Complex Claims Consultant - Healthcare Medical Malpractice CNAComplex Claims Consultant - Healthcare Medical MalpracticeChicago, Illinois$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. As a Complex Claims Consultant, you will be responsible for the overall investigation, management and resolution of claims in multiple states within your assigned jurisdiction including matters of different focus areas depending on the role available, that may involve nurses, therapists, counselors, dentists, aging services or other healthcare provider or facility insureds.
Claims and Research Analyst Zing HealthClaims and Research AnalystIL$64,000–$74,000 / yearMember-centric Impact Statement: From the first day of coverage through every claim and service interaction, Zing Core Operations is meant to reduce friction, fix problems quickly, and ensure members get the help and benefits they've earned-especially during high-stress moments. Supports claims editing escalated provider disputes/appeals and provides guidance across all areas of the company with regards to claims editing and proper coding, billing, and payment.
Complex Claims Consulting Director - Healthcare Severity & Excess team CNAComplex Claims Consulting Director - Healthcare Severity & Excess teamChicago, IllinoisCNA 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.
Claims Specialist, Cyber AXA SAClaims Specialist, CyberChicago, IL$83,500–$145,500 / yearCoordinating and managing communication with internal colleagues and key external stakeholders (e.g., clients, brokers, reinsurers, vendors, etc.) ensuring we are providing the highest level of customer service Responsive claims management in direct coordination with a diverse team of specialists: computer forensics, data breach notification and call center services, credit and ID monitoring, public relations and expert legal counsel. Managing assigned complex Cyber and Technology claims across multiple jurisdictions, setting the case strategy for these claims in partnership with the Cyber Practice Leader and Claims Management, and taking all available steps to achieve the optimal outcome.
AVP - Claims Operations Ryan Specialty GroupAVP - Claims OperationsChicago, IllinoisThe AVP Claims Operations is responsible for managing the team of claims professionals, developing strategic plans to optimize claim outcomes and ensure effective claim advocacy and handling. Differences in race, creed, color, religious beliefs, physical or mental capabilities, gender identity or expression, sexual orientation, and many other characteristics bring together varied perspectives and add value to the service we provide our clients, trading partners, and communities.
Claims Supervisor II - Commercial G/L Philadelphia Insurance CompaniesClaims Supervisor II - Commercial G/LNaperville, PennsylvaniaSummary : Supervises claims adjusters and technical support staff to manage the day-to-day handling and settlement of claims, the processing and tracking of documents, making payments, tracking trends and communicating with underwriting. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.
NewClaims Consultant - Advertising / Personal Injury CNAClaims Consultant - Advertising / Personal InjuryChicago, Illinois$72,000–$141,000 / yearIndividual contributor responsible for the overall strategic management and resolution of highly complex claims that involve personal and advertising injury exposures, including but not limited to intellectual property, class action, and commercial disparagement. Negotiates highly complex settlement packages, and authorizes payment within scope of authority, settling claims in most cost-effective manner and ensuring timely issuance of disbursements.
Remote Claims Representative - 630669D Metro Public AdjustmentRemote Claims Representative - 630669DHammond, INRemoteMetro Public Adjustment is looking for people who are interested in helping homeowners receive the maximum amount they are entitled from their insurance claim. We provide ongoing training and development opportunities to ensure that you will have the skills and knowledge needed to succeed.
Claims Specialist - Property Philadelphia Insurance CompaniesClaims Specialist - PropertyNaperville, IL$84,422–$99,320 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Senior Claims Representative Liberty Mutual Holding Company IncSenior Claims RepresentativeHoffman Estates, ILResponsibilities: Investigates claim using internal and external resources including speaking with the insured or other involved parties, analysis of reports, researching past claim activity, utilizing evaluation tools to make damage and loss assessments. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role.
NewPharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistWoodridge, IllinoisSkills/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, SDIChicago, IL$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 Manager OSI CareersClaims ManagerAurora, IllinoisPosition may require frequent and/or infrequent of bending, squatting, pushing, pulling, stretching/reaching, use hands or fingers, talk, hear, feel objects, tools, controls and standing/walking on concrete flooring. • Develops claim metrics on the mix of claims by type, root cause, frequency, and severity to identify emerging claims issues and trends for communication with management and develops performance benchmarks to track adjusters’ service level.
Major Case General Liability Claims Consultant The Hartford Insurance Group IncMajor Case General Liability Claims ConsultantNaperville, IL$84,800–$127,200 / yearFor full-time, occasional, part-time or remote positions: (1) high speed broadband internet service is required, we do not recommend or support DSL, wireless, Mifi, Hotspots, Fiber without a modem and Satellite; (2) Internet provider supplied modem/router/gateway is hardwired to the Hartford issued computer with an ethernet cable; and (3) minimum upload/download speeds of 5Mbps/30Mbps will be required. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Phoenix, AZ, Naperville, IL, Alpharetta, GA, NYC, NY) will have the expectation of working in an office 3 days a week (Tuesday through Thursday).
Claims Account Manager, Wholesale AXA SAClaims Account Manager, WholesaleCHICAGO, IL$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 and Resolution Prof Humana IncClaims Research and Resolution ProfILRemote$59,300–$80,900 / 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.
NewSr Claims Research and Resolution Humana IncSr Claims Research and ResolutionILRemote$71,100–$97,800 / 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.
Employment Practices Liability Claims Analyst The Hartford Insurance Group IncEmployment Practices Liability Claims AnalystNaperville, IL$82,800–$124,200 / yearCandidates should demonstrate the following competencies: Excellent oral and written communication skills; Strong strategic thinking abilities and execution skills; An ability to communicate thoughts clearly and concisely, and to influence and persuade others; Superior interpersonal skills, with an ability to work well as part of a team and/or in supporting roles. Experience, education and skills: Bachelor's degree required; professional designation and/or legal degree a plus; Insurance company (or law firm) experience a plus; Basic knowledge/understanding of professional lines, and/or litigated coverage and liability exposure desired; EPL a plus.
Senior Claims Specialist Professional Liability Non Profit D&O W. R. Berkley CorpSenior Claims Specialist Professional Liability Non Profit D&ONaperville, IL$135,000–$155,000 / yearAt Berkley Program Specialists, we are dedicated exclusively to program business and excel at partnering with program administrators who possess significant underwriting expertise for homogeneous, niche classes of business. This role requires deep technical expertise in claims-made coverage forms, strong analytical and negotiation skills, and a commitment to delivering exceptional customer service to insureds, brokers, and legal partners.
Pharmacy Prior Authorization Specialist Onco360Pharmacy Prior Authorization SpecialistWoodridge, IllinoisWhat You’ll Do The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests. Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds.