This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The position of Associate Claims Clinical Specialist plays a leading role in the insured or member’s assessment process. We provide services to a variety of clients, all that require your deep knowledge of long-term care needs of an aging or chronically ill population. You will be part of a remote team of clinicians that spends their days reviewing clinical assessments completed by field assessors and writing Plans of Care for Long Term Care Insurance and other government sponsored insurance plans. Some days will be spent reaching out to claimants or members, their families, or facilities to discuss updates to their health and develop a plan of care. As our client list and capabilities grow, our opportunities also grow. This position uses your eldercare expertise and excellent communication skills to assure that the company serves our clients with the highest degree of quality, respect, and customer service. The successful candidate must be caring and empathetic with claimants, members, and their families. - Reviewing clinical assessments completed by field assessors to determine chronic illness status and develop a plan of care with supporting written documentation. - Collaborate with field assessors and facility staff via phone to determine if further information is needed on a claimant or member’s health status. - Call claimants, family members or facility staff to update records on their present health status and provide a new plan of care. - Work with new clients to develop processes that meet their insureds’ needs. Qualifications - RN with a current license in Massachusetts, New York, Illinois, Minnesota, Michigan, Pennsylvania, Washington or residing in a Nursing License Compact state with compact licensure. - A minimum of 3 years of professional clinical experience in case management, home care, or a rehabilitation setting, preferably with a geriatric population. - Strong knowledge of Microsoft applications to include: Outlook and Word. Proficient with workflow management tools and a CRM. - Ability to data input into a CRM while discussing care needs as with a claimant or member. - Excellent communication skills, both oral and written, with a customer service focused attitude to build rapport and relationships. - Ability to meet daily tracked standards in both production and quality. - Demonstrate technical and professional expertise through problem resolution, while maintaining composure. Ability to effectively communicate with both internal and external customers at all levels. - Strong multi-tasking, time management and follow-up skills to complete tasks in time sensitive manner. - Ability to independently resolve service issues and follow escalation protocol on issues. - Ability to make positive impressions over the phone and build rapport with clients, despite conversations that can be difficult or emotion filled. - Ability to work remotely in a quiet environment with strong, reliable internet while maintaining production levels. Requirements - BSN or equivalent. - Knowledge of Long Term Care settings and residents. - Previous experience with Long Term Care, Medicare, or Medicaid Assessments. - Uniform Assessment System certification. - Telephonic case management experience. Benefits - Competitive Compensation & Total Rewards Incentives. - Comprehensive Healthcare Coverage. - Multiple 401(k) Savings Plan Options. - Auto Enrollment in Employer-Directed Retirement Account Feature (100% employer-funded!). - Generous Paid Time Off – Including 12 Paid Holidays, Volunteer Time Off and Paid Family Leave. - Disability, Life, and Long Term Care Insurance. - Tuition Reimbursement, Student Loan Repayment and Training & Certification Support. - Wellness support including gym membership reimbursement and Employee Assistance Program resources (work/life support, financial & legal management). - Caregiver and Mental Health Support Services.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The position of Associate Claims Clinical Specialist plays a leading role in the insured or member’s assessment process. We provide services to a variety of clients, all that require your deep knowledge of long-term care needs of an aging or chronically ill population. You will be part of a remote team of clinicians that spends their days reviewing clinical assessments completed by field assessors and writing Plans of Care for Long Term Care Insurance and other government sponsored insurance plans. Some days will be spent reaching out to claimants or members, their families, or facilities to discuss updates to their health and develop a plan of care. As our client list and capabilities grow, our opportunities also grow. This position uses your eldercare expertise and excellent communication skills to assure that the company serves our clients with the highest degree of quality, respect, and customer service. The successful candidate must be caring and empathetic with claimants, members, and their families. - Reviewing clinical assessments completed by field assessors to determine chronic illness status and develop a plan of care with supporting written documentation. - Collaborate with field assessors and facility staff via phone to determine if further information is needed on a claimant or member’s health status. - Call claimants, family members or facility staff to update records on their present health status and provide a new plan of care. - Work with new clients to develop processes that meet their insureds’ needs. Qualifications - RN with a current license in Massachusetts, New York, Illinois, Minnesota, Michigan, Pennsylvania, Washington or residing in a Nursing License Compact state with compact licensure. - A minimum of 3 years of professional clinical experience in case management, home care, or a rehabilitation setting, preferably with a geriatric population. - Strong knowledge of Microsoft applications to include: Outlook and Word. Proficient with workflow management tools and a CRM. - Ability to data input into a CRM while discussing care needs as with a claimant or member. - Excellent communication skills, both oral and written, with a customer service focused attitude to build rapport and relationships. - Ability to meet daily tracked standards in both production and quality. - Demonstrate technical and professional expertise through problem resolution, while maintaining composure. Ability to effectively