Inside Property Claims Adjuster owns claims from investigation through resolution, gathering information, evaluating damages, reviewing coverage, and helping customers understand what comes next.
Compensation
Base compensation offered for this role is $68,500 - $117,700 annually.
Responsibilities
Investigate, evaluate, and resolve complex first-party homeowner claims
Determine coverage and assess damages
Identify subrogation and fraud potential
Negotiate claim settlements
Provide guidance and support to junior adjusters
Requirements
Nice to have: First-party homeowner/property claims handling
Nice to have: Coverage analysis and complex claims investigations
Nice to have: Residential construction and repair knowledge
Nice to have: Subrogation and fraud identification
Nice to have: Negotiation and settlement of property claims
The role involves handling non-voice customer interactions via email, chat, and social media, resolving queries, maintaining CRM records, and ensuring quality service delivery.
Responsibilities
Handle incoming customer queries via phone, email, chat, or social media
Provide accurate and timely information to customers regarding products, services, or policies
Resolve customer complaints efficiently and escalate issues when necessary
Follow standard operating procedures (SOPs) and company guidelines to ensure consistent service delivery
Maintain documentation and update customer records accurately in the CRM or relevant databases
Patient Support Services Representative handling patient calls, insurance correspondence, billing, and collections for Hudson Headwaters Health Network.
Responsibilities
Support all inquiries internally and externally following HIPAA guidelines
Verify accuracy of demographic and insurance information
Educate Network staff on participating insurances, eligibility status, claims inquiries, and adjustments or appeals
Complete audits as necessary
Oversee hold, MGRHOLD, and other buckets assigned by manager
Supervises claims-resolution staff and oversees post-billing claim resolution across clinic and pharmacy revenue streams.
Responsibilities
Supervise claims-resolution staff, including scheduling, timekeeping, workload allocation, coaching, quality oversight, and performance management.
Ensure clinic and pharmacy claims are followed, corrected, reconsidered, appealed, escalated, and resolved within payer and organizational deadlines.
Review complex, high-dollar, aged, denied, rejected, underpaid, recouped, or otherwise at-risk claims and determine the appropriate resolution path.
Validate that account activity, payer correspondence, appeal support, expected reimbursement, adjustments, and final disposition are accurate and fully documented.
Escalate payer processing failures, contractual disputes, access barriers, and material financial risks through established internal and external channels.
Requirements
High school diploma or GED
Associate degree in healthcare administration, business, health information management, finance, or related field
Bachelor’s degree in healthcare administration, business, health information management, finance, or related field
Manages the most complex investigations of claims, including coverage defenses, liability and damages exposures, and directs all types of investigative activity or litigation on major claims.
Compensation
In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $97,000 to $189,000 annually.
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