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claims specialist

Abacus Plumbing, Air Conditioning & Electrical

<div>
 The Warranty Claims Specialist is a full-time position. This role is primarily responsible for managing warranty and rebate claims from start to finish, ensuring all equipment is properly registered, coordinating with internal teams to locate and return parts, and maintaining accurate records related to warranty, rebate, and registration activities.Strong attention to detail, clear communication, and excellent organizational skills are essential to ensure accurate documentation and timely resolution of all claims.
 
 
 
 What's In It For Me?
 
 
 
 <ul>
 <li>
 Market Value Compensation ($18-$20/hr)
 </li>
 <li>
 PTO Plan
 </li>
 <li>
 Health, Vision and Dental plans for you and your family to choose from
 </li>
 <li>
 401K Retirement Plan with company match up to 30%
 </li>
 <li>
 Life Insurance, Short-Term and Long-Term Disability
 </li>
 <li>
 Special Program Options FSA, EPA, Legal Services and Identity Theft
 </li>
 <li>
 Continuous Training for your Professional Development
 </li>
 <li>
 Working in a dynamic, collaborative, and fun environment
 </li>
 <li>
 Coached and supported career growth
 
 
 
 </li>
 </ul>
 
 What Will I Do?
 
 
 
 <ul>
 <li>
 </li>
 <ul>
 <li>
 Ensure all warranty claims are filed and follow each one through to completion.
 </li>
 <li>
 File all warranty-related parts and service calls are properly registered with manufacturers (i.e. Lennox).
 </li>
 <li>
 Coordinate with Warehouse team to locate and access returnable parts
 </li>
 <li>
 Manage and track life cycle tracking of warranty parts and equipment
 </li>
 <li>
 Use a clear tagging process with technician for parts and equipment
 </li>
 <li>
 Locate, verify, and return warranty-related equipment (ie. thermostats and other required return items)
 </li>
 <li>
 File, maintain and track rebates
 </li>
 <li>
 Assist with special projects as assigned
 
 </li>
 </ul>
 </ul>
 
 Do I Have What It Takes?
 
 
 
 <ul>
 <li>
 High school degree or equivalent
 </li>
 <li>
 Proficient computer skills
 </li>
 <li>
 Experience with Microsoft Excel
 </li>
 <li>
 Proficient with Microsoft Office
 </li>
 <li>
 Detail oriented and deadline driven
 </li>
 <li>
 Ability to work independently, as well as part of a team
 </li>
 <li>
 Strong communication skills
 
 
 
 </li>
 </ul>
 
 Wrench Group and its affiliates are proud to be an Equal Employment Opportunity employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, genetic information, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
 
 The company
 
 encourages all
 
 
 qualified candidates who are eligible to work in the United States to apply, but it does not sponsor applicants or employees who require a visa to work legally.
 
 
 
 
 #AbacusHoustonLI
 
 
 
</div>

Warranty Claims Specialist

The Hartford

<div><h2 class="jobSectionHeader">Job Details</h2>
<div><div><div>Location:</div>
<div>Houston, TX</div>
</div><div><div>Category:</div><div>
Claim</div>
</div><div><div>Employment Type:</div>
<div>Full time, Remote
</div></div><div><div>Job Ref:</div><div>
R2625873-190</div>
</div></div><div><div>General Adjuster - CL08AE
We&rsquo;re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals &ndash; and to help others accomplish theirs, too. Join our team as we help shape the future. 
We are hiring for either Associate General Adjuster or General Adjuster (depending on experience). This is a remote position; however, the role requires regular fieldwork,
General Adjuster: $108,000 - $162,000 
The successful General Adjuster candidate will plan, recommend, reserve and execute the investigation, valuation, disposition and settlement of large Commercial Insurance property claims in a manner consistent with corporate claim settlement policies and procedures and statutory, regulatory and ethics requirements throughout the United States as appropriate. 
The individual in this position will work to achieve fair, equitable and timely claim dispositions and properly assess the indemnity and expense exposure of assigned claims. They will report to a Property Major Case Manager and operate in a team environment that will develop and share business knowledge and claim handling expertise with team members and business partners. This position will also potentially mentor Associate General Adjusters and Property Damage Adjusters.
Qualifications: 
Must have 5+ years of experience as a full file Claim Adjuster for complex property losses in excess of $500,000 in value 
Field experience conducting on-site inspections and estimating property damage 
Strong functional knowledge of commercial claims and be able to appropriately interpret and apply insurance coverage 
College degree or equivalent experience 
Consistent high level of performance and achievement over career span 
Cost estimation preferably using Xactimate and computer competencies required. 
Good working knowledge of regional jurisdictional issues 
Disciplined time management and organizational skills and ability to function in a self-reliant manner 
Availability for nationwide catastrophe operations as necessary 
Must have MS Office knowledge (i.e. Excel, Teams, Word) 
 
