System OneHealthcare Claims Adjuster System OneHealthcare Claims AdjusterBaltimore, MD$25.76–$25.76 / hourWe’re hiring a Healthcare Claims Adjuster with a strong claims processing background and exposure to adjustments, rework, or dispute resolution who wants to grow in that area. System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America.
Metro Public AdjustmentNewClaims Representative- Public Adjusting Services | Flexible Hours Metro Public AdjustmentClaims Representative- Public Adjusting Services | Flexible HoursBaltimore, MD$50,000–$65,000 / yearPart timeNow, we're expanding our team and looking for motivated individuals who want flexibility, independence, and unlimited growth potential. We specialize in helping policyholders receive the maximum settlement they are entitled to under their insurance policies.
System OneClient Relationship Manager System OneClient Relationship ManagerBaltimore, MD$32.10–$32.10 / hourIn this role, you’ll manage escalated service issues and serve as a key point of contact for members and brokers—especially when situations are complex, urgent, or sensitive. System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America.
MedStar HealthPharmacy Technician MedStar HealthPharmacy TechnicianBaltimore, MD$19.55–$34.25Processes refills and performs data entry of new prescriptions including demographics, insurance plans, and prescription information under the supervision of a pharmacist and according to policy; brings to the attention of a pharmacist any claims requiring overrides or interventions; troubleshoots insurance claim rejects; and follows up on problem prescriptions. Processes cash, check, credit card and payroll deduction transactions; secures appropriate signatures; ensures compliance with HIPAA requirements; prepares delivery tickets; reconciles delivery transactions; performs end of day register procedures; runs daily cash report and completes deposits as assigned.
WGK Personal Injury LawyersNewBilingual Personal Injury Legal Assistant WGK Personal Injury LawyersBilingual Personal Injury Legal AssistantBaltimore, MD$25–$31.50 / hourThis includes fielding inbound lead calls, conducting intake interviews in Spanish to gather key facts, assessing case qualification, and guiding eligible clients through the sign-up process in their preferred language. Lost Wage and PIP/Med Pay Claims: You will be responsible for opening and managing first-party claims on behalf of clients, including PIP, MedPay, and lost wage claims.
Ampcus IncorporatedClaims - Adjuster, Claims I Ampcus IncorporatedClaims - Adjuster, Claims IBaltimore, MD$20–$25.75 / hourVerifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records. Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services.
The Progressive CorpClaims Adjuster Trainee The Progressive CorpClaims Adjuster TraineeLancaster, PA$54,000–$57,500 / yearFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://www.progressive.com/careers/how-we-hire/faq/job-scams/. This is a hybrid role, which means you'll work in-office two days that are selected by local leadership and choose where you want to work the other three days, whether that's at home or in the office, for a period of 12 months.
TalteamClaims - Adjuster, Claims I TalteamClaims - Adjuster, Claims IBaltimore, MDVerifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records. The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs.
Lumen Solutions Group, Inc.Claims Adjuster Lumen Solutions Group, Inc.Claims AdjusterBaltimore, MDRemoteThis position is ideal for professionals who have hands-on experience reviewing, researching, adjusting, and resolving claims-related issues while ensuring accuracy and compliance with established guidelines. The ideal candidate will possess a strong background in healthcare claims processing and claims adjustments, with experience working on payer-side operations.
Sedgwick Claims Management Services, Inc.Workers Compensation Claims Adjuster | NJ & VA Jurisdictions | Dedicated Client & Capped Caseload Sedgwick Claims Management Services, Inc.Workers Compensation Claims Adjuster | NJ & VA Jurisdictions | Dedicated Client & Capped CaseloadTelecommuter, MD$70,000–$80,000 / yearPRIMARY PURPOSE OF THE ROLE: To analyze mid to high level Workers Compensation Lost-Time 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Argo Group International Holdings IncTEMP-Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers' Compensation Claims AdjusterMD$41.44–$48.79 / hourBoston 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), Washington, D. C. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
GallagherSenior Workers Compensation Claims Adjuster - DE, PA, NJ GallagherSenior Workers Compensation Claims Adjuster - DE, PA, NJNewark, DelawareRemoteThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives.
