Claims Adjusters, Examiners, and Investigators

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Sr. Claims Specialist, Medical Malpractice (LTC)

**PRIMARY PURPOSE** : To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Analyze and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

+ Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.

+ Negotiates claim settlement up to designated authority level.

+ Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.

+ Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.

+ Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.

+ Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.

+ Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.

+ Represents Company in depositions, mediations, and trial monitoring as needed.

+ Communicates claim activity and processing with the client; maintains professional client relationships.

+ Ensures claim files are properly documented and claims coding is correct.

+ Refers cases as appropriate to supervisor and management.

+ Delegates work and mentors assigned staff.

**QUALIFICATION**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

**Experience**

Six (6) years of claims management experience or equivalent combination of education and experience required.

**Skills & Knowledge**

+ In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business

+ Excellent oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products<

+ Analytical and interpretive skills

+ Strong organizational skills

+ Excellent negotiation skills

+ Good interpersonal skills

+ Ability to work in a team environmentAbility to meet or exceed Performance Competencies

+ When applicable and appropriate, consideration will be given to reasonable accommodations.

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred.

**WORK ENVIRONMENT**

**Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

**Physical:** Computer keyboarding, travel as required

**Auditory/Visual:** Hearing, vision and talking

**NOTE** **:** Credit security clearance, confirmed via a background credit check, is required for this position.

_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is_ **_$100,000_** _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

**The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one.**

_If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to_ Accessibility (careers@crcgroup.com?subject=Accommodation%20request) _(accommodation requests only; other inquiries won't receive a response)._

**Regular or Temporary:**

Regular

**Language Fluency:** English (Required)

**Work Shift:**

1st Shift (United States of America)

**Please review the following job description:**

Analyzes and processes claims by gathering information, drawing conclusions. tracking and managing the claims process.

**ESSENTIAL DUTIES AND RESPONSIBILITIES**

Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.

1. Evaluate claims to ensure accuracy of dates, review coverage, etc.

2. Authenticate all relevant activity on assigned files and makes recommendation for additional activity as appropriate.

3. Manage all claim documentation.

4. Use discretion to submit the necessary information and/or correspondence to the Agent or Insurer to process claims appropriately.

5. Analyze claim coverage.

6. Anticipate and meets all customer needs (both internal and external).

7. Maintain claims and suspense system ensuring follow-up for receipt of policies, endorsements, inspections reports, correspondence, claims, etc. from outside sources.

8. Process all departmental claims in a timely manner according to company policy.

9. Perform other duties as assigned.

**QUALIFICATIONS**

**Required Qualifications:**

The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Bachelor's degree with a concentration in business or equivalent work experience

2. Three years of Construction Defect Claims handling experience and commercial and multi-line knowledge

3. Ability to critically review a claim file for relevant information, accurately access the information and make necessary recommendations

4. Ability to make independent decisions following CRC guidelines with minimal or no supervision

5. Good organizational, time management, and detail skills

6. Extensive knowledge of insurance and CRC processes

7. Ability to maintain a high level of tact and professionalism

8. Good leadership skills to influence all departmental employees in a positive manner

9. Possess strong interpersonal skills

10. Strong verbal and written communication skills

11. Strong computer and office skills

12. Ability to work extended hours when necessary

**Preferred Qualifications:**

1. Adjusting experience

2. Property & Casualty Adjuster License(s) or ability to secure same

**General Description of Available Benefits for Eligible Employees of CRC Group:** All regular teammates (not temporary or contingent workers) working 20 hours or more per week are eligible for benefits, though eligibility for specific benefits may be determined by the division of CRC Group offering the position. CRC Group offers medical, dental, vision, life insurance, disability, accidental death and dismemberment, tax-preferred savings accounts, and a 401k plan to teammates. Teammates also receive no less than 10 days of vacation (prorated based on date of hire and by full-time or part-time status) during their first year of employment, along with 10 sick days (also prorated), and paid holidays. Depending on the position and division, this job may also be eligible for restricted stock units, and/or a deferred compensation plan. As you advance through the hiring process, you will also learn more about the specific benefits available for any non-temporary position for which you apply, based on full-time or part-time status, position, and division of work.

