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<h3>Job Description</h3>
Job DescriptionSUMMARY We are looking for an experienced and dependable Accounts Receivable Claims Specialist with at least 2 years of AR and deduction claims experience to join our Accounting team. This role is ideal for someone who has an investigative mindset and is comfortable navigating through various systems. Success in this role requires strong attention to detail, a proactive and positive attitude, and excellent communication skills, both written and verbal, as you’ll regularly interact with internal teams across departments. Proficiency in MS Office, especially Excel, ERP systems and accounting principles are essential ESSENTIAL FUNCTIONS
<ul>
<li>Review unplanned deductions taken by customers to determine nature of claim and validity</li>
<li>Gather backup documentation for submitting claim for repayment utilizing each customer’s dispute resolution process and/or through SupplyPike</li>
<li>Proactively conduct research and navigate through various systems</li>
<li>Prepare and submit dispute claims</li>
<li>Monitor status of claims and update various trackers</li>
<li>Coordinate with other stakeholder departments within the organization to resolve recurring issues identified through dispute resolution process</li>
<li>Assist in the development of monthly reporting</li>
<li>Generate and distribute dispute claims status reports to key stakeholders</li>
<li>Prepare, process, and apply payments and deductions for specific customers</li>
<li>Maintain written procedure documentation for job related tasks</li>
<li>Participate in continuous improvement activities</li>
<li>Assist with month-end and year-end closings and prepare various reports and/or analysis&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li>
<li>Other duties as assigned</li>
</ul>
 REQUIREMENTS Experience/Education:
<ul>
<li>Two years’ experience in accounts receivable for manufacturing or wholesale company</li>
<li>Associate’s degree in Accounting or equivalent education/experience</li>
<li>Freight Claims experience strongly preferred</li>
<li>Deduction Claims experience highly valued</li>
<li>Knowledge/Abilities/Skills:</li>
<li>Understanding of basic accounting principles</li>
<li>Excellent organization skills, attention to detail</li>
<li>Ability to effectively manage competing priorities and meet deadlines</li>
<li>Excellent verbal and written communication skills</li>
<li>Self-starter requiring limited task supervision</li>
<li>Strong team player</li>
<li>Excellent interpersonal skills</li>
<li>Quick learner and quick thinker</li>
<li>Commitment to and ability to demonstrate TM’s Company values: humility, respect, quality, collaboration, innovation and sustainability</li>
<li>Demonstrated ability to maintain confidentiality of sensitive information</li>
</ul>
Technical Skills:
<ul>
<li>Proficient with accounting and ERP systems such as Dynamics AX / D365</li>
<li>Experience with SupplyPike and TradePro highly valued</li>
<li>Intermediate level skills with MS Office Excel managing large amounts of data including formulas, pivot tables, index match, etc.</li>
<li>10-key proficiency</li>
</ul>
Office Hours/Location: This position is based in Rohnert Park, CA. Office hours are Monday through Friday, 8:30 – 5:00 pm. This is a hybrid role offering the flexibility to occasionally work remotely. Expected in-offices days are Tuesday, Wednesday and Thursday. Subject to change. Physical/Mental Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision Traditional Medicinals, Inc. and its subsidiaries are proud equal-opportunity employers.&nbsp; We wholeheartedly embrace authenticity, diversity, and people's differences. We acknowledge, celebrate, and support individuality to the great advantage of our consumers, our stakeholders, our products, and the planet.&nbsp; We are committed to building an inclusive workplace for all our people.We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. Compensation range is $23.00 - $30.00 Compensation is determined based on non-discriminatory, business-related factors, including but not limited to, training, experience, education and/or professional certifications, geographic location, and market data.
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AR Claims Specialist

<h3>Job Description</h3>
Job DescriptionAbout Us
"Inspired by Spaces, Empowered by People." At Enclave, we don't just build structures; we cultivate environments where our partners, team members, and communities flourish. Our very name reflects our essence - creating distinct spaces that inspires growth and success. As a unified real estate investment firm, Enclave brings together exceptional development, construction, and property management expertise to specialize in multifamily, industrial, and commercial developments across the Midwest and Mountain West. 
Our Growth Story: Since our founding in 2011, we've expanded to over 250 team members, completing more than 150 projects and managing assets exceeding $1.75 billion. Our rapid growth is a testament to the innovative and collaborative spirit that drives everything we do. For six consecutive years, Enclave has been recognized as one of the 50 Best Places to Work. This accolade reflects our commitment to fostering an environment where everyone feels valued, supported, and inspired to excel. 
About the Role Insurance &amp; Claims Manager
The Insurance &amp; Claims Manager will be responsible for identifying, assessing, and managing all Insurance related to the real estate development and property management operations. This includes managing insurance portfolios, ensuring compliance with insurance requirements, and working closely with Construction, Property Management, and legal teams, and external insurance brokers to ensure proper coverages are in place for the company’s real estate assets and developments. The role demands an individual who has in-depth knowledge of the insurance industry, real estate , and property management practices.
Position Logistics
<ul>
<li>Primary Work Location: West Fargo, ND or St. Louis Park, MN Corporate Office</li>
<li>Work Environment: On-Site </li>
<li>Work Schedule: Monday - Friday | Standard Hours</li>
<li>Work Type: Full Time </li>
</ul>
Position Responsibilities
Insurance &amp; Coverage Management:
<ul>
<li>Oversee and manage all corporate insurance programs, including general liability, property, builders’ risk, workers’ compensation, and professional liability.</li>
<li>Work closely with brokers to review, negotiate, and optimize insurance coverage at competitive rates.</li>
<li>Ensure all projects, properties, and company operations are properly insured and compliant with contractual and regulatory requirements.</li>
<li>Evaluate policy renewals, endorsements, and claims history to make data-driven recommendations on risk financing.</li>
<li>Manage the claims process, including resolution and disputes with insurance carriers and third parties, in collaboration with legal and finance teams.</li>
<li>Conduct reviews of policies to outline the coverage limits to clearly reflect the risk exposure</li>
<li>Work with outside brokers and internal legal to understand risk exposure and areas to monitor within corporate policy structure</li>
<li>Regularly update risk management practices to align with industry standards and regulatory changes.</li>
<li>Collaborate with operations, finance, and legal teams to create and enforce risk control policies and best practices.</li>
<li>Implement loss prevention programs and provide training on risk mitigation strategies to employees, contractors, and tenants.</li>
</ul>
Claims Administration &amp; Loss Control:
<ul>
<li>Oversee the claims process, including reporting, tracking, and resolution of property damage, general liability, workers’ compensation, and other claims.</li>
<li>Serve as the primary liaison with insurance carriers, adjusters, attorneys, and third-party administrators to ensure timely claim resolutions.</li>
<li>Analyze claims data to identify trends, root causes, and cost-saving opportunities.</li>
<li>Work with insurance carriers on loss recovery efforts through subrogation, ensuring proper reimbursement and minimizing the impact on loss run reports.</li>
</ul>
Contract &amp; Compliance Review:
<ul>
<li>Review and enforce insurance provisions in contracts, leases, and vendor agreements to align with company risk standards.</li>
<li>Ensure compliance with federal, state, and industry regulations related to insurance and risk management.</li>
<li>Monitor insurance compliance for tenants, contractors, and subcontractors.</li>
<li>Assist in developing and enforcing risk-related guidelines across projects and property management operations.</li>
</ul>
Financial &amp; Budget Oversight:
<ul>
<li>Work with finance teams to develop budgets for insurance premiums, claims, and reserves while managing costs effectively.</li>
<li>Track and manage insurance expenses to ensure adequate financial planning and protection.</li>
<li>Report insurance claims and risk management financial impacts to senior leadership.</li>
</ul>
Stakeholder Collaboration &amp; Training:
<ul>
<li>Act as a key liaison with internal teams (legal, finance, operations) and external stakeholders (brokers, consultants, insurers).</li>
<li>Provide training and education on risk management, loss control, and insurance best practices to staff and relevant parties.</li>
