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Senior Complex & Represented Claims Representative
Location
Alabama + 18 moreAll locations: Alabama | Arizona | Florida | Kentucky | Louisiana | New Jersey | New York | North Carolina | Ohio | Oregon | Massachusetts | Missouri | Pennsylvania | South Carolina | Texas | Utah | Virginia | Washington | Wisconsin
Posted
73 days ago
Salary
$70K - $80K / year
Seniority
Senior
Job Description
Senior Complex & Represented Claims Representative
Swyfft
• Investigate, analyze, and determine the extent of liability concerning first party homeowner property losses and damages. • Effectively communicate and negotiate with policyholders, agents, public adjusters, attorneys, and service providers via phone, email, and internal systems to accurately document claim details. • Successfully manage a pending claim load at varying stages of the claims process. • Interpret and apply the details of an insurance policy to ensure the accuracy of payments and claims declinations. • Interpret and apply computer generated loss estimates, engineer’s reports, and construction terminology. • Update and maintain comprehensive claim handling notations in our electronic claims management system and other related applications. • Mentor our mid and associate level claims representatives.
Job Requirements
- 7+ years of experience as a desk adjuster in the homeowner/property industry
- Adjusting all perils (fire, hail, wind, water, theft, lightning, vandalism, etc.)
- Understanding valued policy states and knowledge of which perils apply and when tendering limits are appropriate
- Previous experience working with contractors, and vendors for claims resolution
- Proficient in handling complex claims with loss values $100K and above
- Previous experience evaluating Proof of Losses
- Previous experience handling CRN, DTPA, NOI, mediations, and appraisals
- Ability to conduct recorded statements with insureds.
- Bachelor’s degree or equivalent experience is preferred.
- High School Diploma or its equivalent (GED) is required.
- Must be proficient with MS Office and other internal insurance related programs, systems or applications (Outlook, Word, and Excel)
- Ability to communicate effectively using programs such as Slack & MS Teams
- Previous experience using systems such as Symbility is a plus.
- HAAG Certification is a plus.
Benefits
- Medical, Dental, and Vision
- Short- and Long-Term Disability (Company Paid)
- Voluntary Long-Term Disability
- Employee Life & AD&D (Company Paid)
- Voluntary Employee, Spouse, and Child Life & AD&D
- Healthcare, Dependent Care and Transit FSA, and Healthcare Savings Account (HSA)
- 401K with a generous matching contribution and no vesting schedule
- 20 days of PTO annually (prorated based on hire date)
- Company Paid Holidays and 2 “Choose Your Own Holidays”
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Key Responsibilities - Review account claim and other documentation to verify payment liability for claims that may have been paid by Medicare in error. - Leverage your knowledge and expertise in medical billing/COB/MSP to review documentation and claim billing, build the case file to determine/validate liability, evaluate and respond to defenses refuting payment liability, status the account and initiate appropriate letter correspondence, answer questions and/or provide information that will bring to successful payment or other appropriate account action. - Initiate correct action with applicable party (health insurance carrier, auto/home/worker’s comp insurance carrier, or legal representative) and documentation based upon payment option, actions required if new information is identified that may change the obligation to pay, or escalation in the event of refusal to pay. - Updates client and/or company systems with clear and accurate information such as contact and updated demographic information, notes from contact dialog and attempts, payment commitment, as well as account status updates as applicable. - Initiates applicable claim activities; follows-up and follows through accordingly to ensure documentation and activity is on-time and accurate in accordance with policies and procedures. - Support internal groups or functions with interpretation of EOB (explanation of benefits), as well as development of knowledge base and understanding of key concepts and terminology in healthcare billing and claims. - Arrives to work on-time, works assigned schedule, and maintains regular good attendance. - Follows and complies with company, departmental and client program policies, processes and procedures. - Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations. - Successfully completes, retains, applies and adheres to content in required training as assigned - Consistently achieve or exceed established metrics and goals assigned, including but not limited to, production and quality. - Completes required processes to obtain client required clearances as well as company regular background and/or drug screening; and, successfully passes and/or obtains and maintains clearances statuses as a condition of employment. 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Required and Preferred Qualifications - Minimum 6 months of medical billing experience, including Medicare, demonstrating depth of knowledge and capability required for the position. - Minimum 2 years of experience in customer service, billing reclamation or recovery, or call center role demonstrating application of similar skills. - High School diploma or GED is required. WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING
Property Adjuster - Field Estimating - PA
AllstateNational General Insurance, a division of Allstate, describes itself as one of the largest insurers in the United States. The company provides personal and commercial auto, recreat
