Workers Compensation Claims Examiner | VA Jurisdiction Experience Required | Remote Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | VA Jurisdiction Experience Required | RemoteVARemote$80,000–$90,000 / yearMental: 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. To analyze Virginia Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Head Of Claims HITTHead Of ClaimsFalls Church, VA$115,000–$165,000 / yearThis role is responsible for enterprise claims strategy, portfolio performance, reserve adequacy, litigation oversight, and total cost of risk while leading the claims organization and partnering with executive leadership on risk financing and insurance program strategy. Job Description: The Senior Manager, Claims & Risk Management leads HITT's enterprise claims function across all property and casualty lines for HITT Contracting and its affiliated operating companies.
ServiceNow Claims Lead Engineer The Fortegra Group IncServiceNow Claims Lead EngineerWashington, DC$120,000–$180,000 / yearThe platform leverages ServiceNow Customer Service Management (CSM), App Engine, and Integration Hub with extensive scripted customizations and complex integrations across policy administration, financial systems, and enterprise data platforms. This role is focused on architecture, design, and hands-on development, working closely with engineering leadership, product stakeholders, and a Software Integrator (SI) to deliver scalable, high-quality solutions.
Complex Claims Consultant - Epl, Private & NFP D&O CNA Financial Corp.Complex Claims Consultant - Epl, Private & NFP D&OWashington, DC$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OWashington, DC$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Claims Resolution Representative Metasys TechnologiesClaims Resolution RepresentativeMcLean, VARemote$18.62–$23.27 / hourThis position serves as a crucial liaison between members, providers, agencies, and the internal claims department, demonstrating leadership, collaborative skills, and commitment to achieving results. Review paper claims and attachments, scanning them using scanning equipment to attach the documents to corresponding transaction control numbers.
Claims Appraiser - Auto Estimatics State FarmClaims Appraiser - Auto EstimaticsGaithersburg, Maryland$69,398.62–$91,000 / yearFull timeWith the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! Additional Details: Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).
Claims Management Program Analyst (O-5 Billet) Non-Supervisory U.S. Department of Homeland SecurityClaims Management Program Analyst (O-5 Billet) Non-SupervisoryWashington, DCLiaises regionally and, or, nationally with applicable stakeholders internal and external stakeholders [e.g., Customs and Border Patrol, Office of Field Operations, Homeland Security Investigation (HSI) and third-party claims vendor] regarding claims processes, trainings, and principles. Should possess some knowledge of International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), current procedural terminology (CPT), diagnosis-related group (DRG), and other Centers for Medicare and Medicaid Services (CMS) coding/billing requirements.
Claims Counsel (Insurance Defense) Williams & Connolly LLPClaims Counsel (Insurance Defense)Washington, DC$165,000–$180,000 / yearResponsibilities include, but are not limited to:* Developing a case strategy* Answering complaints* Drafting and responding to discovery* Client communications* Handling all communications with opposing counsel* Hiring and managing expert witnesses as needed* Drafting motions and responses to motions* Conducting and defending depositions* Drafting mediation statements* Conducting mediations* Appearing in court as needed* Pre-trial preparations* Conduct trials* Drafting settlement agreements* Administrative duties related to case tracking and reporting . This position requires the ability and flexibility to manage a high-volume caseload in cooperation with firm management, partners, associates, other Claims Counsel, and firm employees in a professional manner as well as the ability to manage and prioritize a large volume of work assignments, meeting all deadlines.
NewSenior Claim Adjuster - Workers' Comp FCCI Insurance GroupSenior Claim Adjuster - Workers' CompVA Field, VA$62,419–$96,126 / yearCurrently seeking an experienced Senior Work Comp Claim Adjuster to provide quality, cost efficient, and timely investigation of liability claims and provide exceptional customer service. The selected candidate will evaluate coverage/compensability and may need to complete field investigations with a focus on quality claim handling leading to file resolution.
Sr. Claims Specialist, Professional Liability | Medical Malpractice | Long Term Care Sedgwick Claims Management Services, Inc.Sr. Claims Specialist, Professional Liability | Medical Malpractice | Long Term CareMDIdeal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost‑effective claim resolutions while maintaining a high level of customer service. ESSENTIAL RESPONSIBLITIES MAY INCLUDE: Analyzes and processes complex or technically difficult medical malpractice 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.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistDCRemote$137,496–$164,934 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
Claims Resolution Representative Iconma LLCClaims Resolution RepresentativeVAReview paper claims and attachments, scanning them using scanning equipment to attach the documents to corresponding transaction control numbers. Approve or deny requests for transportation authorization from providers, verify member transportation claims, and process approved claims.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeDCEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
Risk and Claims Specialist Term (Not To Exceed 4 Years & 5 Months) Metropolitan Washington Airports AuthorityRisk and Claims Specialist Term (Not To Exceed 4 Years & 5 Months)Arlington, VA$92,812–$134,577 / yearThe Risk and Claims Specialist serves as a key subject matter expert in the Airports Authority's Risk Management Department, leading the investigation, evaluation, negotiation, and resolution of property, casualty, Workers' Compensation, construction related, and other lines of insurance claims. Works closely with the Claims Program Manager, Safety Program Managers, insurance carriers, legal counsel, outside attorneys, adjusters, and appraisers to evaluate liability, document damages, and resolve claims efficiently and fairly.
NewWorkers’ Compensation Claims Examiner GreenLife Healthcare StaffingWorkers’ Compensation Claims ExaminerWashington, DCJob Qualifications & Certifications: Bachelor’s degree and at least two years of workers’ compensation claims adjusting experience; or eight years of progressively responsible claims-handling experience, including at least three years of workers’ compensation claims adjusting experience. Complete required claim contacts, including 24-hour four-point contacts with injured workers, supervisors, medical providers, and other stakeholders; document activity in the claims management system.
Senior Provider Experience Program Manager - Healthcare Claims CVS Health CorpSenior Provider Experience Program Manager - Healthcare ClaimsDC$106,605–$284,280 / yearWhat you will do: Lead enterprise delivery of multiple, highly complex business process and technology initiatives aligned to the Provider Experience / Provider NPS program, supporting all lines of business. Drive Agile delivery of Provider Experience / Provider NPS initiatives, supporting business process and technology improvements across multiple lines of business.
Enterprise Claims Library Admin, Project Management Capital OneEnterprise Claims Library Admin, Project ManagementMcLean, VirginiaCDX is responsible for Capital One’s digital customer experiences, including its award winning mobile app, its online presence, and Enterprise-grade products and platforms used across all lines of business. Our team is responsible for administering and governing these platforms, and advising on the large-scale transformation of our content supply chain to unlock highly personalized, intelligent experiences for millions of current and prospective customers.
Medical Claims (Billing) Team Leader GT Independence CareersMedical Claims (Billing) Team LeaderSilver Spring, MarylandGT Independence is a family-founded, leading national Financial Management Services (FMS) provider that supports individuals participating in self-direction programs, helping them manage their long-term care and support services at home and in community-based settings. Dedicated to promoting personal choice, independence, and quality of life, GT Independence delivers reliable, person-centered financial and administrative services that empower individuals to direct their own care.
IT Production and Systems Support Engineer (Mainframe and Claims Processing) MindlanceIT Production and Systems Support Engineer (Mainframe and Claims Processing)Columbia, MDThe ideal candidate will combine mainframe expertise, application support, data analysis, and incident management skills to support both legacy and modern platforms while delivering high-quality service to internal teams and external plan vendors. This role is responsible for ensuring stability, performance, and continuous improvement of applications supporting claims vouchering, adjudication, and EDI processing.