claims negotiator

ALpha EMED Billing Solutions

Overview We are looking specifically for an Out-of-Network Negotiator who eats, sleeps, and breathes the No Surprises Act for Surgery specialty.The Role: You will be a point person for all out-of-network revenue. Your day-to-day will involve high-level negotiations with insurance companies, managing the &quot;No Surprises&quot; negotiation process, and winning appeals through meticulous clinical reviews.What You Must Bring:<ul><li>Negotiation Grit: You know how to talk to payers and get claims paid at higher than &quot;median&quot; rates.</li><li>NSA Expertise: You understand how to handle out-of-network claims without triggering balance-billing violations.</li><li>Detail Mastery: You can review complex medical records and terminology to find the &quot;hook&quot; for a successful appeal.</li><li>Team Mindset: You are an independent contractor who loves working with a remote team of other experts.</li></ul>Technical Skills: Professional experience with OON appeals, negotiation portals, and high-level medical revenue cycle management.Duties<ul><li>Process and record incoming denials to review and appeal.</li><li>Manage accounts receivable aging reports to negotiate appeals for no surprise billing with insurance company for review.</li><li>Review patient accounts for discrepancies and resolve issues as needed.</li><li>Collaborate with the medical billing team to ensure proper coding of services using DRG, CPT, ICD-9, and ICD-10 coding systems.</li></ul>Requirements<ul><li>Proven experience in medical billing, collections, or a similar role within a medical office setting.</li><li>Strong knowledge of medical terminology and coding practices (DRG, CPT, ICD-9, ICD-10).</li><li>Familiarity with EMR and EHR systems is highly desirable.</li><li>Excellent attention to detail with strong organizational skills.</li><li>Ability to work independently while managing multiple tasks effectively.</li><li>Strong communication skills for interacting with patients and team members.</li><li>Availability to work a day shift, Monday through Friday.</li></ul>Compensation &amp; Hiring Process:<ul><li>Pay: Starting from $15.00 per hour.</li><li>Job Type: Part-time, Independent contractor.</li><li>Trial Period: A two-week paid trial period will be conducted to assess knowledge and skills.</li></ul>Job Types: Part-time, ContractPay: From $15.00 per hourBenefits:<ul><li>Flexible schedule</li></ul>Application Question(s):<ul><li>Walk me through your system for tracking the 30-day 'Open Negotiation' period and the 4-day 'IDR Submission' window. What do you do if a payer doesn't respond to the initial negotiation notice?</li><li>Explain the difference between a 'Qualified Payment Amount' (QPA) and the 'Offer' we should submit. If a surgeon has a complex case, what specific non-QPA factors would you include in the narrative to justify a higher payment?</li></ul>Work Location: Remote

