field_job_employment_type

field_job_occupational_field_parents_all

field_job_experience

job_organization_name

city

state

<h3>Job Description</h3>
Job Description
Summary: Works to resolve claims/issues that impact the customer as it relates to errors in Order Processing, Accounts Receivable, Shipping, and defective products. There is a strong troubleshooting/problem solving component to this position
 
Essential Responsibilities:
<ol>
<li>Customer Care - Help resolve customer complaints/issues when an order was not entered, shipped, or received correctly. Investigation of customer complaints and ensuring resolution to these issues. Create CFB, document and report policy and procedure errors, and see CFBs through to resolution.</li>
</ol>
<ol>
<li>Carrier Claims - Investigate and gather documentation with evidence. Prepare paperwork and submit claims for pursuance of payment/reimbursement. Act as the liaison with carriers involved with shipping errors.</li>
</ol>
<ol>
<li>UPS - Coordinate the filing of UPS clams</li>
</ol>
<ol>
<li>DOT - Ensure Liberty Pumps is in compliance with all DOT requirements/regulations; stay abreast of new DOT requirements; provide training/education to drivers; maintain driver completed log books</li>
</ol>
<ol>
<li>Risk Management - Assist &amp; work closely with Senior Claims Analyst and Chief Financial Officer in the administration of product liability claims</li>
</ol>
<ol>
<li>Accounts Receivable - work with A/R in the resolution of disputes such as billing errors &amp; shipping errors to ensure timely payments. </li>
</ol>
<ol>
<li>Safety - Members are held responsible and accountable to follow safety guidelines, maintain a clean and organized work area, and use good safety judgment. </li>
</ol>
<ol>
<li>Able to work well in a team environment and diverse group settings</li>
</ol>
<ol>
<li>You will be expected to operate according to ISO 9001 requirements.</li>
</ol>
<ol>
<li>Held responsible and accountable to follow safety guidelines, maintain a clean and organized work area, and use good safety judgment. Expected to report all unsafe activities and conditions to the Supervisor and/or Safety Representative.</li>
</ol>
<ol>
<li>This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the member for this job. Duties, responsibilities, and activities may change at any time with or without notice.</li>
</ol>
Minimum Qualifications: Organizational skills and being able to remain flexible at all times is necessary.Computer literate in common word processing, spreadsheet, and other Windows-based PC programs. 
Education/Training: High school diploma or GED
 
Experience/Skills/Abilities: Ability to read, write, edit, analyze, and comprehend instructions, short correspondence, and general business documents. Ability to speak effectively before groups of customers or employees of organization. Ability to define problems, collect data, establish facts, and draw valid conclusions. Proficient personal computer skills including electronic mail, record keeping, routine database activity, word processing, spreadsheet, graphics, etc. Handle multiple projects simultaneously. Willing to work in a team environment. Self-motivated, capable of taking direction as well as working with minimal supervision. Ability to remain calm under pressure such as working through an employment situation. 
Work Schedule/Hours: Monday – Friday with typical business hours. Occasional overtime may be necessary when working on special projects. Minimal overnight travel (up to 10%) by land and/or air.
Working Conditions: Well-lighted, heated, and/or air-conditioned indoor office/shop environment with adequate ventilation. Light physical activity performing non-strenuous daily activities of an administrative nature. Moderate noise (examples: business office with computers and printers, light traffic).

