claims account specialist

Hartford HealthCare

<div>Location Detail: 9 Farm Springs Rd Farmington (10566)
Work where every moment matters. 
 
Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut&rsquo;s most comprehensive healthcare network. 
 
The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. 
With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. 
Position Summary:
Under the direction of Patient Financial Service (PFS), Accounts Receivable (AR) or Claims Supervisor, assure timely and accurate submission of claims on UB04 or HCFA1500 (bills), monitor responses from clearinghouse, review Electronic Fund Transmission (EFT) responses, respond on underpayments or overpayments via payer portal, payer chat or payer customer service, analyze claim adjustment reason codes, analyze remittance advice remark codes and any revenue cycle activities associated with outstanding insurance balances across all Hartford HealthCare hospitals, medical group and homecare. These duties include the managing of the day-to-day work queue inflow, dashboard monitoring, weekly aging&rsquo;s, Work in Progress (WIP), account activity assignment, and internal department collaboration with daily productivity and quality standards that are tracked and monitored. 
Support and perform high level AR &amp; Denial Specialist tasks to improve operations and problem solve by developing solutions after analyzing data. Maintains a high-level understanding of the operational aspects of the entire revenue cycle as well as the appropriate measures to take in resolving claim issues with payers. This position is responsible for researching insurance company issues, such as network problems, work comp claims, and a variety of special projects. 
Keeps abreast of all regulations and standards to ensure compliance with governmental/regulatory agencies or commercial payers. Assists the organization to comply with all federal/state guidelines. 
Responsible to ensure high quality, cost-effective products or services are delivered in support of the HHC core values, strategic plan and established Patient Financial Services goals and objectives which is not limited to HHC receiving the appropriate payment. 
Position Responsibilities:
Key Areas of Responsibility
Functions as a high-level member of the team that is responsible for the timely cash collections of insurance payments for approximately $550+ million in active inventory and $70 million in denials.
When a claim is denied;
A. Takes appropriate action for payment resolution; documents all activity in accordance with standard work
B. Initiates, updates, resolves denials and payment variances and takes action to resolve account including drafting and submitting appeals, identifying specific reason for underpayments, denials and cause of payment delays. Maximizes insurance reimbursement timely with commercial and governmental payers
C. Resolves denials based on contract and/or fee schedule.
D. Performs due diligence in reconciling outstanding balances ensuring all efforts have been exhausted in resolving issues with payers prior to write-off.
E. Leverages available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolution; documents all activity in accordance with standard work
F. Prepares research and documentation in preparation for meetings with provider reps that will assist in resolution of payer specific issues.
G. Works with leadership to identify, trend and address root causes of issues in the AR.
H. Improves quality and productivity by identifying opportunities and assisting with workflow changes
I. Assists in development of standard work to improve accuracy and understanding of processes.
J. Consistently exceeds productivity and quality performance expectations.
Effectively and continually communicates with peers, management and customers to facilitate the flow of information. Demonstrates H3W Leadership Behaviors.
Actively seeks opportunities to model teamwork through collaboration both within and outside the workgroup in support of the organization&rsquo;s objectives.
Assumes responsibility for self-improvement in collaboration with superior.
Maintain effective positive customer service, ensuring the needs are met and educating staff on the importance of quality customer service.
Provides support for other ad hoc analyses and projects as needed
Provide team support during team vacations and unexpected absence
Training support for onboarding of new colleagues.
Functions as Daily Huddle Leader
Performs other duties as assigned 
Working Relationships:
This Job Reports To: AR Follow Up/Denials Supervisor
If applicable, describe nature of supervision of any External vendors, contractors, affiliate organizations, etc.:
Assist supervisor with the tracking and monitoring of accounts receivables engagements with small balance, out of state Medicaid and credit vendors as needed.<h3 class="jobSectionHeader"> 
Qualifications</h3> 

