claim specialist - property field inspection

auto damage adjuster

auto damage trainee

care coordinator

case manager - workers' compensation Jobs in Kansas City

case manager - workers' compensation

claim specialist - property field inspection Jobs in Kansas City

claims adjuster

GEICO

<div>At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers&rsquo; expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That&rsquo;s why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
Experienced Auto Damage Adjuster- Kansas City, KS
 
Salary: $32.05-$40.70 per hour/$64,575-$82,000
<div><div><div><div><div><div><div><div><div>We are looking for talented Auto Damage Adjusters to join our team in Kansas City, KS. As an experienced Adjuster, you should have a minimum of 12 months of Auto Damage experience and demonstrated a track record of success delivering excellent customer service while promptly and accurately settling claims. The ideal candidate will have the ability to handle complex claims using their technical and industry knowledge.
Qualifications &amp; Skills:<ul><li>
Motor Vehicle Damage Adjuster/Appraiser's License *required*</li><li>
Valid driver&rsquo;s license (must meet company underwriting guidelines) and the ability to maintain applicable state and federal certifications and permits</li><li>
Willingness to be flexible with primary work location &ndash; position may require either remote/field/in-office work</li><li>
Solid computer, mechanical aptitude, and multi-tasking skills</li><li>
Effective attention to detail and decision-making skills</li><li>
Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities</li><li>
Minimum of high school diploma or equivalent</li></ul></div></div></div></div></div></div></div></div></div><div></div><div><div><div><div><h2 class="jobSectionHeader">
Attachments</h2></div></div></div></div> 

At this time, GEICO will not sponsor a new applicant for employment authorization for this position. 
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life&rsquo;s twists and turns. Our mission is to protect people when they need it most and we&rsquo;re constantly evolving to stay ahead of their needs.
We&rsquo;re an iconic brand that thrives on innovation, exceeding our customers&rsquo; expectations and enabling our collective success. From day one, you&rsquo;ll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people&rsquo;s lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career &ndash; and your potential &ndash; in mind. You&rsquo;ll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.<ul><li>
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family&rsquo;s overall well-being.</li><li>
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.</li><li>
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.</li><li>
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.</li></ul>
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.</div>

Auto Damage Adjuster

State Farm

<div>Overview:
<div>
Being good neighbors &ndash; helping people, investing in our communities, and making the world a better place &ndash; 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!</div>
Grow Your Skills, Grow Your Potential:
<div></div>
Responsibilities:
<div>
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.
</div><div>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.
</div><div>Key Responsibilities:</div><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><div>
Where you'll work: This position is located in Kansas City/Lenexa/Olathe, KS. Competitive candidates should reside within one of the listed zip codes and will service this same territory:</div><div>
66013 66018 66030 66031 66061 66062 66083 66085 66204 66205 66206 66207 66208 66209 66210 66211 66212 66213 66214 66221 66223 66224 66251</div><div></div><div> 
This 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.</div><div>
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.
</div>Qualifications:
<div>
Competitive candidates must demonstrate:</div><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><div>
Preferred:</div><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><div>
Additional Details:</div><ul><li>
Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, 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>
Our Benefits:
<div>
Because work-life balance is a priority at State Farm, compensation is based on our standard 38:45-hour work week!</div> 
<div></div><ul><li>
Potential starting salary range: $59,059.65- $90,000.00 annually<ul><li>
Starting salary will be based on skills, background, and experience</li><li>
High end of the range limited to applicants with significant relevant experience</li></ul></li><li>
Potential yearly incentive pay up to 15% of base salary</li></ul><div> 
At State Farm, we offer more than just a paycheck. Check out our suite of benefits designed to give you the flexibility you need to take care of you and your family!</div><div></div><ul><li> 
Get Paid! On top of our competitive pay, you are eligible for an annual raise and bonus.</li><li>
Stay Well! Focus on you and your family&rsquo;s health with our robust health and wellbeing programs. State Farm pays most of your healthcare premium, and we offer multiple healthcare plan options, including a high deductible plan. All medical plans provide 100% coverage for in-network preventative care, AND you and your family have access to vision, dental, telemedicine, 24/7 mental health professionals, and much more!</li><li>
Develop and Grow! Take advantage of educational benefits like industry leading training programs, top-notch tuition assistance programs, employee resource groups, and mentoring.</li><li>
Plan Ahead! Plan for those big moments in life with benefits like fertility/IVF/adoption assistance, college coaching, national discount programs, interactive monthly financial workshops, free financial coaching, and more. You can also start a savings account or consider financing through our State Farm Federal Credit Union!</li><li>
Take a Little &ldquo;You&rdquo; Time! You will have access to our generous time off policies designed so you can plan around holidays, family events, volunteering, or just to take a relaxing day off. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you!</li><li>
Give Back! We offer several ways to give back through our Matching Gift Program, Good Neighbor Grant Program, and the Employee Assistance Fund.</li><li>
Finish Strong! Plan for retirement using free financial advisors and a 401(k) plan with company contributions of up to 7% of your salary.</li></ul><div></div><div> 
Visit our State Farm Careers page for more information on our benefits, locations, and the hiring process of joining the State Farm team!</div></div>

