• Maintain proper file documentation, file notes, and investigation documentation on each assigned claim. • Interact with veterinary clinics to ensure timely claim resolution • Meet or exceed all standards for timeliness, accuracy, and claims volume • Hold or be willing to obtain an Independent Adjuster License • Ensure compliance and support regulatory communications and reporting as needed • Work successfully with cross-functional teams to ensure alignment and support the needs of those teams

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’s how you'll make an impact: - Supervise: Lead and encourage a Workers Compensation 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: Workers Compensation - Prior leadership experience: 2 years - Jurisdictional Experience: FL Requirements - High School Diploma - Minimum of 8 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 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 As a Credentialing Specialist at Metro Vein Centers, you are an integral team member to our continued growth. This role is responsible for provider credentialing, payer enrollment, and recredentialing to ensure clean participation, timely effective dates, and uninterrupted patient access and reimbursement. Reporting to the Supervisor of Credentialing, you’ll work daily in CAQH, payer portals (e.g., Availity), Medicare PECOS, and our credentialing database, collaborating closely with Recruitment, Clinical leadership, and RCM. The ideal candidate is detail-oriented, process-driven, and has experience in provider enrollment. This is a remote role; we’re looking for a self-starter with strong ownership and follow-through. What You’ll Do - Submit and track provider enrollments across Medicare/Medicaid (PECOS) and commercial payers (e.g., Availity) to secure effective dates. - Identify network expansion opportunities by enrolling providers into additional payer products, plans, and service locations. - Maintain CAQH attestations and accurate provider data across payer portals and internal credentialing systems. - Monitor re-validations/re-credentialing and manage expirables to prevent participation lapses. - Assist with onboarding new providers: gather documents, set up NPI/taxonomy/locations, and coordinate start-date readiness. - Respond to payer requests, supply additional documentation, and resolve application issues promptly. - Escalate concerns and complex cases to the Supervisor of Credentialing for timely resolution and participate in special projects as needed. Qualifications - 2+ years in provider credentialing and/or payer enrollment (physician group, MSO, health plan, or hospital). - Hands-on with CAQH (attestations/rosters), Medicare PECOS, and payer portals (e.g., Availity). - Working knowledge of Medicare/Medicaid and commercial enrollment rules. - Proficient in credentialing systems (e.g., MD-Staff/Cactus) and Excel/Google Sheets. - Strong data accuracy and documentation habits; able to maintain clean provider records across multiple systems. - Effective written/verbal communication with payers, providers, and internal stakeholders; escalates issues appropriately. - Proven ability to prioritize in a high-volume environment, meet deadlines, and follow SOPs with minimal supervision. - Self-starter mindset with ownership and follow-through in a remote setting. - High school diploma or equivalent required. 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

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 - Bachelor's degree, or four or more years of equivalent work experience required in an insurance related industry required - At least 3-5 years' experience handling lost time workers compensation claims required; past experience with PA 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