Overview Claims Submissions Specialist (Remote) Lead with GRATITUDE. Practice with EMPATHY. Care with COMPASSION. Be part of NADG's Tribe! NADG is the fastest growing dental services organization of scale in the United States and today consists of a network of over 200+ dental practices in 15 states and 23 regional markets. We are gearing up for continued growth and are excited to recently have become part of the first transatlantic dental services group. Our entrepreneurial culture and commitment to best in class patient care position us as an innovative and dynamic industry leader. We are looking for a Claims Submissions Specialist to come and help us pioneer a new culture of dentistry. Join the tribe! Responsibilities: The Claims Submission Specialist is responsible for maintaining clean claim submission of their assigned offices. This role will be key to building and maintaining positive relationships with the practice teams to ensure maximum results are achieved. - Identify problem accounts, trends in claim issues and escalate them as appropriate. - Update patient account records. - Research and identify coding or clinical documentation issues working to correct errors in a timely manner for maximum reimbursement. - Provide training assistance if needed to new and existing team members - Where applicable, utilize Dental Xchange attachments, Apteryx bridge, and OverJet for electronic document submission with claim. - Understand practice-level responsibilities. - Understand insurance verification responsibilities. - Actively support the company’s culture and business mission by always putting the organization’s people and its customers first. - Expected to work all scheduled work days, during scheduled hours and report to work on time. - Other special projects or responsibilities as assigned. Experience/Requirements - Minimum of two (2) years’ experience in Dental Billing/Coding - Solid background with commercial insurance companies required - Proven understanding of Explanation of Benefits forms, claim forms and insurance billing process - Must be able to build positive relationships with team members and outside clients - Ability to work independently and with others in a fast-paced environment - Excellent verbal, written and interpersonal communication skills required - Experience with Open Dental, M/S office products including Word, Excel, Outlook - Proficient use office applications and able to adapt to and embrace new applications and programs Why You’ll Love Working Here - Comprehensive Benefits: Including 401(k). - Paid Time Off: Competitive PTO that grows with your career. - Career Growth: Opportunities for continuing education and development. - Exciting Work Environment: A supportive atmosphere that celebrates individuality and teamwork, allowing you to thrive. Equal Opportunity EmployerWe embrace diversity and are committed to creating an inclusive workplace. All qualified applicants will receive consideration for employment without regard to race, color, ancestry, religion, sex, sexual orientation, gender identity, age, national origin, disability, veteran status, or any other legally protected characteristic. Ready to Join Us?Apply today and be part of a team that’s revolutionizing dental care! North American Dental Group-branded practices are independently owned and operated by licensed dentists. The practices receive non-clinical business support services from North American Dental Group, a dental support organization. #NADG3

Job Summary Westfield Property Claims resolves first party personal, commercial, and agriculture property claims, which include structural damage. The Inside Claims Senior Representative serves as a technical estimating expert on first party property claims damages. This role leverages technical estimating software, industry repair standards, and analytical skills to produce accurate, timely, and defensible estimates. The role may also determine applicability of coverage, investigate, establish damages, negotiate, and settle claims. The role delivers quality customer service in a high volume, moderate complex work environment, and mentors less experienced Inside Estimators on the team. Job Responsibilities - Review photos, reports, and other documentation from the inspection, to assess damage and prepare accurate estimates. - Utilize industry-standard estimating platform Xactimate, to produce detailed repair scopes. - Determine appropriate repair vs. replacement decisions based on best practices, jurisdictional code requirements, and policy coverage. - Validate the accuracy of insured and/or contractor submitted estimates and to negotiate discrepancies when necessary. - Apply current industry repair standards, materials pricing, labor rates, and construction methodologies. - Provide technical expertise to frontline claims staff. - Communicate clearly with customers, contractors, and vendors to explain scope and estimate decisions as/is necessary. - Document all file activity in accordance with company and regulatory requirements. - Support supplemental estimate reviews. - Ensure all estimates comply with company guidelines, state regulations, and industry’s best practices. - Maintain high levels of accuracy, productivity, and cycle time performance. - Provides support in negotiation of settlements with insureds, attorneys, and other insurance companies. - Manages approved vendors and counsel utilized as necessary in the claim process, including approval of investigation plans and budgets. - Monitors, reviews, and issues payments to vendors and counsel in accordance with guidelines and standards. - Establishes proper reserves for each claim based upon thorough investigation, evaluation, and experience. - Refers claims exceeding authority to appropriate manager or complex claims specialist with recommendations. - Meets established goals & objectives, arranges for salvage disposition and other recovery proceedings as necessary, participates in claim file reviews and audits with customer and broker. - Formulates sound recommendations for claims file handling, subsequent transactions, and renewal processing. - Contribute to continuous improvement efforts, guideline updates, and internal training initiatives. Job Qualifications - 4+ years of Claims Estimating experience. - Bachelor’s degree in Insurance, Business, Communications, Construction Management, or a related field and/or commensurate work experience. - Proficiency with Xactimate Location Remote Licenses and Certifications - Associate in Claims (AIC) (preferred) - Xactimate Level 1–3 Certification - HAAG Residential & Commercial Inspector and/or Reviewer Certification Skills & Competencies - Strong attention to detail and technical accuracy. - Excellent written and verbal communication skills. - Ability to multitask in a fast-paced claims environment. - Customer-focused with strong problem-solving ability. - Negotiation and conflict-resolution skills. - Ability to work independently and make sound decisions. This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management. Founded in 1848, Westfield is a global leader in property and casualty insurance, delivering superior risk insights and innovative solutions to customers through a diverse portfolio of insurance products. Westfield underwrites commercial, personal, surety, and specialty lines of coverage through a network of leading independent agents and brokers in the United States and specialty products through Lloyd’s of London Syndicate 1200. As a mutual insurance company with more than 3,000 employees, Westfield has revenues in excess of $4 billion and more than $10 billion in assets.

About the role As a Customer Experience Specialist at Reserv, you will be an integral part of our dedicated team focused on providing exceptional service to our customers during the insurance claims process. You will handle phone and email inquiries, provide support, and ensure a smooth and positive experience for all involved parties as they navigate their claims journey. Your expertise in multi-line insurance and claims will enable you to deliver exceptional, empathetic assistance. Who you are - Highly motivated and growth-oriented. You're excited by the prospect of building a tech-driven claims org. - Passionate CX professional who cares deeply about the customer and their experience. - Empathetic. You exercise empathy and patience towards everyone you interact with. - Sense of urgency at all times, balanced with the ability to be detail oriented. That does not mean working at all hours. - Creative. You challenge existing assumptions and find creative solutions to problems. - Curious. You want to know the whole story so you can make the right decisions early and be decisive when it counts. - Anti-status quo. You don’t just wish things were done differently, you action on it. - Communicative. You are comfortable with and understand the importance of phone communications throughout the claims process. - And did we mention, a sense of humor. What you'll do - Serve as the primary point of contact for customers, providing professional and compassionate assistance throughout the claims process via phone, email, and other communication channels - Anticipate the customer needs and take action to manage the process to full resolution - Provide guidance and information to customers regarding the claims process, taking any additional steps necessary for the prompt and accurate resolution of their claims - Develop and maintain a solid understanding of claim procedures to provide accurate and consistent information to customers - Accurately record and update customer information, claim details, and related documentation in our internal systems, ensuring data integrity and adherence to company protocols - Identify and address customer concerns, complaints, and disputes with empathy and professionalism - Work collaboratively with internal teams to investigate and resolve complex issues, escalating matters when necessary to achieve timely resolutions - Strive to exceed customer expectations by delivering exceptional service, actively listening to customer feedback, and proactively seeking ways to improve the customer experience - Adhere to company policies, procedures, and regulatory requirements, ensuring the privacy and confidentiality of customer information at all times Requirements - High school diploma or equivalent is needed; bachelor's degree or relevant insurance certifications are a plus - Previous experience in customer service or a call center environment within the insurance industry, preferably with a focus on property or liability claims; high volume, fast-paced - Strong knowledge of insurance claims processes, terminology, and best practices - Excellent communication skills, both verbal and written, with the ability to explain complex concepts clearly and empathetically to customers - Active listening skills to understand customer needs, concerns, and emotions, and respond appropriately - Strong problem-solving and critical-thinking abilities - Proficiency in using customer relationship management (CRM) systems and other relevant software applications - Empathy, patience, and resilience to handle challenging customer interactions with professionalism and composure - Strong organizational and time management skills to prioritize tasks and meet deadlines effectively - Must be able to obtain designated home state claim adjuster license in 60 days Benefits - Generous health-insurance package with nationwide coverage, vision, & dental - 401(k) retirement plan with employer matching - Competitive PTO policy – we want our employees fresh, healthy, happy, and energized! - Generous family leave policy after 8 months of continuous work - Work from anywhere to facilitate your work life balance - Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder! Additionally, we will - Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role - Work toward reducing and eliminating all the administrative work from an adjuster role - Foster a culture of empathy, transparency, and empowerment in a remote-first environment At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!

