Manage all aspects of workers' compensation claims, ensuring accurate wage loss calculations, facilitating communication among involved parties, and coordinating with legal defense for litigated claims to achieve timely and compliant resolutions.

Title: Claims Counsel, Financial Lines & Cyber Location: CA-Los Angeles Job Description: Full time job requisition id JR-000761 MSIG USA continues to grow! Company Overview: MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world’s top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business’s unique risks. We are seeking an experienced and detail-oriented Financial Lines Claims Counsel & Cyber to join our Financial Lines Claims and Cyber team. The Claims Attorney will be responsible for handling complex matters, including high severity claims and class actions, from inception through resolution for Financial Lines and Cyber products with an emphasis on Directors & Officers (D&O), Financial Institutions Professional Liability (E&O), Pension Trust (Fiduciary), Employment Practices Liability, and Fidelity policies. The team also handles other Specialty Lines such as Cyber, Political Risk & Trade Credit, Transactional and Tax claims. You will work closely with internal and external customers and stakeholders, deliver excellent customer service, analyze coverage, draft coverage letters, evaluate liability, make claim presentations, set judgmental reserves, and formulate and execute resolution strategies. The role can be located in one of the following office locations: NYC, Atlanta, Chicago, Cincinnati, Dallas, Los Angeles, or Warren NJ hybrid work environment (4 days in office). Key Responsibilities: - Proactively manage claims throughout their lifecycle from initial notification through final disposition. - Conduct timely and thorough investigations and analyses to determine coverage, liability and damages. - Work closely with insureds, brokers, legal counsel, vendors, and other stakeholders throughout the claims process. - Collaborate on claim resolution strategies. - Negotiate direct and mediated settlements within designated authority limits. - Prepare claim summaries and reports and make presentations. - Provide feedback on claims and trends to underwriting and stakeholders. - Maintain accurate and up-to-date claim files and diary system. Qualifications: - Bachelor’s and Juris Doctorate degrees required - Minimum of 7 years of experience handling insurance coverage litigation, Financial Lines or Cyber insurance claims, commercial litigation or other related experience. - Excellent communication and interpersonal skills to deliver exceptional customer service and build and maintain customer relationships. - Strong negotiation skills. - Detail-oriented with an ability to independently manage a caseload and prioritize tasks and deadlines. - Proficiency in Microsoft Office Suite (Outlook, Excel, Word, PowerPoint) - Ability to travel as needed. *** Candidate must be admitted to practice law in a US jurisdiction and in good standing #LI-HYBRID SALARY: The estimated salary range for this position is $110,000.00 - $230,000.00 per year. This is a good-faith assessment of the salary range for this position only. In determining the actual salary within this range, MSIG USA will consider a candidate’s relevant experience, location, and other job-related factors. Additional Benefits: Healthcare and Retirement Benefits Comprehensive medical, dental, and vision coverage 401(k) with a generous employer match and profit-sharing contribution Wellness incentive program Life and accidental death and dismemberment (AD&D) insurance Flexible spending programs Short-term and long-term disability plans Additional Benefit Programs Paid time off program Paid charitable leave Paid parental leave Tuition reimbursement program Personal insurance (auto/homeowners) discounts It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group! It is the policy of MSIG USA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG USA will provide reasonable accommodations for qualified individuals with disabilities.

Role Description Encova Insurance is seeking a Property Claims Manager. This role will have the option to work a home-based schedule, but you must reside in Ohio. JOB OBJECTIVE: - Coach, monitor and direct claims handling activities and staff within the property team. - Coach, manage, direct and provide development opportunities for property resolution specialists. - Work closely with the Director of Property Claims to execute claims strategies to meet or exceed short and long-term goals. ESSENTIAL FUNCTIONS: - Coach, manage, direct and provide development opportunities for property resolution specialists in preparation for future opportunities. - Effectively communicate and support the claims organization’s mission, strategic vision and the achievement of the overall claims operations objectives. - Ensure property resolution specialists resolve claims in conformance with applicable company policies, practices, procedures and state Fair Claim Practices acts. - Provide vision and leadership to ensure claims objectives are met and are in line with the mission of the organization. - Identify opportunities to apply technology and business processes in innovative ways to reduce costs, improve quality and efficiencies and enhance services. - Model leadership behaviors, motivate staff and promote a positive work environment. - Work with the Director of Property Claims to analyze property operations and lead in the development, implementation and continuous improvement of metrics, processes, initiatives, service and overall results. - Effectively manage the cost containment strategies, expense management and the property team’s expense budget. - Collaborate with sales, underwriting, actuarial, finance and other stakeholders to ensure knowledge sharing on loss developments and risk exposures. - Communicate with agents verbally, in writing and through personal agency visits. - Develop the property resolution specialists in the property team through direct counseling, field ride-along training, periodic group training and day-to-day discussion of files. - Monitor and provide feedback on property resolution specialist activities, file quality and results through periodic and scheduled file reviews as required. - Monitor and coach property specialists in the handling of large losses including assisting with the triage process and field inspections. - Effectively communicate information pertaining to company procedures, policies and practices. - Conduct regular associate performance reviews and administer the salaries of all associates in the property team. - Conduct QA reviews as needed. OTHER FUNCTIONS: - Participate in property training and keep up to date in all property training programs. - Obtain and maintain all applicable licensing as required. - May assume the duties of the Director of Property Claims in their absence. - Other duties as assigned. Qualifications - Bachelor’s Degree from an accredited college or university or equivalent in insurance or business is required. - Professional insurance designations, such as CPCU, strongly preferred. - Strong QA background highly preferred. - Excellent communication skills. - Demonstrated leadership, management and collaboration skills. - Ability to lead, motivate and drive performance. - Excellent interpersonal and conflict resolution skills. - Strong analytical, research, and problem solving skills. - Ability to work effectively in a team environment. - Self-directed and able to work independently. - Requisite expertise in estimating and evaluating property damage. - Knowledge of current systems, applications and tools. - Knowledge of claims operations, including procedures, controls and organization. - Thorough knowledge of commercial and personal property products. - Thorough knowledge of claims best practices, procedures, policies and guidelines. - Strong knowledge of the law as it relates to insurance and insurance policies. Benefits - Health, Dental & Vision Insurance - Company-provided life and income protection plans - Eligibility to participate in a company incentive bonus program - 401(k) Retirement Plan - 100% company match up to 7% on annual salary - Paid Time Off, Paid Holidays, and Floating Holidays - Flexible Work Arrangements - Hybrid and remote depending on the role Company Description Encova Insurance is an EOE/E-Verify employer.

Title: Claims Resolution Specialist Job Description: Location: - Dallas, TX - Fort Worth, TX Remote Full time Calmont Operations Building Department: CBO/PT Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: The Claims Resolutions Specialist/Account Specialist II is primarily responsible for all insurance follow-up responsibilities for the Cook Children's Physician Network. Primary duties include follow-up, analysis, and resolution of outstanding insurance claims, and initiation of the appeals process on behalf of CCPN providers. Will perform duties such as reimbursement analysis; providing updates to the Manager, Insurance Follow-Up & Denials Management with timely financial and volume data related to claims adjudication and payment trend analyses; performs all required patient account adjustments; provides feedback to practice managers regarding the effectiveness of diagnostic and procedural coding; monitors active accounts receivable for identification of potential problems; serves as a liaison between assigned practice(s) and billing office; communicates effectively with patients, practice managers, physicians and others regarding collection of outstanding claims; maintains proper documentation and edits of work performed; and at all times maintains a professional demeanor to assure that patients are treated in an appropriate and compassionate manner. Note: This is a remote position but will require 1-2 weeks of training in Fort Worth as well as some on site work as needed (candidates must live in DFW area). Required Education/Experience: - High School or equivalent required. - At least 3 years' experience in a physician billing environment (or) at least two (2) years working as an Account Specialist I with Cook Children's with a satisfactory performance record. - Intermediate knowledge of coding and medical terminology. - Strong understanding of diversified health insurance plans a plus. - Experience with managed care contracts, denials and payor methodology. - Extensive knowledge of healthcare third-party reimbursement, variance and denial records. - Effective oral and written communication skills. - Prior experience with Epic Resolute Professional Billing preferred. About Cook Children’s: Our not-for-profit organization is comprised of a flagship medical center in Fort Worth, Texas, a new medical center in Prosper, Texas, a physician network, home health company, surgery centers, health plan, health services, and health foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet the unique needs of their child. Cook Children's is honored to continually receive recognition for our outstanding efforts and outcomes in pediatric health care. At Cook Children's, we're more than a health care system––we're your friends, neighbors and even family members. And we're parents too, so we can see the world through your eyes. We see what you're going through––and how we can help you and your child get the best care and support possible. Cook Children’s is an equal opportunity employer. As such, Cook Children’s offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.