Claims Specialist Remote Jobs in Indiana (US)
This page tracks remote claims specialist openings that are location-eligible for Indiana.
This page tracks remote claims specialist openings that are location-eligible for Indiana.
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$15 - $120,000
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• Handle lost time and medical only claim assignments. • Maintain a claim inventory as deemed appropriate by management, approximately 50 open claims at any given time. • Verify, research evaluate and make recommendations on appropriate coverage on each claim, using discretionary judgment. • Make timely contact with members, injured workers, agents, providers, attorneys, etc. • Investigate claim with phone interviews/emails and obtain appropriate documentation. • Evaluate exposure and adjust reserves as required. • Conclude claim processing in accordance with company standards. • Meet with members, agents, injured workers, attorneys, etc. as deemed necessary. • Provide training and act as a mentor for members and other claims personnel. • Complete special projects as assigned by the Claims Leader. • Travel to annual workers compensation conference and/or attend educational seminars. • Pursues a course of personal, professional development.
• Manage an inventory of property claims and evaluate coverage and damages • Conduct investigations and establish action plans based on policy, best practices, and state regulations • Communicate with policyholders, public adjusters, attorneys, and third parties throughout the claims process • Review estimates and negotiate fair settlements with insureds and vendors • Maintain accurate documentation and ensure timely resolution of claims • Apply knowledge of policy, Xactimate, and claims handling guidelines • Demonstrate empathy and deliver exceptional customer service
American Family Insurance, founded in 1927 by insurance salesman Herman Wittwer as Farmers Mutual Automobile Insurance Company, is one of the nation’s leading
Title: Property Field Claims Adjuster (Northwest Indiana) Locations: IN Indianapolis IN Highland IN Schererville IN Crown Point IN Merrillville time type Full time Remote job requisition id R38985 Job Description: You will investigate and maintain property claims, secure information, review coverages, complete field inspections, and settle claims. You will handle moderately complex homeowner property field claims, typically within the Northwest Indiana: Hammond, Highland, Merrillville, Schererville or surrounding area (you must be located in this market). You will also occasionally handle desk claims. This is a fully remote/work from home role where you will spend 80% of your time in the field. On occasion you may be asked to travel to an office location for in person engagement activities such as team meetings, training and culture events. Relocation support offered for eligible candidates. You will report to the Property Claim Manager. A company fleet vehicle is provided with the position and there's an option to use the vehicle for personal use. Position Compensation Range: $57,000.00 - $94,000.00 Pay Rate Type: Salary Compensation may vary based on the job level and your geographic work location. Relocation support is offered for eligible candidates. Primary Accountabilities - Investigates origin and cause of claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, public personnel, etc. - Identifies complex issues and seeks assistance as needed. Handles claims on a good faith basis. - Handles both 1st party and 3rd party claims under multiple policy types and numerous endorsements. - Conducts on-site inspections when needed, evaluates damages, and handles claim negotiations with insureds, claimants, attorneys, public adjusters. - Responds to customer inquiries, makes appropriate decisions and closes file as needed. - Interprets and determines policies, leases, by-laws, declarations, articles and contract coverages and applies to all parties for assigned losses. - Proactively provides all parties with claim process and status as appropriate; answers questions or redirects to other areas. - May be required to complete other assignments, job duties, or participate in projects based upon skills, achievements, or experience. Specialized Knowledge & Skills Requirements - Demonstrated experience providing customer-driven solutions, support, or service. - Demonstrated experience handling 1st and 3rd party, multi-line claims across our operating territories, or other equivalent experience. - Demonstrated experience handling moderately complex claims, or other equivalent experience. - Solid knowledge and understanding of policies and endorsements related to casualty coverages, or other equivalent knowledge. - Solid knowledge and understanding of each phase of the claim handling process, or other equivalent knowledge. - Property claims adjusting experience preferred. Licenses - Valid driver's license required plus an acceptable driving record. - Obtain state specific property casualty claims licensing as required. Travel Requirements - Up to 50%. - Catastrophe duty up to 75% as applicable. Physical Requirements - Ascending or descending ladders, stairs, scaffolding, ramps, poles and the like. This position may require employees to visit areas that have a higher hazard than a typical office such as customer homes, body shops, or other locations. - Moving self in different positions to accomplish tasks in various environments including tight and confined spaces. - Adjusting or moving objects up to 50 pounds in all directions. Working Conditions - Low temperatures. - High temperatures. - Outdoor elements such as precipitation and wind. - Noisy environments. - Hazardous conditions. - Poor ventilation. - Small and/or enclosed spaces. Additional Information - To ensure a strong start, all employees participate in our New Employee Orientation during their first week. This experience is held in person at our Madison, WI Headquarters or one of our AmFam core locations to help you connect with our mission, meet key team members and build relationships that support your growth. At times, sessions may be delivered virtually based on scheduling and availability. - Offer to selected candidate will be made contingent on the results of applicable background checks - Offer to selected candidate is contingent on signing a non-disclosure agreement for proprietary information, trade secrets, and inventions - Sponsorship will not be considered for this position unless specified in the posting #LI-Hybrid We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits. We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law. #LI-JA2
Pie Insurance wants to make purchasing workers’ compensation insurance “easy as pie” for small businesses. Since its founding in 2017, the Washington, DC,
Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage technology to transform how small businesses buy and experience commercial insurance. Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by core values and operating principles that guide every decision we make. The Senior Claims Adjuster will play a critical role in delivering quality claim file management and an industry-leading customer claims experience., This will be completed by adhering to Pie’s Claims Best Practices and complying with regulatory and statutory requirements. This role will work with internal and external partners to deliver best in class performance, identify and pursue claim mitigation opportunities and deliver favorable claim outcomes for Pie’s customers.. How You’ll Do ItClaims Technical Management: - Independently handle all aspects of the workers’ compensation claims from set-up to closure. - Evaluate and handle high dollar, high exposure, complex claims. - Conduct timely 3-point contact investigation, with focus on continued investigation as facts of the case change. - Mitigate the complex exposure while achieving the best outcome. - Determine timely and accurate compensability decisions within statutory requirements. - Set and adjust timely/accurate reserves within authority limits to ensure reserving activities are consistent with the case facts and company best practices. - Ability to present claims to senior management, internal and external stakeholders. - Timely administration of statutory medical and indemnity benefits throughout the life of the claim. - Comply with all applicable statutory guidelines, rules, and regulations. - Control legal activity with defense counsel through the litigation process while managing legal fees and costs. - Prioritize early resolution opportunities, evaluate claim exposure and negotiate settlement. Claims Customer Service: - Serve as a point of contact for our partner agents and customers to provide general claim guidance and help set claim process expectations. - Assist as necessary in providing claim status to agents and insureds, coverage verification and loss run reports, etc. - Provide excellent customer service to internal and external customers and business partners. - Advocate to ensure that Pie has a leading claims customer experience. - Work to continuously improve our claims operations and look at opportunities and gaps in claim service, handling SOPs, protocols and processes. The Right Stuff - High School Diploma or equivalent is required. - Bachelor's Degree or equivalent experience with some college coursework is preferred. - Minimum of 5-years workers’ compensation claim adjusting experience is required (carrier background, preferred). - Claims experience handling California WC claims is required. - Ability to evaluate and identify high dollar, high exposure, complex claims. - Requires active licensing in applicable states Strong communication (written and verbal) skills, to deliver more complex information effectively. - Strong problem-solving skills to be able to manage complex tasks and work through to solutions with little guidance and direction. - Awareness of your own tasks and how it impacts the team and deliverables. - Experience using G-Suite Tools and collaboration tools like Slack is preferred. - Advanced knowledge of jurisdictional regulatory and statutory requirements and CMS/MSA requirements. - Advanced knowledge and experience in claim adjudication, medical, and litigation management. - Advanced ability to analyze and take necessary action in multiple focus areas based on several data points. - Ability to make claim decisions to mitigate exposure while achieving the best outcome. - Ability to use skills to overcome conflict and reach beneficial outcomes. - Ability to mentor junior adjusters. The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that align with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. All AI-powered outputs are still subject to human oversight and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process. Base Compensation Range $95,000—$120,000 USD Compensation & Benefits - Competitive cash compensation - A piece of the pie (in the form of equity) - Comprehensive health plans - Generous PTO - Future focused 401k match - Generous parental and caregiver leave - Our core values are more than just a poster on the wall; they’re tangibly reflected in our work Making every part of working with us "Easy as Pie" - including our offer process. When we find someone we'd like as a Pie-oneer (a member of our team), we move quickly to put together a fair offer based on your skills, experience, location, and compensation expectations. Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members. Location Information Unless otherwise specified, this role is remote. Remote team members must live and work in the United States (territories excluded) and have access to reliable, high-speed internet. Additional InformationPie Insurance is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristic. Pie Insurance participates in the E-Verify program. Please click here, here and here for more information. Pie Insurance is committed to protecting your personal data. Please review our Privacy Policy. Safety First: Pie Insurance is committed to your security during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or onboarding process. Pie Named to 2025 America's Best Startup Employers Pie Insurance 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE
Role Description Performs medical record and claims review for Medicare, Medicaid, and/or other claims data in order to ensure that proper guidelines have been followed and assesses for potential overpayment, fraud, waste, and abuse with regards to Medicare, Medicaid, and/or other claims. - Reviews beneficiary, provider, and/or pharmacy cases for potential overpayment, fraud, waste, and abuse. - Completes desk review or field audits to meet applicable contract requirements and to identify evidence of potential overpayment or fraud. - Consults with benefit integrity investigation experts and pharmacists for advice and clarification. - Completes case summaries and provides results to investigators to support the investigative process. - Provides case specific or plan specific data entry and reporting. - Participates in internal and external focus groups, as required. - Participates in provider onsite visits and beneficiary interviews, as required, for field audits/investigations. - Testifies at various legal proceedings, as necessary. - Provides job-specific orientation and training, as needed. Helps develop training content, resources, and programs specific to job functions. Qualifications - Minimum Bachelor's Degree required (can be substituted for experience). - 2 - 4 years of experience required; 5 - 7 years preferred. - Medical Review or Utilization Management experience preferred. - Medicare/Medicaid experience preferred. Requirements - Current, active and non-restricted RN licensure required. - Coding certification preferred. Benefits - Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities. - Qlarant is a drug-free workplace. All offers of employment are contingent upon successful completion of pre-employment background and drug screens.
Revecore has been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities. We’re powered by people, driven by technology, and dedicated to our clients and employees. If you’re looking for a collaborative and diverse culture with a great work/life balance, look no further.
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 a 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. - 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 - Working knowledge of Microsoft Office (Word, Excel, Outlook). - Technical proficiency to work on multiple computer screens and software applications simultaneously. - Ability to maintain strong performance in a fast-paced, high outbound call center environment with productivity metrics. - Organizational skills while multi-tasking. - Critical thinking and problem-solving skills to find effective and efficient solutions. - Clear communication skills, 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 essential for building trust, supporting collaboration, and strengthening team connections. - A secure internet connection. - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads. - Workspace 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. 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.
Revecore has been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities. We’re powered by people, driven by technology, and dedicated to our clients and employees. If you’re looking for a collaborative and diverse culture with a great work/life balance, look no further.
Role Description As a Health Claims Specialist at Revecore, you will: - Bill and investigate health insurance claims to ensure maximum payment from insurance companies on behalf of our clients (hospitals and medical providers). - Investigate and research health insurance claims. - Follow up on unresolved claims to facilitate payment for commercial health, Medicare, and Medicaid. - Contribute to your team with various denial reports, audits, and overall support. Qualifications - Has experience researching and resolving claims for commercial health, Medicare, and Medicaid. - Knows how to file correct UB04's and 1500 HCFA's with subrogation information to payers for payment. - Familiarity with billing health insurance as part of auto accidents. - Conducts timely follow-up activities to determine claim status and collect and/or provide information to resolve the claim. - Experience working in EPIC. - 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 environment with productivity metrics. Requirements - A private, distraction-free environment to work within 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.
• Investigate and document property claims, including policy review, recorded statements, assigning inspections, updating reserves, preparing or reviewing estimates, and negotiating settlements • Communicate claim updates and decisions verbally and in writing • Handle claims in compliance with all applicable regulations and internal processes • Act as a resource for less experienced staff • Support catastrophe response as needed, to include potential overtime and deployment • Any other duties needed to help drive our purpose and fulfill our values
Role Description Come join us at CarolinasDentist in Asheville where we provide positively-different dentistry! We are a hardworking, fun, outgoing team, who strive to give our patients the best experience all while maintaining an upbeat, yet relaxing atmosphere. We are up to date on all the latest technology and offer both general and cosmetic dentistry including Invisalign. We are looking for an energetic, self-driven team member to join our growing practice. The Claims Coordinator ensures accuracy and timely filing for all dental claims for assigned office and reports problems and issues on follow up report to dental office. Reviews Accounts Receivable reports on assigned rotation for all offices, following up on outstanding insurance claims and balances; working problem EOBs, denials, and processing appeals as needed. Responsibilities: - Reviews clinical note, x-rays, and account ledger for cohesion of information. - Creates and submits e-claims and paper claims attaching any necessary x-rays, notes, narratives, charting, etc. This includes ortho claims. - Sends claims through clearing house and manages all invalid and rejected claims. - Claims should be sent out within 48 hours of the date of service. - Any account or claim issues are included on a Follow Up report to the dental office or assigned to the designated DO team member within PMS with the expectation that answers and corrections will be made within 48 hours of sending the report. - If accounts are unresolved from the dental office from the follow up report, an Urgent Weekly Report goes to the dental office. - Files corrected claims triaged from the AR Specialist based on returned problem EOBs. - Manages Accounts Receivable report on an assigned schedule, reviewing accounts for outstanding insurance claims and balances. - Calls and follows up with insurance companies on claims issues and non-payments. - Maintains and completes all appeals and requests from insurance companies. - Reviews returned EOBs: - Denials - manages info needed for appealing claims. - Denials - manages info needed for missing information or attachments. - Corrected claims and/or retractions. - Tracks all outstanding insurance balances by category and reports to OM when completed. Administrative Responsibilities: - Participates in special projects and tasks as assigned. - Fills in for other Claims/AR Coordinators as needed. - Assists and conducts training of new CBO team members. - Attends and contributes to monthly