**_CRC supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC is a Drug Free Workplace._**

EEO is the Law (https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf) Pay Transparency Nondiscrimination Provision E-Verify (https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify\_Participation\_Poster\_ES.pdf)

Join CRC Group, a leader in specialty wholesale insurance, and take your career to new heights. We're a dynamic team dedicated to innovation, collaboration, and excellence.

Why CRC Group?

• Growth: Advance your career with our learning and leadership development programs.

• Innovation: Work in a forward-thinking environment that values new ideas.

• Community: Be part of a supportive team that celebrates success together.

• Benefits: Enjoy competitive compensation, health benefits, and retirement plans.

Who We’re Looking For

We seek passionate individuals who thrive in a fast-paced, collaborative environment. If you value integrity and are driven to succeed, CRC Group is the place for you.

**The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one.**

_If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to_ Accessibility (careers@crcgroup.com?subject=Accommodation%20request) _(accommodation requests only; other inquiries won't receive a response)._

**Regular or Temporary:**

Regular

**Language Fluency:** English (Required)

**Work Shift:**

1st Shift (United States of America)

**Please review the following job description:**

Analyzes and processes claims by gathering information, drawing conclusions. tracking and managing the claims process.

**ESSENTIAL DUTIES AND RESPONSIBILITIES**

Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.

1. Evaluate claims to ensure accuracy of dates, review coverage, etc.

2. Authenticate all relevant activity on assigned files and makes recommendation for additional activity as appropriate.

3. Manage all claim documentation.

4. Use discretion to submit the necessary information and/or correspondence to the Agent or Insurer to process claims appropriately.

5. Analyze claim coverage.

6. Anticipate and meets all customer needs (both internal and external).

7. Maintain claims and suspense system ensuring follow-up for receipt of policies, endorsements, inspections reports, correspondence, claims, etc. from outside sources.

8. Process all departmental claims in a timely manner according to company policy.

9. Perform other duties as assigned.

**QUALIFICATIONS**

**Required Qualifications:**

The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Bachelor's degree with a concentration in business or equivalent work experience

2. Three years of Construction Defect Claims handling experience and commercial and multi-line knowledge

3. Ability to critically review a claim file for relevant information, accurately access the information and make necessary recommendations

4. Ability to make independent decisions following CRC guidelines with minimal or no supervision

5. Good organizational, time management, and detail skills

6. Extensive knowledge of insurance and CRC processes

7. Ability to maintain a high level of tact and professionalism

8. Good leadership skills to influence all departmental employees in a positive manner

9. Possess strong interpersonal skills

10. Strong verbal and written communication skills

11. Strong computer and office skills

12. Ability to work extended hours when necessary

**Preferred Qualifications:**

1. Adjusting experience

2. Property & Casualty Adjuster License(s) or ability to secure same

**General Description of Available Benefits for Eligible Employees of CRC Group:** All regular teammates (not temporary or contingent workers) working 20 hours or more per week are eligible for benefits, though eligibility for specific benefits may be determined by the division of CRC Group offering the position. CRC Group offers medical, dental, vision, life insurance, disability, accidental death and dismemberment, tax-preferred savings accounts, and a 401k plan to teammates. Teammates also receive no less than 10 days of vacation (prorated based on date of hire and by full-time or part-time status) during their first year of employment, along with 10 sick days (also prorated), and paid holidays. Depending on the position and division, this job may also be eligible for restricted stock units, and/or a deferred compensation plan. As you advance through the hiring process, you will also learn more about the specific benefits available for any non-temporary position for which you apply, based on full-time or part-time status, position, and division of work.

**_CRC supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC is a Drug Free Workplace._**

EEO is the Law (https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf) Pay Transparency Nondiscrimination Provision E-Verify (https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify\_Participation\_Poster\_ES.pdf)

Join CRC Group, a leader in specialty wholesale insurance, and take your career to new heights. We're a dynamic team dedicated to innovation, collaboration, and excellence.

Why CRC Group?

• Growth: Advance your career with our learning and leadership development programs.

• Innovation: Work in a forward-thinking environment that values new ideas.

• Community: Be part of a supportive team that celebrates success together.

• Benefits: Enjoy competitive compensation, health benefits, and retirement plans.

Who We’re Looking For

We seek passionate individuals who thrive in a fast-paced, collaborative environment. If you value integrity and are driven to succeed, CRC Group is the place for you.

SCI, a Congruex Company, is looking for a Field Inspector to join our construction team. Learn more about our operating unit at www.congruex.com/SCI. Who is Congruex Congruex designs and builds broadband and wireless communications infrastructure. The work we do enables everything in the modern world to operate, from healthcare and energy to transportation and social interactions. We deliver turn-key network solutions under a single platform by aligning our engineering and in-market construction operating units. Our vision is to be the best end-to-end provider of network services in the U.S. and our core values of GRIT connect everything we do. We are building tomorrow, together. Will you join us? Your New Job Job Summary: Our operating unit provides underground utility services, and we are looking for a Field Inspector to join our team. This position requires organization, timeliness, accuracy and great focus to detail and safety. Job Responsibilities: Placing door hangers on houses Taking photos during the project Uploading photos to proper files Making sure all employees have the proper PPE. Making sure crews are working safely. Completing punch list items Helping Project Manager with any other duties as needed Required Skills Qualifications: Valid Driver License with a clean driving record Able to work in all outdoor temperatures and conditions. Must have great computer skills. A positive can-do attitude and openness to trying things new ways. GRIT values Guts, Reliability, Innovation, and Teamwork Desired Skills Qualifications: Previous experience in the telecom, utility, construction, and/or engineering industry Why Work At Congruex No matter what role you play, you are an important part of the One Congruex Family. We offer: Medical, Dental Vision Benefits 401(k) Program with a Company Match 10 paid Holidays Paid Maternity Parental Leave Paid Basic Life Insurance Voluntary Options The pillars of Congruex culture are GRIT, safety, inclusion, and family. The Fine Print: We will determine salary based on skills and experience in relation to the function of the role, as well as equity to employees in similar roles. Some benefits have eligibility criteria. All requirements are subject to possible modification to reasonably accommodate individuals with disabilities. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. This document does not create an employment contract, implied or otherwise, other than an at-will employment relationship.

**UMR, UnitedHealthcare’s** third-party administrator (TPA) solution, is the nation’s largest TPA. When you work with **UMR** , what you do matters. It's that simple . . . and it's that rewarding.

In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within **UMR** due to our record-breaking growth.

Regardless of your role at **UMR** , the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast - paced and highly diversified career.

This position is full-time (40 hours/week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am - 5:30pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 4-6 weeks of paid training. The hours during training will be 8:00am - 4:30pm, Monday - Friday. **Training will be conducted virtually from your home.**

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

**Primary Responsibilities:**

+ Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims

+ Analyze and identify trends and provide reports as necessary

+ Consistently meet established productivity, schedule adherence and quality standards

This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You’ll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the member's claim.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

**Required Qualifications:**

+ High School Diploma / GED OR equivalent work experience

+ Must be 18 years of age OR older

+ Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications

+ Ability to work Monday - Friday, in any of our 8-hour shift schedules during our normal business hours of 6:00am - 5:30pm CST, including the flexibility to work occasional overtime, given the business need

**Preferred Qualifications:**

+ 1+ years of experience processing medical, dental, prescription OR mental health claims

+ 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools

**Telecommuting Requirements:**

+ Ability to keep all company sensitive documents secure (if applicable)

+ Required to have a dedicated work area established that is separated from other living areas and provides information privacy

+ Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

**_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._

_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission._

_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._

_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

\#RPO

Consultant Claims - CH08CESr Representative Claims - CH08BE

We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.

COMPLEX CLAIMS UNIT CONSTRUCTION DEFECT– SR. CLAIM REPRESENTATIVE / CLAIM CONSULTANT

This role will be filled as a Sr. Claim Representative or Claim Consultant based on the experience level and qualifications of the candidate(s). The Sr. Claim Representative/Claim Consultant is a claim handling role within the Complex Claims Unit (CCU). CCU Construction is a highly specialized claim organization responsible for the management of construction defect and construction related claims involving bodily injury and property damage. Claims in CCU Construction are often associated with complex fact patterns requiring contract analysis, and coverage issues that may involve multiple years and types of insurance coverage. CCU Construction claims also commonly involve litigation, require subject matter expertise to manage and can involve higher exposures.

RESPONSIBILITIES :

The Sr. Claim Representative/Claim Consultant will demonstrate the ability to timely manage medium to high exposure accounts exhibiting detailed claim knowledge, a well-reasoned analytical focus and a claim resolution strategy. Other responsibilities include:

+ Provide proactive communications to customers and business partners in the management of claims;

+ Respond to inquiries from customers and provide superior customer service;

+ Review and analyze multiple complex policies and coverage parts;

+ Write and articulate clear and concise coverage positions;

+ Conduct investigations regarding claims and/or lawsuits;

+ Manage litigation and counsel, inclusive of litigation planning, budgeting and implementing a liability resolution strategy;

+ Develop coverage, liability and damages assessments and provide recommendations to leadership;

+ Pursue coverage and liability risk transfer against other liable parties and insurance carriers;

+ Conduct complex negotiations and articulate coverage/liability positions.

+ Attend mediations and trials as necessary;

+ Manage expenses, reserves and financial transactions;

+ Consistently maintain up to date claims metrics.

QUALIFICATIONS :

+ Bachelor’s degree preferred; J.D. or CRIS designation is a plus;

+ 3+ years general liability claim handling experience, construction defect claim handling experience is preferred;

+ Experience in handling affirmative/defensive risk transfer;

+ Strong verbal and written communication skills;

+ Strong analytical and critical thinking skills;

+ Ability to present in a roundtable setting with a well-reasoned and analytical evaluation;

+ Strong customer service and active listening skills;

+ Strong time management and organization skills;

+ Strong negotiation and conflict resolution skills;

+ Working proficiency with MS Office, especially Word and Excel;

+ Active Property & Casualty State Insurance Adjuster license, preferred.

+ Depending on experience can hire position as Sr Claim Representative or Claim Consultant.

This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Phoenix, AZ, Naperville, IL) will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise.

Compensation

The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford’s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:

$84,000 - $126,000

The posted salary range reflects our ability to hire at different position titles and levels depending on background and experience.

Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

About Us (https://www.thehartford.com/about-us) | Our Culture (https://www.thehartford.com/about-us/corporate-culture) | What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees) | Perks & Benefits (https://www.thehartford.com/careers/benefits)

Every day, a day to do right.

Showing up for people isn’t just what we do. It’s who we are – and have been for more than 200 years. We’re devoted to finding innovative ways to serve our customers, communities and employees—continually asking ourselves what more we can do.

Is our policy language as simple and inclusive as it can be? Can we better help businesses navigate our ever-changing world? What else can we do to destigmatize mental health in the workplace? Can we make our communities more equitable?

That we can rise to the challenge of these questions is due in no small part to our company values that our employees have shaped and defined.

And while how we contribute looks different for each of us, it’s these values that drive all of us to do more and to do better every day.

About Us (https://www.thehartford.com/about-us)

Our Culture

What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees)

Perks & Benefits (https://www.thehartford.com/careers/benefits)

Legal Notice (https://www.thehartford.com/legal-notice)

Accessibility StatementProducer Compensation (https://www.thehartford.com/producer-compensation)

EEO

Privacy Policy (https://www.thehartford.com/online-privacy-policy)

California Privacy Policy

Your California Privacy Choices (https://www.thehartford.com/data-privacy-opt-out-form)

International Privacy Policy

Canadian Privacy Policy (https://www.thehartford.com/canadian-privacy-policy)

Unincorporated Areas of LA County, CA (Applicant Information)

MA Applicant Notice (https://www.thehartford.com/ma-lie-detector)

Join a large Pharmacy Benefit Management company based out of MN to help analyze and correct pharmaceutical claims!!

Job Description:

+ This role is responsible for performing basic and intermediate level client, member and pharmacy remediation analysis caused by errors coded into the RxClaim processing system, along with claims monitoring and data validation activities.

+ The research and remediation steps can vary based on the issue so this person must be very thorough and detailed.

+ Research and analyze information by employing analytics and data science techniques to research and validate errors, isolate impacted claims, reprocess claims, and determine financial impact to members, health plans and/or pharmacies; translate data into usable client facing reports.

+ The more research and auditing experience they have the more they will succeed in this role. The understanding of medical terminology (Copays, deductibles, and benefit plans) will help them in this role.