Claim Specialist - Property Field Inspection

The Cincinnati Insurance Companies

<div></div><div><div>US-MO-Kansas City<div>
</div></div><div>
Description<div></div> 
Make a difference with a career in insurance 
 
At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into action, we&rsquo;re looking for extraordinary people to join our talented team. Our service-oriented, ethical, knowledgeable, caring associates are the heart of our vision to be the best company serving independent agents. We help protect families and businesses as they work to prevent or recover from a loss. Share your talents to help us reach for continued success as we bring value to the communities we serve and demonstrate that Actions Speak Louder in Person&reg;.
If you&rsquo;re ready to build productive relationships, collaborate within a diverse team, embrace challenges and develop your skills, then Cincinnati may be the place for you. We offer career opportunities where you can contribute and grow.
Build your future with us 
 
Our Field Claims department is currently seeking field claims representatives to service the territory surrounding: Kansas City, MO . The candidate is required to reside within the territory.
This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure accurate settlements.
Be ready to:<ul><li>
complete thorough claim investigations</li><li>
interview insureds, claimants, and witnesses</li><li>
consult police and hospital records</li><li>
evaluate claim facts and policy coverage</li><li>
inspect property and auto damages and write repair estimates</li><li>
prepare reports of findings and secure settlements with insureds and claimants</li><li>
use claims-handling software, company car and mobile applications to adjust loss in a paperless environment</li><li>
provide superior and professional customer service</li><li>
once eligible, become a certified and active Arbitration Panelist</li></ul>
To be an Entry Level Claims Representative:
The pay range for this position is $57,000 - $76,000 annually. The pay determination is based on the applicant&rsquo;s education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance.
Be equipped with:<ul><li>
be available and communicative during your regular business hours</li><li>
a desire to learn about the insurance industry and provide a great customer experience</li><li>
the ability to work unsupervised</li><li>
excellent verbal and written communication skills</li><li>
strong interpersonal skills</li><li>
excellent problem-solving, negotiation, organizational and prioritization skills</li><li>
preparedness to follow-up with others in a timely manner</li><li>
a valid driver&rsquo;s license</li></ul>
Bring education or experience from:<ul><li>
a bachelor&rsquo;s degree</li><li>
AINS, AIC, or CPCU designations preferred</li></ul>
Benefits in addition to compensation include:<ul><li>
company car</li><li>
company stock options, including Restricted Share Units and Incentive based stock options</li><li>
paid time off (PTO)</li><li>
401K with 6% company match</li></ul>
To be an Experienced Claims Representative:
The pay range for this position is $62,000 - $90,000 annually. The pay determination is based on the applicant&rsquo;s education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance.
Be equipped with:<ul><li>
be available and communicative during your regular business hours</li><li>
multi-line claims experience preferred</li><li>
ability to completely assess auto, property, and bodily injury type damages</li><li>
capacity to work unsupervised</li><li>
excellent verbal and written communication skills</li><li>
strong interpersonal skills</li><li>
excellent problem-solving, negotiation, organizational, and prioritization skills</li><li>
preparedness to follow-up with others in a timely manner</li><li>
a valid driver&rsquo;s license</li></ul>
Bring education or experience from:<ul><li>
one or more years of claims handling experience</li><li>
AINS, AIC, or CPCU designations preferred</li><li>
bachelor&rsquo;s degree or equivalent experience required</li></ul>
Benefits in addition to compensation include:<ul><li>
company car</li><li>
company stock options, including Restricted Share Units and Incentive based stock options</li><li>
paid time off (PTO)</li><li>
401K with 6% company match</li></ul>
Enhance your talents<div>
Providing outstanding service and developing strong relationships with our independent agents are hallmarks of our company. Whether you have experience from another carrier or you&rsquo;re new to the insurance industry, we promote a lifelong learning approach. Cincinnati provides you with the tools and training to be successful and to become a trusted, respected insurance professional &ndash; all while enjoying a meaningful career.</div><div>
Enjoy benefits and amenities</div><div>
Your commitment to providing strong service, sharing best practices and creating solutions that impact lives is appreciated. To increase the well-being and satisfaction of our associates, we offer a variety of benefits and amenities.</div><div>
Embrace a diverse team</div><div>
As a relationship-based organization, we welcome and value a diverse workforce. We grant equal employment opportunity to all qualified persons without regard to race; creed; color; sex, including sexual orientation, gender identity and transgender status; religion; national origin; age; disability; military service; veteran status; pregnancy; AIDS/HIV or genetic information; or any other basis prohibited by law. All job applicants have rights under Federal Employment Laws. Please review this information to about those rights.</div></div></div>