Associate General Adjuster: $85,200 - $127,800 
The successful Associate General Adjuster candidate will plan, recommend, reserve and execute the investigation, valuation, disposition and settlement of large commercial insurance property claims in a manner consistent with corporate claim settlement policies and procedures and statutory, regulatory and ethics requirements throughout the United States as appropriate. 
The individual in this position will work to achieve fair, equitable and timely claim dispositions and properly assess the indemnity and expense exposure of assigned claims. They will report to a Property Major Case Manager and operate in a team environment that will develop and share business knowledge and claim handling expertise with team members and business partners. 
 
Qualifications: 
Must have 3+ years' experience as a full file Claim Property Adjuster managing moderately severe property claims. 
Strong functional knowledge of commercial claims and be able to appropriately interpret and apply insurance coverage. 
Field experience conducting on-site inspections and estimating property damage 
College degree or equivalent experience 
Consistent high level of performance and achievement over career span 
Cost estimation preferably using Xactimate and computer competencies required. 
Good working knowledge of regional jurisdictional issues 
Disciplined time management and organizational skills and ability to function in a self-reliant manner 
Availability for nationwide catastrophe operations as necessary 
Must have MS Office knowledge (i.e. Excel)
Compensation
The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford&rsquo;s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:
$108,000 - $162,000
Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age</div></div></div>

General Adjuster / Associate General Adjuster

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
A day in the life of a Field Property Adjuster, and what it takes to do the job!
As a Field Property Adjuster, you will provide exceptional service to our policyholders. Your primary responsibility will involve traveling to our customers' homes to conduct on-site inspections, investigate coverage, prepare estimates, and settle claims promptly and efficiently. Additionally, you will handle virtual claims countrywide, leveraging various platforms and software such as Xactimate and ClaimsX Video Collaboration. Your expertise will be particularly focused on water losses, ensuring our customers receive the highest level of support and resolution for these specific claims. 
You'll wear a few hats that will require a level of experience:<ul><li>
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 claim. You lead with empathy, always.</li><li>
The Investigator &ndash; you&rsquo;ll confidently and independently investigate property claims by performing detailed reviews of damage and interpreting policies to determine coverage.</li><li>
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.</li><li>
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.</li><li>
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.</li><li>
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 in. You&rsquo;ll accomplish this by ensuring timely and accurate documentation is completed as you work on each claim.</li></ul>
Qualifications:<ul><li>
2 years' previous experience as an outside adjuster is highly desired.</li><li>
Previous experience as an outside adjuster is highly desired.</li><li>
Proficiency in using Xactimate and other relevant software for estimating.</li><li>
Strong critical thinking and technical skills to assess damages accurately and expedite claims settlements.</li><li>
Excellent communication and interpersonal skills to provide exceptional customer service.</li><li>
Ability to travel to customers' homes and handle virtual claims countrywide effectively.</li><li>
Detail-oriented and organized, with a focus on delivering high-quality work.</li><li>
This position is not available for California, Alaska, Hawaii or Puerto Rico residents.</li></ul> 
Required Qualifications:<ul><li>
Residency within 60 miles of Austin, TX is mandatory for this role.</li><li>
Are willing and able to carry a 50-pound ladder and access up to a 6/12 pitch on a one to two-story roof.</li><li>
Valid driver's license and willingness to travel as part of the job requirements.</li></ul> 
You&rsquo;re provided with comprehensive training:<ul><li>
The training program is designed to help you build a claims foundation and understand the systems and processes in your day-to-day work.</li><li>
Ongoing training opportunities for continuous improvement happen regularly on the job.</li><li>
You will be required to attend approximately 2 weeks of training that will take place in Dallas, TX.</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><ul><li>
As a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment.</li><li>
Applicants seeking an adjuster role who also hold a resident producer license must formally surrender that license when instructed to by the licensing team. By proceeding with the application process, applicants acknowledge and accept these licensing requirements and agree to comply.</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, Designated Home State (DHS) Florida or Texas License, and/or applicable Appraiser License.<ul><li>Current employees or candidates who have previously worked for Allstate, including its family of companies, are not eligible for this sign-on bonus.</li></ul> 
Company Car:
Based on our Company Car Guidelines, this role may qualify for a company car. Our leadership team determines this based on annual work mileage for this location. You may be required to use your personal vehicle until these guidelines are met. We offer mileage reimbursements for personal vehicle usage during work. 
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>
#LI-NJ1
Skills
Active Listening, Communication, Critical Thinking, Customer Service, Empathy, Multitasking, Negotiation, Time Management, Working Independently, Xactimate
Compensation
Compensation for this role ranges from $56,000 to $98,450 annually and is based on experience, qualifications, location, and internal equity.
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. 
Allstate provides a comprehensive technology setup, including a laptop, monitors, headset, keyboard, and mouse. Employees eligible to work from home also receive a monthly connectivity reimbursement to help offset internet costs. 
When working from home, you must have a dedicated, private workspace free from distractions, along with appropriate desk and seating. Reliable internet is required, with minimum speeds of 50 MB download and 5 MB upload.</div>

