Love + medicine is who we are, it's what we do, it's why people want to work here. If you’re looking for a job to love, apply today. Scheduled Weekly Hours: 40 Emplify Health by Gundersen is looking to add a Prior Authorization Specialist to our team! In this role you will work with hospital departments and insurance companies to obtain the necessary pre-certifications and authorizations for services ordered/scheduled from insurance. Attention to detail, strong communication, and computer and phone skills are important! In this role, You will: - Secure prior authorizations from insurance companies for all hospital and clinical scheduled procedures acting as a liaison between patients, physicians, and insurance providers. - Navigate complex insurance regulations and advocate for patients' needs - Process paperwork effectively and efficiently to ensure all documentation is completed - Maintain strong communication both verbally and written What's Available: - Full time, 1.0 FTE - 40 hours/week - Monday-Friday, hours between 7 am -5 pm, 8-hour shifts - Remote eligible after training in-person - Starting pay of $19.86/hour + more for experience! What You'll Need: - High School Diploma or equivalency - 1-2 years' experience in healthcare with insurance or prior authorization experience required - Excellent problem-solving abilities and strong attention to detail - Strong communication skills, both verbal and written - Coding experience and certifications is a plus! What You'll Get: - Support to grow in your career with access to our Career Development Center and Tuition Investment Program - Top-rated retirement plan and healthcare benefits - Departmental leadership that supports you as you do your best work. - Work/Life balance to love what you do and where you live Emplify Health is comprised of two of the Midwest’s most respected healthcare systems, Bellin Health and Gundersen Health System. Once neighbors, we are now partners, united in our mission to provide exceptional care to our communities. As a not-for-profit, patient-centered healthcare network, we have headquarters in Green Bay and La Crosse, Wisconsin. Our extensive network includes 11 hospitals and more than 100 clinics, serving 67 cities and rural communities across Wisconsin, Iowa, Minnesota and Michigan’s Upper Peninsula. With over 4,500 dedicated nurses and providers, we are committed to delivering primary, specialty and emergency care, along with innovative medical education programs. Join us in making a meaningful difference in the lives of our patients and communities. If you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267. We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values — belonging, respect, excellence, accountability, teamwork and humility — our pillars set our foundation and our future. Equal Opportunity Employer

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Manager PRIMARY PURPOSE: To manage the technical and operational functions within assigned office(s) including compliance with company standards and industry best practices; to ensure consistent delivery of quality services; to be responsible for staffing and training needs; and to be responsible for budget preparation and profit and loss management. Has direct responsibility for 25-49 colleagues. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Responsible for overall operational management for assigned locations/offices. - Establishes policy and procedure to assure compliance to best practices, claims management services standards, state regulations and client service requirements. - Establishes business plan with goal and objectives for the partnership and assigned locations/offices. - Monitors management reports relating to the partnership/office performance. - Assists with the coordination of sales and client service efforts. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. - Supports the organization's quality program(s). - Travels as required. SUPERVISORY RESPONSIBILITIES - Administers company personnel policies in all areas and follows company staffing standards and training recommendations. - Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions. - Provides support, guidance, leadership and motivation to promote maximum performance. QUALIFICATIONS Education & Licensing Baccalaureate degree from an accredited college or university preferred. Licenses as required. Experience Eight (8) years claims management experience including two (2) years supervisory experience or equivalent combination of experience and education. Skills & Knowledge - Excellent oral and written communication, including presentation skills - PC literate, including Microsoft Office products - Leadership/management/motivational skills - Analytical and interpretive skills - Strong organizational skills - Excellent interpersonal skills - Excellent negotiation skills - Ability to work in a team environment - Ability to meet or exceed Performance Competencies WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance W2 General Liability Adjuster PRIMARY PURPOSE: To investigate claims against insurance or other companies for personal, casualty, or property loss or damages; attempts to effect out-of-court settlement with claimant. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Examines claim forms and other records to determine insurance coverage. - Interviews, telephones, or corresponds with claimant and witnesses; consults police and hospital records; and inspects property damage to determine extent of company's liability, varying method of investigation according to type of insurance. - Prepares report of findings and negotiates settlement with claimant. - Recommends litigation by legal department when settlement cannot be negotiated. - Attends litigation hearings. - Revises case reserves in assigned claims files to cover probably costs. - Assists in preparing loss experience report to help determine profitability and calculates adequate future rates. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. - Supports the organizations quality program(s). QUALIFICATIONS Education & Licensing High School diploma or GED required. Experience Six (6) years of general office experience or equivalent combination of education and experience required. Claims industry experience preferred. Skills & Knowledge - Knowledge of professional liability claims - Ability to review information and ensure accuracy and applicable policy placement - Oral and written communication skills - PC literate, including Microsoft Office products - Attention to detail and accuracy - Ability to work in a team environment - Ability to meet or exceed Performance Competencies WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Division or Field Office: Claims I Division Department of Position: Home & Auto Liability Dept Work from: Remote Salary Range: $56,367.00 - $90,040.00 * salary range is for this level and may vary based on actual level of role hired for *This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired. Position may be eligible for an annual bonus payment. At Erie Insurance, you’re not just part of a Fortune 500 company; you’re also a valued member of a diverse and inclusive team that includes more than 6,000 employees and over 13,000 independent agencies. Our Employees work in the Home Office complex located in Erie, PA, and in our Field Offices that span 12 states and the District of Columbia. Benefits That Go Beyond The Basics We strive to be Above all in Service® to our customers—and to our employees. That’s why Erie Insurance offers you an exceptional benefits package, including: - Premier health, prescription, dental, and vision benefits for you and your dependents. Coverage begins your first day of work. - Low contributions to medical and prescription premiums. We currently pay up to 97% of employees’ monthly premium costs. - Pension. We are one of only 13 Fortune 500 companies to offer a traditional pension plan. Full-time employees are vested after five years of service. - 401(k) with up to 4% contribution match. The 401(k) is offered in addition to the pension. - Paid time off. Paid vacation, personal days, sick days, bereavement days and parental leave. - Career development. Including a tuition reimbursement program for higher education and industry designations. Additional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year. Position Summary Exercises independent discretion and judgement in claims handling involving complex liability issues, to include coverage issues and minor injury claims. - This is a remote work from home position in NC. - The ideal candidate will live within 50 miles of the Raleigh Branch Office, however candidates will be considered who live in North Carolina. - NC Adjusters License preferred. Duties and Responsibilities - Conducts investigations, evaluate and make recommendations regarding coverage and liability. - Sets and maintains reserves. Obtains documents to establish the value of claims and negotiates settlement or declines claim. - Documents files and submits final report. - Identifies subrogation opportunities and initiates appropriate action. - Negotiates with all parties, or their representatives, within designated authority. - Completes required training. - Trains and mentors. - Travel for training may be required. The first five duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished. This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become evident. Capabilities - Values Diversity - Nimble Learning - Self-Development - Collaborates - Customer Focus - Cultivates Innovation - Information Management Skills - Instills Trust - Optimizes Work Processes (IC) - Job-Specific Knowledge - Ensures Accountability - Decision Quality Qualifications Minimum Educational and Experience Requirements - High school diploma or equivalent and two years of claims or customer service experience, preferably with casualty claims, required. - Equivalent educational experience will be considered. - Associate's or Bachelor's degree, preferred. Designations and/or Licenses - Appropriate license as required by state. Physical Requirements - Lifting/Moving 0-20 lbs; Occasional (<20%) - Lifting/Moving 20-50 lbs; Occasional (<20%) - Ability to move over 50 lbs using lifting aide equipment; Occasional (<20%) - Pushing/Pulling/moving objects, equipment with wheels; Occasional (<20%) - Climbing/accessing heights; Rarely - Driving; Occasional (<20%) - Manual Keying/Data Entry/inputting information/computer use; Frequent (50-80%)