claims operations specialist

Kern Health Systems

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).
 
KHS reasonably expects to pay starting compensation for the position of Claims Operations Senior Specialist, in the range of $35.89 - 45.76 hourly.
 
**Hybrid Position**
 
About us
 
Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.
 
About the role
 
This highly specialized position is responsible for analyzing statistics of all areas of Claims daily; and assisting in priority area as needed. This position is responsible for knowing and performing all functions within the department: Claims Processing, Auditing, Disputes/Rework, Calls, Training, Inventory Control, Systems Testing, Overpayments, and Encounter Processing – and offering suggestions for improvements to Management. This position is also responsible for keeping abreast of Medi-Cal, Commercial and Medicare rules for Dual membership or other LOB (Dental, Vision, LTC, Transplants, Mental Health, Pharmacy, etc.) and training when necessary.
 This position is responsible for identifying area most in need of attention and applying their knowledge and skill to help that specific area to be within operating standards/goals. This position will be required to perform all functions within Claims Operations. This position will use experience to identify areas to improve in workflow, system enhancements, and Auto Adjudication. This position will also be the primary SME for all other Lines of Business from Medicare to Commercial or other new benefits for Medi-Cal.
 
Essential Duties and Responsibilities
 
<ul>
<li>Analyze and identify (on a daily basis) area in Claims Department needing most assistance to hit optimal benchmarks.</li>
<li>Perform Claims Processing at all levels, Auditing, Dispute Processing, Calls, Overpayments, Encounter Processing, Training, Inventory Control and System Testing at optimum levels as needed with flexibility day to day.</li>
<li>Analyze via reports and experience in daily handling of all related department duties and recommend changes to work processes as needed.</li>
<li>Analyze via reports and experience in daily handling of all related department duties and recommend system enhancements/Auto Adjudication as needed.</li>
<li>Write and run reports in Business Objects as needed.</li>
<li>Acts as a resource and provides support to Customer Service and Provider Relations regarding Claims Payments.</li>
<li>Track and trend Provider disputes, denials and calls to effect improvement in compliance with billing rules and/or opportunities for Provider Training.</li>
<li>Key contact and oversight of Supplemental Payment programs via the Claims Department (Prop 56, GEMT, etc.).</li>
<li>Liaison with High Dollar Claim Review Vendor – monitor, verify, and validate data as well as communicate needs to vendor.</li>
<li>Performs other job-related duties as required.</li>
<li>Adheres to all company policies and procedures relative to employment and job responsibilities.</li>
<li>Telecommuting jobs will require some on site meetings/ trainings as identified by management.</li>
</ul>
Employment Standards: 
Bachelor’s degree in business from an accredited university or equivalent required AND ten (10) years of direct experience in combination of a minimum of eight (8) functions: Claims Processing, Auditing, Provider Dispute Processing/Rework, Claim Call Representative, Training, Inventory Control, System Testing, Overpayment Recovery, and/or Encounter Processing. Experience in Medicare, Medi-Cal and Commercial lines of business required.
 <ul>
<li>OR-</li>
</ul>
Fourteen (14) years of direct experience in combination of a minimum of eight (8) functions: Claims Processing, Auditing, Provider Dispute Processing/Rework, Claim Call Representative, Training, Inventory Control, System Testing, Overpayment Recovery, and/or Encounter Processing. Experience in Medicare, Medi-Cal and Commercial lines of business required
 
We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

Claims Operations Senior Specialist

Mercor

<div>
 
 About The Job
 
 
 
 
 Mercor
 
 connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include
 
 Benchmark
 
 ,
 
 General Catalyst
 
 ,
 
 Peter Thiel
 
 ,
 
 Adam D'Angelo
 
 ,
 
 Larry Summers
 
 , and
 
 Jack Dorsey
 
 .
 
 
 
 Position:
 
 Claims Operations Expert
 
 
 
 Type:
 
 
 Contract
 
 
 
 
 Compensation:
 
 
 $55&ndash;$80/hour
 
 
 
 
 Location:
 
 
 Remote
 
 
 
 
 Role Responsibilities
 
 
 
 <ul>
 <li>
 Develop long-horizon claims tasks with deterministic rubrics to evaluate agent performance against verifiable ground truth.
 </li>
 <li>
 Build scenarios in FNOL and triage, Adjudication, and Specialized handling to ensure tasks have checkable answers.
 </li>
 <li>
 Evaluate FNOL and triage processes, including intake against required-field checklists and coverage analysis with documented determinations.
 </li>
 <li>
 Review adjudication tasks such as reserve setting against guidelines and adjuster notes with required elements.
 </li>
 <li>
 Collaborate on specialized handling scenarios like subrogation screening and SIU fraud referrals using rule-based criteria.
 </li>
 <li>
 Work independently and asynchronously to meet deadlines while improving AI model performance.
 
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 
 Must-Have
 
 
 
 <ul>
 <li>
 3+ years as a claims adjuster, claims operations specialist, or claims supervisor in P&amp;C, workers comp, or specialty lines.
 </li>
 <li>
 Expertise in specific claim types, coverage analysis, reserving practice, subrogation, SIU or fraud investigation, or claims systems like Guidewire ClaimCenter or Duck Creek.
 </li>
 <li>
 Comfortable with claims artifacts: FNOLs, coverage opinions, reserve memos, adjuster notes, settlement, and denial letters.
 </li>
 <li>
 Clear written communication; ability to articulate reasoning step by step and encode it into deterministic rubrics.
 
 
 
 </li>
 </ul>
 
 Preferred
 
 
 
 <ul>
 <li>
 Adjuster licensure in at least one US state.
 
 
 
 </li>
 </ul>
 
 Compensation &amp; Legal
 
 
 
 <ul>
 <li>
 Hourly contractor
 </li>
 <li>
 Strong contributors promoted based on task quality and throughput.
 
 
 
 </li>
 </ul>
 
 Application Process (Takes 20&ndash;30 mins to complete)
 
 
 
 <ul>
 <li>
 Upload resume
 </li>
 <li>
 AI interview based on your resume
 </li>
 <li>
 Submit form
 
 
 
 </li>
 </ul>
 
 Resources &amp; Support
 
 
 
 <ul>
 <li>
 For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
 </li>
 <li>
 For any help or support, reach out to: support@mercor.com
 
 
 
 </li>
 </ul>
 
 PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.
 
</div>

Claims Adjuster | Upto $80/hr Part-time

AllCare Management Services

<div>We Are Seeking Qualified Candidates to Join Our Team!
AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options.
Summary of the Position
This position supports claims operations and financial integrity by performing a variety of administrative and department functions related to claims processing, system COB updates, and audit support. Responsibilities include managing Coordination of Benefits (COB) reporting, implementing updates within the EZ-CAP claims system, processing refunds and overpayment recoveries, and assisting with internal and external audit activities, including HSAG, OHA, CMS, and financial audits. The role also involves reviewing claims identified through monitoring reports, ensuring issues are researched and resolved appropriately, and supporting check run activities to help ensure accurate and timely provider payments. This position works collaboratively with all claims staff, finance, compliance, and IT teams to maintain efficient operations and ensure adherence to regulatory and organizational requirements.
Essential Duties 
1. Maintain and update Coordination of Benefits (COB) information, including reporting, verification, and system updates to ensure accurate claims processing 
2. Review, research, and process refund requests and overpayment recoveries, ensuring compliance with contractual, regulatory, and internal policies 
3. Provide departmental support for internal and external audits, including preparation of documentation and data requests for entities such as HSAG, CMS, and financial auditors 
 
Qualifications
Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
Education
High school diploma or general education degree (GED) required. College degree in an applicable field is preferred.
Experience
One to two years related experience and/or training in administrative and/or medical claims processing required. EZ-CAP claim processing system experience is highly preferred.
Certificates, Licenses, and/or Registrations 
This position does not require any certificates, licenses, or registrations. The following certifications are preferred for this job role: 
<ul><li>Certified Professional Coder (CPC)</li><li> 
Certified Clinical Medical Assistant (CCMA)</li><li>Certified Billing and Coding Specialist (CBCS)</li><li>Certified Medical Administrative Assistant (CMAA)</li><li>Certified Coding Specialist (CCS)</li></ul> 

Technical Skills 
<ul><li>Knowledge of and compliance with HIPAA regulations.</li><li>Proficient in data entry and use of claims management systems</li><li>Knowledge of Medicare and Medicaid, procedures, and regulatory requirements</li><li>Basic understanding of medical coding and billing practices</li><li>Strong attention to detail and ability to identify discrepancies or inconsistencies</li><li>Excellent organizational skills and ability to manage multiple tasks efficiently</li><li>Excellent communication skills, both written and verbal, for interaction with internal and external stakeholders</li><li>Exceptional writing, editing, and proofreading skills.</li><li>Excellent computer skills, including the Microsoft Office Suite (Outlook, Word, PowerPoint, and Excel).</li><li>Skilled at breaking a project into definable and measurable tasks and tracking progress to completion.</li><li>Excellent customer service skills to respond appropriately and interact positively with upset customers.</li></ul>
Interpersonal Skills<ul><li>Reliable, confident, and effective in fostering positive relationships.</li><li>Demonstrates accountability, inspires trust, and connects well with colleagues.</li><li>Trustworthy, accountable, and skilled at collaborative engagement.</li></ul>
Language Skills 
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. 
 
Mathematical Skills
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.
Computer Skills
Has advanced basic computer job skills including logging on to systems, ability to communicate by email, ability to compose documents, enter database information, create presentations, download forms, and preserve/backup important data.
Reasoning Ability
Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to work with problems involving a few concrete variables in standardized situations.
Physical Demands &amp; Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The noise level in the work environment is usually moderate. 
 
<ul><li>The employee must be able to work onsite, as needed.</li><li>The employee can work from a home office, occasionally.</li></ul> 
Company Overview
AllCare Health Website: https://www.allcarehealth.com.
AllCare Health is incorporated as an Oregon Benefit Corporation and has earned the coveted Certified B Corp&reg; status since 2017. As such, AllCare Health considers its impact on community, society, and the environment in all business decisions. We have long recognized the value in social, economic, and environmental concerns of our employees, customers, and community members. (Learn more about B Corps at https://bcorporation.net/about-b-corps)
AllCare Health headquarters are located in Grants Pass in Southern Oregon on the Rogue River, surrounded by mountains, forests, small farms, and breathtaking views. This thriving and energetic community is ideal for families and outdoor enthusiasts, with a temperate Pacific Northwest climate. We enjoy easy access to outdoor sports and recreation, river rafting, fishing, hiking, biking, wineries, outdoor concerts, the world-famous Ashland Shakespeare Festival, the stunning Oregon coast, magnificent redwood forests, pristine beaches, and much more.
The AllCare Health family of businesses is guided by our corporate principles:
Purpose | Working together with our communities to improve the health and well-being of everyone.
Values | Trust, Innovation, Relationships, and Voice.
Vision | Thriving, Inclusive, and Equitable communities.
Brand Promise | Changing Healthcare to Work for You.
AllCare Health is dedicated to building a diverse and authentic workplace centered in belonging and serving our growing community. If you are excited about this open position but your experience does not align perfectly with every qualification in this post, we encourage you to apply anyway or reach out to our human resources department. You may just be the right candidate for this role or others.
If you need accommodations, help in the application process, or wish to receive this job announcement in an alternative format, please call 541-471-4106 and ask for Human Resources.
All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information. 
699 - Claims Processing Assistant_March2026.pdf</div>

CLAIMS PROCESSING ASSISTANT

DAVIES

<div><h3 class="jobSectionHeader">Description</h3><div> 
Our Story</div><div>
Imagine being part of a team that&rsquo;s not just shaping the future but actively driving it. At Davies North America, we&rsquo;re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.</div><div>
 
What's in Store 
We are on the lookout for a Claims Support Specialist, who will be onsite in our Orlando office, who will be responsible for the administrative and clerical functions to assist with OCPS Workers&rsquo; Compensation claims handling as on-site liaison for USIS claims operation.</div><h3 class="jobSectionHeader"> 
Key Responsibilities</h3> 
<ul>
<li>
Administrative/clerical duties related to USIS claims operations on behalf of OCPS.</li>
<li>Scan the FROI reports in Doc Manager (OCPS Program) and Update the FROIs from the OCPS portal.</li>
<li>Handle all faxes pertaining to Workers&rsquo; Compensation claims, saving them in Doc Manager and forwarding to USIS as necessary.</li>
<li>Maintain &ldquo;Claim Paperwork Tracking Log&rdquo; for updating every claim. This requires daily communication with the work locations via email, phone or fax to ensure all forms are submitted from the OCPS locations, including signed FROI, Medical Release, Supervisor Investigation Report, Authorization for Treatment &ndash; forms to be saved in Doc Manager.</li>
<li>Assist OCPS work locations, via phone fax or email, with responses to their questions eg. IW absences, employment status, payment records, addresses, phone numbers, etc.</li>
<li>Assist on the Light Duty program with paperwork, and list in times of high volume.</li>
<li>Request Cigna searches.</li>
<li>Request adjusters to initiate ISO searches.</li>
<li>Run reports from the USIS web site.</li>
<li>Assist with training and putting together training material for OCPS school locations (involves travel within the OCPS district area).</li>
<li>Attach claim documents in the USIS system files utilizing Corrus</li>
<li>Adhere to USIS protocols, policies and procedures regardless of work location.</li>
<li>Assist with other administrative duties, special projects, etc., for USIS as assigned by management.</li>
<li>Work effectively in two different databases/systems, MS Office and Outlook.</li>
<li>Perform other duties as assigned.</li>
</ul><div>
 
This is a full-time role that will require you to be in office in Orlando, FL.</div> 
<h3 class="jobSectionHeader">
Skills, knowledge &amp; expertise</h3> 
<ul>
<li>
Excellent customer service and presentation skills.</li>
<li>High school diploma; excellent office administrative training.</li>
<li>Proficient in Microsoft suite &ndash; Word, Excel, PowerPoint.</li>
<li>Excellent typing/PC skills (40+wpm).</li>
<li>Proficient business letter composition, grammar, spelling, punctuation, etc. in English.</li>
<li>Required to own and safely operate a reliable motor vehicle; maintain vehicle and provide proper licenses and insurance as directed by the company.</li>
<li>Organized, motivated, detail-orientated, self-starter with good judgment.</li>
<li>Professional appearance and demeanor; effective communicator verbally and in writing.</li>
<li>Ability to liaise professionally with client contacts on-site at client location, while effectively maintaining USIS policy and procedure.</li>
<li>Able to work effectively in fast paced environment. Must be a team player, flexible and easy-going. Ability to multi-task and prioritize effectively.</li>
<li>Ability to function efficiently and effectively in multiple systems to accomplish goals of the position, ensuring adherence to USIS policies.</li>
<li>Reliable, good attendance record.</li>
<li>Excellent customer service and presentation skills.</li>
<li>Dedicated to company and corporate culture in support of USIS operations and company goals.</li></ul> 
<h3 class="jobSectionHeader">
Equal Employment Opportunity &amp; Legal Notices</h3><div> 
Benefits</div><div>
At Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees. Our comprehensive benefits package includes:</div><ul>
<li>Medical, dental, and vision plans to support your health and that of your family</li>
<li>A 401(k) plan with employer matching</li>
<li>Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees</li>
<li>Paid holidays</li>
<li>Life insurance and short‑term and long‑term disability coverage</li>
</ul><div>Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee&rsquo;s primary work location. 
</div><div>Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements. 
</div><div>Diversity and Inclusion</div><div>
Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard. 
 
Compensation Transparency:
 
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.
 
 
Background Check &amp; Fair Chance Compliance
</div><div>Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair‑chance hiring requirements. 
 
Massachusetts Notice 
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.</div><div>
 
We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at recruitment@davies-group.com</div> 
<h3 class="jobSectionHeader">
About Davies</h3><div>
We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses. 
 
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation &amp; risk, customer experience, human capital, digital transformation &amp; change management. 
 
Our global team of more than 8,000 professionals operate across ten countries, including the UK &amp; the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research &amp; development, innovation &amp; automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.</div></div>

Workers' Compensation Claims Support Specialist (Orlando, FL)

Alliant Insurance Services

Alliant Insurance Services is one of the nation’s largest and fastest-growing insurance brokerage and consulting firms. We operate through a network of specialized national platforms and local offices to offer our clients a comprehensive portfolio of solutions built on innovative thinking and personal service. Alliant is changing the way our clients approach risk management and benefits, so they can capitalize on new opportunities to grow and protect their organizations.
 More information is available on the company's website at: www.alliant.com.
 
SUMMARY
 
Responsible for advanced operational processing, including complex endorsements, detailed billing reconciliation, elevated inbox management, claims follow-up, reporting, and external policy tracking. This role supports continuous process improvement, helps maintain SOPs, and serves as a resource for Operations Specialist I. Works closely with licensed SES personnel and leadership to ensure accuracy, efficiency, and consistent service delivery.
 
ESSENTIAL DUTIES AND RESPONSIBILITIES
 
Independently process complex property and insurance records in SES systems, including exception scenarios and non-standard workflows.
 
Review, validate, and correct work completed by Level 1 Specialists to ensure accuracy, completeness, and audit readiness.
 
Attach, index, and maintain supporting documentation in accordance with documentation standards and audit requirements.
 
Process complex endorsements involving special conditions and submit and track transactions through SES workflows, resolving routine operational questions directly.
 
Maintain external policy tracking for financial institution portfolios, ensuring accurate documentation, clear status reporting, and timely follow-up.
 
Execute advanced follow-ups for complex, incomplete, or non-standard policy documentation and escalate unresolved issues as needed.
 
Perform advanced billing reconciliation, including multi-system comparisons, GL coding validation, refund analysis, and discrepancy investigation.
 
Research recurring or systemic billing issues and coordinate with Accounting, Operations, or external vendors to resolve complex billing problems.
 
Serve as a primary point of contact for escalated calls and emails requiring advanced operational knowledge, providing clear process explanations within non-licensed scope.
 
Handle high-volume individual and shared inboxes, draft or refine non-template correspondence, ensure compliance with SLAs and communication standards, and provide guidance to Level 1 staff on professional communication and escalation practices.
 
Complete FNOL submissions for complex or time-sensitive losses, conduct proactive follow-ups with carriers or adjusters, manage loss-run requests, reconcile results with internal claim logs, and summarize findings for AEs or leadership.
 
Monitor team-level workflow queues, assign tasks to Operations Specialist I or offshore resources. Provide updates on queue status and risks, utilize Excel and internal systems for analysis and reporting. Assist with SOP and training material updates, support onboarding and mentoring staff, and participate in audits and special projects.
 
Performs all duties in accordance with all company policies and procedures, and all federal, state and local laws, wherein the Company operates.
 
Performs other duties as assigned.
 
QUALIFICATIONS
 EDUCATION/EXPERIENCE
 
Bachelor's Degree or equivalent combination of education and experience
 
Three (3) or more years in insurance operations, trust administration, financial services, or customer service.
 
SKILLS
 
Strong verbal and written communication skills, including advanced email and phone professionalism.
 
Strong analytical, problem solving, and decision making abilities.
 
High attention to detail with the ability to review and validate others’ work.
 
Ability to manage multiple tasks, prioritize effectively, and support a fast-paced environment.
 
Demonstrated ability to mentor junior staff and contribute positively to team culture.
 
Proficiency with Microsoft Office Suite (Excel, Outlook, Word; PowerPoint preferred); experience using agency management or workflow systems preferred.
 
Ability to adapt quickly to process changes and contribute to continuous improvement.
 
#LI-JP1
 
We are proud to provide comprehensive, high quality employee programs to meet employees’ needs now and in the future, including a very competitive financial package. We encourage you to explore what we have to offer.
 For immediate consideration for this position, please click on the “Apply Now" button.
 Alliant Insurance Services, Inc. is an equal opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of race, color, age, religion, gender, sexual orientation, gender identity, national origin, disability, protected veteran status or any other protected status.
 If you are applying for a job and need a reasonable accommodation for any part of the employment process, please call our Career Center at 1-877-901-9473 and let us know the nature of your request and contact information.
 
For more information on Alliant Insurance Service's benefits, click here.

Operations Specialist II - SES #JP

Oak Harbor Freight Lines

Auto & Property Claims Specialist I
 
Oak Harbor Freight Lines is an established, successful regional trucking company operating in Washington, Oregon, Idaho, Nevada, Utah, Arizona, and California. As a premier carrier offering superior service, we are always interested in exceptional people with excellent skills who strive to achieve their best. We are searching for an energetic and upbeat individual to join our team as an Auto & Property Claims Specialist I.
 
The Auto & Property Claims Specialist I will be responsible for overseeing and managing driver and accident claims from initial report through resolution. This position involves a dynamic combination of managing driver incidents, accident claims, and identifying subrogation opportunities. A successful candidate will thrive in an environment that requires multitasking, investigation, information gathering, and detailed record keeping—often moving multiple claims forward simultaneously.
 
Duties include reviewing police reports, gathering photos and documentation, and preparing key
 materials for the review board’s determination. This position will work closely with the shop
 managers, operations leaders, and the Human Resources and Safety departments.
 
Essential Duties and Responsibilities: 
<ul>
<li>Manage and process accident claims from start to finish</li>
<li>Collect and process internal accident reports, including ensuring the preventable/non-preventable ruling is made timely and sent to the Terminal Manager for handling.</li>
<li>Coordinate with multiple departments to gather required documents</li>
<li>Document conversations and e-mail correspondence</li>
<li>Follow up on opening activities</li>
<li>Check claims for validity and accuracy</li>
<li>Identify and pursue subrogation opportunities, including gathering supporting documentation and coordinating recovery efforts</li>
<li>Perform other duties as assigned.</li>
</ul>
Skills, Experience, and Educational Requirements
 <ul>
<li>High School diploma/GED equivalent or higher</li>
<li>Claims or insurance experience preferred, but not required</li>
<li>Effective analytical skills to gather information, analyze facts, and make recommendations based on information collected.</li>
<li>Strong oral and written communication skills, with the ability to convey information clearly and concisely</li>
<li>Excellent time management and organizational skills</li>
<li>Strong PC skills, including Microsoft Office</li>
<li>Multi-task ability as well as detail-oriented</li>
<li>Customer service-focused</li>
<li>Ability to work independently with minimal supervision as well as collaboratively in a team environment</li>
<li>Basic English language proficiency (reading, writing, and verbal) is required.</li>
</ul>
Benefits
 <ul>
<li>Medical, dental, vision – You choose which plan suits you and our family.</li>
<li>Employee only pays 0% up to 2% of gross income.</li>
<li>Family pays 0% up to 4% of gross income.</li>
<li>401K – 100% match up to 5% of employee's contribution.</li>
<li>Accrue 80 hours of PTO within the first 11 months and 120 in your second year.</li>
<li>Holiday pay after your 90 days.</li>
<li>Company Paid Life Insurance.</li>
</ul>
http://www.oakharborbenefits.com/full-time-regular-employees.html
 Oak Harbor Freight Lines is an Equal Opportunity Employer

Auto & Property Claims Specialist

Search 10000+ Claims operations specialist jobs near you this May. New roles added regularly across leading industries. Apply today.

10000 claims operations specialist jobs Near Me

Claims Operations Senior Specialist

Claims Adjuster | Upto $80/hr Part-time

CLAIMS PROCESSING ASSISTANT

Workers' Compensation Claims Support Specialist (Orlando, FL)

Operations Specialist II - SES #JP

Operations Specialist II - SES #JP

Auto & Property Claims Specialist