Claims Examiner - Liability | Multi State Jurisdiction | Auto, BI, PD, GL | Licensing: NY Preferred and Reciprocal required Sedgwick Claims Management Services, Inc.Claims Examiner - Liability | Multi State Jurisdiction | Auto, BI, PD, GL | Licensing: NY Preferred and Reciprocal requiredDowners Grove, ILRemote$65,000–$85,000 / yearPRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. 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.
Pharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistWoodridge, IllinoisSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
Accounts Receivable Specialist - Medical Billing Bionic Prosthetics and OrthoticsAccounts Receivable Specialist - Medical BillingMerrillville, INBionic Prosthetics and Orthotics is seeking an Accounts Receivable Specialist specializing in older and outstanding insurance claims. This position is responsible for researching, tracking, and resolving aged insurance accounts to maximize reimbursement.
Complex Claim Director - Employment Practices Liability American International GroupComplex Claim Director - Employment Practices LiabilityChicago, IL$120,000–$150,000 / yearOur Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. You will be responsible for handling all aspects of complex Employment Practice Liability claims, with opportunity to handle Directors & Officers Lability, from inception through conclusion brought against privately held and not-for-profit insureds.
Liability Claims Adjuster Remote CST/EST Charles Taylor LtdLiability Claims Adjuster Remote CST/ESTILRemoteThe right candidate must perform coverage, liability and damage analysis, maintain timely correspondence and determine the best course of action with low to medium levels of autonomy, while working closely with clients, their employees and attorneys as a moderate to experienced claims professional. Charles Taylor is an independent, global provider of claims solutions, insurance management services and technology platforms for all property and casualty markets, including commercial property, workers' compensation, and auto/liability.
Customer Service Representative - State Farm Agent Team Member Michael Johnson - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberChicago, ILFull timeAs a Customer Service Representative - State Farm Agent Team Member with Michael Johnson - State Farm Agent, you will generate the kind of exceptional client experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Claims Specialist - Property Philadelphia Insurance CompaniesClaims Specialist - PropertyNaperville, IL$84,422–$99,320 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Reimbursement Specialist - Healthcare PhilipsReimbursement Specialist - HealthcareChicago, IL$26–$41 / hourYou're the right fit if: You've acquired 2+ years of experience in Accounts Receivable Management, Reimbursement, Collections, or Denial Management, with hands-on experience resolving denied and rejected insurance claims and working directly with payers. The actual base pay offered may vary within the posted ranges depending on multiple factors including job-related knowledge/skills, experience, business needs, geographical location, and internal equity.
Reimbursement Specialist (Healthcare) PhilipsReimbursement Specialist (Healthcare)Chicago, IL$26–$41 / hourYou're the right fit if: You've acquired 2+ years of experience in Accounts Receivable Management, Reimbursement, Collections, or Denial Management, with hands-on experience resolving denied and rejected insurance claims and working directly with payers. The actual base pay offered may vary within the posted ranges depending on multiple factors including job-related knowledge/skills, experience, business needs, geographical location, and internal equity.
Senior Technical Claims Specialist Argo Group International Holdings IncSenior Technical Claims SpecialistChicago, IL$173,706–$208,386 / yearEssential Responsibilities: Working with limited oversight under broad management direction, adjudicate highly complex claims and insurance coverage disputes mostly for our professional liability line of business, at the highest authority limits on assignments reflecting the highest degree of technical complexity and coordination in liability and litigated claims, potentially with major impact on departmental results. Qualifications / Experience Required: A deep knowledge of claims adjudication and focus on customer service typically achieved through: At least seven years' experience handling insurance coverage issues and disputes, with exposure of $100,000 or more, for Professional Liability claims.
NewClaims Associate - Liability Sedgwick Claims Management Services, Inc.Claims Associate - LiabilityChicago, ILRemote$65,000–$70,000 / yearMental: 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. Processes low level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
Investigator Ethos Risk ServicesInvestigatorChicago, ILFull timeCONDITIONS:While we aim to keep assignments within a 2-hour drive of your residence, occasional further travel and overnight stays (covered by the company) may be requiredMost surveillance cases start at 6:00AM. REQUIREMENTS:Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports.
Surveillance Investigator Allied UniversalSurveillance InvestigatorMerrillville, IndianaThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Claims Specialist II - Workers Compensation Zurich Insurance Group LtdClaims Specialist II - Workers CompensationSchaumburg, ILPurpose: With moderate direction, handles workers compensation claims of low to moderate exposure and complexity within specific limits of authority by following established protocols to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service. Designed with our employees needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable.
Auto Litigation Claims Specialist Zurich Insurance Group LtdAuto Litigation Claims SpecialistSchaumburg, ILDesigned with our employees needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable. Document claims file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate exposure and complexity personal or commercial line claims.
Financial Services Administrator – State Farm Agent Team Member Freddie Villacci, Jr. - State Farm AgentFinancial Services Administrator – State Farm Agent Team MemberChicago, ILFull timeTo excel in this role, we are seeking candidates with the following qualifications: Sales Experience: Prior experience in sales or customer service is preferred, but we welcome individuals with a genuine passion for sales and a determination to succeed. Your key responsibilities will include: Sales and Customer Acquisition: Engaging with potential customers to understand their insurance needs and recommending personalized insurance and financial products that align with their unique requirements.
Account Manager - State Farm Agent Team Member Freddie Villacci, Jr. - State Farm AgentAccount Manager - State Farm Agent Team MemberChicago, ILFull timeTo excel in this role, we are seeking candidates with the following qualifications: Sales Experience: Prior experience in sales or customer service is preferred, but we welcome individuals with a genuine passion for sales and a determination to succeed. Your key responsibilities will include: Sales and Customer Acquisition: Engaging with potential customers to understand their insurance needs and recommending personalized insurance and financial products that align with their unique requirements.
NewFinancial Services Representative – State Farm Agent Team Member Freddie Villacci, Jr. - State Farm AgentFinancial Services Representative – State Farm Agent Team MemberChicago, ILFull timeTo excel in this role, we are seeking candidates with the following qualifications: Sales Experience: Prior experience in sales or customer service is preferred, but we welcome individuals with a genuine passion for sales and a determination to succeed. Your key responsibilities will include: Sales and Customer Acquisition: Engaging with potential customers to understand their insurance needs and recommending personalized insurance and financial products that align with their unique requirements.
Financial Representative – State Farm Agent Team Member Freddie Villacci, Jr. - State Farm AgentFinancial Representative – State Farm Agent Team MemberChicago, ILFull timeTo excel in this role, we are seeking candidates with the following qualifications: Sales Experience: Prior experience in sales or customer service is preferred, but we welcome individuals with a genuine passion for sales and a determination to succeed. Your key responsibilities will include: Sales and Customer Acquisition: Engaging with potential customers to understand their insurance needs and recommending personalized insurance and financial products that align with their unique requirements.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistIL$17–$31.30 / hourThe candidate will serve as a medical/hospital claim processor for rework projects, compliance, and complex issues for a specific provider/network or large-scale rework projects generated as a result of plan sponsor issues, release fallout and/or legal/regulatory/compliance concerns. CVS Health is currently looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department.