location_0_addressRegionName

location_0_addressCountryName

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UNKNOWN

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ADAPTED_NOW

Claims Representative

83547 83602 83604 83605 83607 83610 83611 83612 83615 83616 83617 83619 83622 83623 83624 83626 83627 83628 83629 83631 83632 83633 83634 83636 83637 83638 83639 83641 83642 83643 83644 83645 83646 83647 83648 83650 83651 83654 83655 83656 83657 83660 83661 83666 83669 83670 83671 83672 83676 83677 83686 83687 83702 83703 83704 83705 83706 83709 83712 83713 83714 83716. Physical agility to allow for: frequent lifting, carrying and climbing a ladder; ability to navigate roofs at various heights for inspection of both residential and commercial structures; ability to crawl in tight spaces.

KBSkills

ACTIVE

Claim Specialist - Property Field Inspection US-ID-Meridian Job ID: 2025-40375 Type: Regular Full Time # of Openings: 2 Category: Claims and Investigation Meridian, ID Overview Being good neighbors – helping people, investing in our communities, and making the world a better place – is who we are at State Farm. It is at the core of how we operate and the reason for our success. Come join a #1 team and do some good! Responsibilities Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-related claims for homeowners, commercial properties, and large losses. We are looking for an experienced and highly skilled professional to contribute to our dynamic team. You will be the first point of contact to meet with our insureds, explain coverage, estimate damages, and help them through the claims process while providing Remarkable service. Key Responsibilities:<ul><li>Conduct on-site inspections and assessments of property damages for both residential and commercial claims</li><li>Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently </li><li>May occasionally require interacting with parties who express strong emotions or concerns about ongoing inspections or claim resolutions </li><li>Provide exceptional customer service throughout the claims process, addressing inquiries and concerns promptly and professionally</li><li>Gather necessary evidence, document findings, and prepare detailed reports to support the claims handling process</li><li>Investigate and adjust both personal and commercial property claims with exposures up to $500,000</li><li>Evaluate coverage and policy terms to determine the validity of claims and ensure compliance with local regulations</li><li>Negotiate and settle claims within the authorized limits, considering policy provisions, industry standards, and company guidelines</li></ul>Where you'll work: This position is located in Meridian/Boise, ID. Competitive candidates should reside within a commutable distance of this territory and is responsible for servicing these zip codes:83547 83602 83604 83605 83607 83610 83611 83612 83615 83616 83617 83619 83622 83623 83624 83626 83627 83628 83629 83631 83632 83633 83634 83636 83637 83638 83639 83641 83642 83643 83644 83645 83646 83647 83648 83650 83651 83654 83655 83656 83657 83660 83661 83666 83669 83670 83671 83672 83676 83677 83686 83687 83702 83703 83704 83705 83706 83709 83712 83713 83714 83716This is a Remote-Field position in which you will work from home and utilize a mobile office/vehicle for in-person appointments. Although the primary work location is in the field, with a commutable distance from home, there will be opportunities for virtual work to be completed at home. Additionally, there may be occasions where you will be required to travel outside your assigned area to assist in other territories. Hours of operation are continually evaluated and may change based on business need. Successful candidates are able and willing to work flexible schedules and may be asked to work overtime and/or irregular hours. Qualifications Competitive candidates must demonstrate:<ul><li>Experience as a Property Field Inspection Claim Specialist in the insurance industry, specifically in property claims</li><li>Strong knowledge of property insurance policies, coverage and claim handling practices</li><li>Knowledge of both residential and commercial building construction</li><li>Familiarity with local regulations and compliance requirements in your assigned territory</li><li>Excellent communication and interpersonal skills to effectively interact with clients, agents, and other stakeholders</li><li>Proven effective communication skills to handle difficult/emotional conversations with a customer-minded focus</li><li>Proven ability to assess damages, estimate repair costs, and negotiate settlements</li><li>Detail-oriented with strong organizational and analytical skills</li><li>Proficient in using claims management software and other relevant tools </li><li>Physical agility to allow for: frequent lifting, carrying and climbing a ladder; ability to navigate roofs at various heights for inspection of both residential and commercial structures; ability to crawl in tight spaces</li><li>May be required to complete Rope and Harness Safety Training.</li><li>A valid driver's license is required</li></ul>Preferred:<ul><li>Bachelor's Degree in a related field or equivalent work experience</li><li>Experience in handling complex or high-value claims</li><li>Construction background</li><li>Water mitigation inspection experience</li><li>Xactimate, XactContents</li></ul>Additional Details:<ul><li>Employees must successfully complete all required training, including applicable licensing exam(s) and background checks required of various state(s).</li><li>State Farm recently implemented new pre-employment assessments. Candidates that have previously taken an assessment may be asked to participate in additional testing.</li></ul> PI264986521

Customers and communities rely on us to help them face life's uncertainties. They come to us for guidance with insurance needs, financial planning, and strengthening the community.

