• Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies. • Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing. • Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues. • Participate in ongoing training and professional development activities. • Maintain accurate and detailed records of claims processing activities. • Review claim forms and supporting documents • Determine eligibility, verify data accuracy • Request additional information when needed • Process claims end-to-end • Identify and escalate complex or unusual claims for further review or investigation. • Participate in ongoing training and professional development activities. • Handle more complex claims with multiple services, providers

Headquartered in Richfield, Ohio, Vanliner Insurance Company is a member of Great American Insurance Group. For over 30 years, Vanliner has grown to become the country’s top insurance provider for the moving and storage, parcel and home delivery industries. Our mission since day one, has been to provide first-class insurance products and unparalleled customer service to all of our customers. Our success is driven by the expertise, innovation and commitment to customer service that our employees provide. 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. Founded in 1978 by movers and for movers, Vanliner Insurance Company has grown to become the country's top insurance provider for the moving and storage, last mile and home delivery industries. ( https://natl.com/vanliner/) Vanliner is looking for a Workers Comp Senior Claims Rep to join their team. This individual will either work hybrid from the Richfield, OH office 4 days per week or work fully remote from the USA, if not local to the office. Vanliner’s culture is built on connection, shared learning, and strong relationships. To support this, employees in this role are expected to be on-site four days a week, with the flexibility to work one day remotely. Core in‑office days are Tuesday–Thursday, with the fourth day determined by business needs. Essential Job Functions and Responsibilities Manages an inventory of claims to evaluate compensability/liability. Plans and conducts claim investigations to confirm coverage and to determine liability, compensability and damages. Determines and negotiates appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials. Conveys moderately 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. Performs other duties as assigned. Job Requirements Scope of Job/Qualifications: Works within significant limits and authority on assignments of higher technical complexity and coordination. Demonstrates strong analytical, negotiation, and problem-solving skills. Demonstrates knowledge of insurance policies, coverage, and claims handling procedures. Maintains knowledge of industry laws and regulations. Demonstrates 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. This job is non-exempt in California and Washington Company: NIIC National Interstate Insurance Company Salary Range: $75,000.00 -$80,000.00 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.

Role Description Our client is seeking to add a Senior Workers' Compensation Claims Examiner to their California operations. This role will consist of handling moderate to complex Workers’ Compensation Lost Time claims throughout the state of California from inception to close. Qualified candidates should possess their SIP. - Handle a pending of 90 - 100 mid to complex Workers' Compensation Lost Time claims in California - Investigate claims to determine validity and extent of liability. - Properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses, and others; coordinate medical treatment for injured workers. - Review and evaluate documentation, including applications, reports, and statements. - Ensure legal, regulatory, and fair claims handling compliance. - Identify claims with subrogation potential and pursue reimbursement. - Set or recommend reserves based on results of claim investigation. Qualifications - 7-10+ years of Workers' Compensation Lost Time claims handling experience - Must be well-versed in California Workers’ Compensation Law - Must maintain SIP - Excellent Customer Service and Organizational skills - High School Diploma; Bachelor's Degree preferred but not required Benefits - $100,000 - $115,000 annual base salary - Ability to work from home - Competitive Medical, Dental, Vision and Life plans - Employer matching 401(k) plan Company Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description 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 position is remote. Candidate must reside in California. - 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 - Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”) - Additional duties as assigned Qualifications - 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 Requirements - Bachelor's degree or a combination of education and related experience - Minimum of 3 years’ industry experience and claim handling - Self-Insured Certificate preferred - State Certification as an experienced Examiner - 4850 Experience Required 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: $29.35 - $47.28 per hour Benefits 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 - Paid time off