhanced care to Medicare Advantage, Quality plan, and ACO members by delivering high quality, coordinated healthcare that produces superior outcomes in a cost effective manner. Our clinical team includes physicians, APRNs, RN Care Managers, clinic support staff, and a Quality Improvement team who work together to coordinate care for patients in both the outpatient and inpatient settings. A robust transitional care and high risk outreach program provides physicians with additional information to support their patients outside of the clinic. PCPlus also uses a sophisticated electronic medical record system and robust analytical data analysis to identify patients who are high risk for poor outcomes in order to improve their quality of life. Consistent feedback is provided to the clinical team on all business objectives including quality measures, diagnostic accuracy, and hospitalization rates. Physicians are not measures based on productivity or RVUs, but rather on outcomes of their patient panels. Most physicians will care for panels in the 600-800 range and appointments are scheduled for 30-60 minutes per patient. The Primary Care Physician (PCP) is a Licensed/Board Certified/Board Eligible trained professional in internal or family medicine who plays a key role as part of the clinical operations team providing direct patient care and providing assessments primarily in the ambulatory health care center setting or elsewhere as deemed necessary. It also includes the participation in clinical rounds and conferences plus in-depth documentation through written progress notes and summaries. The PCP will be required to demonstrate the ability to function both independently and in collaboration with other health care professionals. The PCP will consult with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as required. The PCP will adhere to strict departmental goals/objectives, standards of performance, regulatory compliance, quality patient care compliance, and policies and procedures. PCPlus provides highly competitive salaries with opportunity for annual merit increases and bonus potential. A full benefits package including PTO, CME time and reimbursement, malpractice insurance, relocation assistance, a sign on bonus and an employee stock purchase plan provided through our parent company, UnitedHealthcare. If you are looking to focus your practice on quality outcomes not volume of visits, please see our website at ************************ We currently have 8 locations throughout Southeast Louisiana with more coming soon. Primary Responsibilities Assisting in the development of the plan of care in addition to providing appropriate patient/ family/significant other counseling and education Ordering and interpreting appropriate laboratory and diagnostic studies Ordering of appropriate medication and treatments Referring patients for consultation when indicated i.e. dermatology, neurology, ophthalmology, endocrine, surgery, intensive care, infectious disease, hematology, psychiatry, social service, dietary, etc. Documentation through in-depth progress notes and summaries Participates in patient care rounds and conferences Communicates patient management strategies to members of the patient care team Collaborates with members of the multidisciplinary team to ensure that patient management strategies are successful in meeting patient care needs Recognizes situations which require the immediate attention and initiates life-saving procedures when necessary Core Competencies Scientific Foundation Competencies Critically analyzes data and evidence for improving clinical practice Integrates knowledge from the humanities and sciences Translates research and other forms of knowledge to improve practice processes and outcomes Develops new practice approaches based on the integration of research, theory, and practice knowledge Leadership Competencies Assumes complex and advanced leadership roles to initiate and guide change Provides leadership to foster collaboration with multiple stakeholders (e.g. patients, community, integrated health care teams, and policy makers) to improve health care Demonstrates leadership that uses critical and reflective thinking Advocates for improved access, quality and cost effective health care Advances practice through the development and implementation of innovations incorporating principles of change Communicates practice knowledge effectively both orally and in writing Participates in professional organizations and activities that influence health outcomes of a population focus Quality Competencies Uses best available evidence to continuously improve quality of clinical practice Evaluates the relationships among quality, safety, access, and cost and their influence on health care Evaluates how organizational structure, care processes, financing, marketing and policy decisions impact the quality of health care Applies skills in peer review to promote a culture of excellence Anticipates variations in practice and is proactive in implementing interventions to ensure quality Practice Inquiry Competencies Provides leadership in the translation of new knowledge into practice Generates knowledge from clinical practice to improve practice and patient outcomes Applies clinical investigative skills to improve health outcomes Leads practice inquiry, individually or in partnership with others Disseminates evidence from inquiry to diverse audiences using multiple modalities. Analyzes clinical guidelines for individualized application into practice Technology And Information Literacy Competencies Integrates appropriate technologies for knowledge management to improve health care Coaches the patient and caregiver for positive behavioral change Demonstrates information literacy skills in complex decision making Contributes to the design of clinical information systems that promote safe, quality and cost effective care Uses technology systems, with ongoing learning and updates, which capture data on variables for the evaluation of primary care Policy Competencies Demonstrates an understanding of the interdependence of policy and practice Advocates for ethical policies that promote access, equity, quality, and cost Analyzes ethical, legal, and social factors influencing policy development Contributes in the development of health policy Analyzes the implications of health policy across disciplines Evaluates the impact of globalization on health care policy development You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), or M.B.B.S Board certification or eligibility in Family or Internal Medicine Active, unrestricted medical license in Louisiana Valid DEA license Preferred Qualifications Certification in Basic Cardiac Life Support Board certification in Internal Medicine or Family Medicine 1+ years clinical experience in geriatric, adult or family practice setting At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

is Remote in Louisiana At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Clinical Administrative Coordinator is responsible for managing both inbound and outbound calls, averaging approximately 75 calls per day, including cold calling and appointment scheduling for Comprehensive Wellness Assessments. Working within a queue system, the coordinator will confirm, cancel, and backfill appointments using our scheduling platforms. In addition to answering incoming calls and greeting members and visitors, the role involves coordinating educational sessions and maintaining a high level of productivity, with a required 100% performance metric based on appointment conversion rates. The coordinator will be part of a team of 12 to 35 members, participating in bi-weekly team huddles and quarterly one-on-one meetings to support collaboration and performance improvement. Every employee is expected to meet Peoples Health minimum requirements: Commitment: to our Members: We have the power to change our members' lives by placing them at the center of everything we do daily Action: By working together and delivering quality service, we enhance the lives of our members through dedication and teamwork Responsibility: To continue to strive to be the best for our members by adapting and evolving to change, continuing professional development, and to never stop learning Excellence: By exceeding expectations and finding innovative ways to exceed standards, we are changing our members' lives This position is full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:30am - 5:00pm) CST, Monday - Friday. It may be necessary, given the business need, to work occasional overtime. We offer 1 week of paid training. The hours during training will be 8:30am - 5:00pm, Monday - Friday. Training will be conducted virtually from your home or may do in-person training for 3 days, depending on the location. If you reside within the state of Louisiana, you'll enjoy the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Receive and place outbound calls via queue system and scheduling across all covered markets and Telehealth, document as needed. Follow arrival for the scheduled appointment, transcribe notes into the electronic database regarding the Member's appointment, update demographics (i.e. telephone number, address, name PCP, etc.) Document action taken following incoming and / out outbound telephones calls that resulted in a change to schedule (i.e. reschedule, no - show, cancellations, etc.) Validate that insurance subscriber and assignment of benefits is appropriately entered in the patient information section of the electronic health record Support health information technology (HIT) in health care quality improvement Work in coordination company - based security health information systems technology to ensure appropriate documentation of the member's care coordination and record Participate in ongoing training to ensure the records are accurate and secure Follow corporate instruction based on Federal and State guidance related to health information documentation and security Meet or exceed quality metrics for member interaction and production metrics for outbound telephone call volumes. Reviews and updates Member demographics (i.e. address, telephone numbers, etc. in the electronic medical record (s) Maintain accurate and organized call lists Travel to other Service Centers for coverage as needed Answer phones, perform multiple tasks and work independently You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: High School Diploma/GED (or higher) 6+ months of experience with cold calling Intermediate level of experience with Microsoft Office -Microsoft Word, Microsoft Excel (filter, sort), and Microsoft Outlook including the ability to open, create, edit, save, and send documents, spreadsheets, and emails, other forms of documents Ability to work any of our 8-hour shift schedules during our normal business hours of (8:30am - 5:00pm) CST, Monday - Friday Must reside and work remotely from the state of Louisiana Must be 18 years of age OR older Preferred Qualifications: 2+ years of experience in medical office Experience working in a performance metric based role Experience with high volume calling or call center work Experience working with a phone queue Telecommuting Requirements: Reside within the state of Louisiana Ability to keep all company sensitive documents secure (if applicable) Required to have a dedicated work area established that is separated from other living areas and provides information privacy Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Soft Skills: Professional, strong customer service and communication skills Demonstrates consistent punctuality and respect for schedules, ensuring timely attendance to meetings, calls, and deadlines. Maintains focus and effectiveness in high-pressure situations by staying calm, organized, and solution-oriented. Demonstrates the ability to prioritize tasks, adapt quickly, and make sound decisions even when faced with tight deadlines or unexpected challenges. *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 to $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN

All locations Amelia, United States; Atlanta, United States; Charlotte, United States; Chicago, United States; Hartford, United States; Philadelphia, United States; Princeton, United States; Colorado Springs, United States; Dayton, United States; Denver, United States; New Orleans, United States; New York, United States; Phoenix, United States; American Modern Insurance Group, Inc., a Munich Re company, is a widely recognized specialty insurance leader that delivers products and services for residential property - such as manufactured homes and specialty dwellings - and the recreational market, including boats, personal watercraft, classic cars, and more. We provide specialty product solutions that cover what the competition often can't. Headquartered in Amelia, Ohio, and with associates located across the United States, we are part of Munich Re's Global Specialty Insurance division. Our employees receive boundless opportunity to grow their careers and make a difference every day. This position has a hybrid schedule, 40-50% of the time in the office in Amelia, OH. Remote working arrangements will be considered for qualified candidates in other geographical locations. American Modern Insurance Group is seeking a Catastrophe Risk Analyst to join our Portfolio Management and Reinsurance team. As a Catastrophe Risk Analyst, you will work on special projects and provide expert recommendations to support our business decisions. You will apply your analytical skills to catastrophe modeling, portfolio management, and other actuarial tasks to help us optimize our pricing, underwriting, and product development. Responsibilities: Analyze and provide recommendations on catastrophe modeling, pricing, and portfolio optimization. Monitors and provides framework for accumulation management. Develops and maintains management reports. Contributes to the communication and coordination of activities to support corporate objectives. Develops and expands knowledge of relevant tools and technologies. Evaluates existing catastrophe risk models and recommends improvements. Conducts companywide studies to identify and quantify the catastrophe risk factors. Provides feedback and input into global catastrophe related projects. Qualifications: At least three years of catastrophe modeling, pricing, and portfolio optimization as well as experience in data cleaning, data scrubbing using various tools and technologies. Bachelor's degree in mathematics, statistics, actuarial science, economics or finance. Strong analytical and problem-solving skills, with the ability to use complex data to tell a story. Experience working in the insurance or finance industry, with a focus on catastrophe modeling and portfolio management. Ability to discuss catastrophe modeling concepts with non- experts. Proficiency in SQL, Power BI, RiskLink and Excel. Applicants requiring employer sponsorship of a visa will not be considered for this position. Location Requirement Work Location: This role is based in our Cincinnati, OH office. Local Candidates Preferred: Candidates should reside in or near Cincinnati, OH. Non-Local Applicants: Candidates who are not local must be willing to relocate. We are proud to offer our employees, their domestic partners, and their children, a wide range of insurance benefits: Two options for your health insurance plan (PPO or High Deductible). Prescription drug coverage (included in your health insurance plan). Vision and dental insurance plans. Additional insurance coverages provided at no cost to you, such as basic life insurance equal to 1x annual salary and AD&D coverage that is equal to 1x annual salary. Short and Long Term Disability coverage. Supplemental Life and AD&D plans that you can purchase for yourself and dependents (includes Spouse/domestic partner and children). Voluntary Benefit plans that supplement your health and life insurance plans (Accident, Critical Illness and Hospital Indemnity). In addition to the above insurance offerings, our employees also enjoy: A robust 401k plan with up to a 5% employer match A retirement savings plan that is 100% company funded. Paid time off that begins with 24 days each year, with more days added when you celebrate milestone service anniversaries. Eligibility to receive a yearly bonus as a Munich Re employee. A variety of health and wellness programs provided at no cost. Paid time off for eligible family care needs. Tuition assistance and educational achievement bonuses. A corporate matching gifts program that further enhances your charitable donation. Paid time off to volunteer in your community. At American Modern, a subsidiary of Munich Re, we see Diversity and Inclusion as a solution to the challenges and opportunities all around us. Our goal is to foster an inclusive culture and build a workforce that reflects the customers we serve and the communities in which we live and work. We strive to provide a workplace where all of our colleagues feel respected, valued and empowered to achieve their very best every day. We recruit and develop talent with a focus on providing our customers the most innovative products and services. We are an equal opportunity employer. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Apply Now Save job

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. What you do matters. And who you do it for matters even more. If you're looking for more meaningful impact, you should take a serious look at our growing organization. Since our founding in the mid-90's, Peoples Health has brought innovation and compassion to Medicare patients throughout Louisiana. Now, part of the UnitedHealth Group family of companies, our team consists of over 900 people who are experienced in all aspects of care delivery, health maintenance and administrative support. It's our goal to help guide over 60,000 Medicare recipients across the broad spectrum of health and dental services. We're committed to the highest purpose; improving lives. Responsible for the oversight and coordination of all activities in the Primary Care Plus (PCP) Clinic. Develop, implement and monitor systems, procedures and processes required of a recognized Patient Centered Medical Home. Provides leadership and management skills to enable the clinic to meet its goals and objectives within a profitable, efficient, safe and effective working environment. The Clinic Manager performs a wide variety of duties and responsibilities as well as project assignments and is responsible for the day-to-day operations of the clinic. Will apply knowledge of concepts, practices and procedures related to clinic and revenue cycle management to serve the needs of the clinic. Serves as the liaison between the clinic and corporate staff and functions including, but not limited to, policy/procedure implementation, accounts payable, accounts receivable, and compliance. Primary Responsibilities: Provide administrative supervision of clinical staff, medical records, reception, and other clinic staff to ensure the effective implementation of patient services Ensure that the environment of care meets or exceeds all federal, state and accreditation standards and that a safe environment is maintained for staff, patients and visitors Ensure that all equipment is in good working order and that supplies are maintained at efficient levels. Recommend needed additions/deletions Assist in developing, implementing and keeping current operational policies and procedures for all clinic and revenue cycle processes Manage all staff training on clinic policies and procedures Works with Primary Care Plus Revenue Cycle Management staff to insure proper collection and reporting of all revenues, adjustments, expenses, bad debts and contractual allowances Manages patient volume to ensure maximum revenue performance Responsible for ensuring all clinic expenses are aligned with operating budget Reviews monthly financial statements with the Finance Department Assist in developing and reviewing reports from practice management systems Provide assistance, support, and consultation to assist staff in the full utilization of implemented clinical information and practice management systems Assist with the development of business plans, strategic marketing plans to achieve goals/objective to promote the growth and success of the clinic Be an ambassador for the clinic in building the image, foundation, culture and core values of a Patient-Centered Medical Home (PCMH) practice Attend meetings, seminars, workshops and conferences as needed to stay current in clinic operations and standards of care in the community Facilitate interactions between clinic staff and PCP Corporate office Provide oversight of all Quality Improvement activities Conducts and/or coordinates Patient Satisfaction survey results, reviews, assessments and other 'outcomes' activities to ensure quality of care for all clinical programs Maintain confidentiality in all matters Assist with all compliance and internal audit requirements Perform other duties as assigned Management Responsibilities: Monitor both department and individual staff performance, providing ongoing feedback Maintain appropriate staffing levels required to meet departmental goals Interview candidates and makes hiring decisions as needed Identify opportunities for staff development and coordinates training as needed Ensure staff members meet all required licensing, compliance and continuing education requirements Complete timely and thorough evaluations of staff Function as a mentor to staff regarding career goals Proactively manage employee relations issues, utilizing a progressive corrective action plan including appropriate documentation Serve as a resource to other managers regarding issues that impact their departments Develop, manage and work within department budget Ensure compliance by maintaining knowledge of industry trends and legislation related to department Participates in the timely review and updating of departmental policies, procedures, training manuals and job descriptions as needed Core Competencies: Leadership - inspires and motivates others to perform well; leads by example Negotiation and Influential Ability - influences decisions in matters related to department to ensure corporate and departmental needs are satisfied Management skills - includes staff in planning, decision-making, facilitating and process improvement; makes self available to staff, provides regular feedback, and develops staff's skills - encouraging growth Analytical/problem solving skills - identifies and resolves problems in a timely manner and gathers and analyzes information skillfully Judgment - displays willingness to make decisions, exhibits sound and accurate judgment and makes timely and appropriate decisions Planning/organizational skills - prioritizes and plans work activities, uses time efficiently and develops realistic action plans Oral/written communication skills - speaks and writes clearly and persuasively in positive or negative situations. Demonstrates group presentation skills when conducting meetings, leading a team or working with peers Supervisory Responsibility: Supervises all clinic staff Four Elements of Job and Most Important Recruitment Characteristics Industry-specific experience = 35% Functional/technical expertise = 25% Can manage and develop staff = 25% Ability to build relationships = 15% You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 5+ years of clinic or medical office management experience Must have supervisory experience within a clinical setting Proficient in use of Microsoft Office programs Preferred Qualifications: Proficient in use of EHR software in the clinic setting Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

The Manager, Medicare Claims, oversees end-to-end claims services for provider segments, meeting business goals. This role sets performance targets, manages claims processing and financials, handles submissions, refunds, and recoveries, and ensures claims accounting and reporting. Collaboration with claims leadership ensures alignment with customer needs and contracts. What You'll Do Streamline shared processing to reduce management by exception Set operational process to address market trends, BCBSNC capabilities and customer demand Manage accounting and financial reporting functions in support of the Finance Division including overseeing the gathering, preparation, analysis, and reconciliation of financial data to ensure compliance with accepted accounting principles and standards. Participate in projects to improve and/or facilitate claims processing, recovery, and accounting functions. Manage financial recovery activities including refunds and collections Manage team leads and staff by efficiently driving work volume to keep high level of utilization and engagement in the group Resolve complex claims appeal by coordinating with different stakeholders for certain high value claims Collaborate with Audit and Payment Integrity to sustain a pre-determined level of accuracy and quality Design and develop tools and techniques for improvements. Identifies needed process and procedural changes which will result in improved customer satisfaction. Serve as Medicare Claims Subject Matter Expert and single point of contact for performance monitoring and troubleshooting. Represent Claims Operations on monthly CMS calls with CMS Account manager answering questions, providing status updates and expertise routinely and on demand. Ability to engage as requested by Compliance with regulatory entities, especially CMS on monthly calls and serve as an internal point of contact to prepare feedback on issues under CMS review. Use good judgement in understanding issues and work with compliance to prepare for discussions. Ability to represent claims as a knowledgeable SME. What You Bring Bachelor's degree or advanced degree (where required) 8+ years of experience in related field. In lieu of degree, 10+ years of experience in related field. Bonus Points 1-2 years of Medicare and Medicaid experience or a highly regulated operational environment - highly preferred Strong analytical skills with the ability to drive change and manage operations Ensure risks associated with business activities are effectively identified, measured, monitored and controlled within accordance with compliance policies and procedures What You'll Get The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community. Work-life balance, flexibility, and the autonomy to do great work. Medical, dental, and vision coverage along with numerous health and wellness programs. Parental leave and support plus adoption and surrogacy assistance. Career development programs and tuition reimbursement for continued education. 401k match including an annual company contribution Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $98,092.00 - $156,947.00 Skills Accounts Receivable (AR), Claims Analysis, Claims Management, Claims Processing, Claims Resolution, Claims Submission, Documentations, Financial Processing, Health Insurance, Insurance Claim Handling, Insurance Claims Processing, Insurance Industry, Medicare Advantage, People Management, Recruiting