At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. Job Description A day in the life of a Field Property Adjuster, and what it takes to do the job! As a Field Property Adjuster, you will provide exceptional service to our policyholders. Your primary responsibility will involve traveling to our customers' homes to conduct on-site inspections, investigate coverage, prepare estimates, and settle claims promptly and efficiently. Additionally, you will handle virtual claims countrywide, leveraging various platforms and software such as Xactimate and ClaimsX Video Collaboration. 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Required Qualifications: - Residency within Montgomery County, Philadelphia County or Bucks Country is mandatory for this role. - Must be able to travel within 60 miles of residence. - Are willing and able to carry a 50-pound ladder and access up to a 6/12 pitch on a one to two story roof. - Valid driver's license and willingness to travel as part of the job requirements. You’re provided with comprehensive training: - The training program is designed to help you build a claims foundation and understand the systems and processes in your day-to-day work. - Ongoing training opportunities for continuous improvement happen regularly on the job. **You will be required to attend approximately 2 weeks of training that will take place in Wheeling, IL. ** Notice of Licensing Requirement: - As a condition of employment, your office/area may require you to obtain an adjuster and/or an appraiser license which includes passing an additional background check with the Department of Labor. If applicable, you will be required to secure license(s) within 60 days of hire. - If required, the Hiring Manager will work with you along with the Centralized Licensing team to ensure that you are properly licensed. Company Car: - Based on our Company Car Guidelines, this role may qualify for a company car. Our leadership team determines this based on annual work mileage for this location. You may be required to use your personal vehicle until these guidelines are met. We offer mileage reimbursements for personal vehicle usage during work. Allstate Benefits: Being a part of Allstate means you receive a benefits package from Day 1 of employment. This includes time off, healthcare, retirement, and more. That is why as an Allstater, you’ll enjoy a Total Rewards package that includes: - Competitive pay with needed support for continuous development and career advancement. - Flexibility in scheduling and a time off policy that helps support your work/life balance. - Initial and ongoing training to get you proficient in your new role. - Comprehensive benefits like a 401K/pension, education reimbursement, and programs to help you balance work with the rest of your life. Visit www.allstategoodlife.com to learn more. #LI-YS1 Skills Critical Thinking, Customer Service, Negotiation, Property Claims, Time Management, Working Independently, Xactimate Compensation Compensation offered for this role is 56,000.00 - 92,000.00 annually and is based on experience and qualifications. The candidate(s) offered this position will be required to submit to a background investigation. Joining our team isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger – a winning team making a meaningful impact. Allstate generally does not sponsor individuals for employment-based visas for this position. Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click “here” for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click “here” for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the “EEO Know Your Rights” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs. To view the FMLA poster, click “here”. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company’s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee’s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.
Good Hands Repair Network - Automotive Virtual Triage Total Loss Adjuster - Remote - CST/EST
AllstateNational General Insurance, a division of Allstate, describes itself as one of the largest insurers in the United States. The company provides personal and commercial auto, recreat
At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. Job Description As an Automotive Virtual Total Loss Adjuster you will be responsible for providing a superior level of customer service and attention to customers who have a vehicle that needs repaired. 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This position is not available for California, Alaska, and Hawaii residents. When you work from home full time, you’ll need: - A dedicated workspace in your residence that is private and free from distractions - A minimum internet bandwidth of 50 MB down/5 MB up - Appropriate work surface and seating What will Allstate provide: - A technology bundle that includes all equipment needed to perform your work from home (laptop, monitors, headset, keyboard, mouse) - Connectivity reimbursement of $80 per month to offset some of the cost of internet After being hired, employees may need to travel and participate in in-person training. 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This includes any continuing education and/or other state-affiliated requirements for licensing renewal - This role offers a $1,000 sign on bonus if you have an active appraiser license or active adjuster license in TX, FL, or your resident state (current employees and candidates who have previously worked for and are seeking to be rehired at Allstate and its family of companies are not eligible for this sign-on bonus) Benefits Allstate cares about you and your wellbeing. We offer a comprehensive total rewards package that includes pay, benefits, and programs to help you balance work with the rest of your life. You can choose whatever benefits are most important you. Here are some of our offerings: - Competitive salary based on experience and qualifications - Medical, dental, and vision coverage - Allstate pension plan and 401(k) savings plan - Ayco financial coaching - Spring Health mental and emotional wellbeing resources - Paid parental leave - Adoption reimbursement - Paid time off - Tuition reimbursement - Wellness incentives - Allstate Foundation donation match and grant opportunities To learn more about our benefits and programs visit AllstateGoodLife.com Skills Claims Processing, Estimatics, Insurance Claims, Negotiation, Policy Interpretation Compensation The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. Regular, predictable attendance is an essential function of this job The candidate(s) offered this position will be required to submit to a background investigation. Joining our team isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger – a winning team making a meaningful impact. Allstate generally does not sponsor individuals for employment-based visas for this position. Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click “here” for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click “here” for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the “EEO Know Your Rights” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs. To view the FMLA poster, click “here”. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company’s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee’s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.