Education<ul><li> Minimum: High school diploma, GED or equivalent</li><li> Preferred: Associate&rsquo;s degree in health care administration, business management or finance.</li></ul>
Experience<ul><li> Minimum: 3 years medical billing or accounts receivables in a medical facility or professional healthcare revenue cycle setting and/or banking experience</li><li> Preferred: 4+ years of medical billing and/or accounts receivables experience in a large facility or professional healthcare revenue cycle setting.</li></ul>
Licensure, Certification, Registration<ul><li> American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) certification</li></ul>
Knowledge, Skills and Ability Requirements<ul><li> Epic experience and working knowledge of Resolute Hospital and Professional billing modules preferred</li><li> Understanding of medical and insurance terminology, facility and professional billing/reimbursement practices.</li><li> Familiar with CPT, revenue codes and ICD10 codes</li><li> Excellent analytical and problem solving skills</li><li> Excellent communication skills both written and verbal and interpersonal skills</li><li> Knowledge of state and federal regulations as they pertain to billing processes and procedures</li><li> Knowledge of insurance claim processing and third party reimbursement</li><li> Knowledge and understanding of negotiated agreements</li><li> Demonstrated leadership in establishing and achieving goals</li><li> Ability to communicate effectively both orally and in writing, strong computer and math skills required</li><li> Skill in problem solving in a variety of settings</li><li> Skill in time management</li><li> Ability to work efficiently under pressure</li><li> Ability to operate a computer and related applications such as Word, Excel, PowerPoint, etc.</li><li> Ability to work independently and take initiative</li><li> Ability to demonstrate a commitment to continuous learning and to operationalize that learning</li><li> Ability to deal effectively with constant changes and be a change agent</li><li> Ability to deal effectively with difficult people and/or difficult situations</li><li> Ability to willingly accept responsibility and/or delegate responsibility</li><li> Ability to set priorities and use good judgment for self and peers</li><li> Ability to exercise independent judgment in unusual or stressful situations</li><li> Ability to establish and maintain effective working relationships</li></ul> 
We take great care of careers. 
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge &ndash; helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.</div>

