claims examiner

Baystate Health

<div><p><b>Summary</b></p>
<p><b>
Location</b>: 1 Monarch Place; Springfield MA</p>
<p><b>
Schedule</b>: Monday-Friday; 8hrs per day; Flexible start time 7a-630pm</p>
<p></p>
<p></p><p>The Claims Examiner is responsible for providing claims production to the Claims Production Team to enable the administration of non-auto adjudicated claims which contributes to the overall success of Claims Production ensuring specific individual goals, plans, initiatives are executed and delivered in support of the team&rsquo;s business strategies and objectives. The Claims Examiner is responsible for maintaining and adhering to internal controls, ensuring compliance with applicable laws and regulations, and following Health New England&rsquo;s entity level policies and procedures. The position is responsible for reporting unethical or fraudulent activity related to business operations and adhering to Health New England&rsquo;s Code of Conduct.</p>
<p></p>
<p>Accountabilities</p>
<ul><li>Champions a customer focused culture to deepen client relationships and leverage broader Health New England&rsquo;s relationships, systems and knowledge.</li><li>Understand how Health New England&rsquo;s culture and the CX Promise should be considered in day-to-day activities and decisions.</li><li>Actively pursues effective and efficient operations of their respective areas in accordance with Health New England&rsquo;s Values, its Code of Conduct and the Associate Handbook, while ensuring the adequacy, adherence to and effectiveness of day-to-day business controls to meet obligations with respect to operational, compliance, and conduct.</li><li>Champions a high-performance environment and contributes to an inclusive work environment.</li><li>Contributes to overall Claims Production productivity by accurately adjudicating claims at all levels of complexity.</li><li>Meets/exceeds individual, role, and departmental standards of quality and productivity.</li><li>Finalizes claims to correct processing discrepancies and other edits by reviewing all available information and applying documented policies and procedures.</li><li>Resolves specialty pends to remedy processing discrepancies and other edits while coordinating editing from external Claims Adjudication Partners/vendors.</li><li>Evaluates claims to ensure payments are reasonable for the services rendered.</li><li>Identifies discrepancies and/or gaps in auto adjudication, documented policies and procedures to Senior Examiners.</li><li>Identifies unexplained variations in claims adjudication to Senior Examiners.</li></ul>
<h3 class="jobSectionHeader"><b>
High School diploma with a minimum of 3 years of progressively responsible health care claims insurance administration experience or an equivalent combination of education and experience.</b><br>
<ul><li><b>Knowledge and understanding of health care payer industry standards; Experienced in healthcare related standards such as HIPAA, ACA, CMS, AMA, DOI, MassHealth, ERISA and other regulatory agencies</b></li><li><b>Healthcare knowledge of industry coding standards/forms including by not limited to CPT4, ICD10, UB04, and HCF1500.</b></li><li><b>Experience with health claims processing systems and related technology.</b></li><li><b>Experience in handling confidential information.</b></li><li><b>Excellent interpersonal skills; Demonstrated ability to work with teams.</b></li><li><b>Excellent oral and written communication and interpersonal skills.</b></li><li><b>Proficiency with Microsoft Office products.</b></li></ul></h3>
<p>
</p><p></p><p><b>Education:</b></p>
<p>
GED or HiSET (Required)</p>
<p>
</p><p></p><p><b>Certifications:</b></p>
<p></p>
<p><b>Compensation</b></p>
<p>
Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.</p>
<p></p>
<p>Minimum &ndash; Midpoint &ndash; Maximum</p>
<p>
$23.46 &ndash; $26.97 &ndash; $31.91</p><br>
<p></p>
<p><b>
Equal Employment Opportunity Employer</b></p>
<div>
<div><div><div><div><div><div><p>Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.</p></div></div></div></div></div></div></div></div>

