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claims service specialist

commercial litigation claims examiner Jobs in Tampa

commercial litigation claims examiner

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customer claims representative

claims adjuster

Slide Insurance

<div><div>Slide Insurance - Fun. Innovation Driven. Fueled by Passion, Purpose and Technology.

At Slide, you will not only be part of a successful team, but you will also be a part of our Slide Vibe/award winning culture where collaboration and innovation are expected, recognized and awarded!</div>
What you will be doing:
<ul>
<li>Oversee a caseload of large and/or complex residential property claims, ensuring timely and accurate handling.</li>
<li>Deliver superior customer service to each insured and external business partner, maintaining high engagement throughout the claims process.</li>
<li>Proactively communicate and set accurate claims expectations with customers.</li>
<li>Evaluate claims and resolve policy coverage issues within established authority</li>
<li>Examine and analyze policies, forms, and records to determine coverage and the extent of the company's exposure or liability.</li>
<li>Negotiate and settle claims in line with the company's best practices and industry standards, aiming for optimal resolutions.</li>
<li>Research and stay current on all statutory requirements related to residential property claims.</li>
<li>Apply knowledge of multiple state statutes, including the insurance code of ethics, rules, regulations, and guidelines, ensuring legal compliance.</li>
<li>Assign, direct, monitor, and assist in building external partnerships, making expert recommendations when necessary.</li>
<li>Document all relevant information in the electronic claims management system accurately and comprehensively.</li>
<li>Establish timely and appropriate claim reserves in accordance with claim standards, ensuring financial accuracy.</li>
<li>Perform other duties, as assigned.</li>
</ul>
What you already have:

Education, Experience, and Licensing:
<ul>
<li>Bachelor's degree or High School diploma and equivalent relevant work experience required.</li>
<li>4+ years of experience in residential property claims, handling a diverse range of claim types.</li>
<li>3+ years of experience working directly for an insurance carrier.</li>
<li>Experience with state-specific insurance laws and good faith claims handling, with a preference for those knowledgeable in Florida laws required.</li>
<li>Experience with all aspects of front-end claim handling including litigation, third party claims handling preferred.</li>
<li>Industry designations or certifications, such as CPCU or AIC, are a plus.</li>
</ul>
Qualifications/Skills and Competencies:
<ul>
<li>A thorough understanding of insurance-related legal procedures, regulations, and claims processing, with a focus on residential properties.</li>
<li>Strong vendor management and negotiation skills.</li>
<li>Comprehensive knowledge of residential property claims practices and legal terminology.</li>
<li>Xactimate proficiency is highly preferred</li>
<li>Demonstrated leadership and managerial qualities, with the capacity to mentor and guide peers.</li>
<li>Proven adaptability and flexibility; able to adjust to new requirements or unforeseen issues.</li>
<li>Excellent interpersonal skills with a focus on outstanding customer service.</li>
<li>Strong planning and organizational skills.</li>
<li>Exceptional time management skills, ability to prioritize tasks and allocate resources efficiently and ability to work independently.</li>
<li>Proficiency in MS Office/365 applications such as Microsoft Teams, SharePoint, Word, Excel, PowerPoint, and Outlook.</li>
<li>Desire to live Slide's Core Values.</li>
</ul><div>
What Slide offers to you:

The Slide Vibe - An opportunity to be a part of a fun and innovation-driven culture fueled by Passion, Purpose and Technology! Slide offers many opportunities to collaborate and innovate across the company and departments, as well as get to know other Sliders. From coffee chats, to clubs, to social events - we plan it, so all Sliders feel included and Enjoy their Journey.

Benefits - Created using Slider feedback, Slide offers a comprehensive and affordable benefits package to cover all aspects of health...Physical, Emotional, Financial, Social and Professional. A Lifestyle Spending Account is set up for each Slider and Slide contributes to it monthly for use on any benefit that individually suits you - Health Your Way! 


