The Quality Assurance Specialist assesses internal and vendor case files to ensure accuracy, consistency, and compliance with service agreements. They identify performance trends and collaborate with stakeholders to maintain data integrity within the client relationship management system.
The role involves performing clinical assessments and utilization management reviews to ensure evidence-based, cost-effective treatment outcomes. The nurse will collaborate with physicians, claims examiners, and other stakeholders to advocate for patient care while adhering to regulatory and quality standards.
The Sr. Adjuster is responsible for investigating and adjusting residential and commercial property and casualty claims with minimal supervision. This includes conducting site inspections, determining coverage, preparing repair estimates, and negotiating settlements.
Manage a caseload of basic to highly complex claims while mentoring account representatives and specialists. Coordinate specialized services such as subrogation and fraud evaluation while ensuring compliance with jurisdictional requirements.
The Field Case Manager acts as a liaison between injured workers and medical providers to facilitate recovery and return-to-work plans. They serve as patient advocates to coordinate care and ensure resources are used in a cost-effective manner.
The Service Center Specialist tracks trends, investigates client feedback, and assists in developing corrective actions to improve service quality. They also act as a customer liaison, managing claims documentation and directing workflow to ensure client-driven performance objectives are met.
Analyze and resolve complex medical malpractice claims by investigating events, determining exposure, and developing action plans. Coordinate legal defense, manage claim costs, and maintain professional relationships with clients.
The Auto Adjuster is responsible for examining insurance policies, investigating claims, and inspecting property damage to determine company liability. They also negotiate settlements, manage case reserves, and prepare detailed reports on findings.
The specialist manages mid-to-high level auto commercial and personal lines claims by determining exposure, assessing liability, and negotiating settlements. They are also responsible for maintaining accurate claim documentation and fostering professional client relationships.
The Field Adjuster examines insurance policies and inspects property damage to determine the extent of company liability. They are responsible for negotiating settlements with claimants and preparing detailed reports of their findings.
The Quality Assurance Specialist assesses the performance of investigative case files to ensure accuracy, consistency, and compliance with service agreements. They identify trends for service improvement and collaborate with stakeholders to maintain data integrity within the client relationship management system.
The Disability Representative Sr manages complex disability claims by analyzing medical documentation and determining benefit eligibility. They coordinate return-to-work efforts, manage ADA accommodations, and maintain professional relationships with claimants and clients.
The Quality Assurance Specialist assesses the performance of internal and vendor case files to ensure accuracy, consistency, and compliance with service agreements. They identify trends for service improvement and collaborate with stakeholders to maintain accurate data within the client relationship management system.
The Regional General Adjuster handles complex insurance claims up to $10M, including investigating damages, determining liability, and negotiating settlements. They also manage loss reports, reconcile catastrophic claims, and coordinate with legal departments or excess carriers as needed.
Review incoming communications, collect and verify claim details and documents, and accurately enter claims into the claims management system. Apply client-specific instructions and coding, coordinate with relevant parties, and maintain accurate acknowledgements and records.
The Consumer Care Advocate processes incoming claims-related communications and resolves inquiries from claimants, providers, and clients. They are responsible for accurate data entry into claims systems and coordinating necessary referrals or medical examinations.
The Claims Associate analyzes lower-level general liability claims to determine benefits and ensures ongoing adjudication according to company standards. They also support senior staff with complex claims and maintain accurate documentation and client relationships.
The Claims Representative analyzes and processes low to mid-level auto and transportation claims, including property damage and injury assessments. They are responsible for developing action plans, pursuing subrogation, and maintaining professional communication with all involved parties.
Conduct forensic investigations to determine the root cause of structural failures and property losses. Provide expert testimony and guidance on complex engineering assignments while collaborating with various stakeholders.
The Field Case Manager acts as a liaison between injured workers and medical providers to facilitate recovery and timely return-to-work. They serve as a patient advocate to coordinate care and ensure resources are used in a cost-effective manner.
Analyze and manage complex workers' compensation claims to determine benefits, ensure compliance, and negotiate settlements. Coordinate return-to-work efforts and maintain professional relationships with clients while documenting claim files accurately.
The adjuster will investigate and settle residential and commercial property and casualty claims while maintaining client relationships. Responsibilities include examining insurance policies, preparing repair estimates, and conducting interviews with involved parties.
Supervise multiple workers' compensation examiner and technical teams, providing jurisdictional guidance, training, workload oversight, and quality reviews. Manage complex and high-exposure claims, appeals, reserves, and client communications while supporting staff performance and process improvements.
Manages complex property insurance assignments, including site visits, damage scoping, and high-value cost estimating. Provides independent oversight of mitigation processes and maintains accurate reporting for clients and contractors.
The Building Consultant manages property assignments including site visits, damage scoping, cost estimating, and project negotiations. They provide independent oversight of reconstruction costs and mitigation processes while maintaining accurate reporting for clients and adjusters.
The Patient Care Coordinator acts as a primary liaison for callers, managing claims applications and providing detailed documentation. They are responsible for educating customers on claim requirements and directing calls to the appropriate handlers or escalation paths.
The advisor analyzes complex environmental and liability claims to determine exposure and develop resolution strategies. They also coordinate legal defense, manage claim costs, and maintain professional relationships with clients.
The advisor analyzes and resolves complex environmental liability claims by investigating exposures, determining coverage, and managing legal defense strategies. They are responsible for monitoring reserve adequacy, negotiating settlements, and implementing cost containment techniques to ensure efficient claim resolution.
The Telephonic Case Manager facilitates medical recovery and return-to-work strategies by coordinating services and communicating with injured workers, employers, and providers. They perform clinical assessments, identify recovery barriers, and negotiate treatment plans to ensure cost-effective and timely claim resolution.
The role involves conducting forensic investigations to determine the cause and scope of structural damage for residential and commercial buildings. The engineer will also manage quality control, provide expert witness testimony, and collaborate with a national team of experts.