The Manager, IT Category Management, is responsible for directing all sourcing and vendor contracting activities within the assigned categories. This role supervises staff engaged in the sourcing process for high-value and complex goods, services, or projects and initiatives. The incumbent focuses on reducing organizational costs by implementing effective sourcing strategies, tools, and processes. Coordination with third-party vendors, business owners, and the legal team is essential for the preparation, analysis, and negotiation of vendor contracts. Additionally, this position supports business owners across all functional areas in technology vendor selection and ensures that vendor obligations are documented in alignment with business requirements. What You'll Do Manage staff responsible for the development and execution of sourcing strategies in one or more technology categories. Direct and train staff in conducting sourcing events, including development of project work plan, category profile, category strategy, minimum requirements and evaluation criteria, solicitation Guide staff in the development and implementation assorted bid documents and requests (i.e. RFP, RFI, RFQ); and manage status reporting and performance metrics of sourcing and category management activities. Understand, analyze and forecast complex market and industry dynamics and share subject matter expertise and industry knowledge within the established portfolio of products and services Partner with stakeholders to develop business and sourcing strategy and source products and services using proven tools, processes, and analytics to drive and achieve business results. Coordinate the evaluation and analyses of sourcing results from a total cost of ownership perspective, and provide optimization recommendations Lead cross-functional teams responsible for complex vendor negotiations, including those that require specialized subject matter expertise, nonstandard risk mitigation solutions, and coordination of multiple arrangements. Proactively establish and foster successful, positive working relationships with vendor personnel. Drive vendor engagement through formal and informal transactions. Manage contract management function and facilitate effective collaboration with Corporate Compliance, Legal, Audit and Risk Management and other internal stakeholders for compliance activities to ensure regulatory conditions are met. Develop new procedures, training, initiatives, specifications and recommendations for process or policy changes and improvements, as appropriate. What You Bring Bachelor's degree or advanced degree (where required) 8+ years of experience in related field. In lieu of degree, 10+ years of experience in related field. Bonus Points 8+ years Technology procurement experience Highly Preferred Procurement experience at a healthcare company Highly Preferred Procurement experience with key vendors including IBM, Microsoft, Salesforce, ServiceNow, Cognizant, Accenture, NTT Data and HCL Technologies Experience purchasing hardware and software through Value Added Resellers What You'll Get The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community. Work-life balance, flexibility, and the autonomy to do great work. Medical, dental, and vision coverage along with numerous health and wellness programs. Parental leave and support plus adoption and surrogacy assistance. Career development programs and tuition reimbursement for continued education. 401k match including an annual company contribution Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $107,901.00 - $172,642.00 Skills IT Procurement, Negotiation, Strategic Sourcing, Vendor Procurement

The Associate Client Representative supports the daily management of a high-volume Commercial Lines book of select business. Under the direction of a lead servicer, this position consistently provides excellent customer service to external and internal clients to ensure client satisfaction and retention. Primary Responsibilities Supports lead servicer in effectively managing a high-volume book of business ensuring all required tasks are completed accurately and on-time to meet the client needs. Set up and maintain accurate account details, contacts, and policy information in EPIC Attach, organize, and name documents in EPIC Leverage templates and system generated letters and forms to produce standard communications to clients and carriers, including BOR, proposal letters, change requests, proofs of insurance etc. Endorse policy in EPIC Create activities in EPIC and assign applicable team-member. Order loss runs Position Specific Skills/Qualifications Work Experience 0-2 years' experience in Commercial Property and Casualty Professional Licenses/Certifications Licensed or obtaining state Property & Casualty insurance license within a specified time frame Essential Skills/Competencies Knowledge of Excel, Word, and other MS Office products to include basic formatting Able to learn coverage fundamentals. Dedicated to meeting the expectations and requirements of co-workers and clients. Able to quickly find common ground and solve problems. Seeks to obtain industry information, new product information, coverage, and technology to continuously improve knowledge performance. Strong written, oral, and interpersonal communication skills. Able to follow a well-established and familiar set of activities and/or process to derive a solution. Sets priorities and manages workflow to ensure effective, timely, and efficient service delivery. Works to achieve stated objectives and delivers results at the close direction of a senior team member. Education HS Diploma or equivalent Physical Demands & Working Conditions Office work involves working at a desk most of the time, using a stand-up/sit-down adjustable desk. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects. Typing, grasping, and repetitive motion typically is required every day, and walking and standing are required occasionally. Equal Employment Opportunity At World Insurance Associates (WIA), we celebrate and support our differences. We know employing a team rich in diverse thoughts, experiences, and opinions allows our employees, our products, and our community to flourish. WIA is honored to be an equal opportunity workplace. We are dedicated to equal employment opportunities regardless of race, color, ancestry, religion, sex, national orientation, age, citizenship, marital status, disability, gender identity, sexual orientation, or Veteran status. In addition, WIA makes reasonable accommodations to known physical or mental limitations of an otherwise qualified applicant or employee with a disability, unless the accommodation would impose an undue hardship on the operation of our business. #LI-HZ1

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross. Residency in or relocation to Louisiana is preferred for all positions. **Candidate must be local to the Baton Rouge Corporate Office.** **Are you searching for your next career opportunity? Do you have a passion for providing excellent customer service? Would like you like to work from home?** **We are actively recruiting for a Call Center Class beginning in** **March 2026** **! Apply today and join us in supporting our mission to improve the health and lives of Louisianans.** **What does an Account Advisor do?** Serve as first point of contact for the organization. The Account Advisor handles incoming calls from members and providers answering questions and offers guidance via the telephone with individuals in a prompt, courteous, and professional manner. **What is a must have?** + Customer Service experience or equivalent + Must be available to report to the Baton Rouge Corporate Campus for the onsite components of new hire training. + Commitment to training program + Hardwired internet connection with speeds greater than 5MB upload and 10MB download **What's in it for you?** + A comprehensive new hire training program designed to help set you up for success + Competitive pay + Excellent benefits package including medical, dental, vision, life insurance, an amazing Wellness Program, 401k contributions in addition to paid time off, and paid holidays + Professional development opportunities and access to grow your career **POSITION PURPOSE** Resolves benefit and claims inquiries received via the telephone, in person, or other acceptable receipt method from our members or providers in the call center. Promotes and maintains a positive company image through direct contact with customers. Complies with all laws and regulations associated with duties and responsibilities. **NATURE AND SCOPE** + This role does not manage people + This role reports to this job: SUPERVISOR, CUSTOMER SERVICE + Necessary Contacts: Enrollment & Billing, Claims, Provider Relations, Benefit Operations, Network Administration, Sales/Marketing, Accounting, Medical Management, Pharmacy, and Legal departments as well as members, providers, groups, brokers, other plans, insurance companies, Social Security Administration and Centers for Medicare and Medicaid Services (CMS). **QUALIFICATIONS** **Education** + High School Diploma or equivalent preferred **Work Experience** + Prior experience as listed below required: + 1 year of customer service or medical office experience required + Completion of the Medical Assistant, Coding & Insurance Pathway from BRCC, can be used in lieu of the one year of experience. + A certificate in medical office assistant or medical coding can be used in lieu of the one year of experience + Previous experience in a call center is preferred **Skills and Abilities** + Must demonstrate PC skills including Microsoft Office (e.g., Word, Excel, Outlook , etc.) and related software as other corporate software progrms and applications. + Demonstrated verbal and written communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism. + Familiarity with medical and health insurance terminology preferred + Conflict resolution skills and remains calm under pressure/stressful situations + Must be able to to demonstrate critical thinking and problem solving skills + Demonstrate attention to detail + The ability to actively listen and ask appropriate questions, to effectively understand issues that are presented from customers. + Reading comprehension skills are required due to the high amount of direct customer contacts and the need to understand customer contract benefits and training materials. + Effective organizational and interpersonal skills are required. Must have the ability to multi-task and handle work independently as well as organize and prioritize multiple customer issues. + Ability to take ownership of issues from the beginning, seeking First Call Resolution (FCR) + Must be able to verbally communicate on the telephone in a call center environment approximately 95% of the time in the Customer Care Center. + Employees may be expected to work during inclement weather or other emergency situations when needed. + Must have ability to successfully complete Customer Service training, with demonstrated proficiency in training materials. **Licenses and Certifications** + None Required **ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS** + Reviews and researches billing and healthcare claim inquiries from members and providers, to ensure proper benefits and/or payments are applied correctly; researches multiple computer systems/applications to verify data/information accuracy. + Responds to inquiries regarding adjustments, refunds, edits and/or payment registers to ensure completeness, accuracy and customer satisfaction to members or providers. + Maintains knowledge of required lines of business, changes to applicable company policies/procedures, recent laws and regulations, and related computer systems to ensure information is current and accurate when providing service to members or providers on the telephone in the call center. + Meet Customer Service performance goals/expectations in the areas of efficiency, accuracy, quality, production, customer satisfaction, and attendance + The ability to verbally communicate on the telephone approximately 95% of the time. + Account Advisor Is who work on the Medicare LOB must be able to follow CMS (Center for Medicare and Medicaid) standards including but not limited to: following a defined process for handling Medicare Grievances, identify differences between an inquiry, grievance, & appeal, and meet specific schedule requirements (may have to work nights, weekends and/or holidays). **Additional Accountabilities and Essential Functions** _The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions_ + Perform other job-related duties as assigned, within your scope of responsibilities. + Job duties are performed in a normal and clean office environment with normal noise levels. + Work is predominately done while standing or sitting. + The ability to comprehend, document, calculate, visualize, and analyze are required. **An Equal Opportunity Employer** **All BCBSLA EMPLOYEES please apply through Workday Careers.** PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI) **Additional Information** Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account. If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance. In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free. _Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._ _Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results._ **JOB CATEGORY:** **Customer Service & Contact Center Operations**

