Location: Statewide
Company: Allegiance Benefit Plan Mgmt.
vendors, customers, and the public, and to be respectful and courteous in the conduct of this position. ESSENTIAL JOB FUNCTIONS: Essential job functions include the following. Other functions may be assigned as business conditions change. Verifies the accuracy and receipt of all required documentation for each claim submitted.
Collaborates with providers, plan participants, other claims payers, or any other party necessary to obtain information necessary to accurately process a claim. Analyzes information necessary for processing. This includes, but is not limited to, general participant and provider information, managed care affiliation, diagnosis codes, dates, place, type of service,
procedure codes, and charges. Assures that the system processes the claim correctly and determines payment according to the plan as written. Word-processes correspondence to plan participants and providers in reference to pre-determinations and in response to basic benefit questions.
Answers telephone calls from plan participants, group contacts, and customer service representatives pertaining to benefits and claims inquiries. Resolves problematic claims with the assistance of the Team Leader, Claims Manager and/or the Director of Claims. Assigns critically ill patients to large case management. Assists the case manager with direct negotiation and the efficient use of benefits. Assists
other examiners as needed due to workload requirements, including assigned back-up when examiners are absent.
Aids the Team Leader and/or the Claims Manager in the resolution of claim appeals and disputes by providing documentation for review. Researches, calculates and requests refunds when necessary. Contributes to the daily workflow with regular and punctual attendance. Thoroughly researches and completes renewal reports in a timely manner in consultation with the Marketing Department. Process eligible claims on groups before the end of their stoploss contract renewal period. NON-ESSENTIAL JOB FUNCTIONS: Performs related or other assigned duties as required or directed.
Assists the Legal Department with subrogation claims as necessary. Attends various group meetings as required. Assists with audits as needed. Assists with plan benefit set-up and changes as needed. SUPERVISION EXERCISED: None. PHYSICAL WORKING CONDITIONS: Physical requirements are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Sitting 80% Reaching Some Standing 10% Manual Dexterity High Walking 10% Telephone Yes Kneeling Some Computer Screen High (visual acuity corrected to 20/30) Bending Some Lifting up to 30 pounds JOB SPECIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Minimum Education: High school graduation or GED required. College degree and/or training in medical terminology preferred. Certification(s) Required: LOMA/ICA and HIAA coursework and Fraud Training Minimum Experience: Experience in claims processing, medical billing, insurance, or health services preferred.
Familiarity with group health benefits preferred. Other Qualifications: ▪ Excellent oral and written communication skills required. ▪ PC skills, including Windows and Word. Ability to learn all functions of the claims processing software as is necessary for claims processing and adjudication. Must be able to adapt to software changes as they occur. ▪ Typing ability of 45 wpm net. ▪ Knowledge of medical terminology and basic health insurance concepts.
▪ Excellent listening skills. ▪ Basic mathematical skills. ▪ High level of interpersonal skills to work effectively with others. ▪ Ability to organize and recall large amounts of detailed information. ▪ Ability to read, analyze and interpret benefit summary plan descriptions, insurance documents, plan benefits, and regulations and make appropriate applications to specific situations. ▪ Ability to meet productivity standards with 99% financial accuracy and 95% procedural accuracy. ▪ Thorough knowledge of claims processing procedures and requirements. ▪ Ability to project a professional image and positive attitude in any work environment.
▪ Ability to comply with privacy and confidentiality standards. ▪ Ability to be flexible, work under pressure and meet deadlines. ▪ Ability to analyze and solve problems with professionalism and patience, and to exercise good judgment when making decisions. ▪ Ability to operate typical office equipment. ▪ Working knowledge of general office procedures. Job Posted by Applicant Pro
the following position in our NYC office. RESPONSIBILITIES: Be part of a collaborative team. Work with a wide range of clients. Provide innovative solutions to drive operational excellence as a core attribute throughout CSS. Continually maintain and refresh staff development plans and talent maps ensuring regular reviews.
Build strong relationships with stakeholders in broking, broking support, and regional offices Participate in and/or lead the charge for new automation for our clients. Measure performance for clients using messaging and provide regular feedback to them and the CSS client teams on those accounts. Establish clear goals and targets for implementing inbound messaging with
clients. Lead regional team of technicians working to test and implement inbound messaging. QUALIFICATIONS: BA/BS degree in finance, economics, or other business-related areas.
At least 5+ years of applicable experience. Analytical skills and attention to detail, ability to multi-task, manage multiple priorities and work in a rapidly changing environment. Electronic messaging experience in Insurance or Reinsurance. Proficiency in Excel and Microsoft office. Previous experience managing or directing others work. Writing and communication skills. Consultative and sales skills a plus. 1. ) Please elaborate candidate's Electronic messaging experience in Insurance or Reinsurance 2. ) Please
provide the link to candidates Linked In profile: 3. ) What is the candidates work authorization status?
4. ) What is the candidates highest level of education? 5. ) Has the candidate applied or been interviewed for any role with this company in the past? If so, please provide details. 6. ) What is the candidates desired total compensation? (Please specify base salary mission/bonus expectation) 7. ) Where is the candidate located? If candidate is not near the job location, please explain relocation plan in detail (e. g. timeline, relocating with family, selling/buying property)
answering questions, and resolving issues that may arise. The Commercial Lines Account Manager will work closely with the sales team to understand client and prospect needs, submit coverage specifications, obtain quotes from potential carriers, and negotiate/secure the best carrier coverage.
The role offers a competitive salary, attractive benefits and a flexible hybrid work style of 3 days in the office and 2 days from home. Pay Range: $85,000 - $110,000 DOE Responsibilities: Manage accounts, including coordinating services, answering questions, and resolving problems Work closely with the sales team to understand client and prospect needs Submit coverage specifications and obtain
quotes from potential carriers for new and renewal business Maintain accounts/policies Research and resolve any coverage issues, audit issues, or billing discrepancies Support new and existing clients with any inquiries Negotiate and secure the best carrier coverage based on clients' needs Remarket accounts in construction, servicing restaurants and servicing them Requirements: At least 3 years of experience in Commercial Insurance Experience as a Commercial Lines Account Executive is preferred Must hold a Property/Casualty License Experience with construction, restaurants, habitational commercial real estate customer types Experience working with AMS360 is preferred Bachelor's degree
is preferred Benefits: BCBS Health Insurance - 60% coverage for employee Group life insurance 401k with 3% match Vacation/PTO/Sick - 2 weeks Paid holidays - 7 or 8 with 2 floating holidays Incentive program for commercial lines Holiday bonus If you're looking for a challenging but rewarding career, apply for this position today!
#INDOPS #LI-POST #LI-HYBRID
U. S. economy with our goal to reach Real Zero carbon emissions from our operations by 2045 while improving customer affordability and reliability. Are you interested in creating a cleaner environment for future generations? Join our world-class, innovative team today.
Position Specific Description The Senior Insurance Auditor will be based in our Juno Beach office and will report to the Chief Compliance Officer of Palms Insurance and will conduct financial, operational, and compliance audits and advisory projects across all areas of our business. This challenging position will provide consultative support to business partners to identify solutions to address audit findings, and opportunities
for control improvements with the objective of mitigating risk and improving financial and operational performance. Audit areas may include Accounting, IT, Finance, Operations, Claims, and TPA.
Responsibilities will also include advising management on creating/updating process narratives, and flowcharts, performing walkthroughs, control testing, updating deficiency reports, providing control updates to management periodically, documenting action plans, and assisting process owners on ways to improve their processes and working with external auditors as required. The role requires a strong insurance and financial mindset, ability to build good working relationships with process owners
and management, effective communication skills and ability to multi-task when required.
Bachelor's degree in Accounting (or similar major), experience with insurance audit processes, procedures and methodologies and insurance carrier or broker experience. In turn for your hard work and excellent audit performance, we provide competitive pay/benefits, work life balance and opportunities for advancement across the organization. Job Overview Employees in this position contribute to audit and controls consultation projects by identifying and documenting risk exposure, processes and controls related to insurance, providing controls recommendations and best practices, and also testing manual and systematic controls.
