Company ConfidentialLegal Processor Company ConfidentialLegal ProcessorNew York, New York$55,130–$60,000 / yearFull timeRegardless of seniority or role, uphold UNFCU’s mission, core values, and guiding principles by providing an exceptional service experience to colleagues and members alike through consistent demonstration of our service excellence behaviors. Under general supervision, performs moderately difficult processing of legal and organizational documents while verifying member information and ensuring compliance with both governmental and internal regulations.
Careers Integrated Resources IncPatient Support Specialist Careers Integrated Resources IncPatient Support SpecialistHanover, NJ$18–$20.90 / hourAs part of a highly concierge, “white glove” service team, you will guide patients through the entire support process by providing program information, eligibility assistance, reimbursement support, and an exceptional customer experience. · The Patient Support Specialist, under the direction of the Supervisor, is responsible for providing patient healthcare support services that enable access to prescription medications.
Progressive Spine and Orthopaedics LLCNewInsurance Verification Representative Progressive Spine and Orthopaedics LLCInsurance Verification RepresentativeClifton, NJThis position requires strong attention to detail, excellent communication skills, and the ability to work closely with patients, insurance carriers, attorneys, adjusters, employers, surgical coordinators, and billing teams. The ideal candidate will have experience verifying commercial insurance benefits, out-of-network benefits, personal injury claim information, attorney representation, workers’ compensation claim status, and patient financial responsibility.
Diedre Moire Corp.Ins Claims Examiner Medical Malpractice - Union City, NJ Diedre Moire Corp.Ins Claims Examiner Medical Malpractice - Union City, NJUnion City, NJ$100,000–$140,000 / yearFull timeCONSIDERED EXPERIENCE INCLUDES: Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare #DiedreMoire #JobSearch #JobHunt #JobOpening #Hiring #Job #Jobs #Careers #Employment #jobposting #InsuranceJobs #UnderwriterJobs. 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.
CVS Health CorpManager, Claim Processing CVS Health CorpManager, Claim ProcessingNJ$66,330–$145,860 / yearDirects 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. Assists with the development of the claim processing budget by monitoring expenses, tracking budget variances, and identifying cost-saving opportunities while maintaining operational effectiveness and service quality.
Clover Health Investments CorpSenior Claims Researcher Clover Health Investments CorpSenior Claims ResearcherNYRemote$107,000–$130,000 / yearSuccess in this role looks like: By the end of your initial 90-day period: You will have mastered the nuances of Clover's HealthEdge HRP and Source environments and will be actively executing the monthly audit cycle, performing both random and risk-based judgmental audits to ensure baseline payment accuracy. As a Senior Claims Researcher, you will: Technical Quality Auditing: Execute the monthly audit plan as designed by the Director, performing detailed reviews of claims to ensure they align with provider contracts, benefit rules, and pricing guidelines.
Great American Insurance CompanyClaims Technical Director/Senior Claims Specialist-Alternative Markets Great American Insurance CompanyClaims Technical Director/Senior Claims Specialist-Alternative MarketsNew York, NY$100,000–$135,000 / yearAt Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. https://www.greatamericaninsurancegroup.com/about-us/business-operations/division/alternative-markets.
Axis Capital HoldingsSenior Claims Specialist, Excess Casualty Claims - NA Axis Capital HoldingsSenior Claims Specialist, Excess Casualty Claims - NANew York, NY$140,000–$160,000 / yearSenior Claims Specialist, Excess Casualty - North America Claims Job Code 13573 About the Team AXIS is hiring a Senior Claims Specialist, Excess Casualty, to support its expanding presence in North America's Excess market. About You We encourage you to bring your own experience and expertise to the table, so while there are some qualifications and experiences, we need you to have, we are open to discussing how your individual knowledge might lend itself to fulfilling this role and help us achieve our goals.