Responsible for the Risk Management continuing education program which includes authoring and editing medical and nursing RM education. Using an inquisitive mindset and a structured design methodology, the Specialist conducts thorough, complex literature searches across medical, nursing, and risk management sources to build a foundational understanding of the content to develop CME/CNE programs and newsletter articles. The Specialist collaborates with outside medical writers to refine/edit content as needed, ensuring alignment with learning outcome/objectives and professional standards. This position also oversees LAMMICO's ACCME and ANCC accreditation activities including NAB and MOB criteria. Reporting Relationship: Reports directly to the VP of Risk Management & Patient Safety Essential Functions/Responsibilities: Works in a cooperative manner with management, coworkers, customers, and vendors; seeks to support LAMMICO's mission and vision in daily operations Contributes to the development of the department's strategic and operating planning and meets assigned target dates and objectives; helps ensure that department quality, service and productivity standards are met Promotes and encourages innovation in processes, procedures, products, and services in the organization Responsible for the successful maintenance of ACCME and ANCC accreditation programs Oversees the Maintenance of Certification and NAB credit programs Responsible for the assessment of needs of the local and national physician and nursing audiences to strategically plan, implement, measure, and evaluate the effectiveness of the RM loss prevention education program Serves as medical education expert and editor for RM publications and education programs designed for a local and national physician and nursing audience Mentors and evaluates physician and nursing medical writers' content to ensure the development of well-designed, high-quality education courses/presentations Oversees the production of all presentations including live (in person), webinars, video and other multimedia assets. Guides and mentors RM Education Specialists (nurse planner) to ensure the adherence to the accreditation standards of ACCME and ANCC Partners with physicians, risk managers, claim representatives, and legal counsel to provide specific technical RM education consultation to LAMMICO insureds Evaluates and analyzes individual learning activities, aggregates data from all activities to assess the effectiveness of the overall program and initiates relevant quality improvement processes Pursues own professional development by attending regional/national conferences for educators and remains current with the ACCME and ANCC accreditation standards Secondary Functions/Responsibilities: Other responsibilities and special projects as assigned Oversees development of video presentations Qualifications Education, Experience and Skills Required: Masters or Doctorate degree in education or in a healthcare related field Bachelor's Degree in nursing Current license in nursing Knowledge and training in the specific area of technical expertise Minimum of 5-10 years combined experience in Risk Management, quality improvement, nursing, education, and accreditation Highest level of technical skills in RM and adult educational theories and training Professional level writing and editing skills and authorship in relevant healthcare and professional publications ARM, CPHRM or other relevant certification Formal presentation skills to small and large audiences; ability to determine effectiveness of presentation Experience with data analysis, determine technical needs to implement RM strategies Ability to manage multiple projects simultaneously Strong customer focus and team orientation Ability to appropriately handle confidential or sensitive company information Commitment to continuing industry education Strong motivation decision making skills Excellent communication skills with the ability to interact and work effectively with insureds, prospective insureds, and employees at all levels within the organization Ability to manage time, set priorities, and work independently; ability to organize, analyze, and interpret information Proficiency in the use of Microsoft Office Desired: Insurance industry experience

Job Description Successful State Farm Agent is seeking a qualified professional to join their winning team for the role of Licensed Customer Service Representative - State Farm Agent Team Member. Active Property and Casualty license is required. We seek a licensed energetic professional interested in helping our business grow through value-based conversations and remarkable customer experience. Responsibilities include but not limited to: Establish customer relationships and follow up with customers, as needed Provide prompt, accurate, and friendly customer service. Service can include responding to inquiries regarding insurance availability, eligibility, coverages, policy changes, transfers, claim submissions, and billing clarification Use a customer-focused, needs-based review process to educate customers about insurance options Maintain a strong work ethic with a total commitment to success each and every day What we provide Minimum salary $18.00/hour; salary will be increased dependent upon experience, licensing and performance. Once licensed, bonuses and commissions will be paid on sales performance. Paid time off (vacation) Retirement plan (after first year) Valuable experience Growth potential/Opportunity for advancement within my office Requirements Property & Casualty license (required) Life and Health license (required) Excellent interpersonal skills Excellent communication skills - written, verbal and listening People-oriented Organizational skills Self-motivated Detail oriented Proactive in problem solving Dedicated to customer service Able to learn computer functions Pride in getting work done accurately and timely Ability to work in a team environment Ability to multi-task Provide timely and thorough activity reports to agent Selected candidate is expected to remain current in product changes, licensing, technical developments, and continuing education If you are motivated to succeed and can see yourself in this role, please submit your resume. We will follow up with you on the next steps in the interview process. This position is with a State Farm independent contractor agent, not with State Farm Insurance Companies. Employees of State Farm agents must be able to successfully complete any applicable licensing requirements and training programs. State Farm agents are independent contractors who hire their own employees. State Farm agents employees are not employees of State Farm.

