This role will sit remote. The ideal candidate will have a proven commercial litigated claim ... Report on and present large losses during file conferences and claim reviews. * Serve as subject ...
This role will sit remote. The ideal candidate will have a proven commercial litigated claim ... Report on and present large losses during file conferences and claim reviews. * Serve as subject ...
This role will sit remote. The ideal candidate will have a proven commercial litigated claim ... Report on and present large losses during file conferences and claim reviews. * Serve as subject ...
This role will sit remote. The ideal candidate will have a proven commercial litigated claim ... Report on and present large losses during file conferences and claim reviews. * Serve as subject ...
WC Claims Resolution Specialist - Special Risk Policyholders (REMOTE)
Indianapolis, IN · Remote
$22.25 - $30.50/hr
Investigate losses, determine coverage, assess compensability, and review and analyze documents and ... Develop and execute proactive claim resolution strategies, including timely damage evaluations ...
WC Claims Resolution Specialist - Special Risk Policyholders (REMOTE)
Indianapolis, IN · Remote
$22.25 - $30.50/hr
Investigate losses, determine coverage, assess compensability, and review and analyze documents and ... Develop and execute proactive claim resolution strategies, including timely damage evaluations ...
WC Claims Resolution Specialist - Special Risk Policyholders (REMOTE)
Indianapolis, IN · Remote
$22.25 - $30.50/hr
Investigate losses, determine coverage, assess compensability, and review and analyze documents and ... Develop and execute proactive claim resolution strategies, including timely damage evaluations ...
WC Claims Resolution Specialist - Special Risk Policyholders (REMOTE)
Indianapolis, IN · Remote
$22.25 - $30.50/hr
Investigate losses, determine coverage, assess compensability, and review and analyze documents and ... Develop and execute proactive claim resolution strategies, including timely damage evaluations ...
$89K - $105K/yr
This is a remote role open to any location in continental US Manulife is a leading international ... May process all aspects of auditing, formal appeal reviews and contestable claim review. * Audit ...
$89K - $105K/yr
This is a remote role open to any location in continental US Manulife is a leading international ... May process all aspects of auditing, formal appeal reviews and contestable claim review. * Audit ...
Hospital Billing Coordinator
Indianapolis, IN · Remote
$50K - $60K/yr
This is a primarily remote role supporting enterprise Epic implementation, with minimal travel and ... claim accuracy, reduce denials, and help clients optimize revenue cycle performance. * Review ...
Hospital Billing Coordinator
Indianapolis, IN · Remote
$50K - $60K/yr
This is a primarily remote role supporting enterprise Epic implementation, with minimal travel and ... claim accuracy, reduce denials, and help clients optimize revenue cycle performance. * Review ...
Hospital Billing Analyst
Indianapolis, IN · Remote
$45K - $61K/yr
This is a primarily remote role supporting an enterprise Epic implementation, with minimal travel ... claim accuracy, reduce denials, and help clients optimize revenue cycle performance. * Review ...
Hospital Billing Analyst
Indianapolis, IN · Remote
$45K - $61K/yr
This is a primarily remote role supporting an enterprise Epic implementation, with minimal travel ... claim accuracy, reduce denials, and help clients optimize revenue cycle performance. * Review ...
Default FHA Claims QA Analyst II
Westfield, IN · Remote
$24.50 - $26/hr
... remote from home! The Default FHA Claims QA Analyst II will work under moderate supervision, responsible for reviewing FHA mortgage insurance claims for accuracy and submitting the claim form for ...
Default FHA Claims QA Analyst II
Westfield, IN · Remote
$24.50 - $26/hr
... remote from home! The Default FHA Claims QA Analyst II will work under moderate supervision, responsible for reviewing FHA mortgage insurance claims for accuracy and submitting the claim form for ...
Senior Workers' Compensation Claims Adjuster (Remote)
Indianapolis, IN · Remote
$63K - $81K/yr
Establish and maintain proper reserves for each claim to accurately reflect the financial exposure ... Review and interpret commercial insurance policies and accordingly communicate coverage issues ...
Senior Workers' Compensation Claims Adjuster (Remote)
Indianapolis, IN · Remote
$63K - $81K/yr
Establish and maintain proper reserves for each claim to accurately reflect the financial exposure ... Review and interpret commercial insurance policies and accordingly communicate coverage issues ...
Senior Workers' Compensation Claims Adjuster (Remote)
Indianapolis, IN · Remote
$63K - $81K/yr
Establish and maintain proper reserves for each claim to accurately reflect the financial exposure ... Review and interpret commercial insurance policies and accordingly communicate coverage issues ...
Senior Workers' Compensation Claims Adjuster (Remote)
Indianapolis, IN · Remote
$63K - $81K/yr
Establish and maintain proper reserves for each claim to accurately reflect the financial exposure ... Review and interpret commercial insurance policies and accordingly communicate coverage issues ...
Claims Associate - Individual Life
Indianapolis, IN · On-site +1
$21.63 - $36.06/hr
Reviewing and processing Individual Life Claims * Clearing outstanding accounting * Clearing up ... Level II Associates may work with escalating claim issues with minimal leadership consultation ...