AXIS Capital Holdings LtdSenior Claims Specialist, Primary Claims AXIS Capital Holdings LtdSenior Claims Specialist, Primary ClaimsRed Bank, NJ$105,000–$160,000 / yearIdentifying opportunities for contribution, subrogation and contribution to the claim About You We encourage you to bring your own experience and expertise to the table, so while there are some qualifications and experiences, we need you to have, we are open to discussing how your individual knowledge might lend itself to fulfilling this role and help us achieve our goals. Our focus is on hiring, developing, retaining, and rewarding individuals who excel in: Purposeful Action: Delivering top-tier work with a data-driven approach and operating at AXIS speed.
Axis Capital HoldingsSenior Claims Specialist, Primary Casualty Construction Claims Axis Capital HoldingsSenior Claims Specialist, Primary Casualty Construction ClaimsNew York, NY$108,000–$160,000 / yearWe encourage you to bring your own experience and expertise to the table, so while there are some qualifications and experiences we need you to have, we are open to discussing how your individual knowledge might lend itself to fulfilling this role and help us achieve our goals. · Utilizing working knowledge of the legal frameworks and claims handling practices relevant to the specific jurisdiction (i.e., NY) in which the claims arise.
AXIS Capital Holdings LtdClaims Manager - Excess Casualty Claims AXIS Capital Holdings LtdClaims Manager - Excess Casualty ClaimsShort Hills, NJ$160,000–$190,000 / yearClose collaboration with the Specialty Complex Claims team with regard to coverage disputes, including litigation and arbitration matters initiated by Axis issuing companies and when Axis issuing companies are parties to such litigation; Collaborating across disciplines and business units, including: the general counsel team overseeing errors and omissions issues arising from claims handling. Identifying, liability and coverage trends and issues with both individual and portfolio impact and formulating the processes and strategies for handling such claims as well as ensuring accurate and consistent claims management across impacted underwriting segments and lines of business.
Amalgamated LifeDirector, Claims Amalgamated LifeDirector, ClaimsWhite Plains, NYA Disability Claims Director oversees the process of reviewing and managing disability claims, ensuring compliance with applicable company policy, contract language and regulations by evaluating medical records, coordinating with providers, and communicating with claimants to determine eligibility for benefits. The Director reaches out to employers to verify if Claimant is working, appropriate return to work if Claimant is not working, and if possible light duty available.
Metroplus Health Plan IncClaims Adjustment Specialist I Metroplus Health Plan IncClaims Adjustment Specialist INew York, NY$48,791–$50,593 / yearMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics.
Integrated Resources, IncData Quality Analyst / Claims Service Correspondent Integrated Resources, IncData Quality Analyst / Claims Service CorrespondentNew York, NY$60–$65 / hourThe incumbent works closely with Provider Relations, Medical Management, Member Services and the Claims Processing unit; Scope of Role & Responsibilities: Act as a key liaison and service representative for all written provider inquiries and problem resolution; Respond to all claim inquiries from provider sites personnel including physicians, clinical staff, and site administrators; Coordinate and track appropriate problem resolution activities with plan personnel in other departments (i.e., claims, utilization management); Manage and ensure appropriate follow-up and closure for all inquiries; Respond to Provider Inquiries in writing; maintain accurate files; Data Entry into the IMAX system; Perform claim adjustments to correct erroneous payments (overpayments/underpayments); Participate in Special Projects involving Claim Status Investigations; Resolve Member Bills referred from Member Services; Required Education, Training & Professional Experience: In-depth knowledge of MetroPlus Claims Processing protocols and payment schemes; Thorough knowledge of Plan Benefits; Proficiency in IMAX and TXEN; Customer Service Experience a plus; Must be able to handle irate providers in a professional manner; Excellent written/verbal communication skills. This position is responsible for the accurate and timely response to written claim inquiries received from providers and provides support regarding the adjudication and adjustment of claims for multiple lines of business.