GallagherSenior Lost Time Workers Compensation Claims Adjuster - MD, VA, DC GallagherSenior Lost Time Workers Compensation Claims Adjuster - MD, VA, DCHunt Valley, MarylandRemoteThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives.
GallagherSenior Claims Adjuster Workers Compensation GallagherSenior Claims Adjuster Workers CompensationNewark, DelawareRemoteThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives.
GallagherSenior Workers Compensation Claims Adjuster - VA, DC, MD GallagherSenior Workers Compensation Claims Adjuster - VA, DC, MDBaltimore, MarylandRemoteThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives.
Argo Group International Holdings IncTEMP- Claims Adjuster Argo Group International Holdings IncTEMP- Claims AdjusterMD$37.66–$44.33 / hourCalifornia outside of Los Angeles, San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Washington State, and New York State (including Westchester County) Pay Ranges: $41.44 - $48.79 per hour. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Argo Group International Holdings IncTEMP- Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP- Workers' Compensation Claims AdjusterMDRemote$37.66–$44.33 / hourBoston 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), Washington, D. C. Summary: We are looking for a highly capable Workers' Compensation Claims Adjuster to help us with a temporary assignment with a projected end date of 9 October 2026, and work from any of the following office locations: Albany, Chicago, Los Angeles, New York City, Omaha, or Richmond (VA).
Argo Group International Holdings IncTEMP Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP Workers' Compensation Claims AdjusterMD$37.66–$44.33 / hourBoston 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), Washington, D. C. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Zenith American SolutionsMedical Claims Adjuster Zenith American SolutionsMedical Claims AdjusterSparks, MarylandWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
Sinai Hospital of BaltimoreLEGAL COORDINATOR - ENTERPRISE RISK, CLAIMS, INSURANCE Sinai Hospital of BaltimoreLEGAL COORDINATOR - ENTERPRISE RISK, CLAIMS, INSURANCEOwing Mills, MDLEGAL COORDINATOR - ENTERPRISE RISK, CLAIMS, INSURANCE in Owing Mills, MD - LifeBridge Health Career Site LEGAL COORDINATOR - ENTERPRISE RISK, CLAIMS, INSURANCE in Owing Mills, MD - LifeBridge Health Career Site Save Job Saved. Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support - improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.
Nationwide Mutual Insurance CoField Claims Adjuster III, PL Property (Flex Team) Nationwide Mutual Insurance CoField Claims Adjuster III, PL Property (Flex Team)Baltimore, MD$79,500–$148,500 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. Qualifications: · 5 years of insurance field/property claims handling or adjusting experience · Solid experience/proficiency with Xactimate · Solid experience writing own estimates and handling claims start to finish · Strong customer service competency · Strong written & verbal communication skills.
Argo Group International Holdings IncSenior Construction Defect Technical Claims Specialist Team Lead Argo Group International Holdings IncSenior Construction Defect Technical Claims Specialist Team LeadMDRemote$156,000–$187,500 / 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. Qualifications / Experience Required: A deep knowledge of construction defect claims adjudication, along with an exceptional focus on customer service, typically achieved through: A minimum of seven years' experience adjudicating construction defect claims with exposure of $100,000 or more.
PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, Manager PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, ManagerBaltimore, MD$99,000–$232,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. You will analyze client needs, implement solutions, and provide training and support to validate seamless integration and utilization of business applications, enabling clients to achieve their strategic objectives.
CSAA Insurance GroupCommercial Claims Quality & Performance Analyst III - Remote CSAA Insurance GroupCommercial Claims Quality & Performance Analyst III - RemoteHome Teleworkers, MDRemote$74,295–$82,550 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker {+ 21 more}. Partners cross-functionally with Claims Operations Support, TPA relationship managers, business leadership, Legal/Compliance teams, and operational partners to identify risks, evaluate performance trends, and develop solutions that support operational excellence and regulatory compliance.
Ultimate Staffing ServicesClaims Administrator Ultimate Staffing ServicesClaims AdministratorSparks, Maryland$55,000–$65,000This entry-level position is ideal for individuals interested in launching a career in insurance and gaining hands-on experience in claims handling. * Proficiency in Microsoft Word, Excel, and Outlook, with the ability to learn new systems quickly.
