analyst, healthcare medical coding - disputes, claims & investigations

appeals specialist - hospital billing, underpayments

medical case manager - workers' compensation

analyst, healthcare medical coding - disputes, claims & investigations Jobs in Atlanta

appeals specialist - hospital billing, underpayments Jobs in Atlanta

ar representative

liability claims adjuster Jobs in Atlanta

liability claims adjuster

medical case manager - workers' compensation Jobs in Atlanta

claims adjuster

Midway Insurance Management International

Midway Insurance Management International, Inc. provides Claims Management and Adjusting Services.We understand the insurance industry operates in a world where only the fittest will survive. It follows that our success is inherently linked to the success of our insurance partners. We understand that it takes creativity, resourcefulness and honest hard work to become a successful adjusting company.We provide the solutions to the ever increasing demands of the insured, agents and brokers:<ul><li>Casualty</li><li>Transportation</li><li>Auto</li><li>Litigation Management</li><li>Program Management</li><li>Individual Claims Assignments</li><li>Consulting Services</li><li>Administration</li></ul>Liability Adjuster Position:Job Summary:The Liability Claims Adjuster will be responsible for investigating, evaluating, and resolving liability claims related to commercial trucking incidents. This role requires strong analytical and negotiation skills, along with a deep understanding of insurance policies, claims handling procedures, and regulatory compliance. The ideal candidate will have experience in handling complex claims, working with insured parties, claimants, attorneys, and other stakeholders to ensure fair and efficient settlements.Key Responsibilities:<ul><li>Investigate and analyze liability claims, including reviewing accident reports, witness statements, and other relevant documentation.</li><li>Determine coverage, assess damages, and evaluate liability exposure.</li><li>Communicate with insureds, claimants, attorneys, and other involved parties to gather information and negotiate settlements.</li><li>Collaborate with internal teams, including underwriting and risk management, to assess claim impact.</li><li>Manage claims from initial report through resolution, ensuring timely and accurate processing.</li><li>Maintain detailed and organized claim files in compliance with company policies and industry regulations.</li><li>Work with external experts, such as investigators and medical professionals, when needed.</li><li>Prepare detailed reports and recommendations for claims resolution.</li><li>Stay up to date with industry trends, legal developments, and regulatory changes affecting liability claims.</li></ul>Job Type: Full-timePay: $55,000.00 - $75,000.00 per yearBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: Hybrid remote in Atlanta, GA 30326

Liability 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&rsquo;t wait to meet you. 
About the role<ul><li>
Come join an amazing and collaborative team! We are seeking a highly organized and customer-focused General Liability Adjuster with construction defect experience 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. 
 
The ideal candidate has a willingness to work through a design process that supports the quickest claim resolution with the best outcome. In addition, you will collaborate closely with our product and engineering teams to give feedback and identify technology and process improvements.</li></ul>
**While this position may not be open just yet, we are looking ahead. Submit your application to stay on our radar for future roles as we are growing quickly! 
 
