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.

• Supports the claim payment process • Completes regulatory requirements for pharmacy and member payments • Performs complex in-depth analysis and works cross-functionally on projects • Provides guidance to Accounting, Finance, IT and Claims operation functions

• Analyzes and processes complex claims • Works with high exposure claims involving litigation • Ensures ongoing claims within service expectations, industry best practices and specific client service requirements • Identifies and pursues potential third-party subrogation recoveries associated with highest exposure/complexity claims • Reviews high exposure, complex multi-jurisdictional claims to establish potential for third party subrogation recovery • Provides subrogation guidance and direction to both internal and external stakeholders • Develops and pursues third party subrogation • Sends appropriate subrogation lien notifications to appropriate parties • Provides direction to assigned subrogation counsel • Approves and makes timely claim payments relative to subrogation • Manages claim recoveries • Prepares status reports for clients as required • Provides additional layer subrogation expertise to peers • Manages the litigation process • Develops training material and leads department training opportunities