Role Description Our client, a Nationally recognized P&C Insurance Company, is seeking a highly experienced Commercial Auto Large Loss Claims Specialist to join their team. This individual will be responsible for managing complex, high-exposure commercial auto, trucking, and medical transport claims involving severe injuries and significant financial exposure, from initial intake through final resolution. This role requires someone who can confidently navigate high-severity files, collaborate with counsel and vendors, and drive claims to efficient, compliant outcomes while maintaining exceptional service standards. This is a fully remote opportunity offering the chance to work on challenging, high-impact claims within a dynamic and supportive environment. - Manage and investigate 80 - 90 complex commercial auto claims involving severe bodily injury and large loss exposure. - Conduct detailed claim investigations including liability determination, coverage analysis, and damage evaluation. - Collaborate with legal counsel on litigated claims, providing documentation and strategy support as needed. - Evaluate medical documentation, accident reports, witness statements, and other evidence to determine claim value and exposure. - Negotiate settlements with claimants, attorneys, and other involved parties. - Maintain accurate and timely claim documentation in accordance with company procedures and regulatory requirements. Qualifications - 5 – 10+ years of Commercial Auto Bodily Injury claims experience. - Experience handling complex or large loss claims in excess of $500K - $1M. - Must have experience working directly for an Insurance Carrier. - Strong analytical, negotiation, and investigation skills. - Ability to manage multiple complex claims simultaneously while maintaining attention to detail. - Excellent communication and organizational skills. Benefits - $90,000 - $110,000 annual base salary (commensurate with experience). - Comprehensive Medical, Dental, and Vision insurance. - Flexible scheduling and ability to work fully remote. - Attractive PTO package. - Employer-matching 401(k).

Role Description Are you a passionate individual seeking a fulfilling career that offers flexibility and growth opportunities? Look no further! With the option to work from home and enjoy a flexible schedule, you can balance your personal and professional life seamlessly while advancing your career. - Work-Life Balance: Embrace the freedom to work from home and tailor your schedule to fit your lifestyle, ensuring you have time for what matters most to you. - Supportive Environment: Join a nurturing community that values work-life harmony and provides the support and flexibility you need to thrive in your career. - Mentorship & Growth: Access mentorship opportunities from experienced leaders who are dedicated to helping you succeed, empowering you to grow and excel in your role. Qualifications - Dedication to delivering exceptional customer service experiences. - Strong communication and interpersonal skills. - Ability to lead and inspire teams to achieve outstanding results. - Desire to pursue professional growth and development while maintaining a healthy work-life balance. Company Description Global Elite Empire Consultants is a third-party recruiter, not an insurance agency. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Role Description The Senior Associate, Fraud & Complaints, Solar Servicing is responsible for resolving complex cases protecting the Bank from legal, financial, reputational, and operational risk. This role completes thorough investigations into complaints and suspected fraudulent activities, including those involving installer, borrower, sales representative, and first-party and third-party fraud. - Investigate and solve fraud cases using various tools available: LexisNexis, DataTree, Emailage, analytical data, and others. - Investigate, respond to, and resolve routine and high-risk borrower complaints, including Social Media disputes (BBB, Yelp, Facebook). - Resolve FCRA disputes. - Gather and analyze evidence, employing a variety of investigative techniques, such as loan material review, forensic accounting, call listening, data analysis, and interviews, to uncover fraudulent schemes and identify responsible parties. - Perform investigations at the direction of internal and external counsel, and draft first-pass legal responses and recommendations. - Collaborate with internal stakeholders to ensure appropriate actions are taken to detect, address, and prevent future occurrences of identified fraud cases. - Assist in the development and implementation of risk-based prevention strategies and controls to mitigate risks and safeguard company assets. - Stay up to date with emerging fraud trends, industry best practices, and regulatory requirements related to fraud detection and prevention. - Create comprehensive investigative reports, documenting findings, recommendations, and actions taken to address fraud or complaint incidents, as needed. - Assist in the development and implementation of fraud detection tools and systems to enhance the Company's ability to identify potentially fraudulent activities. - Assist with training and aid vendor team supporting fraud and complaint investigations. - Identify and support process enhancements to streamline processes for Fraud & Complaints team. - Execute on special projects. - Perform other duties as assigned. Qualifications - High School Diploma required; Bachelor’s Degree preferred. - Minimum of 3 years of experience within fraud investigation, conducting complex investigations (preferably in a corporate or financial institution setting) required. - Knowledge of lending regulations, and some or all: FCRA, SCRA, Reg Z, UDAAP, BSA/AML, TILA, OFAC required. - Comfortable reviewing loan and financial transaction information. - Proficient with Microsoft Office tools (Outlook, Word, PowerPoint, Excel). - Proficient in LexisNexis, Snowflake, SQL, DataTree, Emailage. - Ability to see patterns, trends, and spot suspicious behavior. - Proficient in utilizing data analysis tools and techniques to identify patterns, anomalies, and trends indicative of fraudulent activities. - Proficient in conducting online investigative research using search engines and open-source intelligence techniques. - Strong knowledge of fraud detection and prevention techniques and a solid understanding of relevant laws, regulations, and industry standards. - Ability to present complex findings and recommendations to