Job Responsibilities: Generate new sales opportunities by following up with all leads provided as well as by networking and gathering referrals Compose and deliver sales proposals to customers, utilizing tools provided Establish and maintain current and new customer relationships by providing professional, knowledgeable and courteous customer service Meet or exceed minimum monthly sales goals Generate and submit all required and appropriate paperwork using company processes and CRM Learn details of local utilities, interconnection requirements, state and local tax incentives Prepare and present in home sales presentations Work with other SCS departments to achieve mutual objectives Participate in ongoing training and professional development Attend expos, fairs, shows and other marketing events Adhere to all processes and procedures as trained Job Requirements: 2 years of sales experience, preferably outside sales Reliable vehicle with proper insurance; personal vehicle is used for sales calls within the designated sales area Strong written and verbal communications skills Willingness and eagerness to learn Professional appearance Ability to work a variety of hours, including evenings and weekends Computer literacy including Microsoft Outlook, Word, Excel, PowerPoint College degree preferred South Coast Solar is an EEO Employer - M/F/Disability/Protected Veteran Status View all jobs at this company

Performs general accounting functions and customer services calls related to premium customer service functions for the Company and the RRG subsidiary. The employee will be responsible for assisting in general accounting functions, such as accounts receivable and accounts payable back-up, invoicing, and banking activities, as well as assisting insureds with questions regarding payments to LAMMICO; its bank lockbox, invoice questions, assistance with online and premium finance payments or financing. The employee will work in a team environment with members of the Finance department and with other departments in the organization such as the Underwriting and IT departments, researching and resolving the proper application of premiums to policies and to resolve issues with online payments. Reporting Relationship: Reports directly to the VP of Finance & Controller Essential Functions/Responsibilities: Works in a cooperative manner with management, coworkers, customers, and vendors; seeks to support LAMMICO's mission and vision in daily operations Meets assigned target dates and objectives; helps ensure that department quality, service, and productivity standards are met. Will prepare monthly deductible billing, ensuring invoices and supporting documentation is mailed timely to insureds and payments are properly posted and deposited. Work under the direction of Senior Accountants on any issues, past due payment calls or notices, and customer service calls related to deductibles Maintain and audit the listing of insureds with Letters of Credit and correspond with the Underwriting department on any issues, follow-up with insureds on renewals of Letters of Credit Reconcile loss fund accounts in Workday accounting system and communicate with Senior Accountant regarding any account balance deficiencies Deposit and log all miscellaneous deposits received Responsible for daily insured invoice process Serve as a back up for insured premium receivable posting and daily cash balancing activities Serve as a backup for accounts payable processing in Workday accounting system Update the daily cash activity for subsidiary companies Answers calls daily from insureds related to payments and payment related issues Works with the Finance, IT and Underwriting Departments to investigate and resolve customer payment related issues Assists customers with service issues from the current online payment vendor Maintain a strong working relationship with the online payment provider Understand the various finance options and be able to assist customers with questions Directs customer service issues that are not payment related to the appropriate department Timely follow up with insureds on payment related issues Responsible for working with the bank on premium related payment issues Responsible for researching issues with the online payment company vendor using their reports platform and working with key individuals at the vendor Suggests and implements new controls and process improvements in the customer service and online payment areas Assists in the annual financial statement audit and state examinations by providing necessary documentation and testing support, as well as answering questions Printing of invoices for customers who request copies Responsible for learning the OASIS core operating system- Accounts Receivable function Serve as a back up for cash reconciliations in Workday Review of vendors and insureds for compliance with OFAC regulations by utilizing the compliance software Secondary Functions/Responsibilities: Other responsibilities and special projects as assigned Other reporting as required by the VP of Finance and Controller Serve as a back up to the Insurance Payable functions Serve as a back up for certain banking activities Serve as a back up to the Sr. Accounting Assistant Other account reconciliation functions as needed Assists Sr. Accounts Receivable Coordinator as needed Assists with testing of Core Operating system upgrades Qualifications Education, Experience and Skills Required: High school diploma or Associate Accounting Degree Prior experience working in an accounting department Strong customer focus and team orientation Understanding of internal controls Ability to appropriately manage confidential and sensitive company and insured information Excellent communications skills with the ability to interact and collaborate effectively with employees at all levels within the organization Ability to manage customer service calls from insureds and provide excellent customer service to both internal and external customers Ability to manage time, set priorities, and work independently Proficiency in the use of Microsoft Office programs, including Teams Desired: Insurance industry experience Accounts Receivable and Payables experience Three years general accounting experience Working knowledge of Medical Professional Liability products/coverages Working knowledge of the OASIS System (core system) Experience with Workday accounting system

A company built to serve you. It's your career, Shelter it! Catastrophe Response Team Adjuster (Resident) $26.92-$37.71 minimum starting pay Job Level - Individual Contributor Shelter maintains broad salary ranges for its roles in order to account for variations in geographic location, education, training, skills, relevant work experience, business needs and market demands. Please remember that this range is the starting base pay only and does not consider other components that make up the total rewards package for the position. This is a position where the adjuster works from home, living in and servicing the Shreveport area. Some travel will be required to assist in our regional area as needs arise. Home office equipment and company vehicle provided. What You Will Be Doing: Handles insurance claims for property damage within an assigned region, traveling to other locations as needed. Investigates, analyzes, evaluates, and settles catastrophe claims, especially those involving wind or hail. Determines claim value, negotiates settlements, and ensures accurate claim handling. Due to the duties and responsibilities of this position, a Credit Bureau Report may be ordered on final candidates. What We're Looking For: * Investigative, analytical, organizational and decision-making skills * Ability to learn through on-the-job training/training courses * Superior skills in negotiation, customer service, written and verbal communication * Ability to travel long distances and overnight when needed and lift/move/climb ladders for inspection in all temperatures * Strong skills in technology * Efficient in time management to maintain schedules and deadlines * Valid driver's license with good driving history * Must have high-speed internet access to support system from residence * Ability to perform the essential functions of the position, with or without a reasonable accommodation. Shelter's uncompromising commitment to excellence doesn't stop with our customers. We recognize our employees are what make us a premier organization in the insurance industry. Shelter Employees enjoy such benefits as: * Health, Dental, Voluntary Vision and Prescription Drug Insurance * Savings and Profit Sharing 401(k) * Paid Time Off for Sick and Personal Leave, Vacation and Holidays * Vitality Wellness Program * "Dress for Your Day" Dress Code * Flexible Scheduling * And much more! #IND1# If interested, please apply by: 01/28/2026

