Overview Being good neighbors – helping people, investing in our communities, and making the world a better place – is who we are at State Farm. It is at the core of how we operate and the reason for our success. Come join a #1 team and do some good! Grow Your Skills, Grow Your Potential Responsibilities Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-related claims for homeowners, commercial properties, and large losses. We are looking for an experienced and highly skilled professional to contribute to our dynamic team. You will be the first point of contact to meet with our insureds, explain coverage, estimate damages, and help them through the claims process while providing Remarkable service. Key Responsibilities: - Conduct on-site inspections and assessments of property damages for both residential and commercial claims - Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently - May occasionally require interacting with parties who express strong emotions or concerns about ongoing inspections or claim resolutions - Provide exceptional customer service throughout the claims process, addressing inquiries and concerns promptly and professionally - Gather necessary evidence, document findings, and prepare detailed reports to support the claims handling process - Investigate and adjust both personal and commercial property claims with exposures up to $500,000 - Evaluate coverage and policy terms to determine the validity of claims and ensure compliance with local regulations - Negotiate and settle claims within the authorized limits, considering policy provisions, industry standards, and company guidelines Where you'll work: This position is located in Jamestown, NY. Competitive candidates should reside within one of the listed zip codes and will service this same territory: 14201 14006 14009 14024 14025 14030 14034 14041 14042 14047 14048 14055 14057 14060 14062 14063 14065 14066 14069 14070 14075 14080 14081 14085 14091 14101 14111 14129 14134 14135 14136 14138 14141 14166 14168 14171 14173 14219 14427 14517 14536 14701 14706 14707 14708 14709 14710 14711 14712 14714 14715 14716 14717 14718 14719 14720 14721 14722 14723 14724 14726 14727 14728 14729 14731 14732 14733 14735 14736 14737 14738 14739 14740 14741 14742 14743 14744 14747 14748 14750 14752 14753 14754 14755 14756 14757 14760 14767 14769 14770 14772 14774 14775 14777 14778 14779 14781 14782 14783 14784 14785 14787 14802 14803 14804 14806 14813 14822 14836 14846 14880 14884 14895 14897 This is a Remote-Field position in which you will work from home and utilize a mobile office/vehicle for in-person appointments. Although the primary work location is in the field, with a commutable distance from home, there will be opportunities for virtual work to be completed at home. Additionally, there may be occasions where you will be required to travel outside your assigned area to assist in other territories. Hours of operation are continually evaluated and may change based on business need. Successful candidates are able and willing to work flexible schedules and may be asked to work overtime and/or irregular hours. Qualifications Competitive candidates must demonstrate: - Experience as a Property Field Inspection Claim Specialist in the insurance industry, specifically in property claims - Strong knowledge of property insurance policies, coverage and claim handling practices - Knowledge of both residential and commercial building construction - Familiarity with local regulations and compliance requirements in your assigned territory - Excellent communication and interpersonal skills to effectively interact with clients, agents, and other stakeholders - Proven effective communication skills to handle difficult/emotional conversations with a customer-minded focus - Proven ability to assess damages, estimate repair costs, and negotiate settlements - Detail-oriented with strong organizational and analytical skills - Proficient in using claims management software and other relevant tools - Physical agility to allow for: frequent lifting, carrying and climbing a ladder; ability to navigate roofs at various heights for inspection of both residential and commercial structures; ability to crawl in tight spaces - May be required to complete Rope and Harness Safety Training. - A valid driver's license is required Preferred: - Bachelor's Degree in a related field or equivalent work experience - Experience in handling complex or high-value claims - Construction background - Water mitigation inspection experience - Xactimate, XactContents Additional Details: - Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s). - State Farm recently implemented new pre-employment assessments. Candidates that have previously taken an assessment may be asked to participate in additional testing Our Benefits Because work-life balance is a priority at State Farm, compensation is based on our standard 38:45-hour work week! - Potential starting salary range: $59,059.65 - $90,000.00 - Starting salary will be based on skills, background, and experience - High end of the range limited to applicants with significant relevant experience - Potential yearly incentive pay up to 15% of base salary At State Farm, we offer more than just a paycheck. Check out our suite of benefits designed to give you the flexibility you need to take care of you and your family! - Get Paid! On top of our competitive pay, you are eligible for an annual raise and bonus. - Stay Well! Focus on you and your family’s health with our robust health and wellbeing programs. State Farm pays most of your healthcare premium, and we offer multiple healthcare plan options, including a high deductible plan. All medical plans provide 100% coverage for in-network preventative care, AND you and your family have access to vision, dental, telemedicine, 24/7 mental health professionals, and much more! - Develop and Grow! Take advantage of educational benefits like industry leading training programs, top-notch tuition assistance programs, employee resource groups, and mentoring. - Plan Ahead! Plan for those big moments in life with benefits like fertility/IVF/adoption assistance, college coaching, national discount programs, interactive monthly financial workshops, free financial coaching, and more. You can also start a savings account or consider financing through our State Farm Federal Credit Union! - Take a Little “You” Time! You will have access to our generous time off policies designed so you can plan around holidays, family events, volunteering, or just to take a relaxing day off. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! - Give Back! We offer several ways to give back through our Matching Gift Program, Good Neighbor Grant Program, and the Employee Assistance Fund. - Finish Strong! Plan for retirement using free financial advisors and a 401(k) plan with company contributions of up to 7% of your salary. Visit our State Farm Careers page for more information on our benefits, locations, and the hiring process of joining the State Farm team!

Lead the development and execution of claims strategies while managing staff performance and ensuring compliance with regulations, fostering collaboration across departments, and implementing cost containment initiatives to optimize operations.

Title: Claims and Benefits Manager Location: Baltimore United States Hybrid Employment Type Full-Time Job Description: Salary $97,972.00 - $118,376 with potential growth up to $152,528.00/year Maryland's Family and Medical Leave Insurance (FAMLI) program makers sure all workers in Maryland have paid time off for medical and family reasons. FAMLI is a social insurance system covering 2.6 million workers and 180,000 employers, delivered as a digitally native, public-facing services. We're in the early stages of building something as big as far-reaching as unemployment insurance or a new health department. We know that delivering services primarily through a website, over the Internet, is a new way of doing business in government. The Claims and Benefits Directorate is responsible for ensuring prompt and accurate processing of paid leave claims and insurance of benefit payments to eligible workers. As a senior leader of the Claims and Benefits Directorate, the Claims and Benefits Manager will report to the Director of Claims and Benefits and will assist with developing and implementing the Claims and Benefits staffing structure, daily operations and procedures and ensuring that state policies and regulations are met by the department. GRADE 22 LOCATION OF POSITION Maryland Department of Labor 100 S. Charles Street Baltimore, Maryland 21201 Main Purpose of Job The Claims & Benefits Manager is one of the senior leaders of the Claims & Benefits Directorate in the Division of Family and Medical Leave Insurance (FAMLI) at the Maryland Department of Labor (MD Labor). During the build phase of FAMLI, the Claims & Benefits Manager will develop processes and procedures to ensure paid leave claims are processed accurately and timely. The Claims and Benefits manager will also develop processes and procedures relating to adjudication of potentially disqualifying issues and the reconsideration of previous denials. The Manager will collaborate with the FAMLI Policy, Digital Services, Insurance Plan Compliance, and Customer Care teams when creating policies and procedures. The Claims & Benefits Manager is an essential team member and is crucial to the success of the Claims & Benefits team, which is at the heart of FAMLI's mission to ensure working Marylanders can afford to take time off to care for their loved ones and themselves. POSITION DUTIES Duties of this position include but are not limited to: Work closely with the Director of Claims and Benefits to determine the most appropriate and efficient organizational structure for the Claims and Benefits Directorate; Drafts MS-22s for necessary positions within the Claims and Benefits Directorate; Serve as hiring manager and oversee hiring, onboarding, and training of Claims and Benefits staff; Work with the Director of Claims and Benefits to draft FAMLI-specific positions for the Claims and Benefits directorate; Establishes adjudication policies and procedures for the Claims and Benefits Directorate; Establishes reconsideration policies and procedures for the Claims and Benefits Directorate; Oversees the implementation of policies and procedures, evaluates their effectiveness, and revises policies and procedures, when needed; Work closely with other FAMLI directorates to build a case management system for Claims and Benefits staff; Investigate operational problems and propose solutions to FAMLI leadership; Claims intake and processing (in person or virtually) as needed if increased volume, backlog/overflow or coverage issues occur; Approves timesheets for team members; Manages scheduling and approves leave to ensure the team is properly staffed; Investigate operational problems and propose solutions to FAMLI leadership; Performs other related leadership duties required; Complete performance reviews and evaluations (PEP); If necessary, ensure corrective actions are taken for those not meeting expectations (PIP); MINIMUM QUALIFICATIONS Education: A Bachelor's degree from an accredited college or university. AND Experience: Ten (10) years of experience of professional experience in program or operations management in a large or complex environment. Six (6) years of experience in administrative staff or professional staff work. Two (2) years of this experience must have involved one or more of the following: the supervision of other employees, applying rules and regulation or exercising responsibility for the development of policies or procedures and an additional four years of experience in a public or private agency related to rendering and /or determining eligibility for Human Service Program, or an insurance claims processing and fraud investigation program. Notes: 1. Candidates may substitute and additional six (6) years of experience in administrative staff or professional staff work for the four (4) additional years of experience. One (1) year of this experience must have involved one or more of the following: the supervision of other employees, applying rules and regulations, or exercising responsibility for the development of policies or procedures. 2. Candidates may substitute additional graduate level education at an accredited college or university at the rate of 30 credits hour on a year-for-year basis for the required general experiences. DESIRED OR PREFERRED QUALIFICATIONS Advanced Degree or Master's Degree is preferred. Strong verbal and written communication skills, with the ability to communicate complex information clearly is preferred. Experience in: Paid leave, unemployment insurance, workers compensation, or any other private or public benefits administration program. Standing up new government programs. Drafting standard operation procedures, policy and/or complex documents. Strategic planning and implementing organization-wide initiatives. Supervising and leading multiple teams or units, including supervisors. Process improvement, systems modernization, or technology implementation. Interpreting and applying state or federal laws, regulations, or administrative policies. SPECIAL REQUIREMENTS All candidates are subject to a background check against files maintained by the Division of Unemployment Insurance (Labor/DUI) to determine whether