meetings. - Reports to CBO-RCM with any grievances or issues. Qualifications - Previous experience in dental office administration, dental billing, or insurance claims processing is highly beneficial. - Familiarity with dental terminology and procedures is essential for accurately processing claims and communicating with dental providers and insurance companies. - A good understanding of dental insurance policies, coverage limitations, and claim submission procedures is necessary. This includes knowledge of common insurance codes (e.g., CDT codes) and claim forms (e.g., ADA dental claim form). - Dental claims coordinators must be detail-oriented to accurately review claims, ensure all necessary information is included, and identify any discrepancies or errors. - Strong communication skills are important for interacting with patients, dental providers, insurance companies, and other staff members, including both verbal and written communication skills. - The ability to effectively manage and prioritize multiple tasks, such as processing claims, following up on outstanding payments, and resolving claim disputes, is crucial in this role. - Proficiency with dental practice management software and other computer applications used for claim processing and administrative tasks is typically required. - Dental claims coordinators often interact with patients regarding billing and insurance matters, so good customer service skills are important for addressing inquiries and concerns in a professional and empathetic manner. - The ability to troubleshoot issues related to claim processing, billing errors, or insurance coverage discrepancies is valuable for resolving issues efficiently and effectively. - Knowledge of and adherence to legal and ethical guidelines related to patient privacy (HIPAA) and billing practices is essential. Benefits - Competitive Pay: Receive pay that matches your experience and performance. - Comprehensive Insurance: Enjoy peace of mind with health, dental, and vision coverage. - Future Planning: Secure your financial future with our 401k retirement savings plan. - Time for You: Paid time off and holidays to recharge. - Growth and Learning: Unlock your potential with opportunities for professional development and growth.
Amrize is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We thank all applicants for their interest; however, only those selected for an interview will be contacted.
Role Description The regional Warranty Claims Investigator is responsible for protecting the interests of Amrize Building Envelope by managing warranty claims. The Claims Investigator will receive, analyze, and make determinations on claims by reviewing data from all available resources to efficiently respond to warranty claim issues. Responsibilities include: - Conducting surveys of job data to determine previous claim history. - Serving as a subject matter expert for the warranty services team. - Reviewing contractor proposals for repair scope, warrantability, suitability, and cost-effectiveness. - Providing clear and concise project management with involved parties utilizing proper communication and document retention. - Fostering positive relationships with internal teammates, external sales teams, and Amrize customers within the assigned region. - Submitting Service Orders, including Purchase Orders and Material Orders, as needed, to contractors providing warranty repair services. - Performing in-depth investigations in the field to analyze roofing systems exhibiting issues. - Maintaining routine detailed expense/travel reporting and maintenance requirements for company-issued equipment. - Developing and negotiating the claim position with all relevant parties and attending meetings when necessary. - Completing all paperwork including photographs related to each claim for proper documentation. - Preparing clear, concise, in-depth repair specifications summarizing rooftop analysis into cost-effective solutions. - Communicating effectively with building owners, roofing contractors, sales reps, building consultants, and lawyers. - Keeping the Warranty Services Supervisor and Regional Manager apprised of relevant claims and issues. - Interfacing with the Warranty Services Coordinator team to assist with roof knowledge development and claim warrantability determination. - Interfacing with the law department to support claims that are approaching or have entered litigation. - Efficiently managing claims expenses to meet budget goals. - Providing guidance to Junior Warranty Claims Investigators regarding claims analysis and processing. - Demonstrating a commitment to health, safety, and environmental policies in all work environments. - Promoting a culture of safety and exhibiting these behaviors. Qualifications - 6+ years of progressive roofing/construction experience is required. - 2+ years of Warranty Claims or Technical Services Experience Preferred. Requirements - Successful candidates must adhere to all safety protocols and proper use of Amrize approved Personal Protection Equipment ("PPE"). - Employees required to wear respirators must be clean-shaven where the respirator seal meets the face to pass fit tests. Benefits - Competitive salary - Retirement Savings: Choose from 401(k) pre-tax and/or Roth after-tax savings - Medical, Dental, Disability, and Life Insurance - Holistic Health & Well-being programs - Health Savings Accounts (HSAs) & Flexible Spending Accounts (FSAs) for health and dependent care - Vision and other Voluntary benefits and discounts - Paid time off & paid holidays - Paid Parental Leave (maternity & paternity) - Educational Assistance Program
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