Claims - Field Claims Representative

<div>At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.
Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers&rsquo; expectations while making a real impact for our company through our shared purpose.
When you join our company, we want you to feel valued, supported and proud to work here. That&rsquo;s why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers.
GEICO is looking for motivated individuals with a passion for customer service and an interest in our Auto Damage Trainee program. Help our customers when they need us most after an accident and help them get back on the road.
Please note that this is a field role. Any candidate(s) selected for the role would be assigned a GEICO fleet vehicle and would be responsible for covering the Kansas City, KS area.
What Makes This Opportunity Exciting?
Our team is looking for candidates who are service driven, thrive in environments that require multitasking, and enjoy being on the go! GEICO&rsquo;s industry-leading paid trainee program includes 3 weeks of required hands-on experience at our Ashburn, VA training facility in addition to 2 weeks in a field training center (NY, TX, CA) with mentors to help you learn and grow. Let GEICO teach you how to write estimates and adjust claims so you can directly assist our customers after accidents or major disasters. Your unique skillset, along with the latest auto-adjusting tools and tech will help you:<ul><li>
Inspect and assess vehicle damage caused by all types of accidents</li><li>
Estimate vehicle repair costs and negotiate equitable settlements</li><li>
Partner with other adjusters and supervisors to work with body shops, rental partners, and parts providers</li></ul>
Auto Damage Adjusters will travel within their assigned territory to body shops, salvage and tow yards, and at times customers homes to write estimates, inspect damage, and interact with the public face-to-face. Adjusters work independently and with their team to ensure that appointments and customer follow up are handled in a timely manner.
Incentives and Additional Perks:<ul><li>
The starting salary for a Trainee Adjuster is $27.98 per hour / $56,375 annually</li><li>
Health &amp; Wellness: Comprehensive healthcare and well-being support available on Day 1.</li><li>
401(k) Match: From day one, you&rsquo;ll be automatically enrolled in our 401(k) plan with a 6% pre-tax contribution. We match 100% of your contributions, up to 6% of your eligible earnings, with employer contributions added to your account each paycheck and vesting immediately.</li></ul>
What We&rsquo;re Looking For:
<ul><li>Critical thinking and decision making in a fast-paced environment</li><li>
Strong computer proficiency, including familiarity with Microsoft Office Suite</li><li>
Ability to prioritize work and multi-task, while navigating through multiple business applications</li><li>
Experience with KPIs and measurable goals</li><li>
High School Diploma or equivalent required, bachelor's degree (preferred)</li><li>
Active Insurance Adjusters license (preferred)</li></ul> 

At this time, GEICO will not sponsor a new applicant for employment authorization for this position. 
The GEICO Pledge:
Great Company: At GEICO, we help our customers through life&rsquo;s twists and turns. Our mission is to protect people when they need it most and we&rsquo;re constantly evolving to stay ahead of their needs.
We&rsquo;re an iconic brand that thrives on innovation, exceeding our customers&rsquo; expectations and enabling our collective success. From day one, you&rsquo;ll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people&rsquo;s lives.
Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career &ndash; and your potential &ndash; in mind. You&rsquo;ll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels.
Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose.
As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers.
Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future.<ul><li>
Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family&rsquo;s overall well-being.</li><li>
Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.</li><li>
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.</li><li>
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.</li></ul>
The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.
GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.</div>