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. Under minimal direction, initiates and manages suspected fraudulent underwriting and insurance premium investigations involving the highest complexity matters. Provides advice, direction, and support to underwriters, auditors, business unit leadership, corporate investigations and other stakeholders across the organization on the detection, investigation, and litigation of suspected underwriting matters. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: * Leads the detailed analysis and completion of thorough and timely investigations of suspected underwriting fraud by following Best Practice Guidelines and collaborating with business stakeholders. * Develops and executes investigation strategy either independently or in collaboration with underwriting professionals, counsel, experts, insureds, and other stakeholders. * Manages investigation activities independently and/or coordinates/oversees vendor service partner activities in the field. * Maintains detailed, accurate and timely case records by following established Best Practices for file documentation and by creating comprehensive reports of investigative findings, and conclusions. * Makes recommendations for resolution by presenting evidence-based findings and proposing solutions of moderate to complex scope. * Identifies opportunities and participates in the design and implementation of process or procedural improvements. * Leads or directs efforts to build and enhance and oversees organizational capabilities by developing and delivering fraud awareness or regulatory compliance training and mentoring SIU staff. * Leads or directs the preparation of cases for appropriate reporting to outside agencies; leads or directs pursuit of criminal or civil actions through gathering and documenting relevant data, organizing and summarizing facts and testifying on behalf of the company in civil or criminal matters. * Continuously develops knowledge and expertise related to insurance fraud by keeping current on related law, regulations, trends, and emerging issues and participating in insurance fraud or related professional associations. May perform additional duties as assigned. Reporting Relationship Typically Manager or Director Skills, Knowledge and Abilities * Solid knowledge of property and casualty claim handling practices * Strong technical knowledge of practices and techniques related to investigations and fact finding. For roles focused in an area of specialty (medical provider investigations), strong technical knowledge of respective specialty practices is required. * Strong interpersonal, oral, and written communication skills; ability to clearly communicate complex issues * Ability to interact and collaborate with internal and external business partners, including outside agencies * Ability to work independently, exercise good judgment, and make sound business decisions * Detail oriented with strong organization and time management skills * Strong ability to analyze complex, ambiguous matters and develop effective solutions * Proficiency with Microsoft Office applications and similar business software, and understanding of relational databases information querying techniques * Ability to adapt to change and value diverse opinions and ideas * Developing ability to implement change * Ability to travel occasionally (less than 10%) Education and Experience * Bachelor's degree or equivalent professional experience. * Minimum of three to five years of experience conducting investigations in the area of a) insurance fraud, b) law enforcement, c) civil or criminal litigation, or d) similar field. * Professional certification or designation related to fraud investigations strongly preferred (e.g., CFE, CIFI, FCLS, FCLA, or similar). #LI-AR1 #LI-Hybrid In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact ***************************.

At SCP Health, what you do matters As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care. Why you will love working here: - Strong track record of providing excellent work/life balance. - Comprehensive benefits package and competitive compensation. - Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect. Primary Duties and Responsibilities: Provide strategy, leadership and accountability for the Arbitration and Recovery departments, ensuring alignment with organizational objectives and driving operational efficiencies across all functions. Develop, refine, and execute strategic plans focused on revenue protection, optimization, and regulatory compliance to maximize financial performance and mitigate risk. Oversee the delivery and interpretation of data, analytics and performance reporting, regularly presenting actionable insights and recovery outcomes to executive leadership and key stakeholders. Foster partnerships across SCP departments including Managed Care, Finance, Legal, and RCS, driving collaboration to design and implement innovative recovery initiatives and process improvements. Collaborate with Analytics, IT and Systems to ensure oversight of large-scale datasets, complex reporting structures, and analytics frameworks to support decision-making and operational transparency. Overseeing the maintenance and auditing of financial data such as the chargemaster file, adhering to all relevant regulatory and compliance standards. Champion cross-departmental collaboration, fostering innovation, and promoting professional development to enhance team capabilities and knowledge depth. Manage strategic vendor relationships to support arbitration processes, automation efforts, drive cost efficiencies, and maintain service quality. Establish and oversee training programs to ensure staff onboarding, continuous learning, and skill advancement align with evolving departmental and organizational needs. Revenue Recovery, Appeals & Arbitration Oversight Lead the strategic development and execution of Federal and State Arbitration programs, ensuring all processes align with regulatory guidelines and organizational objectives to maximize financial returns. Drive continuous evaluation and enhancement of arbitration workflows, focusing on identifying eligible claims, improving cost efficiency, and optimizing return on investment. Oversee the integration and effective use of technology solutions to track and report claim statuses throughout the arbitration lifecycle, maintaining comprehensive federal and state historical arbitration data. Collaborate within SCP and with external vendors (onshore and global) to develop and manage supporting documentation, ensuring compliance with state and federal arbitration rules. Manage functions associated with arbitration, including timely payment of arbitrator fees, accurate tracking of offers and submissions, and maintaining tools to ensure compliance with state laws and contractual obligations. Direct the management and maintenance of the Payer Contracting Module (PCM) and other contract databases, so that all eligible claims are appealed promptly and effectively. Communicate critical appeals trends and challenges to leadership, escalating complex payer issues as necessary. Collaborate with analytics to identify payer trends, appeal results, and recovery opportunities, providing actionable insights to inform strategic decisions. Approve audit findings and collaborate with executive leadership to address claims issues, ensuring alignment with corporate compliance and revenue goals. Contribute to automation and efficiency initiatives to streamline arbitration and non-contracted appeals processes, continuously driving cost reduction, workflow optimization, and improved appeal turnaround times. Present key findings and performance metrics during Monthly Operating Reviews (MORs) to inform leadership and drive strategic decision-making.

Processes transactions with the Cage, Chip Bank, Slots, and Count Rooms quickly and accurately. Is accountable for entire Main Bank Inventory including cash, coin, tokens, chips, and hopper bags. GENERAL REQUIREMENTS: High school graduate or equivalent is preferred. Prior experience in handling large sums of money, with one (1) year previous Cage Cashier experience preferred. A proven proficiency with computers, 10 key adding machines, and knowledge of computer keyboard is preferred. Must be able to enter data, read, and, interpret output from a computer. Must be able to stand for long periods. Must be willing to learn all phases of Cage activity. Must have good math abilities. Must have excellent guest and human relations skills. Must be able to work any day of the week and any shift. Must be able to get along with co-workers and work as a team. Must be able to read, write, speak and understand English. ESSENTIAL JOB FUNCTIONS: Safeguards company assets and adhere to Federal and Louisiana state statutes and gaming commission regulations. Receives and fills Funds Transfers and Cash Transfers from the Cage. Ensures the proper distribution and reconciliation of Slot Wallets for Slot Hosts. Oversees the delivery of Hopper bags to Slots. Balances the Main Bank Inventory and Accountability at the end of shift. Provides prompt and courteous service to internal guests. Creates teamwork by helping co-workers with essential functions. Meets attendance guidelines of the job and adheres to regulatory, departmental, and company policies. DEMANDS NECESSARY TO COMPLETE ESSENTIAL JOB FUNCTIONS: PHYSICAL & MENTAL: Must be able to lift, carry, and/or push up to 50 pounds. Must be able to stoop, bend, grip objects, kneel, have good finger movement, and be able to differentiate colors. Must be able to rack and stack chips. Must be able to learn and follow strictly Title 31 and other gaming regulations. Must be able to handle a stressful environment and tolerate secondary smoke. Must have the manual dexterity and coordination to operate office equipment, including Jet sort, a 10 key adding machine, PC computers, fax machine, and photo copier. Must be able to read, write, speak, and understand English. Must be able to respond to visual and aural cues. WORK ENVIRONMENT: Able to tolerate areas containing secondary smoke, high noise levels, bright lights, and dust. Able to work at a fast pace in mentally and physically stressful situations. Must maintain professional composure in all situations (e.g., demanding or threatening customer and during periods of high business volume). LAD RESERVES THE RIGHT TO MAKE CHANGES TO THIS JOB DESCRIPTION WHENEVER NECESSARY.

