Role Description At Vantage, the Senior Claim Specialist, Casualty Claims will be a critical member of our Casualty team. The mission of the team is to add creativity to tech-enabled efficiency and robust analytics to address risks others avoid. This role will provide complete claim management and loss mitigation services for policyholders on a dedicated account basis. This role independently investigates, evaluates, and manages the disposition of Primary and Excess Casualty claims as well as GL and Auto claims arising out of the Healthcare book of varying degrees of complexity and severity across multiple product types and markets. Additionally, the role supports the Underwriting Business Unit by liaising with account and broker/agent representatives, providing frequent, in-depth exposure analysis to senior leadership, and participating in marketing efforts at industry events and conferences. The ideal candidate for this position possesses extensive knowledge of complex Casualty risks, strong leadership abilities, and a proven track record of success in driving profitable growth. This role reports to the Assistant Vice President of Casualty Claims and is a remote work opportunity. The base salary expectation for this role is between $115,000 and $140,000. Actual base salary for the selected candidate may be higher commensurate with candidate experience and expectations. Additionally, Vantage offers its colleagues performance-based bonus potential, strong health & welfare benefits, retirement plans with company match, competitive time off plans, a highly flexible work environment, and much more. Responsibilities & Accountabilities - Evaluates, reserves, and manages casualty claims to resolution, including oversight of all phases of litigation related to Casualty exposures. - Reviews coverage, drafts coverage letters, and communicates coverage positions to insureds, brokers, and agents as necessary. - Communicates regularly with insureds, brokers, and internal and external stakeholders regarding individual claim development and strategy. - The ideal candidate will have experience handling Primary Casualty claims as well as Umbrella and Excess Casualty claims including trucking and construction claims. - Provides superior customer service to, and proactively builds strong relationships with, all appropriate representatives of assigned accounts, including their internal leadership, brokers, and agents to maximize the competitive advantage derived from the Vantage Claims value proposition. - Adheres to Vantage Claims Best Practices for proper and consistent claim handling performance, compliance, and achievement of business goals, and drives efficient and proactive litigation defense strategies by effectively managing retained counsel. - Thoroughly, clearly, and thoughtfully documents claim files with all relevant factual and evaluative information in compliance with company policies, best practices, and applicable regulatory authority where necessary. - Demonstrates superior subject matter knowledge and negotiation skills to affect appropriate claim outcomes through direct negotiation and utilizing alternative dispute resolution as necessary. - Proactively drives claim development and seeks creative ways to achieve optimal results on every file. - Adheres to Vantage’s reserving and reporting protocols to avoid unexpected developments and outcomes. - Identifies issues and trends within their accounts and the Financial Institutions market and regularly communicates those to insureds, Vantage Claims leadership, Underwriting partners, and actuaries. - Follows all escalation and reporting protocols as required under appropriate circumstances for cases with significant potential exposure. - Attends marketing, account renewal, and reinsurance meetings as appropriate to communicate the Vantage claims handling philosophy and value proposition. - Treats all internal and external stakeholders and business partners respectfully and always demonstrates a positive attitude and collegial approach to their work. Qualifications - Bachelor’s degree or equivalent professional experience required; Juris Doctorate degree helpful. - Minimum of six years of end-to-end Casualty claims handling experience required. - Self-motivated and independent, capable of identifying issues and solving them, but also knowing when to elevate them. - Thrive in a dynamic, team-focused environment and deliver on tight deadlines. - Strong problem-solving and negotiation skills. - Excellent communication and interpersonal relationship-building skills. - Analytical: Able to identify and define problems, extract key information from data, and develop workable solutions to resolve the problems identified. - Drive to Deliver: Takes accountability for work, organizes, and prioritizes, delivers results, is action-oriented, sets and achieves goals, and demonstrates resilience. - Customer service focus: Recognizes customers’ needs, meets their requirements, and adds value to customer outcomes with a pragmatism that balances service with Vantage business imperatives. - Digitally savvy/Insight: Gathers information from a variety of sources, cuts through complexity, considers options, solves problems, and makes decisions. - Strong knowledge of Microsoft Word, Excel, & PowerPoint. Our Vantage Values - Do What’s Right – be a force for good, for our customers, shareholders, colleagues, industry and communities. - Be Relentlessly Curious – ask questions, listen to understand, challenge the status quo, look for ways to say YES, drive innovation, be opportunistic and disciplined. - We’re Better Together – collaborate, be inclusive, supportive, respectful and humble, be a trusted partner internally and externally. - Be Transparent – in who you are, what you think, and how you work, seek and provide alternative points of view, be true to yourself. - Make A Difference – focus on impact, embrace technology, leverage data and analytics as critical assets, act intentionally to deliver on our mission.

