Claims Adjusters, Examiners, and Investigators

At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best – protecting and restoring their dreams when they need us most. We're leveraging our expertise, technology and new ways of working to actively reinvent one of America's largest industries—creating positive impact that empowers our customers, communities, and company to thrive. We are problem solvers who ask critical questions and consistently tackle challenges big and small. Together, we disrupt what's expected of insurance. Lead level role that investigates and maintains highly complex property claims. Determine liability, secure information, reviews coverages, arrange appraisals, and settles claims. Demonstrate experience to perform all areas of claim adjustment activities with the highest degree of competency and independence. You will work in the field and handle complex homeowner property field claims. You will preferably be located Phoenix, AZ. A fleet vehicle is provided with the position. You will report to a Large Loss Senior Manager. We are looking to fill 2 openings.

In this primarily home-based role, you will spend 80% of your time (4+ days per week) working from home and/or in the field handling claims. On occasion you may be asked to travel to an office location for in person engagement activities such as team meetings, trainings, and culture events.

Position Compensation Range:

$86,000.00 - $142,000.00

Pay Rate Type:

Salary

_Compensation may vary based on the job level and your geographic work location._ _Relocation support is offered for eligible candidates._

Primary Accountabilities

+ You will investigate origin and cause of high exposure claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, public personnel, etc. Checks for prior claims and recognizes environmental exposures.

+ You will participate in High Damage Reviews (HDR) to address coverage issues and exposure. Handle claims on a good faith basis.

+ You will handle both 1st party and 3rd party claims under multiple policy types and numerous endorsements.

+ You will conduct on-site inspections when needed, evaluates damages and handles claim negotiations with insureds, claimants, attorneys, public adjusters.

+ You will respond to customer inquiries, makes appropriate decisions, and close file.

+ You will interpret and determine policies, leases, by-laws, declarations, articles, and contract coverages and applies to all parties for assigned losses. Interpret claim history coverages.

+ You will make independent decisions but recognize when assistance is needed.

+ You will provide all parties with claim process and status; answers questions or redirect to other areas.

+ You will be a mentor and subject matter expert for less experienced adjusters.

Specialized Knowledge & Skills Requirements

+ Demonstrated ability to handle 1st and 3rd party, multi-line claims across our operating territories.

+ Demonstrated experience providing customer-driven solutions, support or service.

+ Demonstrated ability to efficiently and effectively handle complex claims.

+ Extensive knowledge of policies and endorsements coverages.

+ Successfully applied knowledge of each phase of the claim handling process.

Licenses

+ Valid driver's license required plus an acceptable driving record.

+ Obtain state specific property casualty claims licensing as required.

Travel Requirements

+ Up to 10%.

+ Catastrophe travel up to 75% as applicable.

Physical Requirements

+ Ascending or descending ladders, stairs, scaffolding, ramps, poles and the like. This position may require employees to visit areas that have a higher hazard than a typical office such as customer homes, body shops, or other locations.

+ Moving self in different positions to accomplish tasks in various environments including tight and confined spaces.

+ Adjusting or moving objects up to 50 pounds in all directions.

Additional Qualifications

+ Advanced Xactimate experience required.

+ 5 or more years’ experience handling field property personal lines claims required.

+ Prefer someone who has handled claims over $50,000.

_\#LI-Hybrid_

+ The candidate(s) selected for this role will be employed by AFICS, Inc. (American Family Insurance Claims Services, Inc.), an affiliate of American Family Mutual Insurance Company, S.I.

+ Offer to selected candidate will be made contingent on the results of applicable background checks

+ Offer to selected candidate is contingent on signing a non-disclosure agreement for proprietary information, trade secrets, and inventions

+ Our policy restricts consideration of applicants needing employment sponsorship (visa) to specialty occupations. Sponsorship will not be considered for this position

We encourage you to apply even if you do not meet all of the requirements listed above. Skills can be used in many different ways, and your life and professional experience may be relevant beyond what a list of requirements will capture. We encourage those who are passionate about what we do to apply!

We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits.

We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.

\#LI-MR1

**Optum** is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.**

The **Senior Claims Examiner** is responsible for providing claims support to our teams in reviewing, analyzing, and researching complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations, and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will ensure timely processing of the member's claim.

This position is full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6am - 6pm CST. It may be necessary, given the business need, to work occasional overtime.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

**Primary Responsibilities:**

+ Review, process and identify medical claims based on standard operating procedures on CPS.

+ Apply appropriate processes and procedures to process claims (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates).

+ Review and apply member benefit plans and provider contracts, Pricing, CMS rate letter, SCA’s etc. to ensure proper benefits and contract language is applied to each claim.

+ Weekly/monthly goal of batches including meeting and maintaining a 95% quality standard and production standard of 90+ claims per day.

+ Examine each claim for appropriate coding of CPT and ICD codes against charges that are billed and entered.

+ Manually adjust pending escalated claims to resolve complex issues related to claim payments.

+ Adjudicate complex medical provider-initiated claims using analytical/problem solving skills.

+ Create and generate any overpayment documentation (notes in system, letter to typing) on all overpayments created by the examiner or any overpayment identified by examiner.

+ Support implementation of updates to the current procedures and participate in new system updates and training.

+ Communicate and collaborate with external stakeholders (e.g., members, family members, providers, vendors) to resolve claims errors/issues, using clear, simple language to ensure understanding.

+ Ensures all claims reporting requirements are met; complete daily production reports and weekly pending reports.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

**Required Qualifications:**

+ High School Diploma / GED

+ Must be 18 years old or older

+ 1+ years of experience processing medical, dental, prescription or mental health claims

+ 1+ years of experience working in a fast-paced, high volume environment processing 50+ claims per day

+ 2+ years of experience in metric-based environment (production, quality)

+ Proficiency with Microsoft Office Suite (Outlook, Word, Excel etc.)

+ Ability to navigate and learn new and complex computer system applicationsAbility to work full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6AM -6PM CST. (Flex schedule they can start anytime between 6am-9am – They can take 30 mins or 1 hour lunch). It may be necessary, given the business need, to work occasional overtime.

**Preferred Qualifications:**

+ Reside within commutable distance to 19500 W INTERSTATE, San Antonio TX 78257

**Telecommuting Requirements:**

+ Ability to keep all company sensitive documents secure (if applicable)

+ Required to have a dedicated work area established that is separated from other living areas and provides information privacy.

+ Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

**Soft Skills:**

+ Proven exceptional ability to organize, prioritize and communicate effectively

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

**A** **_pplication Deadline_** _: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to the volume of applicants._

_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission._

_Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law._

_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

\#RPO

**Optum** is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.**

Imagine this. Every day, in claims centers around the world, UnitedHealth Group is processing and resolving payment information for millions of transactions. Would you think we have some great technology? Would you think we know how to manage volume? You would be right. No one’s better. And no company has put together better teams of passionate, energetic and all out brilliant Claims Representative Associates. This is where you come in. We’ll look to you to maintain our reputation for service, accuracy and a positive claims experience. We’ll back you with great training, support and opportunities.

This position is full time. Employees are required to have flexibility to work our normal business hours of 8:00am-4:30pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 10 - 12 weeks of paid training. The hours during training will be 7:30am-4:00pm CST. Training will be conducted virtually from your home.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

**Primary Responsibilities:**

+ Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing, and adjusting claims

+ Analyze and identify trends and provide reports as necessary

+ Consistently meet established productivity, schedule adherence and quality standards

+ This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You’ll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the member's claim.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

**Required Qualifications:**

+ High School Diploma / GED OR equivalent years of work experience

+ Must be 18 years of age OR older

+ Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications

+ Ability to work full time. Employees are required to have flexibility to work our normal business hours of 8:00am-4:30pm CST. It may be necessary, given the business need, to work occasional overtime.

**Preferred Qualifications:**

+ 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.), using phones and computers as primary job tools

+ 1+ years of experience with processing medical, dental, prescription, OR mental health claims

**Telecommuting Requirements:**

+ Ability to keep all company sensitive documents secure (if applicable)

+ Required to have a dedicated work area established that is separated from other living areas and provides information privacy

+ Must live in a location where can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

The hourly range for this role is $16.00 to $28.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

**_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._

_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission._

_Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law._

_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

\#RPO

Description

We are seeking a detail-oriented OSP (Outside Plant) Field Inspector to join our team on a contract basis. The ideal candidate will be responsible for conducting thorough inspections of Fiber Optic infrastructure, ensuring compliance with industry standards and safety regulations.

Skills

Telecommunication, Fiber optic, Osp, Telecommunications construction, Underground cable, Construction, Inspection, Fiber optic cable, Blueprint, Repair

Top Skills Details

Telecommunication, Fiber optic, Osp, Telecommunications construction, Underground cable, Construction, Inspection, Fiber optic cable

Additional Skills & Qualifications

Responsibilities and Duties

• Inspecting and assessing the condition of outside plant fiber optic facilities,

• Documenting findings and preparing detailed reports on infrastructure quality and compliance issues.

• Collaborating with project managers and engineers to address any discrepancies or corrective actions needed.

• Conducting site visits and audits to verify construction quality and adherence to specifications.

• Collaborate with General Contractors, setting expectations, provide feedback/guidance, and ensure work is being performed to company standards.

• Ability to build and maintain effective working relationships across multiple diverse stakeholders (team, leadership, internal partners, vendors, local governments agencies, and customers, etc.).

• Communicate regularly with management regarding problems or issues impacting production.

• Exceptional work ethic. Must be able to work nights and weekends, variable schedule(s), and extended hours, as necessary.

• Supports with customer escalations resulting from the construction process including damage claim repairs and customer communication.

• Other duties as assigned.

Experience Level

Intermediate Level

Pay and Benefits

The pay range for this position is $25.00 - $29.00

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Phoenix,AZ.

Application Deadline

This position will be accepting applications until Jan 22, 2025.

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Description

We are seeking a detail-oriented OSP (Outside Plant) Field Inspector to join our team on a contract basis. The ideal candidate will be responsible for conducting thorough inspections of Fiber Optic infrastructure, ensuring compliance with industry standards and safety regulations.

Skills

Telecommunication, Fiber optic, Osp, Telecommunications construction, Underground cable, Construction, Inspection, Fiber optic cable, Blueprint, Repair

Top Skills Details

Telecommunication,Fiber optic,Osp,Telecommunications construction,Underground cable,Construction,Inspection,Fiber optic cable

Additional Skills & Qualifications

Responsibilities and Duties

• Inspecting and assessing the condition of outside plant fiber optic facilities,

• Documenting findings and preparing detailed reports on infrastructure quality and compliance issues.

• Collaborating with project managers and engineers to address any discrepancies or corrective actions needed.

• Conducting site visits and audits to verify construction quality and adherence to specifications.

• Collaborate with General Contractors, setting expectations, provide feedback/guidance, and ensure work is being performed to Prime Fiber standards.

• Ability to build and maintain effective working relationships across multiple diverse stakeholders (team, leadership, internal partners, vendors, local governments agencies, and customers, etc.).

• Communicate regularly with management regarding problems or issues impacting production.

• Exceptional work ethic. Must be able to work nights and weekends, variable schedule(s), and extended hours, as necessary.

• Supports with customer escalations resulting from the construction process including damage claim repairs and customer communication.

• Other duties as assigned.

Experience Level

Intermediate Level

Pay and Benefits

The pay range for this position is $25.00 - $29.00

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Phoenix,AZ.

Application Deadline

This position will be accepting applications until Jan 29, 2025.

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Description



We are seeking a detail-oriented OSP (Outside Plant) Field Inspector to join our team on a contract basis. The ideal candidate will be responsible for conducting thorough inspections of Fiber Optic infrastructure, ensuring compliance with industry standards and safety regulations.

Skills

Telecommunication, Fiber optic, Osp, Telecommunications construction, Underground cable, Construction, Inspection, Fiber optic cable, Blueprint, Repair

Top Skills Details

Telecommunication, Fiber optic ,Osp, Telecommunications construction, Underground cable ,Construction ,Inspection, Fiber optic cable

Additional Skills & Qualifications

+ Inspecting and assessing the condition of outside plant fiber optic facilities,

+ Documenting findings and preparing detailed reports on infrastructure quality and compliance issues.

+ Collaborating with project managers and engineers to address any discrepancies or corrective actions needed.

+ Conducting site visits and audits to verify construction quality and adherence to specifications.

+ Collaborate with General Contractors, setting expectations, provide feedback/guidance, and ensure work is being performed to Prime Fiber standards.

+ Ability to build and maintain effective working relationships across multiple diverse stakeholders (team, leadership, internal partners, vendors, local governments agencies, and customers, etc.).

+ Communicate regularly with management regarding problems or issues impacting production.

+ Exceptional work ethic. Must be able to work nights and weekends, variable schedule(s), and extended hours, as necessary.

+ Supports with customer escalations resulting from the construction process including damage claim repairs and customer communication.

+ Other duties as assigned.

Pay and Benefits

The pay range for this position is $25.00 - $29.00

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Phoenix,AZ.

Application Deadline

This position will be accepting applications until Jan 29, 2025.

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Description

We are seeking a detail-oriented OSP (Outside Plant) Field Inspector to join our team on a contract basis. The ideal candidate will be responsible for conducting thorough inspections of Fiber Optic infrastructure, ensuring compliance with industry standards and safety regulations.

Skills

Telecommunication, Fiber optic, Osp, Telecommunications construction, Underground cable, Construction, Inspection, Fiber optic cable, Blueprint, Repair

Top Skills Details

Telecommunication,Fiber optic,Osp,Telecommunications construction,Underground cable,Construction,Inspection,Fiber optic cable

Additional Skills & Qualifications

Responsibilities and Duties

• Inspecting and assessing the condition of outside plant fiber optic facilities,

• Documenting findings and preparing detailed reports on infrastructure quality and compliance issues.

• Collaborating with project managers and engineers to address any discrepancies or corrective actions needed.

• Conducting site visits and audits to verify construction quality and adherence to specifications.

• Collaborate with General Contractors, setting expectations, provide feedback/guidance, and ensure work is being performed to Prime Fiber standards.

• Ability to build and maintain effective working relationships across multiple diverse stakeholders (team, leadership, internal partners, vendors, local governments agencies, and customers, etc.).

• Communicate regularly with management regarding problems or issues impacting production.

• Exceptional work ethic. Must be able to work nights and weekends, variable schedule(s), and extended hours, as necessary.

• Supports with customer escalations resulting from the construction process including damage claim repairs and customer communication.

• Other duties as assigned.

Experience Level

Intermediate Level

Pay and Benefits

The pay range for this position is $25.00 - $29.00

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Phoenix,AZ.

Application Deadline

This position will be accepting applications until Jan 29, 2025.

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

**40479BR**

**Requisition ID:**

40479BR

**Business Unit:**

FSU

**Job Description:**

The FEMA Insurance Specialist:

• Inspects damaged property to include all parts of the structure, taking into consideration condition, design, construction, and land value.

• Photographs interior and exterior components and all areas of the property to document findings. Verifies legal descriptions in public records and uses comparable methods to determine value.

• Prepares detailed appraisal reports. Communicates and coordinates with staff within FEMA as well as local, state, tribal and/or territorial governments.

• May coordinate and complete basic to moderately complex site inspections to validate and record damage to assist in the FEMA Public Assistance grant delivery process.

• Performs other duties as assigned.

\#LI-LP2

**Job Title:**

FEMA - Insurance Specialist

**Group:**

WAF Field Mod Fringe

**Employment Type:**

Temporary

**Minimum Qualifications:**

• HS Diploma or equivalent.

• 5 years of in-field experience or 2 years of in-field of expertise with a bachelor’s degree.

Domestic travel is required.

**EEO Statement:**

We attract the best people in the industry, supporting their efforts to learn and grow. We strive to create a challenging and progressive work environment. We provide career opportunities that span a variety of disciplines and geographic locations, with projects that our employees plan, design, build and operate as diverse as the needs of our clients. CDM Smith is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, pregnancy related conditions, childbirth and related medical conditions, sexual orientation, gender identity or gender expression), national origin, age, marital status, disability, veteran status, citizenship status, genetic information or any other characteristic protected by applicable law.

**Why CDM Smith?:**

Check out this video and find out why our team loves to work here! (https://www.cdmsmith.com/en/Video/Meet-CDM-Smith)

**Join Us! CDM Smith – where amazing career journeys unfold.**

Imagine a place committed to offering an unmatched employee experience. Where you work on projects that are meaningful to you. Where you play an active part in shaping your career journey. Where your co-workers are invested in you and your success. Where you are encouraged and supported to do your very best and given the tools and resources to do so. Where it’s a priority that the company takes good care of you and your family.

Our employees are the heart of our company. As an employer of choice, our goal is to provide a challenging, progressive and inclusive work environment which fosters personal leadership, career growth and development for every employee. We value passionate individuals who challenge the norm, deliver world-class solutions and bring diverse perspectives. Join our team, and together we will make a difference and change the world.

**Job Site Location:**

United States - Nationwide

**Agency Disclaimer:**

All vendors must have a signed CDM Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or written commitments from any other member of the CDM Smith staff will not be considered binding terms. All unsolicited resumes sent to CDM Smith and any resume submitted to any employee outside of CDM Smith Recruiting Center Team (RCT) will be considered property of CDM Smith. CDM Smith will not be held liable to pay a placement fee.

**Amount of Travel Required:**

100%

**Assignment Category:**

Fulltime-Temporary

**Visa Sponsorship Available:**

No - We will not support sponsorship, i.e. H-1B or TN Visas for this position

**Skills and Abilities:**

• Must be a U.S. citizen and be able to obtain a FEMA Badge, which includes a background investigation for a Public Trust position.

• High competency with the use of computers and computing software (Word, Excel).

• Demonstrates good organizational skills to balance and prioritize work.

• Demonstrates strong attention to detail and ability to work independently.

• Good written and oral communication skills.

• Ability to work with multiple stakeholders and process a large volume of requests.

• Ability to adapt to change quickly and remain flexible.

**Background Check and Drug Testing Information:**

CDM Smith Inc. and its divisions and subsidiaries (hereafter collectively referred to as “CDM Smith”) reserves the right to require background checks including criminal, employment, education, licensure, etc. as well as credit and motor vehicle when applicable for certain positions. In addition, CDM Smith may conduct drug testing for designated positions. Background checks are conducted after an offer of employment has been made in the United States. The timing of when background checks will be conducted on candidates for positions outside the United States will vary based on country statutory law but in no case, will the background check precede an interview. CDM Smith will conduct interviews of qualified individuals prior to requesting a criminal background check, and no job application submitted prior to such interview shall inquire into an applicant's criminal history. If this position is subject to a background check for any convictions related to its responsibilities and requirements, employment will be contingent upon successful completion of a background investigation including criminal history. Criminal history will not automatically disqualify a candidate. In addition, during employment individuals may be required by CDM Smith or a CDM Smith client to successfully complete additional background checks, including motor vehicle record as well as drug testing.

**Pay Range Minimum:**

$33.60

**Pay Range Maximum:**

$67.20

**Additional Compensation:**

All bonuses at CDM Smith are discretionary and may or may not apply to this position.

**Work Location Options:**

Successful candidate will be required to work in office and field locations as needed.

**Driver's License Requirements:**

An appropriate and valid driver's license is required.

**Seeking candidates for a potential future opportunity!:**

We are excited to announce that CDM Smith won the next 5-year contract for Public Assistance Technical Assistance Contractors – PA TAC V in the West Zone. The West Zone includes Alaska, Washington, Oregon, Idaho, Nevada, California, Arizona, Northern Mariana Islands, American Samoa, Guam, Hawaii, Nebraska, Iowa, Kansas and Missouri. We are looking for qualified candidates for this position in anticipation of future project opportunities. Please note this is an “Evergreen” position which will be used to build our candidate pool but is not a role that is open at this time. If you are interested in being considered for this position should this position become available, we encourage you to apply to be part of our talent community. By having your information on file, we can reach out to you when this or a similar role officially opens.

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®

Most Loved Workplace®

Forbes Best-in-State Employer

Claims Adjuster - Workers Compensation (REMOTE)

**PRIMARY PURPOSE** **:** To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

Florida experience preferred.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

+ Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.

+ Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

+ Manages subrogation of claims and negotiates settlements.

+ Communicates claim action with claimant and client.

+ Ensures claim files are properly documented and claims coding is correct.

+ May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

+ Maintains professional client relationships.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

+ Travels as required.

**QUALIFICATIONS**

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred.

**Experience**

Four (4) years of claims management experience or equivalent combination of education and experience required.

**Skills & Knowledge**

+ Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business

+ Excellent oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Analytical and interpretive skills

+ Strong organizational skill

+ Good interpersonal skills

+ Excellent negotiation skills

+ Ability to work in a team environment

+ Ability to meet or exceed Service Expectations

**WORK ENVIRONMENT**

When applicable and appropriate, consideration will be given to reasonable accommodations.

**Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

**Physical** **:** Computer keyboarding, travel as required

**Auditory/Visual** **:** Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®

Most Loved Workplace®

Forbes Best-in-State Employer

Claims Adjuster - Liability - Cerritos, California - We require adjusters with both litigation and public entity experience

**PRIMARY PURPOSE** :

To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

**_· Support our public entity liability desks in Cerritos, CA_**

**_· These positions focus on public entity claims involving Auto Liability (AL), General Liability (GL), Employment Practices Liability (EPL), and Childhood Sexual Assault cases_**

**_· We require adjusters with both litigation and public entity experience._**

**_· Very high Volume_**

**_· Call center environment_**

**_· Cradle to grave claim handling_**

**_**** During high volume account may be 6-7 days per week 10 hour days. This is fluid based on client need****_**

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

+ Assesses liability and resolves claims within evaluation.

+ Negotiates settlement of claims within designated authority.

+ Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

+ Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.

+ Prepares necessary state fillings within statutory limits.

+ Manages the litigation process; ensures timely and cost effective claims resolution.

+ Coordinates vendor referrals for additional investigation and/or litigation management.

+ Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.

+ Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.

+ Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.

+ Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.

+ Ensures claim files are properly documented and claims coding is correct.

+ Refers cases as appropriate to supervisor and management.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

+ Travels as required.

**QUALIFICATION**

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.

**Experience**

**_3+ Years with public entity and litigation experience – auto liability (AL), general liability (GL), employment practices liability (EPL), and childhood sexual assault case experience._**

**Skills & Knowledge**

+ Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.

+ Excellent oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Analytical and interpretive skills

+ Strong organizational skills

+ Good interpersonal skills

+ Excellent negotiation skills

+ Ability to work in a team environment

+ Ability to meet or exceed Service Expectations

**WORK ENVIRONMENT**

When applicable and appropriate, consideration will be given to reasonable accommodations.

**Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

**Physical:** Computer keyboarding, travel as required

**Auditory/Visual:** Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $33-$36/hr_ _. Eligible for 401K._ **_Always accepting applications_** _._

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)