NewClaims Adjudicator Independent HealthClaims AdjudicatorBuffalo, NYThe Claims Adjudicator is responsible to respond to client, member, and/or provider inquiries on claim status, benefit designs, and claim payments working in conjunction with the Customer Service Representative. The Claims Adjudicator is responsible for adjudicating and adjusting medical and/or dental claims against established criteria, and in accordance with specific clients SPD's maintaining goals in accuracy and productivity.
NewClaims Representative Installs LLCClaims RepresentativeAmherst, NY$23–$25 / hourPart timeRisk management personnel manage the company’s risk by analyzing and purchasing risk transfer products, assessing, investigating and settling claims to limit ultimate liability, monitoring and assisting the work of outside legal counsel and third-party claims administrators, and reporting on loss history and trends to safety and operations departments and executive leadership. Job Summary : Responsible for taking first report calls of accidents from drivers, assigning adjusters as needed, inputting the information into the computer system, notifying third-party administrators of accidents and performing required follow-up on all these functions.
Claims Services Representative 1 / Trainee 1 / 2 New York State Thruway AuthorityClaims Services Representative 1 / Trainee 1 / 2Buffalo, NY$53,764–$85,158 / yearSubstitution: An associate degree may substitute for two years of experience; a bachelor's degree may substitute for four years of experience; a master's degree may substitute for five years of experience; and a doctorate may substitute for six years of experience. For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply.
Medical Analyst: Legal Nurse, Med. Malpractice Claims (6450) New York State Thruway AuthorityMedical Analyst: Legal Nurse, Med. Malpractice Claims (6450)Buffalo, NYThe Medical Analyst will review and analyze claims and potential claims for medical malpractice and personal injury; assist attorneys in the preparation of answers or other responses to claims under state and federal law; assist in the defense of cases, including participating in the discovery process; draft chronologies which outline the medical treatment rendered to patients; research medical topics relevant to medical malpractice cases; assist attorneys on medical issues and on communication with medical staff at correctional facilities and other medical facilities; and assist with trial preparation, including coordinating logistics for expert medical witness testimony and preparing exhibits for use in court. In addition, the Medical Analyst will assist in searching for and retaining experts needed to defend cases; upload medical records/chronologies and other documentation related to the case into OAG's case management system and routinely update the system; and assist with maintaining library books and supplies.
CAM Claims Processor III M&T Bank CorpCAM Claims Processor IIINY$22.61–$37.67 / hourUnderstand difference between the claim types: Short Sales, Foreclosure Claims, Third Party Claims, Charge Off, Security Claims, Loss Mitigation Claims, and Deed in Lieu Claims. Overview: Submits conventional claims, reviews losses, and reconciles loans for final booking by Default Accounting.
NewClaims Adjudicator Independent Health AssociationClaims AdjudicatorBuffalo, New YorkThe Claims Adjudicator is responsible to respond to client, member, and/or provider inquiries on claim status, benefit designs, and claim payments working in conjunction with the Customer Service Representative. The Claims Adjudicator is responsible for adjudicating and adjusting medical and/or dental claims against established criteria, and in accordance with specific clients SPD’s maintaining goals in accuracy and productivity.
ESIS Claims Assistant Chubb LtdESIS Claims AssistantCheektowaga, NY$40,000–$61,000 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.
CAM Claims Processor II M&T Bank CorpCAM Claims Processor IINY$22.61–$37.67 / hourUnderstand difference between the claim types: Short Sales, Foreclosure Claims, Third Party Claims, Charge Off, Security Claims, Loss Mitigation Claims, and Deed in Lieu Claims. Overview: Submits conventional claims, reviews losses, and reconciles loans for final booking by Default Accounting.
Pharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistBuffalo, New YorkSkills/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 Representative CRST The Transportation SolutionClaims RepresentativeAmherst, New YorkRisk management personnel manage the company’s risk by analyzing and purchasing risk transfer products, assessing, investigating and settling claims to limit ultimate liability, monitoring and assisting the work of outside legal counsel and third-party claims administrators, and reporting on loss history and trends to safety and operations departments and executive leadership. Job Summary : Responsible for taking first report calls of accidents from drivers, assigning adjusters as needed, inputting the information into the computer system, notifying third-party administrators of accidents and performing required follow-up on all these functions.
Claims Specialist BestSelf Behavioral Health IncClaims SpecialistBuffalo, NYA Claims Specialist will organize billing and rebilling materials as well as create and analyze reports from the billing system to provide feedback to program sites. The position prepares claim data for transmission to Medicaid, Medicare, and Managed Care plans.
