We are looking for a diligent and detail-oriented Medical Claims Analyst to join our team in Raleigh, North Carolina. In this long-term contract role, you will play a vital part in ensuring accurate processing and reconciliation of medical claims while supporting a collaborative team environment. If you thrive in a structured setting and have a strong background in medical billing and claims analysis, we encourage you to apply.<br><br>Responsibilities:<br>• Review and reconcile outstanding medical claims with precision and efficiency.<br>• Resubmit previously denied or rejected claims to ensure proper resolution.<br>• Accurately post payments into multiple systems, maintaining consistency and accuracy.<br>• Navigate payer portals to verify claim statuses and payment details.<br>• Perform repetitive clerical tasks with attention to detail and a focus on accuracy.<br>• Collaborate effectively with a team of professionals to meet organizational goals.<br>• Maintain punctuality and reliability to ensure smooth workflow within the team.<br>• Identify discrepancies in claims and resolve them promptly to prevent delays.<br>• Support behavioral health payment posting processes as required.
<p>We are looking for an experienced and meticulous Claims Adjuster to assist with our client with handling New York based Workers Compensation Claims. </p><p>This is a fully remote, temporary-to-permanent opportunity. </p><p>To be considered, candidates must possess a valid NY Adjusters License and have experience working workers compensation specific claims.</p><p>Responsibilities include:</p><ul><li>Conduct in-depth investigations and evaluations of complex workers' compensation claims, applying strong analytical skills to drive informed decision-making and achieve timely resolution.</li><li>Collaborate closely with clients to develop innovative strategies and continuously improve the claims management process.</li><li>Utilize critical thinking and problem-solving abilities to effectively plan, prioritize, and manage tasks that support both client and claimant needs.</li><li>Leverage claims management expertise to assess exposure, determine appropriate action plans, and drive timely and effective claim resolutions.</li><li>Maintain thorough and timely documentation of all claim activities, ensuring transparency and supporting claim outcomes.</li><li>New York Adjusters License is required.</li></ul><p><br></p><p><br></p>
<p>Robert Half is working with a great client on the North Shore seeking a Claims Adjuster to join its team. This is a permanent role, alongside an established team, responsible for visiting local claims sites for assessments, and will work in office a couple days per week as needed. Our client is looking for experience in the insurance industry, preferably property & casualty. Any experience with claims adjusting is preferred.</p><p><br></p><p>Salary is dependent on experience, but somewhere between $70-110K is the target. The benefits are competitive too.</p><p><br></p><p>If interested in and qualified for the Claims Adjuster role please message me ASAP or apply to this listing. Bill.Nichols@roberthalf. Thanks!</p>
<p><strong>Job Description</strong></p><p>We are seeking a skilled and dynamic Insurance focused <strong>Business Systems Analyst</strong> with proven experience in <strong>SQL</strong> and an in-depth understanding of the <strong>Property & Casualty </strong>industry to join our team. The successful candidate will play a key role in bridging the gap between business needs and technical solutions by utilizing analytical tools, industry knowledge, and effective communication skills. This is an excellent opportunity for a professional with technical expertise and insurance acumen to contribute meaningfully to innovative projects.</p><p><br></p><p><strong>Responsibilities</strong></p><ul><li>Collaborate with stakeholders to gather, understand, and document business requirements related to insurance processes and operations.</li><li>Analyze complex data sets using SQL to identify trends, opportunities, and bottlenecks in business processes.</li><li>Develop and implement data-driven solutions that enhance operational efficiency and support strategic decision-making in the insurance domain.</li><li>Create workflow diagrams, business process models, and functional specifications to optimize insurance-related products and services.</li><li>Maintain and update documentation such as business requirements, user stories, and technical specifications.</li><li>Partner with IT and software development teams to ensure solutions align with business goals and are scalable.</li><li>Test, validate, and support implementation of SQL-based solutions while troubleshooting and resolving issues as they arise.</li><li>Conduct in-depth analyses of insurance underwriting, claims, billing, and policy administration functions.</li><li>Monitor industry trends and regulatory changes in the insurance sector to ensure compliance and alignment with best practices.</li><li>Provide insights and recommendations on process improvements, automation opportunities, and system enhancements using data analytics.</li></ul><p><br></p>
<p>We are looking for a Licensed Insurance Claims Investigator/Adjuster to join our team on a contract basis in Dallas, Texas. In this role, you will leverage your expertise to assess and manage risks, analyze complex insurance claims, and provide strategic recommendations. This position offers an opportunity to contribute to the resolution of challenging cases while ensuring compliance with industry regulations. This is a 3-month contract position. 100% REMOTE.</p><p><br></p><p><strong><u>Licensed Insurance Claims Investigator/Adjuster (remote contract role):</u></strong></p><p>Responsibilities:</p><p>• Evaluate and manage diverse insurance claims, including general liability, construction liability, and third-party bodily injury cases.</p><p>• Conduct contractual analysis, interpret policy provisions, and draft comprehensive Reservation of Rights letters and coverage declinations.</p><p>• Analyze complex litigation claims related to auto, garagekeepers, employers liability, and liquor liability.</p><p>• Provide expert insights on state regulations and standard operating procedures to ensure compliance.</p><p>• Collaborate with stakeholders to identify risks and develop effective mitigation strategies.</p><p>• Apply critical thinking to assess data and make sound decisions based on established guidelines and policies.</p><p>• Obtain necessary insurance adjuster licenses within the required timeframe, including completing state-mandated tests.</p><p>• Stay updated on industry trends and engage in continuous development to enhance expertise.</p><p>• Utilize problem-solving skills to challenge the status quo and improve processes.</p><p>• Support the organization by ensuring accurate policy interpretation and adherence to risk management practices.</p>
<p>We are looking for a Licensed Insurance Claims Investigator/Adjuster to join our team on a remote contract basis. In this role, you will leverage your expertise to assess and manage risks, analyze complex insurance and/or litigation claims, and provide strategic recommendations. This position offers an opportunity to contribute to the resolution of challenging cases while ensuring compliance with industry regulations. This is a 3-month contract position. 100% REMOTE.</p><p><br></p><p><strong><u>Licensed Insurance Claims Investigator/Adjuster (remote contract role):</u></strong></p><p>Responsibilities:</p><p>• Evaluate and manage diverse insurance claims, including general liability, construction liability, and third-party bodily injury cases.</p><p>• Conduct contractual analysis, interpret policy provisions, and draft comprehensive Reservation of Rights letters and coverage declinations.</p><p>• Analyze complex litigation claims related to auto, garagekeepers, employers liability, and liquor liability.</p><p>• Provide expert insights on state regulations and standard operating procedures to ensure compliance.</p><p>• Collaborate with stakeholders to identify risks and develop effective mitigation strategies.</p><p>• Apply critical thinking to assess data and make sound decisions based on established guidelines and policies.</p><p>• Obtain necessary insurance adjuster licenses within the required timeframe, including completing state-mandated tests.</p><p>• Stay updated on industry trends and engage in continuous development to enhance expertise.</p><p>• Utilize problem-solving skills to challenge the status quo and improve processes.</p><p>• Support the organization by ensuring accurate policy interpretation and adherence to risk management practices.</p>
<p>We are seeking a detail-oriented and analytical professional to join our team as a <strong>Property Recoveries Analyst</strong>. In this role, you will serve as a key reviewer of billing and recovery processes, ensuring accuracy, compliance with lease terms, and adherence to contractual obligations. You will play a critical role in maintaining billing integrity, identifying variances, and supporting internal and external stakeholders with documentation and issue resolution.</p><p><br></p><p><strong>Key Responsibilities</strong></p><ul><li>Review recovery setups and billing deliverables for accuracy, completeness, and compliance with lease terms, system standards, and documentation protocols.</li><li>Partner with offshore teams by providing clear guidance on required modifications and interpreting lease language when needed.</li><li>Validate rebill corrections, ensuring supporting documentation is accurate and complete.</li><li>Maintain pursuit notes and CAM/Tax notes for audit and historical reference.</li><li>Perform month-over-month, quarter-over-quarter, and year-over-year recovery analyses, identifying material variances and overseeing resolution tracking.</li><li>Investigate recovery leakage at the site level, collaborating with cross-functional teams (Property Management, Insurance, and Tax) to identify root causes and develop corrective actions.</li><li>Leverage financial and operational data to provide insights that optimize recoveries and ensure compliance.</li><li>Contribute to documentation of standard operating procedures (SOPs) and process updates.</li><li>Partner with IT to identify and test system improvements that enhance efficiency and accuracy.</li><li>Mentor and train offshore team members on daily activities and best practices.</li><li>Respond to billing-related inquiries, providing documentation and clarification as needed.</li></ul><p><br></p>
We are looking for a dedicated Claims Adjuster to join our team in a fully remote capacity. This long-term contract role involves adjudicating claims efficiently and ensuring compliance with established processes while delivering exceptional service to pet owners. The ideal candidate will bring strong organizational skills, a customer-focused mindset, and a commitment to meeting performance targets.<br><br>Responsibilities:<br>• Review and process claims in accordance with established procedures and compliance standards.<br>• Ensure claims meet or exceed daily adjudication goals to maintain workflow efficiency.<br>• Provide guidance and oversight to non-licensed claims processors, ensuring accuracy and adherence to regulations.<br>• Obtain and maintain advanced adjuster licenses as required by state and local guidelines.<br>• Identify opportunities for process improvement and contribute to implementing effective solutions.<br>• Communicate effectively with pet owners to address inquiries and provide clarity on claims.<br>• Document claim decisions and maintain accurate records in compliance with organizational policies.<br>• Collaborate with cross-functional teams to ensure claims are resolved in a timely and efficient manner.<br>• Stay updated on industry regulations and best practices to ensure compliance.<br>• Utilize tools such as Microsoft Office Suite to support claims processing tasks.
<p>We are looking for a dedicated and detail-oriented Medical Insurance Verifier to join our team in Long Beach, California. The Medical Insurance Verifier role is integral to helping patients access healthcare services by assisting them with financial options and verifying their eligibility for Medi-Cal and other programs. The ideal candidate will have a strong background in medical billing, insurance verification, and financial counseling.</p><p><br></p><p>Responsibilities:</p><p>• Conduct financial screenings to determine patient eligibility for Medi-Cal, PPO, HMO and other healthcare programs.</p><p>• Guide patients through the application process for HMO, PPO, Medi-Cal, ensuring accuracy and timely submission of required documents.</p><p>• Explain available coverage options and assist patients in understanding their financial responsibilities.</p><p>• Verify insurance eligibility, financial status, and documentation to ensure services are appropriately covered.</p><p>• Collaborate with billing teams and other departments to ensure compliance with Medi-Cal regulations and accurate claims processing.</p><p>• Maintain comprehensive records of patient interactions and screenings in alignment with organizational standards.</p><p>• Stay informed about updates to HMO, PPO, Medi-Cal policies, eligibility criteria, and healthcare regulations.</p><p>• Support the organization’s operations by ensuring seamless patient access to financial assistance programs.</p><p>• Utilize electronic health record (EHR) systems to document and track patient information effectively.</p>
<p>A prominent Michigan-based organization in the insurance sector is looking for a dynamic <strong>Claims Director</strong>. This position is ideal for an experienced leader with expertise in claims management, litigation oversight, and operational strategy.</p><p><br></p><p><strong><u>*This is a remote position; however, candidates must currently reside in Michigan to be considered.*</u></strong></p><p><br></p><p><strong>Responsibilities: </strong></p><p>Responsible for overseeing all operations of the Assigned Claims Program and related organizational tasks. Serves as a member of the senior leadership team, providing strategic and day-to-day oversight of claims functions, litigation, servicing insurers, third-party administrators (TPAs), vendors, and staff. Manages multi-million-dollar budgets, ensures compliance with regulations, and supports the executive team with personnel, technology, and policy initiatives. This role involves managing litigation processes, supervising claims activities, and ensuring compliance with industry regulations and organizational standards. The ideal candidate will possess strong leadership skills, a deep understanding of insurance claims, and expertise in litigation management.</p><p><br></p><ul><li>Direct daily operations of the assigned claims unit, including staff management, workflow, and quality control.</li><li>Develop and manage program budgets, expenses, and financial reporting.</li><li>Oversee litigation strategy, appeal processes, and counsel/vendor partnerships.</li><li>Monitor servicing insurers and TPAs to ensure compliance, performance, and effective claims handling.</li><li>Lead committees, task forces, and organizational initiatives, including No-Fault Reform strategy.</li><li>Provide training, coaching, performance management, and employee engagement initiatives for staff.</li><li>Oversee technology and IT projects supporting claims operations.</li><li>Represent the organization in litigation, industry groups, and external committees as needed.</li><li>Ensure policies, procedures, and statutory requirements are up to date and enforced.</li><li>Review vendor contracts, legal billing, and claims documents to ensure accuracy and compliance.</li><li>Support the executive director and collaborate with leadership on organizational strategy and initiatives.</li></ul>
<p>Reputable personal injury firm is seeking an experienced and compassionate Case Manager to join their team. This position is ideal for someone with a strong background in personal injury law who thrives in a fast-paced environment and is committed to delivering exceptional client service. As a key member of our legal team, you will play a vital role in managing cases, communicating with clients, and supporting attorneys to ensure successful outcomes.</p><p><br></p><p>Responsibilities:</p><p>• Conduct initial interviews with prospective clients to gather relevant case information.</p><p>• Request, review, and organize medical records related to client cases.</p><p>• Maintain consistent communication with insurance companies, medical providers, and clients to provide updates and address inquiries.</p><p>• Draft and send correspondence letters to clients, insurance companies, and healthcare providers.</p><p>• Collaborate closely with attorneys to review case status and develop strategies.</p><p>• Perform investigative tasks related to claims and pre-litigation case work.</p><p>• Manage administrative duties such as faxing, filing, and copying to support case management.</p><p>• Oversee and prioritize a substantial caseload while ensuring accuracy and timeliness.</p><p>• Assist staff and team members with various tasks, ensuring seamless workflow and collaboration.</p><p>• Utilize software tools, including Microsoft Word and Excel, to maintain organized records and documentation.</p>
<p><strong>Firm seeks Coverage Opinion Writing Attorney (No Litigation)</strong></p><p><br></p><p>This Attorney opening involves working closely with insurers to provide expert advice and analysis on insurance coverage matters. The ideal attorney will have a deep understanding of various insurance policies and be adept at drafting comprehensive coverage opinions.</p><p><br></p><p>Key Responsibilities:</p><ul><li>Collaborate with insurers to provide advice on insurance coverage and interpret policies.</li><li>Analyze various types of insurance policies across an array of industries.</li><li>Draft detailed coverage opinions based on policy analysis and contract interpretation.</li><li>Maintain effective communication with clients and internal team members.</li></ul><p><br></p><p>Billable hour target: 1850/year</p><p><br></p><p>Can work 100% remote in US (PST work hours)</p><p><br></p><p><u>Perks of Firm</u>:</p><ol><li>Established for over 30 years</li><li>Multiple offices with large firm resources</li><li>Women-owned firm</li></ol><p><br></p>
We’re hiring Active Licensed Liability Claims Adjusters to support a high-impact project focused on auditing and resolving a backlog of complex claims. This fully remote, contract-to-hire role is ideal for a experienced professional with deep expertise in liability and multi-state licensing. Compensation is competitive and based on experience. <br> Responsibilities Include: Review and audit existing and incoming general liability claims for quality, accuracy, and compliance. Identify issues in claim files and recommend corrective actions. Handle complex claims involving construction liability, bodily injury, property damage, and litigation. Draft coverage letters, interpret policy language, and negotiate settlements. Collaborate with legal counsel and vendors to resolve high-exposure claims. Ensure adherence to state regulations and internal standards.
