Manage end-to-end drug prior authorization and claims cases, assessing requests against clinical guidelines and plan provisions.
Communicate authorization outcomes clearly to members, providers, and internal stakeholders while resolving escalated and complex scenarios.
Serve as a subject matter expert to support teams, training, and continuous improvement initiatives.
The hiring company operates in the insurance and benefits sector, managing complex drug prior authorization and claims cases. It is a global organization with a collaborative culture that values flexibility, continuous improvement, and employee well-being.
Guide customers through the claims process, investigating and processing claims for vehicle/property damage and moderate bodily injury.
Review coverage, set reserves, arrange inspections and rentals, and address customer inquiries to ensure satisfaction and retention.
Analyze medical records, negotiate settlements, and collaborate across departments and team members for a smooth claims experience.
Mercury Insurance helps people reduce risk and overcome unexpected events with auto and property insurance. As one of America's Best Midsize Employers for 2026, the company fosters a culture of growth, fun, and teamwork.
Provide consultative support and policy management for commercial insurance clients across accounts, new business, or renewals.
Drive growth by identifying upsell opportunities, negotiating with underwriters, and converting inbound leads.
Collaborate with team members and partners to deliver tailored coverage solutions while maintaining accurate records.
Zensurance is an InsurTech platform redefining commercial insurance for Canadian businesses through a digital-first experience. The company has been recognized by Deloitte's Technology Fast 50 and Fast 500 for its rapid growth and values ownership, collaboration, and innovation.
Analyze complex liability claims to determine benefits and ensure timely resolution.
Negotiate settlements within authority and identify subrogation opportunities.
Communicate claim activity with claimants, clients, and excess carriers.
Sedgwick is a global risk and claims administration partner helping clients navigate the unexpected. With over 33,000 colleagues worldwide, we foster a caring, inclusive culture.
Manage accident-related accounts from intake to resolution, coordinating no-fault and liability benefits.
Submit claims to carriers, maintain accurate records in AcciClaim, and monitor insurance portals.
Work independently, set priorities, and communicate professionally with patients and adjusters.
Revecore helps hospitals recover revenue they've earned so they can continue serving patients and communities. Trusted by more than 1,300 hospitals across 48 states, the company combines specialized expertise with proprietary technology and fosters a supportive, innovative workplace.
Investigate new claims, make liability/coverage decisions, and negotiate settlements for auto, property, and liability losses.
Manage outside adjusters and experts, ensure state compliance, and maintain required licenses.
Handle small claims suits and respond to time-sensitive arbitrations and DOI complaints.
ClaimsPro LP, part of Davies, provides insurance claims management services, handling liability, auto, property, and marine claims across the US. Davies is Canada's largest privately owned insurance services provider, fostering a culture of continuous learning and technical excellence.
Assess client needs and present insurance options through virtual meetings.
Maintain relationships and handle admin tasks like notes, appointments, and CRM hygiene.
Work from home with a qualified-interest pipeline and no cold calling.
Global Elite Empire Consultants is a remote insurance company that helps clients assess needs and select coverage options. They offer a performance-driven, competitive culture with full training and a qualified lead pipeline.
Assess client needs and teach insurance options through virtual consultations.
Manage administrative tasks including notes, appointments, and CRM hygiene.
Utilize a qualified-interest pipeline without cold calling and advance based on performance.
Global Elite Empire Consultants is a remote insurance consulting firm that provides personalized insurance solutions to clients. The company fosters a performance-driven culture with a focus on training and remote collaboration.
Investigates and processes commercial claims, evaluating coverage and damages within assigned authority.
Communicates directly with insureds, claimants, agents, and internal customers to resolve claims.
Documents claim files, negotiates settlements, and identifies fraud or subrogation potential.
Liberty Mutual is a global insurance company offering commercial and personal insurance products and services. With a fast-growing and inclusive culture, the company values employee development, well-being, and diversity across its large national workforce.
Manage the investigation, evaluation, and resolution of complex auto and homeowner's casualty claims, including severe and catastrophic injuries.
Collaborate closely with trial counsel and attend mediations, arbitrations, trials, hearings, and conferences.
Maintain accurate reserves, oversee counsel billing, and identify suspicious claims for SIU or subrogation.
Liberty Mutual is a global insurance company that provides property and casualty insurance, showing up for people in their toughest moments. With a large and diverse workforce, the company fosters an inclusive culture that values professionalism, integrity, and empathy, and invests in employees' growth and well-being.