Trabajos adjuster en Mount Vernon, New YorkCrear alertas

JOB TITLE: No Fault / PIP Insurance Verification Specialist I EMPLOYER: Progressive Spine & Orthopaedics PAY RANGE: OPM Pay Grade 4 (Hourly) FSLA STATUS: Non-Exempt SUMMARY: The No-Fault / PIP Insurance Verification Specialist I is an entry-level position responsible for obtaining and documenting basic automobile insurance and PIP claim information prior to patient services. This position performs routine insurance verification tasks using established procedures and guidelines and assists with identifying missing or incomplete information. The Specialist I communicates with insurance carriers and adjusters to obtain basic claim and benefit information, documents findings in the electronic health record, and escalates complex issues to a senior team member or supervisor. The role supports accurate patient information, timely care, and billing processes while maintaining confidentiality and compliance with established workflows. ESSENTIAL DUTIES AND RESPONSIBILITIES • Verify active No-Fault / PIP claims, including claim number, date of accident, adjuster information, benefit status or exhaustion, covered body parts, and other applicable coverage details., • Confirm policy and accident state information, liability or policy limits when available, and payer billing or contact information needed to support patient care and billing., • Determine whether precertification or prior authorization is required for applicable services, including office visits, radiology, and other ordered treatment, and document the appropriate payer contact information., • Communicate with insurance carriers, adjusters, attorneys, and legal staff to clarify benefits, resolve missing information, and obtain required documentation., • Request and review supporting No-Fault documentation as applicable, including PIP ledgers, police reports, declaration pages, and relevant medical records., • Coordinate Letters of Protection (LOPs) when appropriate, including obtaining attorney confirmation, sending required requests, and ensuring completed documentation is added to the patient record., • Maintain complete verification documentation in the EHR, including insurance notes, verification forms, task notes, appointment-related information, and patient chart alerts or sticky notes as applicable., • Identify coverage discrepancies, exhausted benefits, missing documentation, or other barriers; escalate issues appropriately and follow HIPAA and established verification workflows. QUALIFICATIONS • High school diploma or equivalent required., • Previous experience with insurance verification, automobile claims, medical benefits, or a related healthcare administrative function preferred; comparable administrative experience may be considered., • Basic working knowledge of insurance eligibility, claim verification, authorization requirements, and healthcare documentation practices, with the ability to learn No-Fault / PIP workflows., • Strong attention to detail and ability to review insurance, medical, and legal documentation for accuracy and completeness., • Professional verbal and written communication skills and ability to manage assigned follow-up with adjusters, attorneys, patients, and internal staff., • Ability to organize multiple verification requests and outstanding items, • Basic computer skills and proficiency with Microsoft Office., • Experience with EHR systems, ModMed, or Microsoft Excel is a plus., • Ability to maintain confidentiality when handling patients, insurance, and claim information. CORE COMPETENCIES • Accuracy and attention to detail • Organization and follow-through • Customer service • Communication • Ability to follow procedures • Basic problem-solving • Confidentiality • Teamwork • Willingness to learn PHYSICAL DEMANDS AND WORK ENVIRONMENT The position is primarily performed in a professional medical office environment. Work requires prolonged periods of sitting and computer use, with occasional standing, walking, bending, reaching, and movement throughout the office. Frequent use of a computer keyboard, mouse, telephone, scanner, and other standard office equipment is required. The position requires the ability to review and process detailed insurance, claims, medical, and legal documentation, maintain confidentiality, and communicate effectively by telephone, email, and electronic systems. DOL / FLSA CLASSIFICATION AND JUSTIFICATION This position is classified as Non-Exempt because its primary responsibilities consist of routine insurance verification, data entry, documentation, follow-up, and administrative support performed according to established procedures and guidelines. The position does not independently exercise the level of discretion and judgment on matters of significance required for the FLSA administrative exemption. The position is therefore eligible for overtime in accordance with applicable federal and state laws. The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. PI8fb552148977-37820-41621531

JOB TITLE: No Fault / PIP Insurance Verification Specialist I EMPLOYER: Progressive Spine & Orthopaedics PAY RANGE: OPM Pay Grade 4 (Hourly) FSLA STATUS: Non-Exempt SUMMARY: The No-Fault / PIP Insurance Verification Specialist I is an entry-level position responsible for obtaining and documenting basic automobile insurance and PIP claim information prior to patient services. This position performs routine insurance verification tasks using established procedures and guidelines and assists with identifying missing or incomplete information. The Specialist I communicates with insurance carriers and adjusters to obtain basic claim and benefit information, documents findings in the electronic health record, and escalates complex issues to a senior team member or supervisor. The role supports accurate patient information, timely care, and billing processes while maintaining confidentiality and compliance with established workflows. ESSENTIAL DUTIES AND RESPONSIBILITIES • Verify active No-Fault / PIP claims, including claim number, date of accident, adjuster information, benefit status or exhaustion, covered body parts, and other applicable coverage details., • Confirm policy and accident state information, liability or policy limits when available, and payer billing or contact information needed to support patient care and billing., • Determine whether precertification or prior authorization is required for applicable services, including office visits, radiology, and other ordered treatment, and document the appropriate payer contact information., • Communicate with insurance carriers, adjusters, attorneys, and legal staff to clarify benefits, resolve missing information, and obtain required documentation., • Request and review supporting No-Fault documentation as applicable, including PIP ledgers, police reports, declaration pages, and relevant medical records., • Coordinate Letters of Protection (LOPs) when appropriate, including obtaining attorney confirmation, sending required requests, and ensuring completed documentation is added to the patient record., • Maintain complete verification documentation in the EHR, including insurance notes, verification forms, task notes, appointment-related information, and patient chart alerts or sticky notes as applicable., • Identify coverage discrepancies, exhausted benefits, missing documentation, or other barriers; escalate issues appropriately and follow HIPAA and established verification workflows. QUALIFICATIONS • High school diploma or equivalent required., • Previous experience with insurance verification, automobile claims, medical benefits, or a related healthcare administrative function preferred; comparable administrative experience may be considered., • Basic working knowledge of insurance eligibility, claim verification, authorization requirements, and healthcare documentation practices, with the ability to learn No-Fault / PIP workflows., • Strong attention to detail and ability to review insurance, medical, and legal documentation for accuracy and completeness., • Professional verbal and written communication skills and ability to manage assigned follow-up with adjusters, attorneys, patients, and internal staff., • Ability to organize multiple verification requests and outstanding items, • Basic computer skills and proficiency with Microsoft Office., • Experience with EHR systems, ModMed, or Microsoft Excel is a plus., • Ability to maintain confidentiality when handling patients, insurance, and claim information. CORE COMPETENCIES • Accuracy and attention to detail • Organization and follow-through • Customer service • Communication • Ability to follow procedures • Basic problem-solving • Confidentiality • Teamwork • Willingness to learn PHYSICAL DEMANDS AND WORK ENVIRONMENT The position is primarily performed in a professional medical office environment. Work requires prolonged periods of sitting and computer use, with occasional standing, walking, bending, reaching, and movement throughout the office. Frequent use of a computer keyboard, mouse, telephone, scanner, and other standard office equipment is required. The position requires the ability to review and process detailed insurance, claims, medical, and legal documentation, maintain confidentiality, and communicate effectively by telephone, email, and electronic systems. DOL / FLSA CLASSIFICATION AND JUSTIFICATION This position is classified as Non-Exempt because its primary responsibilities consist of routine insurance verification, data entry, documentation, follow-up, and administrative support performed according to established procedures and guidelines. The position does not independently exercise the level of discretion and judgment on matters of significance required for the FLSA administrative exemption. The position is therefore eligible for overtime in accordance with applicable federal and state laws. The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. PIde86ee57b45a-26276-41621531

Job Description Company Info: Daniel J. Hannon & Associates, Inc. (DJH) is a Long Island-based insurance claims adjusting/investigating firm which works on behalf of insurance companies, TPAs, law firms and municipalities primarily in the NYC tri-state area, as well as throughout the United States. Job Description: DJH has an immediate need for per diem claims investigators in the Northern Westchester area to conduct field claims adjusting and investigation-related activities in Westchester, Rockland, and Orange counties. Requirements: • Minimum of 2 years claims investigation experience strongly preferred, • Bilingual (with Spanish as second language) is a huge plus, • Valid driver's license and well-maintained personal vehicle, • Strong computer skills, • Candidate must possess strong interpersonal skills and be able to take signed and/or recorded statements, complete detailed scene inspections with photos and measurements, locate/interview witnesses, etc., • Strong writing skills, • Meet time sensitive deadlines and work a flexible schedule, • Self-motivated with the ability to work independently Salary: • Provided starting salary range is negotiable based on relevant experience, • Salary reviewed after 6 months and periodically thereafter, • Bonus eligible\nCompany Description Daniel J. Hannon & Associates, Inc. (www.djhannon.com) is a fully licensed, bonded and insured claims adjusting and investigation firm with locations in Rockville Centre and Buffalo, New York, Haddonfield, New Jersey and Louisville, Kentucky. We specialize in claims investigation, surveillance, trial preparation and social media/background investigations. We perform these services for select insurance, legal and corporate clients. These services provide our clients with cost saving results on a consistent and timely basis. Our standard of excellence is accomplished by maintaining an exclusive and dedicated supervisory and field staff, comprised of former law enforcement agency personnel, experienced surveillance operatives and claims investigators, an attorney, and former insurance company claims managers. Our supervisors and field investigators have an average of over 15 years experience and have undergone formal multi-line adjuster training. Additionally, our contacts at every level of law enforcement are unsurpassed. Daniel J. Hannon & Associates, Inc. (www.djhannon.com) is a fully licensed, bonded and insured claims adjusting and investigation firm with locations in Rockville Centre and Buffalo, New York, Haddonfield, New Jersey and Louisville, Kentucky.\r\n\r\nWe specialize in claims investigation, surveillance, trial preparation and social media/background investigations. We perform these services for select insurance, legal and corporate clients. These services provide our clients with cost saving results on a consistent and timely basis.\r\n\r\nOur standard of excellence is accomplished by maintaining an exclusive and dedicated supervisory and field staff, comprised of former law enforcement agency personnel, experienced surveillance operatives and claims investigators, an attorney, and former insurance company claims managers. Our supervisors and field investigators have an average of over 15 years experience and have undergone formal multi-line adjuster training. Additionally, our contacts at every level of law enforcement are unsurpassed.

Our client, a well-established Third-Party Administrator (TPA), is seeking an experienced.Senior California Workers’ Compensation Claims Adjuster.California workers’ compensation claims.This role is fully remote and ideal for a seasoned professional who can independently handle complex claims wh

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility?. Position Summary Arch Insurance Group Inc., AIGI, has an opening with our Claims Division on the Professional Liability Team with a focus on Lawyers Professional Liability. In this role, the responsibilities include actively managing Professional Liability claims in jurisdictions throughout the United States. Responsibilities • Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposure, • Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care, • Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis, • Maintain contact with the business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary, • Investigate claim and review the insureds' materials, pleadings, and other relevant documents, • Identify and review each jurisdiction's applicable statutes, rules, and case law, • Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues, • Retain counsel when necessary and direct counsel in accordance with resolution strategy, • Analyze coverage, liability and damages for purposes of assessing and recommending reserves, • Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves, • Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills • Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines, • Strong time management and organizational skills, • Demonstrate the ability to take part in active strategic discussions, • Demonstrate the ability to work well independently and in a team environment, • Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word, • Willing and able to travel 15% Education • Bachelor's degree; Juris Doctorate degree required, • Three to seven (3-7) years of working experience with a primary and or excess carrier, broker, or law firm supporting commercial accounts for specialty insurance claims, • Proper & active adjuster licensing in all applicable states For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $111,100 - $172,465/year • Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future., • Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more.

Licensed adjusters and career-entry applicants are welcome. No prior insurance adjusting experience is required for career-entry applicants. Are you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both: experienced licensed adjusters seeking roster opportunities and individuals interested in entering the insurance adjusting industry through licensing and professional training. For experienced adjusters: Already licensed with claims experience? Experienced adjusters who meet our roster requirements may qualify for roster consideration for future deployment opportunities. For new applicants: New to the industry? Independent adjusting is a certification-based career field that often requires: state licensing, Xactimate estimating knowledge, property claims training, and real-world claims workflow understanding. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry. What we offer: • Adjuster licensing assistance, • Xactimate training, • Property inspection & scoping training, • Claims-writing workflow training, • Online and in-person training options, • Resume guidance, • Access to industry staffing firm contacts and resources Why people choose MileHigh Adjusters Houston: • Over 500 five-star Google reviews, • Over 1,750 students trained since 2020, • Hands-on, real-world training approach, • Flexible online and in-person programs Important: Requirements for roster consideration vary based on experience, licensing status, certifications, and client needs. Individuals new to the industry may require additional licensing and/or training before qualifying for certain opportunities. If you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. Contact: 281-741-8505 info@milehighadjustershouston.com

Are you interested in building a career as an independent insurance claims adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both experienced licensed

Are you interested in building a career as an independent insurance claims adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. For experienced adjusters: already licensed with claims experien

Sompo has a unique opportunity for a Senior Technical Specialist, General Liability on our Casualty Claims team. As a Senior Technical Specialist, you will provide insight and analysis on a variety of General Liability Primary Casualty claims, as well as act as a liaison between underwriting, claims, and our Third-Party Administrators. Location: This position can be based out of our New York, NY, Garden City, NY, Purchase, NY, Morristown, NJ, Miami, FL, Charlotte, NC, Alpharetta, GA or Conshohocken, PA office. We strive for collaboration which is why we offer a work environment where our employees thrive and develop long lasting careers. Our business, your impact, our opportunity: What you'll be doing: • Handle Sompo Casualty claims (primary and/or excess) and related systems and processes, • Provide technical oversight and guidance to TPA claim handlers and supervisors, • Adherence to client-specific claim handling guidelines, providing coverage and analytical analysis of potential exposures, • Manage counsel where assigned; develop and execute strategy to control expenses and resolve litigated claims, • Establish appropriate reserves; Analyze loss and expense trends on a portfolio of claims and assist in the development and implementation of plans to improve results, • Ensure that all claim information is reviewed and accurately and timely recorded; proactively manage correspondence and claim files and maintain a current diary in compliance with company standards, • Effectively represent the company's interests in meetings and negotiations; maintain a high level of claim and industry related expertise in order to assure technical competency and communicate to team members regarding significant issues and relevant changes, • Support underwriters and actuaries during the renewal process, communicating with and supporting underwriting and other functional groups within the organization What you'll bring: • Minimum 5 plus years' experience required in general liability claims handling with a career history of increasing responsibility with at least 3-5+ years handling excess claims, including large limit and high exposure claims, • Bachelor's degree required, with a JD preferred; Strong preference for candidate who has pursued or is in the process of pursuing an insurance related designation (e.g. RPLU, CPCU IIA, AMIM); Multiple state adjuster license a plus. Successful candidate may be required to obtain licenses or additional state licenses, • Direct handling of a wide variety of general liability exposure claims with an emphasis on evaluating, handling, negotiating and settling litigated and non-litigated matters with typical exposure up to $2M USD, • Demonstrated ability to establish close working relationship with other departments including underwriting & actuarial, • Strong negotiating, analytical, written and organizational skills, • Effective communication with a wide spectrum of people both internally and externally, • Advanced relationship management skills with internal staff and external partners are required, • Strong computer skills (MS Word, Excel, Outlook and various in-house claims systems Guidewire, Genius, ImageRight is a plus), • Multiple state adjuster licenses a plus. Successful candidate may be required to obtain licenses or additional state licenses Salary Range: $115,000 $130,000 Actual compensation for this role will depend on several factors including the cost of living associated with your work location, your qualifications, skills, competencies, and relevant experience. At Sompo, we recognize that the talent, skills, and commitment of our employees drive our success. This is why we offer competitive, high-quality compensation and benefit programs to eligible employees. Our compensation program is built on a foundation that promotes a pay-for-performance culture, resulting in higher incentive awards, on average, when the Company does well and lower incentive awards when the Company underperforms. The total compensation opportunity for all regular, full-time employees is a combination of base salary and incentives that gets adjusted upfront based on overall Company performance with final awards based on individual performance. We continuously evaluate and update our benefit programs to ensure that our plans remain competitive and meet the needs of our employees and their dependents. Below is a summary of our current comprehensive U.S. benefit programs: • Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution, • Pharmacy benefits with mail order options, • Dental benefits including orthodontia benefits for adults and children, • Vision benefits, • Health Care & Dependent Care Flexible Spending Accounts, • Company-paid Life & AD&D benefits, including the option to purchase Supplemental life coverage for employee, spouse & children, • Company-paid Disability benefits with very competitive salary continuation payments, • 401(k) Retirement Savings Plan with competitive employer contributions, • Competitive paid-time-off programs, including company-paid holidays, • Competitive Parental Leave Benefits & Adoption Assistance program, • Employee Assistance Program, • Tax-Free Commuter Benefit, • Tuition Reimbursement & Professional Qualification benefits Who we are and what we stand for : At Sompo, our shared purpose is to create meaningful value for clients, communities, and each other. We strive to foster a workplace where everyone feels respected, included, and empowered to excel. As a global organization, we embrace diversity and champion equal opportunity. Guided by our core valuesAccountability, Agility, Collaboration, Development, and Integritywe build trust and support one another to achieve our goals worldwide. Life at Sompo Our values come to life in how we hire and grow talent. Employment decisions are based on qualifications, merit, and organizational need, and we strive to ensure equitable access to opportunities so everyone can do their best work. If you need an accommodation for any part of the application process, please contact the recruiter in charge.

Claims adjuster license (NY, CT). We are seeking a qualified Liability Claims Adjuster to join our team. The Liability Claim Adjuster will investigate insurance claims, examine evidence, and prepare reports.

Are you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both: experienced licensed

Are you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both: experienced licensed

Are you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both: experienced licensed

Are you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both: experienced licensed

Are you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both: experienced licensed

MileHigh Adjusters Houston works with both: Experienced licensed adjusters seeking roster opportunities AND Individuals interested in entering the insurance adjusting industry through licensing and professional training. Are you interested in building a career as an Independent Insurance Claims Adju

Are you interested in building a career as an independent insurance claims adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both: experienced licensed

Are you interested in building a career as an independent insurance claims adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters continue to be in demand. MileHigh Adjusters Houston works with both: experienced licensed