ARMStrong Insurance Services is the leading and most trusted name in the world of debt recovery and financial solutions. With a track record of excellence and reliability, we have proudly served businesses across various industries for decades, ensuring efficient B2B collections and tailored debt recovery solutions. As the parent company, ARMStrong is proud to own and operate Brown & Joseph, Paragon, and SubroIQ, each a powerhouse in its own right, providing specialized expertise in debt management and financial services. SubroIQ is seeking a Bilingual Customer Service Specialist as we continue to grow our team! This position includes collecting outstanding balances, providing needed documentation, coordinating the resolution of disputed invoices, and escalating high-risk customer accounts when necessary. Job Responsibilities: Communicate with businesses via the telephone and written correspondence Complete activities such as phone calls, internet searches, third-party report reviews, etc., to obtain reliable contact information Maintain minimum account work standards as assigned by Management. Negotiate claims' resolution with insurance carriers, attorneys, and responsible parties Establish agreements for lien releases Establish monthly payment contracts Prepare investigative correspondence Acquire background information, when necessary Job Requirements: Exercise independent judgment Negotiate settlements Basic proficiency with Microsoft Office, data entry, and strong computer skills, Excel preferred Critical Thinker Strong attention to detail and goal-oriented Ability to deescalate adverse situations Strong interpersonal, communication, and organizational skills Dependability Customer Service experience is REQUIRED Compensation and Benefits: $18 - $20 per hour (DOE) Benefits package with health, dental, vision, life, and disability coverage options 401(k) retirement plan option with company matching Generous paid time off policy - start with 18 days per year Paid holidays immediately upon hire - 7 standard holidays & 2 floating holidays of your choice We look forward to you joining our team! ARMStrong Insurance Services is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.

Looking to Supplement Your Income or Just Be Productive? Become an Independent Residential Insurance Inspector with CIS Group! Are you looking for a flexible, rewarding opportunity that allows you to be your own boss and take control of your schedule? CIS Group is seeking motivated, detail-oriented individuals to join our team as 1099 Property Insurance Inspectors. If you own an LLC and are looking to diversify your work, this might be the perfect opportunity for you! Why Work With Us? Since 1996, CIS Group has been one of the largest and most trusted names in the insurance inspection industry. We offer a platform that allows Independent Contractors to create and grow their own businesses, work flexible hours, and take on a variety of inspections. Whether you're supplementing your current work or looking for a new venture, this position offers flexibility and autonomy. What You'll Do: Travel to residential homes to complete exterior (interior photos here and there) property inspections. Take photos, collect property data, and upload your findings using your smartphone or tablet. Provide high-quality, professional service that delivers accuracy and on-time service, with exceptional communication. Maximize this opportunity by utilizing your unique skillset What We're Looking For: 1099 Independent Contractors - Be your own boss, set your own schedule! Flexible Hours - Work during daylight hours, Monday through Saturday. Comfortable Working Outdoors - This role requires you to work in various weather conditions. Tech-Savvy - A recent smartphone or tablet capable of taking and storing hundreds of photos. Computer Access - Wi-Fi-enabled for uploading data. Reliable Vehicle & Driver's License - Travel to residential properties within your area. Strong Communication Skills - You're a professional and a persistent communicator. You're not someone who just disappears when things get tough. Microsoft Excel Familiarity - Basic computer skills are necessary for managing your inspections. Compensation: Independent Contractors - You get paid per inspection. Fees - Vary based on location and inspection type, allowing for higher earning potential as you demonstrate competency. Why This Is Perfect for You: You've taught yourself how to solve problems and take on new challenges, and you're driven to succeed no matter the obstacles. This opportunity will allow you to create and or build your own business, and the flexibility to grow your income in an industry that remains resilient even through economic downturns. Ready to take control of your future and join a company that values your persistence and resourcefulness? Submit your resume now and become part of the CIS Group team! Job Types: Part-time, Contract Pay: $215.00 per month Benefits: Flexible schedule Compensation Package: 1099 contract Work Location: On the road

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Here's who we are. Strategic Comp is part of Great American Insurance Group, which was established in 1872. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses. The members of the Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG's common stock is listed and traded on the New York Stock Exchange ("NYSE") and NASDAQ under the symbol "AFG". Here's what we do. We provide workers' compensation coverage for large companies, using our deductible program. Our service in claims and loss control is second to none. We've found that a large majority of our customers feel the way our employees do. Our renewal retention is 90+%, meaning our customers don't want to leave us either! Here's what you would be doing if hired for the loss control position. Currently we have an opening for a Senior Loss Control Consultant in Iowa/Nebraska. This role will provide technically competent Loss Control Services in accordance with company policies and procedures and to provide support services within the territory to help acquire and retain profitable business in accordance with our company objectives. The person hired for this position will work from their home and will be required to travel up to 60% of the time including some overnight travel. A company car is provided. In addition to a competitive total rewards program, we offer an annual discretionary bonus for this position. Essential Job Functions and Responsibilities * Surveys and services commercial risks of any size and/or complexity for workers' compensation coverage. * Originates and manages all service account scheduling and activities for the assigned territory. * Meets or exceeds all service standards. * Accomplishes risk improvement by providing management consultation services, developing recommendations for hazard control, and providing direct support services to the insureds. * Conducts loss control services and training for customers to help reduce losses. Participates in team activities designed to help retain accounts. * Maintains specialized state-of-the art professional capabilities in loss control support for workers' compensation products. * Maintains specialized knowledge of company/department manuals and procedures, and relevant Federal, State, and other pertinent codes and regulations applicable to Property, Liability, and Casualty lines of coverage. * Performs other duties as assigned. Job Requirements/Qualifications: * Bachelor's degree and at least 10+ years of loss control experience working for a major writer of workers' compensation insurance is preferred. * The successful candidate will reside in Iowa or Nebraska. * Strong workers' compensation knowledge is required along with the ability to conduct training programs and classes for our clients. * Basic knowledge of underwriting and product management skills. * Broad knowledge of commercial lines of insurance coverage, engineering principles and loss control concepts, and safety standards and codes. * Strong consideration will be given to candidates with industry designations, including ARM, CPCU, Certified Engineering Technician, and Certified Safety Professional. * Extensive use of computers and software programs is required of this position. * Strong verbal and written communication skills is a must. Business Unit: Strategic Comp Salary Range: $100,000.00 -$130,000.00 Benefits: We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits. Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at **************************** * Excludes seasonal employees and interns.