Remote No Surprise Billing Specialist 2 year minimum

PHI Air Medical

<div>Join Our Life-Saving Team in Phoenix, AZ today and take advantage of a $7,500 sign on bonus &mdash; this offer won&rsquo;t last long! Apply Today!
Are you ready to elevate your career to new heights? PHI Health is looking for dynamic, driven individuals to join our team. We are committed to providing top-tier emergency medical services with unmatched speed and efficiency, saving lives when every second counts. By supporting our mission from the ground, you will play a crucial role in orchestrating the seamless operations that keep our advanced fleet soaring and our patients safe.
With PHI Health you&rsquo;ll collaborate with the best minds in the industry, driving initiatives that enhance our services and expand our reach to those who need it most. If you're passionate about making a difference and thrive on challenges, PHI Health offers an extraordinary opportunity to impact lives and develop your professional career in a meaningful way.
Who We Are:
PHI Health is the leading air ambulance provider in the United States. With an unmatched safety record and the best aviation, medical and communication specialists in the field, we set the standard in the air medical industry. We transport more than 22,000 patients each year from our more than 80 bases across the country, all while offering services and outreach education to local communities and leading healthcare systems. Our mission is simple: move communities to health while maintaining the highest standard of safety, period.
Job Summary:
The appeals negotiator is responsible for ensuring the highest reimbursement for all underpaid contractual and non-contractual payers. The negotiator will build and maintain outstanding relationships with all payers while adhering to PHI reimbursement policies. The negotiator will identify, document, and assist in the collections of all contracted and non-contracted underpayments from the payers. The negotiator will provide and produce thorough supporting documentation regarding additional payment for the level of services that were rendered. This position provides oversight and resolution for claim denials that require written response. This includes denials for medical necessity, low &quot;usual and customary&quot; payments, not to the closest facility, and reduction to ground level payments. This position requires a high level of knowledge in compliance, federal and state regulations, and clinical record information extraction. This position reports to the leadership of Patient Financial Services.
Compensation and Benefits<ul><li>
We offer a range of competitive pay and benefits package to keep our teams happy, healthy, and invested.</li></ul>
Schedule/Location<ul><li>
5 &amp; 2</li><li>
Phoenix, AZ</li></ul>
The Successful Candidate Will Have:<ul><li>
High School diploma or GED required.</li><li>
Bachelor's degree preferred with 5 years related work experience.</li><li>
5+ years' experience in medical billing, surgical billing, billing in emergency medical services and collections preferred.</li><li>
Medicare, Managed Care, Workers' Comp. experience.</li><li>
3-5 years of experience in appeals and negotiation background.</li><li>
Expertise in billing software and Internet-based research required.</li><li>
Must have solid knowledge of patient account systems, revenue management processes, workflow systems and the ability to troubleshoot and suggest improvements.</li><li>
Ability to work independently with strong interpersonal skills to effectively interact with all levels of employees both with the client and with PFS.</li><li>
Must have demonstrated experience in researching statutes and understanding regulatory documents.</li><li>
Must demonstrate the ability to draft a professional and effective appeal letter.</li><li>
Ability to verbally communicate details and understand parameters of job responsibilities.</li><li>
Ability to provide written communication using best business practices when composing letters, memorandums, and e-mails regardless of if the communication is inside the Company or with customers, clients, or providers.</li><li>
Ability to read, write and follow specific instructions in both written and verbal form.</li><li>
Requires an in-depth understanding of compliance, regulatory oversight bodies and payer requirements.</li><li>
Team player, interfaces well with employees.</li><li>
Represents the company in a positive, customer friendly attitude to other employees, clients, agencies, entities and patients.</li><li>
May have supervisory responsibility.</li><li>
This position is designated Safety Sensitive for purposes of the Arizona Medical Marijuana Act.</li></ul>
Our Core Competencies:<ul><li>
Safe. We are absolute in our belief in the tenets of Destination Zero and that Zero is not only achievable, but the only acceptable outcome.</li><li>
Efficient. We are focused on outcomes that are smart and responsible by making the best use of our resources to maximize overall productivity and achieve sustainable profitability as a high performing organization.</li><li>
Quality. We are committed to ensuring excellent organizational performance which produces sustainable and reliable outcomes.</li><li>
Service. We are dedicated to the service of our customers, our communities and each other.</li></ul>
The PHI Health Advantage
For more than 40 years, our company has been providing critical air medical transport services across the country. As an organization, we outfit each aircraft we fly with the most advanced technology, subject our crews to the most rigorous protocols and training and pioneer the most-forward thinking safety program in the country.
Everything that we do comes back to the safety of our crew and our patients. Our accident rate is well below the national average and we were the first to receive the Vision Zero Aviation Safety Award. This belief has guided us towards a number of industry firsts and has given us the highest safety rating in the industry.
Join Our Life-Saving Team in Phoenix, AZ today and take advantage of a $7,500 sign on bonus
DISCLAIMER
The above Statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed, as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
PHI, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws</div>

Appeals Negotiator - NSA

Allstate Insurance

<div>At Allstate, great things happen when our people work together to protect families and their belongings from life&rsquo;s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers&rsquo; evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.
Job Description
As a Claims Resolution Adjuster, your main focus will be investigating automobile accidents involving bodily injury. You will have the convenience of working remotely from your home while efficiently handling your responsibilities. You will assess coverage, liability, and damages while providing exceptional customer service throughout your day. Customer communication will take place through different channels, including voice calls, email, and text messages. Through the utilization of innovative platforms and tools, you will engage in negotiation processes to reach fair injury settlements with all parties involved.
The Claims Resolution Adjuster will primarily be responsible for the liability investigation and ultimate decisions, identifying injured parties beyond who is listed at FNOL (First Notice of Loss), and recognizing impactful risk potential on claim files. They will be responsible for supporting the claimant throughout the vehicle restoration process and providing feedback on the Auto process in general. The Claims Resolution Adjuster and Casualty Adjusters will work hand-in-hand throughout the claims process.
Candidates for this role must reside in either the Central (CST), Mountain (MST), or Pacific (PST) time zone. This position is not available to residents of California, Washington, Alaska, Hawaii, or Puerto Rico.
Schedule: 8-hour shift Mon-Fri | 8:00am - 4:30pm or 9:00am - 5:30pm with potential Saturday duty rotation.
You&rsquo;ll wear a few hats to fill a few roles throughout your day that all require a level of experience:
The Customer Service Expert &ndash; you&rsquo;ll live into Allstate&rsquo;s Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each Casualty claim. You lead with empathy, always.
The Investigator &ndash; you&rsquo;ll confidently and independently investigate casualty (and applicable LOB (line of business)) claims by performing detailed reviews of damage and interpreting policies to determine coverage.
The Effective Communicator &ndash; you&rsquo;ll use phone, emails and sometimes even video chat with customers to help them through a fast, fair, and easy claims process. You&rsquo;ll also incorporate a specific approach to claim handling to offer the customer their preference of communication to efficiently discuss their claim needs and keep them updated on the claim progress.
The Negotiator &ndash; you will evaluate and negotiate claims settlements with customers, vendors, third party carriers and claimants, in accordance with all legal and business standard methodologies. With negotiations, you will incorporate tactics in handling challenging and complex situations.
The Problem Solver &ndash; you&rsquo;ll utilize multiple tools to get the job done in a fast-paced environment, including estimate tools, job aids, and additional settlement platforms, all while using your sharp critical thinking skills.
The Recorder &ndash; you&rsquo;ll protect the company financially by executing policies along policy agreements, and you keep a clear record of your work in a claims system that you will be trained on. You&rsquo;ll accomplish this by ensuring timely and accurate documentation is completed as you work on each claim.
Qualifications:<ul><li>
2+ years Claims experience, specifically Casualty Bodily Injury claims background.</li><li>
Claims investigation and negotiation experience is preferred.</li><li>
Experience with liability investigations, investigating coverage, PD coverage, set MOI, rental and resolving liability a plus.</li><li>
Proficient communication skills, especially over the phone, to establish rapport and assess claims accurately.</li><li>
Strong critical thinking and problem-solving skills to evaluate and negotiate injury claims successfully.</li></ul>
Remote Work: 
This position is a permanent remote home-based role. Your home office does not need to be near an Allstate office, but it does need to be in the United States within one of the listed time zones above.
When you work from home full time, you&rsquo;ll need:<ul><li>
A dedicated workspace in your residence that is private and free from distractions.</li><li>
A minimum internet bandwidth of 50 MB down/5 MB up.</li><li>
Appropriate work surface and seating.</li></ul> 
What will Allstate provide?<ul><li>
A technology bundle that includes all equipment needed to perform your work from home (laptop, monitors, headset, keyboard, mouse).</li><li>
Connectivity reimbursement of $80 per month to offset some of the cost of internet.</li></ul> 
Notice of Licensing Requirement<ul><li>
As a condition of employment, your office/area may require you to obtain an adjuster and/or an appraiser license which includes passing an additional background check with the Department of Labor. If applicable, you will be required to secure license(s) within 60 days of hire.</li><li>
If required, the Hiring Manager will work with you along with the Centralized Licensing team to ensure that you are properly licensed.</li></ul>
Sign-On Bonus:
You may be eligible for a $1,000 Licensing Sign-On Bonus if you have the applicable active licenses needed for this role. This could include Home Resident Property &amp; Casualty License, Designate Home State (DHS) Florida or Texas License, and/or applicable Appraiser License.
*Candidates who have previously worked for and are seeking to be rehired at Allstate and its family of companies are not eligible for this sign-on bonus.*
Allstate Benefits
Being a part of Allstate means you receive a benefits package from Day 1 of employment. This includes time off, healthcare, retirement, and more. That is why as an Allstater, you&rsquo;ll enjoy a Total Rewards package that includes:<ul><li>
Competitive pay with needed support for continuous development and career advancement.</li><li>
Flexibility in scheduling and a time off policy that helps support your work/life balance.</li><li>
Initial and ongoing training to get you proficient in your new role</li><li>
Comprehensive benefits like a 401K/pension, education reimbursement, and programs to help you balance work with the rest of your life. Visit www.allstategoodlife.com to learn more.</li></ul>
Please Note:<ul><li>
In our virtual environment, employees are required to engage and participate on camera during online meetings and trainings</li><li>
The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. Regular, predictable attendance is an essential function of this job.</li></ul>
#LI-BC1
Skills
Compensation
Compensation offered for this role is 20.77 - 32.67 per hour and is based on experience and qualifications.
The candidate(s) offered this position will be required to submit to a background investigation.
Joining our team isn&rsquo;t just a job &mdash; it&rsquo;s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger &ndash; a winning team making a meaningful impact.
Allstate generally does not sponsor individuals for employment-based visas for this position.
Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.
For jobs in San Francisco, please click &ldquo;here&rdquo; for information regarding the San Francisco Fair Chance Ordinance. 
For jobs in Los Angeles, please click &ldquo;here&rdquo; for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance.
To view the &ldquo;EEO Know Your Rights&rdquo; poster click &ldquo;here&rdquo;. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs.
To view the FMLA poster, click &ldquo;here&rdquo;. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.
It is the Company&rsquo;s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee&rsquo;s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.</div>

Claims Resolution Adjuster - Remote (PST/MST/CST)

<div>At Allstate, great things happen when our people work together to protect families and their belongings from life&rsquo;s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers&rsquo; evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.
Job Description
In this job, your main focus will be investigating automobile accidents involving single or multiple vehicles, which result in property damage and/or bodily injury with litigation/mediation/arbitration involved. You will have the convenience of working remotely from your home while efficiently handling your responsibilities. You will assess coverage, liability, and damages while providing exceptional customer service throughout your day. Customer and attorney communication will take place through different channels, including voice calls, email, and text messages. Through the utilization of innovative platforms and tools, you will engage in negotiation processes to reach fair injury settlements with all parties involved. 
 
This position is for our Severe/Complex Represented Casualty office with a focus on handling UM/UIM claims in the state of California. The schedule required in this role will be in Pacific Standard Time (PST).
Qualifications:<ul><li>
4+ years of experience handling Represented Bodily Injury claims</li><li>
Uninsured/Underinsured Bodily Injury Claim handling experience</li><li>
Experience with and understanding of litigation, mediation, and arbitration</li><li>
CA bodily injury claim handling experience preferred</li><li>
Proficient communication skills, especially over the phone, to establish rapport and assess claims accurately.</li><li>
Ability to work independently and remotely, while managing time efficiently</li><li>
Familiarity with insurance policies, coverage, and liability determination</li><li>
Strong critical thinking and problem-solving skills to evaluate and negotiate injury claims successfully</li><li>
Knowledge of innovative tools and platforms for effective claims evaluation</li></ul>
You&rsquo;ll wear a few hats to fill a few roles throughout your day that all require a level of experience:
The Customer Service Expert &ndash; you&rsquo;ll live into Allstate&rsquo;s Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each Casualty claim. You lead with empathy, always.
The Investigator &ndash; you&rsquo;ll confidently and independently investigate casualty (and applicable LOB (line of business)) claims by performing detailed reviews of damage and interpreting policies to determine coverage.
The Effective Communicator &ndash; you&rsquo;ll use phone, emails and sometimes even video chat with customers to help them through a fast, fair, and easy claims process. You&rsquo;ll also incorporate a specific approach to claim handling to offer the customer their preference of communication to efficiently discuss their claim needs and keep them updated on the claim progress.
The Negotiator &ndash; you will evaluate and negotiate claims settlements with customers, vendors, third party carriers and claimants, in accordance with all legal and business standard methodologies. With negotiations, you will incorporate tactics in handling challenging and complex situations.
The Problem Solver &ndash; you&rsquo;ll utilize multiple tools to get the job done in a fast-paced environment, including estimate tools, job aids, and additional settlement platforms, all while using your sharp critical thinking skills.
The Recorder &ndash; you&rsquo;ll protect the company financially by executing policies along policy agreements, and you keep a clear record of your work in a claims system that you will be trained on. You&rsquo;ll accomplish this by ensuring timely and accurate documentation is completed as you work on each claim.
Remote Home-Based Work 
This position is a permanent remote home-based role. Your home office does not need to be near an Allstate office, but it does need to be in the United States. This position is not available for California, Alaska, Hawaii, or Puerto Rico residents.<ul><li>
Schedule: Mon-Fri | 8am-4:30pm PST</li></ul> 
When you work from home full time, you&rsquo;ll need:<ul><li>
A home office &ndash; a dedicated workspace in your residence that is private and free from distractions.</li><li>
A minimum internet bandwidth of 50 MB down/5 MB up.</li><li>
Appropriate work surface and seating.</li></ul> 
What will Allstate provide?<ul><li>
A technology bundle that includes all equipment needed to perform your work from home (laptop, monitors, headset, keyboard, mouse).</li><li>
Connectivity reimbursement of $80 per month to off set some of the cost of internet.</li></ul>
Notice of Licensing Requirement:<ul><li>
As a condition of employment, your office/area may require you to obtain an adjuster and/or an appraiser license. If applicable, you will be required to secure license(s) within 60 days of hire.</li><li>
If required, the Hiring Manager will work with you along with the Centralized Licensing team to ensure that you are properly licensed.</li></ul>
Sign-On Bonus:
You may be eligible for a $1,000 Licensing Sign-On Bonus if you have the applicable active licenses needed for this role. This could include Home Resident Property &amp; Casualty License, Designate Home State (DHS) Florida or Texas License, and/or applicable Appraiser License.
*Candidates who have previously worked for and are seeking to be rehired at Allstate and its family of companies are not eligible for this sign-on bonus.*
Allstate Benefits
Being a part of Allstate means you receive a benefits package from Day 1 of employment. This includes time off, healthcare, retirement, and more. That is why as an Allstater, you&rsquo;ll enjoy a Total Rewards package that includes:<ul><li>
Competitive pay with needed support for continuous development and career advancement.</li><li>
Flexibility in scheduling and a time off policy that helps support your work/life balance.</li><li>
Initial and ongoing training to get you proficient in your new role.</li><li>
Comprehensive benefits like a 401K/pension, education reimbursement, and programs to help you balance work with the rest of your life. Visit www.allstategoodlife.com to learn more.</li></ul>
Notes: 
The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. Regular, predictable attendance is an essential function of this job.
#LI-JB3
Skills
Arbitration, Bodily Injury Claims, Business Communications, Critical Thinking, Information Collection, Litigation, Mediation, Negotiation, Time Management
Compensation
Compensation offered for this role is 53,500.00 - 84,625.00 annually and is based on experience and qualifications.
The candidate(s) offered this position will be required to submit to a background investigation.
Joining our team isn&rsquo;t just a job &mdash; it&rsquo;s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger &ndash; a winning team making a meaningful impact.
Allstate generally does not sponsor individuals for employment-based visas for this position.
Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.
For jobs in San Francisco, please click &ldquo;here&rdquo; for information regarding the San Francisco Fair Chance Ordinance. 
For jobs in Los Angeles, please click &ldquo;here&rdquo; for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance.
To view the &ldquo;EEO Know Your Rights&rdquo; poster click &ldquo;here&rdquo;. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs.
To view the FMLA poster, click &ldquo;here&rdquo;. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.
It is the Company&rsquo;s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee&rsquo;s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.</div>

Bodily Injury Adjuster - UM/UIM Severe/Complex Litigation - Remote

Plymouth Rock Assurance

<div>This position is responsible for the handling of Auto Property Total Loss Claims in accordance with NJ Unfair Practices Act. The environment is fast paced with heavy phone work. Strong customer service, organizational, math, verbal, and written skills are required. The position requires patience and the ability to function professionally in adversarial situations.

RESPONSIBILITIES 
Claim Negotiation &amp; Settlement
<ul>
<li>Negotiate and communicate first- and third-party total loss settlements per company and state guidelines across multiple jurisdictions (NY, NJ, PA, MA, CT).</li>
<li>Review damage estimates to confirm vehicles are total losses.</li>
<li>Settle claims within individual authority; escalate or seek supervisor approval when appropriate.</li>
<li>Prepare payments to vehicle owners, banks, and lease companies.</li>
</ul>
Documentation &amp; Compliance
<ul>
<li>Document all settlements and actions in the claim file system.</li>
<li>Maintain an effective diary system on pending files to ensure timely resolution.</li>
<li>Adhere to privacy guidelines, laws, and regulations pertaining to claims handling.</li>
</ul>
Customer Communication
<ul>
<li>Keep insureds and claimants updated on claim status and emerging issues.</li>
<li>Act as an intermediary between the company, preferred vendors, and customers.</li>
<li>Resolve disputes professionally, even in adversarial situations.</li>
</ul>
Vendor &amp; Salvage Coordination
<ul>
<li>Work directly with salvage vendors to move first-party vehicles and obtain salvage bids on third-party vehicles.</li>
<li>Ensure service, loss, and expense control are always maintained.</li>
</ul>
Workflow &amp; Adaptability
<ul>
<li>Prioritize and handle multiple tasks simultaneously in a fast-paced environment.</li>
<li>Adjust quickly to fluctuating workload.</li>
<li>Participate in catastrophic claim handling as requested.</li>
<li>Obtain state licenses as needed.</li></ul> 
 
QUALIFICATIONS
<ul>
<li>College degree or equivalent experience.</li>
<li>1&ndash;2 years of claims handling or related insurance experience preferred.</li>
<li>Basic understanding of vehicle types, features, and terminology.</li>
<li>Familiarity with vehicle financing and leasing concepts.</li>
<li>Strong negotiation, conflict resolution, and customer service skills.</li>
<li>Proficiency with Microsoft Office Suite and claims management systems.</li>
<li>Comfortable conducting searches on auto sales sites to validate availability and pricing.</li>
<li>Ability to manage high call volumes with professionalism and patience.</li></ul> 
 
SALARY RANGE

The pay range for this position is $55,000 to $74,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity. 
 
PERKS &amp; BENEFITS
<ul>
<li>4 weeks accrued paid time off, 8 paid national holidays, and 2 floating holidays per year</li>
<li>Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)</li>
<li>Annual 401(k) Employer Contribution</li>
<li>Free onsite gym at our Woodbridge Location</li>
<li>Resources to promote Professional Development (LinkedIn Learning and licensure assistance)</li>
<li>Robust health and wellness program and fitness reimbursements</li>
<li>Various Paid Family leave options including Paid Parental Leave</li>
Tuition Reimbursement 
<li>
</li></ul> 
ABOUT THE COMPANY

The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of &ldquo;A-/Excellent&rdquo;. 
#LI-DN</div>

Claims Representative, Total Loss

Utica National Insurance Group

<div>The Company
At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected.

Utica National Insurance Group is an &quot;A&quot; rated $2.0B award-winning, nationally recognized property &amp; casualty insurance carrier.

Operating along the Eastern half of the United States, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte.

What you will do

The Property Large Loss Examiner will handle personal and commercial large loss claims and complex claims. With attention to customer service and skills in investigation and negotiation, the Examiner will meet the needs of our insureds and engage in timely claims resolution. As a more senior individual contributor role, this position will require broad technical knowledge at an advanced level. This role will be a hybrid position reporting to New Hartford, NY; Buffalo, NY; or Charlotte, NC.

Key responsibilities
<ul>
<li>Direct handling of both personal and commercial large loss claims with a high level of customer service.</li>
<li>Handles Property claims of a complex nature; performs claims investigations and handles matters requiring broad technical knowledge at an expert level.</li>
<li>Operates on an independent basis with little supervision; mitigates, negotiates and settles claims within assigned authority with a strong focus of overall claim resolution.</li>
<li>Assist in selection, and some oversight, of independent adjusters and coverage counsel.</li>
<li>Reviews court decisions, and coverage interpretations, and is required to have a broad knowledge and understanding of Property law and claim practices.</li>
<li>Responsible for reporting on large losses, litigation reports and reports to reinsurance as needed.</li>
<li>Assists in the development and training of claims personnel in Property department.</li>
<li>Performs other tasks as assigned.</li>
</ul>
What you need:
<ul>
<li>4 year college degree preferred or equivalent experience.</li>
<li>4-8 years of Property claims experience demonstrating expertise in underlying coverages, broad background in litigated matters and development.</li>
</ul>
Licensing

Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment. 


Salary range: $81,000 - $120,000

The final salary to be paid and position within the internal salary range is reflective of the employee&rsquo;s work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications. 


Benefits
We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following:
<ul>
<li>Medical and Prescription Drug Benefit</li>
<li>Dental Benefit</li>
<li>Vision Benefit</li>
<li>Life Insurance and Disability Benefits</li>
<li>401(k) Profit Sharing and Investment Plan (Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)</li>
<li>Health Savings Account (HSA)</li>
<li>Flexible Spending Accounts</li>
<li>Tuition Assistance, Training, and Professional Designations</li>
<li>Company-Paid Family Leave</li>
<li>Adoption/Surrogacy Assistance Benefit</li>
<li>Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance</li>
<li>Student Loan Refinancing Services</li>
<li>Care.com Membership with Back-up Care, Senior Solutions</li>
<li>Business Travel Accident Insurance</li>
<li>Matching Gifts program</li>
<li>Paid Volunteer Day</li>
<li>Employee Referral Award Program</li>
<li>Wellness programs</li>
<li>Personal Insurance Discount</li>
</ul>
Additional Information:

This position is a full time salaried, exempt (non overtime eligible) position.

Utica National is an Equal Opportunity Employer.

Apply now and find out what it&rsquo;s like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Acquisition team will be in touch regarding any change in your candidacy.
#LI-HL1</div>

Property Large Loss Examiner (hybrid)

AmTrust Financial

<div>Overview:
<div>
Amtrust Financial Services, a fast-growing commercial insurance company, is seeking a Complex General Liability Claims Specialist. The successful candidate will evaluate coverage issues and risk transfer opportunities as well as ensuring appropriate investigation of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, and proper negotiation strategy is employed.</div><div></div><div> 
This position will ideally require hybrid attendance in an AmTrust location and is posted remotely for nationwide visibility.</div>
Responsibilities:
<ul><li>Identifying potential risks and managing timely reserves effectively</li><li>
Evaluating coverage issues and risk transfer opportunities</li><li>
Ensuring appropriate investigation of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, proper negotiation strategy is employed.</li><li>
Effectively communicate exposures both internally and externally</li><li>
Overall responsibility for formulating proper resolution strategy to ensure best total outcome.</li><li>
Position may require periodic travel to attend meditations, trials and / or other related meetings</li><li>
Perform other duties as assigned</li></ul>
Qualifications:
<ul><li>Bachelor&rsquo;s degree or equivalent experience in insurance claims management or related field.</li><li>
Minimum of ten (10) years&rsquo; experience in the handling or litigating of commercial general liability claims and five (5) years&rsquo; experience in the handling or litigating of complex commercial general liability claims.</li><li>
Experience in handling Employers Liability/Workers Compensation 1B claims preferred.</li><li>
Proficient computer skills required to navigate our paperless claim file system.</li><li>
Possesses a high level of technical claim and legal knowledge and skills.</li><li>
Excellent communication skills both written and oral.</li><li>
Ability to professionally interact at a high level with parties both internal and external to AmTrust.</li><li>
Easily adapts to changing situations, requirements and priorities.</li><li>
Ability to effectively influence others without damaging relationships.</li><li>
Skillful negotiator.</li><li>
Designated home state adjuster license preferred.</li><li>
CPCU designation/AIC certification preferred.</li></ul><div></div><div> 
The expected salary range for this role is $120K-$145K/year.</div><div></div><div> 
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.</div><div></div><div> 
#LI-BL1</div>
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> 
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> 
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>

Complex Claim Specialist, General Liability

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