ESIS Claims Associate Chubb LtdESIS Claims AssociateCheektowaga, NYThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. Contact, interview, and obtain statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc., to secure necessary claim information.
ESIS Senior Claims Representative, WC Chubb LtdESIS Senior Claims Representative, WCCheektowaga, NY$78,100–$109,400 / yearAbility to plan, organize, and implement general business and people management practices, supported by management and technical training, a business or legal college-level curriculum, or equivalent practical experience. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
Adjuster - Specialty Casualty Claims MerchantsAdjuster - Specialty Casualty ClaimsBuffalo, New YorkResponsible for all claim handling activities on assigned high exposure claims through disposition, including investigation, litigation management, evaluation, procuring appropriate settlement authority, engaging in settlement negotiations, providing instruction and guidance on risk transfer and coverage issues, training and development of claim staff through informal knowledge transfer and formal training activities, preparing for and presenting claims to the Large Loss Committee, and ensuring proper reinsurance reporting and communication. The Adjuster - Specialty Casualty Claims will become part of a dedicated team focusing on providing high-level technical expertise in the handling of commercial umbrella, excess liability, multi-party catastrophic injury, property damage, and construction defect claims.
CLAIMS ADJUSTER Niagara Frontier Transportation AuthorityCLAIMS ADJUSTERBuffalo, NY$53,407–$80,110 / yearInvestigates liability claims, no-fault claims, and other claims involving personal injury or property loss/damage; investigates scene of the accident, takes detailed statements from involved parties, photographs evidence to document investigation files, peruses video evidence, performs other research as necessary. • Inspects damage to structure, motor vehicles, and heavy equipment; reviews repair estimates; reviews medical records and determines value of claim and coverage applicable; prepares a cost benefit analysis for settling claims.
Independent Insurance Claims Adjuster in Lancaster, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Lancaster, New YorkLancaster, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Lockport, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Lockport, New YorkLockport, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Buffalo, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Buffalo, New YorkBuffalo, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Tonawanda, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Tonawanda, New YorkTonawanda, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Grand Island, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Grand Island, New YorkGrand Island, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in North Tonawanda, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in North Tonawanda, New YorkNorth Tonawanda, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in East Amherst, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in East Amherst, New YorkEast Amherst, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Depew, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Depew, New YorkDepew, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Niagara Falls, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Niagara Falls, New YorkNiagara Falls, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Batavia, New York MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Batavia, New YorkBatavia, New YorkIf you are interested in roster opportunities or would like to learn what licensing, training, and qualifications may be needed to pursue a career as an insurance adjuster, please apply today and schedule a brief informational meeting with our team. If additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Claims Adjuster - Attorney Represented Injury The Progressive CorpClaims Adjuster - Attorney Represented InjuryNY$65,300–$97,000 / yearAn ideal candidate will have experience managing an inventory independently, experience assessing and evaluating liability, coverage, and damages, as well as working independently and directly with attorneys to negotiate and settle claims. 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/.
NewRestoration Claims & Estimate Manager Rainbow RestorationRestoration Claims & Estimate ManagerBUFFALO, NY$50,000–$65,000 / yearNeither Rainbow Restoration ("Franchisor") nor its affiliates have the power to: (1) hire, fire or modify the employment condition of franchisees employees; (2) supervise and control franchisees employee work schedule or conditions of employment; (3) determine the rate and method of payment; or (4) accept, review or maintain franchisee employment records. All independently owned and operated franchised businesses operate under the service brands' marks, trademarks, trade names, logos, emblems, slogans, or other indicia of origin in connection with the Rainbow Restoration franchise system within a specified geographical area.
Claims Compliance Manager CentivoClaims Compliance ManagerBuffalo, New YorkManage RxDC (Prescription Drug and Health Care Spending) reporting under the Consolidated Appropriations Act (CAA), including both D2 Medical and P2 Medical data files; coordinate with pharmacy benefit managers (PBMs), stop-loss carriers, and internal teams to compile and submit accurate annual reports on behalf of plan sponsors. Manage and coordinate NSA negotiations for out-of-network claims subject to the open negotiation process; partner with claims leadership and legal counsel to support Independent Dispute Resolution (IDR) proceedings, including submission preparation, documentation, and tracking of outcomes.
Property & Casualty Insurance Claims Operations Consultant, Manager PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, ManagerNY$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.
Auto Damage Claims Adjuster The Progressive CorpAuto Damage Claims AdjusterNY$67,000–$81,200 / 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/ . As an auto damage claims adjuster, you'll serve as Progressive's point of contact with customers - directing and making decisions regarding the repair process from beginning to end.
