This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description If you're looking for the stability of a profitable, growing company with the entrepreneurial spirit of a startup, we’re hiring. SageSure, a leader in catastrophe-exposed property insurance, is seeking a Claims Vendor Specialist. This role is responsible for managing and optimizing relationships with external vendors supporting the claims process. This role collaborates closely with internal claims teams, quality assurance, compliance, legal and finance departments to support efficient claims processing and vendor accountability. If you're interested in joining our growing Claims team, we'd love to hear from you. What you’d be doing: - Build and maintain strong working relationships with vendors and internal claims teams - Monitor vendor performance against SLAs, ensuring timely and accurate claims handling - Prepare materials to allow regular vendor performance reviews with vendor partners - Address performance issues and coordinate corrective actions when necessary - Manage the billing process and vendor expenses - Assist SageSure Program Managers with analyzing and streamlining vendor related processes based on data insights and vendor feedback to enhance operational efficiency and service delivery - Generate reports on vendor performance metrics and key performance indicators for Vendor and Claims leadership - Identify and mitigate risks associated with vendor relationships, including operational risks and compliance issues - Any other duties needed to help drive our purpose and fulfill our values Qualifications - 2+ years of property claims experience - Attention to detail, time management, organizational, multi-tasking, and problem-solving skills - Excellent written and verbal communication skills - Proficiency in Excel, data analysis, and reporting tools - Ability to be adaptable and able to respond quickly to changing vendor needs Requirements - 2+ years of experience in vendor or related role within the insurance industry (highly preferred) - Experience working in a fast-paced environment (highly preferred) Benefits - Generous health benefits and perks - Tuition reimbursement - Wellness allowance - Paid volunteer time off - Matching 401K plan - And more Company Description Named among the Best Places to Work in Insurance by Business Insurance for four years in a row (2020-2023), SageSure is one of the largest managing general underwriters (MGU) focused on catastrophe-exposed markets in the US. Since its founding in 2009, SageSure has experienced exceptional growth while generating underwriting profits for carrier partners through hurricanes, wildfires, and hail. Available in 16 states, SageSure offers more than 50 competitively priced home, flood, earthquake, and commercial products on behalf of its highly rated carrier partners. Today, SageSure manages more than $1.9 billion of inforce premium and helps protect 640,000 policyholders. SageSure has more than 1000 employees working remotely or in-office across nine offices: Cheshire, Connecticut; Chicago, Illinois; Cincinnati, Ohio; Houston, Texas; Jersey City, New Jersey; Mountain View, California; Marlton, New Jersey; Tallahassee, Florida; and Seattle, Washington. SageSure is a proud Equal Opportunity Employer committed to building a workforce that reflects the spectrum of perspectives, experiences, and abilities of the world we live in. We recognize that our differences make us strong, and we actively seek out diverse candidates through partnerships with organizations, institutions and communities that represent various backgrounds. We champion belonging and inclusion for all identities, including, but not limited to, race, ethnicity, religion, sexual orientation, age, veteran status, ability status, gender, and country of origin, striving to create a culture where all individuals feel valued, respected, and empowered to bring their authentic selves to work. Our nimble, highly responsive culture nurtures critical thinkers who run toward problems and engineer solutions. We relentlessly pursue better outcomes by investing in the technology, talent, and tools that position us to succeed in demanding markets. Come join our team! Visit sagesure.com/careers to find a position for you.

• Manages a large inventory of complex claims to evaluate compensability/liability • Plans and conducts complex claims investigations to confirm coverage and to determine liability, compensability and damages • Analyzes and negotiates appropriate claim settlements/reserves within prescribed authority • Conveys complex information regarding coverage and settlements to insureds, claimants, and external partners • Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner • Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements • May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports • Performs other duties as assigned

• Responsible for managing patient account balances including accurate claim submission. • Complies with Notices of Privacy Practices and follows all HIPAA regulations pertaining to PHI and claim submission/follow-up. • Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability and efficiency.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role supports ClearHealth Strategies’ Independent Dispute Resolution (IDR) team in a quasi-legal process focused on dispute review, eligibility analysis, and preparing arbitration briefs to ensure compliance with the federal No Surprises Act and state surprise billing laws. This position is full-time (40 hours/week) Monday - Friday. Employees are required to work an 8-hour shift schedule during our normal business hours of 8:00 am - 5:00 pm depending on the local time zone. It may be necessary, given the business need, to work occasional overtime. - Prepare arbitration briefs. - Respond to inquiries from CMS, arbiters, providers, clients, and ClearHealth management. - Identify issues, analyze EOBs and claim information, apply critical thinking skills to formulate a plan of action, and resolve issues independently. - Triage complex issues to management. - Manage multiple priorities in a time-sensitive manner. - Work in a fast-paced, high-volume environment with quick turnaround time. Qualifications - High School Diploma / GED OR equivalent work experience. - Must be 18 years of age OR older. - 1+ years of experience preparing written summaries, case reviews, reports, or briefs in a regulated, compliance-driven, or legal adjacent environment. - 1+ years experience reviewing and interpreting claims data, Explanation Of Benefits, and supporting documentation to identify issues and determine appropriate next steps. - Experience ensuring compliance with HIPAA privacy and security regulations. - Work full-time between 8:00 am - 5:00 pm local time, including the flexibility to work occasional overtime given the business need. Requirements - 1+ years of experience working with the federal No Surprises Act (NSA) and/or state surprise billing disputes. - Experience supporting or working within personal injury litigation. - Knowledge of the medical claims process. Telecommuting Requirements - 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 - Communicates clearly and professionally, with strong business writing skills. - Effectively prioritizes tasks and manages workload to meet deadlines and goals. - Works collaboratively and contributes positively to a team environment. - Demonstrates a proactive, “ready to work, ready to learn” mindset. - Upholds integrity, accountability, and strict confidentiality. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). - Hourly pay for this role will range from $23.89 - $42.69 per hour based on full-time employment. Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.