• adjudicating claims • accurately receiving and assessing new losses • documenting and investigating claims • maintaining an exceptionally high level of customer service

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a highly organized, detail-oriented, and customer-focused Non-Standard Claims Adjuster to support our deposit replacement and surety programs. In this role, you will manage first-party claims involving non-standard policy language and complex contractual agreements. Success requires strong analytical skills and the ability to interpret policy forms, lease agreements, financial ledgers, and supporting addenda with accuracy and confidence. You will work directly with property managers, policyholders, and internal stakeholders to drive fair, thorough, and timely claim outcomes. This role requires clear communication, sound judgment, and the ability to navigate nuanced coverage positions while maintaining a high level of professionalism and empathy. This position is ideal for an adjuster who thrives in a fast-paced, evolving environment and enjoys working within specialty programs. The right candidate is adaptable, solutions-oriented, and comfortable balancing high claim volume with exceptional service delivery and compliance standards. Who You Are - Highly motivated and growth-oriented. - Passionate adjuster who cares deeply about the customer experience. - Empathetic, exercising patience and understanding in every interaction. - Urgent but balanced, working with a sense of urgency without overextending. - Creative problem-solver, finding innovative ways to resolve claims efficiently. - Comfortable with conflict, viewing it as an opportunity to collaborate. - Curious, wanting to know the whole story to make informed decisions. - Anti-status quo, taking action to improve processes and outcomes. - Communicative, able to break down complex topics and ensure clarity. - Possessing a sense of humor to keep things light when needed. What you'll do - Provide prompt, courteous, and high-quality customer service. - Manage a high volume of low-complexity claims; set and adjust reserves appropriately. - Gather necessary information and documentation to initiate the claims process. - Analyze contracts, financial ledgers, lease agreements, and addenda to determine claim validity. - Ensure compliance with state regulations, policy provisions, and internal procedures. - Communicate with all involved parties and issue payments within the set authority. - Contribute to the continuous improvement of claims guidelines, best practices, and workflows. - Oversee and direct investigative service providers, working closely with clients and stakeholders. - Stay informed on industry trends, legal decisions, and policy changes affecting claims handling. Qualifications - Bachelor’s degree preferred (but if you meet the other qualifications, don’t let that stop you from applying!). - 3 years of experience in general claims handling or related insurance roles. - Ability to interpret non-standard policy language, contract terms, and lease agreements. - Have active adjuster license(s) and be willing to obtain all required licenses within 60 days. - Familiarity with state regulations, policy provisions, and claims procedures. - Strong analytical skills—able to evaluate complex data and make sound decisions. - Curious, proactive, and always looking for better ways to do things. - The desire for continuous learning and professional growth. - Willingness to travel for client and claim needs. - Excellent verbal and written communication skills with strong attention to detail. - Superior organizational skills—able to prioritize and manage workload efficiently. - Comfortable with an Apple laptop, Google Docs, Sheets, and other relevant software. Benefits - Generous health-insurance package with nationwide coverage, vision, & dental. - 401(k) retirement plan with employer matching. - Competitive PTO policy – we want our employees fresh, healthy, happy, and energized! - Generous family leave policy after 8 months of continuous work. - Work from anywhere to facilitate your work-life balance. - Apple laptop, large second monitor, and other quality-of-life equipment.

• Assist client in identifying, validating, and recovering claim overpayments. • Validate claims to ensure the accuracy of algorithms and that no refund has previously been posted to the client’s system(s). • Review and resolve disputed overpayments from client/provider. • Participate in knowledge sharing to brainstorm and resolve claim issues or seek clarifications. • Identify new overpayment opportunities and trends by reviewing and researching areas such as CMS and Medicaid claims processing policies, adjustments by client’s internal unit/other vendors, client’s claims processing policies/system(s), provider, and member contracts. • Interpret and analyze medical and pharmacy claims data as well as provider and enrollment data to accurately assess and demonstrate key insights into trends and opportunities and follow concept development process. • Assist Management with concept approval information needed for client approval on specific trends. • Complete step by step instructions for each algorithm moved to production. • Always represent TREND and our clients in a professional manner. • Cooperate with team members to meet goals and complete tasks in an efficient and effective manner. • Provide feedback to Management regarding inventory levels, algorithm effectiveness/productivity, and new trend/ideas. • Collaborate with TREND Management to identify new opportunities, areas of improvement, and innovate potential solutions. • Escalate to the manager any situation outside the employee’s control that could adversely impact the business relationship. • Train and assist new analysts as needed while maintaining high quality and production results. • Assist with Quality Review process. • Ensure staff is appropriately resolving day-to-day problems in a timely and successful manner

