We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.
Workers' Comp Claim Representative II - CA/CO/AZ
Location
United States
Posted
51 days ago
Salary
$56.7K - $94.9K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Workers' Comp Claim Representative II - CA/CO/AZ
AF Group
SUMMARY: Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Claim Representative II: This is the intermediate level of the claim handler career path. Handles moderate to difficult claims. Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Claim Representative III: This is the advanced level of the claim handler career path. Investigates claims and exercises significant discretion in the determination of compensability of claims. May handle large, more complex customers requiring high touch, labor intensive claim service. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Mentors lower level claim handlers. Coordinates special projects and provides guidance to others. RESPONSIBILITIES/TASKS: Claim Representative I, II, III: - Verifies workers’ compensation coverage of employers and injured employees. - Determines compensability under workers’ compensation by thorough investigation of the claim. - Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits. - Facilitates return to work for the injured employee. - Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure. - Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies. - Manages medical bills for non-indemnity and indemnity claims directly associated with the claimed injury. Approves payment based on knowledge of the treatment plan and medical support showing relationship of treatment to the injury. - Concludes and closes files following resolution of claims to meet internal performance standards while complying with state legislation to avoid penalties and manage expenses. - Negotiates settlements with attorneys or injured parties within given authority at the earliest possible point to bring cases to final disposition. - Works closely with manager on complex files or files above settlement/reserve authority. - Manages outside vendors to ensure cost containment efforts. - Establishes and maintains effective working relationships with all internal and external customers. - Stays abreast of changes in workers’ compensation statutes, case law and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws. ADDITIONAL RESPONSIBILITIES/TASKS: Claim Representative II, III: - Administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts. - Exercises independent judgment to settle cases prior to mediation or litigation. - Actively participates in agent/client relationship management. - Assists in mentoring team members. Claim Representative III: - Mentors team members. - Conducts audits of claim files. - Acts as a back up for team leader. - Coordinates special projects. This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. EMPLOYMENT QUALIFICATIONS EDUCATION OR EQUIVALENT EXPERIENCE: Claim Representative I, II, III: Bachelor’s degree in a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company’s learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged. EXPERIENCE: Claim Representative I: Minimum one year relevant experience that provides the necessary skills, knowledge and abilities or completion of claims trainee program. Bilingual skills preferred. Claim Representative II: Three years experience in a workers’ compensation claims environment which provides the necessary skills, knowledge and abilities, such as experience in reviewing, investigating and closing workers’ compensation claims. Experience handling claims in multiple jurisdictions preferred. Bilingual skills preferred. OR One year of AF Group Claims Representative I experience that includes handling of difficult or complex claims. Claim Representative III: Five years experience in a workers’ compensation claims environment which provides the necessary skills, knowledge and abilities, such as experience in reviewing, investigating and closing complex workers’ compensation claims. Experience handling claims in multiple jurisdictions preferred. Bilingual skills preferred. OR Two years of AF Group Claims Representative II experience that includes discretion in determining compensability of complex claims and/or handling complex, high touch or labor intensive customers. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: Claim Representative I, II, III: - Ability and proficiency in the use of computers and company standard software specific to position. - Knowledge of medical and legal terminology related to the work. - Knowledge of workers’ compensation laws and regulations, including jurisdictional laws. - Effective oral and written communication skills. - Effective customer service skills. - Ability to negotiate, build consensus and resolve conflict. - Ability to manage multiple priorities and meet established deadlines. - Attention to detail and analytical skills. - Ability to work independently as well as within a team. ADDITIONAL SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: Claim Representative II, III: - Ability to make independent decisions. - Ability to solve complex problems. Claim Representative III: - Ability to train and mentor others. WORKING CONDITIONS: Work is performed in an office setting with no unusual hazards. Minimal travel required. PAY RANGE: Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $56,700 and $94,900. The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract. #LI-CD1 #AFG
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Business Development Manager
InovalonFounded in 1998, Inovalon is a publicly-traded information technology and services firm that specializes in cloud-based, data-driven platforms for the healthcar
Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building. Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare’s greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve. Overview: The Business Development Manager applies healthcare industry knowledge, advanced sales acumen, and disciplined territory management to drive growth within an assigned geographic region or book of business. This role independently manages the full sales lifecycle from prospecting through close while maintaining rigorous pipeline management and consistent use of sales operations processes. The Business Development Manager builds influence with both customer stakeholders and internal partners through exceptional communication, consultative selling, and data‑driven insights. Duties and Responsibilities: - Drive demand and increase awareness of Inovalon’s products by engaging prospects and nurturing existing relationships through effective communication across multiple channels, including in‑person meetings, virtual interactions, and phone outreach. - Maintain disciplined and reliable execution of sales operations, including accurate CRM documentation (Salesforce), pipeline hygiene, forecasting, and follow‑up processes. - Identify, qualify, and develop net‑new business opportunities while expanding and strengthening existing client relationships. - Develop an understanding of Inovalon’s enterprise solutions and the ONE Inovalon mission, identifying and connecting opportunities across business units and collaborating with colleagues to ensure customers receive the full value of Inovalon’s offerings—even beyond the assigned territory or BU. - Work closely with assigned Sales team and other team members in your territory to qualify prospect accounts, ensure web demonstrations are completed in a timely and thorough manner, and all sales opportunities are properly gathered with Marketing, Sales, and Business Development departments. - Partner with Marketing to communicate customer insights, competitive trends, and emerging needs that influence product and go‑to‑market strategy. - Lead or support product presentations, solution positioning, and demonstration processes in collaboration with Sales, Marketing, and Business Development teams. - Develop a deep understanding of the territory’s market dynamics, competitive landscape, and customer needs to inform strategic sales planning. - Conduct effective discovery, needs assessments, and consultative conversations that influence customer decision‑makers. - Collaborate with assigned Sales Representatives, Marketing, and Business Development leaders to synergize sales efforts, follow up activities and support each other with identified new business opportunities and clients; - Travel to meet with prospective and existing clients to drive sales outcomes and strengthen relationships. - Serve as an informal mentor or coach to new hires by modeling best practices in sales process discipline, communication, and customer engagement. - Contribute to a positive team culture that emphasizes accountability, collaboration, and continuous improvement. - Maintain compliance with Inovalon’s policies, procedures and mission statement; - Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position; and - Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company. Job Requirements: - 3-5 years of progressive sales or business development experience, preferably within the healthcare, health technology, or payer/provider space. - Demonstrated success managing a territory or book of business with measurable revenue outcomes. - Proven track record of consultative, solution‑based selling, including running discovery, developing value propositions, and influencing cross‑functional decision‑ - Experience maintaining accurate pipeline management, forecasting discipline, and CRM hygiene (Salesforce strongly preferred) with limited supervision. - Advanced communication and presentation skills, with the ability to translate technical or clinical concepts into compelling business value. - Ability to independently drive the full sales lifecycle—prospecting, qualifying, presenting, negotiating, and closing. - Strong territory planning and prioritization skills, with the ability to balance new business generation and account expansion. - Proven ability to conduct strategic, value‑based discussions with C‑suite leaders to advance complex sales opportunities. - Leadership or supervisory experience preferred. - Proficiency in Microsoft Office Suite; strong command of PowerPoint and Excel for sales presentations and territory planning. 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Inovalon is most interested in finding the best candidate for the job, and you may be just the right person for this or other roles. By embracing inclusion, we enhance our work environment and drive business success. Inovalon strives to provide equal opportunities to the communities where we operate and to our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth. Inovalon is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirement. To review the legal requirements, including all labor law posters, please visit this link To review the California Consumer Privacy Statement: Disclosures for California Residents, please visit this link
Description Please note – while this position is fully remote, candidates must be residents of Wisconsin, Kansas, Georgia, Oklahoma, Florida, Arkansas, or Tennessee to be considered. Uncapped Earnings | Performance-Driven | Career Growth Are you competitive, goal-oriented, and motivated by unlimited earning potential? Do you thrive in roles where your effort directly impacts your paycheck? If so, this is the opportunity you’ve been looking for. Join our growing Collection Team, where top performers are rewarded, income is uncapped, and your ability to negotiate, build rapport, and close resolutions can translate into six-figure earnings. This role offers a clear path to high income while allowing you to help consumers resolve outstanding balances with dignity, respect, and professionalism. As a Collection Representative, you'll work directly with consumers who have past-due medical balances, guiding them toward practical, mutually beneficial payment solutions. Why Join Us? This is a true performance opportunity for individuals who want control over their income, a clear path to success, and a professional environment that rewards effort and results. If you’re ready to work hard, earn big, and grow your career—we want to hear from you. What You’ll Do: - Handle high-volume outbound and inbound calls with professionalism and confidence - Negotiate payment arrangements that meet both consumer needs and company goals - Consistently meet and exceed performance metrics (quality, compliance, collections) - Maintain accurate documentation and follow all required laws and standards - Build trust quickly through active listening, empathy, and strong communication. Who Succeeds in This Role Top collectors tend to be: - Highly driven and money-motivated - Reliable and successful working a structured, full-time Mon-Fri schedule - Comfortable on the phone and energized by frequent conversations - Resilient, persistent, and confident handling objections - Empathetic negotiators who can balance firmness with professionalism If you enjoy being measured by results—and rewarded for them—you’ll thrive here. Compensation & Earning Potential We offer a clear, progressive compensation path designed to reward performance: Training Period - $20/hour during virtual training led by industry experts - Learn systems, compliance, call strategy, and negotiation fundamentals Following Training - Transition to $17/hour plus bonus/commission opportunity - Designed so strong performers earn more than their initial hourly rate - Provides stability with significant upside Work Location & Schedule - Remote or in-office (Marshfield, WI) - Remote employees must have a private, dedicated office space - Monday–Friday, full-time: - 8:00 AM – 5:00 PM CST / 9:00 AM – 6:00 PM ET - Commission schedule includes: - Two evening shifts per week (until 7:00 PM CST) - Every other Friday off Additional schedule options, including later evenings and Saturdays, may become available in 2026. 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Description Please note – while this position is fully remote, candidates must be residents of Wisconsin, Kansas, Georgia, Oklahoma, Florida, Arkansas, or Tennessee to be considered. Uncapped Earnings | Performance-Driven | Career Growth Are you competitive, goal-oriented, and motivated by unlimited earning potential? Do you thrive in roles where your effort directly impacts your paycheck? If so, this is the opportunity you’ve been looking for. Join our growing Collection Team, where top performers are rewarded, income is uncapped, and your ability to negotiate, build rapport, and close resolutions can translate into six-figure earnings. This role offers a clear path to high income while allowing you to help consumers resolve outstanding balances with dignity, respect, and professionalism. As a Collection Representative, you'll work directly with consumers who have past-due medical balances, guiding them toward practical, mutually beneficial payment solutions. Why Join Us? This is a true performance opportunity for individuals who want control over their income, a clear path to success, and a professional environment that rewards effort and results. If you’re ready to work hard, earn big, and grow your career—we want to hear from you. What You’ll Do: - Handle high-volume outbound and inbound calls with professionalism and confidence - Negotiate payment arrangements that meet both consumer needs and company goals - Consistently meet and exceed performance metrics (quality, compliance, collections) - Maintain accurate documentation and follow all required laws and standards - Build trust quickly through active listening, empathy, and strong communication. Who Succeeds in This Role Top collectors tend to be: - Highly driven and money-motivated - Reliable and successful working a structured, full-time Mon-Fri schedule - Comfortable on the phone and energized by frequent conversations - Resilient, persistent, and confident handling objections - Empathetic negotiators who can balance firmness with professionalism If you enjoy being measured by results—and rewarded for them—you’ll thrive here. 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Internal Business Development Consultant
TransamericaTransamerica is a holding company for a number of life insurance firms and investment companies that offer services across the country. As an employer, the comp
Internal Business Development Consultant – WFG Canada locations CAN Toronto WFH time type Full time job requisition id R20061300 Job Family Sales Support / Operations About Us At Transamerica, hard work, innovative thinking, and personal accountability are qualities we honor and reward. We understand the potential of leveraging the talents of a diverse workforce. We embrace an environment where employees enjoy a balance between their careers, families, communities, and personal interests. Ultimately, we appreciate the uniqueness of a company where talented professionals work collaboratively in a positive environment — one focused on helping people look forward and plan for the best life possible while providing tools and solutions that make it easier to get there. Who We Are We believe everyone deserves to live their best life. More than a century ago, we were among the first financial services companies in America to serve everyday people from all walks of life. Today, we’re part of an international holding company, with millions of customers and thousands of employees worldwide. Our insurance, retirement, and investment solutions help people make the most of what’s important to them. We’re empowered by a vast agent network covering North America, with diversity to match. Together with our nonprofit research institute and foundation, we tune in, step up, and are a force for good — for our customers and the communities where we live, work, and play. United in our purpose, we help people create the financial freedom to live life on their terms. What We Do Transamerica is organized into three distinct businesses. These include 1) World Financial Group, including Transamerica Financial Advisors, 2) Protection Solutions and Savings & Investments, comprised of life insurance, annuities, employee benefits, retirement plans, and Transamerica Investment Solutions, and 3) Financial Assets, which includes legacy blocks of long term care, universal life, and variable and fixed annuities. These are supported by Transamerica Corporate, which includes Finance, People and Places, General Counsel, Risk, Internal Audit, Strategy and Development, and Corporate Affairs, which covers Communications, Brand, and Government and Policy Affairs. Transamerica employs nearly 7,000 people. It’s part of Aegon, an integrated, diversified, international financial services group serving approximately 23.9 million customers worldwide.* For more information, visit transamerica.com. Job Description Summary IAs part of the World Financial Group (WFG) Distribution team, the Internal Business Development Consultant is responsible for partnering with the WFG business development team, field agents, and field leadership to drive increased agent recruiting, licensing, product sales and to enhance the agent experience. Increase field performance, training, and communications to execute on WFG growth strategies. Serve as a technical knowledge resource to enhance field recruiting, new agent activation, and improve recruit-to-license, license-to-sale, and first-time producer ratios. Implement inbound and outbound call strategies to drive life and annuity/seg fund sales and increase agent engagement. Job Description Responsibilities - Drive WFG life and annuity/seg fund sales growth aligning with the WFG Business Development team to achieve results and execute on activity goals to increase licensed agents, first time producer sales, multi-ticket, and multi-product sales. - Drive increased recruit-to-license and license-to-sales growth for new recruits and agents through on-going technical support, training, issue resolution, and recognition of field accomplishments. - Provide training and troubleshooting activities on contracting and licensing procedures, new business, underwriting procedures, sales concepts, and end-to-end sales processes. - Provide orientation and training on WFG systems, websites, and other digital tools. - Deliver messaging, updates, incentives, etc. regarding WFG supported products, services, and resources to drive sales growth and meet retention objectives. - Support marketing, training, and sales event activities focused on enhancing the experience of new recruits and new agents. - Achieve performance measures/metrics and adhere to quality standards that align with business objectives. Achieve/exceed financial goals and targets. - Recommend and initiate approved improvements to processes and procedures. Qualifications - Two years of sales/distribution and financial services industry experience - Life license, or ability to obtain within 6 months - Understanding of the life insurance industry, securities business, agency operations, and regulations - Outstanding relationship building skills to motivate and encourage recruits and agents - Excellent oral/written communication, presentation, and listening skills - Technical aptitude to learn and train others on WFG platforms - Proactive and independent thinker able to take accountability for tasks and commitments - Attention to detail and the ability to quickly adapt in a rapidly changing environment - Problem-solving and decision-making skills - Organizational skills to manage time and resources Preferred Qualifications - Bachelor’s degree in a business field - Bilingual: English/French/Spanish/Punjabi (oral and written) as required in some territories - Understanding of WFG agency model, company departments and functional areas - Life & Health license - Mutual Fund licenses Working Conditions - This is a hybrid position requiring 2-3 days in office per week in one Toronto, ON. - Relocation assistance will not be provided for this position - Valid driver’s license and vehicle required - Occasional Travel Compensation The salary for this position generally ranges between $67,000 - $70,000 annually. Please note that the salary range is a good faith estimate for this position and actual starting pay is determined by several factors including qualifications, experience, geography, work location designation (in-office, hybrid, remote) and operational needs. Salary may vary above and below the stated amounts, as permitted by applicable law. Disclaimer: Beware of fake job offers! We’ve been alerted to scammers impersonating Transamerica recruiters, particularly for remote positions. Please note: - We will never request personal information such as ID or payment for equipment upfront. - Official offers are sent via DocuSign following a verbal offer—not through text or email. #LI-HR1 This job description is not a contract of employment nor for any specific job responsibilities. Managers may assign other duties and responsibilities as needed. In the event an employee or applicant requests or requires an accommodation to perform job functions, the applicable HR Business Partner should be contacted to evaluate the accommodation request. What We Offer For eligible employees, we offer a comprehensive benefits package designed to support both the personal and financial well-being of our employees. Compensation Benefits - Competitive Pay - Bonus for Eligible Employees Benefits Package - Pension Plan - 401k Match - Employee Stock Purchase Plan - Tuition Reimbursement - Disability Insurance - Medical Insurance - Dental Insurance - Vision Insurance - Employee Discounts - Career Training & Development Opportunities Health and Work/Life Balance Benefits - Paid Time Off starting at 160 hours annually for employees in their first year of service. - Ten (10) paid holidays per year (typically mirroring the New York Stock Exchange (NYSE) holidays). - Be Well Company holistic wellness program, which includes Wellness Coaching and Reward Dollars - Parental Leave – fifteen (15) days of paid parental leave per calendar year to eligible employees with at least one year of service at the time of birth, placement of an adopted child, or placement of a foster care child. - Adoption Assistance - Employee Assistance Program - Back-Up Care Program - PTO for Volunteer Hours - Employee Matching Gifts Program - Employee Resource Groups - Inclusion and Diversity Programs - Employee Recognition Program - Referral Bonus Programs