Property Adjuster - Field Estimating - Austin, TX

TEEMA

<div><h2 class="jobSectionHeader">Senior Workers&rsquo; Compensation Claims Examiner (Texas Licensed)</h2>
We are seeking an experienced Workers&rsquo; Compensation Claims Examiner to join a collaborative claims team handling complex indemnity claims from initial investigation through resolution. This is an excellent opportunity for a detail-oriented professional who thrives in a fast-paced environment and enjoys balancing analytical decision-making with strong client and claimant communication.
In this role, you will independently manage a caseload of approximately 110&ndash;150 workers&rsquo; compensation claims, including complex files requiring advanced investigation, compensability analysis, reserve management, and ongoing medical oversight. You will work closely with claimants, employers, medical providers, attorneys, and internal stakeholders to ensure timely and compliant claim resolution in accordance with Texas workers&rsquo; compensation regulations.
Key Responsibilities:<ul><li>
Investigate and manage workers&rsquo; compensation claims from inception to closure</li><li>
Determine compensability and administer benefits in accordance with state laws and company guidelines</li><li>
Coordinate medical treatment and manage related billing activity</li><li>
Establish and maintain accurate claim reserves</li><li>
Maintain organized documentation and diary management for all claim activity</li><li>
Communicate effectively with clients regarding claim status, trends, and risk concerns</li><li>
Conduct independent file reviews and proactively drive claims toward resolution</li></ul>
Qualifications:<ul><li>
Active Texas Workers&rsquo; Compensation Adjuster License required</li><li>
5+ years of workers&rsquo; compensation claims handling experience, including complex indemnity claims</li><li>
Strong understanding of workers&rsquo; compensation statutes, medical terminology, and claims investigation</li><li>
Excellent written and verbal communication skills</li><li>
Ability to manage a high-volume caseload independently</li><li>
Proficiency with Microsoft Office applications preferred</li></ul>
This position offers the opportunity to join a professional, team-oriented environment where your expertise and judgment will have a direct impact on claim outcomes and client satisfaction.
#Workwolf</div>

Workers Compensation Claims Examiner

Allied Universal Compliance and Investigations

<div>Surveillance Investigator<h2 class="jobSectionHeader">
Overview</h2><div> 
Company Overview:
</div><div>Advance Your Career in Insurance Claims with Allied Universal&reg; Compliance and Investigation Services. Allied Universal&reg; Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our team is committed to innovation and excellence, making a significant impact in the insurance industry. If you&rsquo;re ready to grow with the best, explore a career with us and make a difference.</div><h2 class="jobSectionHeader"> 
Job Description</h2><div> 
Allied Universal&reg; is hiring a Surveillance Investigator. The Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim.</div><div>
</div><ul><li>Must possess a valid driver's license with at least one year of driving experience
</li><li>Multiple positions available!
</li><li>Access to 401k and medical benefits
</li></ul><div></div><div>RESPONSIBILITIES:</div><ul><li>
Conduct independent investigations of insurance claims across a range of coverage types, including workers&rsquo; compensation, general liability, property and casualty, and disability</li><li>
Utilize various surveillance techniques and equipment to monitor subjects covertly</li><li>
Document and report observations, activities, and any relevant information in a clear and concise manner</li><li>
Collaborate with other investigators and law enforcement agencies as needed to gather information and coordinate efforts</li><li>
Maintain confidentiality and adhere to legal and ethical standards in conducting surveillance operations</li></ul><div>
QUALIFICATIONS (MUST HAVE):</div><ul><li>
High school diploma or equivalent</li><li>
Post offer, must be able to successfully complete the Allied Universal Investigations' training/orientation course</li><li>
Minimum of one (1) year of verifiable work experience, preferably involving investigations or other protective service-related field</li><li>
Flexibility to work varied and irregular hours/days including weekends and holidays</li><li>
Ability to type reports in Microsoft Word format with minimal grammatical and punctuation errors</li><li>
Proficient in utilizing laptop computers, video cameras and cell phones</li><li>
Capable of maintaining focus and multitasking effectively in a dynamic environment</li><li>
Demonstrated ability to manage stressful situations with composure and professionalism</li><li>
Ability to work in a very independent environment</li></ul><div>
PREFERRED QUALIFICATIONS (NICE TO HAVE):</div><ul><li>
Associate&rsquo;s Degree or higher, preferably in Criminal Justice</li><li>
Security/Loss Prevention experience</li><li>
Military experience</li><li>
Law enforcement experience</li><li>
Prior insurance investigations experience</li><li>
Prior educational or professional incident reporting and/or investigations experience</li></ul><div>
BENEFITS:</div><ul><li>
Medical, dental, vision, basic life, AD&amp;D, retirement plan and disability insurance</li><li>
Seven paid holidays annually, sick days available where required by law</li><li>
Vacation time offered at an initial accrual rate of 3.08 hours biweekly; unused vacation is only paid out where required by law</li></ul><h2 class="jobSectionHeader"> 
Closing</h2><div> 
Allied Universal&reg; is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: www.aus.com
</div><div>If you have difficulty using the online system and require an alternate method to apply or require an accommodation, please contact our local Human Resources department. To find an office near you, please visit: www.aus.com/offices.</div><h2 class="jobSectionHeader"> 
Requisition ID</h2> 
2026-1612044</div>

Surveillance Investigator

Aveanna Healthcare

<div>
 
 Overview
 
 
 
 
 Position: Healthcare Operations Specialist
 
 
 
 
 Join a Company That Puts People First!
 
 
 
 Aveanna Healthcare is one of the nation&rsquo;s largest private duty nursing companies, continuing to grow and innovate. We pride ourselves on fostering a workplace culture that values diversity, encourages collaboration, and supports our team members every step of the way.
 
 
 
 What Makes Aveanna Different?
 
 
 
 
 Award-Winning Culture
 
 
 
 <ul>
 <li>
 Recognized in Indeed&rsquo;s Work Wellbeing Top 100 Companies of 2024
 </li>
 <li>
 Named Best Company for Work-Life Balance, Happiest Employees, Best Culture, and Best CEO by Comparably in 2024
 
 
 </li>
 </ul>
 
 Comprehensive Benefits Package
 
 
 
 <ul>
 <li>
 Health, Dental, Vision, and Company-paid Life Insurance
 </li>
 <li>
 Paid Holidays, Vacation Days, and Sick Days
 </li>
 <li>
 Quarterly Bonus Opportunities
 </li>
 <li>
 Mileage Reimbursement
 </li>
 <li>
 401(k) Savings Plan with Employer Matching
 </li>
 <li>
 Employee Stock Purchase Plan with a 15% Discount
 </li>
 <li>
 Tuition Discounts and Reimbursement Program (conditions apply)
 </li>
 <li>
 Nationwide Presence with Advancement Opportunities
 </li>
 <li>
 Employee Recognition Programs and Relief Fund
 </li>
 <li>
 Structured New Hire Orientation
 </li>
 <li>
 Employee Resource Groups for Community and Support
 
 
 </li>
 </ul>
 
 Position Details
 
 
 