State Farm

Claim Specialist - Property Field Inspection

Analysis Skills

Claims Management

Claims Processing

Commercial Construction

Commercial Real Estate

Communication Skills

Construction

Cost Estimates

Customer Relations

Customer Support/Service

Data Collection

Detail Oriented

Driver's License

Home Inspections

Industry Standards

Insurance

Interpersonal Skills

Maintain Compliance

Mobile Plant/Equipment

Negotiation Skills

Operational Audit

Organizational Skills

Policy Evaluation

Property Insurance

Regulatory Compliance

Reporting Skills

Residential Construction

Site Evaluation

Willing to Travel

Work From Home

Medical Director

Lead a team/organization of 10 associates across three functions: Education of Humana's Market-based associates on how to drive accurate reporting through provider education; Provider communications; policies and procedures aligned to those functions. The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can contribute to Humana's national planning and operations for Risk Adjustment, Stars, and Interoperability.

<h3>AVP Stars and Risk Adjustment National Medical Director</h3>Location: Meridian, ID, United StatesPosted on: Apr 28, 2023ProfileThe Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can contribute to Humana's national planning and operations for Risk Adjustment, Stars, and Interoperability. Specifically, this role will carry a set of individual contributor and leadership responsibilities.Responsibilities<ol><li>Inform HQRI's provider strategy and increase adoption of Humana's Stars, MRA, and interoperability strategy and programs.</li><li>Lead a team/organization of 10 associates across three functions: Education of Humana's Market-based associates on how to drive accurate reporting through provider education; Provider communications; policies and procedures aligned to those functions.</li><li>Serve as HQRI's clinical industry representative (e.g., Conferences; national vendor or provider partners).</li><li>Serve as a coding expert, which may include working through escalations on coding disputes, policy development or refinement, and coordination and education with providers or Humana associates.</li></ol>Required Qualifications<ol><li>MD or DO degree.</li><li>A current and unrestricted license in at least one jurisdiction.</li><li>Board Certified in an approved ABMS Medical Specialty.</li><li>Excellent communication skills, both written and verbal.</li><li>5 years of established clinical experience.</li><li>Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products.</li><li>Must be passionate about healthcare quality and contributing to an organization focused on maintaining accuracy of coding and documentation to capture the true health status of our members through risk adjustment initiatives.</li><li>Experience with quality assurance and/or regulatory compliance.</li><li>Travel up to 25%.</li></ol>Preferred Qualifications:<ol><li>Certification in diagnosis coding (must receive AAPC certification within one year of hire).</li><li>Ability to help develop and use data and analytics to drive sustainable results.</li><li>External communications for physicians and healthcare providers.</li><li>Prior experience leading teams focusing on the accuracy of medical record documentation and diagnosis coding.</li><li>Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.</li><li>Working knowledge of risk adjustment concepts.</li><li>Internal Medicine, Family Practice, Geriatrics, OBGYN, Hospitalist clinical specialty.</li><li>Detail oriented and effective listener.</li><li>Experience with Stars, including HEDIS, CAHPS and HOS.</li><li>Prior experience in a business function or business consulting role.</li></ol>Additional Information:Vaccine Policy: Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.Scheduled Weekly Hours: 40Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.
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CLevelCrossing

AVP Stars and Risk Adjustment National Medical Director

Clinical Medicine

Conferences

Consulting

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

Data Analysis

Documentation

Family Medicine

Geriatrics

Health Insurance

Healthcare Effectiveness Data and Information Set (HEDIS)

Healthcare Providers

Healthcare Quality

Hospital

Insurance Regulations

Internal Medicine

Interoperability

Leadership

Managed Care

Medicaid

Medical Coding

Medical Records

Medicare

Negative Testing

Obstetrics and Gynecology

Operations Planning

Policy Development

Presentation/Verbal Skills

Quality Assurance

Risk

Team Lead/Manager

Training/Teaching

Writing Skills

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