maintenance supervisor

manager - claims

bodily injury claims adjuster Jobs in Atlanta

bodily injury claims adjuster

case administrator, safeguarding Jobs in Atlanta

case administrator, safeguarding

case manager

claims supervisor

The Home Depot

<div>
 
 
 Position Purpose:
 
 
 
 Responsible for defining, implementing, and managing internal claims programs (self-administration) to control quality and costs associated with general liability claims (e.g. customer bodily injury and property damage). This position ensures the company&rsquo;s claims are handled internally in compliance with industry best practices and company policies, without reliance on a third-party administrator.
 
 
 
 
 
 
 Key Responsibilities:
 
 
 <ul>
 <li>
 25% Claims Handling Standards - Develops and enforces claims handling standards and best practices and oversees quality assurance programs (e.g. file reviews and audits) to ensure adherence to those standards. Drives continuous improvement in claims processes and outcomes under the self-administration model.
 </li>
 <li>
 30% Claims Operations Management - Leads the day-to-day operations of a multi-line general liability claims unit, ensuring consistent application of departmental standards, policies, and procedures. Oversees claim intake, investigation, and resolution processes to maintain efficiency and compliance with service and quality benchmarks. Drives cost containment initiatives, including management of allocated expenses on claims. Monitors loss costs and implement strategies to reduce average claim costs while maintaining fairness and compliance (such as early resolution programs, subrogation efforts, etc.).
 </li>
 <li>
 10% Settlement Authority Oversight - Assumes oversight for all claim settlements and reserve decisions within designated authority levels &ndash; reviewing and approving settlements in accordance with company guidelines. Reviews written settlement evaluations and escalates to the appropriate approval level in the organization when required.
 </li>
 <li>
 10% Stakeholder Communication - Establishes clear interface guidelines and communication channels among all parties involved in claims, including the internal claims team (examiners/adjusters), store management, associates, and the Legal department. Regularly communicates claim status and trends to senior management and other stakeholders.
 </li>
 <li>
 25% Team Leadership - Manages and develops the in-house claims staff. Responsible for the selection, training, performance appraisal, and professional development of direct reports. Fosters a high-performance team culture and provides coaching and guidance to ensure adjusters meet regulatory requirements and company performance standards.
 </li>
 </ul>
 
 
 
 
 
 Direct Manager/Direct Reports:
 
 
 <ul>
 <li>
 This Position typically reports to Senior Claims Manager.
 </li>
 <li>
 This Position may have direct reports.
 </li>
 </ul>
 
 
 
 
 
 Travel Requirements
 
 :
 
 <ul>
 <li>
 Typically requires overnight travel 5% to 20% of the time.
 </li>
 </ul>
 
 
 
 
 
 Physical Requirements:
 
 
 <ul>
 <li>
 Most of the time is spent sitting in a comfortable position and there is frequent opportunity to move about. On rare occasions, there may be a need to move or lift light articles.
 </li>
 </ul>
 
 
 
 
 
 Working Conditions:
 
 
 <ul>
 <li>
 Located in a comfortable indoor area; any unpleasant conditions would be infrequent and not objectionable.
 </li>
 </ul>
 
 
 
 
 
 Minimum Qualifications:
 
 
 <ul>
 <li>
 Must be eighteen years of age or older.
 </li>
 <li>
 Must be legally permitted to work in the United States.
 </li>
 <li>
 Demonstrated supervisory and team management experience in the insurance claims field, with ability to mentor adjusters and implement efficient claims handling processes. Strong leadership abilities evidenced by building effective teams and improving workflow.
 </li>
 </ul>
 
 
 
 
 
 Preferred Qualifications:
 
 
 <ul>
 <li>
 Industry Knowledge: In-depth knowledge of casualty claims best practices, legal compliance (fair claims practices, state regulations), and claims quality control techniques (e.g. file audit and review programs). Capable of establishing and upholding rigorous standards for internal claims operation.
 </li>
 <li>
 Analytical &amp; Communication Skills: Excellent analytical and critical thinking skills to evaluate claim information and make sound decisions quickly. Effective negotiation and communication skills, enabling successful settlement negotiations and collaboration with internal and external stakeholders (customers, attorneys, insurers).
 </li>
 <li>
 Bachelor&rsquo;s degree in risk management, Insurance, Business, or related field preferred (or equivalent industry experience).
 </li>
 <li>
 Professional development in insurance claims or risk management (e.g. industry certifications) is a plus.
 </li>
 </ul>
 
 
 
 
 
 Minimum Education:
 
 
 <ul>
 <li>
 The knowledge, skills and abilities typically acquired through the completion of a high school diploma and/or GED.
 </li>
 </ul>
 
