Role Description At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Role specifics: - Claims Background: Workers compensation lost time, indemnity claims - Jurisdictional Experience: KY, GA, NC, SC - Active Adjusters' licenses: KY, GA, NC, SC - Location: This role is eligible for fully remote work How you'll make an impact: - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients, exhibiting empathy through each step of the claims process. - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. About You: - Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution. - Work in partnership with our clients to deliver innovative solutions and enhance the claims management process. - Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants. Qualifications - High School Diploma. - Minimum of 5 years related claims experience. - Appropriately licensed and/or certified in all states in which claims are being handled. - Knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. Requirements - Bachelor's Degree (Desired). Benefits - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more...

• Works closely with veterinary hospitals, and policyholders to evaluate and review a pet’s medical history to determine a baseline of health. • Investigates and processes assigned insurance claims, verifies coverage, and compensation amounts, per insurance policy. • Updates Explanation of Benefits (EOB), pays and closes claim. • May order medical records from providers. • May communicate with clients and providers during treatment. • Performs other duties and responsibilities as assigned.

Role Description - Responsible for updating patient Billing Episodes and crediting account, as appropriate. - Review and resolve prior authorization/precertification/referral issues that are not valid and contact insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial. - Validates all necessary referrals/prior authorizations/pre-certifications for scheduled services are on file and shared with all appropriate staff and are valid for the scheduled services performed. - Ensure all account activity is documented in the appropriate system and shared with all appropriate staff timely and thoroughly. - Manage clinic emails throughout the day, responding in a timely manner. - Identify, correct, and forward potential reimbursement problems to Revenue Cycle Manager. - Proactively interact with Clinics and other appropriate staff sharing benefits, authorizations, and eligibility. - Responsible for billing all patient claims in a timely manner (weekly billing, secondary and out-of-network plans). - Review claims issues, make corrections as needed, and rebill. Utilize claims clearinghouse, EMRs, and payor portals to review and correct claims and to resubmit electronically when available. - Evaluate bill cycles and change/update when necessary. - Print daily billing reports – both electronic and paper claims. Monitor validation percent. - Work daily claims rejection lists including but not limited to; claims rejected due to auto eligibility process during weekly billing and “Rejected” claims due to eligibility, coordination of care and authorization as part of accounts receivable. - Gather and interpret data from the system and understand appropriate courses of action to take and initiate time-sensitive and strategic steps resulting in payment. - Call and status outstanding claims with third party payors. - Review explanation of benefits to ascertain that claim processed and paid correctly. - Document account follow-up where appropriate. - Identify trends and work with the Revenue Cycle Manager for resolution. - Perform other duties as assigned. Qualifications - High school diploma or equivalent; prefer some college or technical school coursework. - 2+ years of healthcare billing/AR experience, preferred. - Healthcare payor claims follow-up or accounts receivable experience. - Healthcare background with payor appeals experience. - Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint. - Knowledge of office administration procedures with the ability to operate most standard office equipment. - Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality. - Excellent interpersonal skills include the ability to interact effectively and professionally with individuals at all levels; both internal and external. - Exercises sound judgment in responding to inquiries; understands when to route inquiries to the next level. - Self-motivated with strong organizational skills and superior attention to detail. - Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes. - Capable of working within established policies, procedures and practices prescribed by the organization. - English sufficient to provide and receive instructions/directions. Benefits - Comprehensive Medical, Dental, & Vision insurance - Competitive 401(k) plan with company match - Company paid group term life insurance and short-term disability - Generous PTO: Paid vacation, personal time, sick leave, and extended sick leave - Employee Assistance Program (EAP) offering continued support to employee lifestyle and well-being - Career advancement opportunities across a leading national network

• Investigating and confirming the facts of loss for basic to advanced automobile accidents. • Determining coverage, liability, damages, and adjusting claims within the limit of authority. • Partnering with assigned reps for claims involving fraud or subrogation. • Handling investigation regarding all aspects of auto claims with discretion and independence.