Auto Damage Trainee

Traders Insurance

<div>Full-Time &brvbar; Remote (Kansas City Metro Area Candidates Only) 

Traders Insurance is a reliable Kansas City based company offering full-time remote career opportunities. While this role is fully remote, candidates must reside in the Kansas City Metro area.
Play an integral role in driving success as part of a passionate team - all from the comfort of your own home. We value your expertise and dedication and strive to create a supportive environment that encourages both personal and professional growth. As a leading company in our industry, Traders is known for stability, reliability, and a strong commitment to excellence. We believe in employee empowerment, open communication, and giving our team members the opportunity to make a meaning impact. Join us and take advantage of opportunities for learning, development, and career advancement. 

Litigation &amp; Serious Injury Claims Representative

We are seeking a Litigation and Serious Claims Representative to join our Claims team. This role is responsible for investigation and managing bodily injury and associated property damage claims resulting from automobile accidents, including litigated files and higher-complexity exposures.

This position requires a high level of technical expertise, along with strong problem solving and organizational skills to investigate accidents, gather detailed information, and effectively manage the claims process. No two days are the same, and we're looking for someone who thrives in a fast-paced, ever-evolving environment. The ideal candidate will demonstrate strong interpersonal skills, collaborate effectively with team members, and contribute meaningfully to the overall success of the claims department and the company. 

Responsibilities
<ul><li>
Investigate and manage bodily injury and associate property damage claims of moderate to high complexity.
</li><li>Deliver superior customer service through strong verbal and written communication.</li><li>
Interview insureds, claimants, and witnesses.</li><li>
Evaluate coverage determine liability.</li><li>
Partner with appraisers and estimators to coordinate and manage vehicle repairs.</li><li>
Establish timely and appropriate claim reserves in accordance with company reserving philosophy.</li><li>
Negotiate settlements with claimants, customers, and other insurance carriers.</li><li>
Demonstrate strong analytical skills, sound judgement, and owner mindset.</li><li>
Maintain proficiency in Microsoft Word and Excel.</li><li>
Ensure all work aligns with the mission, values, and direction of Traders Insurance.</li><li>
Perform other duties as assigned.</li></ul>

Qualifications
<ul><li>
Experience as an auto claims representative, including bodily injury handling</li><li>
Litigation handing experience preferred</li><li>
AIC or CPCU designation (or equivalent insurance coursework) preferred</li><li>
Ability to obtain licenses in the required states</li><li>
Strong analytical, organizational, and decision-making skills</li><li>
Proficiency in Microsoft Word Excel</li></ul>

Compensation &amp; Benefits
<ul><li>
Medical, Dental, and Vision Insurance</li><li>
Employee and Dependent Life Insurance</li><li>
Paid Time Off</li><li>
Parental Leave</li><li>
401(k) Plan with company participation</li><li>
Ongoing Training and Career Development</li><li>
Opportunities for advancement within a stable, growing organization</li></ul>
Compensation is commensurate with experience. Traders Insurance offers a comprehensive benefits package designed to support our employees both personally and professionally. At Traders Insurance, we are committed to long-term success and creating an environment where individual can grow, contribute and make meaningful impact.</div>

Serious Injury and Litigation Claims Reprsentative I (Remote)

Are you an experienced claims professional ready to take on complex cases and make a meaningful impact? MEM Insurance is seeking a seasoned Claims Representative to join our dynamic Claims team. In this role, you will manage a caseload of high-exposure workers’ compensation claims, oversee advanced medical case management, and develop tailored Return-to-Work plans. You’ll collaborate with vocational consultants, legal counsel, and internal teams to ensure compliance, negotiate settlements, and deliver exceptional service to our policyholders. This position offers the opportunity to work independently while providing leadership on complex claims and contributing to workflow improvements.
 
Essential Duties and Responsibilities
 <ul>
<li>Manage complex workers’ compensation claims involving high financial exposure, sensitive issues, or extended life cycles.</li>
<li>Investigate coverage and compensability, ensuring thorough documentation and compliance with state statutes.</li>
<li>Oversee advanced medical case management, including coordination with Nurse Case Managers and external vendors.</li>
<li>Develop and implement Return-to-Work plans for high-risk claims, collaborating with vocational consultants and legal counsel.</li>
<li>Identify and investigate potential fraud and subrogation opportunities, partnering with the Special Investigation Unit.</li>
<li>Establish and maintain accurate claim reserves within authority levels, ensuring timely responsiveness to changing circumstances.</li>
<li>Evaluate and negotiate settlements within approved authority levels, including structured settlements and Medicare compliance.</li>
<li>Collaborate with legal counsel to manage litigation and ensure adherence to MEM guidelines.</li>
<li>Maintain accurate system data and prepare reports for management on high-profile claims.</li>
<li>Foster cross-departmental collaboration with Underwriting, Premium Consultation, and Loss Prevention.</li>
<li>Provide mentorship and training to junior adjusters, supporting professional growth and team development.</li>
</ul>
Qualifications
 <ul>
<li>High school diploma or equivalent required; bachelor’s degree preferred.</li>
<li>Associate in Claims (AIC) designation preferred.</li>
<li>Valid driver’s license required; Texas-All Lines license preferred.</li>
<li>3–5 years of claims handling experience, primarily in Workers’ Compensation. Missouri experience preferred.</li>
</ul>
Company Culture and Values
 At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other’s growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered.
 
Diversity Statement
 MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities.
 
Total Rewards Overview
 <ul>
<li>Health Plans: Medical, Dental, and Vision</li>
</ul>
Includes fertility benefits, fully paid preventative care, and adult orthodontia.
 <ul>
<li>Employer-Paid Life and Disability Benefits:</li>
</ul>
Life Insurance (3x base salary), AD&D, Short and Long-term Disability.
 <ul>
<li>Wellness and Recognition Program: Employer-paid incentives for employees and spouses.</li>
<li>Flexible Spending Account and Dependent Care options</li>
<li>Health Savings Account: Generous employer contribution.</li>
<li>Time Away from Work:</li>
</ul>
Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave.
 <ul>
<li>Employee Assistance Programs</li>
<li>401k Retirement Plan: Employer match and profit sharing.</li>
<li>Adoption Assistance and Tuition Assistance</li>
</ul>
Notice Regarding Use of Artificial Intelligence
 MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.

Workers' Compensation Claims Representative (Remote)

Blue Cross and Blue Shield of Kansas

<div>
 This job was posted by https://www.kansasworks.com : For more
 
 
 information, please see: https://www.kansasworks.com/jobs/13531726 **Are
 
 
 you ready to make a difference? Choose to work for one of the most
 
 
 trusted companies in Kansas.**
 
 
 You Belong At Blue
 
 
 <ul>
 <li>
 Why Join Us?**
 </li>
 <li>
 **Make a Positive Impact:** Your work will directly contribute to
 
 
 </li>
 </ul>
 the health and well-being of Kansans.
 
 
 <ul>
 <li>
 **Family** **Comes First**: Total rewards package that promotes the
 
 
 </li>
 </ul>
 idea of family first for all employees. Paid vacation and sick leave
 
 
 with paid maternity and paternity available immediately upon hire
 
 
 <ul>
 <li>
 **Professional Growth Opportunities:** Advance your career with
 
 
 </li>
 </ul>
 ongoing training and development programs.
 
 
 <ul>
 <li>
 **Dynamic Work Environment:** Collaborate with a team of passionate
 
 
 </li>
 </ul>
 and driven individuals in a work environment that promotes
 
 
 flexibility.
 
 
 <ul>
 <li>
 **Trust and Stability:** Work for one of the most trusted companies
 
 
 </li>
 </ul>
 in Kansas with over 80 years of commitment, compassion and
 
 
 community.
 
 
 <ul>
 <li>
 **Inclusive Work Environment:** We pride ourselves on fostering a
 
 
 </li>
 </ul>
 workplace where everyone is valued and respected.
 
 
 **Benefits &amp; Perks**
 
 
 <ul>
 <li>
 Base compensation is only one component of your competitive Total
 
 
 </li>
 </ul>
 Rewards package
 
 
 <ul>
 <li>
 Incentive pay program (EPIP)
 </li>
 <li>
 Health/Vision/Dental insurance
 </li>
 <li>
 6 weeks paid parental leave for new mothers and fathers
 </li>
 <li>
 Fertility/Adoption assistance
 </li>
 <li>
 2 weeks paid caregiver leave
 </li>
 <li>
 401(k) plan matching up to 5%
 </li>
 <li>
 Tuition reimbursement
 </li>
 <li>
 Health &amp; fitness benefits, discounts and resources
 
 
 </li>
 </ul>
 **Job Summary**
 
 
 A health claims examiner is responsible for reviewing, evaluating, and
 
 
 processing health, drug, dental and/or ancillary product claims
 
 
 submitted by members or providers for insurance reimbursement. The job
 
 
 involves ensuring that claims are processed accurately and timely, in
 
 
 accordance with policy terms, industry regulations, and company
 
 
 guidelines.
 