Employees document audit results in work papers and report audit results to Management. Job Duties & Responsibilities Establish an insurance audit framework/charter, including evaluating internal processes and controls, meeting audit objectives within a scheduled time frame Create audit guidelines, questionnaires, and report templates to be utilized in all audits to maintain consistency Conduct or oversee Finance, Claims, Compliance, Operations, IT/Data Security & Retention, OFAC compliance Recommends process improvements Communicates verbally and in writing, with coworkers, Management, and customers Recommend process improvements Assist in the presentation of verbal and written audit reports to Management Partner with Next Era Internal Audit team.
Performs other job-related duties as assigned Job Overview This job Identifies, evaluates, and improves the effectiveness of company governance, risk management, and financial reporting controls and operational efficiencies. Job Duties & Responsibilities Oversees and directs a team of internal auditors responsible for multiple audits, SOX control testing and related reporting Meets and consults with business unit management on audit related matters Advises and provides insight to Executive Management on related audit findings Presents Audit Committee with an independent appraisal of the adequacy and effectiveness of the company's system of internal controls Performs other job-related duties as assigned Required Qualifications High School Grad / GEDBachelor's or Equivalent ExperienceExperience:10+ yearsSupervisor/Management Experience:5+ years Preferred Qualifications Certified Public Accountant (CPA)Master's Degree Employee Group: Exempt Employee Type: Full Time Job Category: Audit Organization: Palms Management Services, LLC Relocation Provided: Yes, if applicable Next Era Energy is an Equal Opportunity Employer.
Qualified applicants are considered for employment without regard to race, color, age, national origin, religion, marital status, interaction, interactionual orientation, gender identity, gender expression, genetics, disability, protected veteran status or any other basis prohibited by law. We are committed to a diverse and inclusive workplace. Next Era Energy and provides reasonable accommodation in its application and selection process for qualified individuals, including accommodations related to compliance with conditional job offer requirements, consistent with federal, state, and local laws.
Supporting medical or religious documentation will be required where applicable and permitted by applicable law. To request a reasonable accommodation, please send an e-mail to , providing your name, telephone number and the best time for us to reach you. Alternatively, you may call -xyz X. Please do not use this line to inquire about your application status. Next Era Energy will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
Next Era Energy does not accept any unsolicited resumes or referrals from any third-party recruiting firms or agencies. Please see our for more information. #LI-FB1 PDN-99de5da5-edc-0c3edf69d9f3
Mail/Calendar Soft Skill requirements (team fit/personality requirements) Exceptional Organizational Skills Able to Multi-task Strong Communication Skills Able to build and maintain strong working relationships1.
) Has the candidate applied or been interviewed for any role with this company in the past?
If so, please provide details. 2. ) Where is the candidate located? If candidate is not near the job location, please explain relocation plan in detail (e. g. timeline, relocating with family, selling/buying property) 3. ) What is the candidates desired total compensation? (Please specify base salary mission/bonus expectation) 4. ) Please provide the link to candidates Linked In
profile: 5. ) What is the candidates highest level of education? 6. ) What is the candidates work authorization status? 7. ) Is the candidate open and willing to travel upto 50% of time?
8. ) Please elaborate on the candidate's CAPPS programming knowledge and experience. Skills Intermediate Microsoft office skills Excel - Pivot Tables; Formulas Power Point - Able to edit or create Power Point Outlook Mail/Calendar Soft Skill requirements (team fit/personality requirements) Exceptional Organizational Skills Able to Multi-task Strong Communication Skills Able to build and maintain strong working relationships.
the following position in our NYC office. RESPONSIBILITIES: Be part of a collaborative team. Work with a wide range of clients. Provide innovative solutions to drive operational excellence as a core attribute throughout CSS. Continually maintain and refresh staff development plans and talent maps ensuring regular reviews.
Build strong relationships with stakeholders in broking, broking support, and regional offices Participate in and/or lead the charge for new automation for our clients. Measure performance for clients using messaging and provide regular feedback to them and the CSS client teams on those accounts. Establish clear goals and targets for implementing inbound messaging with
clients. Lead regional team of technicians working to test and implement inbound messaging. QUALIFICATIONS: BA/BS degree in finance, economics, or other business-related areas.
At least 5+ years of applicable experience. Analytical skills and attention to detail, ability to multi-task, manage multiple priorities and work in a rapidly changing environment. Electronic messaging experience in Insurance or Reinsurance. Proficiency in Excel and Microsoft office. Previous experience managing or directing others work. Writing and communication skills. Consultative and sales skills a plus. 1. ) Please elaborate candidate's Electronic messaging experience in Insurance or Reinsurance 2. ) Please
provide the link to candidates Linked In profile: 3. ) What is the candidates work authorization status?