Claims Auditor CentivoClaims AuditorBuffalo, New YorkCentivo is seeking a Claims Auditor who will be responsible for conducting pre-payment, post-payment, and claims adjudication audits across multiple employer groups and product lines, including complex, high-dollar claims. Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.
SIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorBuffalo, NY$25–$35 / hourPart timeWe are dedicated professionals with a motivational management style with proven ability to recruit, develop and direct highly successful teams that consistently excel. Lemieux & Associates, a national leader in the investigative industry, is seeking experienced SIU/Claims Investigators in the Buffalo or surrounding area.
Litigation Claim Adjuster MerchantsLitigation Claim AdjusterBuffalo, New YorkIn October 2024, Newsweek and Statista included Merchants Insurance Group on their first-ever America’s Most Reliable Companies list, which highlights organizations that other companies can feel confident doing business with in 2025. Cultivating relationships with claims and other internal staff, policyholders, attorneys, agents and a variety of service providers and experts all while working towards achieving the most optimal outcomes for Merchants and our policyholders.
Multi-Line Claim Adjuster MerchantsMulti-Line Claim AdjusterBuffalo, New YorkCultivating relationships with claims and other internal staff, policyholders, attorneys, agents and a variety of service providers and experts all while working towards achieving the most optimal outcomes for Merchants and our policyholders. This position interacts extensively with home office technical managers, internal colleagues as well as policyholders, agents, attorneys, appraisers, and a multitude of claim-related service providers.
Claim Specialist - Property Field Inspection State FarmClaim Specialist - Property Field InspectionBuffalo, NY$59,059.65–$90,000 / yearCompetitive candidates should reside within one of the listed zip codes and will service this same territory: 14058 14422 14416 14470 14411 14479 14103 14105 14013 14125 14031 14001 14051 14032 14261 14068 14228 14072 14304 14120 14132 14092 14131 14094 14067 14012 14126 14028 14008 14108 14172 14098 14477 14571 14174 14109 14305 14301 14303 14006 14207 14150 14217 14223 14260 14226 14214 14216 14222 14209 14208 14211 14215 14227 14206 14212 14204 14202 14201 14213 14219 14218 14220 14203 14210 14059 14224 14052 14169 14102 14043 14225 14086 14026 14221 14036 14004 14040 14005 14056 14020 14143 14054 14039 14591 14011 14037 14145 14082 14083 14113 14167 14569 14066 14024 14009 14025 14080 14139 14170 14127 14033 14057 14075 14085 14047. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you!
Workers Compensation Claim Consultant Community Bank, N.A.Workers Compensation Claim ConsultantNYThe consultant partners closely with clients to translate claims data into actionable insights, provides ongoing guidance on risk mitigation and claim resolution strategies, and ensures alignment between claims handling practices and each client's broader risk management objectives. The Workers Compensation Claims Consultant serves as a strategic advisor to clients, delivering proactive, data-driven claims management solutions that reduce total cost of risk and improve claim outcomes.
Workers' Compensation Medical Records Clerk Goldberg Segalla LLPWorkers' Compensation Medical Records ClerkBuffalo, NY$19–$21 / hourGoldberg Segalla is a national civil litigation law firm that represents major national and regional companies and insurance carriers in all aspects of business counseling, risk assessment and dispute resolution including representation in various types of claims, controversies and litigation involving personal and other injuries, property damage, contract disputes and business torts. Goldberg Segalla is committed to building a workplace where talented people from different backgrounds, experiences, and perspectives can succeed, grow, and lead – together.
SENIOR ACCOUNT CLERK Orleans County Personnel DepartmentSENIOR ACCOUNT CLERKAlbion, NYOrder#: NY1664425 SENIOR ACCOUNT CLERK Typical Work Activities: Reviews a variety of more complex financial documents, classifies them and distributes items into a variety of accounts according to prescribed procedures and policies, and makes journal entries; Posts figures to appropriate accounts, makes all necessary adjustments in balances and verifies and reconciles balances, renews status of accounts as adjustments are made and takes appropriate action as authorizing payment, issuing checks or preparing bills; Tracks audits and monitors a variety of accounts, verifies adjustments made to correct allocations and issues reports as required; Operates word processor, personal computer or terminal and typewriter in preparing and generating account records; May supervise employees by assigning and reviewing completed work and instructing new employees in specialized account keeping activities; Prepares funds for deposit into book accounts; Reconciles accounts and prepares reports from information; Contacts clients, vendors or other agencies to obtain additional information; Provides information orally or in writing in response to inquiries on status of accounts; Processes, sorts, indexes, records and files a variety of control records and reports, or supervises the process; May assist in preparation of figures and reports for use in budget preparation; May prepare, review and process claims for State aid; Does more complex payroll transactions and prepares all related reports; Operates calculator, check writing machine and other related office equipment. 25 SeniorAccount Clerk continued Full Performance Knowledge, Skills, Abilities, and Personal Characteristics: Good knowledge of modern methods used in keeping and checking financial records and accounts; Good knowledge of office terminology, procedures, equipment and business English; Ability to supervise the work of account keeping and clerical assistants; Ability to make more difficult arithmetic computations involving fractions, decimals and percentage accurately; Ability to analyze and organize data and prepare records and reports; Ability to operate an alphanumeric keyboard such as a typewriter, word processor or personal computer at an acceptable rate of speed; Ability to understand and interpret complicated oral instructions and/or written directions; Ability to develop effective working relationships and deal diplomatically with the public; Ability to perform close, detail work involving considerable visual effort and strain; Ability to operate a personal computer; Physical condition commensurate with the demands of the position.