Claims Analyst

<h3>Job Description</h3>
Job DescriptionOverview
Company Overview: 
Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you're ready to grow with the best, explore a career with us and make a difference.
Job Description
Allied Universal® is hiring a Claims Investigator. Claim Investigators validate the facts of loss for Insurance claims through scene Investigations, claimant and witness Interviews, document retrieval and data Interpretation.
<ul>
<li>Must possess a valid driver's license with at least one year of driving experience&nbsp;</li>
</ul>
<ul>
<li>Candidate must reside in state listed in job posting&nbsp;</li>
</ul>
<ul>
<li>Pay Rate: $28 - $32 / hr&nbsp;</li>
</ul>
RESPONSIBILITIES:
<ul>
<li>Investigate insurance claims for a variety of coverage to include workers' compensation, general liability, property and casualty and disability</li>
<li>Gather information independently and in collaboration with clients and case managers through various methods such as data collection, interviews, research, and scene investigations</li>
<li>Follow guidance from the handling insurance adjuster to perform field tasks essential to the investigation</li>
<li>Develop and document information on any investigation in a professional and expert manner by writing clear, concise, and grammatically correct reports, memos, and letters</li>
<li>Run appropriate database indices if necessary and verify the accuracy of results found</li>
</ul>
QUALIFICATIONS (MUST HAVE):
<ul>
<li>Must possess one or more of the following:</li>
<ul>
<li>Bachelor's degree in Criminal Justice</li>
<li>Associate's degree in Criminal Justice with a minimum of four (4) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims</li>
<li>High school diploma with a minimum of six (6) years of demonstrated experience conducting complex insurance investigations or adjusting complex claims</li>
</ul>
<li>Ability to be properly licensed as a Private Investigator as required by the states in which you work</li>
<li>Post offer, must be able to successfully complete the Allied Universal Investigations training/orientation course</li>
<li>Minimum of two (2) years of demonstrated experience conducting insurance claims investigations or adjusting complex claims</li>
<li>Working knowledge and understanding of anti-fraud laws, insurance regulations, and compliance rules and standards in their home state and within their designated region of the country</li>
<li>Special Investigative Unit (SIU) Compliance knowledge</li>
<li>Ability to type 40+ words per minute with minimum error</li>
<li>Flexibility to work varied and irregular hours and days including weekends and holidays</li>
<li>Proficient in utilizing laptop computers and cell phones</li>
</ul>
PREFERRED QUALIFICATIONS (NICE TO HAVE):
<ul>
<li>Military experience</li>
<li>Law enforcement</li>
<li>Insurance administration experience</li>
<li>One or more of the following professional industry certifications</li>
<ul>
<li>Certified Fraud Investigator (CFE)</li>
<li>Certified Insurance Fraud Investigator (CIFI)</li>
<li>Fraud Claim Law Associate (FCLA)</li>
<li>Fraud Claim Law Specialist (FCLS)</li>
<li>Certified Protection Professional (CPP)</li>
<li>Associate in Claims (AIC)</li>
<li>Chartered Property Casualty Underwriter (CPCU)</li>
</ul>
</ul>
BENEFITS:
<ul>
<li>Medical, dental, vision, basic life, AD&amp;D, and disability insurance</li>
<li>Enrollment in our company's 401(k)plan, subject to eligibility requirements</li>
<li>Seven paid holidays annually, sick days available where required by law</li>
<li>Vacation time offered at an initial accrual rate of 3.08 hours biweekly for full time positions. Unused vacation is only paid out where required by law.</li>
</ul>
Closing
Allied Universal® is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: <a href="http://www.aus.com" target="_blank">www.aus.com</a> 
If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: <a href="http://www.aus.com/offices" target="_blank">www.aus.com/offices</a>.
Requisition ID 2025-1466223

Claims Investigator - Bronx

<h3>Job Description</h3>
Job Description
 Job Tittle:&nbsp;Claims Reviewer Job ID:&nbsp;75861 Location: Arizona - Remote What you will be doing:
<ul>
<li>
Conducts medical claims review using current claims processing guidelines and established clinical criteria e.g. CDST and policy keys, to evaluate medical necessity, appropriateness of care and program benefits, exclusions and limitations.
</li>
<li>
Validates medical determinations through research of resources including regulatory manuals, computer files, and documentation.
</li>
<li>
Prepares cases program payment or medical director review as indicated.
</li>
<li>
Validates all appropriate data is supplied with program invoice.
</li>
<li>
Reviews claim data for process improvements related to all aspects of claims payment.
</li>
<li>
Ensures contract compliance for timelines regarding resolution of medical claims.
</li>
<li>
Communicates effectively with management and peers.
</li>
<li>
Consistently meets medical claims processing quotas.
</li>
<li>
Identifies and reports any potential quality or fraud issues to management, Quality Management, or Program Integrity as needed.
</li>
<li>
Provides support regarding clinical and coding questions.
</li>
<li>
Performs other duties as assigned.
</li>
<li>
Regular and reliable attendance is required.
</li>
</ul>
 What you must have:
<ul>
<li>
High School Diploma or GED
</li>
<li>
2+ years of claims review experience
</li>
<li>
Knowledge of all types of Medical claims review
</li>
</ul>
 Nice to have:
<ul>
<li>
Claim coding experience
</li>
<li>
Knowledge of behavioral health claims review
</li>
</ul>

Claims Reviewer

<h3>Job Description</h3>
Job Description
About the Role:
We are seeking a detail-oriented and customer-focused Claims Representative to join our team. This role is responsible for resolving claims filed by customers, transportation, and credit departments using a Customer First approach. You will balance customer satisfaction with company interests, ensuring timely and accurate resolution of claims.
Location: Delavan, Wisconsin, 53115 Hybrid (3 days onsite: Mon, Tue, Thu; 2 days WFH: Wed, Fri)
Schedule: Monday to Friday, 7:30 AM – 4:00 PM (30-minute unpaid lunch)
• Process credits, returns, and debits for customer claims in a timely manner (could be due to warranty issues, product quality issues, misships, product qty issues) 
• Maintain strong understanding of the life of an order/life of a shipment in order to effectively problem solve order, invoicing, and shipping issues.
• Consistent follow up on outstanding claims/RMA’s in order to prevent account receivable aging.
• Reporting daily metrics on status of claims including processed and oldest claims. 
• Initiate root cause on claims by contacting department flagged for the claim. 
• Effectively communicating via phone and email to customers and internal departments to ensure resolution to the customer. 
• Identify trending issues, notify stakeholders, and assist in problem resolution activities.
• Work effectively with cross-functional departments. Develop strong relationships with partners in credit, transportation, order processing, and shipping departments.
• Perform other tasks and duties as assigned.. 
Combination of both phone and emails.
Additional Skills &amp; Qualifications
QUALIFICATIONS/ABILITIES:
• Excellent customer service and soft skills - investigate mindset
• Strong organizational, written and verbal communication skills.
• Ability to prioritize, exercise good judgement, handle multiple tasks, meet deadlines, attention to detail and work under pressure 
• Must be able to respond to the customer in a timely manner.
• Proficient in MS Office Products. 
• Must have strong interpersonal skills to effectively communicate with both internal and external clients.
• Demonstrates integrity and ethical standards. 
EXPERIENCE:
• High School diploma 
• 1-3 years of experience in claims, customer service, or related experience.
• SAP experience preferred but not required.
Employee Value Proposition
Join a collaborative team where your problem-solving skills and customer-first mindset will make a direct impact. Enjoy a hybrid work setup and a supportive environment that values integrity and teamwork. 
This position is a contract with potential hire/extension. 
Pay and Benefits
The pay range for this position is $20.00 - $23.00/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 &amp; vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life &amp; AD&amp;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 Delavan,WI.
Application Deadline
This position is anticipated to close on Oct 31, 2025.
h4&gt;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.

Claims Representative

<h3>Job Description</h3>
Job Description
The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
<ul>
<li>Supervises claims staff in their day-to-day operations</li>
<li>Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions</li>
<li>Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements</li>
<li>Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval)</li>
<li>Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions</li>
<li>Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests</li>
<li>Additional duties as assigned</li>
</ul>
KNOWLEDGE &amp; SKILLS:
<ul>
<li>Excellent written and verbal communication skills</li>
<li>Ability to assist team members to develop knowledge and understanding of claims practice</li>
<li>Participate in customer claim reviews and presentations</li>
<li>Effective quantitative, analytical and interpretive skills</li>
<li>Strong leadership, management and motivational skills</li>
<li>Demonstrated, strong customer service skills</li>
<li>Ability to travel overnight and attend meetings if required</li>
<li>Maintains composure under pressure and communicates diplomatically across various channels, including telephone, email, and written correspondence</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 work both independently and within a team environment</li>
<li>Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation</li>
</ul>
EDUCATION &amp; EXPERIENCE:
<ul>
<li>Bachelor's degree or a combination of education and related experience</li>
<li>Demonstrated public speaking skills</li>
<li>Minimum of 5 years’ claims handling experience</li>
<li>Knowledge of WC required</li>
<li>Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel</li>
<li>Self-Insured Certificate 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: $71,696 – $110,701 
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