We are Aaron’s - an industry leader in the sales and lease-to-own retail industry known for quality brand names and superior customer service. We provide our team members the opportunity to reach their full potential in a team-oriented, high-energy, recognition-based environment with competitive pay and benefits. This is much more than a job – it is a career with purpose. Club Claims Specialist The salary range for this role is $13.70 to $17.75 per hour and is a remote role. Overview: You’ll never be bored in this role - as a Club Claims Specialist, will manage the daily claims process of the Aaron's Club Program. This responsibility will involve being the liaison between Aaron's customers, Aaron's stores, and partner of the Aaron's Club program to ensure claims are received and processed in a timely manner. The Details: What You Need: - HS Diploma, some college preferred - 3-4 years of experience - Knowledge and experience with Microsoft Office What You’ll Do: - Delivers consistent, high-quality service to customers & stores throughout the claim life cycle, including but not limited to prompt contact, explaining the process, setting expectations, on-going support - Identify and recommend claims process improvements. - Initiates and conducts follow-ups via proficient use of claims systems and related business systems. - Maintains current knowledge of store operations and P&L, as well as Aaron's Club products & services. - Collaborates with Aaron's accounting, financial, IT, and audit teams to ensure the claims payments are received timely and applied accurately to the store P&L - Assists Aaron's stores with filing Club claims on behalf of the customer, ensuring all needed documentation is completed and sent to BMS, and all stores/customers are provided with high-quality claim handling Additional Requirements: - Ability to manage time and resources to handle daily multi-tasking demands - Strong attention to detail and proactive problem-solving skills - Commitment to providing excellent customer service - Initiative, a strong work ethic, and the ability to adapt to new challenges Aaron’s Total Rewards Our team members are our greatest asset. As an expression of our appreciation, Aaron’s is proud to offer outstanding career training, competitive performance incentives, excellent advancement opportunities, and a distinctive benefits package which includes**: - Paid time off, including vacation days, sick days, and holidays - Medical, dental and vision insurance - 401(k) plan with contribution matching *Note that the pay range provided above is the lowest to highest rate we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, seniority, geographic location, performance, shift, travel requirements, sales or revenue-based metrics, any collective bargaining agreements, and business or organizational needs. Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. **Benefits vary based on FT and pt employment status. Aaron’s Total Rewards Our team members are our greatest asset. As an expression of our appreciation, Aaron’s is proud to offer outstanding career training, competitive performance incentives, excellent advancement opportunities, and a distinctive benefits package which includes: - Sundays off - Employee assistance program - Employee purchase program with exclusive discounts - Physical and financial well-being programs - Tuition reimbursement - Employee Business Resource Groups - 401(k) plan with contribution matching - Paid time off, including vacation days, sick days, and holidays - Life and disability insurance - Medical, dental and vision insurance - Paid paternal leave - Pay on Demand **Benefits vary based on full- and part-time employment status. Note that the pay range provided above is the lowest to highest rate we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, seniority, geographic location, performance, shift, travel requirements, sales or revenue-based metrics, any collective bargaining agreements, and business or organizational needs. About Aaron’s At Aaron’s we offer sales and lease-to-ownership of specialty items including furniture, consumer electronics, home appliances, and accessories throughout the United States and Canada. Our customers shop at Aaron’s for the same reason you should choose us for the next step in your career – our ability to positively influence people’s lives. If you are looking for a company with the passion and dedication to make a difference in the lives of customers and team members alike, join us today. Aaron’s is committed to creating a diverse and inclusive work environment, celebrates our team members’ differences, and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, pregnancy, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, military duty, gender expression, genetic information, or any other protected class. Candidates who require accommodation during the recruitment process should contact hrsupport@aarons.com.Aaron’s is an Equal Opportunity Employer. #LI-Remote#Indeed-Full-Time

