53 apd claim representative ii jobs found

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   ***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. *** APD Claim Representative II (Michigan) – The Auto Club Group Reports to: APD Claim Manager I What you will do: (Primary Duties & Responsibilities) The Auto Club Group is seeking an Auto Claim Representative II who works under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units.  Resolve coverage questions, take statements...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   This catastrophe field claims specialist will cover territories in Detroit Michigan, Chicago Illinois, or Minneapolis Minnesota. Eligible candidates must live within commutable areas of these locations for consideration. Catastrophe Field Claims Specialist - The AAA Auto-Club Group Reports to: Claim Manager as appropriate                                     What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system....

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer Collects data and analyzes information to make decisions regarding certification or denial of treatment Documents all work in the appropriate manner Promotes utilization review services with stakeholders Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP) Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have thorough knowledge of both CPT and ICD coding...

ABOUT HUB: In a rapidly changing world, HUB advises businesses and individuals on how to prepare for the unexpected. As one of the worlds' largest insurance brokers, our focus is dedicated to providing our customers with the peace of mind that what matters most will be protected-through unrelenting advocacy and tailored insurance solutions that put our clients in control. Our growing team of professionals across North America represents a broad, deep and one-of -a kind aggregation of entrepreneurs and leaders recognized for their excellence throughout the insurance community. THE OPPORTUNITY: The Personal Lines Account Manager II provides critical support to clients, manages a book of insurance business of $225,000+ in revenue by acting with a high degree of independent discretion, autonomy, and decision-making. The Account Manager II facilitates positive and effective relationships sales and/or account team colleagues. DUTIES & RESPONSIBILITIES: May work...

ABOUT HUB: In a rapidly changing world, HUB advises businesses and individuals on how to prepare for the unexpected. As one of the worlds' largest insurance brokers, our focus is dedicated to providing our customers with the peace of mind that what matters most will be protected-through unrelenting advocacy and tailored insurance solutions that put our clients in control. Our growing team of professionals across North America represents a broad, deep and one-of -a kind aggregation of entrepreneurs and leaders recognized for their excellence throughout the insurance community. THE OPPORTUNITY: The Account Manager II manages a book of insurance business, and provides professional, courteous service to clients, carrier representatives, underwriters, business partners, and HUB colleagues; manages complex risk and exposures and acts with a high degree of independent discretion, autonomy, and decision-making. The Account Manager II also supports Producers and other support...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager I What you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss. Ensure all possible policyholder benefits are identified,...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   ***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. *** Claim Specialist – Bodily Injury – The Auto Club Group Reports to: Casualty Claim Manager II What you will do: (Primary Duties & Responsibilities) ACG is seeking a prospective Claim Specialist to work under minimal supervision.  In this position, you will: Handle highly complex new and reassigned auto and homeowner bodily injury liability claims. Adhere to ACG claim handling procedures, processes and guidelines. Complete...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   This field claims specialist will cover territories in the Bloomington, Champaign, and Peoria, Illinois area. Eligible candidates must live within a commutable distance to these locations and have a valid state driver's license for consideration. Bloomington Illinois Field Claim Specialist - The AAA Auto-Club Group Reports to: Claim Manager as appropriate                                     What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   ***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. *** Claim Specialist – Bodily Injury – The Auto Club Group Reports to: Casualty Claim Manager II What you will do: (Primary Duties & Responsibilities) ACG is seeking a prospective Claim Specialist to work under minimal supervision.  In this position, you will: Handle highly complex new and reassigned auto and homeowner bodily injury liability claims. Adhere to ACG claim handling procedures, processes and guidelines. Complete...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Eligible candidates for this position must reside within the state of Michigan for consideration. Fremont Michigan Property Desk Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system. Complete coverage analysis including a review of policy...