Sun Life Financial IncSenior Manager, Insurance and Claims Advocacy Sun Life Financial IncSenior Manager, Insurance and Claims AdvocacyBaltimore, MD$76,200–$114,300 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Sun Life Financial IncSenior Manager, Stop Loss & Health Claims Sun Life Financial IncSenior Manager, Stop Loss & Health ClaimsBaltimore, MD$68,200–$102,300 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Baltimore County MarylandAssistant County Attorney III, Chief of Claims Management - Non-Merit Baltimore County MarylandAssistant County Attorney III, Chief of Claims Management - Non-MeritTowson, MD$95,880–$151,097 / yearUnder the general supervision of the Deputy County Attorney, supervises liability and worker's compensation claims against the Baltimore County Self Insurance Fund; supervises administrative staff (excluding attorneys) handling primarily first party and property damage claims; utilizes working knowledge within office setting, providing guidance and technical assistance in order to meet unit goals. Prepares and tries complex cases on behalf of the Baltimore County government in State appellate and Federal courts and the Circuit Court of Baltimore County; prepares briefs, interrogatives, motions and other documents necessary for the proper defense of the County.
AECOMContract Claims Manager AECOMContract Claims ManagerBaltimore, MD$140,000–$182,272.43 / yearWe invite you to bring your bold ideas and big dreams and become part of a global team of over 50,000 planners, designers, engineers, scientists, digital innovators, program and construction managers and other professionals delivering projects that create a positive and tangible impact around the world. The Claims Manager will be responsible for coordinating and reviewing potential contract changes; engaging in claims avoidance activities; and engaging, strategizing, and working with construction oversight teams to support merit assessments and resolution of claims.
CorVel CorpLiability Claims Specialist CorVel CorpLiability Claims SpecialistNottingham, MDRemote$52,999–$85,473 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. The Liability Claims Specialist manages non-complex and non-problematic Heavy Auto and/or General Liability claims under direct supervision of a senior claims professional.
Sun LifeSenior Manager, Insurance and Claims Advocacy Sun LifeSenior Manager, Insurance and Claims AdvocacyBaltimore, MaineThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Kinsley Steel IncClaims & Contracts Paralegal Kinsley Steel IncClaims & Contracts ParalegalYork, PAKinsley Steel, Inc. is a Drug Free Workplace where post-offer applicants and employees are subject to testing for marijuana, cocaine, opioids, amphetamines, PCP, and alcohol when criteria is met as outlined in our policies. Our certified and highly-skilled teams specialize in structural steel design, engineering, detailing, fabrication, erection and retrofit to existing structural members.
Sedgwick Claims Management Services, Inc.Claims Representative (IAP) - Workers Compensation Training Program | Hunt Valley, MD Sedgwick Claims Management Services, Inc.Claims Representative (IAP) - Workers Compensation Training Program | Hunt Valley, MDHunt Valley, MDMental: 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
Sedgwick Claims Management Services, Inc.Claims Representative, Auto | Property Damage Sedgwick Claims Management Services, Inc.Claims Representative, Auto | Property DamageTelecommuter, MD$50,000–$55,000 / yearProcesses auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Education & Experience: Three (3) years of personal line or commercial line property claims management experience or equivalent combination of education and experience required to include knowledge of construction basics.
Sedgwick Claims Management Services, Inc.Claims Representative, Auto Sedgwick Claims Management Services, Inc.Claims Representative, AutoMD$50,000–$55,000 / yearProcesses auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Sun Life Financial IncSenior Manager, Claims Sun Life Financial IncSenior Manager, ClaimsBaltimore, MD$72,500–$108,800 / yearThe Senior Manager, Life & Disability Claims is part of the Claims Management Team and is responsible for the successful management of the day-to-day operations of our Long Term Disability claims team, as well as fostering client relations and ensuring the accurate risk management of disability claims. What you will do: Leads, manages, hires, trains, retains and motivates a team of claims professionals capable of and committed to providing exceptional service to clients, claimants and internal DRMS partners.
