Claims Specialist
2 weeks ago
Key Responsibilities
- Conduct thorough investigations to confirm coverage details.
- Assess liability by reviewing documentation, performing interviews, and identifying negligence.
- Deliver exceptional customer service to all stakeholders involved in the claims process.
- Manage cases represented by attorneys, negotiating fair settlements in a professional manner, while also addressing unrepresented claimants as necessary.
- Oversee Medical Payments and Personal Injury Protection claims.
- Handle multiple cases efficiently, ensuring proper reserving and documenting each step of the claims process.
- Perform additional tasks as assigned by management.
- Comply with all regulatory standards and claims practices established by the organization.
- Maintain required statutory licenses and ensure good standing.
Qualifications
- Ability to read and interpret contracts effectively.
- Adaptability to change and capacity to thrive in a fast-paced environment while managing current workloads.
- Strong communication skills, both written and verbal, to discuss coverage, liability, and settlement matters with attorneys and other parties.
- A minimum of three (3) years of experience in handling Casualty claims is required.
- Experience in customer service is essential.
- A college degree is preferred but not mandatory if relevant experience is demonstrated.
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Access, and Outlook) is preferred.
- A Texas Adjuster's license is mandatory.
-
Claims Specialist
2 weeks ago
McAllen, Texas, United States Fred Loya Insurance Full timeKey Responsibilities Conduct thorough investigations to confirm coverage details.Assess liability by reviewing documentation, performing interviews, and evaluating negligence.Deliver exceptional customer service to all stakeholders in the claims process.Manage cases involving legal representation, negotiating fair settlements with attorneys in a professional...
-
Claims Customer Service Specialist
1 week ago
McAllen, Texas, United States Kemper Full timeLocation: McAllen, TexasCompany Overview:Kemper stands as one of the foremost specialized insurers in the nation. Our achievements are a direct result of the dedicated and diverse individuals who positively impact the lives of our clients daily. We foster a high-performance culture, offering valuable opportunities for personal growth and professional...
-
McAllen, Texas, United States Spherion Full timeWe are looking for a skilled Inbound Medical Insurance Call Center Specialist to enhance our medical insurance division. The successful candidate will leverage their healthcare expertise to assist clients with inquiries regarding their insurance policies, claims, and coverage, delivering precise and empathetic support. This position entails managing a...
-
McAllen, Texas, United States Spherion Full timeWe are looking for a skilled Inbound Medical Insurance Call Center Specialist to enhance our medical insurance department. The successful candidate will leverage their healthcare expertise to assist clients with inquiries regarding their insurance, claims, and coverage, ensuring they receive precise and empathetic support. This position entails managing a...
-
McAllen, Texas, United States Spherion Full timeWe are looking for a skilled Inbound Medical Insurance Customer Service Specialist to enhance our medical insurance division. The successful candidate will leverage their healthcare expertise to assist clients with inquiries regarding their insurance, claims, and coverage, delivering precise and empathetic support. This position entails managing a...
-
Surveillance Specialist
1 week ago
McAllen, Texas, United States The Robison Group Full timeAbout the PositionWe are seeking highly skilled and detail-oriented individuals to join our team as Surveillance Investigators at The Robison Group. As a Surveillance Investigator, you will be responsible for conducting thorough investigations, including workers compensation claims, liability investigations, and background checks.Key ResponsibilitiesConduct...
-
Surveillance Operations Specialist
1 week ago
McAllen, Texas, United States The Robison Group Full timeAbout the PositionWe are seeking skilled professionals to fill the role of Surveillance Investigator at The Robison Group. As a Surveillance Investigator, you will be responsible for conducting thorough investigations, including workers compensation claims, liability investigations, and background checks.Conduct video surveillance in stationary and mobile...
-
Risk Management Coordinator
6 days ago
McAllen, Texas, United States Coca-Cola Southwest Beverages Full timeJob SummaryCoca-Cola Southwest Beverages LLC is seeking a highly skilled Safety Specialist to join our team. As a key member of our organization, you will be responsible for driving the execution of our safety programs at the facility level and supporting our Market Unit and Supply Chain performance.Key ResponsibilitiesConduct training for warehouse, fleet,...
-
Medical Billing Specialist
3 months ago
McAllen, United States FYZICAL Therapy and Balance Centers Full timeJob DescriptionJob DescriptionThis is an exciting time to join the FYZICAL family! If you have one year of billing experience and would enjoy being part of a champion team with a forward-thinking company that takes a unique approach to physical therapy, you are a great fit for our Medical Billing Specialist position in McAllen, TX!In this Medical Billing...
-
Commercial Auto Liability Adjuster
3 weeks ago
McAllen, United States Kemper Full timeLocation(s) Alpharetta, Georgia, Birmingham, Alabama, Dallas, Texas, Lake Mary, Florida, McAllen, Texas Details Kemper is one of the nation's leading specialized insurers. Our success is a direct reflection of the talented and diverse people who make a positive difference in the lives of our customers every day. We believe a high-performing culture, valuable...