What you'll do<ul><li>
Provide prompt, courteous and high-quality customer service to all policyholders and claimants by answering customer calls, filing claims, and resolving customer requests</li><li>
Gather necessary information from customers to initiate the claim and explain policy, coverage, and appropriate course of action</li><li>
Manage an inventory of claims, analyze coverage and identify any potential coverage issues.</li><li>
Establish initial reserves for all potential exposures, and adjust as appropriate throughout the claim</li><li>
Ability to handle all aspects of construction defect claims</li><li>
Ability to handle all aspects of general liability claims including but not limited to Slip and Falls, Habitational, Risk Transfer, Construction, and New York Labor Law</li><li>
Ensure compliance with specific state regulations, policy provisions, and standard operating procedures</li><li>
Communicate with involved parties and negotiate appropriate settlements with claimants, insureds, and attorneys within approved payment authority</li><li>
Provide input for continuous development of claims guidelines, best practices, and process improvements</li><li>
Oversee and direct outside investigative service providers, client counsel and investigative services to resolve the claim while closely with the client.</li><li>
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</li></ul> 
Who you are<ul><li>
Highly motivated and growth-oriented. You're excited by the prospect of building a tech-driven claims org.</li><li>
Passionate adjuster who cares about the customer and their experience.</li><li>
Empathetic. You exercise empathy and patience towards everyone you interact with.</li><li>
Sense of urgency - at all times. That does not mean working at all hours.</li><li>
Creative. You can find the right exit ramp (pun intended) for the resolution of the claim that is in the insured&rsquo;s best interest.</li><li>
Conflict-enjoyer. Conflict does not have to be adversarial, but it HAS to be conversational.</li><li>
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.</li><li>
Anti-status quo. You don&rsquo;t just wish things were done differently, you action on it.</li><li>
Communicative. (we'd love to know what this means to you)</li><li>
And did we mention, you have a sense of humor. Claims are hard enough as it is.</li><li>
You are collaborative and a team player.</li></ul> 
Requirements<ul><li>
Bachelor's degree. JD, Professional insurance designations strongly preferred.</li><li>
Active adjuster license required: resident state license if available, otherwise a Designated Home State (DHS) license</li><li>
Minimum of 5 years of experience ideally with;</li><li><div><ul><li>
General Liability (Premise, Habitational, Auto, Garagekeepers, BOP&rsquo;s, Dwelling)</li><li>
Construction Liability is required.</li><li>
Employers Liability.</li><li>
Liquor Liability/Dram Shop.</li><li>
Complex claims involving litigation.</li><li>
Policy interpretation. Drafting Reservation of Rights letters, coverage declinations.</li><li>
Third-party bodily injury.</li><li>
Third-party litigated bodily injury/property damage.</li></ul></div></li><li>
Willing to obtain all licenses within 45 days, including completing state required testing</li><li>
Knowledge of state regulations, policy provisions, and standard operating procedures</li><li>
Ability to analyze and evaluate complex data and make sound decisions based on established guidelines, policies, and procedures</li><li>
Curious and motivated by problem solving and questioning the status quo</li><li>
Desire to engage in learning opportunities and continuous professional development</li><li>
Ability to collaborate with colleagues within and outside your department</li><li>
Willingness to travel for client and claims needs</li></ul> 
Benefits<ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
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!</li></ul> 
Additionally, we will<ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul> 
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>