2023, 2024 &amp; 2025 BEST PLACE TO WORK - Tampa Bay Business Journal

2024 &amp; 2025 TOP WORKPLACE - Tampa Bay Times &amp; USA Today</div></div>

Senior Claims Adjuster – Large Loss

Chubb Insurance

<div>Responsibilities include, but are not limited to:
<ul><li>Receives assignments and reviews claim and policy information to provide background for investigations. May determine the extent of the policy&rsquo;s obligation to the insured, depending on the line of business.
</li><li>Contacts, interviews, and obtains statements (recorded or in person) from insured individuals, claimants, witnesses, medical professionals, legal representatives, law enforcement, and other relevant parties to gather necessary claim information.
</li><li>Depending on the line of business, may inspect and appraise damage for property losses or arrange for such appraisal.
</li><li>Evaluates facts obtained during investigations to determine the extent of liability and the company&rsquo;s obligation under the policy contract.
</li><li>Prepares reports on investigations, settlements, claim denials, and evaluations of involved parties.
</li><li>Sets reserves within authority limits and recommends reserve changes to the Team Leader.
</li><li>Reviews the progress and status of claims with the Team Leader, discussing challenges and recommending solutions.
</li><li>Prepares and submits to the Team Leader any unusual or potentially undesirable exposures.
</li><li>Assists the Team Leader in developing methods and improvements for handling claims.
</li><li>Resolves claims promptly and fairly.
</li><li>Obtains releases, proofs of loss, or compensation agreements and issues company drafts for claim payments.
</li><li>Communicates claim denials to claimants, insureds/customers, or attorneys as applicable.
</li><li>Manages litigation as required.</li></ul></div>
 <div><ul><li>Minimum of 5 years of technical claims handling experience in Auto and General Liability lines, demonstrating a high level of knowledge and competence.
</li><li>Experience working in a Third-Party Administrator (TPA) environment is strongly preferred.
</li><li>Must obtain and maintain required state licenses.
</li><li>Strong knowledge of insurance coverages and a solid understanding of applicable legal principles.
</li><li>Familiarity with auto liability cost containment programs and proven account management skills.
</li><li>Excellent communication, negotiation, and interpersonal skills for effective interaction with all levels of internal and external stakeholders.
</li><li>Strong analytical and problem-solving abilities.
</li><li>Demonstrated commitment to providing consistently superior customer service.
</li></ul>An applicable resident or designated home state adjuster&rsquo;s license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS&rsquo;s employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.</div>
 <div><div>Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. 
</div><div></div> 
<div>At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.</div></div>

ESIS Senior Claims Representative, AGL

Safepoint MGA, LLC

<div>Safepoint Insurance is an admitted Property and Casualty Insurance carrier. We are based in Temple Terrace, FL. Our Claims Department is growing and we are looking for self-motivated professionals ready to support our organization.
Job Title: Claims Service Representative - Bilingual Preferred
Job Location: Office in Tampa (on Gunn Hwy) 
The Claims Service Representative provides prompt, effective and courteous handling of all inquiries to policy holders and claimants with special emphasis on complying with appropriate guidelines. Complete assigned administrative tasks related to the claims process function. 
Duties and responsibilities<ul><li>
Direct customer and vendor inquiry calls</li><li>
Conduct First Notice of Loss calls and corresponding documentation</li><li>
Monitor Phone Queue for proper coverage and escalate calls when needed</li><li>
Obtain police and fire reports and other reports subject to public information requests</li><li>
Responsible for dispatching examiner assignment to IA or expert</li><li>
Responsible for organizing, scanning and dispatch of incoming and outgoing correspondence such as mail, fax, and emails</li><li>
Responsible for claims projects as assigned</li><li>
Maintain accurate and complete files, updating the claims system daily</li><li>
Print, verify, and mail checks and letters daily</li><li>
Monitor claims inbox for Incoming e-mails, and distribute and file as appropriate</li><li>
Monitor new incoming claims and assign them to appropriate desk or field adjuster</li><li>
Pay invoices and update spreadsheets and claims system</li><li>
Other tasks and projects as may be assigned</li></ul> 
Essential Functions<ul><li>
Use telephone and computer systems to communicate with and service customers</li><li>
Use computer system to update claim files daily</li><li>
Ability to take and direct at least 30 &ndash; 50 phone calls per day</li><li>
Ability to print and physically mail correspondence</li><li>
Ability to work independently in a fast-paced office environment; meet deadlines and manage changing priorities effectively</li></ul> 
Qualifications<ul><li>
College degree or related experience</li><li>
2 years of customer service experience analyzing and solving customer problems</li><li>
Florida All-Lines Adjuster's license (6-20) strongly preferred; ability to obtain license required</li><li>
Proficiency with Microsoft Office products required</li><li>
Ability to use systems such as Policy Port, CMS, Unisoft.</li><li>
Bilingual in English and Spanish preferred</li><li>
Excellent communication skills and ability to interact on a professional level with internal and external personnel and partners</li></ul> 
Licensing requirements
Please note that most organizations overseeing Property and Casualty licensure requirements, including the Florida Department of Financial Services, require individuals to answer background questions about criminal history and undergo fingerprinting as part of the licensing process. Obtaining applicable licensure is a requirement for this position. 
 
Physical requirements
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to type, handle or feel; and reach with hands and arms. 
Working conditions
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, copiers, filing cabinets and fax machines. 
Compensation and Benefits
We recognize that talented professionals are attracted to companies that provide a great place to work, combined with a comprehensive and competitive pay and benefits package, along with opportunities for personal growth and job advancement. For this reason we are pleased to provide:<ul><li>
Market Competitive Wages commensurate with experience</li><li>
Prof. Development and Educational Assistance Programs</li><li>
Safe Harbor 401K Plan with Immediate Vesting and an Automatic Company Contribution</li><li>
Paid Time-Off (Discretionary, PTO, Parental Leave, and others)</li><li>
Company Paid Holidays</li><li>
Health Insurance</li><li>
Dental Insurance</li><li>
Vision Insurance</li><li>
Short and Long Term Disability Insurance (company paid)</li><li>
Flexible Spending Accounts with Company Contribution</li><li>
Health Savings Accounts with Company Contribution</li><li>
Employee Life and AD&amp;D Insurance</li><li>
Dependent Life and AD&amp;D Insurance</li><li>
Company paid AAA Membership</li><li>
Company paid Identity Theft Protection</li><li>
Other Ancillary Insurance Benefit Programs</li><li>
And more&hellip;</li></ul>
Safepoint Insurance is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Safepoint depends solely on your qualifications. 

vl8nGKXJNa</div>

Claims Customer Service Representative

Heritage Insurance

<div></div><div>Commercial Litigation Liability Claims Specialist
Location: Tampa, Florida &ndash; In the heart of the vibrant Westshore District, just minutes from Tampa International Airport
Are you a seasoned commercial liability claims professional who thrives in complex litigation environments? Do you bring deep coverage expertise, sharp negotiation skills, and the confidence to manage high-exposure claims? If so, we invite you to join our team.
At Heritage Insurance, we combine strong financial performance with a people-first culture. As a publicly traded organization, we are committed not only to operational excellence but also to giving back to the communities we serve. Our team members enjoy an exceptional, highly competitive compensation and benefits package, with benefits beginning the first day of the month following your date of hire.
Located in the dynamic Westshore Business District of Tampa, near Tampa International Airport, our office offers convenience, energy, and accessibility in one of the region&rsquo;s most desirable business hubs.
Position Summary
This role is responsible for analyzing complex commercial liability coverage issues and managing litigated claims from inception through resolution in accordance with company Best Practices. You will investigate, evaluate, reserve, negotiate, and settle high-exposure claims while delivering superior customer service and exercising disciplined indemnity and expense management.
The ideal candidate is experienced in interpreting commercial construction contracts, hold harmless agreements, indemnification provisions, and contractual liability defense and indemnity language. You will collaborate closely with coverage counsel, defense counsel, and executive leadership while maintaining ownership of your claim inventory.
Key Responsibilities<ul><li>
Manage complex, litigated commercial liability claims from first notice through disposition.</li><li>
Analyze insurance coverage and issue reservation of rights and disclaimer letters as appropriate.</li><li>
Interpret commercial construction contracts, indemnification agreements, and contractual liability provisions.</li><li>
Develop and implement litigation strategies in partnership with defense counsel in accordance with Litigation Guidelines.</li><li>
Attend mediations, depositions, arbitrations, pre-trials, and trials as needed.</li><li>
Negotiate and settle claims within delegated authority while identifying alternative resolution strategies.</li><li>
Evaluate liability and damages exposure and establish appropriate indemnity and expense reserves.</li><li>
Present high-level claim summaries to executive leadership.</li><li>
Control and manage third-party defense costs in alignment with Legal Department standards.</li><li>
Identify and pursue risk transfer opportunities, including additional insured and other insurance provisions.</li><li>
Maintain strong diary management and documentation standards to ensure timely, compliant file handling.</li><li>
Coordinate investigations with underwriting, subrogation, fraud, fire investigators, OSHA, contractors, engineers, and other technical experts as needed.</li><li>
Ensure compliance with Claim Department Best Practices and company policies.</li></ul>
What You Bring<ul><li>
Exceptional analytical and coverage interpretation skills.</li><li>
Advanced negotiation and complex bodily injury evaluation experience.</li><li>
Proven success managing litigation and collaborating effectively with defense counsel.</li><li>
Strong emotional intelligence and the ability to manage conflict with professionalism.</li><li>
Clear and persuasive written and verbal communication skills.</li><li>
The ability to independently manage a high-exposure inventory in a fast-paced environment.</li><li>
Strong organizational discipline and results-driven mindset.</li><li>
Leadership presence with mentoring capabilities.</li><li>
Advanced proficiency in Microsoft Office products.</li></ul>
Qualifications<ul><li>
Associate&rsquo;s degree required; Bachelor&rsquo;s degree preferred.</li><li>
10+ years of liability claim handling experience (multi-jurisdictional preferred).</li><li>
5+ years of commercial general liability claim handling.</li><li>
5+ years of litigation claim management.</li><li>
5+ years of bodily injury evaluation and negotiation experience (serious injury preferred).</li><li>
Florida Adjuster License required (multi-state licensing preferred).</li><li>
HOA/Condominium claims experience and familiarity with property management documents preferred.</li></ul>
Why Join Us?<ul><li>
Exceptional Compensation &amp; Highly Competitive Benefits</li><li>
Benefits begin the first day of the month following your date of hire</li><li>
A collaborative, entrepreneurial, and supportive work culture</li><li>
Commitment to community involvement and social impact as a publicly traded company</li><li>
Prime Tampa location in the heart of Westshore, minutes from the airport</li></ul>
We are proud to foster an engaging workplace where expertise is valued, collaboration is encouraged, and performance is recognized.
Pre-employment background screening required. Additional checks (driving history, credit report) may apply depending on the position.
Heritage Insurance Holdings, Inc. is an Equal Opportunity Employer and does not discriminate on any legally protected basis.</div>

Commercial Litigation Claims Examiner

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.
 
 
 
 Claims Specialist &ndash; Tampa, Florida
 
 
 Salary: $28.29 - $34.24 per hour / $57,000 - $69,000 annually
 
 
 Claim your career growth as a Claims Service Specialist at GEICO&rsquo;s Tampa, Florida office and be a part of one of the fastest-growing auto insurers in the United States! If you are motivated, all about solutions, and empathetic to the needs of customers, come grow a fulfilling career with us!
 
 
 Through our paid, industry-leading training, you will learn the ins and outs of the claims process and be ready to assist our policyholders when they need us the most &ndash; during an accident. As a Claims Service Specialist, you will collect facts about the accident, investigate claim details, and collect statements from involved parties. Our policyholders will count on your patience, support, and attention to detail to get them back on the road as quickly as possible. GEICO will also give you the space and grace to explore your abilities and learn new ones. So if you are ready to start growing your career, let&rsquo;s talk!
 
 
 Many associates see a base salary increase of 10% within their first year as a Claims Specialist. Top associates can see increases up to 15%!
 
