NewPharmacy Technician Trainee WegmansPharmacy Technician TraineeWestwood, MA$20–$21 / hourAt Wegmans, our pharmacy technicians are instrumental in building trust by providing best-in-class service that sets Wegmans apart and ensures that customers are getting the medical attention, care, and health services that they depend on us for. Putting our people first and offering competitive compensation, comprehensive benefits and a wide range of meaningful perks is just the beginning of what defines a rewarding career at Wegmans.
NewHR Generalist (on site) gategroupHR Generalist (on site)Boston, MA$65,000–$70,000 / yearPartners with various levels of management to understand business objectives and identify corresponding human resource needs; implements strategies to support various business objectives and improve programs to support employee retention. Partners with operations to identify and understand workforce needs; may be responsible for recruiting union hourly employees and for assisting with recruitment for exempt and non-exempt positions.
Attorney Diedre Moire Corp.AttorneyNashua, NH$200,000–$300,000 / yearFull timeCONSIDERED EXPERIENCE INCLUDES: Attorney Lawyer Insurance Company Litigation Policy Development Transaction #DiedreMoire #InsuranceJobs #AttorneyJobs #LitigationJobs #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting. Described compensation is not definite nor precise and may be estimated and approximate and is negotiable depending on market conditions and candidate availability and other factors and is solely at the discretion of employers.
NewAccount Manager - Personal Lines Insurance Vaco LLCAccount Manager - Personal Lines Insurancelawrence, MA$62,000–$70,000 / yearDetermining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.
Accounts Receivable Lead SarnovaAccounts Receivable LeadBoston, MAThe A/R Management Lead also serves as a subject matter expert, identifying process improvements to increase efficiency within the A/R Management team, and acting as a resource to help team members resolve issues. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle.
NewPersonal Lines Account Manager Vaco LLCPersonal Lines Account ManagerNorth Andover, MA$70,000–$85,000 / yearDetermining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.
Insurance Underwriter Med-Mal Diedre Moire Corp.Insurance Underwriter Med-MalLondonderry, NH$150,000–$200,000 / yearFull timeCONSIDERED EXPERIENCE INCLUDES: Underwriting Underwriter VP AVP Medical Malpractice Physicians Surgeons Clinic Surgical Center Allied Healthcare Ambulatory Surgery Medical Labs Imaging Center Substance Abuse Center Ambulance Bariatric Facility Hospices Community Health Facility Blood Bank Weight Loss Center Pharmacies Lasik Center Hospital Nursing Homes Risk Management Specialty Coverage Professional Liability General Liability GL #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #Underwriter #CommercialInsurance. Underwriting Underwriter VP AVP Medical Malpractice Physicians Surgeons Clinic Surgical Center Allied Healthcare Ambulatory Surgery Medical Labs Imaging Center Substance Abuse Center Ambulance Bariatric Facility Hospices Community Health Facility Blood Bank Weight Loss Center Pharmacies Lasik Center Hospital Nursing Homes Risk Management Specialty Coverage Professional Liability General Liability GL _ .
TEMP-Workers'''' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers'''' Compensation Claims AdjusterMARemote$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. Clearing the error involves researching to obtain the missing or misaligned information (sometimes requiring communication with the claimant or insured) and entering or correcting data in various fields in either our claims system or the state's reporting site.
Auto Damage Claims Adjuster- Trainee The Progressive CorpAuto Damage Claims Adjuster- TraineeBedford, NH$58,100–$62,400 / yearFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . Individual will work in the field, office, body shop, network shop, or service center environment and at time be expected to lift, bend stretch, walk, crouch, twist and/or lay on floor.
Multi-Line Claims Adjuster - Massachusetts Provencher & Company, LLCMulti-Line Claims Adjuster - MassachusettsBoston, MAWe excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations.
Auto Claims Desk Adjuster Hybrid Liberty Mutual Holding Company IncAuto Claims Desk Adjuster HybridWestborough, MAYou'd be a great fit if you are: An Empathetic Service Professional: When a claim is received, you skillfully pick up the phone and use your customer centricity and problem-solving skills to confidently assure our customers that you are there to guide them through the process. 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.
Claims Adjuster Trainee The Progressive CorpClaims Adjuster TraineeBedford, NH$54,000–$57,500 / yearYou must reside within a commutable distance of Progressive's South Portland, Maine OR Bedford, NH Claims office at 600 Sable Oaks Dr., South Portland, ME 04106 or 43 Constitution Dr, Bedford, NH 03110. For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ .
Auto Damage Claims Adjuster The Progressive CorpAuto Damage Claims AdjusterBedford, NH$66,800–$81,600 / yearFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . Individual will work in the field, office, body shop, network shop, or service center environment and at time be expected to lift, bend stretch, walk, crouch, twist and/or lay on floor.
Field Property Claims Adjuster Liberty Mutual Holding Company IncField Property Claims AdjusterNewton, MAThe 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. This is a role where people who love every day to be new, different and exciting, can thrive - you'll be traveling on the road to meet customers in person, providing hands-on assessment of damage and empathetic support.
Senior Workers Compensation Claims Adjuster - CT, NH, VT, RI, MA GallagherSenior Workers Compensation Claims Adjuster - CT, NH, VT, RI, MAQuincy, MassachusettsRemoteFull timeThe 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. Investigate, evaluate, and resolve complex indemnity/lost time workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution.
Claims Specialist II - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims Adjuster Liberty Mutual Holding Company IncClaims Specialist II - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims AdjusterBoston, MAAssesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Boston, MA; Westborough, MA; Hoffman Estates, IL; Weatogue, CT; Indianapolis, IN; Plano, TX; Suwanee, GA; or Lake Oswego, OR; Las Vegas, NV; Chandler, AZ.
Claims Specialist - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims Adjuster Liberty Mutual Holding Company IncClaims Specialist - Rideshare Commercial Auto - Attorney Represented Bodily Injury Claims AdjusterMAAssesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. You will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Boston, MA; Westborough, MA; Hoffman Estates, IL; Weatogue, CT; Indianapolis, IN; Plano, TX; Suwanee, GA; or Lake Oswego, OR; Las Vegas, NV; Chandler, AZ.
TEMP-Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Workers' Compensation Claims AdjusterMA$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. Rockwood has become a leading underwriter of workers' compensation for the mining industry by offering workers' compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal.
TEMP-Senior Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP-Senior Workers' Compensation Claims AdjusterMA$48.65–$57.59 / 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 limited technical direction and within broad limits and authority, adjudicate highly complex indemnity workers' compensation claims on assignments reflecting potentially with significant impact on departmental results.
TEMP- Senior Workers' Compensation Claims Adjuster Argo Group International Holdings IncTEMP- Senior Workers' Compensation Claims AdjusterMA$48.65–$57.59 / 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 limited technical direction and within broad limits and authority, adjudicate highly complex indemnity workers' compensation claims on assignments reflecting potentially with significant impact on departmental results.
Senior Claims Representative Liberty Mutual Holding Company IncSenior Claims RepresentativeWestborough, MAResponsibilities: 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.
Insurance Claims Associate (Bilingual/Trilingual) Lendbuzz Funding LLCInsurance Claims Associate (Bilingual/Trilingual)MA$21–$26 / hourWe've been made aware of individuals falsely claiming to represent Lendbuzz using lookalike email addresses (eg @lendbuzzcareers.com). We develop innovative technologies that provide underserved and overlooked borrowers with better access to credit.
Senior Workers Compensation Claims Adjuster - New England GallagherSenior Workers Compensation Claims Adjuster - New EnglandQuincy, MassachusettsRemoteFull timeHow you'll make an impact : Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence.
Auto PD - Adjuster Service Claims The Hanover Insurance Group IncAuto PD - Adjuster Service ClaimsMADigital Fluency: Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes. Customer Centricity: Makes customers/clients and their needs a primary focus of one's actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meets or exceeds customer expectations.
Claims Adjuster II, Field Property - National Catastrophe Nationwide Mutual Insurance CoClaims Adjuster II, Field Property - National CatastropheBoston, MA$62,500–$115,500 / 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. In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments.
NewClaims Analyst - REMOTE Ryder System IncClaims Analyst - REMOTEBoston, MARemoteCompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( https://wd5.myworkday.com/ryder/d/task/2998$46522.htmld ) to log in to Workday to apply using the internal application process.
Claims Representative II - REMOTE Ryder System IncClaims Representative II - REMOTEBoston, MARemoteCompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( http://wd5.myworkday.com/ryder/d/task/1422$3.htmld ) to log in to Workday to apply using the internal application process.
Senior Director, Insurance Claims Ambassador Recruiting ServicesSenior Director, Insurance ClaimsBoston, MassachusettsThis role partners with internal leadership and external advisors to develop risk mitigation strategies, guide insurance decision-making, and support loss prevention initiatives. Our client in the medical sector is seeking a Senior Director, Insurance & Claims to lead and oversee the organization’s insurance programs, self-insured entities, and the management of professional liability and general claims.
AVP, US Healthcare Claims Sompo International Holdings LimitedAVP, US Healthcare ClaimsBoston, MA$145,000–$195,000 / yearThe successful candidate will be able to provide insight and analysis on US Healthcare claims across various product lines, including primary medical liability, excess and surplus lines, and allied healthcare. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Senior Technical Specialist, General Liability Claims Sompo International Holdings LimitedSenior Technical Specialist, General Liability ClaimsBoston, MA$115,000–$130,000 / yearEffectively represent the company's interests in meetings and negotiations; maintain a high level of claim and industry related expertise in order to assure technical competency and communicate to team members regarding significant issues and relevant changes. What you'll bring: Minimum 5 plus years' experience required in general liability claims handling with a career history of increasing responsibility with at least 3-5+ years handling excess claims, including large limit and high exposure claims.
Claims Consultant - Surety (Hybrid) Onebeacon Professional Insurance IncClaims Consultant - Surety (Hybrid)Boston, MA$143,000–$167,000 / yearFor candidates located in San Francisco, CA; Washington DC; our Massachusetts based offices and the New York City metro area, the base salary range is $143,000 - $167,000. In return, we promise you support, opportunities and performance-led financial rewards in a flexible work environment where you can: Shape the future: Help us lead an insurance transformation to better protect people, businesses and society.
Commercial General Liability Claims Representative CNA Financial CorpCommercial General Liability Claims RepresentativeMA$47,000–$78,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following company protocols to verify policy coverage, gather necessary information, maintain appropriate file documentation and authorize disbursements within authority limit. Exercises judgement to determine liability and compensability by conducting investigations to gather pertinent information, taking recorded statements from insureds, witnesses and working with experts to verify the facts of the claim.
Complex Claims Consulting Director - EPL, Private & NFP D&O CNA Financial CorpComplex Claims Consulting Director - EPL, Private & NFP D&OBoston, 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 EPL and Private and Not-For-Profit D&O, 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 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, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing settlements within scope of authority.
Insurance Claims Specialist IST Management Services IncInsurance Claims SpecialistMA$19–$21 / hourIST Management is a BPO Company (Business Process Outsourcing) specializing in providing solutions for the management of physical and digital information through Facilities Management, eDiscovery, and Electronic Document Management services. Consider a new career today as an Office Services Associate with IST Management Services, the fastest-growing, national, facilities management company in the industry.
Property & Casualty Insurance Claims Operations Consultant, Manager PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, ManagerMA$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.
NewDirector Casualty Claims The Hanover Insurance Group IncDirector Casualty ClaimsWorcester, MAResponsible for assessing the present and future resource needs for employees and providing the leadership, mentoring and guidance necessary to build and sustain a high performing workforce. Delivers effective leadership, technical direction, performance management, communication, relationship building, decision making, and customer service.
Casualty Claims Examiner Safety Insurance Group IncCasualty Claims ExaminerBoston, MAConveniently located in the heart of Boston's financial district, our downtown office is a positive space where employees can stay connected to both each other and the pulse of the city. Our success is built on a simple philosophy: deliver the highest quality insurance products at competitive rates while providing exceptional service at every step.
Auto/Physical Damage Claims Representative Concord General Mutual Insurance CompanyAuto/Physical Damage Claims RepresentativeWestborough, MassachusettsAbility to accurately deal with mathematical problems, including geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). Use technology-based information for reference, enter information into computer systems and develop specialized skills, including but not limited to property estimating, auto estimating, and use of computer-based programs as tools.
NewBusiness Analyst - Commercial Claims Payment SME Macpower Digital Assets Edge Private LimitedBusiness Analyst - Commercial Claims Payment SMEWaltham, MA$64 / hourProcess Mapping & Solution Definition Analyze current state payment workflows and define optimized target state solutions. Claims Payment Lifecycle Knowledge Bring expertise in insurance claims payment processing, payment channels, disbursements, payee information platforms, and master data management .
Sr. Claims Counsel, Environmental and Design Professional Liability Sompo International Holdings LimitedSr. Claims Counsel, Environmental and Design Professional LiabilityBoston, MA$125,000–$175,000 / yearThe successful candidate will be able to provide insight and analysis on complex high profile/high exposure Architects & Engineers (Design Professional Liability) and Environmental (Contractors Pollution and Professional Liability, Site Environmental Liability and Excess Environmental Liability) claims. Our business, your impact, our opportunity: What you'll be doing: Provide coverage, liability, and damages analysis for complex environmental and professional liability claims, including Architects & Engineers, Construction Professional, and Pollution.
CGL - Sr Technical Consultant Casualty Claims TalentBurst, Inc.CGL - Sr Technical Consultant Casualty ClaimsWorcester, MARemote$90,000–$120,000 / yearFully responsible for the analysis, investigation, evaluation, negotiation and resolution of complex commercial claims requiring thorough investigations including telephone contacts with the involved parties; technical expertise and complex analysis. Responsible for all aspects of each claim, including informal hearings, arbitrations and claims litigation and maintaining a high level of productivity, confidentiality and customer service.
Regional General Adjuster Specialized Claims - Large Loss Property - Northeast The Hanover Insurance Group IncRegional General Adjuster Specialized Claims - Large Loss Property - NortheastWorcester, MAPOSITION OVERVIEW: The Regional General Adjuster Specialized Claims is a senior-level claims position responsible for the full lifecycle management of highly complex and high-value Marine claims. The position demands a high level of technical expertise, strategic thinking, and collaboration with internal and external stakeholders, including legal teams, engineers, and other subject matter experts.
NewAssistant Director, Data Science: Claims & Service Liberty Mutual Holding Company IncAssistant Director, Data Science: Claims & ServiceBoston, MALead end-to-end development of new predictive models for high-impact business outcomes (e.g., improving claims handling efficiency): frame and test hypotheses, design statistically rigorous experiments, assemble/label training data, engineer features, and train/validate models. D. degree (in Statistics, Mathematics, Economics, Actuarial Science or other scientific field of study) and a minimum of 2 years of relevant experience, a Master s degree (scientific field of study) and a minimum of 4 years of relevant experience or may be acquired through a Bachelor s degree (scientific field of study) and a minimum of 5+ years of relevant experience.
NewClaims 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.
Senior Claims Examiner, Medical & Healthcare Claims Markel Group IncSenior Claims Examiner, Medical & Healthcare ClaimsMAThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. The primary purpose of this job is to handle claims from coverage enquiry through legal liability assessment (where relevant) and quantum analysis, to timely and accurate resolution; ensuring mitigation of indemnity and expense exposure while communicating developments and outcomes as necessary to all internal and external stakeholders.
NewDSNP Claims Resolution Coordinator Mass General BrighamDSNP Claims Resolution CoordinatorSomerville, MassachusettsRemoteThis 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. The 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.
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.
NewComplex Claims Consultant , Medical Malpractice and Dental CNA Financial CorpComplex Claims Consultant , Medical Malpractice and DentalBoston, 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.
NewClaims Consultant, Life Sciences CNA Financial CorpClaims 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 Consulting Director, Major Loss Unit CNA Financial CorpComplex Claims Consulting Director, Major Loss UnitMA$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.