Pipeline General Liability Construction Defect

Safe-Guard Products International, LLC

Please do not respond to direct messages with your personal information. All job applications and your sensitive, personal information should only be submitted via our official job platform. External Job Title: Bi-lingual Customer Support Representative- Spanish or French Internal Job Title: Claims Support Specialist Location: US - SC - Greenville - Onsite FLSA: Non-exempt Shift Times: 11-8 Class Start Date: 9/8/2025 Job Overview: This position provides support to agents, clients, and customers by adjudicating claims, providing claims status, and resolving or escalating customer issues. Communicate effectively with all levels of the organizations. In executing the duties of the role, claims adjuster will ensure the proper documentation, adjudicate per the terms and conditions of the contract, utilizing available resources, and meet schedule expectations informing management of any changes. Job Responsibilities: Handling claims related calls per work schedule performing within defined metrics Order inspection when applicable Follow proper claims procedures as outlined in training and feedback provided by QA or Supervisor Master understanding of clients, agents, and contract terms and conditions Understand exceptions based upon dealership, agent, or client as noted in system Escalate issues to team lead, supervisor, or managers when unable to de-escalate Notify Supervisor when possible fraud is suspected Participate in all training as required to perform the duties of the role Keep record phone calls and transmit claim forms to Dealership or Repair Facility Drive the status of the claim within the Safe-Guard system Receive documentation and organize by claim number Order an appraisal when claim is over threshold amount or possible fraud Send letters to customers and copy dealership if necessary Send missing information letters to customers if documents are missing and copy Dealership if necessary Notate the system Adhere to Quality Assurance Guidelines Ensure premium is first received from Dealership before issuing checks The above statements are intended only to describe the general nature of the job and should not be construed as an all-inclusive list of position responsibilities. Job Requirements: High School Diploma or equivalent Minimum 1-2 years of experience in customer service, insurance claims, call/claims center environment. Proficient computer skills and the ability to troubleshoot and service policy issues Strong interpersonal, analytical and problem-solving skills Superior verbal/written skills and communications skills Ability to exercise sound judgment when interacting with customers and vendors Attention to detail and ability to handle complex situations Proficient in Windows and MS-Office Products (Outlook, Word, PowerPoint &amp; Excel) High attention to detail, good attendance, spelling, mathematical, grammar Ability to analyze complex-detailed reports Must be authorized to work in the U.S Must be able to successfully pass a background check Please note that Safe-Guard has a mandatory training and 90-day introductory period. During the first 90 days, it&rsquo;s important for new team members to adhere to their training and work schedules. The introductory/probationary period is key for training and learning, so being present and punctual is critical to success of the new hires. Candidates seeking this role must have the ability to arrive to work on time and be able to remain present during the full 90-day training and introductory period Job Preferences: Experience within Automotive Industry College degree 2+ years of experience in a high-volume Call Center 2+ years of experience in automotive insurance or warranty claims 1+ year of experience with in an automotive repair or tech role Bilingual or Trilingual with the ability to read, write and speak English and French and/or Spanish in a business setting #LI-Onsite Company Benefits: Medical, Dental, and Vision Insurance Flexible Spending Account Health Savings Account 401(k) Plan with Company Match Company-paid Short-Term and Long-Term Disability Company-paid Life Insurance Paid Holidays and Vacation Employee Referral Program Employee Assistance Program Wellness Programs Paid Community Service Opportunities Tuition Reimbursement Ongoing Training &amp; Personal Development And More! About Safe-Guard Products International Safe-Guard Products International is the leading provider of branded vehicle protection products in the finance and insurance space to the automotive, RV, marine and motorcycle/powersports industries. We are a proud partner to Original Equipment Manufacturers (OEMs), top retailers, and independent agents across the United States and Canada. In nearly thirty years, we have grown to power a client roster of over 50 leading protection brands and protect over 16 million consumers under Safe-Guard contracts. Our success is driven by over 700 employees, who serve over 12,000 dealers and support contract holders across the U.S. and Canada. Safe-Guard continues to experience dynamic growth and has earned a stellar reputation from our clients, dealers, and peers by providing: 1) the highest quality protection products in the industry, 2) a broad platform of branded product, technology, marketing, and training solutions, and 3) an unwavering commitment to uncomplicated care and customer service. Safe-Guard Products International is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, race, color, religion, creed, sex, sexual orientation, gender identity or expression, national origin, marital status, disability or protected veteran status, or any other status or characteristic protected by federal, state, or local law.

Bi-lingual Customer Support Representative- Spanish

Gallagher

<div>Introduction 
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div> 
Overview 
About the INVEST Program
Are you a recent college graduate looking for a long-term, stable, innovative and exciting career that helps make a meaningful difference and supports people through challenges? 
The Emerging Talent INVEST Program (ETIP) &ndash; Guardian Pathway is a 6-month paid, fully remote, entry-level immersive learning experience, designed for recent college graduates to gain real-world exposure, personalized coaching and mentorship and a clear, long-term career path in one of U.S. best industries. 
Program Highlights<ul><li>
6-months, paid, fully remote learning track</li><li>
Virtual classroom, peer shadowing, simulations, case studies, and hands-on experience</li><li>
Fully remote (candidates must physically reside in states specified although the role is remote)</li><li>
Interactive sessions, one-on-one mentorship, collaborative projects, exposure to wide variety of industries, clients, and knowledge material</li><li>
Fully paid licensing and advance education opportunities</li><li>
Career progression post-graduation into claims resolution manager roles and beyond</li></ul>
 