 
 
 Qualifications &amp; Skills
 
 
 
 <ul>
 <li>
 Experience providing outstanding customer service by showcasing expertise, fostering trust and growing customer satisfaction
 </li>
 <li>
 Solid computer multitasking skills
 </li>
 <li>
 Ability to effectively communicate, verbally and in writing, and willingness to expand on these abilities
 </li>
 <li>
 Ability to work comfortably and grow in a fast-paced, high-volume call center environment
 </li>
 <li>
 Minimum of high school diploma or equivalent, college degree or currently pursuing preferred
 </li>
 <li>
 Eagerness to explore new skills and openness to different career paths
 
 
 </li>
 </ul>
 #geico300
 
 
 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>

Claims Service Specialist

NTT DATA

<div>Company Overview: 
Req ID: 360808 
NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. 
 
We are currently seeking a Claims Specialist to join our team and REMOTE. The position is for 6 months and pay rate is $19.25/hour W2 
 
Job Description: 
Claims Specialist 
Job Description 
The claims Specialist will Identify primary vs. secondary coverage when a member has more than one health plan. Reviewing and updating claims to reflect correct COB rules Applying COB primacy rules (subscriber status, effective dates, plan type, Medicare coordination, etc.) Communicating with members, providers, and other insurers to verify coverage details Correcting overpayments, initiating refunds or reprocessing, and maintaining accurate claim records Working within claims systems and following regulatory and compliance requirements (e.g., HIPAA) 
 
Job Duties 
Duties may include the following responsibilities or functions required to support the claims unit.
<ul><li>Reviews, research, and make necessary updates to claims that may include the following: recalculation of benefits to previously processed claims, the processing of claims edits, or initiation of refund requests, according to contractual benefits or provider reimbursement rules, ultimately providing a high degree of customer satisfaction.</li>
<li>Achieves and maintains a clear understanding of all systems, applications, and procedures necessary to identify denial codes, edits, and processing codes pertaining to all claims (including our coordination with additional coverage plans) to process both coordinated and non-coordinated claims correctly. Requesting medical records may be required.</li>
<li>Communicates, both orally and in writing, with internal and external contacts to provide necessary and accurate information for the establishment of sound claims records. This may include, but is not limited to, the coordination of benefits (COB), medical record requests, etc.</li>
<li>Review quality audits for correction or routing within 48 hours of receipt following departmental and corporate guidelines to ensure accuracy of claims processing and customer satisfaction.</li>
<li>Research, investigates, and determines the correct order of benefits for payment to be made by the applicable plans and makes necessary corrections to COB records. Communicates to appropriate department(s) when Medicare has determined primacy incorrectly and ensures a letter is generated to notify Medicare. Failure to report discrepancy could result in a daily fine up to ***</li>
<li>Analyzes, investigates, resolves problem cases (to include COB records, adjusting previously processed claims and requesting refund of overpaid claims). Reviews of all previously processed claims to ensure consistency in payments to maximize recovery of overpayments following corporate and departmental guidelines to ensure financial stability.</li>
<li>Executes procedures to recover funds from providers, subscribers, or beneficiaries where overpayments have occurred to ensure accuracy of claims processing and financial stability.</li>
<li>Steps in and assists in any other capacity as deemed necessary (i.e., training, implementations, and documentation). May complete special projects as assigned by Management due to internal audit findings, multiple provider status changes, and system errors following corporate and departmental guidelines to ensure financial stability and customer satisfaction.</li>
</ul>Required Skills
<ul><li>2 years in medical claims processing required &bull; Coordination of Benefits (COB) processing experience preferred</li>
<li>Strong analytical ability, that includes strong logical, systemic, and investigates thinking.</li>
<li>Strong oral and written communication skills and human relations skills are necessary.</li>
<li>Working knowledge of relevant PC software.</li>
<li>Ability to prioritize multiple streams of work effectively.</li>
</ul>Education
<ul><li>High School Diploma or equivalent required Work Experience</li>
</ul>
 
About NTT DATA: 
 
NTT DATA is a $30 billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize and transform for long term success. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure and connectivity. We are one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&amp;D to help organizations and society move confidently and sustainably into the digital future. Visit us at us.nttdata.com 
 
NTT DATA endeavors to make https://us.nttdata.com accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at https://us.nttdata.com/en/contact-us. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here. If you'd like more information on your EEO rights under the law, please click here. For Pay Transparency information, please click here. 
 
