• Review and process all BC/BS and Commercial high dollar claims (over $10,000) for denials, payor issues and payment trends. • Submit, process and track all appeals for BC/BS and commercial payors. Maintain knowledge of ERISA laws governing employee benefit plans and manage the appeal process for these claims. • Assist A/R staff with complex claim issues they are unable to resolve in a timely manner. • Track and trend all Single Case Agreements. Work closely with Contracting on any SCA payment issues / concerns. • Review payments for BC/BS and commercial payors for rate validation according to our contracts. • Track all denial outcomes for payment, write-offs and transfers to client liability. Identify the root cause for the adjustments to client accounts. Work with management to review adjustment trends and identify potential solutions. • Help maintain integrity of accounts receivable ledger, including aged receivable monitoring on an ongoing basis. • Responsible for maintaining current knowledge of revenue components including benefit plans, contract terms and rates and billing forms and codes. • Check status of claims through use of telephone, websites and/or other means available. • Document adjustments needed to patient accounts. • As needed, participate in phone conference calls with payors. • Pursue collection activities and follow up for balances outside of established norms. • Coordinate collection activities with outside agencies, including court appearances, as needed. • Provide feedback & education management with regards to issues that impact revenue flow. • Provide appropriate documentation and reports designed to assist in fiscal management of the agency. • Serve as a member of the SWAT Team and participate in team meetings. • Serve as a member of the Revenue Cycle Team and participate in all team meetings and activities. • Understand and comply with all of the principles established by the Rosecrance Corporate Compliance Program and Code of Ethics. • Perform all responsibilities in compliance with the mission, vision, values and expectations of Rosecrance. • Deliver exceptional customer service consistently to every customer. • Serve as a role model for other staff, clients and customers and demonstrate positive guest relations in representing Rosecrance. • Assume other related responsibilities as assigned by management.

Primary Details Time Type: Full time Worker Type: Employee Title: Claims Adjuster - Crop The Opportunity: The purpose of this role is to investigate and process crop claims, conduct field inspections, communicate with stakeholders, and ensure compliance with insurance policies and regulations. - Location: Work Remotely Wisconsin, USA - Work Arrangement: This role is fully remote; approximately 20% home office work and 80% field work. - The salary range for this role is between $56,000-$84,000 Your new role - Complete field inspections, reviews and adjustments accurately and efficiently to administer crop insurance policies. - Ensure compliance with insurance statutes and regulations to apply crop policies cost-effectively. - Build and maintain customer relationships through timely and accurate policy service. - Document and transmit loss information accurately to assess potential damages. - Support business objectives through quality control tasks, audits, and risk assessments. - Contribute to a positive work environment by demonstrating cultural expectations and influencing others positively. Required Qualifications - Secondary school certification. - Valid Driver's License. Preferred Qualifications - Bachelor's Degree or equivalent combination of education and work experience. Preferred Work Experience - Experience in the insurance industry. - Experience in agriculture. - Experience in farming. Note: QBE, a global insurance leader, is the proud parent company of NAU Country Insurance Company. NAU Country writes in 48 states and has nine locations nationwide. Together, we combine the history, expertise, innovation, and a shared commitment to excellence to provide unparalleled insurance solutions to our customers and communities worldwide. Compensation Package: The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate’s professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE’s annual discretionary bonus plan based on business and individual performance. We encourage all candidates to apply, even if their salary expectations fall outside of this range, as we are committed to finding the right fit for our team. QBE Benefits: We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to: - Hybrid Working – a mix of working from home and in the office - 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis - Competitive 401(k) program with company match up to 8% - Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice - Tuition Reimbursement for professional certifications, and continuing education - Employee Network and Community – QBE actively supports six Employee Networks, and many ways to give back to your community To learn more, click here: Benefits | QBE US. Why QBE? What if you could have a positive impact – at work and in the world? At QBE, we’re enabling a more resilient future – for our customers, communities, environment, and for our people. We’re building momentum to achieve something significant and know our people are at the center of our success. Our industry offers interesting and varied careers where you can help people to protect what matters most. As part of the QBE team, you’ll get to spend every day working with people who are passionate, talented and kind. And our international scale means we’re big enough for your ambitions, yet small enough for you to make a real impact. Join us now, so you can be part of our success – and we can be part of yours! https://www.linkedin.com/company/qbe-north-america/   QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information.       Equal Employment Opportunity:   QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status.   This position is not eligible for visa sponsorship. Applicants must be authorized to work in the United States on a full-time basis without the need for current or future sponsorship.    Supplementary information   Skills: Adaptability, Communication, Conflict Management, Critical Thinking, Customer Service, Detail-Oriented, Document Management, Financial Advising, Insurance Claims Processing, Intentional collaboration, Managing performance, Regulatory Compliance, Research Analysis, Risk Management, Standards Compliance How to Apply: To submit your application, click "Apply" and follow the step by step process. Equal Employment Opportunity: QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