Role Description Supervising a team of Commercial auto property damage claims adjusters handling complex litigation. - 10 years of demonstrated ability handling Commercial Auto Liability Claims - Overseeing claims adjuster handling experience in Auto Liability, Bodily Injury, Property Damage Claims, 1st and 3rd party claims - Prior TPA experience - Active Adjusters license - 10 years of supervisory experience - Jurisdictions: Nationwide - Licenses: TX, FL, NY - Location: This role is eligible for fully remote work. How you'll make an impact - Supervise: Lead and encourage a liability claims team handling a variety of caseload sizes and complexities to deliver high-quality and efficient service. - Promote Best Practices: Guide claims team to handle claims in accordance with GB’s Best Practices. - Drive Talent: Take charge of adjuster hiring and training, encouraging a culture of performance and continuous improvement. - Manage Workloads: Define team goals, motivate performance, and effectively manage workloads to ensure optimal efficiency. - Utilize Technology: Harness the power of Gallagher's technology to enhance your team's efficiency and overall quality of service. - Client Communication: Communicate with clients, carriers, and brokers in a professional, positive, and proactive manner. - Prioritize and Develop: Effectively manage multiple competing priorities, identify coaching opportunities, and position team members for successful development. Qualifications - Claims Background: 10 years of demonstrated ability handling Commercial Auto Liability Claims and overseeing claims adjuster handling experience in Auto Liability, Bodily Injury, Property Damage Claims, 1st and 3rd party claims, Prior TPA experience, Active Adjusters license, 10 years of supervisory experience - Prior leadership experience: minimum of 8 years - Jurisdictional Experience: Nationwide preferred Requirements - High School Diploma - Minimum of 10 years related claims experience - Appropriately licensed and/or certified in all states in which claims are being handled - Knowledge of all team member related functions Desired - Bachelor's Degree 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...

Role Description Advantia is seeking a Claims Resolution Specialist to join our team! As a Claims Resolution Specialist, you will be essential in ensuring the accuracy and timeliness of billing and reimbursement for medical services. This important role demands a solid understanding of medical terminology, coding, and billing procedures. This role will report to the RCM Manager. - Initiating ERA (electronic remittance advice) set up with clearinghouse and/or third-party portals. - Initiating EFT (electronic funds transfer) set up with payers & third-party portals. - Assist in vendor support of daily cash reconciliation duties. - Clear understanding of RCM Payment Posting Processing (ERA/Manual Posting) of Line-Item Payments/Denials. - Clear understanding of reconciling offset/recoupment payer remits. - Call carriers and third parties to resolve unidentified payments/reconcile items. - Responsible for maintaining payer portal admin and employee registration. - Assist the RCM Manager with various projects. Qualifications - High School/GED Education required - Previous experience in medical billing or a related field is preferred. - Proficiency in electronic health records and billing software preferred. - Athena experience required. Benefits - Health, Dental, and Vision Insurance - Health Savings Account (HSA) and Flexible Savings Account (FSA) Option - 401k Retirement Plan - Life and Disability Insurances - Paid holidays/PTO - Compensation Range: $18.00-$22.00/hr Company Description Advantia Health provides unparalleled healthcare to our customers by employing the most highly qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination or an approved request for accommodation is required as a condition of employment. Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.

Role Description As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statutes, policy provisions, and company guidelines. - Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature - Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable) - Alert Supervisor and Special Investigations Unit to potentially suspect claims - Ensure timely denial or payment of benefits in accordance with jurisdictional requirements - Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure - Negotiate claims settlements with client approval - Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition - Work collaboratively with Lodestar nurse professionals to develop and execute return to work strategies - Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome - Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced - Demonstrate technical proficiency through timely, consistent execution of best claim practices - Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues - Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions - Authorize treatment based on the practiced protocols established by statute or the Lodestar Managed Care department - Assist Lodestar clients by suggesting panel provider information in accordance with applicable state statutes - Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work Qualifications - CA License and SIP designation required - Bachelor's degree, or four or more years of equivalent work experience required in an insurance related industry - At least 3-5 years' experience handling lost time workers compensation claims required; past experience with CA jurisdiction is required - Associate in Claims (AIC) Designation or similar professional designation desired - Active license required or ability to obtain license within 90 days of employment in mandated states - Familiarity with medical terminology and/or Workers' Compensation - Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously - Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details - Strong verbal, written communication skills and customer service skills - Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint - Ability to travel for business purposes, approximately less than 10% Requirements - Lodestar is providing applicants with the anticipated wage range for this position in compliance with state regulations. The wage range for this role is $75,000 to $101,000. - Wage ranges are based on national market data and may cover a wide range of geographies. Applicants may be paid above, within or below this range based on a variety of factors.