Claims Examiner

Delta Dental

<div><div><b>About Us</b></div><div></div><div><br>
Delta Dental of New Jersey and Delta Dental of Connecticut are proud to be leaders in the dental insurance industry, offering a wide range of plans to meet the needs of individuals and employers alike. As New Jersey&rsquo;s largest dental coverage provider, we are committed to delivering high-quality, cost-effective solutions designed to meet the diverse needs of our customers and our team is growing.</div><div></div><div><br>
In Connecticut, Delta Dental of Connecticut, Inc. provides fully insured dental coverage, while Delta Dental of New Jersey administers self-funded dental benefit programs. We proudly serve over 1.7 million individuals through more than 1,800 groups, including commercial, school board, and government programs.</div><div></div><div><br>
Since 1969, Delta Dental has been at the forefront of innovation, offering programs that control costs while ensuring the highest level of benefits.</div><div></div><div><br>
As a member of the national Delta Dental Plans Association, we provide national dental coverage to over 75 million people across 139,000 groups. Our commitment to excellence is reflected in our prestigious Standard &amp; Poor&rsquo;s &ldquo;A+&rdquo; rating for financial strength. Join us and be a part of a trusted company with a rich history of delivering quality dental benefits to millions.</div><div>
We value our associates and support everyone with learning and development, active wellness and diversity initiatives, and volunteer opportunities at causes that you care about.</div><div></div><div><b><br>
About the Position</b></div><div></div><div><br>
Our Claims Examiners are provided with established company guidelines and examine and adjudicate dental claims using these guidelines, with expected levels of quality and productivity.</div><div></div><div><br>
During the first five weeks of employment, you will participate in full‑time, paid training conducted in the office five days per week, Monday through Friday, from 8:30 a.m. to 4:30 p.m. Following the completion of training, this role will transition to a full‑time, hybrid schedule working Monday through Friday from 8:00 a.m. to 4:30 p.m., with in‑office days on Tuesday and Wednesday and remote work on Monday, Thursday, and Friday. This position starts at $22.05 per hour and is benefits-eligible.</div><div></div><p><br>
The expected Start date for this position is April 20th, 2026.</p><div></div><div><b><br>
Essential Functions &amp; Responsibilities</b></div><div><ul><li>
Accesses systems and keys claim data and other information and notations from work queues. Suspends, routes and adjudicates claims and performs research as required. Also, inputs fee filing data, as required</li></ul></div><div><ul><li>
Creates and processes claims for pre-treatment estimates with payments.</li></ul></div><div><ul><li>
Maintains and updates subscribers files with information obtained through inquiries and submitted claims and documents, i.e., family on hold codes applied or removed, student status deferred, addresses updated. Reports file discrepancies to management.</li></ul></div><div><ul><li>
Responsible for researching and retrieving all documentation and resolving all claims in question, including student documentation, provider research, some coordination of benefits, diagnostics materials, etc.</li></ul></div><div><ul><li>
Understands rejects and applies appropriate RFS codes as well as processing policies on applicable claims.</li></ul></div><div><ul><li>
Requests information from providers and subscribers through telephone contact or written correspondence.</li></ul></div><div><ul><li>
Resolves claims related system generated error and adjustment reports.</li></ul></div><div><ul><li>
Supports and participates in completing claims related projects.</li></ul></div><div><ul><li>
Acquire necessary skills through in-house training for Claim Examiner II position. Achieve Level II position within 36 months from start of Claims Examiner I.</li></ul></div><div><ul><li>
When necessary, refers inquiries to management, dental consultants or appropriate outside organizations.</li></ul></div><div><ul><li>
Provides management with required production figures as requested.</li></ul></div><div><ul><li>
Other duties as assigned</li></ul></div><div></div><div><b><br>
Essential Qualifications</b></div><div></div><div><b><br>
Competencies</b></div><div></div><div><div><div><br>
Adaptability-Flexibility</div><div><br>
Communication Skills</div></div><div><div><br>
Computer Skills</div><div><br>
Customer Focus</div></div><div><div><br>
Dependability</div><div><br>
Job Knowledge</div></div><div><div><br>
Productivity</div><div><br>
Quality</div></div><div><div><br>
Teamwork</div></div></div><div></div><div><b><br>
Technical and Functional</b></div><ul><li>
Personal computer skills with the ability to type 25 words per minute</li><li>
Possess the ability to use Microsoft Word and Excel</li><li>
Excellent written and oral communication skills</li><li>
Ability to research and troubleshoot problems</li><li>
Demonstrate good analytical and proofreading skills</li><li>
Attention to detail</li><li>
Good organizational skills</li></ul><div><b>
Key Performance Indicators</b></div><ul><li>
Meet-exceed CPH of 30 or above</li><li>
Maintain TQM of 99% or higher</li></ul><div><b>
Required Physical Abilities</b></div><div>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</div><br>
<div></div><ul><li>
Ability to sit and perform extensive close keyboard and PC work</li><li>
Ability to walk, talk or hear</li><li>
Occasionally required to stand and reach with hands and arms</li></ul><div><b>
Working Environment</b></div><ul><li>
Ability to meet deadlines and attendance standards.</li><li>
The noise level in the work environment is usually moderate.</li><li>
This classification will be required to sign a confidentiality agreement.</li></ul><div></div><div><b><br>
Experience, Education and Certifications Required</b></div><div></div><div><b><br>
Experience Required</b></div><ul><li>
1-3 years claims processing or related service experience</li><li>
Dental Assistant education/experience preferred</li></ul><div><b>
Required Educational Level</b></div><div><ul><li>
Requires high school diploma or equivalent.</li></ul></div></div>

Blue Cross and Blue Shield of Kansas

<div>
 This job was posted by https://www.kansasworks.com : For more
 <br/>
 <br/>
 information, please see: https://www.kansasworks.com/jobs/13531717 **Are
 <br/>
 <br/>
 you ready to make a difference? Choose to work for one of the most
 <br/>
 <br/>
 trusted companies in Kansas.**
 <br/>
 <br/>
 You Belong At Blue
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 <ul>
  <li>
   Why Join Us?**
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   **Make a Positive Impact:** Your work will directly contribute to
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 </ul>
 the health and well-being of Kansans.
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   **Family** **Comes First**: Total rewards package that promotes the
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 </ul>
 idea of family first for all employees. Paid vacation and sick leave
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 with paid maternity and paternity available immediately upon hire
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  <li>
   **Professional Growth Opportunities:** Advance your career with
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  </li>
 </ul>
 ongoing training and development programs.
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 <ul>
  <li>
   **Dynamic Work Environment:** Collaborate with a team of passionate
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  </li>
 </ul>
 and driven individuals in a work environment that promotes
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 flexibility.
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   **Trust and Stability:** Work for one of the most trusted companies
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  </li>
 </ul>
 in Kansas with over 80 years of commitment, compassion and
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 community.
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 <ul>
  <li>
   **Inclusive Work Environment:** We pride ourselves on fostering a
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 </ul>
 workplace where everyone is valued and respected.
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 **Benefits &amp; Perks**
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   Base compensation is only one component of your competitive Total
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 </ul>
 Rewards package
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  <li>
   Incentive pay program (EPIP)
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   Health/Vision/Dental insurance
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   6 weeks paid parental leave for new mothers and fathers
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   Fertility/Adoption assistance
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   2 weeks paid caregiver leave
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   401(k) plan matching up to 5%
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   Tuition reimbursement
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   Health &amp; fitness benefits, discounts and resources
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  </li>
 </ul>
 **Job Summary**
 <br/>
 <br/>
 A health claims examiner is responsible for reviewing, evaluating, and
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 <br/>
 processing health, drug, dental and/or ancillary product claims
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 submitted by members or providers for insurance reimbursement. The job
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 <br/>
 involves ensuring that claims are processed accurately and timely, in
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 <br/>
 accordance with policy terms, industry regulations, and company
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 <br/>
 guidelines.
 <br/>
 <br/>
 This pool will start training on May 26, 2026
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 \"This position is eligible to work remotely or onsite in accordance
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 with our Telecommuting Policy. Applicants must reside in Kansas or
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 Missouri or be willing to relocate as a condition of employment.\"
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 **What you\'ll do**
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 <ul>
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   **Claims review and verification**
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   Accurately review, analyze, and verify healthcare claims
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 </ul>
 submitted by policyholders or medical providers.
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   Ensure all necessary documentation, coding (International
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 Classification of Diseases, Tenth Revision (ICD-10), Current
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 Procedural Terminology (CPT), Healthcare Common Procedure Coding
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 System (HCPCS)), and data are included and correct.
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   Check for eligibility, coverage, and applicable benefits as per
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 policy terms.
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   **Claims Processing**:
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   Enter and process claims information into the system with
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 precision and attention to detail.
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   Apply appropriate insurance guidelines, including deductibles,
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 co-pays, co-insurance, and maximum coverage limits.
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   Approve or deny claims based on policy coverage, ensuring
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 compliance with regulatory and company standards.
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   Perform adjustments to processed claims as needed for corrective
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 action.
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   **Communication**:
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   Correspond with healthcare providers, patients, and internal
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 </ul>
 departments to clarify or resolve discrepancies.
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   **Problem Resolution**:
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   Investigate and resolve complex or escalated claim issues, such
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 </ul>
 as coding errors, benefit misunderstandings, or billing
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 discrepancies.
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   **Compliance and Documentation**:
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   Ensure compliance with state and federal healthcare regulations.
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   Maintain detailed and accurate records of all claims processed,
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  </li>
 </ul>
 including documentation for audits or reviews.
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  <li>
   **Efficiency and Quality**:
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   Meet individual and team pe formance targets related to claims
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 </ul>
 processing speed, accuracy, and quality.
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   Participate in ongoing training to stay updated on changes in
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 </ul>
 health insurance policies and claims processing technologies.
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  <li>
   Monitor and work daily reports to ensure timely claim control.
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  </li>
 </ul>
 **What you need**
 <br/>
 <br/>
 **Knowledge/Skills/Abilities**
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  <li>
   Strong attention to detail and organizational skills.
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   Knowledge of medical claim processing, medical terminology,
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  </li>
 </ul>
 insurance policies, and coding standards (ICD, CPT).
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 <ul>
  <li>
   Excellent communication skills, both written and verbal.
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   Ability to work efficiently under pressure and meet deadlines.
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   Critical thinking and problem solving skills
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   Office and/or computer system experience preferred
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  </li>
 </ul>
 <strong>
  Education And Experience
  <br/>
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   High school diploma or equivalent required
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   Previous experience in healthcare claims processing, medical
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  </li>
 </ul>
 billing, medical terminology, or health insurance is preferred.
 <br/>
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 **Physical Requirements**
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 Office setting, with remote or hybrid work opportunities depending
</div>