WC Claims Supervisor

<h3>Job Description</h3>
Job Description
Job Type: Contract Workplace Type: Hybrid (50% remote, 50% fieldwork) Compensation: $22/hr plus $.50/mi 
COMPANY OVERVIEW
Phoenix Loss Control (PLC) is a US-based business services provider in the cable, telecom, and utilities sector. PLC’s core service is outside plant damage investigation, recovery, and prevention. Across the US and parts of Canada, we help our clients recover the costs of third-party damage to their infrastructure, such as underground fiber optic or gas lines. PLC currently employs over 140 people, servicing some of the largest cable and telecoms operators (e.g., Comcast, Spectrum, AT&amp;T, and Google). PLC is currently aggressively expanding its business and looking for talented and energetic people to bring onboard to help drive growth.  
POSITION SUMMARY
Outside Plant Damage (OPD) costs our clients over 30 million annually. Field investigators are needed to collect, access, and report these damages. This is a part-time, on-call contract job to help support our clients with damage recovery. For our field investigators, each day and every investigation is different. We need inquisitive, self-driven individuals who are comfortable rolling up their sleeves and working in a constantly changing, dynamic environment.  
Duties
<ul>
<li>Conduct on-site field investigations  </li>
<li>Write detailed but concise investigation reports using diverse sources of information, types of evidence, witness statements, and costing estimates  </li>
<li>Develop and maintain comprehensive knowledge of local and state statutes, laws, and regulations for underground and aerial cables and utility service lines  </li>
<li>Remain prepared and willing to respond to damage calls within a timely manner  </li>
<li>Complete damage investigations within 7 days and then work with and support our claims managers to complete the investigation and begin the recovery process  </li>
<li>Respond to damages same day if received during business hours (if not, first response following day) </li>
<li>Accurately record all time, mileage, and other associated specific items  </li>
</ul>
Requirements
<ul>
<li>Interpersonal skills to gather information and conduct field interviews with involved parties including contractors and technicians, witnesses, law enforcement, and possible damagers  </li>
<li>Smartphone to gather photos, videos, and other information while conducting investigations  </li>
<li>Computer, with high-speed internet access, to upload and download reports, research cases, and to interact with our claims system and other databases and portals  </li>
<li>Exceptional attention to detail and strong written and verbal communication skills  </li>
<li>Proven ability to operate independently and prioritize while adhering to timelines  </li>
<li>Strong and objective analytical skills  </li>
<li>Valid driver’s license, current insurance, and reliable vehicle with ability to respond to damages at any time  </li>
<li>Safety vest, work boots, and hard-hat  </li>
</ul>
Preferred Qualifications and Skills
<ul>
<li>Current or previous telecommunication or utility experience  </li>
<li>Knowledge of underground utility locating procedures and systems  </li>
<li>Investigation, inspection, or claims/field adjusting  </li>
<li>Criminal justice, legal, or military training or work experience  </li>
<li>Engineering, infrastructure construction, or maintenance background  </li>
<li>Remote location determined at discretion of investigations manager </li>
</ul>
 This is a contract position. There are no benefits offered with this position.

Field Claims Investigator

<h3>Job Description</h3>
Job DescriptionEmpower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.
Position Overview As a Claims Adjustment Specialist I, this individual will be responsible for analyzing standard to complex post-paid healthcare claims that require in depth research to determine accuracy and mitigate payment errors. The Claims Adjustment Specialist I will also be responsible for adjusting medical claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position will be responsible for responding to inquiries from providers whose claims may be paid incorrectly and performing accurate data entry and maintenance accurate records and files.
Work Shifts
9:00 A.M – 5:00 P.M &nbsp;
Duties &amp; Responsibilities
<ul>
<li>Research and analyze medical claims adjustment requests along with related documentation to determine payment accuracy and adjust/adjudicate as needed using multiple systems and platforms.</li>
<li>Ensure that the proper payment guidelines are applied to each claim by using the appropriate tools, processes, and procedures (e.g., claims processing P&amp;P’s, grievance procedures, state mandates, CMS/Medicare/Medicaid guidelines, benefit plans, etc.)</li>
<li>Research claims that may have paid incorrectly and communicate findings for adjustment; Adjust claims based on findings (i.e., correct coding, rates of reimbursement, authorizations, contracted amounts etc.) ensuring that all relevant information is considered.</li>
<li>Advise business partners of findings outcome if their input is needed to help fix the issue.</li>
<li>Communicate through correspondence with providers regarding claim payment or additional required information in a clear and concise manner.</li>
<li>Process the adjustment of claims in a timely manner, according to established timelines.</li>
<li>Remain current with changes/updates in claims processing, as well as updates to coding systems.</li>
<li>Maintain accurate records of all claims processed, including notes on actions taken.</li>
<li>Generate reports on claim activity as requested.</li>
<li>Respond to audits of claims processed.</li>
<li>Able to work independently and exercise good judgment</li>
</ul>
Minimum Qualifications
<ul>
<li>High School Degree or evidence of having passed a High School Equivalency Program required. Associate degree preferred.</li>
<li>Minimum 2 years of claims operations experience in a healthcare field, with knowledge of integrated claims processing required.</li>
<li>Experience using a PC and claim adjudication system(s)</li>
<li>Experience using Customer Relationship Management (CRM) software; Salesforce is a plus.</li>
<li>Experience working with large data and spreadsheets.</li>
<li>Knowledge of medical terminology, CPT, ICD-10, and Revenue Codes</li>
<li>Processing of Medical Claim Forms (HCFA, UB04)</li>
<li>Knowledge of Medical Terminology</li>
<li>Knowledge of HIPPA Guidelines regarding Protected Health Information</li>
<li>Data Entry of Provider Claim/Billing information</li>
<li>Experience handling or familiarity with Medical Claim inquiries from provider sites personnel including physicians, clinical staff, and site administrators.</li>
</ul>
Professional Competencies
<ul>
<li>Integrity and Trust</li>
<li>Customer Focus</li>
<li>Functional/Technical skills</li>
<li>Written/Oral Communication</li>
<li>Strong Analytical Skills</li>
<li>Knowledgeable in MS Word and Excel</li>
</ul>
Benefits
NYC Health and Hospitals offers a competitive benefits package that includes:
<ul>
<li>Comprehensive Health Benefits for employees hired to work 20+ hrs. per week</li>
<li>Retirement Savings and Pension Plans</li>
<li>Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts</li>
<li>Loan Forgiveness Programs for eligible employees</li>
<li>College tuition discounts and professional development opportunities</li>
<li>College Savings Program&nbsp;</li>
<li>Union Benefits for eligible titles&nbsp;</li>
<li>Multiple employee discounts programs</li>
<li>Commuter Benefits Programs</li>
</ul>
#LI-Hybrid
#MHP50

