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claims specialist - workers' compensation Jobs in Atlanta

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claims specialist workers compensation

Arrow Exterminators

<div><p>Arrow Exterminators is currently seeking a highly skilled and proactive <b>WC Claims Specialist</b> to lead and oversee the day-to-day management of our Workers' Compensation (WC) claims. The ideal candidate will be responsible for collaborating with our Third-Party Administrator (TPA), ensuring timely, accurate, and cost-effective claim handling, maintaining compliance with applicable state WC laws, and supporting business goals through strategic claims management.</p><p><b>
Key Responsibilities</b></p><ul><li>
Oversee and coordinate all aspects of reporting, documenting, and managing workers' compensation claims.</li><li>
Serve as the primary liaison between the company and the TPA for claims handling, escalation, and resolution.</li><li>
Monitor claim activity to ensure timely investigations, accurate compensability decisions, and adherence to best practices.</li><li>
Analyze claim trends and outcomes; prepare reports for leadership on costs, reserves, and risk exposure.</li><li>
Collaborate with HR, the SVP of Risk Management, Safety, and Operations teams to support return-to-work initiatives and ensure modified duty assignments are effectively implemented.</li><li>
Review and challenge reserves, settlements, and litigation strategies to control costs and achieve favorable outcomes.</li><li>
Ensure compliance with state workers' compensation statutes, reporting deadlines, and internal policies.</li><li>
Conduct periodic claim reviews with the TPA and internal stakeholders to assess performance and identify areas for improvement.</li><li>
Provide training and guidance to internal staff on workers' compensation procedures and protocols.</li></ul><p><b>
Qualifications</b></p><ul><li>
Bachelor's degree in Business Administration, Risk Management, Human Resources, or related field (preferred).</li><li>
3+ years of experience in workers' compensation claims management, with direct oversight of WC claims.</li><li>
Knowledge of workers' compensation state laws and claims handling practices.</li><li>
Experience working directly with TPAs, attorneys, and medical providers.</li><li>
Exceptional communication and negotiation skills with the ability to build strong professional relationships.</li><li>
Proficient in claims management systems and Microsoft Office Suite.</li><li>
Strong analytical, organizational, and problem-solving skills.</li><li>
Ability to manage multiple priorities in a fast-paced environment.</li></ul><p><b>
Preferred Attributes</b></p><ul><li>
A proactive, hands-on approach to claims oversight.</li><li>
Strong attention to detail and accuracy.</li><li>
Ability to influence outcomes through effective advocacy and collaboration.</li><li>
Proven track record of reducing claim costs and improving return-to-work outcomes.</li></ul><p><b>
ARE YOU READY TO JOIN OUR TEAM?</b></p><p>
If you feel that you would be an ideal fit for this opportunity, please complete an initial <b>3- minute, mobile-friendly application </b>so that we can review your information. We look forward to learning more about you!</p><p><b>
We are an Equal Opportunity and a Drug-Free Workplace</b></p><p>
The job description is not an exhaustive statement of all the duties, responsibilities, or qualifications of the job, nor is it intended to limit opportunities for necessary modifications. #ArrowExterminators</p><p></p><p><br>
Arrow Exterminators as a <b>PestVets Company </b>is committed to hiring and participating in acts of service for Veterans and active-duty members of the U.S. Military.</p></div>