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Coordinates with the Funding Manager, Funding Supervisor, Branch Manager, Rehabilitation Technology Supplier (RTS), and other office support personnel to ensure all operational procedures are completed in accordance with company policy and within expected time frames. Responsible for correcting and reworking any order that is unable to be billed or has resulted in a claim denial due to missing or incorrect information. This can include: - Coding & Pricing - Gathering information and documents pertinent to the funding package - Ensuring that all documentation is in place - Submission to the funding sources - Collecting payer decisions including authorizations, denials, and deferrals Qualifications - Minimum of 3 years of experience related to Durable Medical Equipment and/or Complex Rehab Technology - Preferred experience in all aspects of a Funding Specialist’s position including processing both Repairs and Non-Repairs - Extensive knowledge of the process and insurance guidelines to secure funding for Durable Medical Equipment and/or Complex Rehab Technology - Comprehensive knowledge of insurance verification for DME - Proficient in Microsoft Excel, Word, and Outlook - Strong ability to problem solve - Knowledge of NSM P&P and ability to interpret and follow payer guidelines and all Policies and Procedures Requirements - Responsible for problem-solving, correcting, and reworking any order that is unable to be billed or has resulted in a claim denial due to missing or incorrect information - Ensures the accuracy of and completes updates to all required coding, modifiers, and pricing - Verifies client benefits and coverage and communicates benefit information to client - Gathers and reviews documentation for payer, including but not limited to: - Proper prescriptions - Letters of Medical Necessity (LMN) - RTS evaluation information - Price lists - Forms (AOB, ABN, rent or purchase letter) - Communicates regularly with Physicians, Therapists, RTSs, and Clients to secure documentation as required by payer - Communicates changes and escalations in the process and collects needed information from branch personnel, Referral sources, Physicians, Therapists, RTSs, and Clients - Investigates and updates any payer requirements - Maintains communication with client throughout the process when applicable, including notifying them of financial responsibility - Coordinates with branch staff to secure pick up and redelivery documentation as required - When appropriate, discusses and secures approvals to write off or adjust balances - Communicates with Billing and Collection team to ensure that timely filing deadlines are met and/or to resolve any clarification on MIRs - Properly noting and closing MIRs with a complete and thorough response through the Funding Portal and Mobility Advisor - Performs any related job duties assigned by the MIR Manager, carrying out all position expectations in a professional manner and with minimal supervision - Responsible to complete all continuing education requirements to include assigned NSM University courses - Must maintain regular and predictable attendance Work Environment This position primarily operates in a work from home environment. The work from home policy and requirements must be adhered to. Occasionally, this job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, printers, photocopiers, filing cabinets, and fax machines. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to: - Talk or hear - Sit - Use hands repetitively to operate standard office equipment - Reach with hands and arms Benefits - 401k - Company paid Long Term Disability - Tuition reimbursement Company Description At all levels, working at National Seating & Mobility provides the opportunity to directly impact our client’s lives by giving them self-reliance and independence. Our teams are comprised of passionate individuals, dedicated to providing the best care to each client. We focus on abilities by leveraging technology and creating mobility solutions that are as unique as our client’s needs. Working at National Seating & Mobility is an opportunity to build a meaningful career while leaving a lasting impact on the lives of those we serve. Located in more than 40 states, we strive for diversity.