• Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing • Secures needed medical documentation required or requested by third party insurances • Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains • Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers • Responsible for consistently meeting production and quality assurance standards • Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer • Updates job knowledge by participating in company offered education opportunities • Protects customer information by keeping all information confidential • Processes miscellaneous paperwork • Ability to work with high profile customers with difficult processes • May regularly be asked to help with team projects • Ensure all claims are submitted daily with a goal of zero errors • Timely follow up on insurance claim status • Reading and interpreting an EOB (Explanation of Benefits) • Respond to inquiries by insurance companies • Denial Management • Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles • Review late charge reports and file corrected claims or write off charges as per client policy • Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy • Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer

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 This position is not available for California, Alaska, Hawaii, Washington, or Puerto Rico residents. A day in the life of a Claims Resolution Adjuster II and what it takes to do the job! As a Claims Resolution Adjuster II, your main focus will be investigating automobile accidents involving single or multiple vehicles which result in property damage and/or bodily injury. You will have the convenience of working remotely from your home while efficiently handling your responsibilities. You will assess coverage, liability, and damages while providing exceptional customer service throughout your day. Customer communication will take place through different channels, including voice calls, email, and text messages. Through the utilization of innovative platforms and tools, you will engage in negotiation processes to reach fair injury settlements with all parties involved. The Claims Resolution Adjuster II will primarily be responsible for the liability investigation and ultimate decisions, identifying injured parties beyond who is listed at FNOL, and recognizing impactful risk potential on claim files. They will be responsible for supporting the claimant throughout the vehicle restoration process and providing feedback on the Auto process in general. The Claims Resolution Adjuster and Casualty Adjusters will work hand-in-hand throughout the claims process. You’ll wear a few hats to fill a few roles throughout your day that all require a level of experience: The Customer Service Expert – you’ll live into Allstate’s Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each Casualty claim. You lead with empathy, always. The Investigator – you’ll confidently and independently investigate casualty (and applicable LOB (line of business)) claims by performing detailed reviews of damage and interpreting policies to determine coverage. The Effective Communicator – you’ll use phone, emails and sometimes even video chat with customers to help them through a fast, fair, and easy claims process. You’ll also incorporate a specific approach to claim handling to offer the customer their preference of communication to efficiently discuss their claim needs and keep them updated on the claim progress. The Negotiator – you will evaluate and negotiate claims settlements with customers, vendors, third party carriers and claimants, in accordance with all legal and business standard methodologies. With negotiations, you will incorporate tactics in handling challenging and complex situations. The Problem Solver – you’ll utilize multiple tools to get the job done in a fast-paced environment, including estimate tools, job aids, and additional settlement platforms, all while using your sharp critical thinking skills. The Recorder – you’ll protect the company financially by executing policies along policy agreements, and you keep a clear record of your work in a claims system that you will be trained on. You’ll accomplish this by ensuring timely and accurate documentation is completed as you work on each claim. Preferred Qualifications: - 2+ years claims adjusting experience determining liability - Claims investigation and negotiation experience is preferred - Experience with liability investigations, investigating coverage, PD coverage, set MOI, rental and resolving liability a plus - Proficient communication skills, especially over the phone, to establish rapport and assess claims accurately - Strong critical thinking and problem-solving skills to evaluate and negotiate injury claims successfully Remote Work: This position is not available to residents of California, Washington, Alaska, Hawaii and Puerto Rico. Schedule: 8 hours shift between the hours of 8:00am - 6:00pm EST or CST zone. This will be Monday – Friday with potential Saturday duty rotation. This position is a permanent remote home-based role. Your home office does not need to be near an Allstate office, but it does need to be in the United States. 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 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. #LI-JS2 Skills Business Communications, Claims Resolution, Critical Thinking, Fraud Investigation, Information Collection, Insurance Claims, Problem Solving, Time Management Compensation Compensation offered for this role is 50,000.00 - 75,050.00 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.

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: - Receives claim, confirms policy coverage and acknowledgement of the claim - Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies - Establishes reserves and authorizes payments within reserving authority limits - Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim - Coordinates early return-to-work efforts with the appropriate parties - Manages subrogation and litigation of claim as it applies - Manages potential claim recoveries of all types - Reports claims to the excess carrier when applicable - Communicates claim status with the customer and claimant - Adheres to client and carrier guidelines and participates in claims review as needed - Develops and maintains professional customer relationships - Complies with rules and regulations of applicable state - Additional duties as assigned KNOWLEDGE & SKILLS: - Excellent written and verbal communication skills - Ability to assist team members to develop knowledge and understanding of claims practice - Ability to identify, analyze and solve problems - Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets - Strong interpersonal, time management and organizational skills - Ability to work both independently and within a team environment - Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation EDUCATION & EXPERIENCE: - Bachelor's degree or a combination of education and related experience - Minimum of 6 years’ industry experience and claim handling - Self-Insured Certificate preferred - State Certification as an experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $61,053 - $98,334 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

National Interstate is a member of Great American Insurance Group. As one of the leading commercial transportation insurers in the nation, we offer risk financing solutions in all 50 states tailored to meet the needs of a wide variety of transportation classes. Our offerings include traditional insurance and innovative alternative risk transfer (ART) programs, including more than a dozen group captive programs catering to niche wheels markets. We are proud to be a multiple Northcoast 99 winner and Cleveland Plain Dealer Top Workplace in Northeast Ohio. It is because of our talented and dedicated team that we are able to live out our company values of integrity, transparency, fairness, accountability, empowerment and collaboration with each transaction we make. If you are ready to join an engaging and driven team such as ours, we would love to hear from you! At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Since 1989, National Interstate has specialized in serving the insurance needs of the wheels-based transportation industry. Our steadfast focus on developing niche expertise in product design, loss control and claim services has made National Interstate one of the most respected names in commercial transportation insurance today. (https://natl.com/) National Interstate is looking for a Workers Comp Adjuster to join their team. This individual will work fully remote from the USA Essential Job Functions and Responsibilities - Manages a large inventory of complex claims to evaluate compensability/liability. - Plans and conducts complex claims investigations to confirm coverage and to determine liability, compensability and damages. - Analyzes and negotiates appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials. - Conveys complex information regarding coverage and settlements to insureds, claimants, and external partners. - Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner. - Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements. - May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports. - Performs other duties as assigned. Job Requirements Education: Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience. Prefer experience handling FL GA NC Experience: Generally, a minimum of 9 years of experience in property and casualty claims handling. Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC). Scope of Job/Qualifications: Works within broad limits and authority on assignments of the highest technical complexity, requiring specialized knowledge. Demonstrates excellent analytical, negotiation, and problem-solving skills. Maintains strong knowledge of insurance policies, coverage, and claims handling procedures. Maintains knowledge of industry laws and regulations. Advanced ability to organize and prioritize caseloads, ensuring timely resolution of claims. Excellent interpersonal and communication skills with the ability to build relationships and lead negotiations. Proven ability to handle confidential information with discretion. Viewed as a senior resource within the Claims department and/or organization. Company: NIIC National Interstate Insurance Company Salary Range: $75,000.00 -$92,000.00 Benefits: We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits. Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers. *Excludes seasonal employees and interns.