How you'll make an impact 
Over the course of this 6-month program you will be partnered with a team of peers and experienced Training Specialists that will create a supportive learning environment designed to position you for successful program completion. You will alternate between self-study modules, virtual classroom-style learning, guided training modules, and hands-on application of the knowledge gained. Over the course of the program, you will progressively increase your hands-on experience to immerse yourself into the world of claims management and client service excellence under the mentorship of the program mentors and training leaders. The program is designed to offer consistent and repeated opportunities to develop, grow and practice your knowledge, advance your education via licensing studies, and help you gain confidence in the unique and highly specialized field of commercial claims handling for world&rsquo;s largest employers and insurance carriers. 
What can you expect?<ul><li>
Participate in Structured Learning: Actively engage in the first phase of the INVEST Program, which includes instructor-led sessions, online modules, job shadowing, and mentorship focused on foundational insurance knowledge, claims operations, and state-specific workers&rsquo; compensation regulations.</li><li>
Shadow Claims Experts: Observe experienced claims professionals and learn best practices in managing lost time (indemnity) workers&rsquo; compensation claims.</li><li>
Practice in a Simulated Environment (&quot;Sandbox&quot;): Apply newly learned concepts in a controlled, simulated claims environment designed to mimic real-world scenarios. The sandbox allows colleagues to practice making decisions, inputting data, and managing mock claims without risk, helping build confidence before handling actual cases.</li><li>
Complete Program Milestones: Achieve key learning objectives and performance checkpoints as you build technical knowledge and professional skills essential for a successful claims career.</li><li>
Collaborate and Network: Engage with peers, mentors, and cross-functional teams to deepen understanding of the claims process and build professional relationships within the organization.</li><li>
Gradual Claim Ownership: Begin handling new workers&rsquo; compensation claims starting in Week 3 of the program. Claim assignments will begin at an incremental, supportive pace, with inventory gradually increasing as confidence and competency develop.</li><li>
Support Claims Management: Take ownership of an evolving portfolio of indemnity claims under close supervision. Begin applying program training to real-world scenarios, including benefit calculations, wage loss evaluations, and return-to-work considerations.</li><li>
Claims Analysis and Learning: Continue developing skills in analyzing medical documentation, regulatory guidelines, state-specific regulations, and supplemental case materials to determine claim strategy, financial exposure and potential next steps.</li><li>
Stakeholder Communication: Engage in professional communication and strategy development with clients; provide support and empathy to the injured employees; secure key details from medical providers and other key stakeholders to support collaborative, outcome-focused, and empathetic claims handling.</li><li>
Client Service Instructions &amp; Carrier Guidelines: 
Learn how to interpret and apply client service instructions and carrier guidelines to ensure claims are handled in compliance with expectations. This includes understanding unique requirements for documentation, communication, and jurisdictional standards across our diverse client base.</li></ul><div>
Reserving Acumen: 
Build core skills in setting and adjusting reserves by analyzing claim details, medical data, and potential outcomes. You&rsquo;ll learn how accurate reserving supports financial stewardship and impacts overall claim strategy.</div> 
 
About You<div> 
Education: Bachelor&rsquo;s degree or 4-year degree from an accredited institution preferred.</div><div>
Candidates possessing a Bachelor&rsquo;s degree will receive preferential treatment. Others with proven experience will be considered.</div><div></div><div> 
Attributes:</div><ul><li>
Active listening skills
</li><li>Problem-solving mindset</li><li>
Adaptable to changes in procedures and technology</li><li>
Computer literacy, including strong familiarity with M365 products (e.g. Outlook, Word, and basic Excel and PPT)</li><li>
Strong verbal and written communication skills</li><li>
Strong time management and ability to multi-task</li><li>
Detail-oriented</li><li>
Curious, learning-focused mindset</li></ul><div></div><div> 
#GBTopJob</div><div>
#remote</div><div>
#INVEST</div> 
 
Compensation and benefits 
We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.
Below are the minimum core benefits you&rsquo;ll get, depending on your job level these benefits may improve:
<ul><li>Medical/dental/vision plans, which start from day one!</li><li>
Life and accident insurance</li><li>
401(K) and Roth options</li><li>
Tax-advantaged accounts (HSA, FSA)</li><li>
Educational expense reimbursement</li><li>
Paid parental leave</li></ul><div>
Other benefits include:</div><ul><li>
Digital mental health services (Talkspace)</li><li>
Flexible work hours (availability varies by office and job function)</li><li>
Training programs</li><li>
Gallagher Thrive program &ndash; elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing</li><li>
Charitable matching gift program</li><li>
And more...</li></ul><div>
**The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.</div><div></div><div> 
We value inclusion and diversity</div>
Click Here to review our U.S. Eligibility Requirements
Inclusion and diversity (I&amp;D) is a core part of our business, and it&rsquo;s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.
Gallagher embraces our employees&rsquo; diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.
Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as &ldquo;protected characteristics&rdquo;) by applicable federal, state, or local laws.
Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.</div>

Emerging Talent INVEST Program - Guardian Associate

<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&rsquo;t wait to meet you. 
About the role<ul><li>
As the Content Manager for Claims Technical Documentation, you will own two critical pillars of 
content at Reserv: technical claims documentation and customer communication management. 
You will build upon and maintain the comprehensive knowledge base that enables our claims 
teams to handle claims with precision, while simultaneously managing all communication 
templates within our claims management system to ensure every claimant interaction is clear, 
empathetic, and professional. 
 
On the technical documentation side, you will maintain our complete documentation library, and 
develop standard operating procedures, claims handling guidelines, and other materials that 
serve as the operational backbone for our growing claims organization. On the communication 
side, you will own our complete library of CMS templates. From initial acknowledgment letters to 
status updates, payment notifications, and closure communications, you will ensure consistency 
and quality across all claimant touchpoints. 
 
Working closely with Claims Operations, Compliance, Onboarding, and Customer Success 
teams you will be the bridge between technical complexity and clear communication. We're 
looking for someone with a deep understanding of claims who can dive deep into claim 
operations, interview subject matter experts about technical processes, and then craft both internal documentation and external communications that make complex information accessible 
and actionable.</li></ul>
What you'll do<ul><li>
Technical Documentation Development: Create and maintain comprehensive claims 
handling documentation including standard operating procedures, workflow 
documentation, desk-level procedures, and other reference materials that enable 
adjusters to handle claims consistently and accurately across multiple lines of business 
and claim types. 
<ul><li>CMS Communication Template Management: Own the complete lifecycle of</li></ul>
communication templates within our claims management system, including creating, 
testing, maintaining, and optimizing templates for letters, emails, SMS messages, and 
other claim party touchpoints to ensure consistency, clarity, and quality across all 
external communications. 
<ul><li>Cross-Functional Collaboration: Partner closely with Claim Operations, QA,</li></ul>
Compliance, Training, and Customer Success, and Claims leadership to gather 
requirements from subject matter experts, validate technical accuracy, and ensure 
documentation and templates support operational objectives, process changes, and 
system enhancements. 
<ul><li>Structured Communication: Partner closely with Claims Operations and Change</li></ul>
Management to ensure the organization is informed of updates to technical 
documentation and related communications. Ensure that all databases are easily 
searchable and referenced for relevant stakeholders. 
<ul><li>Continuous Improvement and Analytics: Leverage feedback from adjusters,</li></ul>
Customer Success, and QA to identify documentation gaps, improve template 
effectiveness, and proactively update materials to reflect process changes, best 
practices, and evolving business needs.</li></ul>
Qualifications<ul><li>
8+ years of claims handling or claims-related experience, preferably across multiple lines 
of business 
<ul><li>Demonstrated ability to create both technical documentation for internal teams and</li></ul>
customer-facing content, with strong attention to detail, accuracy, clarity, and user 
experience 
<ul><li>Strong project management skills with experience coordinating with multiple subject</li></ul>
matter experts, and delivering against competing priorities and deadlines 
<ul><li>Proficiency with documentation tools and content management systems (e.g., Notion,</li></ul>
Google Workspace, claims management systems) 
<ul><li>Excellent written and verbal communication skills with meticulous attention to detail,</li></ul>
technical accuracy, and the ability to adapt tone for different audiences 
<ul><li>Self-starter mentality with the ability to work independently, ask clarifying questions, and</li></ul>
navigate ambiguity in a fast-paced, evolving environment 
 
Preferred Qualifications 
<ul><li>Experience in claims leadership, training, quality assurance, or audit functions</li><li>Experience managing communication templates or customer-facing content at scale,</li></ul>
ideally within a CMS or similar platform 
<ul><li>Background in client services or account management within claims or insurance</li><li>Experience supporting client onboarding or implementation processes</li><li>Familiarity with claims systems, reporting tools, and documentation platforms</li></ul></li></ul> 
Benefits<ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
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!</li></ul> 
Additionally, we will<ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul> 
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>

Claims Technical Documentation & Content Manager

Aspirion

<div>Description:

For over two decades, Aspirion has delivered market-leading revenue cycle services. We specialize in collecting challenging payments from third-party payers, focusing on complex denials, aged accounts receivables, motor vehicle accident, workers&rsquo; compensation, Veterans Affairs, and out-of-state Medicaid.
At the core of our success is our highly valued team of over 1,400 teammates as reflected in one of our core guiding principles, &ldquo;Our teammates are the foundation of our success.&rdquo; United by a shared commitment to client excellence, we focus on achieving outstanding outcomes for our clients, aiming to consistently provide the highest revenue yield in the shortest possible time.
We are committed to creating a results-oriented work environment that is both challenging and rewarding, fostering flexibility, and encouraging personal and professional growth. Joining Aspirion means becoming a part of an industry leading team, where you will have the opportunity to engage with innovative technology, collaborate with a diverse and talented team, and contribute to the success of our hospital and health system partners. Aspirion maintains a strong partnership with Linden Capital Partners, serving as our trusted private equity sponsor.
We are seeking an Appeals Specialist II to join our growing team. As an Appeals Specialist II, you will be exposed to the complex reimbursement methodology between hospitals and insurance companies. Appeals Specialists work closely with assigned project teams on the specialized retrospective recovery process. You will be exposed to the revenue cycle process and various provider clients and systems.
Key Responsibilities<ul><li>
Follow-up with insurance carriers on underpaid claims by phone; complete follow-up actions as advised</li><li>
Research claim variances in hospital patient accounting systems (EPIC, Meditech, Cerner, Athena)</li><li>
Draft appeals to insurance carriers on denied or underpaid claims</li><li>
Review claim detail including coding, billing and insurance information for discrepancies</li><li>
Run claims data through various pricing software</li></ul>
Requirements:
<ul><li>Strong healthcare industry knowledge</li><li>
Ability to troubleshoot and remedy claim submission errors</li><li>
Demonstrated attention to detail</li><li>
Excellent written and verbal communication skills</li><li>
Team-Oriented and Flexible</li><li>
Creative Problem-solving skills</li></ul>
Education and Experience<ul><li>
High School Diploma or GED required; bachelor's degree preferred</li><li>
Hospital billing experience required</li><li>
Previous work from home experience</li></ul>
Benefits
At Aspirion we invest in our employees by offering a full benefits package, including health, dental, vision and life insurance upon hire, matching 401k, competitive salaries, advancement opportunities, and incentive programs.
The US base pay range for this position starts at $19.00 hourly. Individual pay is determined by a number of factors including, but not limited to, job-related skills, experience, education, training, licensure or certifications obtained. Market, location and organizational factors are also considered. In addition to base salary, a competitive benefits package is offered.
AAP/EEO Statement
Equal Opportunity Employer/Drug-Free Workplace: Aspirion is an Equal Employment Opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, pregnancy, religion, national origin, ancestry, medical condition, marital status, gender identity citizenship status, veteran status, disability, or veteran status. Aspirion has a Drug-Free Workplace Policy in effect that is strictly adhered to.
Please note that this position is contingent upon the successful completion of a pre-employment drug screening and background check. These steps are part of our standard hiring process to ensure a safe and compliant workplace.</div>

Appeals Specialist - Hospital Billing, Underpayments

METARPO

<div>We are seeking an experienced Scrum Master with strong Property &amp; Casualty (P&amp;C) Insurance domain knowledge to support Agile delivery teams. The Scrum Master will facilitate Agile practices, remove impediments, and ensure teams deliver high-quality insurance solutions that align with business objectives. This role requires close collaboration with product owners, engineering teams, and insurance business stakeholders.
<ul><li>Bachelor&rsquo;s degree in Computer Science, Business, or related field (or equivalent experience)</li><li>
5+ years of experience as a Scrum Master or Agile Coach</li><li>
Strong experience in Property &amp; Casualty (P&amp;C) Insurance<ul><li>
Exposure to underwriting, claims, billing, or policy administration systems</li></ul></li><li>
Solid understanding of Agile frameworks (Scrum, Kanban, SAFe)</li><li>
Experience working with cross-functional technical and business teams</li><li>
Excellent facilitation, communication, and conflict-resolution skills</li><li>
Proficiency with Agile tools such as Jira, Confluence, Azure DevOps, or Rally</li></ul></div>

Scrum Master – P&C Insurance

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