Claims Adjusters, Examiners, and Investigators

**Why USAA?**

Let’s do something that really matters.

We have an important mission: serving the members of the military community and their families. It’s both a chance to say thank you and the opportunity to put your talents to work in a meaningful way. To do it right, we need the right people. We’re looking for those who share our values of honesty, integrity, loyalty and service. Because what we do is just as important as how we do it. Come be a part of what makes us so special!

It is all about learning and growing.

Our Customer Service Claims Representative role may be a new career for you. There’s a lot to learn, but the pathway is mapped out and USAA is willing to invest in you! Our comprehensive, fully paid four-month training program includes all training materials, licensing costs, class discussions, hands-on training, e-learning modules, and the instructor led guidance will help you to support our members independently.

Our in-office development program provides the training you need and the encouragement to create a proactive and independent support style to service our membership. After completion of training and six months of working in the position, you’ll have the opportunity to work in office three days a week. Relocation assistance is not available for this position.

**The Opportunity**

We are currently seeking dedicated professionals to **work in our Phoenix office** for future customer service claims opportunities in **2024** . We have new training classes starting every month. Military veterans and spouses are highly encouraged to apply.

Work schedules will vary and may include some **nights and weekends** . Schedules will be assigned based on business needs.

Regularly scheduled shift hours after 6 p.m. local time during the week and/or on the weekend will be eligible for **shift premium pay** .

As a Customer Service Claims Representative you will be part of an outstanding contact service center, where you will focus on providing claims service to members regarding the initial contact on all **auto OR property** First Notice of Loss (FNOL) claims. In addition, you will respond to status inquiries from various parties, document reported losses, set appropriate expectations, provide proactive communications, advice, and empathy to our members.

**What you'll do:**

+ Document First Notice of Loss by obtaining relevant information for effective claim investigation. Set up appropriate services, as needed, to proactively move claims forward to the furthest point in the process within scope of role and expectation.

+ Create loss reports, describe or verify coverage as appropriate, and initiate the most effective method of damage assessment to assign for file handling.

+ Assist with questions regarding the claims process and set expectations for next steps to help ensure claims are effectively resolved and accurately documented.

+ Resolve status inquiries and, when appropriate, route to handling adjuster.

+ Effectively operate in a fast-paced, high-volume, contact center environment taking back-to-back calls and navigating multiple systems and programs while maintaining an engaging member interaction that occurs across multiple communication channels.

+ Apply strong time management skills by closely adhering to assigned work schedule.

+ Embrace continuous improvement and development through coaching and collaboration with manager and team members.

+ Use strong call management skills by assisting members within a timely manner and limiting non-productive time.

+ May assign or initiate emergency services when required on specific claims.

+ Support workload surges and catastrophe (CAT) response operations as needed which may include potential weekends, and/or holiday work outside normal work hours.

+ Work various types of claim loss notices and inquiries, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.

+ Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

**What you have:**

+ High School Diploma or GED

+ Ability to provide exceptional customer service for our members by using active listening, verbal, and written communication skills to communicate clearly, professionally, and empathetically.

+ Highly developed interpersonal skills to collaborate effectively in a fast-paced team environment.

+ Ability to prioritize and multi-task while navigating through multiple business applications.

+ Successful completion of a job-related assessment is required.

+ May require acquisition and maintenance of insurance adjuster license within 90 days. (USAA provides all materials and licensing fees)

**What sets you apart:**

+ US military experience through military service or a military spouse/domestic partner

The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

**What we offer:**

**Compensation:** USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. The hiring range for this position is: $43,750 to $45,750 **.**

Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

**Benefits:** At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.

For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.

_Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting._

_USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran._

USAA is an EEO/AA Employer - applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, pregnancy, protected veteran status or other status protected by law.

**Who Are We?**

Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.

**Job Category**

Claim

**Compensation Overview**

The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.

**Salary Range**

$46,900.00 - $77,400.00

**Target Openings**

1

**What Is the Opportunity?**

Travelers' Claim Organization is at the heart of our business. By providing assurance to our customers during life's rainy days, the Travelers Workers Compensation Claim team is committed to partnering with our business insurance customers to help their injured employees return to work as soon as medically appropriate. As a Workers Compensation Claim Professional Trainee, you will handle all aspects of a workers compensation claims. In this role, you will learn how to help our customers and their injured employees when they are injured at work. You will develop the technical skills needed for quality claim handling including investigating, evaluating, negotiating, and resolving claims on losses of lesser value and complexity and provide claim handling throughout the claim life cycle. As part of the hiring process, this position will require the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.

**What Will You Do?**

+ Complete virtual, classroom, and on-the-job training which includes the overall instruction, exposure, and preparation for employees. Completion of an internal training program is required to progress to next level position. The training may require travel.

+ Handle all aspects of a Workers Compensation claim including completing investigations, setting accurate reserves, and making various claim-related decisions under direct supervision. As a trainee, you may also be exposed to claims that could involve litigation, settlement negotiations, Medicare set asides and offsets.

+ Communicate and apprise all parties regarding claim status which may include our business customers, injured employees, medical providers, and legal counsel.

+ Investigate, develop, and evaluate action plans for claim resolution. Assess coverage and determine if a claim is compensable under Workers Compensation including evaluating claims for potential fraud.

+ Achieve a positive result by returning an injured party to work when appropriate. This may include coordinating medical treatment in collaboration with internal or external resources.

+ Effectively prioritize and manage a Workers Compensation claim inventory, including filing and diary systems, document plans of action and complete time-sensitive required letters and state forms.

+ Participate in Telephonic and/or onsite File Reviews.

+ Acquire and maintain relevant Insurance License(s) to comply with state and Travelers’ requirements within three months of starting the job.

+ Perform other duties as assigned.

**What Will Our Ideal Candidate Have?**

+ Bachelor’s Degree or a minimum of 2 years of work or customer service-related experience.

+ Ability to work in a high volume, fast paced environment managing multiple priorities while facing ambiguity.

+ Able to review information from multiple sources and use analytical thinking and problem-solving skills to accurately achieve optimal claim outcomes and determine appropriate next steps.

+ Ability to own and manage all assigned tasks.

+ Provide excellent customer experience by communicating effectively, verbally and written.

+ Able to work independently and in a team environment.

+ Strong attention to detail.

**What is a Must Have?**

+ High School Diploma or GED

+ One year of customer service experience OR Bachelor’s Degree.

**What Is in It for You?**

+ **Health Insurance:** Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment.

+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.

+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.

+ **Wellness Program:** The Travelers wellness program is comprised of tools and resources that empower you to achieve your wellness goals. In addition, our Life Balance program provides access to professional counseling services, life coaching and other resources to support your daily life needs. Through Life Balance, you’re eligible for five free counseling sessions with a licensed therapist.

+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.

**Employment Practices**

Travelers is an equal opportunity employer. We believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. We are committed to recruiting, retaining and developing the diverse talent of all of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results.

If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email ([email protected]) so we may assist you.

Travelers reserves the right to fill this position at a level above or below the level included in this posting.

To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/ .

**Title:**

Claims Adjuster (SCA) HHG/Military Move

**HomeSafe Alliance** is the single global household goods movement manager of over 300,000 Military Household Goods moves per year for USTRANSCOM and the U.S. Armed Forces, Department of Defense civilians, U.S. Coast Guard, and their families.

**This is an SCA position** .

**Position Summary** :

**HomeSafe Alliance** is seeking experienced Claims Adjustors with experience in HHG/Military Move to process and settle claims according to DOD regulations and/or account requirements within the required company timeframe. Adjust claims and make payments and chargeback assessments for cargo, property damage, inconvenience claims, and MCO Demand settlement according to company policies. The claims adjuster responds to internal and external customer disputes and inquiries according to company policies. Must be exceptionally customer service oriented, have effective listening, verbal, and written communication skills, and possess a friendly, helpful demeanor.

**Required Education, Knowledge & Skills:**

+ High school diploma, some college-related courses or Associates Degree desired

+ Previous claims adjusting experience preferred in personal property or cargo claims

+ Must be a U.S. citizen due to contractual requirements.

+ Excellent oral and written communication skills

+ Proficient computer skills – MS Office: Outlook, Word, Excel, PowerPoint)

+ Detail-oriented with superior organizational and time management skills

+ Positive interpersonal and problem-resolution skills

**Job Functions:**

+ Analyze, process, and settle incoming DOD claims in accordance with company policies and within assigned time limits (and per DOD regulations if applicable), assuring that an average claims settlement quota per week is met. This includes cargo, property, and inconvenience claims as assigned.

+ Assess claims liability and chargebacks in accordance with contracts and policies, including providing advance notice of chargeback to agents.

+ Respond to internal and external customer disputes and inquiries, assuring timely response per company policy whether the dispute is in writing or by phone.

+ Utilize the internet as a source for dollar amount comparisons

+ Pay routine repair invoices

+ Answer and direct incoming calls

+ Provide excellent customer service using sound judgment and decision making

+ Strong time management and organization skills with the ability to prioritize and complete assignments on schedule

+ Professional, friendly customer-centered demeanor

+ Ensure claims files are properly documented and claims coding is accurate

+ Typing, filing, scanning, copying, and general office clerical duties

+ Ability to interpret procedures and ensure understanding of compliance

+ Performs other job-related duties as needed

\#LI-SH

Benefits:

+ Medical, Dental and Vision Insurance.

+ Paid time off (PTO) Three weeks of PTO for newly hired employees

+ 401(k)

+ Health and Wellness Programs

+ Disability, Life and AD&D insurance

+ Employee Support program

+ Family Support: Bright Horizons, child and elder care services

+ Teladoc Medical Experts, second opinion program

+ Travel Accident & Medical

+ TRICARE Supplement Plan

+ Voluntary Benefit Plans

+ And more!

HomeSafe is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, disability, sex, sexual orientation, gender identity or expression, age, national origin, veteran status, genetic information, union status and/or beliefs, or any other characteristic protected by federal, state, or local law.

Marine Claims Senior Claims Specialist Role

112521

Zurich North America is hiring an Marine Claims Senior Claims Specialist Role to join our team! We are open to remote work for the right candidate located within the U.S..

In this role you will be responsible for:

+ Ability to handle dedicated accounts.

+ Frequent interaction with Assureds, Brokers and Underwriters.

+ Some travel may be required but this is not very frequent.

Basic Qualifications:

+ Bachelor’s Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.AND

+ Must obtain and maintain required adjuster license(s)

+ Microsoft Office experience

+ Knowledge of insurance regulations, markets and products

Preferred Qualifications:

+ Extensive Marine claims experience preferred.

+ Emphasis on Marine Liability, Hull, Blue water and brown water claims, Jones Act, General Average and Ocean Cargo Claims experience preferred.

+ Licensed in all states as needed preferred.

+ Effective verbal and written communication skills

+ Strong analytical, critical thinking and problem-solving skills

+ Strong multi-tasking and prioritization skills

+ Experience collaborating in a team environment and building cross functional working relationships

+ Proactively shares and promotes sharing of insights

+ Ability to gather unique perspectives from other teams/functions to optimize outcomes.

+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims

+ Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims

+ Ability to determine the scope and exposure for complex claims

+ Ability to leverage trend and relationships to provide high-quality customer service

+ Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts.

+ Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims

+ Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies

Compensation for roles at Zurich varies depending on a wide array of factors including but not limited to the specific office location, role, skill set, and level of experience. As required by local law, Zurich provides in good faith a reasonable range of compensation for roles. For additional information about our Total Rewards, click here (https://www.zurichna.com/careers/benefits) . Other rewards may include short term incentive bonuses and merit increases. **Candidates with salary expectations outside of the range are encouraged to apply, and will be considered based on experience, skill, and education.** The salary provided is a nationwide market range and has not been adjusted for the applicable geographic differential associated with the location where the position may be filled. The starting salary range for this position is $72,800.00 - $119,200.00.

As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time ( https://www.zurichna.com/careers/faq ).

A future with Zurich. What can go right when you apply at Zurich?

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please clickhere (https://www.zurichna.com/careers) to learn more.

As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.

Location(s): AM - Los Angeles, AM - Remote Work (US)

Remote Working: Yes

Schedule: Full Time

Employment Sponsorship Offered: No

Linkedin Recruiter Tag: #LI-LC1 #LI-ASSOCIATE #LI-REMOTE

**You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.**

**Optum** is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.**

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 3:30pm PST. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours during training will be 8:30am - 5:30pm PST, Monday – Friday.

_*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy._

**Primary Responsibilities:**

+ Accurately process professional claims.

+ Responsible for editing and adjusting of claims per the EDI daily audit report.

+ Analyze and adjudicate claims to ensure accurate payment

+ Interpret Fee for Service (FFS) and capitated provider contracts

+ Review claims on a periodic basis

+ Meet Department Quality of 98.50% or better on a weekly and monthly basis. Meet production standard of 350 claims per day.

+ Interfaces with other departments such as eligibility, UM, Configuration to obtain necessary information required for resolution of claims.

+ Advise management of any claim issues or inappropriate and/or incorrect billing

+ Other duties assigned by management.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

**Required Qualifications:**

+ High School Diploma / GED OR equivalent experience

+ 1+ years of experience processing professional medical Insurance claims

+ Experience using windows based programs including Microsoft Word, Microsoft Excel and Microsoft Outlook

+ Must be 18 years of age OR older

+ Ability to work full-time between 6:00am – 3:30pm PST including the flexibility to work occasional overtime given the business need

**Preferred Qualifications:**

+ 2+ years of experience as a Medical Claims Examiner.

+ 2+ years of experience of professional claims processing.

+ Prior Medicare, HMO experience

+ CPT and HCPCS coding skills.

+ Experience in contract interpretation.

+ Working knowledge of Medical Terminology, ICD9, ICD10, CPT4, UB92/1500 forms.

**Telecommuting Requirements:**

+ Ability to keep all company sensitive documents secure (if applicable)

+ Required to have a dedicated work area established that is separated from other living areas and provides information privacy.

+ Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

**California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only:** The hourly range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission._

_Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law._

_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

**\#RPO**

fraud claims specialist.

+ tempe , arizona

+ posted today

**job details**

summary

+ $19.99 - $20 per hour

+ temp to perm

+ no requirements

+ category office and administrative support occupations

+ referenceAB_4518558

job details

Are you an experienced backend/financial services professional looking to secure a role within fraud? If so, this is a great opportunity to join our clients Signature Non-Fraud team! Randstad is looking to hire several Fraud Claims Specialists and we are seeking candidates with great attention to detail, advanced processing skills and the ability to quickly and efficiently navigate multiple systems at once. If that sounds like you, please today!

salary: $19.99 - $20 per hour

shift: First

work hours: 8:30 AM - 5:30 PM

education: No Degree Required

Responsibilities

+ This is back office type work and would not be working on the phones directly with customers.

+ Talent will be working through a queue

+ Talent will be using various systems and screens to gather information, review and analyze information, and document findings they come across in making their decision.

+ Talent should be self starters - once they finish a claim, they will continue working claims out of their queue for the entirety of the day

+ Transaction/customer account review

+ Ability to make sound decisions based on evidence

+ Talent will be working in the fraud & claims department, specifically working with signature non-fraud on customer's debit cards.

Skills

+ Claims

+ Claims Processing

+ Fraud Investigation

+ Banking Operations

+ Customer support

+ Insurance

+ Data Entry

Qualifications

+ Years of experience: 1 year

+ Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

Applications accepted on ongoing basis until filled.

**get in touch**

we are here to help you with your questions.

MW

**mackenzie weathers**

+ [email protected]

fraud claims specialist.

+ chandler , arizona

+ posted today

**job details**

summary

+ $19.99 - $20 per hour

+ temp to perm

+ no requirements

+ category office and administrative support occupations

+ referenceAB_4518559

job details

Are you an experienced backend/financial services professional looking to secure a role within fraud? If so, this is a great opportunity to join our clients Signature Non-Fraud team! Randstad is looking to hire several Fraud Claims Specialists and we are seeking candidates with great attention to detail, advanced processing skills and the ability to quickly and efficiently navigate multiple systems at once. If that sounds like you, please today!

salary: $19.99 - $20 per hour

shift: First

work hours: 8:30 AM - 5:30 PM

education: No Degree Required

Responsibilities

+ This is back office type work and would not be working on the phones directly with customers.

+ Talent will be working through a queue

+ Talent will be using various systems and screens to gather information, review and analyze information, and document findings they come across in making their decision.

+ Talent should be self starters - once they finish a claim, they will continue working claims out of their queue for the entirety of the day

+ Transaction/customer account review

+ Ability to make sound decisions based on evidence

+ Talent will be working in the fraud & claims department, specifically working with signature non-fraud on customer's debit cards.

Skills

+ Claims

+ Claims Processing

+ Fraud Investigation

+ Banking Operations

+ Customer support

+ Insurance

+ Data Entry

Qualifications

+ Years of experience: 1 year

+ Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

Applications accepted on ongoing basis until filled.

**get in touch**

we are here to help you with your questions.

MW

**mackenzie weathers**

+ [email protected]

**Alternate Locations:** Charlotte, NC (North Carolina); Atlanta, GA (Georgia); Omaha, NE (Nebraska); Phoenix, AZ (Arizona); Work from Home

**Work Arrangement:**

Hybrid/Flexible : Work at home and use the office as appropriate for in-person collaboration.

**Relocation assistance:** is not available for this opportunity.

**Requisition #:** 73043

**The Role at a Glance**

We are excited to bring on highly motivated Voluntary Claims Specialist I to staff our ever-growing claims organization.

As a Voluntary Claims Specialist you will be responsible for administering, processing, and adjudicating Accident, Critical Illness, and Hospital Indemnity claims for our members. You'll complete a thorough training to develop new skills and give you the confidence you need to be successful. If you enjoy working in a fast-paced team environment from the comfort of your own home, then please read on!

**What you'll be doing**

• Communicating with claimants, employers and various medical professionals through phone and e-mail to gather information regarding Voluntary Claims.

• Leveraging knowledge of coverage, contract provisions, eligibility & benefits as well as other appropriate resources (e.g., other internal teams, practices/procedures, etc.) to review submitted claim information for payment.

• Applying core knowledge of voluntary insurance products and claims processes to review questions/concerns and provide specific information to

internal/external stakeholders

• Making routine & non-routine decisions under close supervision, applying limited discretion within role except for matters of significance.

• Providing exceptional customer service and proactively recognizing customer and claimant needs and areas of opportunity.

**What we’re looking for**

Must haves:

• High School or GED

• 0-1+ Years of general experience

• Strong written and verbal communication skills

• Excellent organizational skills with the ability to multi-task

Nice to haves:

• Experience with Voluntary Claims (Hospital Indemnity, Accident and Critical Illness)

**What’s it like to work here?**

At Lincoln Financial Group, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future.

**What’s in it for YOU:**

+ Clearly defined career tracks and levels to help you successfully manage your career

+ Leadership development and virtual training opportunities

+ PTO/parental leave

+ Competitive 401K and employee benefits (https://hrdirectdocs.lfg.com/misc/HR/Recruiting/BenefitsResourcesGuide.pdf)

+ Free financial counseling, health coaching and employee assistance program

+ Tuition assistance program

+ A leadership team that prioritizes your health and well-being; offering a remote work environment and flexible work hybrid situations

+ Effective productivity/technology tools and training

**Pay Range:** $19.78 - $24.98

Actual base pay could vary based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role. The base pay is just one component of Lincoln’s total rewards package for employees. In addition, the role may be eligible for the Annual Incentive Program, which is discretionary and based on the performance of the company, business unit and individual. Other rewards may include long-term incentives, sales incentives and Lincoln’s standard benefits package.

**About The Company**

Lincoln Financial Group helps people to plan, protect and retire with confidence. As of Dec. 31, 2023, approximately 17 million customers trust our guidance and solutions across four core businesses – annuities, life insurance, group protection and retirement plan services. As of December 31, 2023, the company had $295 billion in end-of-period account balances, net of reinsurance. Headquartered in Radnor, Pa., Lincoln Financial Group is the marketing name for Lincoln National Corporation (NYSE: LNC) and its affiliates. Learn more at LincolnFinancial.com.

Lincoln is committed to creating a diverse and inclusive (https://www.lfg.com/public/aboutus/companyoverview/diversityinclusion?audience\_page\_id=1422918942386) environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Follow us on Facebook (http://www.facebook.com/lincolnfinancialgroup) , X (https://mobile.twitter.com/lincolnfingroup) , LinkedIn (https://www.linkedin.com/company/4307?trkInfo=tas%3Alincoln+financial%2Cidx%3A3-1-3&trk=tyah) , and Instagram (https://www.instagram.com/lincolnfingroup/) . For the latest company news, visit our newsroom (https://www.lincolnfinancial.com/public/aboutus/newsroom) .

**Be Aware of Fraudulent Recruiting Activities**

If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters.

Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts (Gmail, Yahoo, Hotmail) or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview. Please contact Lincoln's fraud team at [email protected] if you encounter a recruiter or see a job opportunity that seems suspicious.

**Additional Information**

This position may be subject to Lincoln’s Political Contribution Policy. An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln’s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.

Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial Group are considered property of Lincoln Financial Group and are not subject to payment of agency fees.

Lincoln Financial Group (“LFG”) is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, Veteran status, or genetic information. Applicants are evaluated on the basis of job qualifications. If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling 260-455-2558.

This Employer Participates in E-Verify. See the E-Verify (https://www.e-verify.gov) notices.

Este Empleador Participa en E-Verify. Ver el E-Verify (https://www.e-verify.gov/es) avisos.

Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.

**Alternate Locations:** Scottsdale, AZ (Arizona); Omaha, NE (Nebraska); Phoenix, AZ (Arizona); Sacramento, CA (California); San Diego, CA (California); San Francisco, CA (California); San Ramon, CA (California); Seattle, WA (Washington); US Midwest; US Southwest; US West; Work from Home

**Work Arrangement:**

Hybrid/Flexible : Work at home and use the office as appropriate for in-person collaboration.

**Relocation assistance:** is not available for this opportunity.

**Requisition #:** 72881

**The Role at a Glance**

We are excited to bring on highly motivated Short Term Disability Claims Specialists to staff our ever-growing claims organization.

As a Short Term Disability Claims Specialist, you will be responsible for conducting initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations. You’ll complete a thorough training to develop new skills and give you the confidence you need to be successful in your new role. If you enjoy working in a fast-paced team environment from the comfort of your own home, then please read on!

Learn more about a Day in the Life (https://www.youtube.com/watch?v=vbSYiXOPSII&feature=youtu.be) of a Claims Specialist at Lincoln Financial Group!

**What you'll be doing**

+ Communicating with claimants, employers and various medical professionals through phone and e-mail to gather information regarding the Short Term Disability claim.

+ Collaborating with fellow case managers, nurse case managers and consulting physicians to make appropriate and timely claim determinations.

+ Reviewing complex medical records and effectively leveraging a variety of tools and resources to understand appropriate approval durations and future action planning

+ Completing accurate financial calculations consistent with company and state guidelines.

+ Providing exceptional customer service and proactively recognizing customer needs and areas of opportunity.

**What we’re looking for**

Must haves:

High School diploma or GED

1-2 years of experience in claims, leaves or customer service

Strong written and verbal communication skills

Excellent organization skills with the ability to multi-task

Nice to haves:

Experience with disability and/or absence management

Strong mathematical skills for payment calculations

**What’s it like to work here?**

At Lincoln Financial Group, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future.

**What’s in it for YOU:**

+ A clearly defined career framework to help you successfully manage your career

+ Leadership development and virtual training opportunities

+ PTO/parental leave

+ Competitive 401K and employee benefits (https://hrdirectdocs.lfg.com/misc/HR/Recruiting/BenefitsResourcesGuide.pdf)

+ Free financial counseling, health coaching and employee assistance program

+ Tuition assistance program

+ A leadership team that prioritizes your health and well-being; offering a remote work environment and flexible work hybrid situations

+ Effective productivity/technology tools and training

**Pay Range:** $19.78 - $24.98

Actual base pay could vary based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role. The base pay is just one component of Lincoln’s total rewards package for employees. In addition, the role may be eligible for the Annual Incentive Program, which is discretionary and based on the performance of the company, business unit and individual. Other rewards may include long-term incentives, sales incentives and Lincoln’s standard benefits package.

**About The Company**

Lincoln Financial Group helps people to plan, protect and retire with confidence. As of Dec. 31, 2023, approximately 17 million customers trust our guidance and solutions across four core businesses – annuities, life insurance, group protection and retirement plan services. As of December 31, 2023, the company had $295 billion in end-of-period account balances, net of reinsurance. Headquartered in Radnor, Pa., Lincoln Financial Group is the marketing name for Lincoln National Corporation (NYSE: LNC) and its affiliates. Learn more at LincolnFinancial.com.

Lincoln is committed to creating a diverse and inclusive (https://www.lfg.com/public/aboutus/companyoverview/diversityinclusion?audience\_page\_id=1422918942386) environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Follow us on Facebook (http://www.facebook.com/lincolnfinancialgroup) , X (https://mobile.twitter.com/lincolnfingroup) , LinkedIn (https://www.linkedin.com/company/4307?trkInfo=tas%3Alincoln+financial%2Cidx%3A3-1-3&trk=tyah) , and Instagram (https://www.instagram.com/lincolnfingroup/) . For the latest company news, visit our newsroom (https://www.lincolnfinancial.com/public/aboutus/newsroom) .

**Be Aware of Fraudulent Recruiting Activities**

If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters.

Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts (Gmail, Yahoo, Hotmail) or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview. Please contact Lincoln's fraud team at [email protected] if you encounter a recruiter or see a job opportunity that seems suspicious.

**Additional Information**

This position may be subject to Lincoln’s Political Contribution Policy. An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln’s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.

Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial Group are considered property of Lincoln Financial Group and are not subject to payment of agency fees.

Lincoln Financial Group (“LFG”) is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, Veteran status, or genetic information. Applicants are evaluated on the basis of job qualifications. If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling 260-455-2558.

This Employer Participates in E-Verify. See the E-Verify (https://www.e-verify.gov) notices.

Este Empleador Participa en E-Verify. Ver el E-Verify (https://www.e-verify.gov/es) avisos.

Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®

Most Loved Workplace®

Forbes Best-in-State Employer

Claims Examiner - Property/Auto

**PRIMARY PURPOSE** **:** To analyze and process complex or technically difficult (up to $100,000) personal and commercial line property claims by scoping damages and completing an estimate or by obtaining a contractor's estimate for review.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Processes complex commercial and personal line property claims and ensures claim files are properly documented and coded correctly.

+ Responsible for litigation process on litigated claims.

+ Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.

+ Reports large claims to excess carrier(s),

+ Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.

+ Identifies and pursues subrogation opportunities; secures and disposes of salvage.

+ Communicates claim action/processing with insured, client, and agent or broker when appropriate.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

+ Travels as required.

**QUALIFICATIONS**

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Licenses as required.

**Experience**

Five (5) years of claims management experience or equivalent combination of education and experience required to include knowledge of construction basics, property estimating software experience and in-depth knowledge of personal and commercial lines property policies, coverages, principles, and laws.

**Skills & Knowledge**

+ In-depth knowledge of personal and commercial line property policies, coverages, principles, and laws

+ Knowledge of construction basics and property estimating software

+ Knowledge of appropriate application of deductibles and sub-limits

+ Strong oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Strong organizational skills

+ Strong interpersonal skills

+ Good negotiation skills

+ Ability to work in a team environment

+ Ability to meet or exceed Performance Competencies

**WORK ENVIRONMENT**

When applicable and appropriate, consideration will be given to reasonable accommodations.

**Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

**Physical** **:** Computer keyboarding, travel as required

**Auditory/Visual** **:** Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 18.00 - 36.98 USD Hourly. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**