Claims Specialist - Workers' Compensation

Liberty Mutual Insurance

<div><b>Description
</b><div><div><div><div><p><b>Advance Your Career with Liberty Mutual&rsquo;s
</b></p><p><b>Personal Lines Casualty Team!</b></p></div></div></div></div><div></div><p><br>
Our Casualty Attorney Represented team is currently hiring for Senior Claims Specialists to manage attorney represented and litigated auto and homeowner's bodily injury claims. This role will manage, investigate and resolve claims as well as assist in providing prompt and quality service to policyholders for mild to moderate severity and/or complexity claims.</p><p></p><p><b><br>
Remote: </b>This is a remote position for candidates who live more than 50 miles from our Claims offices.</p><p></p><p><b><br>
Hybrid: </b>Candidates who live within 50 miles will be on-site at least two days per month.</p><p></p><p><b><br>
This position follows an Eastern Time work schedule.</b></p><p><br>
</p><p><b>Responsibilities:</b></p><ul><li>
Manages, investigates, and resolves claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels.</li><li>
Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.</li><li>
Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status.</li><li>
Confers with trial counsel and prepares trial reports.</li><li>
Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action.</li><li>
Responds to various written and telephone inquiries including status reports.</li><li>
Ensures adequacy of reserves.</li><li>
Accountable for security of financial processing of claims, as well as security information contained in claims files.</li><li>
Updates files and provides comprehensive reports as required.</li><li>
Responsible for managing the practices and billing activities of outside and in-house counsel.</li><li>
Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory.</li></ul><p><b>
Preferred Qualifications:</b></p><ul><li>
2+ years Personal Lines Third Party Auto Casualty Experience.</li><li>
2+ years Attorney Represented Experience.</li></ul><b>
Qualifications</b><div><ul><li>
Strong written and oral communications skills required.</li><li>
Good interpersonal, analytical, investigative, and negotiation skills required.</li><li>
Customer service experience preferred.</li><li>
Demonstrated competency of legal liability, general insurance policy coverage and State Tort Law.</li><li>
The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and at least 12-18 months of directly related experience.</li><li>
Ability to obtain proper licensing as required.</li></ul><p><b>
Applicants residing in Washington state, California, or the District of Columbia are not eligible at this time.
</b></p></div><b>About Us</b><p><b>
Pay Philosophy:</b> The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.</p><p></p><p><br>
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.</p><p></p><p><br>
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://www.libertymutualgroup.com/about-lm/careers/benefits<br>
<br>
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.<br>
<br>
<b>Fair Chance Notices</b></p><ul><li>
California</li><li>
Los Angeles Incorporated</li><li>
Los Angeles Unincorporated</li><li>
Philadelphia</li><li>
San Francisco</li></ul></div>

Senior Casualty Claims Specialist - Eastern Standard Time Zone

Reserv

<div><p><b>About Reserv</b></p><p>
Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike. We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can't wait to meet you!</p><p></p><p><b><br>
About the role</b></p><p>
We are seeking a highly organized and customer-focused Bilingual Transportation Physical Damage Claims Adjuster to join our team. You will be responsible for speaking to customers on the phone, educating and helping the customer work through their claim to the best possible outcome. Your role will also be responsible for handling an inventory of claims, triaging critical claims, and delivering exceptional customer service!</p><p><br>