The Qualified Rehabilitation Consultant (QRC)/Vocational Case Manager provides vocational rehabilitation services and medical case management to individuals following a work place injury through coordination with client, insurer, physician, employer, attorney and others with the ultimate goal being the client’s timely return to gainful employment. The Vocational Case Manager interviews and evaluates the client to determine the degree of disability, eligibility and feasibility of vocational rehabilitation services. This position determines suitable job goals consistent with the clients’ interests, aptitudes and physical limitations; supporting the goals of the Case Management department, and of CorVel. Candidates with case management experience or vocational rehabilitation background encouraged to apply This is a Minnesota Field Case Management position. Only MN candidates will be considered. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Schedule and carry out appointments...

The Subrogation Representative is responsible for analyzing and conducting investigation of all assigned files for recovery and resolution of subrogation claims utilizing effective negotiation skills of liability and damage disputes.  Hours: Monday to Friday 8:15AM- 4:30PM (Hours can vary depending on start time). This position requires you to work out of our West Trenton, NJ office . This role is hybrid working 3 days in office and 2 days from home once training is completed. Salary: The level and salary is commensurate with direct experience and credentials.  Level I - $51,120 - $59,331 annually based on experience  Level II - $58,737 - $74,031 annually based on experience Essential Duties and Responsibilities: Receive and process subrogation claims, seeking recoveries from adverse parties and/or their insurance carriers. Thoroughly review, evaluate and investigate subrogation claims to obtain necessary information for prompt resolution. Negotiate...

Description Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers an exciting opening for a Senior Workers Compensation Claims Specialist within the West Region!   The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads.   Depending on your overall skills and experience, you may be considered as a Senior Claims...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Eligible candidates must reside within the state of Michigan for consideration. Fremont Michigan Property Desk Claims Specialist- AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create additional sub-claims if needed.  Complete an investigation of the...

SUMMARY:   The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision. Primarily responsible for the investigation and management of workers’ compensation claims. Conducts one point contact on the managed claims, determines compensability of claims, manages the medical treatment program, and confirms the claimant’s disability will not exceed waiting period timelines.  This includes calling and discussing potential claim activity and work-related injuries with policyholders, and claimants, providers, attorneys, agents, and state agencies, when necessary.   ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Investigates workers’ compensation claims including a mandatory contact to the employer within the required time frame with additional contacts to the employee or provider, as necessary.   Inform medical providers of billing address and billing...

Our General Claims department in Hammonton, NJ is looking for a Property Damage Representative candidate who has excellent communication skills as well as strong organizational and time management skills.  We are looking for talent with and without prior experience in the insurance industry. Hours: Monday through Friday, 8:45 a.m. to 5:00 p.m. with work from home opportunities after training is complete. Salary: The level and salary is commensurate with direct experience and credentials.  Level I - $51,120.55 - $67,542.80 annually based on experience  Level II - $58,737.25 - $89,324.95 annually based on experience  Sr. Level - $77,698.40 - $102,805.30 annually based on experience Responsibilities Appropriately handle, settle and close property damage (automobile) claims by bringing a prompt and amicable resolution Verify coverage, open claims, contact parties involved Verify and investigate information presented by first and third party claimants...

New Jersey Manufacturers Insurance Company (NJM) was founded in 1913 by a group of manufacturers seeking to provide cost-effective, safety conscious and financially secure workers' compensation insurance for their workers. From inception the Company has operated as a mutual, with a focus on the needs of its policyholders. Today, NJM Insurance Group, is a leading mid-sized U.S. property and casualty insurance company with 90 consecutive years of A+ financial strength ratings by AM BEST. Due to exceptional employee experience, NJM has been included on the latest Forbes List of Best Employers in New Jersey for the fourth year in a row. The NJM reputation for being a top provider of outstanding customer service was reaffirmed by the most recent J.D. Power Auto Insurance Claims Survey. Over the last five years, the Company has focused on a strategic plan that calls for it to become a regional property & casualty insurer and has transitioned away from its affinity-based...

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of...

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of...

The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer Collects data and analyzes information to make decisions regarding certification or denial of treatment Documents all work in the appropriate manner Promotes utilization review services with stakeholders Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have thorough knowledge of both CPT and ICD coding Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers...