Claims Processor Jobs in Boston, MA

Directs work flow to ensure the efficient and accurate processing of medical claims by establishing and monitoring productivity and quality metrics, managing and developing a team of claims support individuals, implementing process improvement initiatives, and fostering collaboration with internal and external stakeholders to optimize claim processing, minimize errors, and enhance overall operational effectiveness and customer satisfaction.

Qualifications BS/BA degree or equivalent work experience Minimum of 2 years experience in claims adjustment, general insurance or formal claims training Required to obtain and maintain all applicable licenses Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU) Knowledge of claims investigation techniques, medical terminology and legal aspects of claims. • Assesses 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.

Assesses 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.

Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines.

Applicants must have (A) at least two (2) years of full time, or equivalent part-time professional or paraprofessional experience in personnel interviewing, vocational counseling, employment counseling, rehabilitation counseling, educational counseling, credit collection, credit interviewing, credit investigation, claims adjudication, claims settlement, claims examining, claims, investigation, claims interviewing, social work or social casework, or (B) any equivalent combination of the required experience and the substitutions below. '',''Job Service Rep I'',''Job Service Rep I'',''United States-Massachusetts-Boston-100 Cambridge Street'',''United States-Massachusetts-Boston-100 Cambridge Street'',''Administrative Services'',''Administrative Services'',''Department of Workforce Development'',''Department of Workforce Development'',''Full-time'',''Full-time'',''Day'',''Day'',''May 8, 2026, 3:54:11 PM'',''May 8, 2026, 3:54:11 PM'',''30'',''30'',''87,213.36'',''62,303.54'',''87,213.36'',''Yearly'',''Dennis

p>Well count on you to:

• Respond promptly and professionally to incoming requests regarding: EOR requests, claim status requests/updates and general claim questions from Account Management, Sales, Brokers, Policyholders and Third-Party Administrators.

  The key to Berkleys success is our nimble approach to risk - our ability to quickly understand, think through, and devise a plan that addresses each clients challenges, coupled with the strong backing of a Fortune 500 company.

You will act as the crucial technical bridge between our MGA, TPA partners, and Fronting Carriers/Reinsurers, ensuring our claims process maintains rigorous technical control to protect loss ratios, litigation spend, and carrier relationships.

strong>Key Responsibilities: Lead the implementation of EDI 837 and proprietary claims files for multiple health plans Analyze existing claims data, identify issues, and perform root cause analysis to resolve ingestion errors Recommend and implement changes to ensure claims are processed accurately within internal systems Develop a strong understanding of business rules, core platforms, and applications supporting EDI exchanges Design and support end-to-end frameworks for encounter and claims data exchanges Facilitate discussions with health plans and internal stakeholders to gather and clarify requirements Create and maintain detailed documentation, including business requirements, process flows, and technical specifications Communicate effectively across business and technical teams to ensure alignment and delivery. Reason for interest in this position: Contact Number: Email ID: LinkedIn Profile URL: Full Address (Street, City, State, Zip Code): Notice Period (in weeks): Current Work Authorization Status: Hourly pay rate expectation: Are you willing to relocate and work onsite at Boston, MA,?

You will join a team of experienced claims professionals and will investigate and resolve Commercial Property and Inland Marine claims to provide the best possible claim outcome and employ best efforts to ensure that the customers' interests are protected. You can find additional information about this type of scam and report any fraudulent employment offers via the Federal Trade Commission''s website (https://consumer.ftc.gov/articles/job-scams), or you can contact your local law enforcement agency.

li>Auditing new business to make sure workflow has been completed correctly (quote sheets, signed applications, completed checklists, etc.).

A Personal Lines Processor is primarily responsible for processing documents related to personal lines insurance and providing administrative support to the Producers and Account Managers.

They communicate with policyholders, insurance agents, and other parties involved to gather necessary information and resolve any issues. Clean Harbors, Norwell, MA is looking for a Claims Specialist to join their safety conscious team!

Advocate'',''Advocate'',''United States-Massachusetts-Boston-1 Ashburton Place'',''United States-Massachusetts-Boston-1 Ashburton Place'',''Community and Social Services'',''Community and Social Services'',''Victim & Witness Asst Board'',''Victim & Witness Asst Board'',''Full-time'',''Full-time'',''Day'',''Day'',''May 29, 2026, 1:17:02 PM'',''May 29, 2026, 1:17:02 PM'',''1'',''1'',''60,000.00'',''60,000.00'',''60,000.00'',''Yearly'',''Stephanie MOVA strives to advance victim rights by ensuring all victims and survivors of crime across the Commonwealth are supported and empowered through access to high-quality services that are trauma-informed, culturally responsive, and reflective of diverse communities.

For more information, visit www.suffolk.com and follow Suffolk on Facebook, Twitter, LinkedIn, YouTube, and Instagram.

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Our current reasonable and good faith estimate of the annual salary or hourly wage range for this position is approximately $47,000 - $49,000 based on a variety of factors including, but not limited to, relevant skills and experience. That means providing a great work environment, encouraging work/life balance, offering flexible work arrangements, and competitive salaries and benefits packages.

Through 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.

The Claims Senior Medpay Adjuster handles moderate to high complexity Auto claims matters involving material damage, property and / or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

li>Frequently communicate key client and Family Office matters/concerns, team updates, market developments and claims trends with PCS field leadership teams (Zone Leaders and Zone Client Advisor Leaders) as well as MMA regions.

p style="margin:0px">Berkley Accident and Health is a risk management company that designs innovative solutions to address the unique challenges of each client. Company Details:

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This entry-level position supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

div>Claims Senior Auto Adjuster

The Claims Senior Auto Adjuster supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities.

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.

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. 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.

Performs a combination of duties in accordance with departmental guidelines: Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages. 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.

In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $97,000 to $189,000 annually. In conjunction with senior level management, works within assigned limits of the broadest authority on assignments requiring the highest degree of technical complexity and coordination.

p>Performs a combination of duties in accordance with departmental guidelines:

• Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages.

• 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.

The 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. Gallagher's Claims and Risk Consulting team includes more than 100 safety and risk control professionals across the country with in-depth knowledge of current and emerging regulations, safety and health management, and operational exposures.

li>Assesses 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 claims, and refers claims to the subrogation group or Special Investigations Unit as appropriate. To learn more about our benefit offerings please visit: https://www.libertymutualgroup.com/about-lm/careers/benefits.

Office machines as normally associated with a professional office environment, including the use of telephones, personal computers, word processing and other software, email, videoconference applications, copiers, scanners and fax machines. While performing duties of this job, the employee is regularly required to use hands to finger, handle, feel or operate objects, including office equipment, or controls and reach with hands and arms.

p>Position Description:

Lead, manage, and provide insurance coverage advice on high exposure complexconstruction claims, includingbut not limited to professional liability, construction defect, general liability, builders' risk, pollution liability, subcontractor default, payment and performance bonds, employment, wage and hour, and pollution claims from initial notice through claim closure, including subrogation and litigation domestically and globally.

Essential Duties & Key Responsibilities:

• Manage specialty, complex, and high exposure insurable claims including but not limited to professional liability, construction defect, general liability, builders' risk, pollution liability, subcontractor default, payment and performance bonds, employment, wage and hour, and pollution claims.

li> Excellent written communication: capable of presenting work and writing work reports, scope of work, and contractual documentation;

Business Communications, Claims Processing, Clerical Skills, Data Entry, Detail-Oriented, Documentations, Insurance Claims, Investigative Thinking, Invoice Processing, Invoices, Large Loss Claims, Large Scale Data Processing, Microsoft Excel, Microsoft Office, Office Administration, Organizing, Outbound Calls, Police Reports, Timeliness. In this role, you will handle a variety of administrative tasks, including ordering police reports, submitting claims to other carriers, completing social media and trace report requests, and processing invoices.

The examiner will be responsible for handling of specialty lines claims and management oversight of TPA claims as well as some handling of individual claim files, collaborating with underwriters throughout the claims process and marketing BHSI Claim Service to customers. Part of Berkshire Hathaway's insurance operations, we bring our solutions to market with our stellar brand name, top-rated balance sheet, and the expertise of our global team of professionals, who exude excellent capabilities and strong character.

Lead Analytical Projects: Own moderately complex, end-to-end analytical projects independently, partnering with Claims Process, Data Office, Product, and other key partners to develop rigorous solutions and see initiatives through to measurable impact. Drive Financial Insight: Design and conduct moderate-to-high complexity analyses evaluating the financial performance of claims operations, process changes, and newly adopted tools or vendor partnerships across the full claim lifecycle.

An 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. Candidates should reside within a commutable distance to either our South Portland, Maine, Bedford,NH, Colchester, VT, Canton, MA, Woburn, MA or Westborough, MA claims office to support our Work Location Strategy.

As an Associate Field Inspector, you will play a critical role in supporting the claims process by conducting on-site inspections, documenting damages, and providing accurate field information to the handling adjuster. Through hands-on training, mentorship, and field experience, you will build the skills necessary to investigate losses, write estimates, and ultimately manage and settle property claims independently.

p>You'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.

Providing management oversight to Third Party Administrators DBA claims personnel by monitoring the claims online using the Third Party Administrators claim systems. At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex.

At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex.

Will be required to attend virtual and in person mediations and settlement conferences to negotiate cost-effective settlements, and potentially attend trials.

At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex.

Will be required to attend virtual and in person mediations and settlement conferences to negotiate cost-effective settlements, and potentially attend trials.

The Claims Manager, Risk Management will be responsible for: Active oversight of claims currently managed by a Third Party Administrator as well as direct handling of an active inventory of primary and excess claims related to policies written out of the Risk Management Profit Center in various jurisdictions. At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex.

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Our current reasonable and good faith estimate of the annual salary range for this position is approximately $60,000 - $62,000 based on a variety of factors including, but not limited to, relevant skills and experience, educational background and certifications, performance and qualifications, market demand for the role and other organizational needs.

The company offers a competitive compensation plan which for this role include: o Hourly: $50-$70/hr o This is a temporary role (not permanent) - estimated 3-6 months o Part time 20 - 25 hours a week The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

The 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.

Through 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.

p>The 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.

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The starting pay range for this position is: $99,500.00 - $132,900.00

Additionally, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.