Accts Rec & Denial Spec 2 / PA Third Party Follow Up

North East Medical Services

<div>SUMMARY OF POSITION: 
The Patient Account Specialist I interprets EOBs for correct payment verification, adjustments, and denials. The Patient Account Specialist I is also responsible for handling outstanding claims on aging reports and resolving patient inquiries regarding billing statements and insurance overage-related matters. The Patient Account Specialist I has to maintain up-to-date knowledge about CPT, ICD-10 CM, billing regulations, and payers' requirements. The Patient Account Specialist I has to comply with HIPAA guidelines and maintain confidentiality regarding patient account status and the organization's financial affairs.
<h1 class="jobSectionHeader">ESSENTIAL JOB FUNCTIONS:</h1><ul><li>
Reviews, edits, processes, and submits electronic and hardcopy claims to various payers (Medicare, Medicaid, Managed Care, and Private Insurance) for FQHC (Federally Qualified Health Centers) and FFS (Fee-For-Service) reimbursement, ensuring accuracy of payment entries and completeness of charge capture information.</li><li>
Maintains up-to-date knowledge of medical billing requirements for FQHC Medi-Cal, Medicare, state, local programs, and private insurance payers.</li><li>
Reports issues or payment trends (e.g., charges applied to the wrong visit, incorrect billing codes) to the supervisor for resolution.</li><li>
Edits charge/claim details and corrects submission errors to ensure accuracy.</li><li>
Researches and resolves outstanding claims on aging reports to minimize delays in reimbursement.</li><li>
Responds to payer requests and remittance advices promptly and professionally, including phone calls, letter responses, appeals, and submission of medical records or additional information as required.</li><li>
Under the guidance of the Patient Account Specialist II, addresses patient inquiries and billing complaints by making necessary adjustments, exploring all options to secure claim payments, referring complex issues to appropriate staff, and ensuring proper follow-up.</li><li>
Posts charges and submits claims for NEMS physicians&rsquo; hospital visits.</li><li>
Provides training and support to the Billing Department and front desk staff in Member Services, Medical, Dental, Optometry, Laboratory, and Radiology Departments.</li><li>
Adheres to policies and procedures for billing records retention.</li><li>
Acts as a liaison between physicians, insurance companies, and third-party organizations by processing and verifying invoices, ensuring claim reimbursements, and auditing patient accounts.</li><li>
Performs additional duties as assigned by management.</li></ul><h1 class="jobSectionHeader">
</h1><ul><li>Completion of an AA/AS degree is required, and a 4-year university diploma is preferred or maybe substituted with a minimum of 3 years of work experience in healthcare.
</li><li>Working experience in a healthcare or FQHC setting is preferred</li><li>
Working experience with Epic PB Resolute is preferred</li><li>
Familiar with Medicare, Medicaid, Private insurances, Managed Care (HMO &amp; PPO), CPT, and ICD-10 CM</li><li>
Must have excellent analytical and communication skills</li><li>
Must be proficient in computer skills</li><li>
Ability to write business correspondence</li><li>
Strong organizational skills to coordinate multiple, varied billing processes simultaneously</li><li>
Upholds high customer service standards in a demanding and complex health care organization</li><li>
Demonstrates initiative, resourcefulness, integrity and dedication to timeliness to achieve high customer satisfaction levels</li>
Self-motivated, diligent, organized, resourceful, responsible, and enthusiastic 
<li>
</li></ul>LANGUAGE:<ul><li>
Proficient in written and spoken English and Chinese (Cantonese and/or Mandarin)</li>
Fluent in other languages is an asset 
<li>
</li></ul>STATUS:<ul><li>
This is an FLSA Non-exempt position.
</li><li>This is not an OSHA high-risk position.</li>
This is a Full Time position. 
<li>
</li></ul>NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).</div>

PATIENT ACCOUNT SPECIALIST I

Renown Health

<div>
 
 Position Purpose
 
 
 
 The Insurance and Claims Specialist will review and correct claim errors ensuring accurate, timely claim submission and account follow-up to assigned payors and reimbursement on first claim submitted. The Specialist will appeal healthcare claims denied by third-party payors to obtain reimbursement and handle difficult, hard to collect accounts that have been deemed by the insurance company as unpayable. The Specialist will conduct analysis and resolve incorrect reimbursement issues and credit balance resolution with payors. This position is responsible to know all state/federal regulations that relate to contracts and to the appeal process and/or government payor billing and follow-up regulations to include CCI, LCD/NCD and medical necessity rules.
 
 
 
 Nature and Scope
 
 
 
 
 The Insurance And Claims Specialist Is Responsible For
 
 
 
 <ul>
 <li>
 Work assigned Work Queues to correct errors, ensuring accurate claims and reimbursement on first claim submission.
 </li>
 <li>
 Audit denials and payment variances to determine root cause and correction as required.
 </li>
 <li>
 Auditing payment variances ensuring appropriate reimbursement.
 </li>
 <li>
 Provide specific and in depth contract knowledge to ensure maximum reimbursement of healthcare claims.
 </li>
 <li>
 Resolve credit balances by reviewing payments, adjustments or transfers correcting the patient account to reflect an accurate account receivable balance.
 </li>
 <li>
 Work with leadership and other internal departments to improve processes, increase accuracy, create efficiencies and decrease denials to achieve the overall goals of Renown Health.
 </li>
 <li>
 Maintain a current knowledge of CPT/HCPCS, ICD, DRG, HCFA forms, ability to manipulate and analyze 837 and all other HIPAA transaction sets.
 
 
 </li>
 </ul>
 This position is required to operate within policy and procedural guidelines that will ensure accurate accounts receivable reporting and is compliant with policy and procedural guidelines consistent with Renown Health goals and objectives.
 
 
 This position does not provide patient care.
 