Philadelphia Insurance Companies

<div><p><b>Description</b>
</p><p><b>Marketing Statement:</b></p><p>
Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.</p><p></p><p>
We are looking for a Associate Claims Examiner to join our team!<br>
<br>
Summary:<br>
Investigate and analyze insurance claims to determine extent of Insurer's obligations. Settle claims with first and third party claimants in accordance with policy provisions and applicable law.<br>
<br>
A typical day will include the following:<br>
Travel may be required to attend customer service calls, mediations, and other legal proceedings.<br>
Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts.<br>
Communicates with all relevant parties and documents communication as well as results of investigation.<br>
Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner.</p><p></p><p><b>
EEO Statement:</b></p><p>
Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.</p><p></p><p><b>
Benefits:</b></p><p>
We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.<br>
Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at https://www.phly.com/Careers/default.aspx</p></div><p></p>

Associate Claims Examiner

Prudential

<div><div>Job Classification:</div>
Operations - Insurance Operations<div></div><div><div>
At Prudential, we make lives better by solving the financial challenges of our changing world. Bring your experience and unique insights to a collaborative culture focused on meeting our customer needs!</div><div><br>
Enabling Solutions is transforming our Enterprise-wide operating model to be a customer-obsessed organization that inspires all our employees to be bold and better in all that we do.<br>
The U.S. Back Office Customer Service (BOCS) organization is seeking a Claims Examiner to join our Group Life Claim Team of Beneficiary Fulfillment on our Specialized Client Concierge Team. Our Concierge Team strives to be customer obsessed by providing a &ldquo;white glove&rdquo; service throughout the life of the claim. This involves making outbound calls and providing a proactive approach to bring resolution to each claim. This is a high touch service model where you will be interacting daily with beneficiaries and families during a difficult time of loss. Customer Service skills, Empathy, and a willingness to help others are key skills for a successful candidate in this role.<br>
<br>
The successful candidate will be trained to adjudicate life insurance claims for Group Insurance with a focus on accuracy, timeliness, and appropriate decision making. The candidate will also be trained to answer phone calls in order to assist beneficiaries and family members through the claim process. During in-classroom and on-the-job training, the incumbent will learn how to navigate our claim system, learn about our products, policies, and procedures and how to assist our customers at a time of critical need.<br>
<br>
The successful candidate will be responsible for effectively adjudicating claims to meet production, quality, and service metrics in accordance with policy/procedures and regulatory guidelines. This entails working with both internal and external partners to obtain information required for claim handling. The Claims Examiner also:<br>
<br>
<b>Key Responsibilities</b></div><ul><li>
Reviews claims and extracts information for processing</li><li>
For a portion of the day will be staffed to an incoming call line in order to assist beneficiaries and family members with questions and claim status</li><li>
Be flexible and available for evening phone coverage on a rotating basis</li><li>
Collects information and processes death claims</li><li>
Verifies, corrects, and completes claims information by telephone, letter, or personal contact</li><li>
Conducts investigations and gathers supporting documentation on claims</li><li>
Calculates benefits payable</li><li>
Approves (to a specified amount) or denies claims in accordance with established procedures</li></ul><div></div><div><b>
Qualifications</b><br>
The characteristics below describe our ideal candidate</div><div><br>
Entrepreneurial Mindset</div><ul><li>
Future State Vision, Present Day Action - Able to keep the long run goals in sight while tackling and overcoming the day-to-day deliverables and challenges.</li><li>
Creative Problem Solver - Evaluates situations from all angles, does not shy away from out of the box solutions that have not been attempted before.</li><li>
Motivated Self Starter - Enthusiastic about tackling challenges and leads the way on getting the ball rolling.</li></ul><div></div><div>
Versatile Communicator and Collaborator</div><ul><li>
