Title: Part Time Claims Coordinator Location: Middletown, Connecticut, United States Department: Operations Job Description: Description POSITION SUMMARY: Claims Coordinator Behavioral Health Claims & Managed Care | Part-Time | Hybrid | Middletown, CT – must be a CT resident About ABH ABH has been a cornerstone of Connecticut's behavioral health system partnering with state agencies, providers, and communities to strengthen access and quality of care across the state. As a nonprofit, we're driven by our mission. We manage mental health and substance abuse services, provide customized technology to operate programs efficiently, and participate in research representing best practices in the field. Behind all of it is a dedicated team making sure the operational and financial infrastructure runs the way it should and that's where this role comes in. If you are passionate about making a difference, aligned with our mission, and looking for a part-time opportunity that offers the flexibility to fit your life, we'd love to have you on our team. DUTIES AND RESPONSIBILITIES: - Process and adjust claims for the BHRP-Clinical, BHRP-Basic, Military Support, and Pre-Trial Intervention programs - Conduct weekly claims audits with emphasis on high-dollar submissions and compile audit reports - Manage check runs and eligibility file uploads as needed - Assist with weekly and monthly financial reporting - Support the claims denial review process and special claims projects - Respond to provider and staff inquiries about claims status, eligibility, and benefits - Assist in training new and existing claims staff - Maintain working knowledge of CPT and ICD-10 codes, behavioral health insurance terminology, and HCFA/UB-04 claim form requirements - Uphold confidentiality of all protected health information in accordance with HIPAA policies Work Arrangement CT residence only - This is a part-time, hybrid position offering real flexibility. Much of this role's work can be performed remotely, and we support work-from-home when responsibilities and workflows allow for it. Why Join ABH - Part-time schedule with genuine work-life flexibility - Hybrid work arrangement with meaningful WFH opportunity - Contribute to a mission-driven nonprofit that has been a cornerstone of Connecticut's behavioral health system - Collaborative team environment at a stable, established organization - Opportunities for growth across a diverse range of programs and functions ABH is an equal opportunity employer committed to a diverse and inclusive workplace. Requirements EDUCATION AND EXPERIENCE REQUIREMENTS: - Associate’s degree/Bachelor’s preferred in business or related field preferred; - Three years of demonstrated work experience in claims processing or in the behavioral health customer service field; - Attends trainings specific to job duties; - Attends annual Conflict of Interest. KNOWLEDGE/SKILLS/ABILITIES: - In-depth knowledge of ABH’s various utilization management and claims systems created by ABH and used by all the GA staff; - Must be flexible in order to respond quickly and positively to shifting demands; - Strong attention to detail; ability to work on multiple tasks and meet deadlines; - Excellent PC skills with demonstrated experience using Microsoft Office Package (MS Word, Excel, Outlook); - Strong written and verbal communication skills required. - Due to the need for in-person client support across Connecticut, this position requires residency within the state.

Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage technology to transform how small businesses buy and experience commercial insurance. Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by core values and operating principles that guide every decision we make. The Claims Adjuster will play a vital role in delivering quality claim file management and an industry-leading customer claims experience. This will be completed by adhering to Pie’s Claims Best Practices and complying with regulatory and statutory requirements. This role will work with internal and external partners to deliver best in class performance, identify and pursue claim mitigation opportunities and deliver favorable claim outcomes for Pie’s customers. How You’ll Do ItClaims Technical Management: - Independently handle all aspects of the workers’ compensation claims from set-up to closure. - Conduct timely 3-point contact investigation, with focus on continued investigation as facts of the case change. - Mitigate claim exposure while achieving the best outcome. - Determine timely and accurate compensability decisions within statutory requirements. - Set and adjust timely/accurate reserves within authority limits to ensure reserving activities are consistent with the case facts and company best practices. - Timely administration of statutory medical and indemnity benefits throughout the life of the claim. - Comply with all applicable statutory guidelines, rules, and regulations. - Control legal activity with defense counsel through the litigation process while managing legal fees and costs. - Prioritize early resolution opportunities, evaluate claim exposure and negotiate settlement. Claims Customer Service: - Serve as a point of contact for our partner agents and customers to provide general claim guidance and help set claim process expectations. - Assist as necessary in providing claim status to agents and insureds, coverage verification and loss run reports, etc. - Provide excellent customer service to internal and external customers and business partners. - Participate in interactions with TPA adjusters and claims partners to drive optimized claims outcomes and top-notch claims experience. - Advocate to ensure that Pie has a leading claims customer experience. - Work to continuously improve our claims operations and look at opportunities and gaps in claim service, handling SOPs, protocols and processes. The Right Stuff - High School Diploma or equivalent is required. - Bachelor's Degree or equivalent experience with some college coursework is preferred. - Minimum of 2-years workers’ compensation claims experience is required. - Claims experience working in CA, AZ, and UT is preferred. - Strong communication (written and verbal) skills, to deliver more complex information effectively. - Strong problem solving skills to be able to manage complex tasks and work through to solutions with little guidance and direction. - Awareness of your own tasks, and how it impacts the team and deliverables. - Experience using G-Suite Tools, and collaboration tools like Slack is preferred. - Knowledge of jurisdictional regulatory and statutory requirements and CMS/MSA requirements. - Demonstrated knowledge and experience in claim adjudication, medical management and litigation management. - Developing ability to analyze and take necessary action in multiple focus areas, based on several data points. - Ability to use skills to overcome conflict and reach beneficial outcomes. - Ability to make claim decisions to mitigate exposure while achieving the best outcome. The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that align with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. All AI-powered outputs are still subject to human oversight and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process. Base Compensation Range $85,000—$105,000 USD Compensation & Benefits - Competitive cash compensation - A piece of the pie (in the form of equity) - Comprehensive health plans - Generous PTO - Future focused 401k match - Generous parental and caregiver leave - Our core values are more than just a poster on the wall; they’re tangibly reflected in our work Our goal is to make all aspects of working with us as easy as pie. That includes our offer process. When we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an equitable and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges. Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members. Location Information Unless otherwise specified, this role is remote. Remote team members must live and work in the United States (territories excluded) and have access to reliable, high-speed internet. Additional InformationPie Insurance is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristic. Pie Insurance participates in the E-Verify program. Please click here, here and here for more information. Pie Insurance is committed to protecting your personal data. Please review our Privacy Policy. Safety First: Pie Insurance is committed to your security during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or onboarding process. Pie Named to 2025 America's Best Startup Employers Pie Insurance 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE

• 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.