insurance law specialist

Matthiesen, Wickert & Lehrer, S.C.

Job description:Matthiesen, Wickert &amp; Lehrer, S.C., is a national subrogation and litigation firm with offices in Hartford, WI; New Orleans, LA; Irvine, CA; Austin, TX; and Jacksonville, FL.. We are seeking a reliable and proactive Subrogation Specialist to join our team at our office in Austin, Texas. Candidate must be detail-oriented and comfortable with handling multiple projects simultaneously.The primary purpose of this position is to investigate, negotiate and settle a large volume of subrogation claims throughout the United States. The candidate will identify at-fault parties, assess liability, damages and pursue viable recovery sources, or may work to collect reimbursement interests from settlements. The candidate will professionally and effectively communicate with insurance company clients, insured parties, responsible parties, attorneys, law enforcement agencies, as well as any entity associated with the investigation of a claim. The candidate will navigate the firm&rsquo;s proprietary database and legal resources to prepare demand letters and settlement packages. In addition, the candidate will be responsible for maintaining detailed electronic claim files along with monitoring and maintain current diaries for follow-up.The ideal for this position would have experience handling subrogation or investigating insurance claims, and/or debt collection. Strong communication and negotiation skills are necessary as this position has close contact with opposing attorneys and the firm&rsquo;s clients across the country.Subrogation Specialist Requirements and Qualifications<ul><li>High School Diploma, prefer College Degree</li><li>Must be able to read, write and clearly speak the English language.</li><li>Must be able to handle difficult conversations and exhibit conflict management skills.</li><li>Prior claims handling or debt collection experience.</li><li>Must be able to handle deadlines and have a strong attention to detail.</li><li>Must be able to multi-task and work overtime if needed.</li><li>Must be a team player where no task is too small or unimportant when working on projects.</li><li>Must be proficient in Microsoft Office, Adobe Acrobat Pro, Share File with a knowledge of document/case management and timekeeping software.</li><li>Law Firm experience a plus.</li></ul>Work Location: In PersonBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Subrogation Specialist

Philadelphia Insurance Companies

<div>Description
Marketing Statement:
Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.
We a re looking for a Claims Specialist - Auto to join our team!
JOB SUMMARY 
Investigate, evaluate and settle more complex first and third party commercial insurance auto claims.
JOB RESPONSIBILITIES 
Evaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. 
Communicates with all relevant parties and documents communication as well as results of investigation. 
Thoroughly understands coverages, policy terms and conditions for broad insurance areas, products or special contracts. 
Travel is required to attend customer service calls, mediations, and other legal proceedings. 
JOB REQUIREMENTS 
High School Diploma; Bachelor's degree from a four-year college or university preferred. 
10 plus years related experience and/or training; or equivalent combination of education and experience.<ul><li>National Range : $82,800.00 - $97,300.00</li><li>Ultimate salary offered will be based on factors such as applicant experience and geographic location.</li></ul>
EEO Statement:
Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.
Benefits:
We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online. 
Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at https://www.phly.com/Careers/default.aspx</div>

Claims Specialist - Auto

Nationwide

<div>
 If you&rsquo;re passionate about helping people protect what matters most to them at a Fortune 100 company with nearly $70 billion in annual sales, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide&rsquo;s Property and Casualty team could be the place for you! At Nationwide&reg;, &ldquo;on your side&rdquo; goes beyond just words. Our customers and partners are at the center of everything we do and we&rsquo;re looking for associates who are passionate about delivering extraordinary care.
 
 
 
 Job Description Summary
 
 
 
 If you can put your keen legal mind to work analyzing, managing and resolving insurance coverage and claims, we want to know more about you! Working on our team offers the opportunity to be involved in settling litigated and non-litigated claims of low to moderate complexity and severity in terms of exposure and coverage.
 
 
 As a Claims Specialist, you'll investigate, evaluate and negotiate claims to successful resolution. This role supports the management liability and specialty lines of business, including errors and omissions, directors and officers and employment practices liability. You will have low monetary authority and work under limited direct supervision and monitoring. We will count on you to collaborate and provide insight to our business partners on claims and policy wording questions and maintain, develop and influence relationships with customers and business partners.
 
 
 
 Job Description
 
 
 
 
 Key Responsibilities:
 
 
 
 <ul>
 <li>
 Investigates and evaluates coverage, liability and damages to set an appropriate claim strategy, settlement and file reserves within approved claims authority.
 </li>
 <li>
 Provides timely and appropriate evaluation of claims to identify and manage reserves in compliance with company standards.
 </li>
 <li>
 Analyze coverage and provide comprehensive coverage analysis and claim resolution strategies.
 </li>
 <li>
 Provide feedback on claim trends and development. Provide input to underwriters on review of potential and existing insured&rsquo;s claim experience.
 </li>
 <li>
 Delivers outstanding customer service and satisfaction through effective interactions with insured, agents, and legal counsel.
 </li>
 <li>
 Maintains current knowledge of applicable lines of insurance, insurance regulations, court decisions which may impact the claims function, current guidelines and policy changes and modifications. This may require attending various seminars and training sessions.
 </li>
 <li>
 Contributes to a collaborative environment by consistently demonstrating teamwork, motivation, positive behavior and effort to achieve goals and objectives.
 
 
 </li>
 </ul>
 
 May Perform Other Responsibilities As Assigned.
 
 
 
 
 Reporting Relationships:
 
 Reports to Claims Director, Freedom Specialty
 
 
 
 Typical Skills And Experiences
 
 
 
 
 Education:
 
 College degree preferred. Juris Doctorate desired.
 
 
 
 License/Certification/Designation:
 
 Associates must acquire the required Federal and/or state licenses/registrations within the time period designated by the business unit. Additional licenses/registrations may be required when new products and services are implemented. If an associate fails or is unable to acquire required licenses/registrations within the designated time period, the associate will be ineligible to continue in the position.
 
 
 
 Experience:
 
 Typically, two to four years of claims handling experience. Prior experience in directing defense counsel required. Specific experience in a specific line of business may be required by the hiring business unit.
 
 
 
 Knowledge, Abilities and Skills:
 
 Specific knowledge in a particular line of business and/or additional education may be required. Familiarity with various types of insurance policies preferred. The ability to evaluate and interpret information, strong written and verbal communication skills, the ability to multi-task, strong time management and organizational skills, the ability to effectively and efficiently manage all responsibilities.
 
 
 Other criteria, including leadership skills, competencies and experiences may take precedence.
 
 
 Staffing exceptions to the above must be approved by the hiring manager&rsquo;s leader and HR Business Partner.
 
 
 
 Values:
 
 Regularly and consistently demonstrates the Nationwide Values.
 
 
 
 Job Conditions
 
 
 
 
 Overtime Eligibility:
 
 Not Eligible (Exempt)
 
 
 
 Working Conditions:
 
 Normal office environment
 
 
 
 ADA:
 
 The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.
 
 
 
 Credit/Background Check:
 
 Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process.
 
 
 
 Benefits
 
 
 
 We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage, paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here.
 
 
 Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law.
 
 
 #claims
 
 
 For NY residents please review the following state law information: Notice of Employee Rights, Protections, and Obligations LS740 (ny.gov) https://dol.ny.gov/system/files/documents/2022/02/ls740_1.pdf
 
 
 
 Note To Employment Agencies
 
 
 
 We value the partnerships we have built with our preferred vendors. Nationwide does not accept unsolicited resumes from employment agencies. All resumes submitted by employment agencies directly to any Nationwide employee or hiring manager in any form without a signed Nationwide Client Services Agreement on file and search engagement for that position will be deemed unsolicited in nature. No fee will be paid in the event the candidate is subsequently hired as a result of the referral or through other means.
 
 
 Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. If a Sales job, Sales Incentives, based on performance goals are possible in addition to this range. Note on Compensation for Part-Time Roles: Please be aware that the salary ranges listed below reflect full-time compensation. Actual compensation may be prorated based on the number of hours worked relative to a full-time schedule.
 
 
 The national salary range for Claims Specialist II - Management Specialty Lines : $69,500.00-$129,000.00
 
 
 The expected starting salary range for Claims Specialist II - Management Specialty Lines : $69,500.00 - $103,500.00
</div>

Claims Specialist II - Management Specialty Lines

ECLARO

<div>
 
 Job Number: 26-00468
 
 
 
 Be at the forefront of innovation. ECLARO is looking for an
 
 Insurance Specialist
 
 for our client in
 
 Chapel Hill, NC.
 
 
 
 ECLARO&rsquo;s client is notable public research university. If you&rsquo;re up to the challenge, then take a chance at this rewarding opportunity!
 
 
 
 Position Overview:
 
 
 
 <ul>
 <li>
 This Insurance Specialist position offers both dental and medical insurance services for the Client.
 </li>
 <li>
 The Insurance Specialist works in all areas of billing and reimbursement, including private dental insurance companies and managed care organizations.
 </li>
 <li>
 This role requires specialized knowledge of insurance industry standards related to billing and reimbursement, along with a strong understanding of accounts receivable.
 </li>
 <li>
 This position collaborates closely with private insurance carriers, particularly those contracted with the clinics.
 </li>
 <li>
 It also requires a comprehensive understanding of dental and medical terminology, dental procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing, and the policies and contracts of multiple insurance vendors.
 
 
 </li>
 </ul>
 
 Pay Rate:
 
 $24.00/Hour
 
 
 
 Responsibilities:
 
 
 
 <ul>
 <li>
 The responsibilities of this role include filing dental insurance claims and pre-treatment estimates for privately insured patients.
 </li>
 <li>
 Obtaining and providing the clinical documentation necessary for claims processing, such as x-rays, chart notes, and letters of necessity.
 </li>
 <li>
 Investigating denied claims, following up on those investigations, and submitting appeals for those denied claims.
 </li>
 <li>
 Verifying essential documentation including insurance cards, insurance explanations of payment, provider narratives, and insurance consent.
 </li>
 <li>
 Regularly auditing patient records for accuracy and completeness of billing, coding, and clinical documentation.
 </li>
 <li>
 This position will require extensive communication with various insurance companies, along with effective use of insurance portals.
 </li>
 <li>
 Effective communication and deductive reasoning are essential skills.
 </li>
 <li>
 Compliance with HIPAA regulations is mandatory.
 </li>
 <li>
 Other duties as assigned.
 
 
 </li>
 </ul>
 
 If hired, you will enjoy the following ECLARO Benefits:
 
 
 
 <ul>
 <li>
 401k Retirement Savings Plan administered by Merrill Lynch
 </li>
 <li>
 Commuter Check Pretax Commuter Benefits
 </li>
 <li>
 Eligibility to purchase Medical, Dental &amp; Vision Insurance through ECLARO
 
 
 </li>
 </ul>
 If interested, you may contact:
 
 
 
 Lester Candilado
 
 
 
 
 jan.candilado@eclaro.com
 
 
 
 
 6466800168
 
 
 
 
 Lester Candilado | LinkedIn
 
 
 
 
 Equal Opportunity Employer:
 
 ECLARO values diversity and does not discriminate based on Race, Color, Religion, Sex, Sexual Orientation, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status, in compliance with all applicable laws.
</div>

Insurance Specialist

Aspire General Insurance

<div>Description:

Aspire General Insurance Company and its affiliated general agent, Aspire General Insurance Services, are on a mission to deliver affordable specialty auto coverage to drivers without compromising outstanding service.
Our company values can best be described with ABLE: to always do the right thing, be yourself, learn and evolve, and execute. Join our team where every individual takes pride in driving their role for shared success.
What You'll Do
 Reporting directly to the Subrogation Supervisor. The Subrogation Specialist is responsible for managing all Subrogation claims assigned to them for recovery and managing all collection efforts in maximizing subrogation recoveries for the department. The Subrogation Specialist is responsible for identification, research, and recovery of Subrogation claims. The specialist identifies legally responsible entities and pursues, negotiates, and settles Subrogation collections from all parties such as legally liable parties, claimant carriers, Insured Attorneys (in the case of Medical Payment (Med-Pay recoveries). 
DUTIES AND RESPONSIBILITIES:
1. Have knowledge of pertinent litigation and collection guidelines including Fair Debt Collection and Practices Act (FDCPA) and/or state laws, as well as CA DOI Fair Claims Regulations
2. Work and maintain new assignments referred over by the Subro dispatcher.
3. Oversee their assigned files in the Aspire Claims System, using the task-diary system to stay up to date on tasks whenever possible to effectively bring files to a conclusion.
4. Have applicable knowledge or experience using ISO claims searches.
5. Interact with Subrogation- CSR for any needed follow up or use of tools such as requesting MVR &amp; CVR requests.
6. Have a strong understanding of liability &amp; comparative negligence.
7. Understanding how to package a Subrogation demand and the documents needed thereof.
8. Determine, recommend, files for litigation. Providing a detailed rationale and outline.
9. Produce grammatically correct and clearly written correspondence including letters, memos, reports and claim file documentation.
10. Maintain timely follow up and document all Subrogation files with appropriate action plans to move the claim forward to conclusion.
11. Report to Management as soon as there is an awareness of any issues or concerns which may be detrimental to the department or Company; recommend policies and procedures to Management regarding quality issues that may arise.
12. Regular and predictable punctuality and attendance.
13. Ability to maintain departmental expectations.
14. Issue deductible reimbursements timely.
15. Send Subrogation closing letters when applicable.
16. Maintain a case load between 300 to 350 assignments.
Requirements: 
1. 1-2 years&rsquo; experience in subrogation and collections and or 2-4 years as a liability adjuster
2. Must have a clear understanding of insurance industry practices, standards, and terminology.
3. Must be able to pass a background check.
4. Must have the ability to work in a high volume, fast paced environment while managing multiple priorities.
5. Must have a disciplined approach to all job-related activities.
6. Must have a solid foundation of personal organization, sound decision making and analytical skills, strong interpersonal and customer service skills.
7. Must have strong keyboard skills as well as proficiency in Windows and MS Office products.
8. Must have strong self-managing skills.
9. Must have excellent judgment in decision-making
INTER-RELATIONSHIP COMPONENT:<ul><li>
Ability to develop excellent working relationships with Staff, Partners, Clients, and outside agencies.</li><li>
Ability to communicate with others in an effective and friendly manner, one that is conducive to being a conscientious team member, fostering a spirit of good will, indicative of a professional environment and atmosphere.</li><li>
Ability to be a team player and work cohesively with other Aspire General Insurance employees and Partner Companies&rsquo; staff to achieve company goals.</li><li>
Able to represent the Company in a professional manner and contribute to the corporate image.</li><li>
Able to consistently provide excellent customer service.</li></ul>
WORKING CONDITIONS:<ul><li>
This is an hourly position.</li><li>
This work environment is fast-paced, and accuracy is essential to successful task completion.</li><li>
The office is that of a highly technical company supporting a paperless environment.</li><li>
Travel may be required.</li><li>
Requires extended periods of computer use and sitting.</li></ul>
Benefits: Medical, Dental, Vision, HSA*, PTO, 401k, Company observed Holidays
Individuals seeking employment at Aspire General Insurance Services LLC are considered without regards to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, gender identity, or sexual orientation in accordance with federal and state Equal Employment Opportunity/Affirmative Action record keeping, reporting, and other legal requirements.<ul><li>Dependent on plan selected</li></ul></div>

Avera Health

<div><div><div><div><div><div><div><div>Location:
</div></div></div></div></div></div></div>Avera Marshall Hospital
Worker Type:
Regular
Work Shift:
Day Shift (United States of America)
Pay Range:
The pay range for this position is listed below. Actual pay rate dependent upon experience.
$19.50 - $25.50
Position Highlights
Monday - Friday, 8:00 AM - 4:30 PM 
 
You Belong at Avera
Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. 
 
A Brief Overview
 
 
Responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete in the time allowed by the insurance companies to prevent denials or penalties. Specialists are responsible for documenting accurate insurance information and authorization details to optimize reimbursement from both the payer and patient. The Specialist must maintain strong working knowledge of insurance plans, contract requirements, and resources to facilitate appropriate insurance verification and authorization. Specialists must also be able to understand and interpret patient liability and benefits for all payer types including copays, co-insurance, and out-of-pocket responsibilities in order to provide patients and families with information on their financial responsibility. The Specialist will calculate and communicate to the patient a financial responsibility estimation, provide charity applications and/or direct the patient to the business office for payment and assistance options. The Specialists will collect patient liability prior to service and attempt to collect prior balances. The Specialist collaborates with various other departments to ensure proper reimbursement on accounts. The Specialists are to conduct all transactions appropriately and consistently, and complete government regulatory forms accurately with the patient or patient's representative. Specialists must maintain compliance with government regulations (i.e. EMTALA and HIPAA) as it pertains to the insurance process.
 
 
What you will do 
 
 
<ul><li>Process eligibility and secure full benefit coverage information (including COBRA when applicable) with insurance companies and employers, confirm all demographic information is correct, and ensure coordination of benefit (COB) and insurance plan codes are accurate. Specialists must verify insurance coverage immediately for inpatient and outpatient accounts that are same day and next day add-ons.
</li><li>Identify all payment sources for accurate primary and secondary payer coverage and required authorizations to prevent denials and/or reduction in payment for patients entering the facility for care.
</li><li>Obtain necessary paper/electronic referrals, authorizations and pre-certifications from Primary Care Physician and/or Specialty Physician when required by payers, Managed Care, and traditional Medicaid and enters information into the health information system.
</li><li>Collects and validates accurate patient demographic and insurance information, verifies insurance, obtains pre-certification/authorization as required and enters all necessary information.
</li><li>Calculate and communicate patient estimates for hospital services utilizing a deposit matrix or patient payment estimator to determine estimated patient responsibility and communicates financial expectations to the patient.
</li><li>Educates patients on their benefits, offers the patient/family the opportunity to pay their estimated patient responsibility prior to services rendered, and identifies methods of payment available. Identifies patients in need of financial assistance and provides charity applications and referrals to the business office as necessary.
</li><li>Responsible to screen all self pay patients for potential payer coverage and directs applicable accounts to the advocacy team for further review. Assure all payer requirements are met, including non-coverage waivers, Advance Beneficiary Notices, sterilization forms, and other forms as applicable.
</li><li>Provide communication concerning change of insurance coverage, prior to billing, from Registration staff and/or Patient Advocate/Billing staff.
</li><li>Maintain professional development by attending workshops, in-services, and webinars to remain up-to-date on insurance rules and regulations in addition to changes within the industry.
</li></ul> 
Essential Qualifications
 
 
The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.
 
 
Required Education, License/Certification, or Work Experience: 
 
 
<ul><li>1-3 years Related experience in billing, insurance or registration.
</li><li>1-3 years Healthcare experience
</li></ul> 
Preferred Education, License/Certification, or Work Experience: 
 
 
<ul><li>Associate's finance, business or healthcare.
</li></ul> 
Expectations and Standards 
 
 
<ul><li>Commitment to the daily application of Avera&rsquo;s mission, vision, core values, and social principles to serve patients, their families, and our community.
</li><li>Promote Avera&rsquo;s values of compassion, hospitality, and stewardship.
</li><li>Uphold Avera&rsquo;s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
</li><li>Maintain confidentiality.
</li><li>Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
</li>Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. 
<li>
</li></ul> 
Benefits You Need &amp; Then Some
Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.
<ul><li>PTO available day 1 for eligible hires.
</li><li>Up to 5% employer matching contribution for retirement
</li><li>Career development guided by hands-on training and mentorship
</li></ul>Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org .</div>

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