Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health. Job Summary The Appeals and Grievance (A&G) Coordinator is responsible, per State and Federal regulations, for assisting with all operational aspects of the Appeals and Grievances assignment process for Point32Health. Responsibilities include, but are not limited to: processing daily mail received by the A&G department, handling outgoing mail for the A&G department, distribution and classification of cases in compliance with applicable timeframes and regulations, gathering information on behalf of the A&G Analyst with external vendors, coordinating the request for medical records, tracking effectuations, facilitating delivery of appeals and related information to key departments and appeals committee members; analyzing and reporting data regarding department processes as requested from management; note trends in Appeals and Grievances and notify supervisors of their findings. The coordinator must possess a broad understanding of all Point32Health lines of business and benefit structures as well as have an understanding of regulatory requirements and timeframes. Essential functions will occur simultaneously; therefore, the employee must be able to appropriately handle each of these functions, prioritize them, and seek assistance when necessary. These essential functions need to be performed on a consistent and regular basis, using good judgment. The employee must be able to learn and apply Point32Health’s policies and complex and frequently changing regulatory requirements consistently and the judgment to seek guidance as needed. Job Description Key Responsibilities/Duties – what you will be doing (top five): - Assign new verbal and written appeals and grievances to Appeals and Grievances Analyst. - Support A&G Analyst in timely completion of Appeals and Grievances. - Adheres to all regulatory, internal and compliance timeliness expectations. - Responsible for distribution of incoming mail as well as department manual mail processing. - Other duties and projects as assigned. Qualifications – what you need to perform the job Certification and Licensure Education - Required (minimum): Associate’s Degree or equivalent experience in health care, conflict resolution or related field - Preferred: Experience - Required (minimum): 1-2 years of member services representative/customer service experience in health care - Preferred: 1-2 years’ Appeals and Grievance experience in assigning and handling appeals and grievances Skill Requirements - Excellent organizational skills required.  Excellent interpersonal/communication skills are essential.  Must have computer skills with experience in EXCEL, and WORD.  Must have knowledge and demonstrated ability in the use of Windows applications and other comparable systems/applications. - Knowledge of basic medical terminology. - Individual must be able to appropriately identify urgent situations and follow the appropriate protocol. Position also requires the ability to manage multiple priorities as well as having the initiative, judgment, and perception to operate within a fast paced, high stress environment. Individual must possess strong organizational, logical reasoning, analytical, and problem-solving skills as well as the attention to detail necessary to act within this complex environment. Individual must also be able to work independently but be able to identify when they should ask for help. The individual should be flexible to respond to changing needs in the Department. - Must be able to work well independently and as a team member.  Must be able to work closely with other department staff and must have work coverage plan in place in preparation for scheduled and unscheduled absences, due to importance of position to department’s compliance with various processes. - Requires excellent interpersonal skills and an ability to recognize and understand sensitive customer-oriented issues.  Position also requires daily contact, by telephone, with members, providers, and internal departments. Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel): - Must be able to work under normal office conditions and work from home as required. - Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations. - May be required to work additional hours beyond standard work schedule. - May require occasional weekend hours or evening hours as the needs of the various lines of business dictate. Disclaimer The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the position's duties at any time. Salary Range $20.98 -$31.46 Compensation & Total Rewards Overview The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law. Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes: - Medical, dental and vision coverage - Retirement plans - Paid time off - Employer-paid life and disability insurance with additional buy-up coverage options - Tuition program - Well-being benefits - Full suite of benefits to support career development, individual & family health, and financial health For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/ We welcome all All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org