any monies are owed to Labor/DUI as a result of unemployment insurance overpayment/fraud. Any unpaid debt may have an impact on whether or not a candidate is offered employment. SELECTION PROCESS All information concerning the qualifications, including any required documentation (diploma, transcript, certificate, etc.) must submitted and received by the closing date. Information submitted after this date will not be considered. Applications that meet minimum and/or selective qualifications will be referred to the hiring unit for interview selection. Units will select those candidates most closely demonstrating the qualifications for the interview. A resume and cover letter are strongly encouraged for this position. Please upload one Word or PDF file that includes your combined cover letter and resume using the 'Transcript' upload function, or via the JobAps 'Other' tab. EXAMINATION PROCESS The assessment may consist of a rating of your education, training, and experience related to the requirements of the position. It is important that you provide complete and accurate information on your application. BENEFITS This is a full-time, permanent position and eligible for full State benefits, which includes: Flexible hours and hybrid teleworking Paid holidays 12-13 per year Generous paid leave package (annual, sick, personal and compensatory leave) State Pension ('defined benefit'plan) Tax-deferred supplemental retirement saving plans (401(k) and 457) Comprehensive, subsidized health, dental and prescription plans with little to no deductibles, free generic prescriptions, and free preventative health services Flexible Spending Accounts plans for Health Care and Daycare State Employees FURTHER INSTRUCTIONS A resume and cover letter are strongly encouraged for this position. Please upload on Word or PDF that includes your combined cover letter and resume using the 'Transcript' upload function, or via the JobAps 'Other' tab. U.S. Military Veterans may qualify for additional bonus points towards certification. Any job offer will be contingent on the candidate providing a U.S. military form DD214 verifying honorable discharge form services prior to starting employment (and may be requested prior to the interview)

Title: Health Insurance Claims Supervisor Location: Menasha, WI 54952, USA Brookfield, WI 53005, USA Hybrid Claims Production Full-time Requisition #: CLAIM002306 Job Description: Network Health's success is rooted in our mission to enhance the life, health, and wellness of the people we serve. This mission drives every decision we make - including the selection of individuals who join our growing team. We are seeking a Claims Supervisor to provide leadership and oversight of the daily operations within our Claims Production Department, including outsourced vendor management across multiple lines of business. This role plays a critical part in ensuring operational efficiency, regulatory compliance, and high-quality service delivery. The Claims Supervisor will: - Supervise claims production activities and ensure efficient, accurate workflow - Hire, coach, and performance manage team members - Prioritize daily work, departmental initiatives, and special projects - Support the Manager of Claims in driving overall department performance - Serve as a subject matter resource and represent the department in meetings - Lead special projects and respond to emergent operational issues - Ensure compliance with state mandates, regulatory requirements, and internal policies This position requires strong leadership skills, sound judgment, analytical thinking, and a solid understanding of claims operations to maintain operational excellence and support continued organizational growth. Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both with our hybrid workplace model. Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team. Job Responsibilities: - Demonstrates commitment and behaviors aligned with the philosophy, mission, values, and vision of Network Health. - Applies organizational, regulatory, and credentialing principles, policies, and procedures to the claims production process. Assists the Manager of Claims Production and/or Manager of Claims Recovery with regulatory reporting and compliance audits, including Data Validation, Financial Audits, and CMS Program Audits. - Monitors and tracks Service Level Agreements (SLAs) and Key Performance Indicators (KPIs), identifies patterns, and escalates issues to leadership as needed. - Supervises assigned claims staff, including hiring, training, performance evaluations, salary recommendations, and managing discipline and termination processes. Collaborates with the Manager of Claims Production on hiring, salary decisions, discipline, and terminations. Provides performance feedback to improve the skills and performance of both claims and claims recovery staff. - Coordinates staffing schedules to maintain optimal staffing levels. Establishes department turnaround times and production rates. Sets departmental priorities and develops efficient workflows to meet objectives. Ensures compliance with desk procedures and regulatory requirements. - Prepares and analyzes daily, weekly, and monthly operational reports, distributing relevant data to appropriate departments. Works with the Manager of Claims Production to set claims-related goals and develop strategies to meet them. - Maintains communication with other Network Health departments to assess and improve the effectiveness of the claims function, including standardizing and documenting policies and procedures, facilitating new policy implementation, and identifying opportunities for internal efficiency improvements. - Recommends and oversees employee training for claims staff. Organizes and leads regular staff and department meetings. - Performs claims-related tasks, such as processing high-dollar claims, monitoring suspended claims reports to ensure timely resolution, and serving as a liaison between the claims department and other departments. Documents results in QNXT, TMG FACETs, TMG Call, and QuickBase applications. - Other duties as assigned. Job Requirements: - Associate Degree or equivalent experience required. Bachelor's degree preferred - One year of experience in a leadership role, preferably in a health insurance industry - At least two years of health insurance claims experience is required Network Health is an Equal Opportunity Employer