Claims Specialist

Claims SpecialistClaims SpecialistFull TimeRemoteMid LevelTeam 10,001+Since 1856H1B SponsorCompany SiteLinkedIn

Location

Alaska + 6 moreAll locations: Alaska | California | Montana | New Mexico | Oregon | Texas | Washington

Posted

1 day ago

Salary

$21 - $37 / hour

Seniority

Mid Level

Associate Degree2 yrs expExperience acceptedEnglish

Job Description

Claims Specialist

Providence

• Support the Clinical Research billing and account review needs of the Providence Health System • Review charges, processing and tracking of ongoing research-related clinical billing • Regularly review research-related billing process for accuracy and compliance

Job Requirements

  • 2 years Experience in research billing and coding, or closely related experience
  • Associate's Degree Healthcare Administration or related field, or 2 additional years of related experience
  • Bachelor's Degree Healthcare Administration or related field, or 4 additional years of experience

Benefits

  • Health care benefits (medical, dental, vision)
  • Life insurance
  • Disability insurance
  • Time off benefits (paid parental leave, vacations, holidays, health issues)
  • 401(k) Savings Plan with employer matching
  • Comprehensive benefits package
  • Well-being resources

Related Categories

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Warranty Claims Investigator

Amrize

Amrize is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We thank all applicants for their interest; however, only those selected for an interview will be contacted.

Role Description The regional Warranty Claims Investigator is responsible for protecting the interests of Amrize Building Envelope by managing warranty claims. The Claims Investigator will receive, analyze, and make determinations on claims by reviewing data from all available resources to efficiently respond to warranty claim issues. Responsibilities include: - Conducting surveys of job data to determine previous claim history. - Serving as a subject matter expert for the warranty services team. - Reviewing contractor proposals for repair scope, warrantability, suitability, and cost-effectiveness. - Providing clear and concise project management with involved parties utilizing proper communication and document retention. - Fostering positive relationships with internal teammates, external sales teams, and Amrize customers within the assigned region. - Submitting Service Orders, including Purchase Orders and Material Orders, as needed, to contractors providing warranty repair services. - Performing in-depth investigations in the field to analyze roofing systems exhibiting issues. - Maintaining routine detailed expense/travel reporting and maintenance requirements for company-issued equipment. - Developing and negotiating the claim position with all relevant parties and attending meetings when necessary. - Completing all paperwork including photographs related to each claim for proper documentation. - Preparing clear, concise, in-depth repair specifications summarizing rooftop analysis into cost-effective solutions. - Communicating effectively with building owners, roofing contractors, sales reps, building consultants, and lawyers. - Keeping the Warranty Services Supervisor and Regional Manager apprised of relevant claims and issues. - Interfacing with the Warranty Services Coordinator team to assist with roof knowledge development and claim warrantability determination. - Interfacing with the law department to support claims that are approaching or have entered litigation. - Efficiently managing claims expenses to meet budget goals. - Providing guidance to Junior Warranty Claims Investigators regarding claims analysis and processing. - Demonstrating a commitment to health, safety, and environmental policies in all work environments. - Promoting a culture of safety and exhibiting these behaviors. Qualifications - 6+ years of progressive roofing/construction experience is required. - 2+ years of Warranty Claims or Technical Services Experience Preferred. Requirements - Successful candidates must adhere to all safety protocols and proper use of Amrize approved Personal Protection Equipment ("PPE"). - Employees required to wear respirators must be clean-shaven where the respirator seal meets the face to pass fit tests. Benefits - Competitive salary - Retirement Savings: Choose from 401(k) pre-tax and/or Roth after-tax savings - Medical, Dental, Disability, and Life Insurance - Holistic Health & Well-being programs - Health Savings Accounts (HSAs) & Flexible Spending Accounts (FSAs) for health and dependent care - Vision and other Voluntary benefits and discounts - Paid time off & paid holidays - Paid Parental Leave (maternity & paternity) - Educational Assistance Program

United States
Mercury Insurance logo

Property Claims Examiner II

Mercury Insurance

Trusted by customers. Loved by team members. The smarter way to career.

OtherRemoteTeam 5,001-10,000Since 1962H1B Sponsor

Role Description If you’re passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury Insurance Property Claims team could be the place for you! Upon completion of the training program, ideal candidates will transition into a property claims Examiner adjusting position, collaborating with vendors, and/or virtually inspecting and estimating losses damaged by fire, water, weather, or other unexpected events. The Property Claims Examiner will apply knowledge of current Company policies, applicable regulatory standards, and procedures to investigate, evaluate and settle moderate Homeowner's property claims in a timely and efficient manner as to prevent unnecessary expense to the Company and policyholders, and provide exceptional service to our customers. Responsibilities - Investigate and resolve Homeowners claims of moderate complexity in a prompt and efficient manner. - Document with photographs, measurements, recorded interviews as needed, write a repair estimate to capture damages, and complete thorough file notes. - Ability to use imagery and advanced video technology to collaborate with onsite vendors and insureds to identify damage and write damage estimates from a virtual setting. - Compare facts gathered during the investigation against the policy to determine coverage of claim; extend or deny coverage as appropriate. - Establish reserve amounts within prescribed settlement authority limit and negotiate settlement of claims; recommend claims which exceed personal authority limit to supervisor for approval. - Responsible for effectively and timely communicating with insureds and/or their representatives to resolve issues and ensure customer satisfaction. - Prioritize own responsibilities and effectively manage claims workload to regularly monitor progress and expenses to properly resolve inventory to conclusion. - At times may direct, monitor, and review files handled by independent adjusters to conclusion. - Other functions may be assigned. Qualifications - Bachelor’s degree preferred or equivalent combination of education and experience. - Ability to obtain state specific property claims licensing, as required. - Must successfully participate and complete formal property claims training program that may take place in person, virtually, or a combination of both. - Prior experience using estimating software like Xactimate. - Experience in a related field: property claims experience, customer service environment, construction, restoration, mitigation. - Known for clear and professional communication, both written and verbal. - Bilingual and/or prior military experience is a plus. - 3-5+ years equivalent industry experience is preferred. Requirements - Possess the ability to work independently with limited or no supervision over daily activities required to successfully investigate, evaluate, write damage estimates, negotiate, and resolve property claims. - Have a passion for outstanding customer service. - Make quality decisions based upon a mixture of analysis, wisdom, experience, and judgment, including the ability to negotiate. - Be comfortable with and adaptable to new technology and business tools. - Be able to seamlessly transition between various methods of inspection, including video or photo, to write a damage estimate. - Possess strong organizational, time management, and prioritization skills to handle varying workloads due to seasonal volume changes and catastrophes. - Be able and willing to work flexible work shifts and may be asked to work overtime, as needs arise. Benefits - Competitive compensation. - Flexibility to work from anywhere in the United States for most positions. - Paid time off (vacation time, sick time, 9 paid Company holidays, volunteer hours). - Incentive bonus programs (potential for holiday bonus, referral bonus, and performance-based bonus). - Medical, dental, vision, life, and pet insurance. - 401 (k) retirement savings plan with company match. - Engaging work environment. - Promotional opportunities. - Education assistance. - Professional and personal development opportunities. - Company recognition program. - Health and wellbeing resources, including free mental wellbeing therapy/coaching sessions, child and eldercare resources, and more.

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$62.9K - $142.2K / year
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Role Description As a Sr. Field Adjuster, Homeowner Claims, you will obtain and record required loss information from the insured. Under close supervision, you will investigate, evaluate, negotiate, and settle homeowners’ property/personal property claims, including adjustment to conclusion; involves low- to higher-complexity claims that typically require physical inspection. You will be the owning adjuster for all claims assigned at the Field Adjuster level. In this role, you will be expected to progress to the competency level of a Level 5 Homeowner Adjuster. May be required to assign, coordinate, and oversee independent adjuster assignments. - Investigate and evaluate all elements of property loss claims of moderate-high severity both in the field and virtually. - Contact and meet with the insured or 3rd party virtually or in-person to photograph and inspect all damaged dwellings, other structures, and personal property. - Determine scope of repairs and prepare a repair bid using Xactimate estimating system. - Come to an agreed cost of repair with the insured, and possibly Network Repair Program contractor (NRP) or insured's contractor. - Follow the repair process to conclusion. - Ensure that the cause of the loss is thoroughly investigated and identified with the assistance of experts where needed. - Settle and pay dwelling or other structure damages once the coverage analysis is completed. - Handle all correspondence to ensure the file is regulatory compliant. Qualifications - Requires 6+ years related professional experience with transferrable skills. - 4+ years claims experience with preferred emphasis on homeowner claims. - High school diploma required. - Related bachelor’s degree or higher may be in lieu of 2 years experience. - Knowledge of Xactimate repair estimating system. - Knowledge of homeowner policies and procedures. - A valid driver’s license and insurable driving record or alternative transportation to safely transport large and/or heavy equipment between sites is required. Requirements - Bachelor Degree or combination of education and experience. - 2+ years field experience. - Knowledge of home construction. Benefits - Total compensation package, annual bonus eligibility for most roles. - 401(k) with a company match. - Flexible Workplace: Remote-first culture with Home-Flex roles. - Career Growth: Opportunities for development and long-term success. - Inclusion and Belonging: A welcoming workplace fostering innovation. - Sustainability: Initiatives to build resilient communities and reduce environmental impact.

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Okta logo

Claims Specialist

Okta

The World's Identity Company

Full TimeRemoteTeam 5,001-10,000Since 2010H1B Sponsor

• Leverage your Pharmacy Claims Experience to manage and resolve claims efficiently, ensuring our clients get the support they need. • Be a vital part of a team that’s dedicated to enhancing patient care through meticulous claims management and customer service. • Manages and identifies a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks. • Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines. • Ensures approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement. • Monitors and resolves at risk revenue associated with payer set up, billing, rebilling and reversal processes. • Works as a team to identify, document, communicate and resolve payer/billing trends and issues. • Reviews and works to convert billing exception reports to ensure claims are billed to accurate financial plans. • Prepares and maintains reports and records for processing. • Performs other tasks as assigned.

Kentucky