Current jobs related to Associate Claim Specialist - Portland - Opportunities at MEMIC

  • Claims Support Specialist

    2 weeks ago

    Portland, Oregon, United States City of Portland Full time

    Job SummaryWe are seeking a skilled Claims Support Specialist to join our team at the City of Portland. As a Claims Support Specialist, you will play a critical role in supporting our claims processing operations.Key ResponsibilitiesSupport claims processing operationsProvide excellent customer serviceCollaborate with team members to resolve claimsProcess...

  • Claims Director

    4 weeks ago

    Portland, Maine, United States OneAmerica Full time

    Job Title: Director of Claims AdjudicationJob Summary:The Director of Claims Adjudication will be responsible for overseeing the effective and efficient delivery of claims adjudication and claims service for group short-term disability claims. This role will contribute to the development of strategic goals and objectives, as well as the overall leadership of...

  • Claims Director

    1 month ago

    Portland, Maine, United States OneAmerica Full time

    Job SummaryThe Director of Claims will be responsible for leading the claims team in delivering high-quality claims adjudication and service for group short-term disability claims. This role will contribute to the development of strategic goals and objectives, as well as the overall leadership of the team.Key ResponsibilitiesDevelop and implement strategies...

  • Medical Claims Specialist

    1 week ago

    Portland, United States CorVel Enterprise Comp, Inc. Full time

    Job SummaryCorVel Enterprise Comp, Inc. is seeking a skilled Medical Claims Specialist to manage non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims. The ideal candidate will have a strong understanding of claims practice, relevant statutes, and medical terminology.This role is open for remote, hybrid, or...

  • Claims Resolution Specialist

    2 weeks ago

    Portland, Oregon, United States City of Portland Full time

    We are seeking a skilled Claims Resolution Specialist to join our team at the City of Portland. This role will involve working closely with our claims team to resolve customer complaints and issues in a timely and efficient manner.Key Responsibilities:Respond to customer inquiries and resolve claims in a professional and courteous mannerWork closely with the...

  • Claims Workforce Specialist

    3 days ago

    Portland, United States Automobile Club of Southern California Full time

    Claims Workforce SpecialistExcited to grow your career?We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!Note: This position is remote at this time. Candidates...

  • Claims Director

    5 months ago

    South Portland, United States OneAmerica Full time

    Job Details Description At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and...

  • Medical Only Claims Specialist

    1 month ago

    Portland, United States CorVel Corporation Full time

    The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel.  This role is open for remote, hybrid, or onsite work. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms...

  • Claims Processor

    2 weeks ago

    Portland, Maine, United States CareFirst BlueCross BlueShield Full time

    {"PURPOSE": "Under the guidance of experienced professionals, you will review and process claims to ensure timely and accurate payments. Your attention to detail and analytical skills will be essential in identifying key elements of processing requirements based on contracts, policies, and procedures.", "ESSENTIAL FUNCTIONS": "Examine and resolve...

  • Claims Examiner

    3 weeks ago

    Portland, Maine, United States CareFirst BlueCross BlueShield Full time

    Job SummaryCareFirst BlueCross BlueShield is seeking a skilled Claims Processor to join our team in the NASCO Claims Operations department. As a Claims Processor, you will play a critical role in reviewing and adjudicating paper/electronic claims, ensuring timely payments and accurate processing.Key ResponsibilitiesExamine and resolve non-adjudicated claims...

  • Recovery Claims Specialist

    2 weeks ago

    Portland, Oregon, United States Portland General Electric Full time

    Job SummaryAt Portland General Electric, we're committed to delivering innovative clean energy solutions that are affordable and accessible to all. As a Recovery Claims Collection Processor, you'll play a critical role in ensuring cost recovery and mitigation for claims that occur within our distribution system.Key ResponsibilitiesInvestigate claims and...

  • Claims Adjuster

    2 weeks ago

    Portland, Oregon, United States Progressive Insurance Full time

    Job Title: Claims AdjusterAs a Claims Adjuster at Progressive Insurance, you will play a critical role in investigating and resolving bodily injury claims. You will work independently to determine coverage and liability, while managing physical damage and non-attorney represented bodily injury exposures. Your strong negotiation and customer service skills...

  • Insurance Claims Adjuster

    2 weeks ago

    Portland, Oregon, United States Amica Insurance Full time

    Insurance Claims Adjuster RoleAmica Insurance is seeking a talented Insurance Claims Adjuster to join our team. As a Claims Examiner, you will be responsible for conducting thorough investigations of claims, assessing loss sites, and performing research to determine the validity of claims. You will also be responsible for balancing investigations with file...

  • Claims Leadership and Operations Director

    2 months ago

    Portland, Maine, United States OneAmerica Full time

    About the RoleAs a key member of our team at OneAmerica, the Director of Claims will be responsible for leading the claims team in delivering exceptional service and ensuring timely and accurate claims adjudication. This role will contribute to the development of strategic goals and objectives, as well as provide overall leadership and direction to the...

  • Claims Examiner II

    4 weeks ago

    Portland, Maine, United States Reliance Matrix Full time

    Job SummaryWe are seeking a highly skilled and detail-oriented Claims Examiner II to join our team at Reliance Matrix. As a Claims Examiner II, you will be responsible for obtaining and analyzing information to make claim decisions and payments on Long Term Disability (LTD) and Waiver of Premium (WOP) claims.Key ResponsibilitiesObtain and analyze information...

  • Claims Adjuster

    2 weeks ago

    Portland, Oregon, United States Progressive Insurance Full time

    Job SummaryAs a Claims Adjuster - Liability Investigator at Progressive Insurance, you will play a critical role in investigating and resolving bodily injury claims. This is a hybrid role that requires you to work independently, managing both physical damage and non-attorney represented bodily injury exposures. You will be responsible for making coverage...

  • Claims Examiner

    2 weeks ago

    Portland, Oregon, United States Sedgwick Full time

    About the RoleSedgwick is seeking a highly skilled Claims Examiner to join our team in a dynamic and fast-paced environment. As a Claims Examiner, you will be responsible for analyzing and processing complex Workers Compensation claims, ensuring timely and accurate resolution, and providing exceptional customer service to our clients.Key...

  • Claims Examiner

    1 month ago

    Portland, Oregon, United States Sedgwick Full time

    About SedgwickSedgwick is a global industry leader that values its employees and provides a culture of caring. We offer flexibility, time for personal growth, and support for mental, physical, financial, and professional well-being.Job SummaryWe are seeking a Claims Examiner - Workers Compensation to analyze high-level claims, determine benefits due, and...

  • Claims Examiner

    2 months ago

    Portland, Oregon, United States Sedgwick Full time

    About the RoleSedgwick is seeking a skilled Claims Examiner to join our team in a dynamic and fast-paced environment. As a Claims Examiner, you will play a critical role in analyzing and processing complex Workers Compensation claims, ensuring timely and accurate resolutions for our valued clients.Key ResponsibilitiesAnalyze and process claims through...

  • Claims Examiner

    1 month ago

    Portland, Oregon, United States Sedgwick Full time

    About SedgwickSedgwick is a global industry leader that values its employees and provides a culture of caring. We offer flexibility, time for personal growth, and support for mental, physical, financial, and professional well-being.Job SummaryWe are seeking a driven Claims Examiner to analyze high-level Workers Compensation claims on behalf of our valued...

Associate Claim Specialist

2 months ago

Portland, United States Opportunities at MEMIC Full time
Job DescriptionJob Description

The Mission of The MEMIC Group is to make workers' comp work better with compassion, trusted partnerships, and relentless commitment to workforce safety. The secret to the success and longevity of great organizations is their shared vision and strong values. At MEMIC our values are to be conscientious, to be an expert, to be a partner, to be curious and to be transparent.

The Associate Claim Specialist investigates, evaluates, negotiates, and resolves low, medium and high complexity medical only claims and low complexity lost time claims, including new lost time files that are within settlement and reserve authority up to maximum. (Supervisor will determine actual individual authority up to the stated maximum).

Requirements:

  • Communicates with insureds, injured workers, agents, brokers, witnesses, attorneys, loss prevention, and underwriters to obtain and relate necessary information to determine coverage/compensability, facts of loss, and degree of liability/exposure. Maintains contact throughout the life of the file as needed.
  • Administers the delivery of timely, appropriate medical and indemnity benefits when applicable.
  • Evaluates claim exposure, investigates, negotiates, and resolves medical only and lost time claims with potential for modified duty or periods of total disability.
  • Maintains quality claim files in accordance with best practices, company policy, procedures and state workers' compensation statutes.
  • Implements Managed Care strategies, coordinates rehabilitation or medical management, processes bills, reviews all mail through ImageRight, and monitors progress as appropriate.
  • Interacts with State and Federal Boards and Commissions, while establishing and maintain proper reserves, as appropriate.
  • Keeps up to date on State laws and Company procedures relating to various claims and educates injured worker and/or insured on same.
  • Participates in in-house and outside training programs to keep up to date on relevant issues/topics.
  • Understands medical terminology and standard medical procedures as they pertain to workers' compensation.
  • Maintains a working knowledge of all computer systems currently in use.
  • Travels throughout States as required for handling claims inventory assigned.
  • Continues education in claims through WCP, Associate in Claims, or Claims Law (AEI) courses.

Requirements:

  • No previous experience needed; on-the-job training provided.

  • Proficient in Microsoft Office (Word and Excel).

  • Must have valid driver's license.

  • Strong attention to detail and strong verbal and written communication skills a must.

  • Must have flexibility and be self-directed with ability to manage time and other resources wisely.

  • Must have the ability to work effectively with other organizational team members.

  • If jurisdiction requires, obtain required adjuster licenses within 6 months of employment, or earlier, at manager discretion. Additional licenses may be required throughout course of employment.

Our comprehensive benefits package includes all traditional offerings such as:

  • Health Insurance options, Dental Insurance options and Vision Insurance
  • Employee Life Insurance/AD&D and Dependent Life Insurance options
  • Short-term & Long-term Disability
  • Health Savings Account with potential employer match
  • Flexible Medical and Dependent Care Account
  • Accident Insurance
  • Critical Illness Insurance
  • Employee Assistance Program
  • Legal/Identify Theft Insurance options
  • Long Term Care Insurance
  • Pet Insurance
  • 401 (k) Retirement Plan with match up to 5%, plus profit sharing & discretionary contributions (subject to vesting)
  • 4 weeks of Paid Time Off (PTO)
  • 7 paid holidays

We also offer other benefits to help foster a healthy, balance lifestyle such as:

  • Flextime schedules
  • Paid Parental Leave
  • Student loan paydown and refinancing assistance
  • Educational assistance for job related courses, seminars, certifications or degrees
  • One paid day every year to volunteer for your non-profit of choice
  • On-site fitness center (Maine & Virginia) or fitness reimbursement
  • Subsidized parking
  • Sit-Stand desks & daily stretch breaks

MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law. MEMIC is an equal opportunity employer encouraging diversity in the workplace.

MEMIC's Job Applicant Privacy Notice

#IND2022