Flexible and Adaptable - Able to flex their style of communication and find new ways to partner to build a cohesive team and maintain progress.</li><li>
High Awareness - Understands how different individuals and groups will react to changes and anticipates future.</li><li>
Persuasive - Able to get team members and business partners on board with the vision and execution of transformation objectives.</li></ul><div></div><div>
Intelligent Risk Taker and Decision Maker</div><ul><li>
Intelligent Risk Taker - Evaluates situations, understands the challenges, takes the necessary risks to get tasks completed.</li><li>
Decisive &ndash; Can make decisions that will be instrumental in moving work forward.</li><li>
Takes Ownership - Takes responsibility for one&rsquo;s work as if it was their own business.</li></ul><div></div><div>
Low Ego Leadership</div><ul><li>
Authentic, Thoughtful, Fair, and High Integrity - Treats everyone as equal, listens to different perspectives, and establishes an inclusive environment.</li><li>
Optimistic &ndash; Remains positive and inspiring during difficult situations and drives others to be a part of the solution.</li><li>
Embraces Humility &ndash; Understands that this job is not about knowing the right answer, it's about finding the right answer.</li></ul><div></div><div>
We also prefer:</div><ul><li>
Bachelor's degree or equivalent years of industry experience preferred</li><li>
Working knowledge of Life or Disability Claims is a plus</li></ul><div></div><div><div>
This position will work virtually, therefore new hires must be able to provide the following &amp; all new hires who work remotely will be held accountable to these standards:</div><ul><li>
Subscribe to internet service provider plan with at least 25 Mbps download speeds. You must be willing to troubleshoot any issues or outages with your home internet service, contacting your service provider as necessary.</li><li>
Must have the capability to handle calls with a cell phone (would need to have unlimited data and minutes) or a landline. Your personal phone number will not be identified to customers.</li><li>
Quiet area in your home with minimal distractions and noise free.</li><li>
Reliability and Dependability throughout our extensive training program is required.</li></ul><div></div><div>
#LI-MG1</div></div></div><div></div><div><b>
What we offer you:</b></div><div></div>
Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $45,700.00 to $75,500.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills.<ul><li><div><b>
Market competitive base salaries, with a yearly bonus potential at every level</b><b>.</b></div></li><li><div><b>
Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of absences, such as parental and military leave</b><b>.</b></div></li><li><div>
401(k) plan with company match (up to 4%).</div></li><li><div>
Company-funded pension plan.</div></li><li><div><b>
Wellness Programs</b><b> </b>including up to $1,600 a year for reimbursement of items purchased to support personal wellbeing needs.</div></li><li><div><b>
Work/Life Resources</b> to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development.</div></li><li><div><b>
Education Benefit</b> to help finance traditional college enrollment toward obtaining an approved degree and many accredited certificate programs.</div></li><li><div><b>
Employee Stock Purchase Plan: </b><b>Shares</b> can be purchased at 85% of the lower of two prices (Beginning or End of the purchase period), after one year of service.</div></li></ul><div></div><div>
Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance. To find out more about our Total Rewards package, visit <div>Work Life Balance | Prudential Careers. </div>Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.</div><div></div><div><div>
Prudential Financial, Inc. of the United States is not affiliated with Prudential plc. which is headquartered in the United Kingdom.</div></div><div></div><div><div>
Prudential is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, sex, sexual orientation, gender identity, national origin, genetics, disability, marital status, age, veteran status, domestic partner status, medical condition or any other characteristic protected by law.</div></div><div></div><div><div>
If you need an accommodation to complete the application process, please email <div>accommodations.hw@prudential.com</div>.</div></div><div></div><div><div><br>
If you are experiencing a technical issue with your application or an assessment, please email <div>careers.technicalsupport@prudential.com</div> to request assistance.</div></div></div>

