NewCommercial Auto Bodily Injury Claims Representative Plymouth Rock Management Company of New JerseyCommercial Auto Bodily Injury Claims RepresentativeBoston, MA$86,000–$118,000 / yearThe Plymouth Rock Company and its affiliated group of companies that write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
Claims Consultant, Life Sciences CNAClaims Consultant, Life SciencesBoston, MassachusettsPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims with large exposures that require a high degree of 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 complex manage litigation and authorizing payments within scope of authority.
NewWorkers Compensation Claims Specialist, East CNAWorkers Compensation Claims Specialist, EastBoston, Massachusetts$54,000–$103,000 / yearEssential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Managing Director Strategic Claims Oversight - Healthcare Severity CNA Financial CorpManaging Director Strategic Claims Oversight - Healthcare SeverityBoston, MA$97,000–$189,000 / yearDevelops and maintains collaborative working relationships with internal and external business partners including Operations, Underwriting, Actuary and Risk Control and regularly shares claims outcomes, trends, legal developments and other relevant business updates. Responsible for the ongoing management of staff by attracting talent, setting clear direction, providing appropriate guidance, managing performance, recognizing contributions, and developing capabilities.
Major Litigation Unit Complex Claims Consulting Director CNA Financial Corp.Major Litigation Unit Complex Claims Consulting DirectorBoston, MA$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of the most complex commercial claims, which are generally multi-year and have very significant loss exposure, by following company protocols to manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which may include pursuit of risk transfer, extensive negotiations and complex litigation management. Drives the resolution of 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 - Hospitals , Allied Facilities And Physicians CNA Financial Corp.Complex Claims Consultant - Hospitals , Allied Facilities And PhysiciansBoston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex healthcare 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 Specialist - Professional Liability (Real Estate) CNA Financial Corp.Complex Claims Specialist - Professional Liability (Real Estate)Boston, MA$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Complex Claims Consultant - Lawyers Professional Liability (Large Law) CNA Financial Corp.Complex Claims Consultant - Lawyers Professional Liability (Large Law)Boston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex professional liability claims, with 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 Consultant, Life Sciences CNA Financial Corp.Claims Consultant, Life SciencesBoston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial claims with large exposures that require a high degree of 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 complex manage litigation and authorizing payments within scope of authority.
Complex Claims Consultant/Specialist - Lawyers Professional Liability CNA Financial Corp.Complex Claims Consultant/Specialist - Lawyers Professional LiabilityBoston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial 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 - Hospitals , Allied Facilities and Physicians CNA Financial CorpComplex Claims Consultant - Hospitals , Allied Facilities and PhysiciansBoston, MA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex healthcare 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.
NewComplex Claims Consultant - Healthcare Medical Malpractice CNA Financial Corp.Complex Claims Consultant - Healthcare Medical MalpracticeBoston, MA$72,000–$141,000 / yearResolves 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. Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial 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.
NewDSNP Claims Resolution Coordinator Mass General BrighamDSNP Claims Resolution CoordinatorSomerville, MassachusettsRemote$19.81–$28.30 / hourThe DSNP Claims Resolution Coordinator is responsible for reviewing, researching, and resolving Dual Eligible Special Needs Plan (DSNP) claim inquiries, provider correspondence, and escalations received through Customer Service and internal business partners. This role determines whether claim adjustments are needed, applies Medicare and Medicaid benefit and payment guidelines, and ensures claims are processed accurately, timely, and in accordance with Mass General Brigham Health Plan policies, contractual requirements, and regulatory expectations.
Complex Claims Consulting Director - Healthcare Severity & Excess Team CNA Financial Corp.Complex Claims Consulting Director - Healthcare Severity & Excess TeamBoston, MA$97,000–$189,000 / yearCNA is a market leader in insuring Healthcare providers and entities including Allied Healthcare Facilities, Aging Services and Allied Healthcare Providers, including nurses, nurse practitioners, physical therapists, counselors, pharmacists, massage therapists, and more than 100 other categories of medical service providers. This role is responsible for analyzing complex coverage matters, driving claim resolution, managing complex litigation including risk transfer opportunities, advising leadership on legal and claim risks, and partnering with Underwriting and other business units on emerging trends and portfolio management.
Remote Claims Representative 630810 Metro Public AdjustmentRemote Claims Representative 630810Woonsocket, RIRemoteAccepting applications form Rhode Island, Connecticut, New Hampshire, Vermont, Maine, New York and New Jersey in the United States only. If you think you would be a great fit for our team, click Apply to seize this opportunity and shape your own future You will receive a link to schedule an informative interview session.
NewPharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistWaltham, MassachusettsSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
Claims Manager, SDI AXA SAClaims Manager, SDIBoston, MA$139,300–$219,300 / yearClaims Manager - SDI Chicago, IL | Hartford, CT | Exton, PA | New York, NY | Morristown, NJ| Boston, MA | USA As the SDI Claims Manager, you will play a pivotal role in leading a team that handles high-exposure Subcontractor Default Insurance (SDI) claims for some of the largest construction contractors in the industry. By combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business property, casualty, professional, financial lines and specialty.
Claims Account Manager, Wholesale AXA SAClaims Account Manager, WholesaleBOSTON, MA$139,300–$219,300 / yearClaims Account Manager - Wholesale Location - Exton, Hartford, NYC, Chicago As a Claims Account Manager - Wholesale, you will be responsible for claim account management functions for customers in our growing Wholesale (Programs, Excess & Surplus) business unit, helping to deliver on AXA XL Claims value in the marketplace and managing claims-related service issues for our customers, Third Party Administrators ("TPA") and key distribution partners. By combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business property, casualty, professional, financial lines and specialty.
NewClaims Research & Resolution Representative Humana IncClaims Research & Resolution RepresentativeMARemote$40,000–$52,300 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Property Claims Specialist Ursus, Inc.Property Claims SpecialistAndover, MA$30–$32.47 / hourExcellent written communication: capable of presenting work and writing work reports, scope of work, and contractual documentation; Excellent verbal communication: able to verbalize in clear, concisely, and tactful communication with senior executive management, clients, peers, and team members. The position is responsible for the day-to-day activity of property loss and business interruption claims, communication of loss incidents, interaction/coordination with Operations and Maintenance groups, claims submission, preparation and coordination with claims consultants, financial tracking and reporting for accounting, and status reporting on recovery.