Claims Associate - Individual Life
Indianapolis, IN · On-site +1
$21.63 - $36.06/hr
Reviewing and processing Individual Life Claims * Clearing outstanding accounting * Clearing up ... Level II Associates may work with escalating claim issues with minimal leadership consultation ...
Claims Associate - Individual Life
Indianapolis, IN · On-site +1
$21.63 - $36.06/hr
Reviewing and processing Individual Life Claims * Clearing outstanding accounting * Clearing up ... Level II Associates may work with escalating claim issues with minimal leadership consultation ...
Quick apply
Claims Associate - Individual Life
Indianapolis, IN · On-site +1
$21.63 - $36.06/hr
Reviewing and processing Individual Life Claims * Clearing outstanding accounting * Clearing up ... Level II Associates may work with escalating claim issues with minimal leadership consultation ...
Account Resolution Associate
Indianapolis, IN · Remote
$45K - $61K/yr
Review, prepare and contact third party payors in a timely manner to determine claim status for ... Self-starter with ability to work independently in remote settings; prior remote experience ...
Account Resolution Associate
Indianapolis, IN · Remote
$45K - $61K/yr
Review, prepare and contact third party payors in a timely manner to determine claim status for ... Self-starter with ability to work independently in remote settings; prior remote experience ...
Also act as a clinical resource for field claim partners. This is a remote position however, you ... Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer ...
Also act as a clinical resource for field claim partners. This is a remote position however, you ... Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer ...
Medical & Disability Nurse Case Manager
Indianapolis, IN · Remote
$67K - $126K/yr
Also act as a clinical resource for field claim partners. This is a remote position however, you ... Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer ...
Medical & Disability Nurse Case Manager
Indianapolis, IN · Remote
$67K - $126K/yr
Also act as a clinical resource for field claim partners. This is a remote position however, you ... Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer ...
Patient Billing Representative
Indianapolis, IN · On-site +1
$14/hr
This is a remote position for those that reside in = AL, GA, ID, IA, IN, KS, LA, MI, MS, NV, NC, ND ... Interpret and clearly explain claim notes, balances, and billing outcomes to patients. * Verify ...
Patient Billing Representative
Indianapolis, IN · On-site +1
$14/hr
This is a remote position for those that reside in = AL, GA, ID, IA, IN, KS, LA, MI, MS, NV, NC, ND ... Interpret and clearly explain claim notes, balances, and billing outcomes to patients. * Verify ...
Patient Billing Representative
Indianapolis, IN · Remote
$14/hr
This is a remote position for those that reside in = AL, GA, ID, IA, IN, KS, LA, MI, MS, NV, NC, ND ... Interpret and clearly explain claim notes, balances, and billing outcomes to patients. * Verify ...
Patient Billing Representative
Indianapolis, IN · Remote
$14/hr
This is a remote position for those that reside in = AL, GA, ID, IA, IN, KS, LA, MI, MS, NV, NC, ND ... Interpret and clearly explain claim notes, balances, and billing outcomes to patients. * Verify ...
Global Quality Assurance Specialist
Indianapolis, IN · On-site +1
Remote and Hybrid schedules available * Schedule: Mon-Fri between the hours of 0800 - 2000 ... cancellation claim appeals; reviews and responds to appeals on previously adjudicated claims ...
Global Quality Assurance Specialist
Indianapolis, IN · On-site +1
Remote and Hybrid schedules available * Schedule: Mon-Fri between the hours of 0800 - 2000 ... cancellation claim appeals; reviews and responds to appeals on previously adjudicated claims ...
Property Adjuster II
New Castle, IN · On-site +1
$63K - $100K/yr
Remote Salary Range: $63,130.00 - $100,843.00 * salary range is for this level and may vary based ... reserves, reviews reports and related materials, directs experts, determines coverage and claim ...
Property Adjuster II
New Castle, IN · On-site +1
$63K - $100K/yr
Remote Salary Range: $63,130.00 - $100,843.00 * salary range is for this level and may vary based ... reserves, reviews reports and related materials, directs experts, determines coverage and claim ...
REMOTE Foreclosure Specialist Team Lead (7:00 A.M or 7:30 A.M to 4:00 P.M PST)
Westfield, IN · On-site +1
$28 - $33/hr
Review and process quality control reports, identify areas for continuous improvement. * Monitor ... Monitor foreclosure sales, third-party funds, deed issuance, and transitions to REO or claim filing ...
REMOTE Foreclosure Specialist Team Lead (7:00 A.M or 7:30 A.M to 4:00 P.M PST)
Westfield, IN · On-site +1
$28 - $33/hr
Review and process quality control reports, identify areas for continuous improvement. * Monitor ... Monitor foreclosure sales, third-party funds, deed issuance, and transitions to REO or claim filing ...
Remote Claim Reviewer information
What is the difference between Remote Claim Reviewer vs Remote Claims Processor?
| Aspect | Remote Claim Reviewer | Remote Claims Processor |
|---|---|---|
| Required Credentials | High school diploma or equivalent; insurance knowledge often preferred | High school diploma or equivalent; basic insurance or data entry skills |
| Work Environment | Home-based, independent review setting | Home-based, processing claims and data entry |
| Industry Usage | Insurance companies, third-party administrators | Insurance companies, healthcare providers |
| Common Search Intent | Comparing roles involving claim review and evaluation | Roles focused on processing and data entry of claims |
The main difference is that Remote Claim Reviewers evaluate and assess insurance claims for accuracy and validity, often requiring insurance knowledge. Remote Claims Processors handle the entry and processing of claims, focusing on data entry and administrative tasks. Both roles are remote and industry-specific but differ in responsibilities and skill requirements.
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Senior Complex Claims Specialist (REMOTE)
Amerisure Mutual Insurance CompanyIndianapolis, IN • On-site, Remote
Full-time
Medical, Retirement, PTO
Posted 19 days ago
Job description
Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure's promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best "A" (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus.
Amerisure is currently recruiting for a Senior Complex Claims Specialist. This role will sit remote. The ideal candidate will have a proven commercial litigated claim background and also possess the following skill set.
Summary Statement
Manage a portfolio of claims presenting moderate to high complexity and exposure to ensure Industry Leading Customer Experience through exceptional service, unmatched relationships and superior claims outcomes. Contribute to the achievement of Claims department goals, established to achieve the company's strategic objectives.
Essential Tasks/Major Duties
- Build and maintain strong relationships with agents and policyholders through being inclusive, communicative, accessible, and maintaining relevant, insightful, and informative file documentation.
- Directly handle an assigned portfolio of litigated and non-litigated commercial general and auto liability claims presenting moderate to high complexity and exposure across multiple jurisdictions.
- Conduct relevant, creative, and comprehensive investigation and evaluation on coverage, liability, and damages throughout the life of the claim by analyzing material facts, circumstances, and developments applying applicable law and legal principles.
- Positively influence claims outcomes through developing, continuously adjusting, and executing on action plans designed to achieve desired resolutions.
- Identify and pursue early resolution when appropriate.
- Identify and evaluate risk transfer.
- Proactively establish and adjust loss reserves throughout the life of the claim based on newly identified and material information and developments in order to reflect probable ultimate exposure.
- Report on and present large losses during file conferences and claim reviews.
- Serve as subject matter expert to less experienced staff.
- Participate in mediations and settlement conferences and attend trials.
- Negotiate settlements.
- Maintain current knowledge of multijurisdictional legal and regulatory claims developments and trends.
- Engage in/external resources as needed to achieve optimal claims outcomes while monitoring and mitigating costs.
- Adjudicate claims in accordance with Amerisure claims guidelines and quality standards.
Knowledge, Skills & Abilities
- Bachelor's degree or equivalent work-related experience.
- 10 years of commercial claims experience, including 5 years with moderate to high complexity and exposure commercial general and auto liability claims (including trucking liability), and 3 years handling litigated files and directing outside defense counsel.
- Extensive knowledge of current tort, contract, and coverage laws in multiple jurisdictions.
- Experience in FL, GA, IL, SC, and TX, with a proven ability to handle claims in new or less familiar jurisdictions.
- Ability to identify potential for aggravated liability and create resolution strategies to mitigate exposure.
- Ability to lead discussions, make presentations, and communicate technical results to a non-technical audience.
- Excellent organizational skills and ability to function in a changing environment.
- Willingness to take on new assignments as required.
- Ability to think strategically with supporting analytical and problem-solving skills, including the ability to deal with ambiguity.
- Demonstrated successful ability to build positive relationships and partnerships within the department, across the organization, and with external customers.
- Industry accreditation preferred.
- Ability to obtain appropriate state licensing as required.
- Ability to travel overnight up to 20%
Just as we are committed to creating exceptional value for our Partners For Success agencies and policyholders, Amerisure also remains committed to being an employer of choice. We reinforce this commitment by adhering to an Employee Value Proposition that, in part, is provided through a competitive total rewards package. This package includes competitive base pay, performance-based incentive pay, comprehensive health and welfare benefits, a 401(k) savings plan with profit sharing, and generous paid time off programs. We also offer flexible work arrangements to promote work-life balance. Recognized as one of the Best and Brightest Companies to Work For in the Nation and one of Business Insurance magazine's Best Places to Work in Insurance, we provide a workplace that fosters excellence and professional growth. If you are looking for a collaborative and rewarding career, Amerisure is looking for you.
Amerisure Mutual Insurance Company is an Equal Employment Opportunity employer. Amerisure provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (to include sexual orientation and gender identity), national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable federal, state, or local laws. Amerisure complies with all applicable laws governing nondiscrimination in employment in all locations where the company operates. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Amerisure prohibits harassment or discrimination of any kind and is committed to maintaining a workplace free from unlawful harassment or discrimination. Amerisure prohibits retaliation against anyone who reports discrimination, participates in an investigation, or opposes unlawful practices. Any improper interference with an employee's ability to perform their job duties may result in disciplinary action, up to and including termination.
About Amerisure
Sourced by ZipRecruiter
Industry
Insurance services
Company size
501 - 1,000 Employees
Headquarters location
Farmington, MI, US
Year founded
1912