<p>We are looking for a dedicated Case Manager to join our team in Fairfield, California, supporting our mission in the non-profit sector. This is a Contract position where you will play a vital role in providing outreach, case management, and support services to individuals experiencing homelessness and their families. The ideal candidate will have exceptional organizational skills, a passion for helping others, and the ability to coordinate services that empower clients toward self-sufficiency.</p><p><br></p><p>Responsibilities:</p><p>• Coordinate the client intake process, including initial assessment and eligibility determination for all new referrals.</p><p>• Conduct outreach efforts in various locations to connect with individuals experiencing homelessness and provide necessary support.</p><p>• Manage a caseload of clients, offering intensive housing and vocational case management services.</p><p>• Collaborate with clients to design personalized service plans that align with their goals and needs.</p><p>• Work closely with Housing Specialists to foster relationships with landlords and support housing retention.</p><p>• Develop individual budgets and service plans for clients, ensuring resources are allocated effectively.</p><p>• Facilitate access to community services, including crisis intervention, health care, employment assistance, and substance abuse treatments.</p><p>• Conduct regular meetings with participants to address goals, financial planning, and education or employment opportunities.</p><p>• Maintain accurate and confidential case files, ensuring timely submission of required program reports.</p><p>• Drive to field locations and program sites to deliver services while adhering to agency vehicle policies.</p>
We are looking for a Claims Admin Support Specialist to join our team in Maitland, Florida. This role involves performing a variety of administrative and clerical tasks, ensuring office operations run smoothly under direct supervision. As this is a long-term contract position, it offers stability and an opportunity to contribute to a dynamic work environment.<br><br>Responsibilities:<br>• Maintain and manage the inventory of office supplies to ensure availability for daily operations.<br>• Operate and oversee office equipment such as fax machines, printers, and copiers, ensuring proper functionality.<br>• Coordinate document shredding services with external vendors to uphold confidentiality standards.<br>• Handle document management tasks, including retrieving files, making copies, and delivering documents as needed.<br>• Draft routine correspondence and respond to visitor inquiries with professionalism and efficiency.<br>• Open, sort, and distribute incoming mail and packages, including deliveries from FedEx and other couriers.<br>• Assist in organizing meetings, coordinating record retention, and performing additional clerical support as requested.<br>• Conduct research and compile reports based on leadership requests to support decision-making processes.<br>• Occasionally travel to fulfill job-related duties and meet organizational needs.
<p>We are looking for a detail-oriented Personal Injury Plaintiff Case Manager to join our team in Los Angeles, California. In this role, you will oversee personal injury cases, ensuring efficient claim processing, effective communication, and timely management of client needs. The ideal candidate will have a strong background in case management and a commitment to delivering exceptional client service.</p><p><br></p><p>Responsibilities:</p><p>• Process and open health insurance claims with accuracy and attention to detail.</p><p>• Upload and organize critical documents into the company’s case management software.</p><p>• Schedule and coordinate medical appointments while maintaining an up-to-date calendar.</p><p>• Serve as the primary point of contact for clients, addressing their concerns promptly and professionally.</p><p>• Ensure proper documentation and tracking of case details to support smooth claim administration.</p><p>• Collaborate with internal teams to streamline workflows and maintain case progress.</p><p>• Utilize CRM tools to manage client interactions and maintain detailed records.</p><p>• Monitor case timelines and ensure all deadlines are met.</p><p>• Stay informed about personal injury law and regulations to provide informed support.</p><p>• Maintain confidentiality and adhere to legal compliance standards.</p>