Sun Life Financial IncAssociate Director, LTD Claims Sun Life Financial IncAssociate Director, LTD ClaimsBaltimore, MD$103,000–$154,500 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Blue Cross and Blue Shield AssociationPrincipal Solutions Architect - Claims Processing (Remote) Blue Cross and Blue Shield AssociationPrincipal Solutions Architect - Claims Processing (Remote)Baltimore, MDRemote$155,600–$278,135 / yearMust have recent solution/domain architecture experience with Facets G6 real-time and batch claims processing, pre-adjudication validation, EDI-based transaction data management, claim editing engines, and third-party integrations with partner organizations that provide these services. Has an expert knowledge of integration solutions and communicates with business owners, domain architects, other Solution Architects, technical delivery staff, and key technical stakeholders, including Security, Data, and Technology Centers of Excellence.
Under Armour IncGlobal Casualty Claims Specialist Under Armour IncGlobal Casualty Claims SpecialistBaltimore, MD$60,000–$80,000 / yearAt Under Armour, we are committed to empowering those who strive for more, and the companys values - Act Sustainably, Celebrate the Wins, Fight on Together, Love Athletes and Stand for Equality - serve as both a roadmap for our teams and the qualities expected of every teammate. Handles a multitude of tasks simultaneously while maintaining focus and effectiveness, maintaining a high productivity level to maximize the productivity of the department leadership.
CorVel CorpWorkers'''' Compensation Medical Only Claims Specialist CorVel CorpWorkers'''' Compensation Medical Only Claims SpecialistNottingham, MD$16.74–$26.92 / hourPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. ABOUT CORVEL: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
Arch Capital Group LtdVP, Consumer Claims Arch Capital Group LtdVP, Consumer ClaimsHunt Valley, MD$150,200–$202,770 / yearPosition Summary: The Vice President of Consumer Claims is responsible for overseeing the staffing, operational processes, and workflows for consumer claims related to warranty products, lender claims (such as GAP waivers, mortgage and lender-placed insurance), as well as travel, accident, and health claims. Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs.
Argo Group International Holdings IncNewSenior Environmental Technical Claims Specialist Argo Group International Holdings IncSenior Environmental Technical Claims SpecialistMD$99,200–$118,100 / yearAlternatively, we are also open to consider candidates working from home anywhere in the continental United States This individual will report to a manager who works in New York City and is focused on adjudicating first and third party commercial environmental claims (mostly complex storage tank claims) and contributing to providing superb results for our clients. Boston 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), Washington, D. C.
Argo Group International Holdings IncNewSenior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistMDRemote$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.
CNA Financial CorpComplex Claims Consultant - EPL, Private & NFP D&O CNA Financial CorpComplex Claims Consultant - EPL, Private & NFP D&OTimonium, MD$72,000–$141,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities Performs 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.
CNA Financial CorpComplex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OTimonium, MD$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.
Sedgwick Claims Management Services, Inc.Workers'''' Compensation Claims Examiner | NY & VT Jurisdictional Knowledge | Remote Sedgwick Claims Management Services, Inc.Workers'''' Compensation Claims Examiner | NY & VT Jurisdictional Knowledge | RemoteMDRemote$70,000–$80,000 / yearTo analyze Medical Only & Lost-Times 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. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Hybrid (Hunt Valley or Largo, MD office) | MD Jurisdictions Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Hybrid (Hunt Valley or Largo, MD office) | MD JurisdictionsHunt Valley, MD$65,000–$85,000 / yearTo analyze Lost-Time 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. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
TriWest Healthcare AllianceClaims Recoup & Collect Anlyst TriWest Healthcare AllianceClaims Recoup & Collect AnlystBaltimore, MDRemoteFull timeUnder limited supervision, manages and performs claims department activities related to recoupments and collections, including validation of recoupment setup, conducting collections calls with providers, establishing payment arrangements, tracking and trending outstanding recoupments, establishing payment arrangements, and coordinating collections activities with other departments. Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding.
TriWest Healthcare AllianceSupervisor, Claims Admin TriWest Healthcare AllianceSupervisor, Claims AdminBaltimore, MDRemoteFull timeThe Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.
CorVel CorpClaims Specialist CorVel CorpClaims Specialistnottingham, MD$51,807–$83,551 / yearThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.