claims processor

State of South Carolina

<div><div><div><h2 class="jobSectionHeader"><b>Job Responsibilities</b></h2></div><br>
<p></p><div><br>
<br>
The SC Public Employee Benefit Authority (PEBA) is the administrator and co-trustee of retirement and insurance programs for over half a million active and retired public employees of the State of South Carolina and their dependents.<br>
<br>
This position is responsible for processing retirement claims for members and beneficiaries of the South Carolina Retirement System, the Police Officers Retirement System, the State Optional Retirement Program, and the South Carolina National Guard Retirement System.<br>
<br>
<b>Job duties include:</b><br>
<ul><li>
Processing claims for benefits upon the death of members (retired, active, and inactive) and beneficiaries.</li><li>
Processing claims for service and disability retirement benefits.</li><li>
Finalizing benefit payments for service and disability retirees who are on payroll in estimated status.</li><li>
Processing refund claims so that members receive refund payments.</li></ul></div><p></p>
<div><h2 class="jobSectionHeader"><b>Minimum and Additional Requirements</b></h2></div>
<div><p>A bachelor's degree and at least one year of professional experience in retirement programs or a closely related area. An equivalent combination of education and related experience may be substituted for the required degree.<br>
<br>
<i>Ability to read and comprehend retirement statutes and applicable written materials. Ability to explain retirement matters to members, employers, and beneficiaries. Ability to communicate effectively in oral and written form. Ability to perform mathematical calculations with a high degree of accuracy. Ability to prioritize and complete a large volume of work with close attention to detail.</i></p></div>
<div><h2 class="jobSectionHeader"><b>Additional Comments</b></h2></div>
<div><p>In addition to 13 paid holidays, this position is eligible for comprehensive insurance programs, retirement plans, and a generous paid leave program.</p></div></div></div>

Benefits Specialist - Retirement Claims

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary</b></p><p>
Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider refunds and returned checks. May handle customer service inquiries and problems.</p><ul><li>
Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise.
</li><li>Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process.</li><li>
Performs claim re-work calculations.</li><li>
Follow through completion of claim overpayments, underpayments, and any other irregularities.</li><li>
Process complex non-routine Provider Refunds and Returned Checks.</li><li>
Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks.
</li><li>Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals.</li><li>
Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures.</li><li>
Review and handle relevant correspondences assigned to the team that may result in adjustment to claims.</li><li>
May provide job shadowing to lesser experience staff.</li><li>
Utilize all resource materials to manage job responsibilities.</li></ul><p><b><br>
Required Qualifications</b></p><ul><li>
2+ years medical claim processing experience.</li><li>
Experience in a production environment.</li><li>
Demonstrated ability to handle multiple assignments competently, accurately, and efficiently.</li>
Effective communications, organizational, and interpersonal skills.<br>
<li>
</li></ul><p><br>
<b>Preferred Qualifications</b></p><ul><li>
DG system claims processing experience.</li><li>
Associate degree preferred.</li></ul><p><b><br>
Education</b></p><ul><li>
High School Diploma or GED.</li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$18.50 - $42.35<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><br>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p><br>
We anticipate the application window for this opening will close on: 06/19/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Senior Claims Benefit Specialist

Progressive

<p></p><div>Progressive is dedicated to helping employees move forward and live fully in their careers. Your journey has already begun. Apply today and take the first step to Destination: Progress.<br>
<br>
As a claims adjuster trainee, you'll learn how to help customers get back on the road after an accident. This is not a field position, which means you'll be building relationships with customers over the phone. In a fast-paced environment, you'll learn how to resolve a full case load of claims efficiently while managing the claims process from start to finish. You'll have the support of a collaborative team and ongoing coaching from leaders. We'll also teach you the insurance stuff - providing in-depth training on property damage and insurance contracts so you can confidently and independently adjust claims.<br>
<br>
This is a hybrid role, which means you'll work in-office two days that are selected by local leadership and choose where you want to work the other three days, whether that's at home or in the office, for a period of 12 months. After that period, the days you'll be expected to report to an office for important meetings, training, and collaboration will vary based on business need. In this hybrid work environment, you'll be supported by your leaders and tenured colleagues to develop relationships, establish connections, and share practices that are important to your development. If you prefer an in-office environment, you're welcome to work in the office as often as you would like.<br>
<br>
<b>Duties &amp; responsibilities (upon completion of training)</b><ul><li>
Determine coverage</li><li>
Determine liability (who's at fault for the damages)</li><li>
Interview customers, claimants, and witnesses</li><li>
Partner with appraisers/estimators to manage vehicle repairs</li><li>
Negotiate with customers and other insurance carriers and resolve claims</li></ul><br>
<b>
Must-have qualifications</b><ul><li>
Three years of work experience OR</li><li>
Bachelor's degree OR</li><li>
Two years work experience and an associate degree</li></ul><br>
<b>
Schedule:</b> Monday-Friday 9:00am-6:00pm with the exception of Claims Ownership class which is Monday-Friday 8:30am-5:30pm<br>
<br>
<b>Location:</b> Open to claims offices in Columbia, Greenville, Myrtle Beach, and North Charleston<br>
<br>
<b>Compensation</b>
<ul><li>$52,500-$56,000/year based on experience</li><li>
Gainshare annual cash incentive payment up to 16% of your eligible earnings based on company performance</li></ul><br>
<b>
Benefits</b><ul><li>
401(k) with dollar-for-dollar company match up to 6%</li><li>
Medical, dental &amp; vision, including free preventative care</li><li>
Wellness &amp; mental health programs</li><li>
Health care flexible spending accounts, health savings accounts, &amp; life insurance</li><li>
Paid time off, including volunteer time off</li><li>
Paid &amp; unpaid sick leave where applicable, as well as short &amp; long-term disability</li><li>
Parental &amp; family leave; military leave &amp; pay</li><li>
Diverse, inclusive &amp; welcoming culture with Employee Resource Groups</li><li>
Career development &amp; tuition assistance</li></ul><br>
Energage recognizes Progressive as a 2025 Top Workplace for: Innovation, Purposes &amp; Values, Work-Life Flexibility, Compensation &amp; Benefits, and Leadership.<br>
<br>
Equal Opportunity Employer<br>
<br>
Applicants must be authorized to work for any employer in the U.S. without the need or potential need, of current or future sponsorship for employment. Progressive does not hire candidates with (e.g., F-1 CPT, OPT, or STEM OPT, H-1B, O-1, E-3, TN) statuses for this role.<br>
<br>
For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://www.progressive.com/careers/how-we-hire/faq/job-scams/</div>

Claims Adjuster Trainee

Steadily Insurance Agency

<p><b>Location:</b> Overland Park, KS (Kansas City Metro)<br/><b>Employment Type:</b> Full-time, In-Office<br/><b>Salary:</b> $65,000 - $85,000 base salary including meaningful equity.</p><p>Steadily is hiring an <b>Associate Claims Adjuster </b>who is the very best at what they do. You&rsquo;ll be surrounded by team members who are the best at what they do, which will just make you even better. You&rsquo;ll be responsible for guiding our customers through the claims process with empathy, accuracy, and speed - making sure we create a fast, easy, and effortless experience.</p><p>This is a full-time, <b>in-office position</b> based in <b>Overland Park, KS.</b></p><p>What You&rsquo;ll Do</p><ul><li>You will complete a structured onboarding program that will help give you a strong foundation in basic insurance principles and property claims.</li><li>You will complete an adjuster licensing course and acquire applicable licensing for the role.</li><li>You will learn the Steadily approach to claims handling, helping create a fast, easy, and effortless experience for our customers.</li><li>Establish new claims by taking customer&rsquo;s First Notice of Loss</li><li>Request appraisals, estimates, cause &amp; origin reports, and various other reports to assist in the investigation of the claim</li><li>Communicate with customers using their preferred channel of communication (phone, text, email, mail)</li><li>Review estimates and reports and issue payments as owed under the policy contract</li><li>Adjust claim files with extremely high quality, exceeding the expectations of internal/external auditor security, including ample documentation, regular diary entries, and quality application of coverage and compliance with all claims related laws and regulations</li><li>If there is a catastrophe, you will be responsible for helping the entire team in an all-hands-on-deck approach</li><li>Assist in establishing new workflows, improve existing workflows, and build claims processes</li></ul><p>Your Background</p><ul><li><b>Experience</b>: You may not have direct experience in insurance or claims adjusting, but you bring relevant skills and the eagerness to learn quickly. Experience in customer-facing roles that require strong communication skills, critical thinking, problem solving, and handling high-stakes conversations is a big plus.</li><li><b>Communication: </b>You possess superior verbal and written communication skills. You can communicate concisely and diplomatically, maintaining a calm demeanor and professional communication.</li><li><b>Digital</b>: You have above average computer skills. You&rsquo;re great at independently learning new software quickly and are savvy using online resources.</li><li><b>Self-Driven: </b>You thrive under intense pressure and can manage a large workload with minimal oversight. There is no task too small or beneath you; &ldquo;that&rsquo;s not my job&rdquo; is not in your mantra.</li><li><b>Hungry</b>: You want to make the leap into an earlier-stage tech company to rapidly accelerate your growth. You want to roll up your sleeves and hustle &ndash; you are not looking for a traditional 9-5 job.</li><li><b>Project Management</b>: As part of this role, you may be asked to assist in projects. Prior project experience is a plus.</li></ul><p>Compensation and Benefits</p><ul><li><b>Salary:</b> $65,000 - $85,000</li><li><b>Shift time</b>: 10am-7pm CST, which will come with a $5,000 per year shift differential</li><li><b>Equity:</b> Stock options in a fast-growing company</li><li><b>Time Off:</b> 3 weeks PTO + 6 federal holidays</li><li><b>Insurance:</b> Medical, dental, vision, life, disability, HSA, FSA</li><li><b>Retirement:</b> 401(k)</li><li><b>Perks:</b> Free snacks, team lunches, collaborative office culture</li></ul><p>Locations</p><ul><li>Overland Park, Kansas (Kansas City Metro)</li><li>Steadily is building a workplace environment of team members who are passionate and excited to be together in person. Our offices are in Overland Park or central Austin, and are key to our fast-paced growth trajectory.</li></ul><p>Why Join Steadily</p><ul><li><b>Good company. </b>Our founders have three successful startups under their belt and have recruited a stellar team to match.</li><li><b>Top compensation</b>. We pay at the top of the Kansas City market (see comp).</li><li><b>Growth opportunity</b>: We&rsquo;re an early-stage, fast-growing company where you&rsquo;ll wear a lot of hats and shape product decisions.</li><li><b>Strong backing</b>. We&rsquo;re growing fast, we manage over $20 billion in risk, and we&rsquo;re exceptionally well-funded.</li><li><b>Culture</b>: Steadily boasts a very unique culture that our teammates love. We call it like we see it and we&rsquo;re nothing if not candid. Plus, we love to have a good time. Check out our <b>culture deck</b> to learn what we&rsquo;re all about.</li><li><b>Awards:</b> We've been recognized both locally and nationally as a top place to work. Recently we were ranked 16th on Forbes' 2026 Best Startup Employers list, and 63rd on the prestigious Inc 5000 Fastest Growing Companies list. We've also been recognized as one of the Best Landlord Insurance Companies in 2026 by CNBC, a Top 2025 Startup in Newsweek, in Investopedia's Best Landlord Insurance Companies, and we won Austin Business Journal's Best Places to Work in 2025.</li></ul><p>We&rsquo;re excited to meet you!</p><p>Job Type: Full-time</p><p>Benefits:</p><ul><li>401(k)</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Referral program</li><li>Relocation assistance</li><li>Vision insurance</li></ul><p>Work Location: In person</p>

Associate Claims Adjuster

Automobile Club of Missouri

Job Summary
<br><br>
This entry-level position supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include liability investigation, coverage evaluation, and claims resolution and negotiation strategies of lower complexity claims in compliance with established company technical and customer service best practices. Under moderate supervision, works within specific limits and authority to resolve claims with well-defined procedures.
<br><br>
Job Duties
<br><br>
Communicate and interact with a variety of individuals including insureds and claimants. Verify and explain benefits, coverages, fault, and claims process either verbally or in writing which complies with regulatory and statutory requirements.
<br><br>
Conduct investigations to determine liability and damages and differentiate between allegations and facts. Identify and obtain statements from insureds, claimants, and witnesses.
<br><br>
Evaluate and negotiate within settlement authority with insureds and claimants to resolve first and third-party claims in multiple markets. Demonstrate proficiency with estimate review, material damage, liability, analysis of claims, claims technology, and tool usage.
<br><br>
Coordinate with internal and external departments as required.
<br><br>
Respond quickly to customer needs and inquiries.
<br><br>
Overtime and holiday hours may be required.
<br><br>
Qualifications
<br><br>
Bachelors Equivalent combination of education and experience Preferred
<br><br>
No prior claims experience.
<br><br>
Knowledge of Microsoft Office suite and general computer software.
<br><br>
Organization and planning recognition skills required.
<br><br>
Oral and written communication skills required.
<br><br>
Interpersonal skills required.
<br><br>
Property and Casualty Insurance License, valid in selling state - Issued by State
<br><br>
May be required to obtain an Adjuster license as applicable in accordance with state law. within 60 Days
<br><br>
The starting pay range for this position is $25.48 – $28.03 per hour. Additionally, you will be eligible to participate in our incentive program based upon your team and individual performance.
<br><br>
<b>Remarkable benefits:</b><br>
<ul>
<li>Health coverage for medical, dental, vision</li>
<li>401(K) saving plans with company match AND Pension</li>
<li>Tuition assistance</li>
<li>Floating holidays and PTO for community volunteer programs</li>
<li>Paid parental leave</li>
<li>Wellness programs</li>
<li>Employee discounts (membership, insurance,</li>
</ul>
travel, entertainment, services and more!)
<br><br>
Auto Club Enterprises is the largest club within the national AAA federation. We have nearly 17,000 employees in 24 states helping more than 18 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity – we win. All of Us! With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
<br><br>
“Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value.”
<br><br>
AAA is an Equal Opportunity Employer
<br><br>
Our organization participates in E-Verify
<br><br>
The Automobile Club of Southern California will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance (FCIHO), the Unincorporated Los Angeles County (ULAC) regulation, and the California Fair Chance Act (CFCA).

Claims Auto Adjuster

Gainwell Technologies LLC

<div><div><div><div><div><p>Claims Specialist- Anchorage, AK (Hybrid)
</p></div></div></div></div><div><div><div><div><b>Date: </b>Jun 8, 2026
</div></div></div></div><div><div><div><div><b>Location:
</b>Any city, AK, US, 99999
</div></div></div></div><div><div><div><div><b>Req ID: </b>36193
</div></div></div></div><div><div><div><div><b>Work Mode: </b>Virtual (Exception only)
</div></div></div></div><div></div><div><div><div><div><div>Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You&rsquo;ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.</div><div></div><div><div><div><div><b><br>
Summary</b></div>
</div><div><div>
As <b>Claims Specialist- Anchorage, AK (Hybrid)</b>, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve &mdash; a community&rsquo;s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare&rsquo;s biggest challenges. Here are the details on this position. HMS is hiring Claims Specialists to support our Alaska account. These positions processes moderately complex claims for our Alaska Medicaid client. They will make decisions on payment of medical claims using the existing policy and rules to ensure accurate and timely completion.</div></div></div><div></div><div><div><div><b><br>
Your role in our mission</b></div>
</div><div><ul><li>Review and research suspended medical claims and adjudicate them per DHS policy.</li>
<li>Refer claims to Utilization Review and Provider Services units.</li>
<li>Maintain necessary documentation.</li>
<li>Participate in meetings as necessary.</li>
<li>Participate in process improvement sessions.</li>
<li>Train as a back-up for other areas, such as document control, courier, and customer service desk.</li>
<li>Other duties as assigned</li>
</ul></div></div><div><div><div><b>What we're looking for</b></div>
</div><div><ul><li>Ability to work both independently and as part of a team.</li>
<li>Strong communication skills with the ability to communicate clearly and effectively in writing and verbally.</li>
<li>Ability to access and retrieve information using a PC.</li>
<li>Intermediate understanding of Microsoft Office products.</li>
<li>Organizational skills to balance and prioritize work, and analytical and problem-solving skills.</li>
</ul></div></div><div><div><div><b>What you should expect in this role</b></div>
</div><div><ul><li>Hybrid role with ability to work in the Anchorage, AK office preferred, with the possibility of working remotely from another state for the right candidate. The person will need to work Alaska Time hours.</li></ul><br>
<div></div>
<div>
#LI-LS2</div>
<div>
#LI-HYBRID</div></div></div></div><br>
<div></div>
<div>
The pay range for this position is $37,500.00 - $53,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You&rsquo;ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.</div><br>
<div></div>
<div>
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You&rsquo;ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.</div><br>
<div></div>
<div><i>
Gainwell Technologies </i><i>is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. </i><i>Gainwell Technologies defines &ldquo;wages&rdquo; and &ldquo;wage rates&rdquo; to include &ldquo;all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.</i></div></div></div></div></div></div><p></p>

Claims Specialist- Anchorage, AK (Hybrid)

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Claims Specialist- Anchorage, AK (Hybrid)