Senior Claims Examiner

State of Nebraska

<div><p><b>The work we do matters!
</b></p><p><b>Hiring Agency:
</b></p>Insurance - Agency 22<br>
<p><br>
<b>Location:
</b></p>Lincoln, NE<br>
<p><br>
<b>Hiring Rate:
</b></p>$23.802<br>
<p><br>
<b>Job Posting:
</b></p>JR2026-00024513 Insurance Claims Examiner (Open)<br>
<p><br>
<b>Applications No Longer Accepted On </b>(If no date is displayed, job is posted as open until closed):
</p>05-01-2026<br>
<p><br>
<b>Job Description:
</b></p>An Insurance Complaint Examiner is responsible for reviewing incoming complaints, creating inquiry correspondence to send to insurance companies and reviewing their responses for compliance with Nebraska state insurance statutes. The Examiner is also a public-facing position and is responsible for answering questions about insurance from the public.
<br>
<br>
Look at what we have to offer!
<br>
<br>
<ul><li>13 paid holidays
</li><li>Vacation and sick leave that begin accruing immediately
</li><li>Military leave
</li><li>156% (that's not a typo!) state-matched retirement
</li><li>Tuition reimbursement
</li><li>Employee assistance program
</li><li>79% employer paid health insurance plans
</li><li>Dental and vision insurance plans
</li><li>Employer-paid $20,000 life insurance policy
</li><li>Public Service Loan Forgiveness Program (PSLF) through the Federal government
</li><li>Wide variety and availability of career advancement as the largest and most diverse employer in the State
</li><li>Opportunity to be part of meaningful work and make a difference through public service
</li><li>Training and Development based on your career aspirations
</li><li>Fun, inviting teammates
</li><li>A safe and secure environment
</li></ul><br>
At the State, we stand by our core values of treating others with dignity and respect, acting ethically in all situations, and creating an environment where our customer is our top priority. Apply to join our team today!<br>
<p></p><br>
<p><b>Job duties: </b>Responds to telephone inquiries, emails and letters from individuals requesting information pertaining to insurance practices, products and premiums, and to state and federal insurance-related law. Reviews incoming complaints to identify potential concerns or violations and to determine what information, documentation and other evidence will be relevant and essential to the investigation. Corresponds with all entities involved, i.e., consumers, agents, insurance company personnel, medical providers, attorneys, and employers, gathering information necessary to evaluate complaints Reports results of reviews to consumers. Reviews and evaluates complaint responses to ensure complainants concerns have been addressed and to ensure companies and agents have acted in accordance with Nebraska insurance statutes and Department of Insurance rules and regulations. Drafts letters to complainants to report outcome of investigations; Drafts memorandums and organizes evidence obtained in case investigations to submit to department counsel for consideration of administrative action. Utilizes State Based Systems (SBS) database to track case history/activity and to retrieve licensing information and extract data to create reports of company and producer complaint activity. Other duties as assigned within the scope of the classification.
</p><p></p><p><b>Requirements/Qualifications
</b></p><p><b>Minimum Qualifications: </b>Bachelor degree in business or related field AND one year of experience in insurance industry or insurance regulation OR five years&rsquo; experience working in insurance industry or insurance regulation. Employee must have successfully completed all required on-the-job training to be eligible for this classification.<br>
</p><p></p><p><b>Other: </b>Regular and reliable attendance is required.<br>
</p><p></p><br>
<p><b>Knowledge, Skills, &amp; Abilities: </b>Knowledge of: Nebraska insurance statutes and Department of Insurance rules and regulations; the overall operation of insurance companies; insurance principles and industry practices. Ability to: Interact with insurance representatives and complainants with diverse perspectives to resolve issues; Interpret and explain insurance contracts, statutes, rules, and regulations; Identify and collect data and documents pertinent to the case; Understand and interpret relevant data and documents; interview complainants; Extract and compile statistical data; Make decisions and exercise sound judgment; Use a computer to create cases, exchange information, generate correspondence and track activity; learn new computer software programs. Skills in: Strong written and oral communication; Microsoft Outlook, Microsoft Word, and Microsoft Excel.<br>
</p><p></p><br>
<p>If you're <b>currently </b>employed by the State of Nebraska, please don't apply through this external career site. Instead, log in to Workday and open the <b>Jobs Hub - Internal Apply </b>app from your home landing page. You can access Workday anytime through the Link web page: https://link.nebraska.gov/<br>
</p><h2 class="jobSectionHeader"><br>
<b>Benefits
</b></h2><p>We offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.
<br>
<br>
Check out all that the State of Nebraska has to offer! Benefit eligibility may vary by position, agency and employment status. For more information on benefits, please visit: https://statejobs.nebraska.gov/index.html#benefits
</p><p></p><p><b>Equal Opportunity Statement
</b></p><p>The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.</p></div>