Main Position Details:

Job Title: Claims Analyst

Start Date: 7/14

Pay: $24.00/Hr

Training: 4-5 weeks in length Monday-Friday, 8:00am-4:30pm CST

Schedule: Pick your schedule, start time between 7:00am - 9:00am CST

Location: 100% remote. All equipment is provided.

Duration: Contract. Set to finish at the end of the year.

Qualifications:

+ 2+ years of claims experience with emphasis on researching & auditing (not processing or production).

+ Claims software experience with RxClaims being preferred

Pay and Benefits

The pay range for this position is $24.00 - $24.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Jun 20, 2025.

h4>About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Responsible for building a complete document package with all appropriate/applicable supporting invoices, breakdowns, ledgers, foreclosure, bankruptcy, and loss mitigation relevant documents based on a specific claim type in a timely and efficient manner. This position is responsible for adhering to all guidelines set forth by insurer, investor, and master servicing guidelines.

+ Evaluates/reconciles loan level balances (corporate and escrow advances) for expenses incurred to determine claimable vs non claimable to maximize reimbursement on behalf of the servicer and/or client

+ Files respective investor/insurer initial and final claims based on the respective guidelines for allowable limits

+ Reviews MI claim Explanation of Benefits (EOB) or Insurer Advice of Payments (AOP) and research curtailment reasons for potential rebuttal

+ Files Appeal or Supplemental Claims ensuring all allowable advances and interest are recovered from the MI companies and/or Insurer.

+ Monitors pre/post conveyance processes on government loans

+ Satisfies audit requests

+ Monitors claim deadlines and exceptions reports

+ Monitors REO activity on investor claim files

+ Ensures all receivables are paid w/ no penalties or interest curtailments

+ Ensures payment to vendors in a timely manner

+ Corresponds with attorney/trustees, vendors, and agency representatives to ensure claims are processed within insurer and investor guidelines

+ Works in conjunction with attorneys, agencies, PMI companies, investors and master servicers to expedite the completion of the claim to minimize losses

+ Complies with and have working knowledge of all FNMA, FHLMC, PMI, FHA, VA, investor and master servicer rules and regulations

+ Performs regular reviews of all cases/claims on a regular basis

+ Requests UPB removal on loans from Investor Reporting Department once the claim process has been completed

+ Assists in the training of new employees

+ Performs other work and duties as assigned

Skills & Qualifications:

+ Claims analysis, claims preparation, mortgage, default, MSP, loss mitigation, default servicing

+ Must be very strong in Excel and have used Vlookup and Pivot Tables on a consistent daily basis.

+ Working knowledge of the Black Knight MSP servicing system

+ Working knowledge of MS Outlook, Word, Excel, Power Point, and ability to learn industry related systems

+ Able to work both independently and within a team environment

+ Excellent time management skills

+ Working knowledge with Microsoft Office, spreadsheets and software applications

+ Strong analytical skills

+ Excellent verbal and written communication skills

+ Detail oriented with ability to successfully manage multiple priorities

+ Able to work in fast paced environment with the ability to meet deadlines

Pay and Benefits

The pay range for this position is $26.00 - $38.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a hybrid position in Phoenix,AZ.

Application Deadline

This position is anticipated to close on Jun 27, 2025.

h4>About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Location:

2721 N Central Ave, Phoenix, Arizona 85004 United States of America

Repwest Insurance is seeking a Claims Adjuster to handle Bodily Injury claims.

This is an in-office position in our Phoenix, Arizona office.

As a Bodily Injury Adjuster at Repwest, you will be responsible for investigating, evaluating, and resolving bodily injury and property damage claims involving U-Haul equipment and properties.

Essential Duties:

+ Review claims to determine coverage

+ Conduct liability investigation by obtaining statements, review of photos, videos, police reports and any other evidence

+ Working with independent adjusters as needed for field work

+ Prepare forms and correspondence such as denial letters and release forms

+ Gather necessary documents to determine settlement value of claim

+ Maintain productivity within company set standards

Requirements:

+ Experience handling bodily injury claims

+ Good communication and organizational skills

+ Basic computer skills with knowledge of Microsoft Word and Excel

+ High School Diploma or equivalent

+ Must obtain an Arizona adjuster’s license within 30 days of employment

U-Haul Offers:

+ Full Medical coverage

+ Prescription plans

+ Dental & Vision Plans

+ New indoor fitness gym

+ Gym Reimbursement Program

+ Registered Dietitian Program

+ Weight Watchers

+ Onsite medical clinic for you and your family

+ Career stability

+ Opportunities for advancement

+ Valuable on-the-job training

+ Tuition reimbursement program

+ Free online courses for personal and professional development at U-Haul University®

+ Business and travel insurance

+ You Matter Employee Assistance Program

+ Paid holidays, vacation, and sick days

+ Employee Stock Ownership Plan (ESOP)

+ 401(k) Savings Plan

+ Life insurance

+ Critical Illness/Group Accident

+ 24-hour physician available for kids

+ MetLaw Legal program

+ MetLife auto and home insurance

+ Mindset App Program

+ Discounts on cell phone plans, hotels, and more

+ LifeLock Identity Theft

+ Savvy consumer wellness programs - from health care tips to financial wellness

+ Dave Ramsey’s SmartDollar Program

+ U-Haul Federal Credit Union

+ Wellness Program

U-Haul Holding Company, and its family of companies including U-Haul International, Inc. (“U-Haul”), continually strives to create a culture of health and wellness. Consistent with applicable state law, U-Haul will not hire or re-hire individuals who use nicotine products. The states in which U-Haul will decline to hire nicotine users are: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Pennsylvania, Texas, Utah, Vermont, Virginia, and Washington. U-Haul has observed this hiring practice since February 1, 2020 as part of our commitment to a healthy work environment for our team.

U-Haul is an equal opportunity employer. All applicants for employment will be considered without regard to race, color, religion, sex, national origin, physical or mental disability, veteran status, or any other basis protected by applicable federal, provincial, state or local law. Individual accommodations are available on requests for applicants taking part in all aspects of the selection process. Information obtained during this process will only be shared on a need to know basis.

Join the Adventure: Business Operations Coordinator

_Camping World is growing—and so can your career._

We’re on the lookout for a detail-driven, organized, and energetic Business Operations Coordinator to join our thriving team. In this pivotal role, you’ll play a key part in supporting dealership operations, managing inventory records, and ensuring smooth and efficient administrative processes that keep our business moving forward.

**What** **You’ll** **Do**

+ Deliver professional, friendly, and solutions-focused service to customers throughout their RV selling journey

+ Collaborate with internal teams to keep operations organized, efficient, and focus on customer satisfaction

+ Handle, scan, and manage important customer and transaction documents using our internal database

+ Support incoming RV purchases by organizing and stocking new inventory into our system, ensuring timely and accurate processing for our customers

+ Oversee the completion of purchase contracts

+ Ensure high levels of accuracy and compliance across all customer-facing documentation and processes

**What** **You’ll** **Need to Succeed**

+ Proficiency in Microsoft Office tools, including Outlook, Word, and Excel

+ Experience with working within multiple business or dealership systems

+ Strong attention to detail and organizational skills, especially when managing documentation and time-sensitive tasks

+ Ability to handle confidential information with professionalism and discretion

+ Excellent written and verbal communication skills, with a customer-first mindset

+ Comfortable communicating with team members and customers across multiple departments and levels

+ Solid understanding of general office procedures and comfort using standard office equipment

+ Ability to thrive in a fast-paced environment and manage multiple priorities efficiently

+ Ability to occasionally lift items up to 25 lbs.

**Compensation Transparency**

Compensation for this role is based on multiple factors including skills, experience, certifications, and organizational needs. It is uncommon for new hires to start at the top of the range, as pay is tailored to each individual’s background and qualifications. A reasonable estimate of the current pay range for this position is listed below.

**Pay Range:**

In addition to competitive pay, we offer Paid Time Off, 401(k), an Employee Assistance Program, Good Sam Roadside Assistance, discounts, paid parental leave (if eligibility is met), Tuition Reimbursement (if eligibility is met), and on the job training opportunities. Full-time associates are offered a comprehensive benefit package including medical, dental, vision and more! Part-time associates are offered access to dental & vision coverage! For more information please visit: www.mycampingworldbenefits.com

We are an equal employment opportunity employer. The Company's policy is not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, veteran or uniformed service-member status, genetic information, or any other basis protected by applicable federal, state, or local laws.