• To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements • Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim • Negotiating settlement of claims within designated authority • Communicating claim activity and processing with the claimant and the client • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner

• To analyze and process low to mid-level auto and transportation claims • Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy • Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution • Identifies and pursues subrogation opportunities; secures and disposes of salvage • Communicates claim action/processing with insured, client, and agent or broker when appropriate • Maintains professional client relations • Performs coverage, liability, and damage analysis on all claims assignments • Performs other duties as assigned • Supports the organization's quality program(s)

Role Description As an Auto Claims Specialist at Revecore, you will make high-volume, outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies, on behalf of our clients (hospitals and medical providers). - Investigate and research details of an auto accident to determine the payer. - Make high volume of outbound calls to patients, insurance company representatives, and attorneys. - Submit bills and proper documentation to the insurance company, ensuring maximized payments to our clients (medical providers). - Determine follow-up steps and resubmit bills for additional payment if bills aren't paid correctly. - Contribute to your team with various denial reports, audits, and overall support. Qualifications - Have a working knowledge of Microsoft Office (Word, Excel, Outlook). - Possess technical proficiency to work on multiple computer screens and software applications simultaneously. - Can maintain strong performance in a fast-paced, high outbound call center environment with productivity metrics. - Remain organized while multi-tasking. - Use critical thinking and problem-solving skills to find effective and efficient solutions. - Communicate clearly, both verbally and in writing. - Experience with Coordination of Benefits and a general understanding of insurance billing (a plus, but not required). Requirements - A private, distraction-free environment to work from in your home. - On-Camera Presence: Being on camera is an essential part of our culture. - A secure internet connection. - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads. - Workspace area must accommodate all workstation equipment (laptop, monitor, keyboard, mouse, docking station, and headset). - Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check. - Must reside in the United States within one of the specified states. Benefits - Paid training and incentive plans. - Medical, dental, vision, and life insurance benefits available on day 1. - Excellent work/life balance. - Employee Resource Groups build community and foster a culture of belonging and inclusion. - 401(k) contributions matched. - Career growth opportunities. - 12 paid holidays and generous paid time off.

Role Description The Senior Claims Specialist within GB Specialty is responsible for managing moderately complex Healthcare Professional Liability - Medical Malpractice claims. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements. - Analyzes coverage and settles moderately complex claims in Healthcare Professional Liability. - Generally, incumbent does not work on workers’ compensation claims. - Able to manage the full-life cycle of all assigned claims files. - Analyzes coverage and determines defense obligations. - Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans. - Creates reservation of rights and coverage denial letters. - Negotiates settlements with clients, client attorneys, and Public Adjusters. - Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary. - Prepares reserve and settlement authority requests for client and carrier approval. - May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage. - Has a solid understanding of claims processing and the insurance brokerage business. - Has a basic understanding of the terminology and case law associated with medicine professional liability claims. - Handles claims consistent with clients’ and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements. - Incumbents at this level should be able to work at full caseload capacity. Qualifications - Bachelor's Degree and 5+ years related claims experience required. - Prior experience working within the applicable specialty claims area or demonstrated ability to handle unique/challenging claims issues. - Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements. - Knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. Requirements - JD Highly Preferred. - Licensed Attorney highly preferred. - 2+ years of prior experience adjusting claims in Healthcare professional Liability - Medical Malpractice. 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...