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is $19.25/hour. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance. 
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&amp;D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits. 
#indist 
#li-northamerica</div>

Healthcare Claims Specialist

Humanitary Medical Center, INC

<div></div><div>HMC Dental Services Inc. is seeking a highly experienced and detail-oriented Dental Billing Specialist to join our elite, technology-driven dental practice. The ideal candidate will have a strong background in dental billing, ADA coding, insurance verification, and account reconciliation. This role is pivotal to maintaining an efficient revenue cycle and providing an outstanding patient experience through accurate and transparent billing practices.<h3 class="jobSectionHeader">
Key Responsibilities</h3><h4 class="jobSectionHeader">
Insurance Claims Management</h4><ul><li>
Prepare and submit dental claims accurately and timely (electronic and manual).</li><li>
Verify dental insurance eligibility and benefits (PPO &amp; Medicare Advantage).</li><li>
Attach necessary documentation (e.g., x-rays, perio charting, narratives) through platforms,</li><li>
Follow up on unpaid, denied, or underpaid claims to ensure maximum reimbursement.</li><li>
File appeals and corrections for denied claims, including submission of supplemental information.</li><li>
Submit pre-authorizations and predeterminations as required.</li></ul><h4 class="jobSectionHeader">
Patient Account Management</h4><ul><li>
Post insurance and patient payments (EFT, checks, and patient payments).</li><li>
Reconcile and manage accounts receivable, ensuring accurate and timely follow-up.</li><li>
Generate and send monthly patient statements, particularly for balances following insurance denials.</li><li>
Respond to billing inquiries and resolve patient account issues professionally and promptly.</li><li>
Assign overdue balances to collections when necessary, following internal protocols.</li></ul><h4 class="jobSectionHeader">
Billing Accuracy &amp; Compliance</h4><ul><li>
Ensure accurate use of ADA procedure codes.</li><li>
Identify and correct account errors, such as inaccurate demographics or insurance setup.</li><li>
Stay current with dental insurance billing policies and coding updates.</li><li>
Maintain compliance with federal, state, and payer-specific regulations.</li></ul><h4 class="jobSectionHeader">
Reporting &amp; Collaboration</h4><ul><li>
Prepare daily, weekly, and monthly billing and production reports.</li><li>
Collaborate with front desk, dental assistants, and providers to ensure accurate documentation and timely billing.</li><li>
Support credentialing and re-credentialing processes for providers as needed.</li><li>
Assist Financial Coordinator with cost estimates and patient financial responsibility reviews.</li><li>
Maintain the cleanliness and confidentiality of all billing-related documentation.</li></ul><h3 class="jobSectionHeader"> 
Qualifications &amp; Skills</h3><ul><li>
Minimum 2 years of dental billing experience required.</li><li>
Strong knowledge of ADA coding, PPO and Medicare Advantage plans.</li><li>
Experience with dental software Open Dental.</li><li>
High attention to detail and ability to multitask in a fast-paced environment.</li><li>
Excellent communication, organizational, and analytical skills.</li><li>
Strong customer service orientation with a problem-solving mindset.</li><li>
Must work on-site; remote work is not available for this position.</li><li>
Bilingual in English and Spanish is a plus.</li><li>
Knowledge of HIPAA and dental billing compliance standards</li></ul>
You will be eligible for a generous benefits package that includes:<ul><li>Paid time off (PTO)</li><li>Paid Holidays</li><li>401K</li><li>Voluntary Life Insurance</li><li>Employee Assistance Program (EAP)</li><li>Medical, Dental and Vision Benefits</li></ul>
Work Location:<div>
4200 W Cypress St. Suite 690</div><div></div><div> 
Humanitary Medical Center Inc. complies with all federal, state, and local laws prohibiting employment discrimination of any kind. Humanitary Medical Center Inc. is an at-will employer and can terminate its employment relationship at any time, with or without cause, and without notice.</div></div>

Billing Dental

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