</ul>
General Responsibilities
<ul>
<li>Perform other duties as assigned</li>
<li>All employees are responsible for the general upkeep of work and shared spaced</li>
<li>Punctual and regular attendance is required of all employees</li>
</ul>
We're Seeking Individuals Who Are:
<ul>
<li>
Highly knowledgeable in insurance policies and risk management, particularly within the real estate, construction, and property management sectors.
</li>
<li>
Experienced in managing complex insurance portfolios including general liability, property, workers’ comp, and builders’ risk coverages.
</li>
<li>
Strategic thinkers who can evaluate insurance needs, negotiate with brokers, and implement cost-effective coverage solutions.
</li>
<li>
Skilled at managing claims from initial reporting to resolution, working effectively with carriers, adjusters, and attorneys.
</li>
<li>
Detail-oriented professionals who can analyze claims data to uncover trends, identify risks, and recommend proactive solutions.
</li>
<li>
Committed to compliance and staying up to date with evolving insurance regulations and industry best practices.
</li>
<li>
Collaborative team players who can partner with legal, finance, construction, and operations to ensure proper insurance structures are in place.
</li>
<li>
Independent, self-motivated professionals who can prioritize effectively in a dynamic, fast-paced environment.
</li>
<li>
Committed to continuous improvement, always seeking ways to strengthen the company’s risk posture and coverage strategies.
</li>
<li>
Confident decision-makers with strong negotiation and interpersonal skills, comfortable liaising across all levels of the organization.
</li>
</ul>
Qualifications
<ul>
<li>Bachelor’s in , Insurance, Business, Accounting, Finance, or related field.</li>
<li>CRM, ARM, or CPCU (preferred).</li>
<li>5+ years in insurance, ideally in real estate development, construction or property management.</li>
<li>Strong understanding of real estate, construction, development, leasing, and property management.</li>
<li>Experience managing complex insurance programs and claims for real estate or construction projects.</li>
<li>In-depth understanding of liability, property, workers' comp, builders’ risk, and commercial insurance.</li>
<li>Skilled in Microsoft Office (Excel, Word, PowerPoint</li>
<li>Strong verbal and written communication and negotiation skills.</li>
<li>Able to manage multiple priorities in a fast-paced environment.</li>
<li>Detail-oriented and highly organized.</li>
<li>Proactive, with strong decision-making abilities.</li>
<li>Ability to work independently and within a team.</li>
<li>Strong at building relationships with key stakeholders</li>
</ul>
Culture &amp; Total Rewards ApproachWhy Join Enclave? 
When you become part of Enclave, you join a team of trailblazers in the real estate, construction, and property management industry. Our collaborative and fun-loving culture encourages you to thrive both professionally and personally. Our Core Values define what we say and do. 
<ul>
<li>Care For Each Other: We value people for who they are and take pride in our relationships with team members, clients, and partners</li>
<li>Do The Honorable Thing: We are committed to upholding the highest standards in our words and actions.</li>
<li>Be Empowered: We encourage true autonomy, which results in team members who are remarkably inspired and high-performing.</li>
<li>Promote Innovation: We constantly reach further and don't accept the status quo to bring the best service and product to the marketplace.</li>
</ul>
Total Rewards Approach 
Our salary ranges are established based on a combination of market data, internal equity, and the unique characteristics of our organization such as our size, revenue, and industry. Within the range, individual pay is determined by multiple factors including job-related skills, experience, and relevant education or training. 
We offer comprehensive health, dental, and vision insurance plans, a 401k retirement plan with company match, and company-paid life and disability insurance. Here's what else you can look forward to:
<ul>
<li>Work-Life Balance: Enjoy Paid Time Off (PTO), paid holidays, and dedicated volunteer time, ensuring you have the time to recharge and give back to the community. </li>
<li>Professional Growth: Be part of a company that values your development, offering a culture that supports learning, innovation, and career progression. </li>
<li>Additional Perks: Take advantage of our Health Savings Account (HSA), Flexible Spending Account (FSA), supplemental voluntary benefits, paid maternity/paternity leave, and more! Enclave supports your overall well-being and financial security. </li>
</ul>
Join Enclave and be part of a dynamic team that's shaping the future of real estate, construction, and property management. With us, you'll find more than just a job - you'll find a place where your contributions matter, your growth is supported, and your potential is limitless. Together, we'll create spaces that inspire and empower. 
Enclave provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law.

Insurance & Claims Manager

<h3>Job Description</h3>
Job Description
Who are we? A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world. Part of Berkshire Hathaway’s insurance operations, we bring our solutions to market with our stellar brand name, top-rated balance sheet, and the expertise of our global team of professionals, who exude excellent capabilities and strong character.
We are a values-based organization where respect, integrity, excellence, collaboration, and passion define who we are and how we do business. We value diversity of backgrounds, experience, and perspectives and strive to foster an inclusive environment that enables all our team members to bring their best selves to work. We are one team committed to building a culture where every teammate has the opportunity to contribute and be recognized. Want to be part of the team building the finest property, casualty, and specialty lines insurance company in the world?
Learn more about our unique culture and history.
 
Job Opportunity: 
Berkshire Hathaway Specialty Insurance (BHSI) has an exciting opportunity for an experienced Multi-Line Claims Examiner to join our dynamic Claims team. The Examiner will be responsible for handling of specialty lines claims and management oversight of TPA claims as well as some handling of individual claim files, collaborating with underwriters throughout the claims process and marketing BHSI Claim Service to customers. We are seeking candidates with a high level of technical skill, as well as excellent communication and interpersonal skills. The position will be based in either our New York, Boston or Atlanta office. 
 
Duties &amp; Responsibilities:
<ul>
<li>Responsible for oversight, managing and adjusting of primary and TPA claims to include; commercial auto, general casualty, errors &amp; omission, accident &amp; health, homeowner and commercial property claims. Ensure high level of customer service and technical claim file quality.</li>
<li>Duties include proactive handling of claims from first notice of loss through ultimate resolution, working and advising internal partners on claims, developing a plan of action for ultimate resolution, obtaining budgets and meeting with clients and brokers. Audit and oversite of TPA claims.</li>
<li>Provides outstanding customer service and works well with the insured, broker and TPA in the handling and adjudication of claims.</li>
<li>Analyze and draft coverage letters as appropriate and communicates coverage positions effectively.</li>
<li>Conducts, coordinates, and proactively directs investigation, defense and settlement of claims.</li>
<li>Directs and closely monitors assignments to experts and defense counsel.</li>
<li>Evaluates information on coverage, liability, and damages to determine the extent of exposure to the insured and the company.</li>
<li>Drafts reports, sets reserves within authority or make claim recommendations concerning reserve changes.</li>
<li>Travels to audits, conferences, mediations, and trials as necessary</li>
</ul>

 Qualifications, Skills, and Experience:
<ul>
<li>Should have a high degree of specialized and technical competence in the handling multi line claims.</li>
<li>Minimum of 3 -5 years multi line claim handling experience.</li>
<li>College degree preferred.</li>
<li>Ability to work independently and assimilate learning materials on many different subjects from various sources.</li>
<li>Excellent interpersonal communications and negotiation skills.</li>
<li>Ability to work in a team environment.</li>
<li>Should have technical competence in all aspects of multi-line claims with particular emphasis on customer service.</li>
<li>Experience in handling and adjusting claims in all 50 states and possess required licenses.</li>
</ul>
 
BHSI Offers:
<ul>
<li>A competitive package and exciting growth opportunities for career-oriented teammates.</li>
<li>A dynamic, action oriented, and thoughtful environment centered on always doing the right thing for our customers, teammates, and our other stakeholders.</li>
<li>A purposely non-bureaucratic organization that embraces simplicity over complexity and emphasizes individual excellence in a team framework.</li>
<li>Benefits that support your life and well-being, which include:</li>
</ul>
<ul>
<ul>
<li>Comprehensive Health, Dental and Vision benefits</li>
<li>Disability Insurance (both short-term and long-term)</li>
<li>Life Insurance (for you and your family)</li>
<li>Accidental Death &amp; Dismemberment Insurance (for you and your family)</li>
<li>Flexible Spending Accounts</li>
<li>Health Reimbursement Account</li>
<li>Employee Assistance Program</li>
<li>Retirement Savings 401(k) Plan with Company Match</li>
<li>Generous holiday and Paid Time Off</li>
<li>Tuition Reimbursement</li>
<li>Paid Parental Leave</li>
</ul>
</ul>

The base salary range for this position is $60,000 to $80,000, along with annual bonus eligibility. Total compensation for a candidate is determined by their relevant skills, location, and experience. We value our teammates – both their capabilities and character – as demonstrated by our amazing culture.
NOTE: Compensation will be commensurate with experience. This job description is not intended to be all-inclusive. Team Member may perform other related duties as negotiated to meet the ongoing needs of the organization.

Claims Examiner, Programs

<h3>Job Description</h3>
Job Description
Education and / or Experience:
<ul>
<li>High School Diploma and 3 years adjudication experience in a managed care setting.</li>
<li>Knowledge of CPT-4, HCPCS, Hospital Revenue, and ICD-9 coding.</li>
<li>Knowledge of HMO, DHS, DMHC, and CMS claims processing guidelines.</li>
<li>Strong knowledge of Microsoft Windows environment such as Word and Excel.</li>
<li>Self-starter, willing to take on multiple tasks.</li>
<li>Must meet minimal claims adjudication production standards.</li>
<li>Strong knowledge of Coordination of Benefits (COB) applications.</li>
<li>Must be able to interpret health plan benefits.</li>
<li>Must be able to review, interpret and apply contract rates.</li>
<li>Ability to communicate effectively orally and written typing 35 words per minute.</li>
<li>Strong organizational skills with emphasis on prioritizing and attention to details</li>
</ul>
Position Summary:
To evaluate and determine the appropriate path and to assist in the expedited processing of all claims, special projects and escalated reconsiderations originating from various internal and external sources and to serve as the first level of telephonic and written response for such issues.
Essential Duties and Responsibilities include the following:
<ul>
<li>Maintain the workflow of all departmental projects.</li>
<li>Provide reports and on-going updates to Claims management.</li>
<li>Assist in the processing of claims, special projects and medical records from all sources.</li>
<li>Oversees staff activities to maintain high level of productivity.</li>
<li>Monitor claims related functions to ensure health plan and regulatory compliance.</li>
<li>Participate with training determined by unit Supervisor regarding claims adjudication issues discovered in audit or through appeals.</li>
<li>Perform audits of claims activities such as turnaround time for acknowledgement, forwarding of claims to correct payer, and processing timeframes.</li>
<li>Provide primary support to the Supervisor of the Institutional unit including special projects.</li>
<li>Recommend process improvements based on appeal tracking and trending reports.</li>
<li>Support Claims management in other company functions such as Medical Review management.</li>
<li>Handle and document resolution to escalated telephone and written claims.</li>
<li>Implement and coordinate issue resolution processes.</li>
<li>Liaison for department with outside providers and internal departments.</li>
<li>Provide supervisory coverage for Claims unit as needed.</li>
<li>All other duties as directed by management.</li>
</ul>
The pay range for this position at commencement of employment is expected to be between&nbsp;&nbsp;$28 - $30 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare &amp; Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.
Full Time Position Benefits:
The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.
Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.
Health and Wellness:
<ul>
<li>Employer-paid comprehensive medical, pharmacy, and dental for employees</li>
<li>Vision insurance</li>
<li>Zero co-payments for employed physician office visits</li>
<li>Flexible Spending Account (FSA)</li>
<li>Employer-Paid Life Insurance</li>
<li>Employee Assistance Program (EAP)</li>
<li>Behavioral Health Services</li>
</ul>
Savings and Retirement:
<ul>
<li>401k Retirement Savings Plan</li>
<li>Income Protection Insurance</li>
</ul>
Other Benefits:
<ul>
<li>Vacation Time</li>
<li>Company celebrations</li>
<li>Employee Assistance Program</li>
<li>Employee Referral Bonus</li>
<li>Tuition Reimbursement</li>
<li>License Renewal CEU Cost Reimbursement Program</li>
<li>Business-casual working environment</li>
<li>Sick days</li>
<li>Paid holidays</li>
<li>Mileage</li>
</ul>
Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.
Company DescriptionAs one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare &amp; Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success. 
<h3>Company Description</h3>
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare &amp; Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Claims Adjudication Examiner

<h3>Job Description</h3>
Job Description
Summary:
A Hospital Claims Auditor is responsible for the overall quality of claims processes as well as compliance, in accordance with outside regulations and the contractual obligations of the Health Plans and/or Hospital Clients. Research, reviews and contacts provider services for problem claims and issues, as needed. Suggests process improvements to management and is a resource of information to all staff. The Claims auditor also performs special projects and helps department manager and director as needed. They review and audit the Examiners’ adjudicated claims for accuracy and providing feedback.
Duties and Responsibilities:
· Audit daily processed claims through random selection as outlined by organizational Policies and Procedures. Utilize appropriate system-generated reports applicable to specialty claims.
· Conduct Claims Examiner training as required. Document training materials and attendees.
· Conduct in-depth research of contract issues, system-related problems, claims processing Policies and Procedures, etc., to confirm cause of trends. Recommend actions/resolutions to Senior Management.
· Work with other organizational departments
· Assist in the development of Claims Department Policies and Procedures.
· Provide backup for other auditors/trainers within the Department.
· Perform other tasks as assigned by Senior Management.
· Promote a spirit of cooperation and understanding among all personnel.
· Attend organizational meetings as required
· Adhere to organizational Policies and Procedures.
· Adhere to MedPOINT Management’s core value: Accountability, Community, Celebration, Integrity, Innovation &amp; Collaboration
Minimum Job Requirements:
· High School Diploma required.
· Three years of experience in a managed care claims adjudication setting e.g., HMO/MSO, required.
· Expertise in coding structure, ICD-10, CPT-4 and Revenue Codes, required.
· Definitive understanding of provider and health plan contracting, delineation of risk, medical terminology and standard industry reimbursement methodologies required.
Knowledge, Skills and Abilities Required:
· Strong organizational, analytical and oral/ written communication (English) skills required.
· Proficiency in PC application skills, e.g., word processing, spreadsheets, preferred
· Experience in training development and presentation preferred
· Must be able to follow directions and also perform independently according to departmental standards.

Hospital Claims Auditor

<h3>Job Description</h3>
Job Description
The Indemnity Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.
 This is a remote position.
ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
<ul>
<li>Receives claims, confirms policy coverage and acknowledgment of the claim</li>
<li>Determines validity and compensability of the claim</li>
<li>Establishes reserves and authorizes payments within reserving authority limits</li>
<li>Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision</li>
<li>Communicates claim status with the customer, claimant and client</li>
<li>Adheres to client and carrier guidelines and participates in claims review as needed</li>
<li>Assists other claims professionals with more complex or problematic claims as necessary</li>
<li>Requires regular and consistent attendance</li>
<li>Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”)</li>
<li>Additional projects and duties as assigned</li>
</ul>
KNOWLEDGE &amp; SKILLS: 
<ul>
<li>Excellent written and verbal communication skills</li>
<li>Ability to learn rapidly to develop knowledge and understanding of claims practice</li>
<li>Ability to identify, analyze and solve problems</li>
<li>Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets</li>
<li>Strong interpersonal, time management and organizational skills</li>
<li>Ability to meet or exceed performance competencies</li>
<li>Ability to work both independently and within a team environment</li>
</ul>
EDUCATION &amp; EXPERIENCE: 
<ul>
<li>Bachelor's degree or a combination of education and related experience</li>
<li>Minimum of 1 year of industry experience and claims management preferred</li>
<li>State Certification as an Experienced Examiner</li>
</ul>
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. 
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. 
Pay Range: $51,807 – $83,551
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. 
ABOUT CORVEL
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). 
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote

Indemnity Claims Specialist

<h3>Job Description</h3>
Ready to Navigate Auto Claims and Support Our Customers? Join the NLC Insurance Team!&nbsp;
 