 
 This pool will start training on May 26, 2026
 
 
 \"This position is eligible to work remotely or onsite in accordance
 
 
 with our Telecommuting Policy. Applicants must reside in Kansas or
 
 
 Missouri or be willing to relocate as a condition of employment.\"
 
 
 **What you\'ll do**
 
 
 <ul>
 <li>
 **Claims review and verification**
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 <li>
 Accurately review, analyze, and verify healthcare claims
 
 
 </li>
 </ul>
 submitted by policyholders or medical providers.
 
 
 <ul>
 <li>
 Ensure all necessary documentation, coding (International
 
 
 </li>
 </ul>
 Classification of Diseases, Tenth Revision (ICD-10), Current
 
 
 Procedural Terminology (CPT), Healthcare Common Procedure Coding
 
 
 System (HCPCS)), and data are included and correct.
 
 
 <ul>
 <li>
 Check for eligibility, coverage, and applicable benefits as per
 
 
 </li>
 </ul>
 policy terms.
 
 
 <ul>
 <li>
 **Claims Processing**:
 </li>
 <li>
 Enter and process claims information into the system with
 
 
 </li>
 </ul>
 precision and attention to detail.
 
 
 <ul>
 <li>
 Apply appropriate insurance guidelines, including deductibles,
 
 
 </li>
 </ul>
 co-pays, co-insurance, and maximum coverage limits.
 
 
 <ul>
 <li>
 Approve or deny claims based on policy coverage, ensuring
 
 
 </li>
 </ul>
 compliance with regulatory and company standards.
 
 
 <ul>
 <li>
 Perform adjustments to processed claims as needed for corrective
 
 
 </li>
 </ul>
 action.
 
 
 <ul>
 <li>
 **Communication**:
 </li>
 <li>
 Correspond with healthcare providers, patients, and internal
 
 
 </li>
 </ul>
 departments to clarify or resolve discrepancies.
 
 
 <ul>
 <li>
 **Problem Resolution**:
 </li>
 <li>
 Investigate and resolve complex or escalated claim issues, such
 
 
 </li>
 </ul>
 as coding errors, benefit misunderstandings, or billing
 
 
 discrepancies.
 
 
 <ul>
 <li>
 **Compliance and Documentation**:
 </li>
 <li>
 Ensure compliance with state and federal healthcare regulations.
 </li>
 <li>
 Maintain detailed and accurate records of all claims processed,
 
 
 </li>
 </ul>
 including documentation for audits or reviews.
 
 
 <ul>
 <li>
 **Efficiency and Quality**:
 </li>
 <li>
 Meet individual and team pe formance targets related to claims
 
 
 </li>
 </ul>
 processing speed, accuracy, and quality.
 
 
 <ul>
 <li>
 Participate in ongoing training to stay updated on changes in
 
 
 </li>
 </ul>
 health insurance policies and claims processing technologies.
 
 
 <ul>
 <li>
 Monitor and work daily reports to ensure timely claim control.
 
 
 </li>
 </ul>
 **What you need**
 
 
 **Knowledge/Skills/Abilities**
 
 
 <ul>
 <li>
 Strong attention to detail and organizational skills.
 </li>
 <li>
 Knowledge of medical claim processing, medical terminology,
 
 
 </li>
 </ul>
 insurance policies, and coding standards (ICD, CPT).
 
 
 <ul>
 <li>
 Excellent communication skills, both written and verbal.
 </li>
 <li>
 Ability to work efficiently under pressure and meet deadlines.
 </li>
 <li>
 Critical thinking and problem solving skills
 </li>
 <li>
 Office and/or computer system experience preferred
 
 
 </li>
 </ul>
 
 Education And Experience
 
 
 
 <ul>
 <li>
 High school diploma or equivalent required
 </li>
 <li>
 Previous experience in healthcare claims processing, medical
 
 
 </li>
 </ul>
 billing, medical terminology, or health insurance is preferred.
 
 
 **Physical Requirements**
 
 
 Office setting, with remote or hybrid work opportunities depending
</div>

Claims Examiner

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