 
 
 Disclaimer
 
 
 
 The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
 
 
 
 Minimum Qualifications
 
 
 
 Requirements - Required and/or Preferred
 
 
 
 Name
 
 
 
 
 Description
 
 
 
 Education:
 
 
 Must have working-level knowledge of the English language, including reading, writing and speaking English. Associates degree preferred.
 
 
 
 Experience
 
 
 
 One year healthcare billing office experience with extensive knowledge of healthcare billing, government and third party payor requirements. Associate degree or certification in accredited billing certification may be accepted in lieu of years of experience.
 
 
 
 License(s)
 
 
 
 None.
 
 
 
 Certification(s)
 
 
 
 None.
 
 
 
 Computer / Typing
 
 
 
 Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
</div>

Insurance and Claims Specialist

National Truck Protection

<div>Position Summary:
The Concierge Claims Specialist is responsible for managing the end‑to‑end claims experience for strategic, high‑profile business partners and fleet customers. This role functions as a relationship manager and trusted advisor, delivering a white‑glove, account‑management approach to claims handling for medium‑ and heavy‑duty commercial vehicle service contracts. Serving as the primary liaison between elite partners, fleet customers, executive stakeholders, repair vendors, and internal leadership, the Concierge Claims Specialist exercises independent judgment to adjudicate diesel and engine‑related failures, proactively manage claim outcomes, and align claims strategies with partner expectations and organizational goals. 
Key Responsibilities
Strategic Account &amp; Relationship Management:<ul><li>
Serve as the primary account manager and point of contact for assigned strategic partners, fleet customers, and elite business accounts.</li><li>
Build and maintain strong working relationships with partner representatives, fleet managers, and senior customer contacts to ensure confidence in the claims process.</li><li>
Deliver a high‑touch, concierge‑level service experience, tailored to partner‑specific service standards and operational needs.</li><li>
Represent the organization professionally in escalated or sensitive claim situations, reinforcing trust, transparency, and brand values.</li></ul>
Claims Evaluation &amp; Decision‑Making:<ul><li>
Independently manage the full lifecycle of complex and high‑visibility claims, from first notice through resolution and payment.</li><li>
Analyze and adjudicate diesel, gas engine, and component failures in accordance with vehicle service contract terms, coverage interpretations, and authority guidelines.</li><li>
Evaluate diagnostic findings, ECM data, repair estimates, maintenance histories, and supporting documentation to determine coverage applicability and repair scope.</li><li>
Exercise discretion and judgment to approve, modify, or deny claims and related expenses within delegated authority.</li></ul>
Negotiation &amp; Cross‑Functional Coordination:<ul><li>
Collaborate with repair facilities, vendors, parts suppliers, and internal teams to validate failures, negotiate repair terms, and expedite resolutions to minimize fleet downtime.</li><li>
Lead negotiations related to repair scope, labor times, and parts pricing, balancing cost control with partner satisfaction.</li><li>
Coordinate internally with leadership, technical teams, and management to resolve non‑standard, high‑impact, or escalated claims.</li></ul>
Strategic Insight &amp; Continuous Improvement:<ul><li>
Monitor and analyze claim trends, recurring issues, and cost drivers across assigned accounts or fleets.</li><li>
Provide actionable insights and recommendations to leadership regarding service improvements, claim strategies, and product or process enhancements.</li><li>
Participate in partner‑specific calibration calls, training sessions, and joint initiatives to ensure alignment with performance expectations and service metrics.</li><li>
Maintain comprehensive and accurate documentation of all claim activity and partner interactions.</li><li>
Provide professional updates, reporting, and recommendations to upper management to support informed decision‑making.</li><li>
Ensure all claims handling activities comply with company policies, contractual obligations, regulatory requirements, and industry best practices.</li></ul> 
Qualifications<ul><li>
3+ years of experience in claims handling, account management, warranty administration, vehicle service contract adjudication, insurance, fleet manager or a related customer‑facing professional role.</li><li>
Demonstrated experience managing high‑profile customers, strategic accounts, or fleet relationships.</li><li>
Hands‑on experience with diesel engine claims or medium/heavy‑duty commercial vehicle environments strongly preferred.</li><li>
Proven ability to exercise independent judgment in resolving non‑routine, complex, or escalated issues.</li><li>
Strong negotiation, communication, and relationship‑management skills, with the ability to influence outcomes at multiple organizational levels.</li><li>
Ability to manage competing priorities while maintaining a high standard of service in a fast‑paced environment.</li><li>
Proficiency with claims management systems and Microsoft Office Suite.</li><li>
Associate&rsquo;s degree or higher, or completion of a technical or trade program, preferred.</li></ul></div>