Insurance Claims Examiner

AmTrust Financial

<div>Overview:
<div>
AmTrust is a major player in the commercial P&amp;C market and the third largest workers' compensation provider in the U.S. Our small business insurance product suite continues to expand with Cyber, BOP, Employment Practices Liability Insurance (EPLI), Package and other core coverages and capabilities, including more middle-market and large accounts.</div><div></div><div><br>
As a Workers&rsquo; Compensation Claims Examiner Associate, you'll dive into investigating and resolving employee injury claims. You'll be the key link between injured workers, healthcare providers, employers, and legal teams, ensuring fair and efficient claim handling. Master examination by assessing liability through detailed evaluations, hone investigation skills by interviewing claimants and reviewing medical files and sharpen negotiation tactics for fair claim resolutions. Ultimately, you'll confidently settle claims using your investigative insights.</div><div></div><div><b><i><br>
Note, this is an in-office opportunity out of our South Jordan, UT office</i></b></div>
Responsibilities:
<div>
At AmTrust, we are excited about fostering organic growth and promoting from within! This training program is your gateway to an exciting Claims career journey. Our commitment to your growth doesn't stop when the training ends. AmTrust is dedicated to continually nurturing and training all adjusters to advance their careers in claims. Whether you're eager to climb the ranks in adjusting or aspire to leadership roles, we're here to develop top-notch adjusters and future leaders through this rewarding program!</div>
Qualifications:
<div><b>
Requirements</b></div><ul><li>
4-year degree OR 3 years of relevant experience &ndash; ideal candidate for the role is a recent graduate or early-career professional interested in a dynamic, intellectually engaging role.</li><li>
Strong analytical, communication, and problem-solving skills.</li><li>
Strong organizational abilities and attention to detail.</li><li>
Ability to work collaboratively and independently in a fast-paced environment.</li><li>
Interest in building a long-term career in insurance or claims management.</li></ul><div><b>
Benefits</b></div><ul><li>
15-22 Paid Holidays and 18 days of PTO.</li><li>
Monday through Friday work schedule &ndash; no nights or weekends required.</li><li>
401k Savings Plan</li><li>
Medical, Dental and Vision Health Benefits &ndash; including spouses and children.</li><li>
Internal Wellness Program with yearly discounts and incentives.</li><li>
Paid training and State Licensure.</li></ul><div></div><div><b><br>
Why Claims?
</b></div><div>A Claims career is dynamic and intellectually stimulating, enhancing your skills in policy interpretation, legal understanding, and medical expertise. You&rsquo;ll collaborate with defense attorneys, engage in trials and mediations, and hone investigative, analytical, and negotiation skills. Exposed to facets like Underwriting, Loss Control, Managed Care, and SIU, Claims opens diverse career paths with technical and leadership growth&mdash;perfect for making an impact and building a lasting career.</div><div></div><div><b><br>
Why Insurance?
</b></div><div>AmTrust provides insurance protection, warranty programs and risk management expertise to small businesses, professional and financial services firms, retailers, and manufacturers worldwide. The insurance industry is vital for economic stability, offering financial protection and career opportunities with $932.5 billion in premiums and 2.98 million US employees in 2024. Careers include Claims, Loss Control, Underwriting, Actuary, and Sales, with resilience to economic fluctuations and skills transferable across sectors.</div><div></div><div><i><br>
The expected salary range for this role is $23.00/hr - $28.50/hr.</i></div><div></div><p><i><br>
Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations.</i></p>
What We Offer:
<div>
AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical &amp; Dental Plans, Life Insurance, including eligible spouses &amp; children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.</div><div></div><div><br>
AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.</div><div></div><div><br>
AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.</div></div>

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