Claims Adjustment Specialist I

<h3>Job Description</h3>
Job Description
Arrow Exterminators is currently seeking a highly skilled and proactive WC Claims Specialist to lead and oversee the day-to-day management of our Workers' Compensation (WC) claims. The ideal candidate will be responsible for collaborating with our Third-Party Administrator (TPA), ensuring timely, accurate, and cost-effective claim handling, maintaining compliance with applicable state WC laws, and supporting business goals through strategic claims management.
Key Responsibilities
<ul>
<li>Oversee and coordinate all aspects of reporting, documenting, and managing workers' compensation claims.</li>
<li>Serve as the primary liaison between the company and the TPA for claims handling, escalation, and resolution.</li>
<li>Monitor claim activity to ensure timely investigations, accurate compensability decisions, and adherence to best practices.</li>
<li>Analyze claim trends and outcomes; prepare reports for leadership on costs, reserves, and risk exposure.</li>
<li>Collaborate with HR, the SVP of Risk Management, Safety, and Operations teams to support return-to-work initiatives and ensure modified duty assignments are effectively implemented.</li>
<li>Review and challenge reserves, settlements, and litigation strategies to control costs and achieve favorable outcomes.</li>
<li>Ensure compliance with state workers' compensation statutes, reporting deadlines, and internal policies.</li>
<li>Conduct periodic claim reviews with the TPA and internal stakeholders to assess performance and identify areas for improvement.</li>
<li>Provide training and guidance to internal staff on workers' compensation procedures and protocols.</li>
</ul>
Qualifications
<ul>
<li>Bachelor's degree in Business Administration, Risk Management, Human Resources, or related field (preferred).</li>
<li>5+ years of experience in workers' compensation claims management, with direct oversight of WC claims.</li>
<li>Knowledge of workers' compensation state laws and claims handling practices.</li>
<li>Experience working directly with TPAs, attorneys, and medical providers.</li>
<li>Exceptional communication and negotiation skills with the ability to build strong professional relationships.</li>
<li>Proficient in claims management systems and Microsoft Office Suite.</li>
<li>Strong analytical, organizational, and problem-solving skills.</li>
<li>Ability to manage multiple priorities in a fast-paced environment.</li>
</ul>
Preferred Attributes
<ul>
<li>A proactive, hands-on approach to claims oversight.</li>
<li>Strong attention to detail and accuracy.</li>
<li>Ability to influence outcomes through effective advocacy and collaboration.</li>
<li>Proven track record of reducing claim costs and improving return-to-work outcomes.</li>
</ul>
ARE YOU READY TO JOIN OUR TEAM?
If you feel that you would be an ideal fit for this opportunity, please complete an initial 3- minute, mobile-friendly application so that we can review your information. We look forward to learning more about you!
We are an Equal Opportunity and a Drug-Free Workplace
The job description is not an exhaustive statement of all the duties, responsibilities, or qualifications of the job, nor is it intended to limit opportunities for necessary modifications.
 
Arrow Exterminators as a PestVets Company is committed to hiring and participating in acts of service for Veterans and active-duty members of the U.S. Military.
 
Arrow Exterminators is a Drug-Free Workplace and performs Pre-employment Drug Screens and Background Checks on all employees. 
 Job Posted by ApplicantPro

WC Claims Specialist

<h3>Job Description</h3>
Job Description
is position is for an established and productive professional individual contributor in Risk Consulting with demonstrated experience in defining and deploying risk strategies and programs for clients. The person understands the big picture and clearly articulating point of view with rationale through logical written and verbal communications. This position begins to develops an area of expertise "major", becoming 'go-to' resource for the client on specific topics.

62,252 claims Jobs