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claims adjuster

Reserv

<div>
 
 About Reserv
 
 
 
 Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike. We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can't wait to meet you.
 
 
 
 Requirements
 
 
 
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 Minimum 5 years of experience in commercial transportation, with a focus on delivery and/or courier 1st party and 3rd party claims.
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 Active licensure, home state or designated home state
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 Willingness to obtain all relevant licenses within 45 days of hire
 
 
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 About The Role
 
 
 
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 We are seeking highly organized and customer-focused Commercial Transportation Physical Damage Claims Adjusters to join our team. The successful candidate will be responsible for speaking to customers on the phone, educating and helping the customer work through their claim to the best possible outcome. Your role will also be responsible for handling an inventory of claims, triaging critical claims, and delivering service to all constituents of the claim.
 
 
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 The ideal candidate has a willingness and experience to work with all parties attendant to a claim to quickly achieve optimal claim results.
 
 
 
 Who You Are
 
 
 
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 Highly motivated and growth-oriented. You're excited by the prospect of being part of a tech-driven claims organization.
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 Passionate claim professional who cares about the customer and their experience.
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 Empathetic. You exercise empathy and patience towards everyone you interact with.
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 Sense of urgency - at all times. That does not mean working at all hours.
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 Creative. You can find the right exit ramp (pun intended) for the resolution of the claim that is in the insured's best interest.
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 Conflict-enjoyer. Conflict does not have to be adversarial, but it HAS to be conversational.
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 Curious. You have to want to know the whole story so you can make the right decisions early and action them to a prompt resolution.
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 Anti-status quo. You don't just wish things were done differently, you action on it.
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 Communicative. (we'd love to know what this means to you)
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 And did we mention, you have a sense of humor. Claims are hard enough as it is.
 
 
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 What You'll Do
 
 
 
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 Provide prompt, courteous and high-quality customer service to all policyholders and claimants by responding to customer inquiries, initiating investigations and resolving customer claims.
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 Gather necessary information from customers to initiate the claim and explain policy, coverage, and appropriate course of action
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 Manage an inventory of claims, establish initial reserves for all potential exposures, and adjust as appropriate throughout the claim
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 Coordinate the repair of damaged vehicles and assist with rental reimbursement
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 Recognize recovery opportunities in regards to subrogation and salvage, as well as total loss
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 Ensure compliance with specific state regulations, policy provisions, and standard operating procedures
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 Communicate with involved parties and negotiate appropriate settlements with claimants, insureds, and attorneys within approved payment authority
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 Provide input for continuous development of claims guidelines, best practices, and process improvements
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 Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to resolve the claim
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 Engage in learning opportunities to build knowledge of personal lines claims, court decisions impacting the claims function, current guidelines in claims function, and policy changes and modifications
 
 
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 Qualifications
 
 
 
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 Active insurance adjuster's license by way of a designated home state, or home state
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 Minimum of 5 years of experience on commercial transportation claims, ideally in the delivery/ courier space, dealing with First-Party and Third-Party PD/Total Loss
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 Willing to obtain all licenses within 45 days, including completing state required testing
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 Knowledge of state regulations, policy provisions, and standard operating procedures
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 Commercial experience necessary
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 Bachelor's degree preferred (lack of one should not stop you from applying if you possess all the other qualifications)
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 Ability to analyze and evaluate claims data and make sound decisions based on established guidelines, policies, and procedures
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 Curious and motivated by problem solving and questioning the status quo
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 Desire to engage in learning opportunities and continuous professional development
 
 
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 Benefits
 
 
 
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 Generous health-insurance package with nationwide coverage, vision, &amp; dental
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 401(k) retirement plan with employer matching
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 Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!
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 Generous family leave policy after 8 months of continuous work
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 Work from anywhere to facilitate your work life balance
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 Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!
 
 
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 Additionally, We Will
 
 
 
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 Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role
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 Work toward reducing and eliminating all the administrative work from an adjuster role
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 Foster a culture of empathy, transparency, and empowerment in a remote-first environment
 
 
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 At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!
</div>

APD Claims Adjuster, Courier Delivery

Piedmont Healthcare

<div>Overview:

At Piedmont Healthcare, you&rsquo;ll love a shared purpose, be motivated to be your best, and be recognized for your contributions. Piedmont Healthcare leaders are in your corner and invested in your success. Our wellness programs and comprehensive total benefits and rewards will meet your needs for today and help you plan for the future.
Responsibilities: Reviews, analyzes, and codes medical record documentation to include, but not limited to, medical diagnostic and complex procedural information for various medical and surgical subspecialties for the correct ICD-10, CPT, Modifiers and/or HCPCS codes to the greatest specificity. Abstracts demographic and coding information into the information system accurately and completely. Reviews documentation for medical necessity. Audits orders and claims before submission for entirety and accuracy and to minimize claim denials. Assesses records and prepares reports. Provides technical guidance to physicians and other departmental staff in identifying and resolving issues or errors. Develops effective working relationship with physicians and other stakeholders. Primary coding responsibility is complex procedural and surgery coding. Qualifications: Education<ul><li>
H.S. Diploma or General Education Degree (GED) Required
</li><li>Coding Certificate program (AAPC accredited ) Preferred
</li></ul>Work Experience<ul><li>
3 years of coding experience for Interventional Radiology, Cardiology, EP and Cardiothoracic specialties Required
</li><li>Experience coding across multiple specialties and remote coding experience is Preferred
</li></ul>Licenses and Certifications<ul><li>
One or more of the following certifications Upon Hire Required
</li><li>RHIA - Registered Health Information Administrator or</li><li>
RHIT - Registered Health Information Technician or</li><li>
CCA - Certified Coding Associate or</li><li>
CPC, CPC-A, or CPC-H or</li><li>
CCS or CCS-P
</li><li>Cardiology Specialties: Cardiothoracic, Interventional, EP, and Cardiovascular Surgery coding/certification Preferred
</li><li>Transplant Surgery coding/certification Preferred
</li><li>Neurosurgery Surgery coding/certification Preferred
</li></ul>Business Unit : Company Name: Piedmont Healthcare Corporate</div>

Specialty Coder - PHYS

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APD Claims Adjuster, Courier Delivery

Specialty Coder - PHYS