Role Description Seeking an experienced and detail-oriented Senior General Liability Claims Adjuster to join a growing team. This fully remote position is ideal for candidates based on the West Coast of the United States. The individual in this role will be responsible for managing a portfolio of General Liability and Commercial Auto claims, ensuring timely and accurate resolution in accordance with company standards. Qualifications - Minimum of 5 years of experience handling General Liability claims. - Active Adjuster’s License required. - Strong understanding of liability claims and litigation management. - Excellent negotiation, communication, and analytical skills. - Ability to work independently in a remote environment while maintaining high accuracy and service standards. - Proficiency with claims management systems and Microsoft Office Suite. - Previous Hawaii General Liability experience highly preferred. Requirements - Manage a diverse portfolio of General Liability and Commercial Auto claims. - Handle primarily property damage claims, with some bodily injury exposures. - Oversee litigated files and coordinate with defense counsel as needed. - Ensure compliance with all internal guidelines and applicable regulations. - Collaborate with internal teams and external partners to achieve effective claim outcomes. - Maintain detailed and organized claim documentation throughout the process. Benefits - Salary Range: $75,000 – $90,000 annually (commensurate with experience). - Competitive benefits package, paid time off, professional development opportunities, etc. Company Description Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage technology to transform how small businesses buy and experience commercial insurance. Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by core values and operating principles that guide every decision we make. The Claims Operational Enablement Administrator will work closely with the Senior Claims Operational Enablement Specialist to ensure optimal use of claims platforms through comprehensive resource development, documentation, testing, and continuous improvement initiatives. This role will assist in driving efficiency, accuracy, and compliance across the claims function. How You’ll Do It Operational Enablement - Assist with the development of training programs for claims adjusters and operations teams on best practices, tools, and new system updates. - Assist with documenting technology-related standard operating procedures (SOPs) to improve efficiency and reduce claim cycle times. - Assist with maintaining an up-to-date knowledge base, FAQs, and playbooks to ensure consistency and efficiency in claims handling. Run-the-Business System Orchestration - Assist with the development of training programs for claims adjusters and operations teams on best practices, tools, and new system updates. - Assist with documenting technology-related standard operating procedures (SOPs) to improve efficiency and reduce claim cycle times. Assist with maintaining an up-to-date knowledge base, FAQs, and playbooks to ensure consistency and efficiency in claims handling. Collaboration - Develop and maintain training calendars, scheduling in-person and virtual sessions to accommodate diverse learner needs and business requirements. - Regularly review and update resources to reflect process changes and industry developments. - Create training tracking mechanisms for continuing education (CE) compliance. The Right Stuff - High school diploma or GED required. - 1+ year of experience with knowledge of claims processes and general requirements. - 3+ years of experience with PowerPoint, Scribe, Adobe Products, or other authoring tools; graphic design experience a plus. - Ability to communicate effectively with a variety of audiences in written form. - Ability to manage tasks varying in complexity and work through solutions with guidance and direction. - Interpersonal and cross-team collaboration skills. - Ability to run a project from start to finish with guidance. The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that align with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. All AI-powered outputs are still subject to human oversight and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process. Base Compensation Range $50,000—$65,000 USD Compensation & Benefits - Competitive cash compensation - A piece of the pie (in the form of equity) - Comprehensive health plans - Generous PTO - Future focused 401k match - Generous parental and caregiver leave - Our core values are more than just a poster on the wall; they’re tangibly reflected in our work Our goal is to make all aspects of working with us as easy as pie. That includes our offer process. When we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an equitable and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges. Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members. Location Information Unless otherwise specified, this role is remote. Remote team members must live and work in the United States (territories excluded) and have access to reliable, high-speed internet. Additional Information Pie Insurance is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristic. Pie Insurance participates in the E-Verify program. Please click here, here and here for more information. Pie Insurance is committed to protecting your personal data. Please review our Privacy Policy. Safety First: Pie Insurance is committed to your security during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or onboarding process. Pie Named to 2025 America's Best Startup Employers Pie Insurance 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE

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 St. Joseph/Cameron, MO. Competitive candidates should reside within one of the listed zip codes and will service this same territory: 64401 64440 64443 64448 64454 64477 64484 64501 64503 64504 64505 64506 64507 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 annually - 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!