 
 
 
 
 Preferred Education:
 
 
 <ul>
 <li>
 The knowledge, skills and abilities typically acquired through the completion of a bachelor's degree program or equivalent degree in a field of study related to the job.
 </li>
 </ul>
 
 
 
 
 
 Minimum Years of Work Experience
 
 :
 
 <ul>
 <li>
 8
 </li>
 </ul>
 
 
 
 
 
 Preferred Years of Work Experience:
 
 
 <ul>
 <li>
 10
 </li>
 </ul>
 
 
 
 
 
 Minimum Leadership Experience
 
 :
 
 <ul>
 <li>
 3+ years of previous leadership experience
 </li>
 </ul>
 
 
 
 
 
 Preferred Leadership Experience:
 
 
 <ul>
 <li>
 5+ years of previous leadership experience
 </li>
 </ul>
 
 
 
 
 
 Certifications:
 
 
 <ul>
 <li>
 Insurance licensing as required by state
 </li>
 </ul>
 
 
 
 
 
 Competencies:
 
 
 <ul>
 <li>
 Decision Quality
 </li>
 <li>
 Collaborates
 </li>
 <li>
 Drives Engagement
 </li>
 <li>
 Ensures Accountability
 </li>
 <li>
 Plans and Aligns
 </li>
 <li>
 Communicates Effectively
 </li>
 <li>
 Customer Focus
 </li>
 <li>
 Develops Talent
 </li>
 <li>
 Drives Results
 </li>
 <li>
 Manages Conflict
 </li>
 </ul>
 
 
</div>

Claims Manager

<div>Position Purpose:
Responsible for defining, implementing, and managing internal claims programs (self-administration) to control quality and costs associated with general liability claims (e.g. customer bodily injury and property damage). This position ensures the company&rsquo;s claims are handled internally in compliance with industry best practices and company policies, without reliance on a third-party administrator.
Key Responsibilities:<ul><li>
25% Claims Handling Standards - Develops and enforces claims handling standards and best practices and oversees quality assurance programs (e.g. file reviews and audits) to ensure adherence to those standards. Drives continuous improvement in claims processes and outcomes under the self-administration model.</li><li>
30% Claims Operations Management - Leads the day-to-day operations of a multi-line general liability claims unit, ensuring consistent application of departmental standards, policies, and procedures. Oversees claim intake, investigation, and resolution processes to maintain efficiency and compliance with service and quality benchmarks. Drives cost containment initiatives, including management of allocated expenses on claims. Monitors loss costs and implement strategies to reduce average claim costs while maintaining fairness and compliance (such as early resolution programs, subrogation efforts, etc.).</li><li>
10% Settlement Authority Oversight - Assumes oversight for all claim settlements and reserve decisions within designated authority levels &ndash; reviewing and approving settlements in accordance with company guidelines. Reviews written settlement evaluations and escalates to the appropriate approval level in the organization when required.</li><li>
10% Stakeholder Communication - Establishes clear interface guidelines and communication channels among all parties involved in claims, including the internal claims team (examiners/adjusters), store management, associates, and the Legal department. Regularly communicates claim status and trends to senior management and other stakeholders.</li><li>
25% Team Leadership - Manages and develops the in-house claims staff. Responsible for the selection, training, performance appraisal, and professional development of direct reports. Fosters a high-performance team culture and provides coaching and guidance to ensure adjusters meet regulatory requirements and company performance standards.</li></ul>
Direct Manager/Direct Reports:
<ul><li>This Position typically reports to Senior Claims Manager.
</li><li>This Position may have direct reports.</li></ul>
Travel Requirements:<ul><li>
Typically requires overnight travel 5% to 20% of the time.
</li></ul>Physical Requirements:
<ul><li>Most of the time is spent sitting in a comfortable position and there is frequent opportunity to move about. On rare occasions, there may be a need to move or lift light articles.</li></ul>
Working Conditions:
<ul><li>Located in a comfortable indoor area; any unpleasant conditions would be infrequent and not objectionable.</li></ul>
Minimum Qualifications:
<ul><li>Must be eighteen years of age or older.</li><li>
Must be legally permitted to work in the United States.</li><li>
Demonstrated supervisory and team management experience in the insurance claims field, with ability to mentor adjusters and implement efficient claims handling processes. Strong leadership abilities evidenced by building effective teams and improving workflow.</li></ul>
Preferred Qualifications:<ul><li>
Industry Knowledge: In-depth knowledge of casualty claims best practices, legal compliance (fair claims practices, state regulations), and claims quality control techniques (e.g. file audit and review programs). Capable of establishing and upholding rigorous standards for internal claims operation.</li><li>
Analytical &amp; Communication Skills: Excellent analytical and critical thinking skills to evaluate claim information and make sound decisions quickly. Effective negotiation and communication skills, enabling successful settlement negotiations and collaboration with internal and external stakeholders (customers, attorneys, insurers).</li><li>
Bachelor&rsquo;s degree in risk management, Insurance, Business, or related field preferred (or equivalent industry experience).</li><li>
Professional development in insurance claims or risk management (e.g. industry certifications) is a plus.</li></ul>
Minimum Education:<ul><li>
The knowledge, skills and abilities typically acquired through the completion of a high school diploma and/or GED.</li></ul>
Preferred Education:<ul><li>
The knowledge, skills and abilities typically acquired through the completion of a bachelor's degree program or equivalent degree in a field of study related to the job.</li></ul>
Minimum Years of Work Experience:<ul><li>
8</li></ul>
Preferred Years of Work Experience:
<ul><li>10</li></ul>
Minimum Leadership Experience:<ul><li>
3+ years of previous leadership experience</li></ul>
Preferred Leadership Experience:
<ul><li>5+ years of previous leadership experience</li></ul>
Certifications:
<ul><li>Insurance licensing as required by state</li></ul>
Competencies:
<ul><li>Decision Quality</li><li>
Collaborates</li><li>
Drives Engagement</li><li>
Ensures Accountability</li><li>
Plans and Aligns</li><li>
Communicates Effectively</li><li>
Customer Focus</li><li>
Develops Talent</li><li>
Drives Results</li><li>
Manages Conflict</li></ul></div>

Manager - Claims

<div>
 Req170496
 
 
 
 Position Purpose
 
 
 
 Responsible for defining, implementing, and managing internal claims programs (self-administration) to control quality and costs associated with general liability claims (e.g. customer bodily injury and property damage). This position ensures the company&rsquo;s claims are handled internally in compliance with industry best practices and company policies, without reliance on a third-party administrator.
 
 
 
 Key Responsibilities
 
 
 
 <ul>
 <li>
 25% Claims Handling Standards - Develops and enforces claims handling standards and best practices and oversees quality assurance programs (e.g. file reviews and audits) to ensure adherence to those standards. Drives continuous improvement in claims processes and outcomes under the self-administration model.
 </li>
 <li>
 30% Claims Operations Management - Leads the day-to-day operations of a multi-line general liability claims unit, ensuring consistent application of departmental standards, policies, and procedures. Oversees claim intake, investigation, and resolution processes to maintain efficiency and compliance with service and quality benchmarks. Drives cost containment initiatives, including management of allocated expenses on claims. Monitors loss costs and implement strategies to reduce average claim costs while maintaining fairness and compliance (such as early resolution programs, subrogation efforts, etc.).
 </li>
 <li>
 10% Settlement Authority Oversight - Assumes oversight for all claim settlements and reserve decisions within designated authority levels &ndash; reviewing and approving settlements in accordance with company guidelines. Reviews written settlement evaluations and escalates to the appropriate approval level in the organization when required.
 </li>
 <li>
 10% Stakeholder Communication - Establishes clear interface guidelines and communication channels among all parties involved in claims, including the internal claims team (examiners/adjusters), store management, associates, and the Legal department. Regularly communicates claim status and trends to senior management and other stakeholders.
 </li>
 <li>
 25% Team Leadership - Manages and develops the in-house claims staff. Responsible for the selection, training, performance appraisal, and professional development of direct reports. Fosters a high-performance team culture and provides coaching and guidance to ensure adjusters meet regulatory requirements and company performance standards.
 
 
 </li>
 </ul>
 
 Direct Manager/Direct Reports
 
 
 
 <ul>
 <li>
 This Position typically reports to Senior Claims Manager.
 </li>
 <li>
 This Position may have direct reports.
 
 
 </li>
 </ul>
 
 Travel Requirements
 
 
 
 <ul>
 <li>
 Typically requires overnight travel 5% to 20% of the time.
 
 
 </li>
 </ul>
 
 Physical Requirements
 
 
 
 <ul>
 <li>
 Most of the time is spent sitting in a comfortable position and there is frequent opportunity to move about. On rare occasions, there may be a need to move or lift light articles.
 
 
 </li>
 </ul>
 
 Working Conditions
 
 
 
 <ul>
 <li>
 Located in a comfortable indoor area; any unpleasant conditions would be infrequent and not objectionable.
 
 
 </li>
 </ul>
 
 Minimum Qualifications
 
 
 
 <ul>
 <li>
 Must be eighteen years of age or older.
 </li>
 <li>
 Must be legally permitted to work in the United States.
 </li>
 <li>
 Demonstrated supervisory and team management experience in the insurance claims field, with ability to mentor adjusters and implement efficient claims handling processes. Strong leadership abilities evidenced by building effective teams and improving workflow.
 
 
 </li>
 </ul>
 
 Preferred Qualifications
 
 
 
 <ul>
 <li>
 Industry Knowledge: In-depth knowledge of casualty claims best practices, legal compliance (fair claims practices, state regulations), and claims quality control techniques (e.g. file audit and review programs). Capable of establishing and upholding rigorous standards for internal claims operation.
 </li>
 <li>
 Analytical &amp; Communication Skills: Excellent analytical and critical thinking skills to evaluate claim information and make sound decisions quickly. Effective negotiation and communication skills, enabling successful settlement negotiations and collaboration with internal and external stakeholders (customers, attorneys, insurers).
 </li>
 <li>
 Bachelor&rsquo;s degree in risk management, Insurance, Business, or related field preferred (or equivalent industry experience).
 </li>
 <li>
 Professional development in insurance claims or risk management (e.g. industry certifications) is a plus.
 
 
 </li>
 </ul>
 
 Minimum Education
 
 
 
 <ul>
 <li>
 The knowledge, skills and abilities typically acquired through the completion of a high school diploma and/or GED.
 
 
 </li>
 </ul>
 
 Preferred Education
 
 
 
 <ul>
 <li>
 The knowledge, skills and abilities typically acquired through the completion of a bachelor's degree program or equivalent degree in a field of study related to the job.
 
 
 </li>
 </ul>
 
 Minimum Years Of Work Experience
 
 
 
 <ul>
 <li>
 8
 
 
 </li>
 </ul>
 
 Preferred Years Of Work Experience
 
 
 
 <ul>
 <li>
 10
 
 
 </li>
 </ul>
 
 Minimum Leadership Experience
 
 
 
 <ul>
 <li>
 3+ years of previous leadership experience
 
 
 </li>
 </ul>
 
 Preferred Leadership Experience
 
 
 
 <ul>
 <li>
 5+ years of previous leadership experience
 
 
 </li>
 </ul>
 
 Certifications
 
 
 
 <ul>
 <li>
 Insurance licensing as required by state
 
 
 </li>
 </ul>
 
 Competencies
 
 
 
 <ul>
 <li>
 Decision Quality
 </li>
 <li>
 Collaborates
 </li>
 <li>
 Drives Engagement
 </li>
 <li>
 Ensures Accountability
 </li>
 <li>
 Plans and Aligns
 </li>
 <li>
 Communicates Effectively
 </li>
 <li>
 Customer Focus
 </li>
 <li>
 Develops Talent
 </li>
 <li>
 Drives Results
 </li>
 <li>
 Manages Conflict
 </li>
 </ul>
</div>

Reserv

<div>About Reserv
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&rsquo;t wait to meet you. 
About the role<ul><li>
As a Team Lead at Reserv, you will be a working leader providing support to a Claims manager with leadership and claim technical responsibilities. Leadership responsibilities will include overseeing work done within the Commercial Auto Claims adjusting staff. We want your background and experience to deliver operational effectiveness, particularly in leveraging technology and analytics to drive better efficiencies and performance. You will serve a critical role with the team, the customers, and the client. This role will balance management responsibilities and individual contributor responsibilities when volume dictates the need for assistance with a claim.</li></ul>
Who you are<ul><li>
Highly motivated and growth-oriented, impactful and influential</li><li>
Claims professional - you are knowledgeable and have a track record of success in commercial auto claims adjudication.</li><li>
Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles.</li><li>
Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.</li><li>
Passionate - Claims professional who cares about their team, the customer, and their experience</li><li>
Empathetic leader - You exercise empathy and patience towards everyone you interact with</li><li>
Sense of urgency - at all times. That does not mean working at all hours</li><li>
Creative - You challenge existing assumptions and find ways of leveraging technology and the talents of your team to address problems</li><li>
Curious - You want to know the whole story so you can make the right decisions early and be decisive when it counts.</li><li>
Problem solver - You have the ability to take a &lsquo;deep dive&rsquo; into the details of the business while staying focused on the big picture.</li><li>
Anti-status quo - You don&rsquo;t just wish things were done differently; you act on it</li><li>
Communicative - You are comfortable with and understand the importance of phone communications throughout the claims process.</li><li>
And did we mention a sense of humor? Claims are hard enough as it is!</li></ul>
What we need
We need you to do all the things typical to the role:<ul><li>
Flexibility - you will need to be able to switch from claims handling to coaching and feedback</li><li>
Agility- you must have an agile mindset and the ability to pivot from focus to focus in a moment&rsquo;s notice</li><li>
Be consistently dependable in achieving or exceeding goals and overcoming obstacles</li><li>
Implement and maintain best practices for claims handling, including claim intake, investigation, evaluation, settlement, and recovery</li><li>
Align team with client and customer expectations of the claims process</li><li>
Serve as a resource for escalated claims</li><li>
Foster a positive work environment, promote teamwork, and encourage professional growth and development</li><li>
Attract, hire, retain, and provide a high level of training with the support of the rest of the leadership team</li><li>
Prepare and present comprehensive claims reports, metrics, and analyses to clients and customers; advise clients on claim trends and loss mitigation</li></ul>
Job Duties:<ul><li>
Serve as backup/leader when the Manager is out of office</li><li>
Responsible for having direct reports</li><li>
Responsible for initial onboarding tasks / access and new hire cultural immersion</li><li>
SME for first-line questions, escalations, roundtable discussions</li><li>
Increased reserve and payment authority with the ability to assist with moderate reviews</li><li>
Identify topics and trends to discuss in team Huddles and Elevated Claims Experience Workshops lead/ co-lead by Team Leads, Managers, and other Reserv employees</li><li>
Customer Obsession Champions - Active advocates who help leadership cultivate a customer-centric mindset</li></ul>
Requirements<ul><li>
5+ years of insurance claims experience in multiple lines of business, preference for an auto with some bodily injury experience</li><li>
3+ years of leadership experience with a preference for experience managing in a remote environment</li><li>
Comfortable with technology and the ability to evolve the claims systems and processes to drive better efficiencies and outcomes</li><li>
Demonstrated commitment to quality, accuracy, and attention to detail</li><li>
Integrity, ethics, and a strong sense of accountability in handling confidential and sensitive information</li><li>
Active adjuster license required: resident state license if available, otherwise a Designated Home State (DHS) license</li></ul> 
Benefits<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> 
Additionally, we will<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> 
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!</div>

Claims Team Lead Auto Property Damage

<div><h3 class="jobSectionHeader">About Reserv</h3>
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&rsquo;t wait to meet you.<h3 class="jobSectionHeader"> 
About the role</h3>
As a Claims Team Lead, Litigation at Reserv, you will be a working leader providing support to a claims manager with leadership and claim technical responsibilities. Leadership responsibilities will include overseeing work done within the Commercial Auto Claims adjusting staff. We want your background and experience to deliver operational effectiveness, particularly in leveraging technology and analytics to drive better efficiencies and performance. You will serve a critical role with the team, the customers, and the client. This role will balance management responsibilities and individual contributor responsibilities when volume dictates the need for assistance with a claim.<h3 class="jobSectionHeader">
Who you are</h3><ul><li>
Highly motivated and growth-oriented, impactful and influential</li><li>
Claims professional - you are knowledgeable and have a track record of success in commercial auto claims adjudication.</li><li>
Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles.</li><li>
Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.</li><li>
Passionate - Claims professional who cares about their team, the customer, and their experience</li><li>
Empathetic leader - You exercise empathy and patience towards everyone you interact with</li><li>
Sense of urgency - at all times. That does not mean working at all hours</li><li>
Creative - You challenge existing assumptions and find ways of leveraging technology and the talents of your team to address problems</li><li>
Curious - You want to know the whole story so you can make the right decisions early and be decisive when it counts.</li><li>
Problem solver - You have the ability to take a &lsquo;deep dive&rsquo; into the details of the business while staying focused on the big picture.</li><li>
Anti-status quo - You don&rsquo;t just wish things were done differently; you act on it</li><li>
Communicative - You are comfortable with and understand the importance of phone communications throughout the claims process.</li><li>
And did we mention a sense of humor? Claims are hard enough as it is!</li></ul><h3 class="jobSectionHeader">
What we need</h3>
We need you to do all the things typical to the role:<ul><li>
Oversee a team of commercial auto adjuster direct reports</li><li>
Implement and maintain best practices for claims handling, including claim intake, investigation, evaluation, settlement, and recovery</li><li>
Align team with client and customer expectations of the claims process</li><li>
Serve as a resource for escalated claims</li><li>
Foster a positive work environment, promote teamwork, and encourage professional growth and development</li><li>
Attract, hire, retain, and provide a high level of training with the support of the rest of the leadership team</li><li>
Prepare and present comprehensive claims reports, metrics, and analyses to clients and customers; advise clients on claim trends and loss mitigation</li><li>
Serve as backup/ leader when the Manager is out of office</li><li>
Responsible for initial onboarding tasks/ access and new hire cultural immersion</li><li>
SME for first-line questions, escalations, roundtable discussions</li><li>
Increased reserve and payment authority with the ability to assist with moderate reviews</li><li>
Identify topics and trends to discuss in team Huddles and Elevated Claims Experience Workshops lead/ co-lead by Team Leads, Managers, and other Reserv employees</li></ul><h3 class="jobSectionHeader">
Requirements</h3><ul><li>
5+ years of insurance claims experience in multiple lines of business with bodily injury experience</li><li>
3+ years of leadership experience with a preference for experience managing in a remote environment</li><li>
Comfortable with technology and the ability to evolve the claims systems and processes to drive better efficiencies and outcomes</li><li>
Demonstrated commitment to quality, accuracy, and attention to detail</li><li>
Integrity, ethics, and a strong sense of accountability in handling confidential and sensitive information</li></ul><h3 class="jobSectionHeader">
Benefits</h3><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> 
Additionally, we will<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> 
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!</div>

Claims Team Lead Litigation

Empowerment Resource Center

<div><div>Job Classification: Billing &amp; Coding Specialist</div><div>
Reports To: Client Services Supervisor</div><div>
FLSA Status: Part -Time not to Exceed 29 Hours week</div><div></div><div> 
Summary: Reports to the Client Services Supervisor. The Billing &amp; Coding Specialist is responsible for managing the end-to-end medical billing process, including claim submission, payment posting, denial resolution, and reconciliation across EMR and QuickBooks systems and payer compliance to ensure timely and accurate revenue collection for the organization. . This position ensures compliance with payer contracts and coding standards, promotes accurate reimbursements, and supports financial transparency. The role plays a vital part in maintaining the organization&rsquo;s financial health, improving cash flow, and ensuring alignment with private insurance carrier agreements.</div><div></div><div> 
The Billing &amp; Coding Specialist must have a strong understating of CPT, ICD-10 and insurance billing codes, as well as, working knowledge of payer contracts, private carrier reimbursement methodologies, and compliance requirements, The incumbent ensures that all claims are processed correctly, reimbursement are maximized, and revenue is maintained through careful monitoring, auditing, and collaboration with internal departments and payers. The role supports and enhances the insurance billing function through diligent claim management, payer communication, and reconciliation activities that promote accurate reimbursement and financial transparency.</div><div></div><div> 
Essential Duties and Responsibilities:</div><div></div><h1 class="jobSectionHeader"> 
Insurance Claims Management</h1><div><ul><li>
Verify CPT codes prior to claim submission in the EMR system to ensure compliance and maximize reimbursement.</li><li>
Collaborate with coding and revenue cycle teams to resolve complex CPT coding issues beyond standard expertise.</li><li>
Prepare, review, and submit insurance claims through the EMR system, ensuring compliance with payer-specific and contractual requirements.</li><li>
Monitor and manage claim submissions to ensure accuracy, timely filing, and proper follow-up on rejections or denials.</li><li>
Research claim denials and rejections, determine root causes, and take corrective actions to resolve issues promptly.</li><li>
Revise and resubmit corrected claims with necessary documentation and coding updates to secure proper reimbursement.</li><li>
Participate in weekly meetings with clinic leadership to analyze denials, rejections, and claim status for continuous improvement.</li><li>
Monitor the adjudication of submitted claims to verify timely processing, accuracy, and alignment with contracted reimbursement rates.</li><li>
Represent and advocate for corrected or underpaid claims during follow-up with insurance carriers.</li><li>
Ensure all billing activities comply with payer contracts, including fee schedules, covered services, and filing deadlines established by private carriers.</li></ul>
Payment Processing<div><ul><li>
Post all insurance payments&mdash;checks, ACH, and virtual card payments&mdash;into the EMR system, ensuring proper allocation to patient accounts.</li><li>
Collaborate with Accounts Receivable (A/R) to review outstanding claims, address aged accounts (91+ and 121+ days), and ensure all posted payments are reflected accurately.</li><li>
Track unpaid claims, follow up with insurance companies, and execute collection procedures on delinquent accounts to minimize write-offs.</li><li>
Pull and review A/R reports regularly to identify trends, payment delays, or discrepancies</li></ul></div>
Contract Compliance and Payer Relations<div><ul><li>
Maintain up-to-date knowledge of payer contracts, reimbursement terms, and policy changes for private carriers.  Verify that all claims, payments, and adjustments adhere to negotiated fee schedules and contractual obligations.</li><li>
Identify and report patterns of underpayment or contract violations by payers to management.</li><li>
Assist leadership with payer audits, renegotiations, and periodic reviews to ensure continued compliance and optimal reimbursement.</li><li>
Serve as a liaison between the organization and private insurance carriers to promote positive working relationships and resolve contract-related billing concerns.</li><li>
Participate in regular meetings with A/R and billing support teams to align on claim status, outdated accounts, and reconciliation needs.</li><li>
Communicate professionally with insurance representatives, patients, and internal teams to facilitate timely resolutions and optimize reimbursement workflows.</li></ul></div>
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.<div><ul><li>
Education and/or Experience: High school diploma or equivalent required; Associate&rsquo;s or Bachelor&rsquo;s degree in Healthcare Administration, Accounting, or related field preferred. 2+ years of experience in medical billing, insurance claims, or accounts receivable management required. Proficiency in EMR systems. Strong understanding of CPT, ICD-10, and insurance billing codes (certified coder preferred but not required). Working knowledge of payer contracts, private carrier reimbursement methodologies, and compliance requirements. Excellent organizational, analytical, and problem-solving skills. Strong communication skills and attention to detail.</li><li>
Certifications, Licenses, Registrations: Certified coder preferred, but not required.</li><li>
Language Skills: Fluency in English and Spanish is preferred. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, participants, funders, and the general public.</li><li>
Computer Skills: Must possess extensive computer skills and experience with software use (Word, Excel, PowerPoint, Publisher, Adobe, etc.). Must be proficient in Microsoft Office Suite; Electronic mail software; Microsoft Exchange. Medical software &ndash; Electronic medical/health records software and Client management software. Helpful if you have experience in Greenway, and any Telemedicine platform. Knowledge of Quest and LabCorp systems.</li><li>
Mathematical Skills: Basic math, bookkeeping and accounting skills.</li><li>
Reasoning Ability: Effective computer skills to use bookkeeping and account management software in a timely and efficient manner. Strong communication, including writing, speaking and active listening. Must be a great communicator, meticulous, and possess excellent interpersonal skills. Great customer service skills, including interpersonal conversation, patience and empathy. Good problem-solving and critical thinking skills. Organization, time management and prioritization abilities. Ability to be discreet and maintain the security of patient or customer information. Understanding of industry-specific policies, such as HIPAA regulations for health care. Demonstrate the ability to exercise discretion, independent judgment, and business acumen. Exhibit the finesse to handle private, confidential, protected, and sensitive information. Possess a genuine empathy for clients and a willingness to help others. Possess excellent communication skills and the tact to deal effectively with clients, guests, program staff, medical and behavioral health professionals, and executive-level staff. Must have the ability to interact with professional staff and clients from diverse socioeconomic background, races, and cultures. Must have the ability to conduct Internet research. Must possess strong leadership, team-building, management, organizational, and time management skills. Must possess the ability to develop innovative action plans to improve efficiency and processes, minimize cost/waste, and meet quality standards.</li></ul></div></div><div> 
Employment Standards &amp; Conditions: Must successfully pass a pre-employment drug screen and background check.
Must be able to work flexible hours when required.
Must submit verification of completion of the following current health screenings:
Influenza immunization
Tuberculin Skin Test (TB) within the past 12 months
HBV immunization (required if position requires direct contact with clients) 
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk and hear.
The employee is regularly required to sit, stand and walk.
The employee s regularly required to use hands to key, handle, or feel and reach with hands and arms.
The employee must occasionally lift and/or move up to 25 pounds. 
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is moderate.
Empowerment Resource Center (ERC) values a diverse, respectful, and collaborative work environment. We establish and maintain trustful relationships with our staff, partners, funders, and the communities that we are privileged to serve. ERC makes all hiring and employment decisions without regard to race, creed, color, age, gender, gender identity, marital or parental status, religion, ancestry, national origin, physical or mental disability, sexual orientation, sexual identity, immigrant status, political affiliation or belief, exoffender status (depending on the offense and position to be filled), and/or unfavorable military discharge.</div></div>

Billing & Coding Specialist

AIG Claims, Inc.

<div>At AIG, we are reimagining the way we help customers to manage risk. Join us as a Complex Claims Liability Director, TPA Oversight to play your part in that transformation. It&rsquo;s an opportunity to grow your skills and experience as a valued member of the team.
Make your mark in Claims
Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.
How you will create an impact
As Complex Claims Director &ndash; TPA Oversight, you will analyze and process bodily injury and third-party property damage claims by investigating and gathering information to determine the exposure on the claim; ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans. You will determine need for and direct independent adjusters to gather information to determine exposure on the claim and control their costs.<ul><li>
Identify and evaluate coverage issues; prepare comprehensive coverage letters with supervisory review and analysis; retain and provide direction to coverage counsel when necessary.</li><li>
Assess liability and resolve claim within established evaluation. Maintain diaries and complete tasks within required timeframes as set forth by department guidelines; ensure claim files are timely and properly documented with clear and concise analysis on coverage, damages, reserves, and liability including an action plan for resolution. Process and pay invoices within a timely manner.</li><li>
Coordinate vendor referrals for additional investigation and/or litigation management. Calculate and assign timely and appropriate reserves; monitor reserve accuracy throughout the life of the claim.</li><li>
Refer case as appropriate to supervisor and management. Respond to requests or directions in a professional and timely manner.</li><li>
Attend arbitrations, mediations, settlement conference and trials.</li><li>
Successfully complete required State licensing examinations and continuing education requirement.</li><li>
Communicate with all internal business partners including underwriters to make sure underwriting is aware of large losses and industry trends.</li><li>
Partner with TPA Governance and Relationship Management to help TPA&rsquo;s and Insureds comply with claim handling and reporting guidelines.</li><li>
Work with TPA Claims Financial to check the accuracy of TPA financials ensuring alignment with TTPO financials.</li></ul>
What you will need to succeed<ul><li>
7 plus years of General Liability/Auto claims experience.</li><li>
Experience with complex and high exposure General Liability Bodily Injury and Property Damage claims.</li><li>
Excellent communication skills (verbal/written) and strong negotiation skills.</li><li>
Advanced experience and capabilities in litigation claims management, including ADR and mediation processes, involving auto/GL exposures.</li><li>
Strong technical expertise interpreting insurance contracts.</li><li>
In depth knowledge of claim handling procedures, claims performance strategies, and claim best practices.</li><li>
Advanced analytical and problem solving skills.</li><li>
Should also have a demonstrated ability to initiate and champion change initiatives that leverage technology and improve skills in benchmarking.</li><li>
Creativity in resolving challenging business problems, as well as ability to achieve business goals and objectives is essential.</li></ul>
Ready to accelerate your career? We would love to hear from you.
Compensation for this position includes base salary and eligibility for a bonus in accordance with the terms of the applicable incentive plan. In addition, we&rsquo;re proud to offer a range of competitive benefits, a summary of which can be viewed here: US Benefits.
#LI-AIG #claimsprofessionals #InsuranceJobs #legalcareers #paralegaljobs #claimsexaminer #claimsadjuster #InsuranceCareers #insuranceTPA
At AIG, we value in-person collaboration as a vital part of our culture, which is why we ask our team members to be primarily in the office. This approach helps us work together effectively and create a supportive, connected environment for our team and clients alike.
Enjoy benefits that take care of what matters
At AIG, our people are our greatest asset. We know how important it is to protect and invest in what&rsquo;s most important to you. That is why we created our Total Rewards Program, a comprehensive benefits package that extends beyond time spent at work to offer benefits focused on your health, wellbeing and financial security&mdash;as well as your professional development&mdash;to bring peace of mind to you and your family.
Reimagining insurance to make a bigger difference to the world
American International Group, Inc. (AIG) is a global leader in commercial and personal insurance solutions; we are one of the world&rsquo;s most far-reaching property casualty networks. It is an exciting time to join us &mdash; across our operations, we are thinking in new and innovative ways to deliver ever-better solutions to our customers. At AIG, you can go further to support individuals, businesses, and communities, helping them to manage risk, respond to times of uncertainty and discover new potential. We invest in our largest asset, our people, through continuous learning and development, in a culture that celebrates everyone for who they are and what they want to become.
Welcome to a culture of inclusion
We&rsquo;re committed to creating a culture that truly respects and celebrates each other&rsquo;s talents, backgrounds, cultures, opinions and goals. We foster a culture of inclusion and belonging through learning, cultural awareness activities and Employee Resource Groups (ERGs). With global chapters, ERGs are a cornerstone for our culture of inclusion. The talent of our people is one of AIG&rsquo;s greatest assets, and we are honored that our drive for positive change has been recognized by numerous recent awards and accreditations.
AIG provides equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national origin, veteran status, disability or any other legally protected categories.
AIG is committed to working with and providing reasonable accommodations to job applicants and employees with disabilities. If you believe you need a reasonable accommodation, please send an email to candidatecare@aig.com.
<div><div><div><div><div><div><div>Functional Area:</div></div></div></div></div></div></div>
CL - Claims
AIG Claims, Inc.</div>

Complex Claims Liability Director, TPA Oversight

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Complex Claims Liability Director, TPA Oversight