4. ) What is the candidates highest level of education? 5. ) Has the candidate applied or been interviewed for any role with this company in the past? If so, please provide details. 6. ) What is the candidates desired total compensation? (Please specify base salary mission/bonus expectation) 7. ) Where is the candidate located? If candidate is not near the job location, please explain relocation plan in detail (e. g. timeline, relocating with family, selling/buying property)
answering questions, and resolving issues that may arise. The Commercial Lines Account Manager will work closely with the sales team to understand client and prospect needs, submit coverage specifications, obtain quotes from potential carriers, and negotiate/secure the best carrier coverage.
The role offers a competitive salary, attractive benefits and a flexible hybrid work style of 3 days in the office and 2 days from home. Pay Range: $85,000 - $110,000 DOE Responsibilities: Manage accounts, including coordinating services, answering questions, and resolving problems Work closely with the sales team to understand client and prospect needs Submit coverage specifications and obtain
quotes from potential carriers for new and renewal business Maintain accounts/policies Research and resolve any coverage issues, audit issues, or billing discrepancies Support new and existing clients with any inquiries Negotiate and secure the best carrier coverage based on clients' needs Remarket accounts in construction, servicing restaurants and servicing them Requirements: At least 3 years of experience in Commercial Insurance Experience as a Commercial Lines Account Executive is preferred Must hold a Property/Casualty License Experience with construction, restaurants, habitational commercial real estate customer types Experience working with AMS360 is preferred Bachelor's degree
is preferred Benefits: BCBS Health Insurance - 60% coverage for employee Group life insurance 401k with 3% match Vacation/PTO/Sick - 2 weeks Paid holidays - 7 or 8 with 2 floating holidays Incentive program for commercial lines Holiday bonus If you're looking for a challenging but rewarding career, apply for this position today!
#INDOPS #LI-POST #LI-HYBRID
U. S. economy with our goal to reach Real Zero carbon emissions from our operations by 2045 while improving customer affordability and reliability. Are you interested in creating a cleaner environment for future generations? Join our world-class, innovative team today.
Position Specific Description The Senior Insurance Auditor will be based in our Juno Beach office and will report to the Chief Compliance Officer of Palms Insurance and will conduct financial, operational, and compliance audits and advisory projects across all areas of our business. This challenging position will provide consultative support to business partners to identify solutions to address audit findings, and opportunities
for control improvements with the objective of mitigating risk and improving financial and operational performance. Audit areas may include Accounting, IT, Finance, Operations, Claims, and TPA.
Responsibilities will also include advising management on creating/updating process narratives, and flowcharts, performing walkthroughs, control testing, updating deficiency reports, providing control updates to management periodically, documenting action plans, and assisting process owners on ways to improve their processes and working with external auditors as required. The role requires a strong insurance and financial mindset, ability to build good working relationships with process owners
and management, effective communication skills and ability to multi-task when required.
Bachelor's degree in Accounting (or similar major), experience with insurance audit processes, procedures and methodologies and insurance carrier or broker experience. In turn for your hard work and excellent audit performance, we provide competitive pay/benefits, work life balance and opportunities for advancement across the organization. Job Overview Employees in this position contribute to audit and controls consultation projects by identifying and documenting risk exposure, processes and controls related to insurance, providing controls recommendations and best practices, and also testing manual and systematic controls.
Employees document audit results in work papers and report audit results to Management. Job Duties & Responsibilities Establish an insurance audit framework/charter, including evaluating internal processes and controls, meeting audit objectives within a scheduled time frame Create audit guidelines, questionnaires, and report templates to be utilized in all audits to maintain consistency Conduct or oversee Finance, Claims, Compliance, Operations, IT/Data Security & Retention, OFAC compliance Recommends process improvements Communicates verbally and in writing, with coworkers, Management, and customers Recommend process improvements Assist in the presentation of verbal and written audit reports to Management Partner with Next Era Internal Audit team.