Are you a proactive, empathetic individual with 0-3 years of experience, looking to accelerate your career in the auto insurance claims field? NLC Insurance Companies is searching for a dedicated Claims Representative to join our dynamic Auto Claims Unit in Norwich, CT. This is an excellent opportunity to become an expert in auto claim investigations and provide crucial support to our policyholders during challenging times.&nbsp;
 
About NLC Insurance:&nbsp;
 
For nearly two centuries, NLC Insurance Companies has been a trusted partner for our customers, offering reliable protection and guidance. We are more than an insurance company; we are a dedicated team committed to excellence and compassionate service. At NLC, we cultivate a collaborative environment that champions employee development and provides a clear path for career growth, especially for those starting or advancing in the insurance sector.&nbsp;
 
Your Role:&nbsp;
 
As an Auto Claims Representative, you will be instrumental in managing first-party and potentially third-party auto claims from the initial report through to resolution. You will be a primary contact for our insureds and claimants, guiding them through the auto claims process with clarity, professionalism, and care. This role operates with hybrid flexibility from our Norwich office.&nbsp;
 
What You'll Do:&nbsp;
 
<ul>
<li>Investigate, evaluate, and negotiate auto claims, including physical damage and potentially minor bodily injury claims, ensuring fairness and efficiency.&nbsp;</li>
<li>Communicate clearly and empathetically with policyholders, claimants, repair shops, and other parties involved, explaining coverage, process, and settlement details.&nbsp;</li>
<li>Analyze claim documentation, such as police reports, photos, witness statements, and repair estimates, to determine liability and assess damages.&nbsp;</li>
<li>Maintain accurate and thorough records of all claim activity in our systems.&nbsp;</li>
<li>Work collaboratively with team members and other departments to ensure a seamless claims experience.</li>
</ul>
What We're Looking For:&nbsp;
 
<ul>
<li>0-3 years of relevant experience (experience in auto claims, auto damage appraisal, or customer service in the insurance industry is a plus).&nbsp;</li>
<li>A bachelor's degree is preferred, or equivalent work experience.&nbsp;</li>
<li>Exceptional communication (verbal and written), interpersonal, and customer service skills.&nbsp;</li>
<li>Strong analytical, problem-solving, and decision-making abilities.&nbsp;</li>
<li>Meticulous attention to detail and excellent organizational skills.&nbsp;</li>
<li>An eagerness to learn, adapt, and contribute to a fast-paced environment.&nbsp;</li>
<li>Ability to work effectively both independently and as part of a supportive team.&nbsp;</li>
</ul>
Why Join NLC Insurance?&nbsp;
 
<ul>
<li>Career Advancement: Structured opportunities for growth and development within a stable and reputable company.&nbsp;</li>
<li>Expert Mentorship: Learn from experienced auto claims professionals in a supportive and collaborative setting.&nbsp;</li>
<li>Make a Difference: Provide essential support to individuals involved in auto accidents, helping them navigate the claims process and recover.&nbsp;</li>
<li>Team-Oriented Culture: Be part of a company that values your contributions, fosters teamwork, and encourages continuous improvement.&nbsp;</li>
<li>Comprehensive Benefits: We offer a competitive salary and benefits package including 401(k) with matching, dental, health, life, and vision insurance, flexible spending account, and paid time off.&nbsp;</li>
<li>Hybrid Work Model: Enjoy the flexibility of working both remotely and in our Norwich office.&nbsp;</li>
</ul>

Ready to Apply?&nbsp;
 
If you are passionate about helping people and are ready for a challenging and rewarding role in auto claims, we encourage you to apply!&nbsp;
Please submit your application to: <a href="mailto:employment@nlcinsurance.com" target="_blank">employment@nlcinsurance.com</a> &nbsp;
Application Deadline:&nbsp; Open Until Filled&nbsp;
 
Location:&nbsp;
 
Norwich, CT 06360 (Hybrid work, must be able to commute to Norwich, CT)&nbsp;
NLC Insurance is an Equal Opportunity Employer&nbsp;

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