Concierge Claims Specialist

Old Republic International

<div>WHO ARE WE? 
Old Republic Surety Company underwrites contract, fidelity, and commercial bonds, serviced through a strong and partnered network of independent insurance agencies. Solutions provided include bid bonds, performance and payment bonds, and maintenance bonds for large, middle market and smaller growing contractors. ORSC consistently offers superior service and creative underwriting options in all 50 states and some of the U.S. territories.
ORSC continues to expand it geographic footprint and product offering while consistently delivering significant, market-leading growth and maintaining a strong underwriting margin.<div>
Are you ready to take your career to the next level as a Claims Specialist with a company known for stability, expertise, and integrity? At Old Republic Surety Company, we&rsquo;re looking for a driven and detail-oriented Claims Specialist who thrives in a fast-paced environment and is passionate about delivering fair, timely, and strategic claim resolutions.</div><div></div><div> 
</div><div>
As a Claims Specialist, you&rsquo;ll play a role in protecting our clients and our business by managing complex commercial surety claims from investigation through resolution.</div><div></div><div> 
</div><div>
We&rsquo;re seeking a Claims Specialist who is analytical, proactive, and confident in decision-making. If you enjoy interpreting complex legal documents, negotiating outcomes, and collaborating with professionals across industries, this role is designed for you.</div><div>
</div><h3 class="jobSectionHeader">
What You&rsquo;ll Do as a Claims Specialist</h3><ul><li>
Ensure equitable claim service is performed in a timely and professional manner involving commercial surety claims</li><li>
Interpret bond language to determine company liability and identify issues requiring escalation</li><li>
Coordinate investigations, working closely with internal teams and external partners</li><li>
Evaluate resolution strategies and recommend effective courses of action</li><li>
Establish and maintain appropriate reserves while proactively mitigating loss</li><li>
Negotiate and settle claims within authority limits, clearly communicating liability decisions</li><li>
Develop surety defenses and manage complex coverage issues</li><li>
Pursue salvage opportunities, including indemnification and subrogation efforts</li><li>
Control Loss Adjustment Expenses through strategic use of attorneys, consultants, and accountants</li></ul><h3 class="jobSectionHeader">
What You Bring</h3><div>
As a successful Claims Specialist, you combine technical expertise with strong communication and organizational skills. You&rsquo;re comfortable working independently while managing multiple priorities with precision.</div><ul><li>
High School Diploma or equivalent required</li><li>
Minimum 2 years of related experience or 3 years in insurance claims</li><li>
Strong ability to interpret complex legal and financial documents</li><li>
Excellent negotiation and communication skills</li><li>
Proficiency with Microsoft Office and computer systems</li><li>
Exceptional attention to detail and organizational abilities</li><li>
Ability to maintain confidentiality and exercise sound judgment</li><li>
Strong proofreading and recordkeeping skills</li></ul>
COMPANY BENEFITS
Financial:<ul><li>
Competitive salary</li><li>
401k Savings &amp; Profit-Sharing Plan, including company match contribution</li><li>
Roth investment options</li><li>
529 Education Savings Plan</li><li>
Employee Referral Bonus Program</li></ul>
Health:<ul><li>
Health Insurance</li><li>
Dental Insurance</li><li>
Flexible Spending &amp; Health Savings Account options</li><li>
Life Insurance</li><li>
Vision Insurance</li><li>
Supplement Life Insurance</li><li>
Long-Term Disability Insurance</li><li>
Paid Leave of Absence Benefits</li><li>
Accident &amp; Critical Illness Insurance</li><li>
Pet Insurance</li></ul>
Work-Life Balance:<ul><li>
37.5 hour standard work week</li><li>
Casual business attire</li><li>
Generous paid time-off (PTO)</li><li>
Paid holidays</li><li>
Volunteer opportunities</li><li>
Company-sponsored events and outings</li></ul><div><div><div><div>
#LI-VG1</div></div></div></div>
Old Republic Surety Company is an Equal Opportunity Employer and is committed to maintaining a diverse workplace.</div>