Trainer Aither HealthTrainerAmherst, New York$60,000–$75,000 / yearProvide uptraining and refreshers to current employees as needed, covering key platforms like Zoho , claims workflows, and other core systems and procedures. Deliver comprehensive, engaging training to new associatesâensuring theyâre equipped with the tools, knowledge, and mindset to succeed in their roles.
Law Clerk Goldberg Segalla LLPLaw ClerkBuffalo, NY$23–$25 / hourGoldberg Segalla is a national civil litigation law firm that represents major national and regional companies and insurance carriers in all aspects of business counseling, risk assessment and dispute resolution including representation in various types of claims, controversies and litigation involving personal and other injuries, property damage, contract disputes and business torts. Work includes, but is not limited to, analyzing complex workplace issues, drafting of pleadings and discovery, reviewing case and court docket information, legal research and caselaw focused on state and federal labor and employment laws.
ACCOUNT CLERK TYPIST (TEMPORARY) (ASSESSMENT & TAXATION) City of Buffalo NYACCOUNT CLERK TYPIST (TEMPORARY) (ASSESSMENT & TAXATION)Buffalo, NY$41,887–$46,336 / yearPerforms simple audits such as checking amounts on vouchers against receiving copies of orders;Maintains simple cost accounts and cost records:- may be required to transfer account information to spreadsheets;Balances daily journal sheets;Prepares and makes bank deposits and checks against bank statements;May be required to disburse petty cash funds and process service orders to replenish petty cash;Operates personal computer, calculating, checkwriting and other office machines;-enters/retrieves data from computer records;Inputs receipts, payrolls, requisitions, vouchers, property data, values, exemptions, and other materials from copy or rough drafts using equipment with the alpha-numeric keyboard, i.e. personal computers, etc. Assists in the preparation of budget requests and maintains inventory records;Assists in the preparation of periodic reports for management and control purposes;Maintains and updates employee payroll and paid leave records;May answer telephones and deals directly with the general public, vendors or contractors providing information about departmental functions and activities;May maintain various clerical reports concerning office activities and functions;Inputs billing, file maintenance for miscellaneous charges, data, records and information using personal computer programs, etc.
Billing Analyst - Dental COMMUNITY HEALTH CENTER OF BUFFALO, INC.Billing Analyst - DentalBuffalo, NY$18.25–$21.25 / hourNegotiate payment terms on outstanding patient balances owed, perform functions related to Accounts Receivable, Credit, and Collections, attend meetings as required, and perform other duties as assigned. Coordinate the paper/document flow related to billing and patient accounts under the direction of the Director of Billing, including correlating records and registration information as well as forwarding specific registration information to third-party billing.
Revenue Integrity Coder Catholic Health SystemRevenue Integrity CoderBuffalo, NYSummary: Under the direction of the Manager/Director of Revenue Integrity, including oversight from System revenue cycle leadership, the Revenue Integrity Coder of Infusion Services will be responsible for optimization of charge capture, charge review, appropriate documentation and work queue edits for all infusion services, specifically Oncology and Chemotherapy. The incumbent actively participates as needed in both external third-party audits and in internal audits and as well as quality improvement initiatives, assists with special projects, and works closely with Catholic Health fiscal teams, Clinical Center Leadership, and Prior Authorization teams.
Commercial Lines Account Manager Assistant (Hybrid) Patriot Growth Insurance ServicesCommercial Lines Account Manager Assistant (Hybrid)Buffalo, NY$24.04–$26.44 / hourPromark Partners Insurance (PPI) Services began in 1977 as an association of three insurance agencies with over 50 years of combined experience, and the desire to pool their knowledge and expertise to build one agency dedicated to serving all the needs of their clients. Participate in marketing efforts to identify new business opportunities, including assisting with prospecting potential clients and attending industry events to support the expansion of the agency’s client base.