technical and non-technical stakeholders. - High ethical standards and integrity, maintaining confidentiality and professionalism throughout investigations. - Bilingual (English / Spanish) preferred, but not required. - Advanced certifications such as Certified Fraud Examiner (CFE) preferred, but not required. - Experience with fraud or complaint handling in the solar industry preferred, but not required. - Experience with fraud detection software and knowledge of relevant technologies. - Excellent verbal, written, and interpersonal communication skills. - Strong organizational skills and attention to detail. - Outstanding problem-solving and time management skills. - Self-motivated, self-directed, and results-oriented. - Adaptable and able to multitask in a fast-paced environment. - Can work independently and within a team; solution-oriented with a collaborative approach. Requirements - Work is primarily conducted in an office setting while certain positions may allow for remote work through the use of technology at management discretion. - Remain in a stationary position for extended periods of time. - Use hands and fingers. - Utilize a computer monitor with visual acuity. - Operate technology or other office machinery such as printers, scanners, etc. - Communicate clearly verbally and/or in writing with others. Benefits - Comprehensive health, dental, and vision plans. - 4 weeks PTO. - 401k + company match. - Metro SmartTrip benefits ($50/mo). - Remote or hybrid work schedules for most positions. - Incentives for purchasing solar panels, electric vehicles, biking to work, etc. - Paid subscriptions to Veterans Compost, Capital Bikeshare, Imperfect Foods reimbursement, and more! - Best Workplaces for Commuters 2023 & 2024 winner. - The Washington Post Top Workplaces 2023, 2024, and 2025 winner. - American Banker Best Banks to Work For 2023 winner.

Role Description The Claims Data Strategy Lead role is responsible for providing senior-level, hands-on leadership across complex healthcare claims data initiatives. This is a highly autonomous individual contributor role with full ownership accountability for identifying problems, driving solutions, and delivering outcomes with minimal oversight. The role requires rapid ramp-up, strong technical judgment, and the ability to translate complex and disparate claims data into scalable, high-performance analytics that directly support product, client, and business objectives. - Own and drive end-to-end solutions across healthcare claims data initiatives, from problem definition through implementation and validation. - Serve as a senior authority on medical, pharmacy, behavioral health, dental, DME, and ancillary claims data, including experience with FACETs, BlueChip, Prime Therapeutics, ESI, and aggregated claims sources. - Design, build, and optimize advanced SQL-based data models, views, and automation frameworks with a focus on performance, scalability, and maintainability. - Develop and maintain complex claim adjustment sequencing and disposition logic, including support for split claims and multiple, disparate source configurations. - Build utilization metrics tied directly to underlying service-level data, including inpatient, outpatient, professional, and behavioral health levels of care. - Apply deep expertise in healthcare transactions and standards, including 837, 834, 820, HL7, and CCDA, to ensure data accuracy and analytical integrity. - Independently assess unfamiliar data environments and rapidly develop a working understanding of new datasets using systematic, repeatable methodologies. - Proactively identify data gaps, risks, and improvement opportunities and drive them to resolution without waiting for direction. - Partner closely with product, analytics, engineering, and leadership teams to ensure claims data assets support broader business and client goals. This role carries clear ownership accountability and is expected to proactively drive work forward rather than operate in a task-by-task or advisory capacity. Given the seniority and scope of the role, the individual is expected to operate with a high degree of independence, requiring minimal day-to-day oversight. Success in this role is defined by the ability to identify problems, propose solutions, and execute through completion. Qualifications - Bachelor’s degree in Computer Science, Information Systems, or related field (or equivalent practical experience) - 7-10 years of experience working with healthcare data, with deep specialization in claims data and analytics - Expert-level proficiency in SQL and advanced query development across large, complex datasets - Extensive experience building and optimizing complex data models, views, and automation frameworks within SQL platforms - Strong understanding of healthcare claims data structures, including medical, pharmacy, behavioral health, and ancillary claims - Demonstrated ability to develop and maintain complex claim adjustment sequencing and disposition logic - Proven ability to independently assess unfamiliar data environments and rapidly develop working solutions - Strong analytical, problem-solving, and critical-thinking skills - Excellent communication and collaboration abilities across technical and non-technical stakeholders - Ability to work independently, take full ownership of initiatives, and manage multiple priorities with minimal oversight Preferred Qualifications - Experience working with FACETs, BlueChip, Prime Therapeutics, ESI, or aggregated healthcare claims sources - Hands-on experience with healthcare transactions and standards including 837, 834, 820, HL7, and CCDA - Experience developing utilization metrics tied to service-level claims data (inpatient, outpatient, professional, behavioral health) - Strong understanding of performance tuning, query optimization, and scalability considerations in large data environments - Experience supporting analytics, product, or client-facing use cases in healthcare or payment integrity contexts - Background in building reusable, table-driven logic and automation frameworks Company Description SmartLight Analytics was formed by a group of industry insiders who wanted to make a meaningful impact on the rising cost of healthcare. With this end in mind, SmartLight works for self-funded employers to reduce the wasteful spend in their healthcare plan through our proprietary data analysis. Our process works behind the scenes to save money without interrupting employee benefits or requiring employee behavior changes.