Claims Specialist, Commercial

lonestar

<div>As an Auto Bodily Injury Claims Specialist and embrace a role that offers the thrill of tackling complex cases while championing customer well-being. You'll be empowered to innovate solutions, ensuring clients receive the support they truly deserve. The position's work-from-home flexibility allows you to create your ideal work environment, promoting a healthy work-life balance without sacrificing productivity. Contribute to a fun and energetic team that thrives on high performance and forward-thinking ideas.
Your empathetic approach and problem-solving skills will shine as you build meaningful connections while resolving claims efficiently. With Lonestar, you'll not only advance your career but also make a positive impact in the lives of others. You will be provided great benefits such as Medical, Dental, Vision, 401(k), Life Insurance, Health Savings Account, Flexible Spending Account. Commitment to Training &amp; Development, Competitive Salary, and Paid Time Off. Take the leap and bring excellence and integrity to the forefront of our claims process!<h3 class="jobSectionHeader">
WHAT WOULD YOU DO AS A AUTO BODILY INJURY CLAIMS SPECIALIST</h3>
As an Auto Bodily Injury Claims Specialist at Lonestar, you can expect a dynamic day filled with engaging responsibilities and meaningful client interactions. Each day will involve reviewing and assessing new claims, investigating details, and communicating with policyholders to gather necessary information. You'll collaborate with medical professionals to evaluate claims and determine appropriate compensations, using your problem-solving skills to navigate complex situations.
Your schedule will be Monday to Friday, either from 8 AM to 5 PM or 8:30 AM to 5:30 PM, after training, this position is hybrid (3 days in-office/2 days work from home), allowing you ample time to focus, strategize, and innovate. You'll participate in regular team meetings to share insights, ensuring everyone stays aligned and empowered to provide exceptional customer service. Expect an energetic environment where your contributions matter, and every day brings new challenges and opportunities to excel!<h3 class="jobSectionHeader">
DOES THIS SOUND LIKE YOU?</h3>
To thrive as an Auto Bodily Injury Claims Specialist at Lonestar, you will need a blend of technical knowledge and superior interpersonal skills. With 3-5 years of experience in Auto Bodily Injury/Casualty claims, you should possess a Texas Licensed Adjuster certification and familiarity with multi-state licensing is a plus. Proficiency in legal and medical terminology will aid in conducting thorough investigations and preparing accurate claim evaluations. Strong negotiation and analytical skills are essential for effectively resolving claims and presenting them for settlement authority. You should be comfortable in an automated claims processing environment, utilizing various software tools to document policy status, coverage, liability, and damages accurately.
A knack for organization and the ability to maintain positive relationships with customers, co-workers, and third parties will be key to your success. You will also benefit from knowledge of fraud reduction practices and state-specific regulations, ensuring a compliance-driven approach to your role.
Knowledge and skills required for the position are:<ul><li>
Review &amp; determine course of action on each file assigned</li><li>
utilizing technical knowledge &amp; experience for the purpose of supporting final disposition of a loss.</li><li>
Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage</li><li>
liability status</li><li>
and damages that are applicable for each claim.</li><li>
Process Bodily Injury</li><li>
and coverage claims in accordance with established office procedures.</li><li>
Work closely with Third Parties</li><li>
plaintiff counsel and Claims Director to determine necessary injury and coverage investigation.</li><li>
Research case and statutory law in order to conduct proper claim investigation.</li><li>
Document policy status</li><li>
coverage</li><li>
liability and damages on all claims and notify re-insurer on qualifying claims.</li><li>
Prepare and present claim evaluations for the appropriate settlement authority.</li><li>
Maintain reasonable expense factors.</li><li>
Handle other duties as assigned.</li></ul>
QUALIFICATIONS REQUIRED:<ul><li>
Minimum of 3-5 years in Auto Bodily Injury/Casualty claims experience a MUST!</li><li>
Texas Licensed Adjuster - All Lines is required (Multi-State licensing is preferred)</li><li>
Non-Standard insurance experience a plus, not required</li><li>
Bi-lingual a preferred but not required!</li><li>
Knowledge of legal and medical terminology.</li><li>
Excellent negotiation, analytical, organizational, and interpersonal and communication (verbal, written, and phone) skills.</li><li>
Strong skills in the areas of verbal and written communication with an ability to develop and maintain positive customer experience, co-worker, management and third-party relationships.</li><li>
Experience in an automated claims processing work environment</li><li>
Knowledge of fraud reduction practices</li><li>
General working knowledge of policies</li><li>
file procedures</li><li>
state rules and regulations.</li><li>
Ability to pass written examinations where required by state statutes to become a licensed Claims Adjuster.</li></ul><h3 class="jobSectionHeader">
MAKE YOUR MOVE</h3>
If this sounds like the right job for you, don't wait - apply today to join our team. We look forward to hearing from you!</div>