Equitable Financial Life Insurance CompanyNewLife Claims Consultant (HYBRID or REMOTE) Equitable Financial Life Insurance CompanyLife Claims Consultant (HYBRID or REMOTE)NYRemote$75,000–$90,000 / year418584'',''true'',''418584'',''false'',''Submission for the position: Life Claims Consultant (HYBRID or REMOTE) - (Job Number: 260000BT)'',''false'',''418584'',''false'',''true'',''Life Claims Consultant (HYBRID or REMOTE)'',''260000BT'',''UNITED STATES-Remote'',''UNITED STATES-Remote'',''UNITED STATES-NC-Charlotte, UNITED STATES-NY-Syracuse'',''UNITED STATES-NC-Charlotte, UNITED STATES-NY-Syracuse'',''Equitable'',''Equitable'',''Full-time'',''Full-time'',''!*! In addition to base pay, Equitable provides compensation to reward performance with base salary increases, spot bonuses, and short-term incentive compensation opportunities.
Career DevelopersNewClaims Assistant (Full-Time) ( Hybrid in NJ,GA,IL, or NYC ) Career DevelopersClaims Assistant (Full-Time) ( Hybrid in NJ,GA,IL, or NYC )Berkley Heights, NJ$70,000–$75,000 / yearRefer a friend: Referral fee programCareer Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence. Skilled at working with adjusters, brokers, insureds, and internal stakeholders to support timely claim resolution while maintaining accurate records and ensuring compliance with company procedures.
VNS HealthDirector, Claims System Configuration and Processing VNS HealthDirector, Claims System Configuration and ProcessingNew York, NY$137,800–$183,800 / yearPowered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond. Architects and validates claims system configurations to ensure full alignment with provider contracts, reimbursement methodologies, and benefit structures, minimizing financial leakage and ensuring contractual integrity.
VNS HealthDirector, Claims System Configuration and Processing (Onsite 4 Days/Week) VNS HealthDirector, Claims System Configuration and Processing (Onsite 4 Days/Week)New York, New York$137,800–$183,800 / yearArchitects and validates claims system configurations to ensure full alignment with provider contracts, reimbursement methodologies, and benefit structures, minimizing financial leakage and ensuring contractual integrity. Provides executive oversight for system configuration, provider contract integrity, regulatory translation into system logic, claims dispute resolution, audit governance, cost avoidance initiatives, and operational service excellence.
EmblemHealth IncClaims Triage Analyst EmblemHealth IncClaims Triage AnalystNew York, NY$56,160–$99,360 / yearResponsible for receiving, researching and resolving inquiries and requests from internal EmblemHealth departments and business partners (i.e., account management, provider network management, provider file operations, client retention, access to care, care café, membership, COB, Contact Center, G&A, etc.) regarding claim outcomes. Collaborate with EmblemHealth and CTS business partners as needed to validate accuracy of benefit configuration, NetworX rate sheets, provider participation status, provider file and membership file, including COB flags impacting the claim(s) adjudication outcome.
CVS Health CorpNewSenior Claims Benefit Specialist CVS Health CorpSenior Claims Benefit SpecialistWork At Home, NJ$18.50–$42.35 / hourOur 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.
HealthCare Partners, MSOClaims Audit Coordinator HealthCare Partners, MSOClaims Audit CoordinatorGarden City, NY$50,000–$60,000 / hourOur network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners.
ServiceMaster RestoreClaims Coordinator ServiceMaster RestoreClaims CoordinatorPort Chester, NY$20–$20Over 30 years of leadership under franchise owners Mike Vitti and Scott Fabrizio understanding the importance of delivering an immediate response for customers seeking cleaning, restoration or remediation services. The ideal candidate is comfortable working in a fast-paced environment, managing multiple files simultaneously, and supporting operational workflows related to water, fire, mold, and reconstruction claims.
Amalgamated LifeExecutive Director, Claims Amalgamated LifeExecutive Director, ClaimsWhite Plains, NYThe Executive Director must directly manage the day-to-day Claims operations with direct oversight of Claims managers and their performance in meeting the needs of the departmental and company goals. Direct the day-to-day activities, tasks, and processes to ensure the efficient operation of the claims processing units and all related tasks to meet the claims payment TAT, accuracy and production goals, and objectives.
Normann StaffingClaims Manager Normann StaffingClaims ManagerRye Brook, NY$70,000–$110,000 / yearManage auto estimating processes, auto service management, auto body repair coordination, water damage restoration assessments, mold remediation evaluations, construction inspection reports, and automotive repair claims. This position offers an engaging opportunity for professionals experienced in insurance claim management who are committed to excellence in customer service while ensuring regulatory compliance across diverse claim types including workers' compensation, automotive repairs, medical billing, and property restoration projects.
Aon CorporationSenior Claims Advocate, Financial Services Group Aon CorporationSenior Claims Advocate, Financial Services GroupNew York, New York$91,800–$114,800 / yearAs part of an industry-leading team, you will help empower results for our clients by delivering innovative and effective solutions as part of our Financial Services Group Legal and Claims Practice Group. We are proud of the investment our firm has made in this valuable client resource and firmly believe Aon’s Legal and Claims Practice Group is a significant competitive advantage for our clients.
EmblemHealth IncSr. Claims Project Specialist EmblemHealth IncSr. Claims Project Specialistnew york, NY$68,040–$118,800 / yearQualificationsBachelor's DegreeProject Management (PMI) or Six Sigma/related certification preferred4 - 6+ years' experience with claims, claims support, vendor oversight, analytics and/or UAT management requiredHealth plan industry experience requiredProven track record of successfully managing medium to large (division/department) projects requiredExperience in staff and process management in positions with a history of increasing responsibility requiredAdditional years of experience and/or training/certifications may be considered in lieu of educational requirements requiredExperience utilizing metrics and analytics to define and verify outcomes and performance relative to SLAs requiredHealth plan functional, operational, analytic and/or UAT domain expertise requiredStrong communication skills (verbal, written, presentation, interpersonal) requiredProficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams, etc.) requiredAdditional InformationRequisition ID: 1000002775Hiring Range: $68,040-$118,800. Lead cross-functional teams (Payment Integrity, Provider Claims Resolution, Grievance and Appeals, Provider Network Management, Customer Service) to track/monitor the resolution of Claims Issue (medical, hospital and dental) for HMO/PPO claims (Facets).Monitor/Analyze claims issues to identify trends, inefficiencies, and potential risks.
Metroplus Health Plan IncClaims Quality Analyst Metroplus Health Plan IncClaims Quality AnalystNew York, NY$55,000–$65,000 / yearAbout NYC Health + Hospitals MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens, and Staten Island through a comprehensive list of products including but not limited to New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Healths network includes over 27,000 primary care providers, specialists, and participating clinics.
RelatedNewClaims Associate, Risk Management RelatedClaims Associate, Risk ManagementNew York, New York$120,000–$140,000 / yearResponsibilities: We are looking for a Claims Associate who will assist in the administration and documentation of the property, casualty, workers’ compensation and financial/executive risk claims for the company’s real estate portfolios and corporate activities. This role requires strong organizational, communication, and interpersonal skills, as well as the ability to work collaboratively with insurers, brokers, legal counsel, third-party administrators, and internal stakeholders.
Maven ClinicNewSenior Product Manager, Claims & Payments, Payer Integrations & Clinic Experience Maven ClinicSenior Product Manager, Claims & Payments, Payer Integrations & Clinic ExperienceNew York City, NY$160,000–$185,000 / yearYou will sit at the intersection of provider operations, payments infrastructure, payer integrations, and partner relationships, from provider payment workflows and payment reconciliation to claims submission, 835 remittance processing, payer integrations that connect Maven's financial infrastructure to health plan partners, and clinic portal enhancements that make Maven turnkey for fertility networks and clinic partnerships. We are looking for a senior, hands-on product manager to own and evolve Maven's provider payments, claims-based billing, payer integrations, and clinic experience, the systems and workflows that power how clinic partners, providers, health plan partners, and Maven transact, exchange claims data, reconcile payments, and operate together at scale.
Career DevelopersClaims Specialist (Fidelity Lines) ( Remote ) ( Full-Time ) Career DevelopersClaims Specialist (Fidelity Lines) ( Remote ) ( Full-Time )Berkley Heights, NJRemote$145,000–$170,000 / yearThe role also evaluates claims for reserve and settlement, executes settlement strategy, negotiates settlements proactively, attends arbitrations, and ensures appropriate file documentation. Handle claims in accordance with Claim Handling Best Practices in all phases of the claim, including through initial contact, investigation of the claim, evaluation of the claim for coverage and reserving for exposure, and in the resolution and documentation of claims.
VNS HealthNewClaims Analyst VNS HealthClaims AnalystNew York, New York$66,300–$79,800 / yearThis role partners with Claims Operations and technical teams to troubleshoot processing issues, support system implementations and configuration changes, analyze claims data and trends, and identify opportunities to improve claims accuracy, turnaround times, and operational efficiency. Overview: The Business Analyst, Claims is responsible for supporting core claims processing operations for the health plan through workflow analysis, system support, and operational improvement initiatives.
Marsh & McLennan Companies IncCyber Claims Advocate Marsh & McLennan Companies IncCyber Claims AdvocateNew York, NY$84,700–$180,300 / yearLiaises with clients, and third parties as necessary such as attorneys and technology forensic firms, for claim/events-related issues or client service concerns to resolve complex issues with insurers on claims notifications, updates, information requests, the hiring of professionals, queries, acknowledgements or other issues, payment issues, keeping all relevant parties informed, as appropriate, of any potential problems, contentious claims or general claims trends. Reviews incoming documentation and new claims notifications of a complex nature or for large and/or complex clients, informs all relevant parties of any potential problems or contentious claims, and refers to Claims Advocates as needed.
EmblemHealth IncClaims Review Analyst EmblemHealth IncClaims Review AnalystNew York, NY$48,600–$83,160 / yearIdentify potential/actual claims problems (single or recurring/trending) and document root cause analysis; present findings to management. Review and analyze suspected underpaid and overpaid claims from hospital, ancillary, and provider groups based on contractual and industry guidelines.
Deloitte Touche Tohmatsu LtdInsurance Claims Business Analyst Deloitte Touche Tohmatsu LtdInsurance Claims Business AnalystNew York, NY$128,000–$252,500 / yearOur 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.
Metroplus Health Plan IncClaims Supervisor Metroplus Health Plan IncClaims SupervisorNew York, NY$60,000–$70,000 / yearRequired Education, Training, & Professional Experience High School Diploma and minimum 7 years of claims operations experience in a healthcare field required or: Associates degree and minimum 5 years of claims operations experience in a healthcare field. Claims Supervisor Job Ref TE0049 Category: Claims Department CLAIMS Location: 50 Water Street, 7th Floor, New York, NY 10004 Job Type: Regular Employment Type: Full-Time Work Arrangement: Hybrid Salary Range: $60,000.00 - $70,000.00.
MetLife IncDisability Bridge Technical Claims Specialist MetLife IncDisability Bridge Technical Claims SpecialistNY$64,800–$86,400 / yearRecognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. Coordinate cross‑functional and cross‑site collaboration with Unit Leaders, business consultants, training partners, systems teams, and peers to resolve discrepancies, support multidisciplinary claim discussions, align on best practices, and ensure consistent, accurate claim administration.
Nesco Resource, LLCClaims Intake Specilist Nesco Resource, LLCClaims Intake SpecilistNew York City, NY$33–$40 / hourNesco Resource has partnered with a well-established, nationally recognized company with a long-standing presence in critical infrastructure and public service to identify a Claims Intake Specialist. - Prolonged sitting while answering phones at a computer terminal for the majority of the workday required.
AXA SAChief Claims Officer, Americas AXA SAChief Claims Officer, AmericasStamford, CT$325,000–$385,000 / yearComplex Litigation Strategy: Partnering closely with the Global and Regional Heads of Litigation, the successful candidate will manage a comprehensive litigation management strategy, including panel counsel governance and cost-containment initiatives, to minimize legal expenses and optimize outcomes in a complex regulatory environment. By combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business property, casualty, professional, financial lines and specialty.
Aon PlcSenior Claims Advocate, Financial Services Group Aon PlcSenior Claims Advocate, Financial Services GroupNew York, NY$91,800–$114,800 / yearScope of Role: Manage the claims process for Aon's Financial Services Group's ("FSG") clients from start to finish Provide expert advice on reporting procedures and claims process Ensure timely and accurate reporting of claims Obtain and review coverage positions from insurers Establish and manage lines of communication between clients and insurance carriers Serve as the point person for the client on all FSG claims related matters Serve as the client's advocate with the insurers Partner with clients to ensure that insurers are updated as necessary with respect to pending claims Obtain consent from insurers for retention of defense counsel and vendors Engage insurers in resolution of claims, such as seeking consent to settlement opportunities and ensuring payment of defense fees and expenses Assist clients and brokers on coverage issues for Directors and Officers Liability, Errors and Omissions, Employment Practices, Fiduciary, and Fidelity policies Maintain adequate documentation of claims related correspondence Work alongside Claims Attorneys to help clients resolve complex claims issues Contribute to data produced by the Legal and Claims Practice Group for the benefit of internal and external clients Any and all other responsibilities as deemed necessary by supervisor to achieve the purpose of the job Competencies, Knowledge & Experience Demonstrates a strong understanding of claims management process Possesses knowledge of Financial Lines market and insurer partners Analytical skills Attention to detail Customer and interpersonal skills Skilled in MS Office suite Has at least 5 years' experience handling claims or commensurate legal or insurance experience Education: Bachelor's degree or equivalent years of proven experience The salary range for this position is $91,800 - $114,800 annually. Aon is looking for a Senior Claims Advocate in the Financial Services Group As part of an industry-leading team, you will help empower results for our clients by delivering innovative and effective solutions as part of our Financial Services Group Legal and Claims Practice Group.
Marsh & McLennan Companies IncPrivate Client Claims Advocacy Leader Marsh & McLennan Companies IncPrivate Client Claims Advocacy LeaderNew York, NY$125,000–$233,000 / yearFrequently 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. Directs and interfaces with PCS Operations and EPIC Transformation teams to design and implement contemporary claims technologies, including claims 'use cases' for Risk Services and Solutions data platform.
DB Insurance Co., Ltd.3rd Party Claims Adjuster/Examiner - HYBRID DB Insurance Co., Ltd.3rd Party Claims Adjuster/Examiner - HYBRIDGreat Neck, NYFull timeIn this role, you will handle claims involving third-party liability, specifically in commercial trucking and business policies, working to resolve them efficiently while ensuring fair settlements. Key Responsibilities: Investigate, evaluate, and resolve third-party claims including bodily injury, property damage, and liability claims including ones in litigation for commercial trucking and business policies.
Career DevelopersNewJunior Claims Specialist (1-3 years) (Hybrid in Berkeley Heights, NJ) (Full-Time) Career DevelopersJunior Claims Specialist (1-3 years) (Hybrid in Berkeley Heights, NJ) (Full-Time)Berkley Heights, NJ$75,000–$85,000 / yearDuties and Responsibilities:Assisting in claims in accordance with Claim Handling Best Practices in all phases of the claim, including through initial contact, investigation of the claim, evaluation of the claim for coverage and reserving for exposure, and in the resolution and documentation of claims. Refer a friend: Referral fee programCareer Developers Inc., a distinguished staffing and consulting firm, is proud to celebrate 30 years of service excellence.
Computer Task Group, IncEpic HB Admin / HB Claims Remit Computer Task Group, IncEpic HB Admin / HB Claims RemitNY$125,000–$135,000 / yearKey Responsibilities Provide day-to-day support for Epic HB Admin, Claims, and Remittance (Remit) workflows across revenue cycle operations Troubleshoot and resolve issues related to claims processing, billing edits, and remittance posting Configure and maintain Epic HB billing rules, charge router, claim edits, and remittance logic Analyze claim rejections/denials and partner with operations teams to implement root cause solutions Support EDI transactions, clearinghouse integrations, and payer-specific requirements Monitor system performance and conduct proactive audits to ensure billing accuracy and compliance Collaborate with revenue cycle stakeholders (billing, coding, finance) to support end-to-end workflows Participate in system upgrades, enhancements, testing cycles, and optimization initiatives Develop and maintain documentation, workflows, and training materials for operational teams Provide production support including issue triage, incident management, and resolution tracking Required Qualifications Epic HB Certification(s) - required (HB Admin strongly preferred; Claims/Remit experience required) 5+ years of Epic HB experience, including Admin, Claims, and Remittance functionality Strong experience supporting hospital revenue cycle operations, including billing, claims management, and payment posting Deep understanding of claims lifecycle, denials management, and remittance processing (835/ERA) Hands-on experience with Epic build, configuration, and support within HB modules Knowledge of EDI transactions, clearinghouses, and payer rules Proven ability to troubleshoot complex issues and work directly with operational stakeholders Strong communication skills with the ability to translate technical concepts to non-technical users Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required. This individual will play a key role in maintaining and optimizing Epic HB (Hospital Billing) workflows, with a strong focus on claims processing, remittance, and operational support.
Mount Sinai Health SystemHealth Plan Claims Analyst I- Environmental Medicine Mount Sinai Health SystemHealth Plan Claims Analyst I- Environmental MedicineNew York, NY$64,526.72–$81,675 / yearMount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.
Everest Group LtdSenior Casualty Claims Specialist - TPA Oversight Everest Group LtdSenior Casualty Claims Specialist - TPA OversightNew York, NY$120,000–$150,000 / yearJob Summary: Everest Insurance, a member of Everest Re Group, Ltd., has an opportunity for an experienced claims professional or attorney to join our Auto and GL TPA Oversight - Casualty Claims team in Warren, NJ, New York, NY or Philadelphia, PA. Job Description: About Everest: Everest is a global leader in risk management, rooted in a rich, 50+ year heritage of enabling businesses to survive and thrive, and economies to function and flourish.
Ryan Specialty GroupSenior Claims Advocacy Specialist Ryan Specialty GroupSenior Claims Advocacy SpecialistNew York, New YorkThey represent the company in high-level negotiations, monitor industry trends, and drive initiatives for operational efficiency and strategic development, fostering strong relationships for organizational success in the specialty insurance market. • Develops and implements advanced strategies for generating claims insights and advocacy, leveraging industry expertise and insights to optimize claim resolution outcomes.
EMC Insurance Group Inc.Casualty Claims Adjuster I EMC Insurance Group Inc.Casualty Claims Adjuster INY$55,795–$77,098 / yearIdentifies, investigates, and proactively pursues opportunities for recovery including arranging of evidence preservation in legal compliance that meets custody, control, transfer, analysis, and disposition of physical and/or electronic evidence. Resolves questions of coverage, liability and the value of the claims and communicates with insureds and claimants to resolve claims in a timely manner.
MetLife IncPet Claims Adjuster MetLife IncPet Claims AdjusterNYRecognizednon Fortune magazine''s list of the "World''s Most Admired Companies",nFortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companiesnto Work For, MetLife, through its subsidiaries and affiliates, is one of thenworld's leading financial services companies; providing insurance, annuities,nemployee benefits and asset management to individual and institutionalncustomers. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
Berkshire Hathaway GUARD Insurance CompaniesSr. Workers' Compensation Claims Adjuster - Complex/Litigation (NJ) Berkshire Hathaway GUARD Insurance CompaniesSr. Workers' Compensation Claims Adjuster - Complex/Litigation (NJ)Parsippany, NJ$50,000–$100,000 / yearWith supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, long‑term careers. Good things are happening at Berkshire Hathaway GUARD Insurance Companies—an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway.
Berkshire Hathaway GUARD Insurance CompaniesSr. Workers'' Compensation Claims Adjuster Complex/Litigation (NJ) Berkshire Hathaway GUARD Insurance CompaniesSr. Workers'' Compensation Claims Adjuster Complex/Litigation (NJ)New York, NY$50,000–$100,000 / yearThis role may be based out of any of our office locations, including: New York, NY; Parsippany, NJ; Conshohocken, PA; Wilkes‑Barre, PA; Alpharetta, GA; Rosemont, IL; Plano, TX; Scottsdale, AZ; and Rancho Cordova, CA. Good things are happening at Berkshire Hathaway GUARD Insurance Companies-an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway.