FULL_TIME

FEED

UNKNOWN

About the Role: Responsible for IOA insurance Claims Management activities including: client advocacy, service and communication, problem claim resolution, data analysis and action, monitoring triggered activities, claims reviews and audits, workers compensation claim oversight, reserve analysis, unit stat and stewardship reporting, client education and consulting, sales support, litigation process management, new client onboarding, intake process support, data management and entry, and Producer communication. Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity.

YEAR

DescriptionJob Description:Title: Claims Advocate – Risk ServicesFully remote | Experience/Book Focus: Commercial Auto, Trucking, Transportation, Property Cargo   Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity. Additionally, there may be occasions when on-site presence is necessary to meet specific business needs. Learn more about our locations here: <a href="https://ioausa.com/locations/" rel="nofollow noopener noreferrer" target="_blank">ioausa.com/locations</a> About the Role: Responsible for IOA insurance Claims Management activities including: client advocacy, service and communication, problem claim resolution, data analysis and action, monitoring triggered activities, claims reviews and audits, workers compensation claim oversight, reserve analysis, unit stat and stewardship reporting, client education and consulting, sales support, litigation process management, new client onboarding, intake process support, data management and entry, and Producer communication.   Key Responsibilities: <ul><li>Performance Standards: Meet all production, quality, and service expectations. </li></ul><ul><li>Client Service Excellence: Deliver outstanding service by anticipating client needs and responding promptly. </li></ul><ul><li>Client Advocacy: Serve as a dedicated advocate, providing high levels of ongoing support and consultation. </li></ul><ul><li>Problem Claim Resolution: Manage complex or delayed claims to ensure timely and favorable outcomes. </li></ul><ul><li>Loss Report Analysis: Review aggravated inequity loss reports and take appropriate corrective actions. </li></ul><ul><li>Activity Monitoring: Track triggered claim activities and implement necessary follow-up actions. </li></ul><ul><li>Claims Review & Auditing: Conduct and participate in formal claims reviews and audits. </li></ul><ul><li>Workers Compensation Oversight: Monitor workers compensation claims via the IOA Claims Portal and drive them to closure. </li></ul><ul><li>Reserve Accuracy: Perform reserve analysis to ensure timely and accurate case reserves in line with best practices. </li></ul><ul><li>Carrier Relationship Management: Build and maintain strong relationships with carriers to influence positive claim outcomes. </li></ul><ul><li>Claims Mediation: Act as an intermediary between clients and carriers to facilitate effective and timely resolutions. </li></ul><ul><li>Client Education: Provide ongoing education on statute changes, state-specific procedures, and claims best practices. </li></ul><ul><li>Trend Identification & Risk Mitigation: Identify claims trends, recommend risk mitigation strategies, and collaborate with Risk Advocates. </li></ul><ul><li>Sales Support: Assist with Producer presentations and contribute to sales efforts through claims insights. </li></ul><ul><li>Reporting & Documentation: Prepare and deliver stewardship and unit stat reporting in accordance with departmental standards. </li></ul>  Ideal Candidate Qualifications: <ul><li>5+ years of claims handling experience; preferred experience in an agency advocate or liaison role </li></ul><ul><li>Licensed Insurance Adjuster or state equivalent </li></ul><ul><li>Exceptional customer service, communication, multi-tasking, organizational, delegation, and decision-making skills </li></ul><ul><li>Ability to perform large work volumes with high accuracy </li></ul><ul><li>Proficiency in MS Office (Outlook, Word, Excel) </li></ul><ul><li>High School Diploma (or equivalent) </li></ul>  What We Offer: <ul><li>Competitive salaries and bonus potential </li></ul><ul><li>Company-paid health insurance </li></ul><ul><li>Paid holidays, vacations, and sick time </li></ul><ul><li>401K with employer match </li></ul><ul><li>Employee stock plan participation </li></ul><ul><li>Professional growth and career progression opportunities </li></ul><ul><li>Respectful culture and work/family life balance </li></ul><ul><li>Community service commitment </li></ul><ul><li>Supportive teammates and a rewarding work environment </li></ul>  What to Expect (Application Process): <ul><li>30-Minute Phone Screen, Online Assessments, and Interview(s) </li></ul>Salary Rangehe expected pay range for this position is $70,000 to $95,000 per year, depending on experience, relevant skills, and geographic location.Insurance Office of America is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Insurance Office of America

Claims Advocate - Risk Services (Trucking/Transportation)

Analysis Skills

Auditing

Best Practices

Cargo/Freight

Claims Management

Claims Processing

Consulting

Corporate Policies

Corrective Action

Customer Support/Service

Data Analysis

Data Entry

Data Management

Data Processing

Diversity

Documentation

Health Insurance

Insurance

Insurance Claims

Litigation

Microsoft Excel

Microsoft Office

Microsoft Outlook

Microsoft Word

Multitasking

Onboarding

Problem Solving Skills

Process Management

Relationship Management

Risk

Risk Analysis

Risk Management

Sales

Sales Management

Sales Support

Service Delivery

Stewardship

Stock Purchase Plans

Time Management

Trend Analysis

Trucking

Worker's Compensation

Jobvite Talemetry Organic Easy Apply

OTHER

The Targeted Case Manager Community Support Specialist is responsible for coordinating care and services for individuals who require assistance in accessing medical, social, and educational services due to mental health, substance use, or chronic health conditions. The role involves working with clients to develop and implement individualized care plans, ensuring they receive the necessary resources and support to improve their quality of life.

This position requires coverage for the following areas: Cambridge, Denton, Easton, Centreville, and Chestertown. The Targeted Case Manager Community Support Specialist is responsible for coordinating care and services for individuals who require assistance in accessing medical, social, and educational services due to mental health, substance use, or chronic health conditions. The role involves working with clients to develop and implement individualized care plans, ensuring they receive the necessary resources and support to improve their quality of life.Job Responsibilities:Client Assessment and Engagement: - Conduct comprehensive assessments of clients' needs, strengths, and goals. - Build trusting relationships with clients to identify their health and social service needs. - Evaluate client eligibility for various services and assist with referrals to appropriate resources.Care Coordination - Develop and implement individualized service plans (ISPs) in collaboration with the client and other stakeholders (family, healthcare providers, social services). - Coordinate and monitor services across various sectors, including healthcare, social services, education, and housing. - Advocate for the client's access to services, such as mental health treatment, housing, medical care, and vocational training.Collaboration and Communication - Act as a liaison between the client, healthcare providers, and other community organizations. - Collaborate with interdisciplinary teams (e.g., doctors, social workers, therapists) to ensure holistic care for the client. - Participate in care team meetings and provide updates on the client's progress and needs.Documentation and Reporting: - Maintain accurate, timely, and confidential client records, including assessments, case notes, and service plans. - Track and document progress toward client goals and adjust care plans as necessary. - Ensure compliance with all applicable regulations and reporting requirements for funding agencies.Crisis Management and Support: - Assist clients in managing crises, including mental health emergencies, housing instability, or legal issues. - Provide immediate interventions when necessary and coordinate emergency services when required.Client Advocacy and Education - Educate clients about their rights, available services, and community resources. - Advocate on behalf of clients to remove barriers to accessing services, including legal, economic, or social challenges.Qualifications:Education: High School Diploma - Master's degree in social work, psychology, counseling, or a related field. A master's degree is preferred.Experience:Previous experience in case management, social services, or healthcare settings is required. Experience working with underserved populations or individuals with mental health or substance use disorders is highly desirable.Licenses/Certifications: Depending on the state, licensure as a social worker (LCSW, LMSW) or case manager (CCM) may be required or preferred.Skills and Competencies:Strong understanding of healthcare, social services, and community resources. - Excellent interpersonal and communication skills. - Ability to work independently and as part of a multidisciplinary team. - Strong problem-solving and advocacy skills. - Familiarity with electronic health record (EHR) systems and case management software. - Ability to manage multiple cases and prioritize tasks effectively.Work Environment:The role may involve working in a healthcare setting, community-based organizations, or conducting home visits. - Occasional travel may be required to meet with clients or attend meetings.Requirements:Valid Driver's License, Clean driving record, Background check, and the ability to commute.COVID-19 considerations: ( When required) Masks, Handwashing, Temp Checks, Vaccinations Records, & Testing.Salary:Based on experience and qualifications. CompetitiveJob Types: Full-time, Part-timeBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Community Behavioral Health (CBH) is a not-for-profit 501c (3) corporation contracted by the City of Philadelphia to provide mental health and substance abuse services for Philadelphia County Medicaid recipients. Supported through state funding, CBH works in partnership with the City of Philadelphia and the Commonwealth of Pennsylvania to provide vital behavioral health services. Today, CBH is responsible for providing behavioral health coverage for the City’s 420,000 Medicaid recipients. Its primary activities include: <ul><li>Authorizing payment for behavioral health services</li> <li>Requiring provider agencies to deliver effective and medically necessary services</li> <li>Achieving management and operational efficiencies to lower healthcare costs</li></ul> CBH is located in Philadelphia’s historic center city district. We offer competitive salaries and liberal benefit package, including: <ul> <li>403(b) with 8% company match</li> <li>Medical HMO & HNO, Dental, Vision, and Pre ion Drug coverage, with low co-pays</li> <li>Basic and Supplemental Life & AD&D </li> <li>Generous paid time off, including holidays, vacation, personal and sick days</li> <li>Long-Term Disability</li> <li>Tuition Reimbursement</li> <li>Employee Assistance Program</li> <li>Transit Program</li> <li>Company Wellness Program</li> <li>Retiree Health Care</li> </ul> Most importantly, we offer an opportunity for dedicated professionals to have an immediate impact in the lives of the people we serve. Please review our web site at <a href="http://www.phila.gov/dbhids" target="_blank">www.phila.gov/dbhids</a> for more information about our company and to apply for positions.

Advocate Jobs in Dover, DE

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Advocate Jobs in Dover, DE

Claims Advocate - Risk Services (Trucking/Transportation) Insurance Office of America

Targeted Case Manager Community Support Specialist Community Behavorial Health

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