communicate with both internal and external customers at all levels. - Strong multi-tasking, time management and follow-up skills to complete tasks in time sensitive manner. - Ability to independently resolve service issues and follow escalation protocol on issues. - Ability to make positive impressions over the phone and build rapport with clients, despite conversations that can be difficult or emotion filled. - Ability to work remotely in a quiet environment with strong, reliable internet while maintaining production levels. Requirements - BSN or equivalent. - Knowledge of Long Term Care settings and residents. - Previous experience with Long Term Care, Medicare, or Medicaid Assessments. - Uniform Assessment System certification. - Telephonic case management experience. Benefits - Competitive Compensation & Total Rewards Incentives. - Comprehensive Healthcare Coverage. - Multiple 401(k) Savings Plan Options. - Auto Enrollment in Employer-Directed Retirement Account Feature (100% employer-funded!). - Generous Paid Time Off – Including 12 Paid Holidays, Volunteer Time Off and Paid Family Leave. - Disability, Life, and Long Term Care Insurance. - Tuition Reimbursement, Student Loan Repayment and Training & Certification Support. - Wellness support including gym membership reimbursement and Employee Assistance Program resources (work/life support, financial & legal management). - Caregiver and Mental Health Support Services.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This experienced Workers’ Compensation Claim Adjuster position is responsible for investigating, evaluating, and resolving assigned workers’ compensation claims. This role may also serve as an advanced developmental position for individuals seeking future supervisory or management opportunities. Additionally, the Claim Specialist is accountable for delivering high‑quality claim services that meet CCMSI’s corporate standards and uphold the level of service our clients expect. - Investigate, evaluate, and adjust workers’ compensation claims in compliance with established standards, procedures, and applicable laws. - Set claim reserves or provide reserve recommendations within assigned authority levels. - Review, approve, or oversee medical, legal, damage, and miscellaneous invoices to ensure they are reasonable and related to the claim; negotiate disputed bills when necessary. - Authorize and process claim payments according to established guidelines, industry standards, and assigned payment authority using the claim payment system. - Negotiate settlements in accordance with Corporate Claim Standards, client-specific instructions, and state regulations when appropriate. - Assist in selecting, referring, and supervising outside service providers (e.g., legal counsel, surveillance vendors, case management). - Maintain an organized and up‑to‑date personal diary within the claim system to track ongoing file activity. - Assess and pursue subrogation opportunities to ensure timely recovery. - Calculate disability rates in compliance with state laws and guidelines. - Provide timely, effective communication with clients, claimants, and other involved parties throughout the claim lifecycle. - Submit required notices for qualifying claims to excess and reinsurance carriers. - Adhere to Corporate Claim Handling Standards and follow all special client instructions. Qualifications - Minimum of 5 years of workers’ compensation claim adjusting experience. - Proficiency in Microsoft Office (Word, Excel, Outlook). - Strong written and verbal communication skills. - Proven ability to manage deadlines and multiple priorities effectively. - California jurisdiction experience required. Requirements - Bilingual (Spanish) proficiency - highly valued for communication with claimants, employers, or vendors, but not required. - California SIP certification. - Claim review presentation experience. - AIC, ARM, or CPCU designation. Benefits - 4 weeks paid time off that accrues throughout the year in accordance with company policy + 10 paid holidays in your first year. - Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance. - Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP). - Career growth: Internal training and advancement opportunities. - Culture: A supportive, team-based work environment.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Allstate Dealer Service (ADS) Vehicle Service Contract (VSC) Mechanical Claims Adjuster is an intermediate-level role responsible for adjudicating mechanical claims, reviewing inspection reports, and handling some ancillary claims for extended warranties. This position requires the use of mechanical knowledge and repair facility experience to adjudicate claims according to warranty contract specifications. The adjuster must be able to make decisions in a fast-paced call center environment. - Compile, review, and provide moderately complex to complex mechanical damage estimates, and manage the settlement process - Research reasonable part costs and labor rates in the local market - Accurately document notes and the repair decision-making process - Adjudicate claims promptly and efficiently, with minimal supervision, using prior mechanical experience to determine coverage per contract terms - Prepare repair estimates through discussions with dealerships or independent repair facilities - Complete additional tasks as directed by management - Communicate with customers, dealerships, and independent repair facilities in a call center environment - Contact customers, agreement holders, inspectors, vendors, and others to secure necessary information as needed - Confirm facts and determine if further follow-up is required Qualifications - High School Diploma or GED required - ASE Certifications are a plus - Minimum 5 years of experience in automotive dealerships or independent repair facilities - In lieu of the above, an equivalent combination of education and experience may be considered Requirements - Proficiency with Alldata and/or Mitchell ProDemand software - Intermediate skills in Microsoft Word and Excel - Intermediate negotiation and conflict resolution skills - Strong written and verbal communication skills - Ability to learn new computer programs and departmental processes - High-speed internet is required. Satellite internet providers are not acceptable Benefits - Compensation offered for this role is 50,000.00 - 75,050.00 annually and is based on experience and qualifications