Overview A Payment Accuracy, Coordination of Benefits (COB) Specialist, is a member of the greater Coordination of Benefits Business Unit (BU). Coordination of Benefits involves situations in which an individual is covered by two or more health plans. Our specialists are passionate about what they do and are experts at reviewing, discovering, and validating substantial amounts of data and delivering results and insights for our clients. A Payment Accuracy, COB Specialist, is responsible for reviewing and analyzing claims, member, and group data to identify instances of recoverable claims for the benefit of Cotiviti and our clients. Under direct supervision, this individual will be responsible for establishing the correct order of liability for our clients’ members. This individual will also be responsible for inputting accurate claim recovery information in the proprietary Cotiviti software tools, as well as assisting with related inquiries throughout the claim recovery process. Responsibilities - This individual will work under direct supervision and will be monitored for efficiency in production and quality review of assigned work. - Demonstrates a strong ability to proactively develop and uphold a solid grasp of Centers for Medicare and Medicaid Services (CMS) and National Association of Insurance Commissioners (NAIC) guidelines to accurately determine liability order. - Leverages cutting-edge Cotiviti audit tools such as the Recovery Management System (RMS), COB Tracker, and client-specific systems to conduct thorough member investigations. - Creates detail-oriented, accurate notes in Cotiviti audit tools and/or client tools throughout the member investigation. - Meets or exceeds standards of production and quality as identified by compliance and regulatory guidelines and set forth by the Team Lead and/or Manager when reviewing concept and claim identifications for the client. - Prepares and evaluates responses to client disputes both internally and externally within the Business Unit as needed. - Identify and solve problems by classifying errors and overpayments for our healthcare clients. - Identifies opportunities for continuous improvement for efficiencies within reporting and streamlining research processes. - Demonstrates understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements. - Has a basic understanding of the healthcare industry, as well as proven track record of delivering results. - Assures confidentiality and security of all data, adhering to all HIPAA (Health Insurance Portability and Accountability) laws and requirements. Demonstrates the skills, knowledge, and ability to ensure that our environment is safe, complying with industry standards. - Has ability to take responsibility for outcome, whether positive or negative and apply learning as applicable. - Integrates information from various sources and considers broader context. - Tries unique ways of doing things and tests promising ideas. - Actively seeks information to understand rationale. - Complete all responsibilities as outlined on annual Performance Plan. - Complete all special projects and other duties as assigned. - Must be able to perform duties with or without reasonable accommodation. This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change. Qualifications - High School Diploma - Required. - Bachelor’s degree (Preferred) and/or a minimum of one (1) year of related experience in healthcare. - At least 1-year Cotiviti experience is recommended for individuals seeking their next opportunity internally. (Example: Retrieval Agent and/or Audit Support positions). - Healthcare industry experience, including knowledge of Coordination of Benefits (Preferred). - Computer proficiency including Microsoft office (Word, Excel, Outlook). - Excellent verbal and written communication skills. - An enthusiasm for working with large datasets and diverse databases will set you up for success in this position. - You thrive in both individual and team environments, showcasing self-motivation and determination to achieve success. - Understands and embodies Cotiviti's Core Values, Strategic Pillars, and Operations Disciplines to achieve successful performance in completing assigned responsibilities and interactions with the organization, both internally and externally. Mental Requirements: - Ability to analyze large volumes of data, identify trends, discrepancies, and anomalies. Must have exceptional attention to detail to ensure accuracy in financial records and audit findings. - Demonstrates strong critical thinking skills, with the ability to assess complex situations, identify key issues, and propose practical solutions. Able to approach challenges methodically and with a strategic mindset. - Makes informed decisions based on available data, regulations, and auditing standards. Must be able to weigh options and make recommendations that align with both compliance requirements and organizational goals. - Strong understanding of auditing standards, regulations, and industry best practices. Must be able to apply these standards consistently to ensure accurate and compliant audit processes. - Ability to recognize when something is wrong or needs further investigation. Must have the initiative to probe deeper into financial records or processes to uncover issues, inconsistencies, or irregularities. Physical Requirements and Working Conditions: - Remaining in a stationary position, often standing or sitting for prolonged periods. - Repeating motions that may include the wrists, hands, and/or fingers. - No adverse environmental conditions expected. - Must be able to provide a dedicated, secure work area. - Must be able to provide high-speed internet access / connectivity and office setup and maintenance. Base compensation ranges from $20.00 to $23.00 per hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration. Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law. Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page. Date of posting: 3/16/2026Applications are assessed on a rolling basis. We anticipate that the application window will close on 3/25/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected. #LI-Remote#LI-KB1#junior