Performs other job-related duties as assigned Job Overview This job Identifies, evaluates, and improves the effectiveness of company governance, risk management, and financial reporting controls and operational efficiencies. Job Duties & Responsibilities Oversees and directs a team of internal auditors responsible for multiple audits, SOX control testing and related reporting Meets and consults with business unit management on audit related matters Advises and provides insight to Executive Management on related audit findings Presents Audit Committee with an independent appraisal of the adequacy and effectiveness of the company's system of internal controls Performs other job-related duties as assigned Required Qualifications High School Grad / GEDBachelor's or Equivalent ExperienceExperience:10+ yearsSupervisor/Management Experience:5+ years Preferred Qualifications Certified Public Accountant (CPA)Master's Degree Employee Group: Exempt Employee Type: Full Time Job Category: Audit Organization: Palms Management Services, LLC Relocation Provided: Yes, if applicable Next Era Energy is an Equal Opportunity Employer.
Qualified applicants are considered for employment without regard to race, color, age, national origin, religion, marital status, interaction, interactionual orientation, gender identity, gender expression, genetics, disability, protected veteran status or any other basis prohibited by law. We are committed to a diverse and inclusive workplace. Next Era Energy and provides reasonable accommodation in its application and selection process for qualified individuals, including accommodations related to compliance with conditional job offer requirements, consistent with federal, state, and local laws.
Supporting medical or religious documentation will be required where applicable and permitted by applicable law. To request a reasonable accommodation, please send an e-mail to , providing your name, telephone number and the best time for us to reach you. Alternatively, you may call -xyz X. Please do not use this line to inquire about your application status. Next Era Energy will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
Next Era Energy does not accept any unsolicited resumes or referrals from any third-party recruiting firms or agencies. Please see our for more information. #LI-FB1 PDN-99de5da5-edc-0c3edf69d9f3
Mail/Calendar Soft Skill requirements (team fit/personality requirements) Exceptional Organizational Skills Able to Multi-task Strong Communication Skills Able to build and maintain strong working relationships1.
) Has the candidate applied or been interviewed for any role with this company in the past?
If so, please provide details. 2. ) Where is the candidate located? If candidate is not near the job location, please explain relocation plan in detail (e. g. timeline, relocating with family, selling/buying property) 3. ) What is the candidates desired total compensation? (Please specify base salary mission/bonus expectation) 4. ) Please provide the link to candidates Linked In
profile: 5. ) What is the candidates highest level of education? 6. ) What is the candidates work authorization status? 7. ) Is the candidate open and willing to travel upto 50% of time?
8. ) Please elaborate on the candidate's CAPPS programming knowledge and experience. Skills Intermediate Microsoft office skills Excel - Pivot Tables; Formulas Power Point - Able to edit or create Power Point Outlook Mail/Calendar Soft Skill requirements (team fit/personality requirements) Exceptional Organizational Skills Able to Multi-task Strong Communication Skills Able to build and maintain strong working relationships.
individuals who value opportunity, mentoring and a chance to stand out. We are looking to add Personal Lines Account Managers to our team! In this role, you will engage and service new and existing clients with our industry-leading client relationships management process.
The successful candidate will possess: 220 or 440 license Problem solving aptitude An interest in continuous learning Passion for client engagement Ability to analyze market trends and apply to the client relationship 3+ years previous inside PL account management experience Excellent verbal and written communication skills College degree preferred Proficiency in Microsoft Suite Knowledge of AMS360 a plus Bilingual English/Spanish
a plus As a Personal Lines Account Manager at SBIR, you will be joining a team who thrive on constant learning and enjoy the freedom to exercise personal initiative, while working collaboratively, when desired.
We provide the tools and knowledge necessary to deliver high quality solutions and positive results for clients. Your role on the team will include overseeing new and renewal business, managing the marketing and binding process, fielding coverage questions, responding to claims concerns, and identifying coverage opportunities. If you are looking for a company that provides you with a chance to stand out, stand up and grow, while working and playing hard, wed love to hear from you
-- Setnor Byer Insurance & Risk. What we offer Competitive compensation with bonus potential Generous medical, dental and vision package 401K with a rich company match Life Insurance Short-term disability Rich paid time-off Paid holidays Flex start times Continuing education assistance Catered Lunches Monthly Massages Charitable matching Pet adoption reimbursement On-site gym Plus extra surprise rewards