Auto Bodily Injury Claims Specialist

Liberty Mutual Insurance

<div>Description
<div>Under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Assists in providing service to policyholders/customers on mid-sized and/or large commercial accounts. 
Training is a critical component of your success, and that success starts with reliable attendance. Attendance and active engagement during training are mandatory. Training will require 1 week in our Plano, TX office onsite in July 2026. 
To be considered for this position, candidates must reside within 50 miles of Hoffman Estates, IL, or Indianapolis, IN, and will be required to work in the office twice a month. Candidates located in Ohio, Montana, Virginia and Minnesota are eligible for 100% remote work, as we do not have claims offices in these states. Please note that this policy is subject to change. 
Responsibilities 
<ul><li>
Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly.</li><li>
Establishes action plans based on case facts, best practices, protocols, jurisdictional issues and available resources.</li><li>
Manages an inventory of property/casualty and disability claims (e.g. workers` compensation, general liability, commercial automobile, property, group benefits), evaluates compensability/liability and losses, and negotiates settlements within prescribed limits.</li><li>
Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols.</li><li>
Confirms or denies coverage based on facts obtained during the investigation and advises policyholders as to proper course of action.</li><li>
Makes effective use of loss management techniques (e.g. Immediate Contact Plan, L9 check, Disability Management, open end release, first call settlements) and other resources.</li><li>
Updates files and provides comprehensive reports as required.</li></ul></div>
Qualifications<div><ul><li>
Effective interpersonal, analytical and negotiation abilities required</li><li>
Ability to provide information in a clear, concise manner with an appropriate level of detail</li><li>
Demonstrated ability to build and maintain effective relationships</li><li>
Demonstrated success in a professional environment; success in a customer service/retail environment preferred</li><li>
Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent</li><li>
Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory</li><li>
Licensing may be required in some states</li></ul></div>
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. 
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. 
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://www.libertymutualgroup.com/about-lm/careers/benefits 
 
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. 
 
Fair Chance Notices<ul><li>
California</li><li>
Los Angeles Incorporated</li><li>
Los Angeles Unincorporated</li><li>
Philadelphia</li><li>
San Francisco</li></ul></div>

Associate Claims Specialist

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