If you bring strong analytical skills, excellent communication, and a passion for exceptional customer service to quickly achieve optimal claim results&mdash;we want to hear from you!</p><p></p><p><b><br>
Who you are</b></p><ul><li>
Excited about building a tech-driven claims organization</li><li>
Passionate about the customer experience</li><li>
You're empathetic and patient with everyone you interact with</li><li>
Driven by a sense of urgency (without working around the clock)</li><li>
Creative in finding the right resolution that serves the insured's best interest</li><li>
You're comfortable with conflict&mdash;see it as conversational, not adversarial</li><li>
Curious about the whole story so you can make the right decisions early</li><li>
Anti-status quo&mdash;you don't just wish things were different, you make them different</li><li>
A strong communicator</li><li>
You have a sense of humor (claims are hard enough as it is!)</li></ul><p><b><br>
What you'll do</b></p><ul><li>
Provide prompt, courteous and high-quality customer service to all policyholders and claimants by answering customer calls, filing claims, and resolving customer requests</li><li>
Gather necessary information from customers to initiate the claim and explain policy, coverage, and appropriate course of action</li><li>
Manage an inventory of claims, establish initial reserves for all potential exposures, and adjust as appropriate throughout the claim</li><li>
Coordinate the repair of damaged vehicles and assist with rental reimbursement</li><li>
Recognize recovery opportunities in regards to subrogation and salvage, as well as total loss</li><li>
Ensure compliance with specific state regulations, policy provisions, and standard operating procedures</li><li>
Communicate with involved parties and negotiate appropriate settlements with claimants, insureds, and attorneys within approved payment authority</li><li>
Provide input for continuous development of claims guidelines, best practices, and process improvements</li><li>
Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to resolve the claim</li><li>
Engage in learning opportunities to build knowledge of personal lines claims, court decisions impacting the claims function, current guidelines in claims function, and policy changes and modifications</li></ul><p><b><br>
Qualifications</b></p><ul><li>
Bachelor's degree (lack of one should not stop you from applying if you possess all the other qualifications)</li><li>
Minimum of <b>3-5 years</b> of experience on commercial transportation claims, dealing with Third-Party PD/Total Loss</li><li>
Active adjuster license required: resident state license if available, otherwise a Designated Home State (DHS) license</li><li>
You're willing to obtain all licenses within 60 days, including completing any state required testing</li><li>
Knowledge of state regulations, policy provisions, and standard operating procedures</li><li>
Commercial experience necessary</li><li>
Ability to analyze and evaluate claims data and make sound decisions based on established guidelines, policies, and procedures</li><li>
Curious and motivated by problem solving and questioning the status quo</li><li>
Desire to engage in learning opportunities and continuous professional development</li><li>
Bilingual (fluent in Spanish and English)</li></ul><p><b>
Benefits</b></p><ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!</li></ul><p></p><p><b><br>
Additionally, we will</b></p><ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul><p><br>
At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!</p></div><p></p>

Bilingual Commercial Complex Claims Adjuster: Auto Damage

MCMC

<div><div><div><b>Ready for a Rewarding Career that Fits Your Lifestyle?</b>
</div></div><p></p><div><div>Imagine a job where you can keep your <b>clinical skills sharp</b>, tackle exciting challenges, AND work from the comfort of your own home. Sounds like the perfect mix, right?</div></div><p>
</p><p></p><div><div><b>MES</b> is looking for a <b>self-driven, high-performing Registered Nurse (RN) or Licensed Vocational Nurse (LVN)</b> to join our dynamic team as a <b>Clinical Quality Assurance Coordinator</b>. In this role, you&rsquo;ll ensure our <b>Peer Review case reports</b> are nothing short of exceptional&mdash;delivering top-notch quality and integrity, all while staying fully aligned with <b>client agreements</b>, <b>regulatory standards</b>, and <b>state and federal mandates</b>.</div></div><p>
</p><div><div>The position is <b>100% remote</b> with a schedule of<b> </b><b>Monday through Friday:</b></div></div><ul><li><div><b>
three days: 12-8:30PM EST
</b></div></li><li><div><b>two days: 8-4:30PM EST</b></div></li></ul><p>
</p><ul><li><div>Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.</div></li><li><div>
Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.</div></li><li><div>
Ensures that all client instructions and specifications have been followed and that all questions have been addressed.</div></li><li><div>
Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.</div></li><li><div>
Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.</div></li><li><div>
Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report.</div></li><li><div>
Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.</div></li><li><div>
Ensures the provider credentials and signature are adhered to the final report.</div></li><li><div>
Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.</div></li><li><div>
Assists in resolution of customer complaints and quality assurance issues as needed.</div></li><li><div>
Ensures all federal ERISA and/or state mandates are adhered to at all times.</div></li><li><div>
Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.</div></li><li><div>
Promote effective and efficient utilization of company resources.</div></li><li><div>
Participate in various educational and or training activities as required.</div></li><li><div>
Perform other duties as assigned.</div></li></ul><p>
</p><div></div><div><div>If you&rsquo;re ready to make a real impact in healthcare, all while enjoying the flexibility of working remotely, we want to hear from you!
</div></div><p></p><ul><li><div>Active RN/LVN nursing license required.</div></li><li><div>
Must be a graduate of an accredited nursing program or related medical experience; bachelor's degree preferred.</div></li><li><div>
A minimum of two years clinical or related field experience; or equivalent combination of education and experience.
</div></li><li><div>Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.</div></li><li><div>
Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; Ability to compute rates and percentages.</div></li><li><div>
Must be a qualified typist with a minimum of 40 W.P.M</div></li><li><div>
Must be able to operate a general computer, fax, copier, scanner, and telephone.</div></li><li><div>
Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.</div></li><li><div>
Must possess excellent skills in English usage, grammar, punctuation and style.</div></li><li><div>
Ability to follow instructions and respond to upper managements&rsquo; directions accurately.</div></li><li><div>
Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.</div></li><li><div>
Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.</div></li><li><div>
Must be able to work independently, prioritize work activities and use time efficiently.</div></li><li><div>
Must be able to maintain confidentiality.</div></li></ul><p>
</p><p></p><div><div><b>MES Solutions</b> is a premier provider of independent medical examination and peer review services to the insurance, corporate, legal, and government sectors. Members of our credentialed medical panel conduct physical examinations or medical record reviews, delivering reports that assist clients in the resolution of automotive, disability, liability, and workers' compensation claims. MES has been providing services nationally since 1978 in accordance with the industry's highest standards of operating excellence and regulatory compliance.</div></div><p>
</p><p></p><div><div>Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.</div></div><div><div><b>
Equal Opportunity Employer - Minorities/Females/Disabled/Veterans</b></div></div><div><div><b><i>
MES offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.</i></b></div></div></div>

Clinical Quality Assurance Coordinator

<div><p><b>Before you apply to a job, select your language preference from the options available at the top right of this page.</b></p><p></p><p>
Explore your next opportunity at a Fortune Global 500 organization. Envision innovative possibilities, experience our rewarding culture, and work with talented teams that help you become better every day. We know what it takes to lead UPS into tomorrow&mdash;people with a unique combination of skill + passion. If you have the qualities and drive to lead yourself or teams, there are roles ready to cultivate your skills and take you to the next level.</p><p></p><p><b>
Job Description:</b></p><p>
The Marine Claims Supervisor manages a team of expert adjusters to provide support for UPS multiple business functions, global accounts, and customers.</p><p><br>
This position is responsible for delivering quality, timely claim productivity on a consistent basis, conducting audits, while ensuring adjuster goals are met with favorable results. The incumbent makes certain proper handling of loss/damaged claims by qualified licensed adjusters. This position supervises administrative and specialists&rsquo; staff.</p><p><b><br>
Responsibilities</b></p><ul><li>
Demonstrates an understanding of insurance products and policies.</li><li>
Conducts employee training and development plans.</li><li>
Has monthly head-to-head with employees.</li><li>
Audits and approves claim payment requests of Claims Adjusters.</li><li>
Review&rsquo;s adjuster phone calls for professionalism, completeness, and accuracy.</li><li>
Responds to customer claims and damage inquiries.</li><li>
Creates claims training courses and videos, as needed.</li><li>
Maintains processes and procedures.</li><li>
Provides team coaching, training, and people development.</li><li>
Provides proper system access.</li><li>
Manages employee moves and promotions in Workday.</li><li>
Supervises individual and team performance.</li><li>
May create and/or run already existing reports.</li><li>
Assists with recruiting, interviewing, and hiring any future candidates.</li><li>
Oversee team goals annually.</li><li>
Maintains a small book of claims.</li><li>
Must be able to interpret customer and/or vendor contractual agreements.</li><li>
Willing to learn UPS terms and conditions for various regimes.</li></ul><p></p><p><b>
Qualifications/</b><b>Requirements:</b></p><ul><li>
Strong written and verbal communication skills.</li><li>
Strong digital literacy and fluency in different technology solutions and systems.</li><li>
Strong time and Organizational skills.</li><li>
Strong decision &ndash; making skills.</li><li>
Strong analytical skills.</li><li>
Active Listening skills.</li><li>
Demonstrates a detailed understanding of supply chain concepts.</li><li>
Understands risk management principles identifies risk factors that may impact UPS and/or client.</li><li>
Demonstrates flexibility to changes.</li><li>
Negotiation skills</li></ul><p></p><p><b>
Preferences:</b></p><ul><li>
Bachelor&rsquo;s degree or international equivalent</li><li>
Experience leading others.</li><li>
Minimum 3 years claims investigation adjudication experience.</li><li>
Proficient with Microsoft Office Products (Word, Excel, SharePoint, and Outlook)</li><li>
Driving Culture: Is a team player who works on being a positive influence with their peers and our customers.</li></ul><p></p><p><b>
Other Considerations:</b></p><p>
Interaction Type: Interacts with leadership, claims team, internal and external customers.</p><p>
Experience Level: Intermediate</p><p></p><p><b>
Employee Type:</b></p><p>
Permanent</p><p>
UPS is committed to providing a workplace free of discrimination, harassment, and retaliation.</p><p></p><p><b>
Other Criteria:
</b></p><p>UPS is an equal opportunity employer. UPS does not discriminate on the basis of race/color/religion/sex/national origin/veteran/disability/age/sexual orientation/gender identity or any other characteristic protected by law.</p><p></p><p><b>
Basic Qualifications:</b></p><p>
Must be a U.S. Citizen or National of the U.S., an alien lawfully admitted for permanent residence, or an alien authorized to work in the U.S. for this employer.</p><p></p><p><b>
Other Criteria:</b></p><p><b>
Position is Internal Grade Level 20D</b></p><p><b>
Last Day to Apply 4/24/2026 at 11:59pm ET</b></p><p><b>
Candidate must be located in the same geographic location as position or willing to self-relocate</b></p><p></p><p><b>
Employee Type:</b></p>
Permanent<p></p><p>
UPS is committed to providing a workplace free of discrimination, harassment, and retaliation.</p><p></p><p><b>
Other Criteria:
</b></p><p>UPS is an equal opportunity employer. UPS does not discriminate on the basis of race/color/religion/sex/national origin/veteran/disability/age/sexual orientation/gender identity or any other characteristic protected by law.</p><p></p><p><b>
Basic Qualifications:</b></p><p>
Must be a U.S. Citizen or National of the U.S., an alien lawfully admitted for permanent residence, or an alien authorized to work in the U.S. for this employer.</p></div><p></p>

Customer Relationship Supervisor

Truist

<div><p><b>The position is described below. If you want to apply, click the Apply Now button at the top or bottom of this page. After you click Apply Now and complete your application, you'll be invited to create a profile, which will let you see your application status and any communications. If you already have a profile with us, you can log in to check status.</b></p><p></p><p>
Need Help?</p><p></p><p><i>
If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to </i><i>Accessibility</i><i> (accommodation requests only; other inquiries won't receive a response).</i></p><p></p><p><b>
Regular or Temporary:</b></p>
Regular<p></p><p><b>
Language Fluency: </b>English (Required)</p><p></p><p><b>
Work Shift:</b></p>
1st shift (United States of America)<p></p><h3 class="jobSectionHeader"><b>
Please review the following job description:</b></h3><p></p>
Provide timely and efficient completion of client transactions while maintaining accurate records and thorough proper handling of all monies assigned. Deliver superior quality service, identifying and understanding the client&rsquo;s financial needs. Cross-trained to support sales and service activities, with a particular focus on assisting with outbound calling and supporting Integrated Relationship Management (IRM) activities.<p></p><p>
ESSENTIAL DUTIES AND RESPONSIBILITIES<br>
Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.<br>
1. Provide a distinctive client experience to ensure a consistent service level by engaging clients with smiling, facilitating courteous conversation, conducting both complex and standardized transactions while uncovering needs. Performs more complex transactions with assistance as necessary.<br>
2. Educate clients on digital, self-service solutions including ATMs, Online and Mobile banking to make banking easier and enhance their service experience.<br>
3. Support team sales process by participating in client outreach through outbound calls, checking for client offers, and identifying client needs or opportunities by fulfilling the need or referring the client to the appropriate branch team members or specialist.<br>
4. Understand the importance of Integrated Relationship Management (IRM) to ensure we seamlessly deliver Truist expertise and solutions for our clients&rsquo; unique needs.<br>
5. Participate fully in all components of the established Truist Retail Community Bank Leadership Routines.<br>
6. Commit to advancing individual and product knowledge to better serve consumer and business clients by attending sales, service and product knowledge meetings and all applicable training classes and web-based learning.<br>
7. Adhere to internal controls, operational procedures and risk management policies. Stays informed of all changes in policies and procedures to ensure compliance with current guidelines.<br>
8. Serve as secondary contact for new account openings and problem resolution, offering applicable products and services to clients and prospects. Handles proportionate volume of work based on branch demands.<br>
<br>
QUALIFICATIONS<br>
Required Qualifications:<br>
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 functions.<br>
1. High school diploma or equivalent education<br>
2. Two years of teller or cash handling or client service experience<br>
3. Six months of client relationship building or sales experience<br>
4. Excellent interpersonal and communication skills, including a desire to interact with clients and prospects<br>
5. Ability to master personal computer (PC) keyboard and software skills necessary for branch automation<br>
6. Ability to multi-task under time constraints<br>
7. Demonstrated proficiency in basic computer applications, such as Microsoft Office software products<br>
8. Ability to travel to accommodate temporary staffing needs as required to include temporary assignment or locale changes<br>
9. Ability to work weekends and/or extended hours with occasional travel and overnights may be included<br>
<br>
Preferred Qualifications:</p><p>
1. One year of client relationship building or sales experience<br>
2. Knowledge of advanced or complex branch transactions, risk management and loss prevention<br>
3. Experience with sourcing and prospecting for new clients and client relationship building<br>
4. General understanding of bank operations, policies and procedures</p><p></p><p><b><br>
General Description of Available Benefits for Eligible Employees of Truist Financial Corporation: </b>All regular teammates (not temporary or contingent workers) working 20 hours or more per week are eligible for benefits, though eligibility for specific benefits may be determined by the division of Truist offering the position. Truist offers medical, dental, vision, life insurance, disability, accidental death and dismemberment, tax-preferred savings accounts, and a 401k plan to teammates. Teammates also receive no less than 10 days of vacation (prorated based on date of hire and by full-time or part-time status) during their first year of employment, along with 10 sick days (also prorated), and paid holidays. For more details on Truist&rsquo;s generous benefit plans, please visit our Benefits site. Depending on the position and division, this job may also be eligible for Truist&rsquo;s defined benefit pension plan, restricted stock units, and/or a deferred compensation plan. As you advance through the hiring process, you will also learn more about the specific benefits available for any non-temporary position for which you apply, based on full-time or part-time status, position, and division of work.</p><p></p><p><b><i>
Truist is an Equal Opportunity Employer that does not discriminate on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status, or other classification protected by law. Truist is a Drug Free Workplace.</i></b></p><p></p><p>
EEO is the Law E-Verify IER Right to Work</p></div>

Universal Banker - Madison Yards

Alopex

<div>
 <strong>
  Job Title: Patient Access &amp; Eligibility Specialist
  <br/>
  <br/>
 </strong>
 Overview:
 <br/>
 <br/>
 The Patient Access &amp; Eligibility Specialist plays a critical role in supporting patient access to care management services by ensuring accurate insurance verification, confirming program eligibility, and assisting patients through administrative intake processes.
 <br/>
 <br/>
 This role serves as the front door to the care management program, helping identify eligible patients for Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and other virtual care services.
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 The Patient Access &amp; Eligibility Specialist verifies insurance coverage, confirms patient eligibility, answers incoming patient calls, manages voicemail communications, and ensures accurate documentation within electronic medical record (EMR) systems and care management platforms.
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 The ideal candidate has strong technical proficiency, excellent communication skills, and the ability to navigate multiple healthcare systems efficiently while delivering a professional and compassionate patient experience.
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 Reports To: Nursing Manager
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 Department: Clinical Operations
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  Job Description
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  Patient Call Management &amp; Communication
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   Answer incoming patient calls and provide professional, courteous assistance.
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   Respond to patient inquiries related to care management programs and services.
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   Manage voicemail systems by reviewing incoming messages and ensuring calls are routed to the appropriate team member or department.
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   Coordinate call routing to Care Coordinators, Enrollment Specialists, or other staff based on patient needs.
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   Ensure patient messages are handled promptly and accurately to support timely follow-up.
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   Document all patient communications within the care management platform.
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   Maintain strict adherence to HIPAA and patient privacy standards during all interactions.
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  Insurance Verification &amp; Eligibility Determination
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   Verify patient insurance coverage and eligibility for care management programs.
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   Confirm payer requirements for Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and other services.
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   Review patient benefits, coverage status, and eligibility criteria.
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   Identify patients who qualify for enrollment in care management programs.
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   Document eligibility verification results in the appropriate systems.
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  Enrollment Pipeline Support
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   Prepare eligible patient lists for the Enrollment team by verifying eligibility and insurance coverage.
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   Flag patients who meet program criteria for outreach and enrollment.
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   Support enrollment readiness by ensuring patient demographic and insurance data is accurate.
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   Communicate eligibility findings with Enrollment Specialists to support effective patient outreach.
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   Assist with administrative preparation for patient enrollment processes.
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  Administrative &amp; Platform Support
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   Maintain accurate patient demographic and insurance information within care management platform.
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   Assist with patient record updates and administrative workflows related to care management services.
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   Ensure documentation is accurate, complete and compliant with program requirements.
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   Support internal teams with patient information verification and administrative tasks.
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  Technology &amp; Data Accuracy
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   Utilize electronic medical records (EMR), care management platforms, and telephony systems to support patient access workflows.
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   Demonstrate strong technical proficiency when navigating multiple healthcare platforms simultaneously.
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   Maintain a high level of accuracy when entering patient information into healthcare systems.
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   Assist with resolving minor data discrepancies and escalate system issues when necessary.
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  Qualifications and Skills Required:
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   1&ndash;3 years of experience in healthcare administration, patient access, insurance verification, or care coordination support
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   Experience verifying health insurance eligibility and benefits
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   Familiarity with Chronic Care Management (CCM), Remote Patient Monitoring (RPM), or population health programs preferred
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   Experience working with electronic medical record (EMR) systems
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   Strong technical proficiency and ability to learn new healthcare platforms quickly
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   Experience handling patient phone calls in a professional healthcare environment
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   Excellent verbal communication and patient engagement skills
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   Strong organizational and time management abilities
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   High attention to detail and documentation accuracy
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  Competencies:
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 Competency
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 Definition
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 Patient Communication
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 Provides clear, compassionate communication when assisting patients.
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 Insurance Verification
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 Demonstrates strong understanding of insurance coverage and eligibility processes.
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 Technical Acumen
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 Navigates EMR systems and healthcare technology platforms efficiently.
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 Attention to Detail.
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 Ensures accuracy in documentation and patient data entry.
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 Compliance Awareness
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 Maintains HIPAA compliance and proper handling of protected health information.
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 Organization
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 Manages multiple tasks and systems effectively in a fast-paced environment.
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 Collaboration
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 Works closely with Enrollment Specialists, Care Coordinators, and operations staff.
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 Key Performance Indicators (KPIs)
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   Insurance verification accuracy rate
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   Eligibility verification turnaround time
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   Patient call response quality and timeliness
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   Voicemail response and routing accuracy.
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  Work Location, Shift &amp; Schedule
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 This position is remote (please see remote requirements below). Shifox/Alopex employees work Monday-Friday r according to the business hours of client practices.
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  Remote Position Requirements:
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 Reliable and stable Internet &ndash; all programs used by
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  Patient Access &amp; Eligibility Specialist
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 are internet based. A quiet and professional work environment suitable for speaking with patients about sensitive information and Protected Health Information (PHI), free of distractions.
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  Compensation
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 Contractors are paid on a monthly basis, see below.
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 Rate $17.00-$18.00 per hour
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Patient Access & Eligibility Specialist

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