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.

Role Description Metro Vein Centers is seeking a detail-oriented Medical Claims Resolution Specialist to support our billing and revenue cycle operations. This role is responsible for resolving denied, underpaid, and aging insurance claims while helping ensure accurate reimbursement and timely account resolution. You’ll work directly with insurance payers, payer portals, billing systems, and internal operational teams to investigate claim issues, submit appeals, and reduce revenue delays across our growing national clinic network. The ideal candidate has prior experience in medical billing, insurance follow-up, denial resolution, or accounts receivable within a healthcare environment. Success in this role requires strong problem-solving skills, attention to detail, urgency, and the ability to manage high claim volumes while navigating complex payer guidelines. This is a fully remote role supporting Metro Vein Centers’ growing national operations. The ideal candidate is highly organized, detail-oriented, and comfortable working independently in a fast-paced, high-volume claims environment. What Your Day Looks Like - Investigating denied or underpaid medical claims - Following up with insurance payers through portals and phone communication - Reviewing payer guidelines and submitting claim appeals - Managing aging reports and prioritizing time-sensitive accounts - Reprocessing claims and updating billing information within the EMR system - Collaborating with billing, coding, and operational teams to resolve claim issues - Managing multiple claims simultaneously while maintaining productivity and accuracy standards What You’ll Do - Investigate and resolve denied, unpaid, or underpaid insurance claims - Submit timely and accurate appeals based on payer-specific guidelines and supporting documentation - Follow up on aging claims through payer portals, phone calls, and billing systems - Review claim edits, rejections, and payment discrepancies to determine resolution steps - Perform insurance re-verification and reprocess claims as needed - Post adjustments, payments, and account updates accurately within the EMR system - Maintain detailed documentation regarding claim follow-up activity and payer communication - Collaborate with internal billing, coding, and operational teams to reduce recurring denials and reimbursement delays - Support departmental productivity, quality, and turnaround time expectations What You’ll Bring - Ability to work independently and maintain productivity in a fully remote environment - Strong understanding of medical billing, claims follow-up, denial management, and insurance workflows - Knowledge of CPT, ICD-10, EOBs, payer guidelines, and medical billing terminology - Comfortable navigating payer portals, EMR systems, and healthcare billing platforms - Strong analytical and problem-solving skills with attention to detail - Ability to manage multiple claims and deadlines within a fast-paced environment - Clear written and verbal communication skills when working with payers and internal teams - Organized, self-motivated, and accountable work style Education & Experience - High school diploma or equivalent required - 2+ years of experience in medical billing, insurance follow-up, denial resolution, claims management, or healthcare revenue cycle operations required - Prior experience with surgical, specialty practice, outpatient, or procedural billing strongly preferred - Familiarity with Centricity / Athena EMR preferred - Experience reviewing appeals, denials, EOBs, and payer correspondence strongly preferred Schedule & Location - Fully remote position - Standard business hours Monday–Friday - Candidates must have reliable internet access and a distraction-free remote work environment Benefits - Medical, Dental, and Vision Insurance - 401(k) with Company Match - Paid Time Off (PTO) + Paid Company Holidays - Company-Paid Life Insurance - Short-Term Disability Insurance - Employee Assistance Program (EAP) - Career Growth & Development Opportunities Compensation Starting at $20/hour and up to $25/hour based on experience.