 <ul>
 <li>
 Compensation: $17.00 hourly + quarterly bonuses
 </li>
 <li>
 Schedule: Full-time schedule, Monday&ndash;Friday, daytime hours
 </li>
 <li>
 Location: Houston, TX
 
 
 </li>
 </ul>
 
 Responsibilities Of The Operations Specialist
 
 
 
 <ul>
 <li>
 Customer Service Support: Deliver top-level service to internal and external clients for all clinical operational support activities at the branch.
 </li>
 <li>
 General Office Duties: Manage tasks such as scanning, filing, handling incoming calls, emails, and faxes, distributing mail, processing invoices, and ordering office supplies.
 </li>
 <li>
 Compliance Coordination: Support recruiting and onboarding efforts, maintain personnel files, ensure credentialing, and assist with risk management processes.
 </li>
 <li>
 Medical Records Management: Perform data entry, organize and distribute physician plans of care, and uphold communication standards within the office.
 </li>
 <li>
 Payroll Assistance: Review weekly timesheets, audit payroll files, and serve as the primary contact for caregiver payroll inquiries.
 
 
 </li>
 </ul>
 
 Qualifications Of The Operations Specialist
 
 
 
 <ul>
 <li>
 High School Diploma or equivalent required; College Degree is a PLUS.
 </li>
 <li>
 Experience in payroll and/or human resources is highly preferred.
 </li>
 <li>
 Proficient in Microsoft Office Suite, with strong skills in Word and Excel.
 </li>
 <li>
 Team player with excellent organizational skills and the ability to multitask effectively.
 </li>
 <li>
 Home health experience is a PLUS.
 </li>
 <li>
 Proficiency in English; bilingual skills are a PLUS.
 
 
 </li>
 </ul>
 Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related requirements, including vaccinations and testing, subject to medical or religious exemptions.
 
 
 
 Take the Next Step in Your Career!
 
 
 
 Join a team where you can grow, lead, and make a real difference in the lives of others. Apply now to become part of Aveanna&rsquo;s supportive and dynamic environment!
</div>

Healthcare Operations Specialist

Texas Children's Hospital

<div>We are searching for a Senior Financial Analyst &mdash; someone who works well in a fast-paced setting. In this position, you will assist in maintaining the financial and statistical records of the Health Plan, ensuring that executives, management and the board can continuously measure Health Plan performance relative to its goals and strategies.
 
Think you&rsquo;ve got what it takes?
<div>Job Duties &amp; Responsibilities
 
<ul><li>Ensure that monthly source data validates current membership, retroactive membership adjustments and payment amounts, according to contracted rates and membership distribution
</li><li>Review monthly membership and payment amounts to resolve errors and discrepancies, and identify and analyze issues or trends that need attention
</li><li>Reconcile claims expense to lag schedules
</li><li>Research and correct any discrepancies.
</li><li>Calculate IBNR in accordance with TCHP procedure using reconciled lag and payment schedules
</li><li>Reconcile accrual-based expense totals to actual cash distribution
</li><li>Ensure that payments are made in timely fashion
</li><li>Coordinate with Treasury to monitor available cash against expected cash requirements
</li><li>Analyze and resolve issues that create discrepancies among revenue membership and eligibility membership
</li><li>Reconcile revenue amounts reported for general ledger, financial reporting, decision support, and regulatory reporting
</li><li>Review reporting requirements to identify supporting schedules needed.
</li><li>Prepare schedules as assigned for monthly, quarterly and annual financial and regulatory reporting packets.
</li><li>Research and respond to inquiries from management and other departments.
</li><li>Assist with preparation of annual budget. Assists managers and directors in comparing budget to actual performance
</li></ul></div>Skills &amp; Requirements
<ul><li>5 Years Accounting Or Analytical Work Experience Required
</li><li>Bachelor's degree in Accounting, Finance, Or Business Administration Required
</li><li>Master&rsquo;s degree may substitute for two years of the required experience
</li><li>A Certified Public Accountant (CPA) license issued by the Texas State of Public Accountancy, or equivalent state Board for out of state residents, may substitute for two years of the required experience.</li></ul></div>

Financial Analyst, Sr - TCHP

Explore 27+ Claims specialist in Houston this June. Find roles across top companies and apply now to boost your career.