Primary Details Time Type: Full time Worker Type: Employee Title: Claims Adjuster - Crop The Opportunity: The purpose of this role is to investigate and process crop claims, conduct field inspections, communicate with stakeholders, and ensure compliance with insurance policies and regulations. - Location: Work Remotely Massachusetts or Connecticut USA - Work Arrangement: This role is fully remote; approximately 20% home office work and 80% field work. - The salary range for this role is between $56,000-$84,000 Your new role - Complete field inspections, reviews and adjustments accurately and efficiently to administer crop insurance policies. - Ensure compliance with insurance statutes and regulations to apply crop policies cost-effectively. - Build and maintain customer relationships through timely and accurate policy service. - Document and transmit loss information accurately to assess potential damages. - Support business objectives through quality control tasks, audits, and risk assessments. - Contribute to a positive work environment by demonstrating cultural expectations and influencing others positively. Required Qualifications - Secondary school certification. - Valid Driver's License. Preferred Qualifications - Bachelor's Degree or equivalent combination of education and work experience. Preferred Work Experience - Experience in the insurance industry. - Experience in agriculture. - Experience in farming. Note: QBE, a global insurance leader, is the proud parent company of NAU Country Insurance Company. NAU Country writes in 48 states and has nine locations nationwide. Together, we combine the history, expertise, innovation, and a shared commitment to excellence to provide unparalleled insurance solutions to our customers and communities worldwide. Compensation Package: The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate’s professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE’s annual discretionary bonus plan based on business and individual performance. We encourage all candidates to apply, even if their salary expectations fall outside of this range, as we are committed to finding the right fit for our team. QBE Benefits: We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to: - Hybrid Working – a mix of working from home and in the office - 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis - Competitive 401(k) program with company match up to 8% - Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice - Tuition Reimbursement for professional certifications, and continuing education - Employee Network and Community – QBE actively supports six Employee Networks, and many ways to give back to your community To learn more, click here: Benefits | QBE US. Why QBE? What if you could have a positive impact – at work and in the world? At QBE, we’re enabling a more resilient future – for our customers, communities, environment, and for our people. We’re building momentum to achieve something significant and know our people are at the center of our success. Our industry offers interesting and varied careers where you can help people to protect what matters most. As part of the QBE team, you’ll get to spend every day working with people who are passionate, talented and kind. And our international scale means we’re big enough for your ambitions, yet small enough for you to make a real impact. Join us now, so you can be part of our success – and we can be part of yours! https://www.linkedin.com/company/qbe-north-america/   QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information.       Equal Employment Opportunity:   QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status.   This position is not eligible for visa sponsorship. Applicants must be authorized to work in the United States on a full-time basis without the need for current or future sponsorship.    Supplementary information   Skills: Adaptability, Communication, Conflict Management, Critical Thinking, Customer Service, Detail-Oriented, Document Management, Financial Advising, Insurance Claims Processing, Intentional collaboration, Managing performance, Regulatory Compliance, Research Analysis, Risk Management, Standards Compliance How to Apply: To submit your application, click "Apply" and follow the step by step process. Equal Employment Opportunity: QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

• Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants. • Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. • Calculate benefit payments and approve payment of Claims within a certain monetary limit. • Responsible for Claims management of assigned case load within guidelines of published performance standards. • Opens new Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith’s timeframes and guidelines. • Sets appropriate reserves according to Zenith’s timeframes and guidelines. • Creates and executes action plans needed to bring case to closure. • Completes detailed settlement evaluations and recommends appropriate settlement value, within authority; negotiates claim settlements with injured workers and/or injured workers’ attorneys.