Claims Examiner Workers' Comp I Maxim Healthcare Services IncClaims Examiner Workers' Comp IColumbia, MDParticipates in calls with local offices, third-party administrators (TPAs), medical providers, attorneys, and other Maxim team members, in order to agree upon, communicate, and execute claim handling plans. Working independently and in coordination with other WC team members, the WC Examiner I will consult with the WC Manager regarding reserve adjustments, a plan of action, and the appropriate settlement value of assigned claim files.
NewWorkers Compensation Claims Representative | Medical Only Workers Compensation | VA Jurisdiction Sedgwick Claims Management Services, Inc.Workers Compensation Claims Representative | Medical Only Workers Compensation | VA JurisdictionVARemote$45,000–$60,000 / yearPRIMARY 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 is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Complex Claims Consultant - Epl, Private & NFP D&O CNA Financial Corp.Complex Claims Consultant - Epl, Private & NFP D&OWashington, DC$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.
Claims Appraiser - Auto Estimatics State FarmClaims Appraiser - Auto EstimaticsGaithersburg, Maryland$69,398.62–$91,000 / yearFull timeWith 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! Additional Details: Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).
Claims Resolution Representative Metasys TechnologiesClaims Resolution RepresentativeMcLean, VARemote$18.62–$23.27 / hourThis position serves as a crucial liaison between members, providers, agencies, and the internal claims department, demonstrating leadership, collaborative skills, and commitment to achieving results. Review paper claims and attachments, scanning them using scanning equipment to attach the documents to corresponding transaction control numbers.
NewClaims Management Program Analyst (O-5 Billet) Non-Supervisory U.S. Department of Homeland SecurityClaims Management Program Analyst (O-5 Billet) Non-SupervisoryWashington, DCLiaises regionally and, or, nationally with applicable stakeholders internal and external stakeholders [e.g., Customs and Border Patrol, Office of Field Operations, Homeland Security Investigation (HSI) and third-party claims vendor] regarding claims processes, trainings, and principles. Should possess some knowledge of International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), current procedural terminology (CPT), diagnosis-related group (DRG), and other Centers for Medicare and Medicaid Services (CMS) coding/billing requirements.
Claims Counsel (Insurance Defense) Williams & Connolly LLPClaims Counsel (Insurance Defense)Washington, DC$165,000–$180,000 / yearResponsibilities include, but are not limited to:* Developing a case strategy* Answering complaints* Drafting and responding to discovery* Client communications* Handling all communications with opposing counsel* Hiring and managing expert witnesses as needed* Drafting motions and responses to motions* Conducting and defending depositions* Drafting mediation statements* Conducting mediations* Appearing in court as needed* Pre-trial preparations* Conduct trials* Drafting settlement agreements* Administrative duties related to case tracking and reporting . This position requires the ability and flexibility to manage a high-volume caseload in cooperation with firm management, partners, associates, other Claims Counsel, and firm employees in a professional manner as well as the ability to manage and prioritize a large volume of work assignments, meeting all deadlines.
Sr. Claims Specialist, Professional Liability | Medical Malpractice | Long Term Care Sedgwick Claims Management Services, Inc.Sr. Claims Specialist, Professional Liability | Medical Malpractice | Long Term CareMDIdeal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost‑effective claim resolutions while maintaining a high level of customer service. ESSENTIAL RESPONSIBLITIES MAY INCLUDE: Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
NewWorkers’ Compensation Claims Examiner GreenLife Healthcare StaffingWorkers’ Compensation Claims ExaminerWashington, DCJob Qualifications & Certifications: Bachelor’s degree and at least two years of workers’ compensation claims adjusting experience; or eight years of progressively responsible claims-handling experience, including at least three years of workers’ compensation claims adjusting experience. Complete required claim contacts, including 24-hour four-point contacts with injured workers, supervisors, medical providers, and other stakeholders; document activity in the claims management system.
Head of Claims HITT ContractingHead of ClaimsWashington DC, District of ColumbiaThis role is responsible for enterprise claims strategy, portfolio performance, reserve adequacy, litigation oversight, and total cost of risk while leading the claims organization and partnering with executive leadership on risk financing and insurance program strategy. The Senior Manager, Claims & Risk Management leads HITT's enterprise claims function across all property and casualty lines for HITT Contracting and its affiliated operating companies.
Enterprise Claims Library Admin, Project Management Capital OneEnterprise Claims Library Admin, Project ManagementMcLean, VirginiaCDX is responsible for Capital One’s digital customer experiences, including its award winning mobile app, its online presence, and Enterprise-grade products and platforms used across all lines of business. Our team is responsible for administering and governing these platforms, and advising on the large-scale transformation of our content supply chain to unlock highly personalized, intelligent experiences for millions of current and prospective customers.
Medical Claims (Billing) Team Leader GT Independence CareersMedical Claims (Billing) Team LeaderSilver Spring, MarylandGT Independence is a family-founded, leading national Financial Management Services (FMS) provider that supports individuals participating in self-direction programs, helping them manage their long-term care and support services at home and in community-based settings. Dedicated to promoting personal choice, independence, and quality of life, GT Independence delivers reliable, person-centered financial and administrative services that empower individuals to direct their own care.
Claims Data Consultant Deloitte Touche Tohmatsu LtdClaims Data ConsultantArlington, VA$80,300–$133,900 / yearFrom strategy to execution, this team delivers integrated, end-to-end support and advisory services covering valuation modeling, cost optimization, restructuring, government operations modernization, business design and transformation, infrastructure and real estate, mergers and acquisitions (M&A), and sustainability. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
IT Production and Systems Support Engineer (Mainframe and Claims Processing) MindlanceIT Production and Systems Support Engineer (Mainframe and Claims Processing)Columbia, MDThe ideal candidate will combine mainframe expertise, application support, data analysis, and incident management skills to support both legacy and modern platforms while delivering high-quality service to internal teams and external plan vendors. This role is responsible for ensuring stability, performance, and continuous improvement of applications supporting claims vouchering, adjudication, and EDI processing.
Principal Data Scientist, Customer Protection Agentic Claims Data Science Capital OnePrincipal Data Scientist, Customer Protection Agentic Claims Data ScienceMcLean, VirginiaCurrently has, or is in the process of obtaining one of the following with an expectation that the required degree will be obtained on or before the scheduled start date: A Bachelor's Degree in a quantitative field (Statistics, Economics, Operations Research, Analytics, Mathematics, Computer Science, or a related quantitative field) plus 5 years of experience performing data analytics. As a Data Scientist at Capital One, you’ll be part of a team that’s leading the next wave of disruption at a whole new scale, using the latest in computing and machine learning technologies and operating across billions of customer records to unlock the big opportunities that help everyday people save money, time and agony in their financial lives.
Claims Consultant CoreTechsClaims ConsultantBethesda, MDRemote$110,000–$160,000 / yearSUMMARY/OBJECTIVE: The Claims Consultant will be responsible for conducting impact analysis, analyzing risk on complex projects, and performing forensic schedule and cost analysis consisting of identifying critical path delays, schedule disruptions, evaluating labor productivity, and pricing general conditions costs. Perform construction claims forensic analysis including document review and organization, key issue identification, schedule analysis, labor productivity studies, general conditions calculations, pricing, and graphic exhibits for input to expert reports.
NewFalse Claims Act (FCA) Litigation Partner / Counsel Orion PlacementFalse Claims Act (FCA) Litigation Partner / CounselWashington D.C., WashingtonRemoteYou will have the flexibility to work remotely, lead sophisticated matters, build meaningful client relationships, mentor attorneys, and play an important role in the continued growth of a nationally focused False Claims Act and complex litigation practice. Note: Candidates must have 10+ years of private practice legal experience, including 5+ years of substantive False Claims Act investigations and/or litigation experience, and a portable book of business of at least $250,000.
VP, Claims Adjudication Pie Insurance Holdings IncVP, Claims AdjudicationDCRemote$200,000–$260,000 / yearLead and develop a team of Directors and Senior Managers, including setting and tracking goals, assigning and reviewing work, managing processes and staff activities, performance management, coaching and mentoring. You will be fostering relationships at every level both internally with team members and other senior leaders, as well as externally, working to build relationships with key partners in the industry.
NewSupervisory Veterans Claims Examiner (Assistant Education Officer) U.S. Department of Veterans AffairsSupervisory Veterans Claims Examiner (Assistant Education Officer)Washington, DC$131,525–$170,987 / yearPlease make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50s (current/former Federal employees), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). Strategic Planning, Resource Allocation & Budget Management: Experience forecasting workload, planning staffing levels, allocating resources (space, equipment, budget), developing budget estimates, or implementing cost-reduction initiatives.
NewLead Veterans Claims Examiner U.S. Department of Veterans AffairsLead Veterans Claims ExaminerWashington, DC$107,446–$139,684 / yearYou will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics): PROGRAM MANAGEMENT: Set priorities, coordinates work operations among teams, develops internal procedures to ensure that supervisors and employees are informed of aspects of human resources programs, reviews evaluations prepared by supervisors, takes disciplinary action, approves, and disapproves leave and supervises the day - to - day operations.et priorities, coordinates work operations among teams, develops internal procedures to ensure. ORAL COMMUNICATION: Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); makes clear and convincing oral presentations; listens to others, attends to nonverbal cues, and responds appropriately.